Archive for the ‘Bone Health’ Category

Teaching Nurse Practitioners

April 11, 2014 @ 6:48 am
posted by Dr Ginther

Katie Bries, ARNP, taught the Bone Health section for the Nurse Practitioner students at Allen College this year.  She did a great job covering the basics.  Unfortunately, she had time only for the basics.  This is true in teaching NPs everywhere.  It is true of all aspects of medicine when teaching MDs, DOs, PAs, and all others.  There is only time for the basics.

Any Healthcare Provider who wants to fully master a subject must take “Electives” for additional training in the field they plan to focus on in practice.  With MDs and DOs there are formal “Residencies” lasting 3 or more years after graduation.  NP and PA students take “Clinicals” in various fields before, and sometimes after, graduation.  Cedar Valley Bone Health has hosted clinicals for local and out-of-state Providers.

You Need The Rest Of The Story

April 7, 2014 @ 10:50 pm
posted by Dr Ginther

Last week a patient lamented that according to TV and Radio, “just about everything is bad for me”.  So we discussed that reporters are paid to get people to watch and listen.  Nobody wants to hear that their mother was right when she said “Drink your Milk”.  But everyone will listen to a report that “Calcium is Bad for you if you take Daily Supplements “.  This is true ONLY IF you take enough daily supplements and enough additional Calcium in your food to total way over 1500 mg in a day, but that ruins the story. 

We miss Paul Harvey.  He always told “The Rest of the Story”.

Low Salt is a Double Win

March 21, 2014 @ 10:40 pm
posted by Dr Ginther

Most people know that a diet high in Sodium puts them at increased risk for high blood pressure, heart attack and stroke (brain attack).  Very few people realize that a diet high in Sodium puts them at increased risk for Osteoporosis and Fracture (Bone Attack).  How can this be?

The exact same molecule controls both Sodium and Calcium in the kidney.  This means that you cannot pee out excess Sodium without also peeing out needed Calcium.  If you take in more Sodium than the 1500 mg you need daily, you need to take in extra Calcium to make up for the Calcium you pee out along with the extra Sodium.  Or you could cut down on Sodium.  That is not easy.

The International Society for Clinical Densitometry (ISCD) met last week.  Our society has been dedicated to properly evaluating DXA to determine Bone Mineral Density (BMD) and t-score.  Now ISCD is taking the next step.

The recurring theme at the 2014 ISCD joint meeting with the International Osteoporosis Foundation (IOF) was that DXA, BMD, and t-score are only tools to reach the real goal.  The real goal is Preventing Fractures.  DXA, BMD, and t-score alone do not get us to that goal.  As health care providers, we can best prevent fractures by evaluating the reasons for Fracture Risk, and correcting those issues.