Archive for the ‘Bone Health’ Category
Several patients have concerns about oral surgery while taking Prolia. This is not a problem – if you follow guidelines.
Prolia is different from other Antiresorptives. Prolia does not accumulate in bone. 5 to 6 months after your last dose, Prolia has lost its effect of slowing bone turnover. Therefore, it is safe to proceed with surgery on bone (including dental surgery) 6 months after your last dose.
Patients worry about OsteoNecrosis of the Jaw (ONJ), but this is very rare. In fact ONJ virtually never occurs without a tooth extraction or serious periodontal disease. Even then, it is rare unless you also have cancer, have poorly controlled diabetes, or are seriously Deficient in Vitamin D3, or Calcium, or Protein intake.
Elective Orthopedic Surgery timing is the same. If you need a Total Hip Replacement (THR) or Total Knee Replacement (TKR), schedule the surgery for 6 months after your last dose of Prolia.
Any time you plan to have surgery on bone, you should Optimize Your Bone Health First. Get a Complete Bone Health Evaluation. Optimize your Vitamin D level (at 40 to 80 ng/ml). Optimize your Calcium intake in foods and supplements combined (at 400 to 500 mg at all 3 meals daily). Optimize your daily Protein intake (1 g Protein for every kg body weight).
Sometimes you will also need the Anabolic, Forteo, to increase bone matrix and improve healing. More about that another time.
Get the best possible result from orthopedic or dental surgery. Wait 6 months after Prolia, and do your part to optimize your bone health.
Jay Ginther, MD
Do better than another shirt or tie for Fathers’ Day. Make sure your Dad stays Fracture Free! What? Men don’t have Osteoporosis or Fractures. But they do!
25% of all Osteoporosis patients are Men. Each year 80,000 men have hip fractures. Over 30% of those men die of complications of their hip fractures.
1/4 of all Men over 50 will Break a Bone due to Poor Bone Health (Osteoporosis). More Men over 50 will Break a Bone than will have Prostate Cancer.
Many diseases and some medications increase fracture risk. So do many modern lifestyle errors. The good news is that simple measures can Decrease Fracture Risk.
Enough Absorbable Calcium spread out through the day. Enough Vitamin D3 to achieve a 25-hydroxy Vitamin D level of at least 40. 1 gram of Protein for every kilogram of body weight daily. Multiple Vitamins & Minerals. Balance and Weight-bearing exercises daily.
Go to the National Osteoporosis Foundation website (www.nof.org) or click the link at your right. Read The Man’s Guide to Osteoporosis.
Get a Complete Bone Health Evaluation. Fix potential problems.
Take Control. You can Avoid Fractures.
Jay Ginther, MD
The Imaginarium (Children’s Science Museum) at the Grout Museum in Waterloo, IA is teaching bone health this summer. Good choices for bone health during growing years are the best way to avoid future problems and osteoporosis.
“The Bone Zone” is a special exhibit from Purdue University Department of Nutrition now through 5 September. Interactive exhibits teach interesting facts about bone, and guide participants to healthy choices for bone health. The target audience is K-8, but adults learn a few things too.
You can learn about Calcium content of foods. Fortuneteller “Madame Ulna” will tell your bone future based on activity choices. You can compare the strength of a human femur to equally strong wood, concrete and steel.
Cedar Valley Bone Health, Cedar Valley Orthopedics, and Cedar Valley Medical Specialists, PC sponsored the exhibit. As sponsors we brought our kids and grandkids to a special opening. “The Bone Zone” is really cool.
Take your kids and grandkids to the Grout Imaginarium this summer. They’ll have a great time, and great bones.
Jay Ginther, MD
Orthopedic Surgeons treat fractures. Now Orthopods are joining the fight to Prevent Fractures.
At the National Osteoporosis Foundation (NOF) 2015 meeting, Orthopedic Surgeons were the most numerous specialty among docs (MD and DO) . This is huge! In 2007 we were above 1% for the first time. Now we are 17%. What has happened?
Orthopods can easily identify persons with bone health issues, because a fracture is the clearest clue that there may be a bone health problem. Often patients see orthopedics for a fracture and do not see their regular primary care doc until their next annual check-up.
The idea that bone health (including osteoporosis) could and should be identified and treated in an orthopedic office was very unusual when I started in 2007. It is still not common, but it is spreading rapidly. We have directly helped a dozen other offices start treating bone health.
The latest trend is for Nurse Practitioners (NPs) and Physician Assistants (PAs) to do most of the bone health assessment and treatment within an orthopedic, or other, office. That was evident at the meeting. Over 1/3 of the attendees were NPs or PAs – many of them working in orthopedic offices.
Family Medicine docs, NPs, and PAs also attended in record numbers. This is a growing trend. Proactively addressing bone health, before a fracture, is taking its rightful place in primary care.
Orthopedic, Family Medicine, and Geriatric practices are increasingly offering bone health evaluation and treatment.
Take Control of Your Bone Health. Get a Complete Bone Health Evaluation.
Jay Ginther, MD