Archive for the ‘Osteoporosis’ Category

Not an Accident – It was a Bone Attack

March 27, 2014 @ 6:12 pm
posted by Dr Ginther

If you have a Heart Attack or a Stroke (Brain Attack), you don’t say it was an accident.  You check out your heart or blood pressure to see what is wrong that can be corrected.  In this way, you decrease the risk of another heart attack or stroke.

If you have a Fracture after a fall, don’t say it was an accident.  Check out your Bone Health to see what can be improved or corrected.  In this way, you won’t have increased Fracture Risk the next time you fall.  Anyone can fall, but not everyone fractures.  A fall can be an accident, but a fracture is a Bone Attack – a warning to check your bone health.

In 7 years, I have never evaluated someone for bone health without finding at least one issue that can be improved.  That included myself, when I was honest and actually evaluated my own situation.

“Bisphosphonate Holiday” 2014

March 8, 2014 @ 8:56 pm
posted by Dr Ginther

“You are entering a Data-Free Zone”   That was unfortunately the messasge at the joint meeting of the International Society for Clinical Densitometry (ISCD) and the International Osteoporosis Foundation (IOF) last month.  We simply do not have data from a study involving tens of thousands of patients.  We do know some things that are helpful.

Bisphosphonates build up in bone over time.  After about 5 years of Bisphosphonate therapy, you should have enough medication in your bones to last for additional years.  How many years?  That depends.  Different individuals lose Bisphosphonates from their bones at different rates.  Different Bisphosphonates tend to stay in bone longer or shorter than others.  We call the time you are able to stop taking medication for a while (because you have enough in your bones already) ”Bisphosphonate Holiday”.

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. 

It’s the Fractures, Stup..

February 21, 2014 @ 4:36 pm
posted by Dr Ginther

Dr Neil Binkley took this line from politics in his address to the International Society for Clinical Densitometry (ISCD) and International Osteoporosis Foundation (IOF) joint meeting yesterday.  Dr Binkley is known for his blunt style and his ability to go directly to the heart of the matter.

As an orthopedic surgeon, I agree completely that the real issue is Fractures and how to Prevent themA Fracture is a Bone Attack. It is a warning that the patient needs evaluation of their Bone Health.  After a Heart Attack, nearly 100% of patients get an evaluation of their heart health.  After a Bone Attack, barely 20% of patients in the USA get an evaluation of bone health – and that is for life changing hip fractures!  Other fractures are far less likely to get an evaluation.