More than half of the older Americans suffering a hip fracture last year had been warned ahead of their hip fracture.  That warning was in the form of a previous fracture.  Less than 20% of those warned took any action to prevent their hip fracture.  A smaller percent than died of their fracture.

A “Bone Attack” fracture does not necessarily mean that you need to take medication.  It does mean that you need to have a complete bone health evaluation.  It means that you should at least get enough Calcium, Vitamin D and proper Exercises.

At NOF this year the emphasis was on the actions needed to Take Control Naturally.  This is the necessary first step for everyone.  A Fracture Liaison Service, such as “Own the Bone” (see the link to the right) has been shown to work well in most of the world, including the USA, at Kaiser and Geisinger.

The coming campaign is “2M2M”.  Watch for it.

Jay Ginther, MD

Weak Muscles and Poor Posture can cause the bones of the spine to slowly crumble into “humpback”.  Strengthening those muscles and working on posture can stop the spine from crumbling further, and can correct at least part of the kyphosis.  That improves balance, and prevents falls and fractures!

The key is strengthening the muscles that extend your back into a fully upright position.  Lying on your stomach while lifting your head and legs off the floor is too difficult for many of us, but most people can gradually work up to it over many months of daily exercises.

Keeping your spine straight, even when bending forward, is best.  Curling your spine forward can produce a crushing pressure on the front of your vertebrae equal to several times your body weight.  You should avoid this as much as possible, especially while reaching forward with weight in your hands.

Most individuals require 2 or 3 sessions of personal physical therapy training start at a safe level and gradually advance.  At NOF we were shown one woman who started bent forward more than 90 degrees and was able to stand almost fully upright within a year.  Impressive!

Anyone can incorporate proper spine extension exercises into their personal plan to Take Control Naturally.

In Waterloo, IA, Guia Palma at Cedar Valley Physical Therapy will teach you how.

Jay Ginther, MD

Awareness that simple actions can decrease Fracture Risk was the big theme at the National Osteoporosis Foundation (NOF) annual meeting this past week.  We can cut that risk a lot.  Awareness that many fractures can be prevented is the first step.

I will be writing about the various actions discussed at NOF.  Researchers presented updated exercises for maximal benefit with minimal harm.  Again we learned that peak bone strength depends on nutrition and exercise during childhood, adolescence and young adulthood.  Peak bone strength determines fracture risk later in life.  These tips will be added to the Take Control Naturally series.

Matching the right medication (when necessary) to the right person requires knowledge of exactly how each medication works.  Maximizing benefits is imporant here also.

Be aware that you are at risk for fracture.  Be aware that you can reduce that risk.  Decide to reduce that risk and live better.

Jay Ginther, MD

Millions strive for The Cure for breast cancer.  Millions have joined Go Red For Women sponsored by the American Heart Association.  These are wonderful efforts.  But what about the millions of women harmed each year by Osteoporotic Fracture?  They suffer a “Bone Attack”.  When will we care enough about osteoporosis to launch a similar campaign?

The National Osteoporosis Foundation meets this week.  NOF has taken the lead in promoting Osteoporosis Prevention, Detection and Treatment.  We are making progress, but there is much more to do.  Assuring that our children get enough Calcium, Vitamin D and Exercise while growing can be a huge part of prevention.

Use our link to the NOF website.  Search the categories on the left column of this blogsite for specific information on many topics.  Get involved.  Take Contol Naturally.  Get a complete bone health evaluation.

And don’t forget men!  One quarter of all men over 50 will suffer an Osteoporotic Fracture.  One third of those who die from their hip fracture are men.

So much suffering can be avoided if enough people care enough to become involved.

Jay Ginther, MD

Your age and past actions are huge factors.  The earlier you Know Where You Stand, the better.  Click on the “Categories” in the left column to explore the answers.

My Aunt Henrietta is far beyond prevention.  In her late 80″s, she is deep into treatment with medications.  Successful treatment!  Her story is at the top of the “Categories” list.

My daughter in her early 30′s is flirting with low BMD.  She can Take Control Naturally if she is faithful with her Calcium and Vitamin D supplements.  She remembers to give our grandson his Vitamin D supplement, lots of milk and no soda pop.

My generation in 50′s and 60′s needs to be really faithful with Calcium in Foods, Calcium Citrate, Vitamin D, and Multiple Vitamins & Minerals.  See each of these videos in the right column.  Some in my generation have waited too long and need to add medications.  “Osteoclasts Gone Wild” describes the types and actions.

Start now and do what you have to do.  Remember:  If you don’t take care of your body, where are you going to live?

Jay Ginther, MD

Fall prevention, balance and strengthening exercises were the main topics.  To take control naturally we did “the Stork” by balancing on one foot.  Holding this position for a full minute is quite a challenge.  We discussed “Wii Fit” and formal Physical Therapy training locally with Guia Palma, PT.

We drank milk and munched cookies while discussing how to scatter Calcium Citrate supplements throughout the day (as needed) to reach 1500 mg total calcium daily in doses of not more than 5-600 mg each.  It’s harder than you think.

Bone models were used to review the different actions of the Anabolic (Forteo) and Antiresorptives, and when each class of medication might be needed.

We’re all in this together.

Jay Ginther, MD

Cedar Valley Bone Health Institute of Iowa

4006 Johnathan Street, Waterloo, IA

Topic:   Answers to your Questions

Orthopods are often too busy treating the recent fracture to do a complete work-up and initiate correction of the Osteoporosis.  Unfortunately, many pimary care docs are also too busy treating (now out of control because of the fracture) diabetes, hypertension, heart failure, pulmonary problems, etc in the weeks after a fracture.  Setting up a system is key to getting a complete bone health evaluation and treatment before everyone, patient included, forgets to try to prevent further fractures.

At the Iowa Orthopedic Society meeting, I spoke with several orthopods and their staffs about ways to assure that all their fracture patients receive appropriate care.  That is a full office visit about nothing but bone health.  Ideally this would be with their primary care doc.  In practice, a combined bone health service more often avoids patients falling through the cracks.

I met with members of a large Orthopedic and Neurosurgical group practice.  These docs not only want to deal with their fracture patients, but also want to optimize bone health BEFORE elective surgeries such as total joint replacements and spine fusions!

These Orthopods and Neurosurgeons get it.  Their patients will benefit from lower fracture risk and lower risk of other complications due to poor bone quality!  That is improved patient care!

Jay Ginther, MD

And our grandson RJ visiting for Easter weekend.  Grandma thinks he is the cutest thing since his mother.  He walked the first mile before needing to be carried back.  We have found our personal Blue Zone.

Do the things you enjoy.  Walk 2-3 miles every day if you can.  Enhance your life.  Enhance your health, including your bone health.  Take Control Naturally.  Find your Blue Zone.

At 20 months, RJ is approaching his 2′s.  He is just beginning to be a 2-year old.  May his mother find that phase as enjoyable in him as we found it in her.

Jay Ginther, MD

Healthcare Reform has mandated that we adopt Enhanced Electronic Medical Records.  The enhancements will allow us to document compliance with numerous new reporting requirements.  Many of the required reports have nothing to do with the patient’s current visit, but will enhance government statistics of overall trends in national health measures.

We now take blood pressures at each visit.  In theory, I should then adjust the patient’s medications.  In reality, we record the meds the patients say they are taking, and refer them back to the doctor managing the blood pressure.  At some future date, when the government figures out how we all can share all medical information and yet keep all records private, my blood pressure readings will be available to that doctor.

Another goal is that all tests will be ordered electronically, with results coming back into the chart automatically, and with a reminder if they do not.  We have to specify the date and location that the test will be done.  If either of those does not work out, we need to cancell the original order and generate a new one with corrected information.  We also need to record the reason the first planned test did not occur.

We just received one reprieve.  ICD-10 (which increases the number of possible diagnoses we must choose from and link to every test, medication and treatment) has been postponed for a year.  The current ICD-9 has about 40,000 diagnoses.  ICD-10 will have over 500,000 to choose from.  Now that’s progress.

Jay Ginther, MD