This week a patient told me “I can’t have Osteoporosis, because I feel fine!” Osteoporosis is often silent. Osteoporosis can sneak up on you. You do not feel a thing – until the first fracture. And even then you must pay attention to realize that you have been warned.
High blood pressure can hide until the first stroke, or TIA if you are lucky. High cholesterol can hide until the first heart attack, a minor one if you are lucky. Diabetes can be overlooked until your eyesight or kidneys fail, or you lose a leg to ulcers. However, all of these, including Osteoporosis, can be successfully treated before a major problem arrives!!!
Yesterday was a Blue Zone Day. I had stayed overnight in Minneapolis after speaking there on Friday. Grandson RJ was waiting for Papa J first thing Saturday morning. We went to the park, where we hunted for pine cones for him to throw, and robins for him to chase on the vacant soccer fields. Then I walked, while he ran, to the playground at the other end of the park. Last year, at only 2, he could do some of the ladders and slides. Now he is king of all ladders and slides!
The National Osteoporosis Foundation presented “Interdisciplinary Symposium on Osteoporosis 13″ last Thursday through Sunday. Over 400 attendees braved flooded streets and major delays at O’Hare. It was well worth it.
Lectures focussed on bringing new knowledge into clinical practice. The emphasis was on what we can do for individual patients. That is how we practice – helping one individual person achieve better bone health at a time.
This year the theme was teamwork. A coordinated program involving doctors, nurses, nurse practitioners, physician assistants, physical therapists, dietitians, all working in a single coordinated effort works the best.
We learned more about what can be done to improve bone health without medications. We studied the very limited data about “natural” substances and how they may work. We reviewed the data from clinical trials of pharmaceutical medications involving tens of thousands of human patient years. We learned more about how each pharmaceutical medication works compared to other meds and compared to the natural disease process.
We debated the “ideal levels” of calcium and vitamin D3. People are all different. Even the same person has different needs at different ages.
I will be discussing the topics covered at the symposium over the next weeks. The really good news is that each year we know more and can do more to prevent osteoporosis, to decrease fracture risk. And we can do more to treat osteoporosis too.
Jay Ginther, MD
The goal of Bone Health Evaluation and Treatment is Fracture Prevention! DXA and Bone Mineral Density (BMD) are useful tools for evaluation. But DXA and BMD are only one out of many tools for bone health evaluation. DXA t-score and BMD should never be the sole goal of treatment.
As an orthopedic surgeon, my goal is always Decreasing Fracture Risk. In the USA we sometimes seem to have forgotten that real goal. We focus too much on DXA t-scores. We should focus on the patient. We should treat “Clinical Osteoporosis”. The patient deserves a complete Bone Health evaluation.