RJ and Gwen are spending Spring Break with Grammy and Papa. Grandchildren are Blue Zones for us. Also a challenge: can we tire them out as quickly as they tire us out?
Three days into Spring Break, they have hit many highlights. They have enjoyed the Phelps Youth Pavillion at the Arts Center and the Imaginarium (Children’s Science Center) at the Grout Museum. RJ saw a very good “Illusionist” at the Waterloo Rec Center. Papa could not figure out the stunts either.
RJ and Gwen both drink milk at every meal. They want to grow strong bones.
Today they and Grammy watched Papa sing in the church choir. After “second breakfast”, we all set up RJ’s Thomas the Train set he had brought from home. Gwen helped by repeatedly setting off the noismaker in the crossing guard.
This afternoon RJ attended a Waterloo Blackhawks hockey game with his Uncle Alex. He liked being close to the ice.
It is barely dark outside and they have crashed. We are about to too. Nearly a week of Blue Zones left.
Jay Ginther, MD
Ann spends a week in Florida each winter with several friends and was stronger, more agile and more confident this year than last. She stepped in and out of the hot-tub easily instead of slowly and awkwardly. She zoomed up and down stairs. She had to slow down when walking with her friends. What has happened?
A year ago she followed a fragility fracture with below average and decreasing BMD on DXA, and a newly crumbling vertebral fracture on VFA. She has Clinical Osteoporosis. That got her attention. She was determined to play on the floor with her active preschool grandchildren. You cannot do that if you are crumbling. She was ready to do whatever it took to get back in the game.
She added Adora Chocolates (500mg calcium in each) to her usual diet. She added Protein shakes (chocolate) and increased intake of chicken, fish, and beef to meet the new protein guidelines. She remembered to take extra Vitamin D3 and her Multiple Vitamins & Minerals almost every day.
She got serious about her “10,000 steps” every day and went up and down stairs frequently instead of saving up things for a single trip. She did not actually join an exercise class as promised.
She started the anabolic, Forteo, to build her bone density and strength. A daily little shot is a nuisance, especially keeping it cold while travelling, but she wanted results.
This year repeat DXA showed increased BMD. VFA confirmed no further crumbling. She zoomed through airports and left her friends in the dust in Florida. These results have made her even more determined.
She has Taken Control of her Future Life. You can too.
Jay Ginther, MD
Falls are the immediate cause of most “wrist”, shoulder and ankle fractures, and of many Hip fractures. Two or more falls in a year indicate a need for more than basic balance and strength training. You need to analyze why you fell. Then work to avoid repetition. Formal Physical Therapy, teaching exercises to do at home, is best.
Major Fall Risk Factors: loose rugs and minor step-ups into a room; the scuffing gait needed for slippers, sandals or clogs; poor vision and bifocals; bending to pick something off the floor without hanging on to support; not using chair arms; slow gait; and not using a cane or walker on uneven surfaces (out-of-doors). If you have any of these, work to eliminate them.
Walking for exercise does NOT reduce falls. Even walking over a mile daily. Balance and strength training DO reduce falls. The simplest to do at home is to stand on one leg. The goal is 30 seconds. Many of us need to hang on to something solid at first and gradually work up to “no hands”. PT will teach additional exercises as you improve.
Lifestyle Integrative Functional Exercises! Look at all daily activites, then modify your lifestyle to avoid Fall Opportunities. Avoiding Falls is just as important as taking osteoporosis medications for Avoiding Fractures.
Take Control Naturally. Avoid Falls. Avoid Fractures.
Jay Ginther, MD
Driving to Chicago in February was cold and snowing. But it was hot indoors at the ISCD (International Society for Clinical Densitometry) Annual Meeting and Position Development Conference (PDC).
While no new technologies were introduced, the PDC evaluated the scientific studies of several recent innovations. Most are best done in research centers. One recent innovation could make it to clinical centers. Trabecular Bone Score (TBS) is a software addition to DXA that adds information about the quality of bone by re-analyzing the L1, L2, L3 vertebrae.
We have discussed how adding Vertebral Fracture Assessment (VFA) to a DXA Bone Mineral Density (BMD) improves Fracture Risk calculation. TBS has the same potential. The main issues blocking TBS are software cost, added time, and the fact that all insurances (including Medicare) currently do not pay for it.
We also attended presentations about patient treatment issues. Fracture Prevention is much more than just checking a T-score with DXA. National experts shared their knowledge of medical issues that can strongly influence Bone Health and Fracture Risk. More about these sessions next time.
You can Take Control of your Future with action to decrease your fracture risk.
Jay Ginther, MD