Iowa Irish Fest

August 5, 2015 @ 10:15 pm
posted by Dr Ginther

Waterloo hosted the Iowa Irish Fest for the 9th year this past weekend.  It has gradually grown to include the Celtic heritages of Ireland and Scottland.  With activities for children as well, it is a family Blue Zone.

We enjoyed the Shepherds Pie, Bangers & Mash, Irish Stew, Soda Bread along with Stout or Ale or Crispin (Hard) Cider over the 3 days of the event.  Most interesting to me was the Haggis – in regular sausage casing rather than a sheep’s stomach.

The entertainment was outstanding.  The Trinity Irish Dancers are girls from Chicago, Milwaulkee and Madison.  This year they became the first team from this side of “the pond” to win the international championship.

Gaelic Storm was the band featured in the movie Titanic.  They are great.  The Screaming Orphans are an outstanding band that happens to be all female.  Lots of other very good mixed bands – most with fiddles and a variety of drums, some with bagpipes.

We watched some of the Celtic Games – feats of strength requiring much practice to do safely and well.

Blue Zone weekend.

Jay Ginther, MD

Prevent and Treat ONJ with Forteo

July 31, 2015 @ 7:54 am
posted by Dr Ginther

Dentists and Oral Surgeons are sometimes wary of their patients being on ANY Osteoporosis Medications when they undergo tooth extractions or other dental proceedures.  One osteoporosis medication is different from all the others.  Forteo is the only Anabolic medication currently available in the USA.  Forteo does not cause dental and jaw problems.  Forteo can be used to treat ONJ and other bone problems of the jaw.

OsteoNecrosis of the Jaw (ONJ) is a rare complication of tooth extraction.  If you have cancer, are on chemotherapy, have uncontrolled diabetes, or are on the higher doses of Antiresorptive Osteoporosis Medications used in Cancer Patients with Metastases, ONJ is less rare.

ONJ is the result of too slow bone repair by the OsteoBlasts (the cells that make new bone matrix).  Antiresorptive medications slow down both OsteoClasts (the cells that resorb bone) and OsteoBlasts.

Forteo cannot cause ONJ.  Forteo (Teriparatide) stimulates OsteoBlasts.  That increases new bone matrix formation.  Therefore, Forteo can prevent and treat ONJ.

Forteo has been shown to improve bone healing in dental surgery, including implant osseointegration and healing alveolar defects.  Ref:  Batshutski JD, Eber RM, Kinney JS, et al.  Teriparatide and osseous regeneration in the oral cavity.  N Engl J Med. 2010, 363:2396-2405.  Ref:  Kuchler U, Luvizuto ER, Tangl S, et al.  Short-term Teriparatide delivery and osseointegration: a clinical feasibility study.  J Dent R. 2011:90(8):1001-1006.

As a former orthopedic surgeon, I have discussed these issues with several of our local oral surgeons and dentists.

If you are facing oral surgery or tooth extraction, discuss your osteoporosis medications with your dental surgeon.  Most osteoporosis medications should be held for your surgery.  Forteo is the exception.  Forteo actually helps your jaw heal after dental surgery.

Jay Ginther, MD

RAGBRAI is a Blue Zone

July 25, 2015 @ 4:44 pm
posted by Dr Ginther

RAGBRAI ends today.  It is one of the largest organized week-long recreational activites anywhere.  Officially the (Des Moines) Register Annual Great Bicycle Ride Across Iowa, the 2015 event included 17,000 registered participants for the entire 7 days.  Thousands more tag along for a day or two near their homes.

With neighbors, we hosted an extended family group of ten, including children down to age 5.  The family had gathered from Charleston, SC, Pittsburgh, PA, Ames and Iowa City, IA to spend a week together.  We supplied showers, beds, laundry facilities, supper and breakfast.  Many other Waterloo-Cedar Falls residents supplemented the official campground at UNI.

The sheer numbers of bicyclists created local traffic havoc for hours as they snaked their way from Souix City to Davanport covering 467 miles (the shortest route ever).  The towns affected got to meet interesting folks from nearly every state and several foreign countries.

We thoroughly enjoyed getting to know our guests.  The families we hosted have enjoyed a full week together seeing and meeting Iowa and its people.

Read “The Blue Zones” and “Thrive” by Dan Buettner.  Plan to have a Blue Zones experience of your own.

Jay Ginther, MD

Determining the correct 25-hydroxy Vitamin D level is still a work in progress.  In the 8 years I have been attending meetings, we have made considerable progress.  NOF 2007 was the first time any society proposed an intake above 400 IU daily and a 25-hydroxy Vit D level of more than 20 ng/ml.

At the 2015 U. Wisconsin “Bare Bones Symposium” the latest recommendations were discussed.  I have summarized them here.

Take Vitamin D3.  D3 is Cholecalciferol (what we make in sunshine).  Vitamin D2 is Ergocalciferol (what plants make and use).  D3 works much better in people than D2 becuse it is the right stuff.   It lasts 5 times longer and the assay is more accurate.

Test for 25-hydroxy Vitamin D level and aim for between 40 and 80 ng/ml.  At 40 ng/ml over 98% of people can absorb and utilize Calcium fully.  You want to have some margin of safety since lab test results vary by at least 20%.  If you are seriously deficient, we give 50,000 IU of D3 every M, W, F based on your level and size, to correct the level quickly.

If you do not want to test your level, and you are the “average person” of 154# or 70 kg, you should take 3800 IU daily.  This should achieve the 40 ng/ml level – eventually.  If you are very deficient, this could take a year or more.  If you are larger than the old average, or you have digestive issues, you will need more.

Finally, some cancer researchers believe that 70 ng/ml is better for preventing and treating cancers.  If they are right, you should go for the higher level.  If they are wrong, you have done no harm by going for the higher level.

Take Control of your Bone Health.  Take enough D3.

Jay Ginther, MD