We said goodbye to my father-in-law these past weeks. He was 90 and alert to the end. Hospice is wonderful for both patient and family. Don had the time to say goodbye to everyone over the last months and died with his family in attendance for the final hours.
The final events became a family gathering of his 14 grandchildren, many with spouses, and 11 great grandchildren, with # 12 due this week. The next generations became the focus, as it should be.
I recently saw a patient who has not improved her Bone Mineral Density despite 2 years of Forteo followed by 3 years of Reclast. The good news is that she stopped having Fragility Fractures. But she is very disappointed that her BMD has not improved.
Her problem is obvious. She is willing to take high-powered osteoporosis medications. She is not willing to take Calcium either in her diet or in supplements.
WRONG!!!! 85% of women who suffer Fragility Fractures have “Osteopenia”. Close to 90% of men. How can this be? ”Osteopenia” is NOT a Diagnosis. Unfortunately, most people do not understand that “Osteopenia” is not a Diagnosis.
Fracture Risk is not just DXA t-score or Bone Mineral Density (BMD). ”Osteopenia” is a BMD t-score of minus 1.1 through minus 2.4. Increased Fracture Risk (the NIH definition of Osteoporosis) starts at minus 2.5 at age 60, but Increased Fracture Risk starts at minus 1.3 at age 80. And that is only if there are no other Risk Factors, such as previous fracture, parent with a hip fracture, smoking, inhalers, etc.
Sodium intake of less than 2500 mg daily helps preserve your bone health, decrease fracture risk, and prevent osteoporosis. It also helps prevent high blood pressure, heart attack, and stroke. Many Americans consume a diet with 5000 mg of sodium or more daily.
Fast food can be a killer unless you pay attention. McD Angus, Bacon & Cheese with a Chocolate Shake is 2450 mg of sodium. There are smarter choices if you look. McD Hamburger with Wildberry Smoothy is only 535 mg. Southwestern salad without chicken plus a Fruit+Yogurt Parfait is 220 mg.
Prepared foods, such as canned soup, can have 800 mg or more sodium per serving. But I can make great french onion soup from fresh using Herb-Ox Sodium Free Bouillon and Hy-Vee Swiss Cheese (50 mg sodium/oz). Helluva Good Cheddar has only 25 mg/oz.