Today is Veterans Day in the USA. It is a day when we remember those who lost their lives in the service of our country. It is a day when we remember and thank all those who have served our country.
In Waterloo – Cedar Falls, IA we presented a musical tribute to Veterans and country. Many vets and their families attended. The theme was United We Sing. We celebrated the spirit of our country, which is still combining the strengths and dreams of people from around the world.
As we enjoy great freedom and prosperity, we paused today to thank those whose sacrifices have made it possible. Thank you for serving.
Jay Ginther, MD
On the 94th anniversary of the armistice ending the “war to end all wars”. 11th hour, 11th day, 11th month in 1918.
How can we make Bone Health patient education more effective? An entire office visit only about bone health / osteoporosis prevention and treatment, is an effective start. This I have done since 2007. Now national leaders are looking for the next step. The answer surprised me.
In 2012, presenters at National Osteoporosis Foundation (NOF), International Society for Clinical Densitometry (ISCD), and American Society for Bone and Mineral Research (ASBMR) have said the same thing: Spend less time on each visit, but increase the number of visits. Studies are showing that this works.
25-hydroxy Vitamin D level recommendations for patients were plentiful at the American Society for Bone and Mineral Research (ASBMR) 2012 meeting. Many opinions. Little agreement. Research presented was usually observational. It did not specifically look at daily activity levels in relation to falls. It often only studied the elderly and nursing home residents.
Dr Neil Binkley, of the University of Wisconsin, gave the clinical summary presentation about Vitamin D dosing. He cited studies of blood levels in people who get their Vitamin D naturally from the sun. That included surfers, farmers, construction workers, and traditional herdsman cultures in Africa. These groups have average blood levels in the 40-60 ng/ml range. I recommend levels above 40 for my patients.
Today I taught the Nurse Practitioner class at Allen College. Their Bone Health – Osteoporosis section included 3 hours of classroom lecture and discussion. We also spent an hour teaching the basics of DXA, VFA, and how to read them correctly. This is not a full ISCD course, but enough to get the students pointed in the right direction.
Teaching is stimulating. Trying to distill the 250+ hours of Continuing Medical Education I have taken in the last 5 years down to 3 hours is challenging. Students always have thought-provoking questions. They make me think, and when I think, I learn too.