A fragility fracture is a fracture which happens from minor trauma. A stress fracture happens from repeated normal daily activities, like walking or going up or down stairs. This is a fracture from no trauma.
Bone must be at very high risk of fracture to develope a stress fracture. Clinical Osteoporosis was defined by NIH in 2001 as increased risk of fracture. Therefore, a Stress Fracture is defined as Clinical Osteoporosis.
The FDA has approved Prolia for men with osteoporosis, who are “at high risk for fracture”. This affects a sizeable number of men. High fracture risk includes men with crumbling spine “humpback” vertebral fractures (kyphosis), other fractures (especially hip), inhaler and other steroid use, parental history of fractures, and smoking. See the posts about these topics and FRAX.
Prolia is especially useful in individuals with Heartburn or Reflux Disease (GERD) and decreased kidney function, including many older individuals with older, tired kidneys. Women have had Prolia available since 2010. Having this additional option for men is important.
A parent is worried about a teen-aged daughter who has decided that she is a Vegan. She has decided that she will be more healthy if she avoids all animal products. But she has not yet added the plant products necessary for those who avoid meat and dairy. A healthy diet is more about what is included than what is avoided.
Protein, Calcium, and B vitamins are among the essential nutrients that need to be replaced. We need to look to people who have had centuries to discover what foods are necessary when meat is rare or absent. Tofu, lentils, garbanzos, and beans of many varieties head the list. All grains , including rice, should be eaten brown and whole.
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.