Posts Tagged ‘Fracture’
Fractures get no respect. 20% of women and over 30% of men over 65 die within 6 months of a Hip Fracture. But nobody is worried about hip fractures!
Hip Fracture is never mentioned on the death certificate. The complications of the hip fracture get all the credit. Pneumonia, pulmonary embolis (blood clots), worsening heart failure, kidney failure or even septicemia (infection in the blood stream) from bed sores might make the list, but not the initial event, the hip fracture.
Nearly 80% of Vertebral Fractures are mistaken for pulled muscles or arthritis in the back. Yet vertebral collapse fractures are a strong indicator of death within the year in men and women. Again, pneumonia, heart failure, respiratory failure (shortness of breath), malnutrition from inability to eat enough get the blame. The vertebral fractures and resulting kyphosis (humpback) never get credit for the misery and death they cause.
More women die each year from complications of fractures than from breast cancer or stroke or heart attack. Nobody seems to care, because the fracture itself is never blamed for the complications it causes.
If we identified the original fracture starting the rapid decline, we would be more concerned with bone health and fracture risk. As it is we ignore fracture risk at our peril, especially as we get older like me (60’s).
Respect Fracture Risk. Take Control of your future.
Jay Ginther, MD
My wife and I visited the tropics during January. We did Tai Chi every morning while watching the sun rise. A Blue Zone experience. Worth getting up early!
Tai Chi is mostly about balance and co-ordination. (Difficult to appreciate if you watched our group of rookies.) Improving balance, co-ordination, and core muscle strength helps to prevent falls as well as strengthen muscles and bones. We found it interesting and invigorating and plan to continue now that we are back in Iowa snow country.
Tai Chi is ideal for older individuals, like myself. Yoga is easier for those younger and more flexible. Ballroom dancing is a favorite of those who can do it. Recreational sports work too, as long as you are careful and avoid collisions. All have the advantage that they can be group activites.
Exercise is a necessity for optimal bone health. Balance training and fall prevention are very helpful for fracture prrevention. Along with enough Calcium, Vitamin D3, Protein, and Multiple Vitamins & Minerals, this may be all you need to prevent osteoporosis and fractures.
Take Control Naturally.
Jay Ginther, MD
I often hear: “I do not have osteoporosis, but my friend…” How are you certain that you do not have a bone health issue that could be improved upon? By the simple belief of “not me !!!” This I understand all too well after doing the same.
In bone health, the first sign of trouble is often a fracture, possibly a hip fracture, with a 20-30% chance of death. This is not good. In heart health, a rhythm problem, can lead to “V fib”, which often leads to death within minutes, unless you get to a defibrillator. Also not good.
I now have a new 2-lead pacemaker with defibrilator. I was completely unaware that my heart had become a ticking time bomb. I was lucky to have a routine annual heart check-up scheduled. Otherwise, my first warning could have been “V fib” with sudden death. Really not good.
Once I realized I had a problem, I moved quickly to the solution – pacemeker defibrillator. I wasted no time. Now I am able to do all the things I want to – travel, grandchildren, etc.
You do not need to be as clueless as I was. Take Control of your health. Check on your risks for diabetes, high blood pressure, heart disease, and bone health. Then take action to correct problems. Get a Complete Bone Health Evaluation as well as evaluation of the rest of your body.
Jay Ginther, MD
Usually we operate on a Hip Fracture. We do that in order to: preserve Independent Living; or preserve independent ambulation in Assisted Living; or preserve assisted ambulation in a Care Facility; and always to preserve quality of life. But what if none of those goals are possible?
At the St Paul Geriatric Fracture Conference this month, it was proposed that alternative care to surgery is sometimes more humane and less costly to society – both laudable goals. The ideal care for a patient with a fractured hip is to thoroughly discuss all alternatives before proceeding to surgery.
Family and other caregivers should all join the patient for a relaxed discussion of the future, weighing quality of life issues radically changed by the usual loss of function / independence imposed by the fracture. Only after concensus is reached, should surgery proceed – if that is the chosen path.
Unfortunately, the clock is ticking. The likelihood of death, medical complications of the fracture, medical complications of surgery, and permanent disabilities begin to increase only 12 hours after fracture. Gathering all interested parties and making informed life-changing decisions within that time limit is very challenging.
Ideally the patient, family, care-givers and primary physician have discussed the possibility of fracture and come to tentative decisions about what sorts of care are desired. This is especially true for patients who already cannot ambulate, are becoming demented, or have a limited quality of life.
Involve the patient in the decision while he/she can still express his/her desires. Written Advanced Directives are ideally on file with physician and hospital. Allow the patient to Take Control of his/her Future.
My wife and I have discussed our desires with our children. We have advanced directives on file. You should too.
Jay Ginther, MD