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Posts Tagged ‘“Humpback”’

“I want to treat my bone health entirely naturally – without any “artificial” medications.”  That might be possible if you are among the less than half of all women not destined to suffer one or more fragility fractures without medication.  Your odds are certainly better if you take all the measures outlined over the past weeks.

Years ago Osteoporosis was rarely a problem.  100 years ago most people died before age 65.  200 years ago most people died before age 40.  We live too long to avoid the natural decline in bone health.  (I would rather live long and deal with medications).

When I was in medical school (45 years ago) we lived entirely naturally in terms of bone health.  Most woman, and some men, became stooped forward with “humpback” kyphosis until they fell, broke a hip and either died or were shipped to a nursing home forever.  There was nothing we could do to prevent that.

Now we know a bunch of natural things we can do to postpone that scenario, but we cannot prevent it entirely in many people without adding medication.  Adding medication may be “cheating”, but I would rather stay active and enjoy life.

Take Control Naturally as long as you can, but evaluate your bone health periodically and add osteoporosis medication when your fracture risk rises.

Jay Ginther, MD

So how do you find out what aspects of your bone health are pretty good already, what will be easy to fix, and what will take some real work?  Start with a Complete Bone Health Evaluation.

DXA is about 1/3 of the story and should include both hips and spine.  When you are as old as I am, the spine probably is too arthritic to be really accurate, but helps complete the picture.  If you have had a total hip replacement, you should use the non-dominant forearm.

VFA will pick up many persons at increased fracture risk who are missed by DXA alone.  You should ask for VFA, especially if you or a parent have kyphosis (humpback) or have lost height.

The FRAX calculation picks up different individuals at high fracture risk.

Blood tests should include CBC, CMP, TSH, PTH, and 25-hydroxy Vitamin D as a start.  Further testing may be needed.

A medical history and examination focused on bone issues is a critical part of the full consultation.  We allot a minimum of 30 minutes for discussion.  Often a follow-up visit is needed to be sure both we and our patients are clear on the whole picture.

DXA alone misses over half of the individuals who need to improve their bone health.  Get a Complete Bone Health Evaluation.

Jay Ginther, MD

Fractures Get No Respect

February 19, 2015 @ 10:04 pm
posted by Dr Ginther

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

Don’t Be a Humpback – Prevent Humpback

March 17, 2014 @ 7:37 pm
posted by Dr Ginther

Last time we discussed the disabilities caused by “humpback” kyphosis.

A major factor in “humpback” is weak back muscles.  Upright posture decreases the strain of gravity pulling you forward.  Strong back muscles maintain upright posture.  A great exercise is to lie on your stomach and then lift your chest and thighs off the floor (or firm mattress).  Do this several times a day.

Far more important is workplace posture.  Too many of us slouch forward because our computer screens are below eye level.  Adjust your work station so that you are comfortable sitting upright, looking straight ahead.  If you are reading from a book or paper, use a slanted stand to bring your work to you.  Don’t be a pretzel trying to bring yourself to your work.