Archive for April, 2013
Yesterday was a Blue Zone Day. I had stayed overnight in Minneapolis after speaking there on Friday. Grandson RJ was waiting for Papa J first thing Saturday morning. We went to the park, where we hunted for pine cones for him to throw, and robins for him to chase on the vacant soccer fields. Then I walked, while he ran, to the playground at the other end of the park. Last year, at only 2, he could do some of the ladders and slides. Now he is king of all ladders and slides!
The National Osteoporosis Foundation presented “Interdisciplinary Symposium on Osteoporosis 13” last Thursday through Sunday. Over 400 attendees braved flooded streets and major delays at O’Hare. It was well worth it.
Lectures focussed on bringing new knowledge into clinical practice. The emphasis was on what we can do for individual patients. That is how we practice – helping one individual person achieve better bone health at a time.
This year the theme was teamwork. A coordinated program involving doctors, nurses, nurse practitioners, physician assistants, physical therapists, dietitians, all working in a single coordinated effort works the best.
We learned more about what can be done to improve bone health without medications. We studied the very limited data about “natural” substances and how they may work. We reviewed the data from clinical trials of pharmaceutical medications involving tens of thousands of human patient years. We learned more about how each pharmaceutical medication works compared to other meds and compared to the natural disease process.
We debated the “ideal levels” of calcium and vitamin D3. People are all different. Even the same person has different needs at different ages.
I will be discussing the topics covered at the symposium over the next weeks. The really good news is that each year we know more and can do more to prevent osteoporosis, to decrease fracture risk. And we can do more to treat osteoporosis too.
Jay Ginther, MD
The goal of Bone Health Evaluation and Treatment is Fracture Prevention! DXA and Bone Mineral Density (BMD) are useful tools for evaluation. But DXA and BMD are only one out of many tools for bone health evaluation. DXA t-score and BMD should never be the sole goal of treatment.
As an orthopedic surgeon, my goal is always Decreasing Fracture Risk. In the USA we sometimes seem to have forgotten that real goal. We focus too much on DXA t-scores. We should focus on the patient. We should treat “Clinical Osteoporosis”. The patient deserves a complete Bone Health evaluation.
Once again we are warned of the dangers of calcium supplements. Once again those studies cited prescribed supplements without regard to total calcium intake, including diet. What matters is total calcium intake, including diet.
I prescribe a lot of Calcium Citrate for my patients. I would prefer not to. Dietary Calcium is more easily digested than supplements, and appears to hold fewer dangers than Calcium Carbonate or other calcium supplements. Unfortunately, we have lost our taste for calcium rich foods. There are tasty choices.