skeleton

Jan STEvEN van CALCAR

An illustration from Andreas Vesalius’s historic 1543 anatomy book.

We live in Kodiak. We love being outdoors. We like the healthy lifestyle. But we often forget about keeping our bones healthy.

Our bones are a living organ. Our bodies resorb old bone and rebuild new bone. How well your body can do this depends on a variety of factors. We reach our peak bone mass much earlier than we thought — 19 for girls and 20.5 for boys.

We all lose bone mass as we age. Osteoporosis, or severe thinning of the bones, can lead to bone fractures. This is mostly seen in older women but is seen in men as well.  I had a 26-year-old female patient who fell off of a 4-foot deck (long story) and broke her hip. Surprisingly, she had osteoporosis; so it can be seen at any age.

There are many conditions, medications and diseases that can cause or contribute to osteoporosis. Common conditions include gastrointestinal disorders that can prevent the absorption of calcium, such as celiac disease or pancreatitis. A common medication is glucocorticoids that are used for asthma and other inflammation. (Asthma itself does not contribute to osteoporosis.) There are many more conditions and medications that contribute to osteoporosis. You need to review these with your doctor.

Around 40-50 percent of postmenopausal women will eventually suffer an osteoporosis-related fracture within their lifetimes. That is an incredibly high number.  I had an older patient whose husband gave her a squeeze and broke two of her ribs. My grandmother picked up an iron skillet and broke her back. My mom stepped off a curb and broke her foot. I’m sure most of us have seen the little old ladies who are hunched over.

Most of us are not aware of how devastating a fracture can be. There are nearly 750,000 spine fractures and 300,000 hip fractures per year in this country due to osteoporosis. Over half of the people who have hip fracture cannot go back to normal function. They are unable to resume their normal lifestyle and many have to seek in home aid or wind up in nursing home care.

It is also an important cause of mortality. For instance, for a 50-year-old female, her lifetime risk of dying from a hip fracture and its complications is 2.8 percent, the same as her lifetime risk of dying from breast cancer. At any given age a hip fracture in a man has twice the death rate as in women.

It is fast and easy to evaluate your bones using a test called DEXA, a specialized X-ray study. This test is recommended if you are a female 65 years old or perhaps younger if you have a high risk factor. The high risk factors are fragility fracture, you weigh less than 127 pounds, you have a medication or disease that causes osteoporosis, familial history hip fracture, smoker, alcohol abuse or rheumatoid arthritis. 

DEXA is recommended for men after 70 years old. The incidence of osteoporosis is expected to rise for men and new guidelines are expected for screening men. Your doctor can evaluate your DEXA and make a calculation of your risk of breaking a bone. Nonetheless, it is useful in deciding lifestyle changes and if you are thinking about medical treatment.

If you are diagnosed with osteoporosis, there are medications that can help slow bone loss and some that help build new bone. Your doctor will review these with you and make suggestions for you.

At every age the key to good bone health are eat a healthy diet that includes calcium, vitamin D3 and weight-bearing exercise. It is very important that we give our kids a good start for their bone health. I am a gynecologist, so I deal with women who are at risk for osteoporosis. The basics for good bone health are the same for your entire life span.

Ask your doctor about gynecology at Providence Kodiak Medical Center Specialty Clinics and other steps to help keep your bones healthy.

Enjoy our outdoor bounty and stay safe.

 

Dr. Jeanmarie K. Salinas is a gynecologist with Providence Kodiak Medical Center Specialty Clinics.

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