January 3, 2012

“Silent Disease” – Health Minute With CASI

Osteoporosis is often called the “silent disease” because bone loss occurs without symptoms. People may not know until a sudden strain, bump, or fall causes a hip or vertebral fracture. Osteoporosis, or porous bone, is a condition characterized by low bone mass and structural detraction of bone tissue, which leads to increased bone fragility. This is the major cause of fractures in post-menopausal women.

• Collapsed vertebrae may initially be manifested as back pain, loss of height, or spinal deformities such as kyphosis or stooped posture. Osteoporosis often goes unnoticed because it cannot be detected by conventional x-ray until more than 25 to 40 percent of the calcium in bone is lost.
• Lab values looked at by a physician, serum calcium, phosphorus, and alkaline phosphatase levels remain normal, although alkaline phosphatase may be elevated after a fracture.
• Tests ordered bone mineral density (BMD) measurements are used to measure bone density.
• One of the most common is the dual energy x-ray absorptiometry, which measures bone density in the spine, hips, and forearm. These areas tend to be the most common sites for fractures.

Risk Factors: Female gender, increasing age, Caucasian or Asian race, family history, ophorectomy, anorexia, small stature, sedentary lifestyle, insufficient calcium intake. Care of the patient with osteoporosis focuses on proper nutrition,
calcium and vitamin D supplementation, exercise, and medication. If dietary intake is not enough, calcium supplement should be taken. Moderate amounts of exercise are important to build up and maintain bone mass. Increases muscle strength,
coordination, and balance. Walking is preferred to high impact activity such as aerobics and running, both of which would put to much stress on the patient. Patients should be instructed to quit smoking, cut down on alcohol intake, and decrease intake of high-phosphate carbonated beverages. At least 25 to 35 million people in the United States have some degree of osteoporosis. Eight times more common in women.

Drug Therapy:
• Estrogen therapy after menopause, it is most effective when combined with calcium. The greatest benefit of estrogen is probably in the first 10 years after menopause. Transdermal estrogen has been shown effective in women who are
postmenopausal with established osteoporosis.
• Biphosphonates inhibit osteoclast-mediated bone resorption, thereby increasing BMD and total bone mass.
• Always follow instructions for taking these medications properly to prevent GI symptoms.

Efforts should be made to keep patients with osteoporosis ambulatory in order to prevent further loss of bone substance related to immobility. Treatment also involves protecting areas of potential fractures. High doses of vitamins can also cause great harm. Always start with your primary physician for treatment.

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IDEAS: Sugar free candy, Diet soda, new t-shirts,new baseball caps, small bags of chips, microwave popcorn, trinkets men will enjoy, etc.