Advice to Keep the Doctor Away
Meet four of Utah’s top doctors and find out how to stay out their waiting rooms.
Salt Lake The Magazine for Utah
LEXIE KITE
February, 2009
Bone health
At the University of Utah Orthopaedic Center, the state’s only multidisciplinary bone clinic, Dr. Amy Powell has found her niche as a physician and assistant professor working directly with bone surgeons. Powell and her team of collegial physicians are leading the fight for improved screening and treatment of osteoporosis.Were working with a disease with few, if any, symptoms and no known cure, she explains,but the research my colleagues and I are producing is transforming this field from one of after-fracture treatment to one of health and prevention. As president of the Metabolic Bone Disease Society of Utah, Powell devotes her days to the study of osteoporosis, a major health threat for 44 million Americans, or 55 percent of people 50 and older. A silent disease in which bones become fragile and more likely to break, it is the most common bone health problem Powell sees in both women and men. Among people over 50 in the U.S., one in two women and one in four men will have an osteoporosis-related fracture in their lifetimes. And while those people who have had a previous fracture are at the greatest risk of having osteoporosis, Powell warns the disease strikes all ages, races and sexes. Current treatment of the disease often involves regular doses of medication and surgical procedures involving months of recovery, but Powell says two new medical breakthroughs are making life easier for those with osteoporosis-related fractures. The first is an anabolic medication called Forteo the only anabolic drug available that builds bone and speeds fracture healing time. The second medical advance is a once-per-year IV infusion called Reclast, perfect for those with digestion problems common with taking medication or for the majority of people who do not take their medication regularly.While these treatments make life easier for osteoporosis patients, Powell is confident the future is one of osteoporosis screening and prevention. By evaluating patients with a bone density scan and testing them against known risk factors, she is nearing her preventative ideals. In an ideal world, we could identify patients at high risk of bone fracture based on their personal criteria, and were actually getting close, she says. My team stands out from other orthopaedic centers across the country because I work with surgeons at an academic medical center who want to understand better why fractures heal, why some fractures dont heal, and how metabolic bone disease plays a role in this,” she explains with passion in her voice. We have a great group of interested physicians, so the questions that come up day-to-day in clinic often turn into research ideas and sometimes publications. We are truly covering all the bases here.
Studies show the greatest bone building occurs in the 8-to-18-year range and begins declining after age 50. We can make our bones stronger and decrease bone loss once it has begun through exercise, good nutrition and medical assessment. How to avoid the doctor:
Build-A-Bone Program If you have osteoporosis or are at risk for bone-density problems, you can learn how to care for and strengthen your bones with the Build-A-Bone program at University Health Cares orthopaedic center. Whether you're trying to manage osteoporosis or prevent it, the Build-A-Bone program offers tips for optimizing bone health,says Patty Trela, a physical therapist who developed the program. For more information or to register, call 801-587-7005. Bone-healthy nutrition tips from Patty Trela, Build-A-Bone founder. Get adequate nutrition Important nutrients include calcium, vitamin D, vitamin C and magnesium. Recently, the recommendation for Vitamin D has increased and the National Osteoporosis Foundation recommends Vitamin D3. Vitamin C is important in the building of bone, cartilage, tendon and other connective tissues. A low intake of Vitamin C is associated with a faster rate of bone loss. Rich dietary sources of Vitamin C include fruits and juices (citrus, berries, melons), leafy green vegetables, peppers and tomato products. Calcium supplements should be taken in doses less than 500 mg at a time with food. Nine- to 18-year-olds should be taking in 1,300 mg of calcium per day, while 19- to 50-year-olds should consume 1,000 mg and 51-year-olds and older require 1,200 mg. Bone responds to exercise stress, specifically weight-bearing exercise, where the impact of the activity stresses bone. Try running, jumping, dancing, gymnastics or ball sports. Resistive exercises, where the muscular pull on the bone increases the bone strength, are equally effective. Try weight lifting, gym exercise machines, or using tubes or bands. Studies show 2-3 times per week is good for bone, at 8-12 repetitions per exercise. Evidence suggests back extension exercises are best for your spine. Back extension exercises are performed when you bend backwards when standing or lying on your stomach. Studies also show that exercises in which you bend forward from the waist or do exercises like sit ups can cause fractures in an osteoporotic spine. Avoid.
