Osteoporosis: “The most important factor is prevention”

May is Women’s Health Month, a great time to celebrate and promote stronger health and a perfect time to discuss the latest information about preventing and treating health challenges like osteoporosis.

More than 44 million American women experience the debilitating effects of the bone disease, and many women fear aching joints and brittle bones are an inevitable part of aging. It is important to know the risks, and engage opportunities to maintain optimum bone-health.

Dr. Lawrence R. Housman is an orthopaedic surgeon who specializes in musculoskeletal disease at Tucson Orthopaedic Institute. He sat down with us to discuss the best ways to prevent and treat osteoporosis.

OsteoporosisWhy are women at greater risk for osteoporosis?  

Women start with a lower bone density than men. They also lose bone mass more quickly as they age. Between ages 20-80, women will lose about 1/3 of her bone density compared to men who lose only 1/4 of their bone density in that time frame. Estrogen levels also affect bone density, and women lose bone mass more quickly in the years immediately following menopause than at any other time of their lives.

What can accentuate this risk?

Alcohol in moderation is not a risk factor, however more than four drinks per day results in a twice the risk of hip fracture. Steroids can also increase this risk. Long term use of steroids will double the risk of fracture in women.

It should be noted that proton pump inhibitors (e.g. Nexium/Protonix used for stomach disorders such as acid reflux) decrease the absorption of calcium from the stomach.

While increasing fiber, phylates (beans, wheat bran), oxalates (spinach, beet greens, rhubarb) and phosphorus (colas) can provide other health benefits they can also interfere with calcium metabolism.

What are the most effective means of preventing osteoporosis?

Regular exercise is one of the most effective means of preventing osteoporosis. Thirty minutes per day – walking is excellent, and Tai Chi reportedly decreases falls by 47 percent and hip fracture by 25 percent.

Nutrition is another import part of maintaining healthy bones. Fruits and vegetables are important. Women ages 19-50 should take in 1000 mg of calcium daily and women older than 50 should get 1200 mg per day.

Vitamin D is another vital nutrient the body needs to prevent osteoporosis. An individual can get their vitamin D through measured exposure to sunlight or through supplements. A diet with dairy, protein or calcium fortified foods (e.g. orange juice), fish (salmon/sardines) and yogurt (6 ounces has 300 mg of calcium) will go a long way in getting vitamin d to the bones.

What are the warning signs of the disease – and when is it time to see a doctor?

There are usually no warning signs before a fracture occurs; therefore, the most important factor is prevention.

A primary care provider (PCP) is the best person to monitor bone health. Most physicians recommend a DEXA (bone density test) after the age of 50.

The DEXA scan is the bone density test done most frequently and is predictive of fracture risk. The scan will also show whether you have normal bone density, osteopenia (bone is becoming weaker) or osteoporosis (bone is at high risk for fracture).

If a fracture occurs, then an orthopaedist would enter the picture to advise on treatment concerning the spine or extremity fracture.

If diagnosed with osteopenia or osteoporosis – what’s next?

With treatment patients can live normal, active and happy lives.

There are many types of medications that are now available – which work to reverse and then rebuild the bone loss. With treatment, the risk of a vertebral fracture drops from between 30-70 percent and the risk of a hip fracture drops by up to 40 percent.

Housman OsteoporosisDr. Housman is an orthopaedic surgeon who practices at the Tucson Orthopaedic Institute. He earned a medical degree from the University of Alberta in Edmonton, Canada and completed an orthopaedic surgery residency at the Montreal General Hospital and McGill University. Dr. Housman is fellowship trained in several orthopaedic pursuits and is a past chief of staff at Tucson Medical Center. He has also served as president of the Western Orthopaedic Association and Arizona Orthopaedic Society.

 

 

New TMC One endocrinologist is now available to tackle an assortment of complex cases

Dr. Shubh Preet Kaur Board-Certified Endocrinologist  TMC One

Dr. Shubh Preet Kaur
Board-Certified Endocrinologist
TMC One

Tucson Medical Center and TMC One, formerly Saguaro Physicians, are proud to welcome Dr. Shubh Preet Kaur, a board-certified endocrinologist who is accepting new patients. She specializes in diagnosing and treating diabetes, thyroid disorders, adrenal and pituitary gland disorders, metabolic disorders, menstrual irregularities, osteoporosis and calcium disorders.

“I believe in providing the same care to each patient that I would want for my family. My goal is to provide evidence-based, cost-effective and personalized health care of the highest quality to all my patients,” said Dr. Kaur.

Learn more about Dr. Kaur, her unique approach to patient care and why she really knows firsthand what challenges diabetics face:

What is your background?

I grew up in India and completed medical school there before starting a residency in internal medicine at Rochester General Hospital in upstate New York. I was then presented with a great opportunity to be the chief resident for the Internal Medicine Residency Program at the University of Arizona. I went on to complete an endocrinology and metabolism fellowship here at the University of Arizona.

What inspired you to go into Endocrinology?

I find complexities of the endocrine system challenging and fascinating. Having multiple family members with diabetes inspired and attracted me further to care for people suffering from diseases of the endocrine system.

How do you help primary care physicians care for their patients with diabetes?

Diabetes is a very complex disease, which affects almost all the organs of the human body. I help primary care physicians care for patients affected by this dreadful disease in whom simple medication regimens do not work, whose disease is hard to control or whose disease has progressed to a stage of complete insulin dependence or overt organ damage. Together, we help patients maintain optimal metabolic goals with the latest the field has to offer. I work with my patients to help them prevent further complications and maintain a healthy and independent lifestyle. Multiple other specialists also help us provide the best possible care to our patients.

At what point does a diabetic patient need to see an endocrinologist rather than just receive care from a primary care physician?

Patients are usually referred to an endocrinologist for adrenal, pituitary, thyroid and calcium metabolism-related issues. Patients with diabetes are often referred if the disease is hard to control, progresses to a state where they require complex medication regimens, have wide blood sugar ranges, multiple complications or if they are having difficulty getting to their target blood sugars.
After completing your endocrinology fellowship from the University of Arizona, what made you decide to stay in Tucson?

My training brought me to Tucson. I never thought I would stay here long, and now I don’t think I will ever leave. The small town feel with the amenities of a big city, great outdoors and the warm weather keep me in Tucson.

What interests you outside of work?

I try to spend as much time as possible with 2-year-old daughter, taking her to the zoo to meet her favorite animal, Nandi, the baby elephant.

What has been your most valuable life experience that has impacted your medical career?

My parents have diabetes so I have firsthand experience about how difficult it can be on patients and their families. I think of my parents when I see my patients and strive to improve their quality of life.

How do you approach your relationship with your patients?

I believe in providing the same care to each patient that I would want for my family. My goal is to provide evidence-based, cost-effective and personalized health care of the highest quality to all my patients.

Dr. Kaur is located at TMC One, 5295 E. Knight Dr., right across from TMC.
She is accepting new patients! Call (520) 324-1010 to make an appointment.
Standard office hours are Monday through Friday, 8 a.m. – 4 p.m.


Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461