Thursday, April 17, 2014

Senior Scope: How to prevent broken bones

From:  Northwest Indiana Times

They’re one of the most feared events for an older adult: falls that cause fractures. A broken bone can mean surgery, hospitalization, and certainly pain, but there are ways to lessen the odds of them ever happening.

At the top of the list for three area health professionals is exercise. “Of all the treatments for osteoporosis, the one thing that has been shown to help is weight training, 20 minutes a day,” says Dr. Gregory McComis at North Point Orthopaedics in Dyer and Munster, Ind. Dr. Nancy Trimboli at Trimboli Chiropractic in Munster, Ind., says weight lifting and muscle strengthening exercises can be done several ways. “You can do a class where you’re on the floor and it’s set to music. Tai chi and yoga are excellent for muscle strength and weight bearing exercises.” Dr. Kristine Teodori, gerontologist and staff physician at Franciscan St. Anthony Health-Crown Point, says walking is great exercise. “Ideally if you are capable you can walk in your own neighborhood, with wrist band weights.” If walking is limited, “You can perform exercises in a chair with leg lifts and hand weights.”

Trimboli says diet plays a big role in bone strength. She suggests doubling the amount of fruits and green, leafy vegetables you consume, by adding greens to pastas and spinach in smoothies, for example. Avoid too much sugar and carbonated drinks like pop, Trimboli cautions: The phosphoric acid in soda pop weakens bones by removing mineral from them. And, according to nutritional research, “Acid-blocking drugs like Nexium, Prilosec, and the like inhibit the stomach from absorbing calcium from your food.”

Super supplements

“The most important part in the treatment of osteoporosis is never getting it,” says Teodori. “Prevention is huge.”

Do vitamins help? “Calcium and vitamin D are very important in preventing fractures and osteoporosis,” says Teodori. McComis says, “For women over 60 and men over 50, it should be 600 milligrams of calcium twice a day and 5,000 milligrams of Vitamin D per week for every woman. If a bone density test indicates a woman has osteoporosis, she should have 50,000 milligrams per week.”

While health professionals’ recommended amounts of a vitamin or mineral may vary somewhat, Trimboli says tricalcium phosphate is the best calcium supplement because it’s absorbed better, though calcium citrate is a good second best. She advises purchasing it at a health food store or from a health professional. And “Vitamin D3 is the most digestible; the only way to know how much you personally need each day is through a blood test.” Teodori recommends vitamin D3 to maintain a Vitamin D level greater than 40.

McComis recommends a bone density test for all women at age 50. Teodori screens all her geriatric patients every two years.

McComis cautions, “Other vitamins don’t help (bone strength) at all, and the stuff advertised for cartilage and such, doesn’t do anything.” But green tea—just green tea in a tea bag—is good for bones, says Trimboli.

All agree that while hormone replacement therapy can help strengthen bones, “Most women have stopped taking estrogen replacement hormones because the risk for breast and ovarian cancers outweighs any benefit,” says McComis. Trimboli says an alternative can be bio-identical hormones.

One thing to keep out of the body is cigarette smoke. “Smoking tends to cause more rapid bone loss and lower bone mass,” says Trimboli..

Preventing falls

The three most common fractures for the elderly are spine, hip. and wrist, says McComis. Balance exercises can help keep seniors steady on their feet. Trimboli says it can be as simple as standing on one foot, then progressing to standing on two feet with eyes closed. Next, an exercise ball or mini trampoline.

Simple preventative measures are crucial, says McComis:
  • Get rid of anything that might cause a slip or trip, like throw rugs and extension cords.
  • Put rubber mats in the bathroom and non-slip grids in the bathtub.
  • Have handicap rail bars at the toilet area and the bathtub.
  • For patients with diabetic neuropathy, daily examination of the bottoms of feet for ulcers is essential “Those can contribute to a fall or the loss of a foot or leg. Proper shoe wear is also important for those patients.”
  • A lot of seniors get spine fractures because they don’t lift properly. Women especially need to be careful of heavy lifting.