After 2 vertebral fractures, she is odds on favorite to fracture another vertebra within the year.  She is also unlikely to respond well to an antiresorptive such as Fosamax, Actonel, Boniva, Reclast, Prolia or their generics because of her severe osteoporosis.  Game over?  Not at all.

Multiple vertebral fractures make her an ideal candidate for an anabolic medication.  Forteo (2002), Tymlos (2017), and Evenity (2019) all can salvage her bone health and increase her bone matrix by 20% or more.  I recommended she see someone up to date in the options available.  There are several in Chicago.  And several here in Iowa.

She needs a Complete Bone Health Evaluation and anabolic treatment.  Of course that includes enough absorbable calcium, enough Vitamin D3, and other nutrition.  Anabolic medications specifically require enough protein to work because they build new bone matrix, which is collagen, which is protein.

You don’t have to fracture again and again.  We can help.

Jay Ginther, MD

Don’t just get a DXA.  DXA alone misses 85% of Fracture Risk, especially in older individuals.  You should get a Complete Bone Health Evaluation to catch any problems early.  “Take Control Naturally” with enough calcium, Vitamin D, protein, and exercises every day.

What is a Complete Bone Health Evaluation?

DXA read by an ISCD Certified Clinical Densitometrist is a start.  ISCD certification assures proper reading.

Vertebral Fracture Assessment (VFA) identifies vertebrae which have collapsed, up to 80% of which are not recognized.  (I missed mine.)

FRAX calculates Fracture Risk far more accurately than DXA and Bone Mineral Density alone.

Blood tests include CBC and CMP routinely done for annual check-ups.  We add monohydroxy Vitamin D, PTH, TSH and phosphorous.

History and physical examination focused on bone health and 20-30 minutes consultation solely about bone health, fracture prevention, osteoporosis prevention, or osteoporosis treatment.

A Complete Bone Health Evaluation allows many of our patients to Take Control Naturally with proper nutrition and exercise alone.

Jay Ginther, MD

Wish your Dad a fulfilling and healthy life.  Avoid unnecessary problems, like fractures.  One in four men over 50 will have osteoporosis and unnecessary fractures unless they are treated for their osteoporosis.  Most fractures are a major inconvenience.  The majority of hip fractures in men over 70 result in complications leading to death or nursing home.

Detect osteoporosis early to start treatment to prevent fractures.  In many cases the only treatment necessary is improved nutrition and lifestyle.

Start with a Complete Bone Health Evaluation.  That includes DXA/VFA, blood tests, focused history and physical, and focused consultation.

We find major and minor nutritional issues.  We help Dad correct them with enough calcium, vitamin D3, protein, other vitamins and minerals.

Improved lifestyle can improve diabetes, high blood pressure, strength, balance, and overall enjoyment of life.

Really care for your Dad by helping him to a happier, healthier life.  Help him Take Control of his future.

Jay Ginther, MD

All 4 grandkids are in California and we are in Iowa and will not be seeing each other in June as we have in the past.  I’ll miss helping the younger ones carefully catching fireflies.

The upside is that with much less busy lives all around, we have used FaceTime and Zoom at least weekly with both pairs of grandkids.  That’s a new normal Grammy and I like.

Jay Ginther, MD

We wear masks and we ask our patients to do the same.  You must answer the required questions before proceeding.  We have hand sanitizer at the front desk and in each room.  We sanitize surfaces and pens between patients.

If you see our receptionist with her mask off while talking on the phone, please stand back.  Unfortunately, masks and telephones do not play well together.

We sanitize our DXA machine between patients.  We can often safely put off repeat DXA/VFA patients for 6 months or even a year if they are well established and have been stable with no changes in treatment.

New DXA/VFA patients and those with changes in medical regimens should have their studies done as scheduled.  Outpatient blood tests are slower than before because of social distancing, masks, and sanitizing surfaces between patients.

Consultations and lab follow-ups can be done by telemedicine for most insurances in Iowa.  However, each insurance company has its own (changing) rules and limits on how long they will pay for telemedicine.  Computer sites which are approved for telemedicine charge for use.  You need a computer or cell phone compatible with the approved site.

We are all waiting for a vaccine.  But, for many persons, a hip fracture carries a higher risk of death than Covid-19.  Pay attention to your bone health.  Avoid a hip fracture.

Jay Ginther, MD

Cedar Valley Bone Health Institute of Iowa has additional handouts, as do most bone health practices.  www.BoneDocBlog.com has over 475 posts on various bone health topics.

Take Control of Your Future.

Jay Ginther, MD

NOF has recorded an interview with Amy Goyer, author of “Juggling Life, Work, and Caregiving”.  Amy is the AARP family and caregiving expert consultant and speaker.  Go to: https://www.bonetalk.org/podcast-episodes/2019/perspectives-on-caregiving .

Jay Ginther, MD

Most private insurance also covers DXA/VFA.  Citing the correct qualifications is more complicated and varies from company to company, but most individuals do qualify if the DXA facility works hard enough.

At Cedar Valley Bone Health Institute of Iowa, we take responsibility for obtaining insurance coverage for DXA/VFA provided the patient has valid health insurance coverage and has not had a previous DXA within 1 year.  Even if both hose criteria are not met, we often can avoid charging the patient for the cost of DXA/VFA.

Jay Ginther, MD

Go to https://www.nof.org/news-events/advocacy/ambassadors-leadership-council/ for a state by state list of current members.  In Iowa 2 of 4 are also founding members of the Iowa Bone Club.

Jay Ginther, MD

NOF has a brief video about deciding ahead of time who will speak for you if you cannot.  Go to https://www.youtube.com/watch?v=iTxv-20ULwQ&feature=youtu.be .

Much better is the next video – a TED talk by Ellen Goodman at https://www.youtube.com/watch?v=xbWcLYOniWU about The Conversation Project.  Talk about end of life care.  What YOU want to happen.

Given our medical backgrounds, my wife and I clearly know what we do not want and have made it clear to our kids.  Most people never have The Conversation because it is too early – until it is too late. 

Take control.  Decide how you would like to spend your last days.  Choose a health care proxy.  Talk about it.  Do the necessary paperwork.

Jay Ginther, MD