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Bone clinic works to boost osteoporosis awareness

The Hawk Eye - 5/16/2017

May 16--Nationwide, only 20 percent of patients who have osteoporosis receive treatment for their weakened skeletal system, which is why practitioners at Burlington'sPain Centers of Iowa started Iowa Bone Care Center in January.

As one of only four National Osteoporosis Foundation fracture liaison specialists in the state, nurse practitioner Michelle Prisner said people often aren't aware their bone density has decreased until they experience a break after a short fall.

"I don't want to see anyone fracturing. I want to improve patients' quality of life, and I'm just here to help with the bone health," Prisner said.

So throughout May, which is Osteoporosis Awareness Month, she and her team is offering bone density scans -- also known as dual-energy X-ray absorptiometry, or DEXA scans -- to their interventional pain clinic patients. Such scans should be done after experiencing a fragility fracture and every two years beginning at the age of 50, Prisner said.

"Many times, patients have never had their bones looked at, so they don't realize that they have osteopenia or osteoporosis," she said, explaining steopenia occurs when bone density is lower than what it should be, but not low enough to require treatment.

Once bone density is low enough to increase the risk of low-trauma fracture, it is considered osteoporosis. If left untreated, recurring re-fractures are more likely.

People suffering low-trauma fractures like a broken hip can wind up staying in care facilities for extended periods of time as they undergo skilled rehabilitation for six weeks to three months. The lack of activity during recovery puts them at increased risk of pneumonia. This can be fatal, especially in elderly patients.

"About 44 percent of men who have a hip fracture will die in the first year (because of complications)," Prisner said.

Nicole Hawk is familiar with the risk. The clinics' administrative assistant lost her grandmother to pneumonia after her grandmother broke her leg. The same happened to a licensed practical nurse.

Christina Blain's aunt was laid up in a care center after breaking her hip, femur and a couple other bones.

Blain pointed to the billions of dollars spent each year on care for patients being treated for breaks caused by osteoporosis.

"With the health care crisis that we have, a lot of it is cost for something that could have been prevented," she said.

Prisner agreed.

"These fractures impose a tremendous burden on our aging populations and our health care system," she said.

Prisner, Blain and registered nurse Rachel Diercks said osteoporosis often is pushed aside to address more pressing medical issues. Additionally, they said, people are unaware of treatment options.

"When you talk to people about it, they've heard about osteoporosis, but they don't really realize that there's something out there that you can do about it to prevent it or to prevent yourself from re-fracturing a bone," Diercks said.

Not only is osteoporosis treatable, it also can be reversible. Prisner said medications can reduce fracture risk by 30 to 70 percent. The length of time patients should use such medications and supplements to increase their bone density varies on a case by case basis.

RISK FACTORS AND BONE HEALTH

Risk factors for osteoporosis-related fracture include older age, low bone density, previous broken bones as an adult, frequent falls, low body weight, low calcium intake, low vitamin D, inactive lifestyle, smoking cigarettes, family history of osteoporosis and consuming more than three alcoholic beverages per day. Chemotherapy, radiation and long-term use of corticosteroids also increase risk of post-fragility fracture.

"Bone is constantly remodeling. It's sloughing off and rebuilding itself. We have a new skeleton about every 10 to 12 years," Prisner said, so it's important to take care of it.

Bone does this through bone-removing and bone-building cells. After menopause, bone-removing cells cause women to lose bone at a faster rate, which can lead to postmenopausal osteoporosis. For this reason, women who have had a complete hysterectomy also are at greater risk of developing osteoporosis, though that doesn't mean men should shrug it off.

"The majority of people overall have osteoporosis at some point in time in their life," Diercks said.

MAKING AN APPOINTMENT

The clinic is open from 8 a.m. to 4 p.m. Thursdays, though it likely will be extended in the future.

"We will be branching that out to other days as word gets out and we become more busy seeing and treating osteoporosis patients," Prisner said.

Hawk said the clinic is booking into mid-June, as physician referrals have increased and more people know about it. Walk-ins and self-referrals are accepted.

Initial visits typically take between 45 to 60 minutes. During that time, care providers will perform an overall health assessment, labs and fall risk assessment. They also will gather information regarding past fractures, vitamin intake and family history.

Follow-up appointments typically are recommended each month at first, then every three months.

To schedule an appointment or learn more, call Iowa Bone Care Center at (319) 753-3986.

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(c)2017 The Hawk Eye (Burlington, Iowa)

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