When Dave Mage learned that Christiana Care was offering free bone health screenings and consultations with clinicians on how to prevent fractures, he eagerly signed up for the July 8 event in the John H. Ammon Medical Education Center.
The 81-year-old Newark-area resident has tremors associated with Parkinson’s disease and takes several medications for co-morbidities. He says it is easy for him to lose his balance. In fact, he’s fallen twice since December 2015, resulting in painful impacts to his lower back.
“I am glad for this screening,” Mage said. “A while back I had a bone density scan, and I am thinking it may be time to schedule another one.”
Christiana Care’s second annual Freedom from Fractures event was held in partnership with the National Bone Health Alliance as a way to raise awareness about the prevalence of low bone density in the U.S., where there are 2 million fragility fractures each year.
Research shows that half of women over 50 and up to a quarter of men over 50 will break a bone due to osteoporosis, a disease of the bone tissue in which fracture risk increases with age. Normal bones should not break when a person falls from a standing height, so any fracture in a person over 50 is an important warning sign.
“Bone fragility tends to be a silent disease and one that is not well-recognized,” said Timothy Manzone, M.D., section chief of Nuclear Medicine and chair of Christiana Care’s Bone Health Advisory Committee, a group of physicians working to raise awareness of bone health issues and implement best practices. “It is important for people to be aware of their risk and learn what to do to avoid broken bones, since there are factors people can change.”
At the free screenings, volunteer Dorothy Davis, a retired nurse, used a risk calculator to help people assess their potential risk of fracture from a fall. Participants learned that they had a low, moderate or high risk of fracture and were given written guidelines on how to improve bone health. They also had an opportunity to meet with clinicians, including Angela Godek, BSN, RN-BC, a nurse navigator at Christiana Care’s Strong Bones Program, a resource for physicians and their patients.
“There is a lot to talk about, as people who score moderate or above on the fracture risk calculator are encouraged to have a bone density scan,” Godek said.
For those at risk, she pointed out that the Strong Bones Program can connect participants with local health care providers who are experts in bone health, including endocrinologists, orthopaedic surgeons, rheumatologists, sports medicine physicians and women’s health providers. The Strong Bones Program also helps patients to schedule bone density scans and provides education about ways to maintain and improve bone health.
In general, women 65 or older and men 70 or older should be screened for osteoporosis with a dual X-ray absorptiometry (DXA) bone density scan, which is a quick, painless test that uses less radiation than a typical X-ray. The test provides a clinician with a numeric value — known as a T-score — that is vital in assessing bone health so that patients can be offered personalized treatments to prevent fractures, said Dr. Manzone.
Older patients benefit from knowing their T-score much as they benefit from knowing their blood pressure and cholesterol numbers, he said. T-scores are also recognized by insurance companies as a measure that shows the need for follow-up treatment to prevent broken bones.
“Unfortunately, broken bones cause pain and disability,” said Brian J. Galinat, M.D., MBA, chair of the Department of Orthopaedic Surgery and physician leader of the Musculoskeletal Service Line. “But we’re here to help people avoid all that and let them know that continuing to be a healthy person and staying out of the hospital starts with keeping abreast of healthy bones.”
Dr. Galinat was on hand for the free screenings to let volunteers and clinicians know that their attention to this issue is appreciated. But he also was taking the opportunity to learn about the issues that brought participants, such as Dorothy McKelvey of Wilmington, to the screenings.
At 76, McKelvey wants to live a long and active life, walking every day and enjoying all that she can. She does not want to worry about falls and said she had a recent bone density scan through Christiana Care.
In her consultation with Stephanie A. Fegley, MSN, FNP, BC, a family nurse practitioner in the Strong Bones Program, McKelvey asked about her T-score and learned that she is doing better than she imagined.
“I have some bone loss — what is called osteopenia — but it is not to the point where I need medication,” said McKelvey. She said she plans to do more weight-bearing exercise to improve her bone health.
That’s the good news — people can take positive steps to maintain strong bones, Dr. Galinat said.
“We are here to create osteo-awareness, not osteo-paranoia,” he said. “We want to keep people active so they can have fun and not have to visit the doctor.”