Bone-afide advice from experts, patient on osteoporosis - August 7, 2020

Courtesy of NWI.Life • August 7, 2020

By: Stacey Kellogg

Our body’s framework – a strong, healthy skeleton – is easy to take for granted, until you have a break that could change your life forever. Preventing bone mass loss starts with a healthy relationship with your primary care provider, who will help determine when it’s time for diagnostic or routine bone density testing to screen for osteopenia or osteoporosis. The experts at the Northwest Indiana Breast Center at Methodist Hospitals, who offer a variety of diagnostic testing including bone densitometry, are backed by leading edge technology to help women and men live their best lives.

“Our main goal is to prevent fragility factures, particularly in those who are most at risk for fractures of the hip,” said William Theodorou, M.D., a board certified radiologist at Methodist Hospitals who reads the bone density tests and diagnoses osteopenia and osteoporosis. “Hip fractures seem to be the most life altering types of fractures and can cause significant morbidity and limitations to lifestyle, especially in elderly patients. A hip fracture can be devastating to their health.”

The Northwest Indiana Breast Care Center works closely with the Osteoporosis Clinic at Methodist Hospitals to carefully screen, treat, and monitor women and men with bone mass conditions.

Osteopenia is reduced bone mass that is less severe than its more serious sister disease, osteoporosis. It is the precursor to osteoporosis, which is a medical condition marked by brittle, fragile bones that are prone to fracture due to changes in hormones or deficiencies in vitamin D or calcium.

Marsha Smith knows all too well the debilitating effects of osteoporosis. Hers likely manifested itself early with a broken foot, but like most nurses (she’s been one for 32 years), Smith admits that she didn’t really pay attention to the potential for osteoporosis back then because she was so busy caring for everyone else.

It was after Smith broke her back that the diagnosis was confirmed.

“I am a 10-year cancer survivor, and I also had a hysterectomy, and it was after that surgery that it really started to affect my bones,” she said.

Smith’s back was broken during a car accident, and with the expert care of Methodist Physician Group’s orthopedic spine surgeon Elian Shepherd, M.D., she has healed and regained her independence and mobility.

“The bones were so tiny that he had to order special screws to put my back back together,” Smith said. “I’m now one of the most flexible 60-year-olds you’ll ever meet, and I have hardware in my spine. I work in my rock garden, I haul rocks and boulders, I’m a nurse – I’m active.”

Smith credits Shepherd and his team for healing her and is now a regular patient at the Northwest Indiana Breast Center for routine bone density testing. She urges women to let go of any anxiety around the test.

“It’s nothing. It’s like you’re lying on a padded table and a machine moves across you. They do your hips and wrist and lower back. You don’t feel anything, you’re wide awake, and it’s easier than getting an X-ray,” she said.

Kirsten Wiley, RT, M, is a technologist who performs the DEXA scan, which stands for dual energy X-ray absorptiometry.

“Typically we will image the left hip or lower back, because the left hip is where osteoporosis will generalize, and there is a particular protocol for lower back as well,” Wiley said. “But if a patient has had surgery or other indications that need imaging, we will look at whatever is in the physician’s order.”

Wiley said the technology used at the Northwest Indiana Breast Care Center is new as of January 2020, offering staff and patients access to the latest diagnostic technology with additional capabilities for future growth.

Staff there have also revised protocols to make screening and diagnostic testing safe for women and men during the pandemic.

“Because we are in a breast center, women may come in nervous about their mammogram and bone density testing, so we strive to make them as comfortable as possible, especially during the pandemic,” she said. “We are not using lockers, and patients keep their clothes and belongings with them during their exam. Before they even come to our center, they are screened on the first floor, and everyone is masked. We have our patients strategically scheduled so nobody is waiting in the rooms together, and of course, we are constantly sanitizing.”

Aside from that, patients can expect a warm, relaxing atmosphere, and have the peace of mind that the physicians interpreting their exams and diagnosing any issues are well versed in the practice.

“As a radiologist you don’t have to have the certification to read DEXA scans but I have it and I highly recommend it. It’s important to have a more holistic view of what you’re doing,” Dr. Theodorou said.

While radiologists are often the silent partners in a patient’s bone density testing process (in other words, they don’t have direct communication with the patients in many cases), Dr. Theodorou finds it exceptionally useful to interact with the physicians who take care of the patients on a regular basis, whether specialists or primary care.

The accrediting organization Dr. Theodorou mentioned is the International Society of Clinical Densitometry.

“They have formalized the process of evaluating bone density and treating bone density issues or preventing osteoporosis specifically, but they are a collective of primary care providers, radiologists, and geriatricians – pretty much anyone who would be involved in treating and evaluating patients with risk factors of osteoporosis,” he said. “In modern medicine we get segmented, so this association and its continuing education opportunities provide us with an outlet to see different perspectives.”

Smith is a regular at the Northwest Indiana Breast Care Center at Methodist Hospitals for her recommended mammography and bone density screenings.

“It’s a preventive thing and that’s what the osteoporosis clinic is about – preventing people from having broken bones,” she said. “Diet is very important. You have to have a healthy calcium and vitamin D intake. I’m also a huge proponent of not smoking. Smoking is the worst thing a person can do to themselves.”

Having served as a nurse for more than three decades, Smith has had a lot of opportunities to interact with patients who are living well into a full century.

“I always ask my elderly patients, ‘What do you to do keep young?’ And they tell me – you gotta keep moving,” Smith said.

Broken hips, backs, or other bones can significantly impede that, and can even be deadly for elderly individuals. Smith urges all women regardless of age to have important conversations with their primary care providers about mammography and bone density testing, and to stay vigilant on getting their screenings as soon as their providers recommend them.

Many women will schedule their mammography and bone density screening exams at the same time at the Northwest Indiana Breast Care Center at Methodist Hospitals. For more information visit https://www.methodisthospitals.org/clinical_services/breast-care-center/. For more information about the Osteoporosis Clinic at Methodist Hospitals, visit https://www.methodisthospitals.org/clinical_services/orthopedic-spine-center/osteoporosis-clinic/.