Welcome to the Better Bone Clinic website.
Better Bone Clinic is a medical practice whose only focus is osteoporosis—its diagnosis, treatment and management.
Osteoporosis, the silent intruder
As you may already know, osteoporosis is a “silent” medical condition that often causes no symptoms at all, until there is a fracture of a wrist or hip or spinal vertebra. Just as with other conditions like cancer where it can sometimes be “too late” once it is detected, good surveillance is the key to protect against the increased risk and catastrophes of fractures.
Goal of Better Bone Clinic
If you have been diagnosed with osteoporosis, it is our goal to help you prevent from ever having a “fragility fracture” due to osteoporosis. If you have had a fragility fracture (a fracture from an activity or minor accident that was too mild to cause a fracture if your bones were stronger), it is our goal to make sure you never have another one.
Bone Density (DXA) Scan
A bone density scan (otherwise known as a DXA scan) is the current gold standard to detect decreased bone density—osteopenia or osteoporosis. Everybody’s bone density will decrease with age, and all of us will develop osteopenia if we live long enough. But some of us will have more rapid loss of bone density and fall into the range of osteoporosis. It is important to get a baseline DXA scan with certain milestones like turning 50, or upon menopause.
As noted above, a decline in bone density is a natural part of aging. A certain degree of osteopenia is acceptable but should be watched to make sure there is no slide into osteoporosis, because menopause and one’s family genetics, nutrition, medications, and certain medical conditions can accelerate the loss of bone resulting in osteoporosis. Most bone density testing is done every two years, but may be done sooner to monitor the effects of treatment.
Lab tests
Blood testing is the other mainstay of monitoring. We check Vitamin D, parathyroid and thyroid hormone, calcium, and a complete blood panel. Abnormal blood work can indicate there is another condition that may need to be treated. We check bloodwork again after corrective actions are taken.
Calcium balance
Bone has an organic (living) framework onto which calcium attaches to make it hard. Bone is always “turning over” its calcium, keeping a set balance with the calcium in our blood. If your intake of calcium is very low—or you are low in Vitamin D to help your digestive system absorb calcium—your bone will lose density simply because the body’s job is to keep the blood calcium level normal, even at the expense of weakening bone.
The science behind treatment
Because the body must maintain the balance of calcium in blood, there are cells (“osteoclasts”) in bone that break bone down and release calcium into the bloodstream, and cells that make new bone (osteoblasts) that take calcium from the bloodstream and deposit it into the bone. Most osteoporosis medications only slow down the loss of bone (they either suppress or are toxic to the osteoclast), but don’t do anything to stimulate the body to make new bone. However, if you already have osteoporosis, it becomes exceedingly important to try to deposit new bone—or at least not lose further bone—because you at increased risk for a fragility fracture. If you have osteoporosis, we believe you should be on medication that stimulates your body to make new bone.
Falls can be dangerous
A bigger risk than osteoporosis itself is in falling when you have osteoporosis. Being on medication for osteoporosis can eventually decrease your overall risks, but learning to prevent falling can have an immediate effect. We want all of our patients to have a Fall Risk Assessment Test, and anyone identified as a fall risk will be offered specialized physical therapy to work on balance and gait.
Exercise
Another risk-reducer is weight-bearing exercise. Bone strengthens when exposed to a load. But people with osteoporosis are at increased risk for fractures. This seeming “Catch 22” of exercising with osteoporosis must be guided at first with safe, thoughtful exercises and strict do’s and don’ts. We offer all our patients with osteoporosis qualified instruction and training in exercise by a credentialed physical therapist.
Call to Action
For many people, being diagnosed with osteoporosis (especially if it is diagnosed because of a fracture) causes panic and depression and a feeling like “the end is near”. Indeed, the statistics with hip fractures are sobering: 20% of people who suffer a hip fracture die within a year of their fall. We believe the diagnosis of osteoporosis should instead be a “wake-up call” and “call to action”. In addition to medication and diet, there is so much that can be done to have a vibrant and safe life in spite of the diagnosis. We purposely named our osteoporosis clinic the “Better Bone Clinic” to put a positive light on the treatment and management of osteoporosis. We want to help you gain control and confidence in effectively treating and managing osteoporosis.
