Dec 5, 2012

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy


When I grew a moustache for Movember, half of it was white. My facebook page now pushes ads to me saying Meet Faithful Senior Singles in your area, not Meet Hot Young Women. Im starting to disapprove of the music my kids listen to. In Erics hockey dressing room at 7:30 am on a Sunday morning, I get to hear Gangnam Style pumping out of the speakers. Apparently that is just standard to get seven and eight year old boys and girls up for their hockey game. At least I cant understand most of the words. Some of the other songs played in the dressing room have lyrics like, Drink all day, play all night. And Lets play naked twister back at my hotel. Im just going to assume the kids dont know what that means. Maybe Im not feeling old so much as feeling jealous that we never got music in the dressing room when I was a seven year old hockey player.


Just like disapproving of the music young people listen to, another sure sign of aging is your risk of osteoporosis. Osteoporosis is estimated to effect over 800,000 Canadians. That is about 1 in 37 people in Canada.


Osteoporosis is when your bones get thinner and more brittle. If you look at a bone under a microscope, it looks like a honey comb. It isnt solid. When a person has osteoporosis, the microscopic structure changes, and the holes in the honey comb get bigger. The bone also gets weaker. Osteoporosis is called a silent disease. Sometimes the first sign of the disease is when a person breaks a bone unexpectedly. For example, someone with osteoporosis can break a rib by coughing. Other bones that can break in osteoporosis are the vertebrae in the spine, the upper thigh bone, the wrist, and the hip. Hip fractures are the most serious osteoporotic fracture. People with osteoporosis begin to break their hips at about age 60 and the average age of a hip fracture patient is 80. About 5% of people who break a hip die in hospital. Twenty percent of women and 30% of men die within a year of breaking their hip.


What causes osteoporosis? Bones are a living tissue. Bones are built up by a type of cell called osteoblasts. Bones are broken down by cells called osteoclasts. Up until the age of 30 the osteoblasts are more active. They build a scaffolding of protein and then fill up the spaces with calcium, phosphorous and other minerals. The osteoclasts are still breaking down old bone, but up to the age of 30 you are building more bone than you are breaking down. The osteoclasts and osteoblasts are pretty much in balance between the ages of 30 and 50. Then after the age of 50, the amount of estrogen drops in women and the amount of testosterone drops in men. We think that is the trigger that causes less bone to be built than is broken down. So after the age of 50 our bones start to get less dense. For many people this gradual decline in bone mass is no big deal. For some people the bone density decreases rapidly and the bones get so fragile and porous they break easily. This is osteoporosis.

What factors put someone at risk of developing osteoporosis? The one of the biggest risk factors is being female. Women are 4 times more likely to get osteoporosis than men. Besides being female, other risk factors include being Caucasian or Asian, being over 65, having a small frame, having relatives with osteoporosis, being inactive, low calcium intake, smoking and high caffeine intake.


How do you know for certain that your bones are thinning and you are at risk of an osteoporotic fracture? Sometimes the doctors can tell you have osteoporosis by the way you break a bone. Before you actually break a bone it can be difficult to tell that your bones are thinning with a regular exam and regular X-rays. The gold standard to see if your bones are thinning is a special X-ray called a DEXA or dual-energy x-ray absorptiometry. This special DEXA x-ray can only be done in Winnipeg and often there is a long wait to get in and have one done. The Dauphin Clinic Pharmacy has brought in another tool to assess your fracture risk. It is a machine that shoots sound waves through your heel. This heel ultra-sound cant diagnose osteoporosis like a DEXA scan, but it can help predict how likely you are to develop certain bone fractures in the future. We are running the heel scanning clinic December 13th and 14th. Call us at 204-638-4602 to book your appointment. Appointments will last 15 minutes and cost $25.00.


What can you do to help reduce the risk of breaking a bone? Depending on your age, you should be getting 1000 to 1500 mg of calcium per day either from your diet or supplements. You should be getting 800-2000 IU of Vitamin D per day. Calcium helps build and maintain bone. Vitamin D helps your body absorb calcium from the gut. Regular weight-bearing exercise will also help build bone. Regular walks with the dog 4-5 times a week for about 20 minutes each will help strengthen your bones. Also, quit smoking and reduce your caffeine intake.


If your doctor has determined your bones are already thinning and you are at risk for breaking them, they may put you on a prescription medication. There are a lot of choices but the most common class of medications are called the bisphosphonates. The have names like alendronate, fosamax, risedronate and actonel. They are a little complicated to take. You have to take them first thing in the morning at least 30 minutes before food and you cant go lie back down during that 30 minutes. On the plus side, there are bisphosphonates that you can just take once a week, which reduces their inconvenience.


The Korean rapper Psys Gangnam Style video is now officially the most viewed video on YouTube. My kids dont care if I dont like their music. And if age seems to be creeping up on you as well, consider calling the Dauphin Clinic Pharmacy for a heel scanning appointment on Dec 13 and Dec 14.



As always if you have any questions or concerns about these or other products, ask your pharmacist


For more information on Osteoporosis please see: www.osteoporosis.ca

Psy video Gangnam Style - www.youtube.com/watch?v=9bZkp7q19f0

Peter Mansbridge does Gangnam Style - http://www.cbc.ca/news/offbeat/story/2012/10/16/video-gangnam-style-peter-mansbridge.html


The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca


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