SDRandCo 6 225x300 Dealing With OsteoporosisWhat Is Osteoporosis?

A Bone Disease

Osteoporosis is a disease that thins and weakens the bones to the point that they become fragile and break easily. Women and men with osteoporosis most often break bones in the hip, spine, and wrist, but any bone can be affected. You can’t “catch” osteoporosis or give it to someone else.

In the United States, more than 40 million people either already have osteoporosis or are at high risk due to low bone mass, placing them at risk for more serious bone loss and fractures. Although osteoporosis can strike at any age, it is most common among older people, especially older women.

How Bone Loss Occurs

Bone is living tissue. Throughout our lives, the body breaks down old bone and replaces it with new bone. But as people age, more bone is broken down than is replaced.

The inside of a bone normally looks like a honeycomb, but when a person has osteoporosis, the spaces inside this honeycomb become larger, reflecting the loss of bone density and strength. The outside of long bones — called the cortex — also thins, further weakening the bone. In fact, the word “osteoporosis” means “porous bone.”

Sometime around the age of 30, bone mass stops increasing, and the goal for bone health is to keep as much bone as possible for as long as you can. In most women, the rate of bone loss increases for several years after menopause, then slows down again, but continues. In men, the bone loss occurs more slowly. But by age 65 or 70, most men and women are losing bone at the same rate.

Osteoporosis is often called “silent” because bone loss occurs without symptoms. People may not know that they have osteoporosis until a sudden strain, bump, or fall causes a bone to break. This can result in a trip to the hospital, surgery, and possibly a long-term disabling condition.


Diet and Exercise are Important

Fortunately, in your older years, you can still take steps to protect your bones. You’ll need a balanced diet rich in calcium and vitamin D, a regular exercise program, and, in some cases, medication. These steps can help you slow bone loss. In addition, you’ll want to learn how to fall-proof your home and change your lifestyle to avoid fracturing fragile bones.

Getting Enough Calcium

Bone is made up of calcium, protein, and other minerals. Getting enough calcium helps protect bones by slowing bone loss. Women over age 50 should consume 1,200 milligrams (mg) of calcium daily. Men between the ages of 51 and 70 should consume 1,000 mg of calcium a day, and men over 70 should consume 1,200 mg per day. To make sure you get enough calcium, make foods that are high in calcium part of your diet. The most concentrated food sources of calcium include

  • low-fat dairy products such as low-fat milk, yogurt, and cheeses
  • calcium-fortified orange juice.

Non-dairy foods that can be a good source of calcium include

  • dark green, leafy vegetables such as broccoli, collard greens, and bok choy
  • sardines and canned salmon
  • almonds
  • foods fortified with calcium, such as tofu, cereals, and orange juice.

Although foods rich in calcium are believed to be the best source of calcium, most Americans’ diets do not contain enough calcium. Fortunately, you can choose to eat calcium-fortified foods to ensure that you meet your daily calcium requirement. You can also take calcium supplements to help fill the gap. The most common calcium supplements are calcium carbonate and calcium citrate.

Getting Enough Vitamin D

Vitamin D helps your body absorb calcium. Exposure to sunlight causes your body to make vitamin D. Some people get all the vitamin D they need this way. However, many older people, especially those who are indoors most of the time and/or live in northern areas, are not getting enough vitamin D. Many people also have trouble getting enough vitamin D during the winter months when sunlight is limited.

As you grow older, your need for vitamin D increases. People ages 51 to 70 should consume at least 600 international units (IU) of vitamin D daily. People over age 70 should consume at least 800 IUs daily. According to current recommendations, certain kinds of fish — herring, salmon, tuna — and low-fat milk fortified with vitamin D are good sources of vitamin D. A vitamin D supplement may also be necessary to meet the daily requirement.

Exercises for Bone Health

Exercise can make bones and muscles stronger and help slow the rate of bone loss. It is also a way to stay active and mobile. Weight-bearing exercises done three to four times a week are recommended for bone health. Walking, jogging, playing tennis, and dancing are examples of weight-bearing exercises. Strengthening and balance exercises, such as Tai Chi, may help you avoid falls and reduce your chance of breaking a bone.

For more on weight-bearing exercises that older adults can try, go to Exercises to Try: Strength Exercises.

Proper posture and body mechanics are important when doing exercises. If you have osteoporosis, you should avoid activities that involve twisting your spine or bending forward from the waist, such as conventional sit-ups, toe touches, or swinging a golf club.

Preventing Falls and Fractures

Some ways to reduce falls and fractures include

  • keeping rooms free of clutter
  • anchoring carpets and area rugs
  • wearing rubber-soled shoes for traction
  • having regular eye exams.

When used properly, hip protectors are also effective in preventing fractures.

 Photo: by SDRandCo

150193044 bce9e7abe3 z 300x225 The Threat of Drug Resistant BacteriaAntibiotics are powerful tools for fighting illness and disease, but overuse of antibiotics has helped create bacteria that are outliving the drugs used to treat them.

Antibiotic resistance is a quickly growing, extremely dangerous problem. World health leaders have described antibiotic-resistant bacteria as “nightmare bacteria” that “pose a catastrophic threat” to people in every country in the world. Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics, and at least 23,000 people die each year as a direct result of these infections. Many more people die from other conditions that were complicated by an antibiotic-resistant infection.

In addition, almost 250,000 people who are hospitalized or require hospitalization get Clostridium difficile each year, an infection usually related to antibiotic use. C. difficile causes deadly diarrhea and kills at least 14,000 people each year. Many C. difficile infections and drug-resistant infections can be prevented.

How Bacteria Become Resistant

When bacteria are exposed to antibiotics, they start learning how to outsmart the drugs. This process occurs in bacteria found in humans, animals, and the environment. Resistant bacteria can multiply and spread easily and quickly, causing severe infections. They can also share genetic information with other bacteria, making the other bacteria resistant as well. Each time bacteria learn to outsmart an antibiotic, treatment options are more limited, and these infections pose a greater risk to human health.

Infections Can Happen to Anyone, Anywhere

Anyone can become infected with antibiotic-resistant bacteria anywhere and anytime. Most infections occur in the community, like skin infections with MRSA and sexually transmitted diseases. However, most deaths related to antibiotic resistance occur from drug-resistant infections picked up in healthcare settings, such as hospitals and nursing homes.

What you can do to protect yourself against drug-resistant infections

There are many ways you can help prevent the creation and spread of resistance. First, when you are sick, do not demand antibiotics from your doctor or take antibiotics that were not prescribed to you directly for your specific illness. When taking antibiotics, do not skip doses, and make sure to follow the directions about dose and duration from your doctor.

Second, like all diseases, common safety and hygiene methods can prevent disease and spread. Make sure to:

  • Get updated and regular vaccinations against drug-resistant bacteria
  • Wash your hands before eating and after using the restroom to avoid putting drug-resistant bacteria into your body
  • Wash your hands after handling uncooked food to prevent ingesting drug-resistant bacteria that can live on food
  • Cook meat and poultry thoroughly to kill bacteria, including potential drug-resistant bacteria

What healthcare providers can do to protect patients from drug-resistant infections

There are many ways to help provide the best care to your patients while protecting them against antibiotic-resistant infections.

  • Follow all necessary infection control recommendations, including hand hygiene, standard precautions, and contact precautions.
  • Diagnose and treat resistant infections quickly and efficiently. Treatment options change often because resistance is complex. Make sure to follow the latest recommendations to ensure you are prescribing appropriately.
  • Only prescribe antibiotics when likely to benefit the patient, and be sure to prescribe the right dose and duration.
  • Be sure to clearly label dose, duration, and indication for treatment, and include appropriate laboratory diagnostic tests when placing antibiotic orders. This will help other clinicians caring for the patient to change or stop therapy when appropriate.
  • Take an antibiotic time out, reassessing therapy after 48-72 hours. Once additional information is available, including microbiology, radiographic, and clinical information, a decision can be made on whether to continue the same therapy.
  • When transferring patients, ensure the other facilities are notified of any infection or known colonization.
  • Keep tabs on resistance patterns in your facility and in the area around your facility.
  • Finally, encourage prevention methods with your patients. Make sure they understand how to protect themselves with vaccines, treatment, and infection control practices such as hand washing and safe food handling.


Photo: Derek Bridges

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