Special clinic identifies patients at risk of breaking bones

Normal healthy bone, left, osteoporosis, right

It happens to all of us. As we get older, we lose bone mass. Some of us, particularly women, lose enough bone mass to have osteoporosis and become at risk of having fractures.

After practicing general orthopedics for 30 years at West Tennessee Bone & Joint Clinic, Dr. John Everett now focuses his practice on identifying people who have osteoporosis and prescribing a treatment plan to help them avoid fractures. 

“The whole idea is to lower their risk,” he said.

On Mondays, he offers his osteoporosis clinic at West Tennessee Bone & Joint. “We have the perfect place to catch patients at risk,” he said. Since he is semi-retired, he adds, “I can spend the extra time that’s needed to talk to the patient about osteoporosis and how to lessen their risk of getting a fracture.”

As orthopedic surgeons, his colleagues treat many broken and fractured bones. Telltale signs of bone thinning are fragility fractures — fractures that occur with a low impact when they should not have happened at all. Another sign is that a patient has experienced more than one fracture.

Aging is a common cause of osteoporosis. Most people have their peak bone mass in
their 20s. “The higher your bone mass at its peak, the better you are down the road,” said Dr. Everett.

While about 75 percent of your peak bone mass is determined genetically, good nutrition and exercise at a young age are very important in obtaining peak bone mass, he said.

With age, bones start thinning. Post-menopausal women can have a bigger drop in bone mass because of their lack of estrogen. Men can get osteoporosis, too, but 80 percent of people with the condition are women.

Other factors contributing to bone loss include rheumatoid arthritis; hyperthyroidism; and certain drugs, such as steroids.

Most patients will get a DEXA scan before they first see Dr. Everett in the osteoporosis clinic. The DEXA scan compares a person’s bones to a 30-year-old person’s bones, when bone mass for most people is close to its peak. Most insurance companies will pay for the DEXA scan, he said.

Some patients will have osteopenia, a below normal bone mass that needs to be monitored because these patients are at risk for getting osteoporosis. For those with osteoporosis, Dr. Everett can prescribe medications that can slow down bone thinning or even build up bone mass.  “These drugs lower the risk of more fractures.”

Dr. Everett also advises patients to get adequate calcium, exercise, eat healthy and avoid smoking. He’ll also emphasize how to avoid falling and how to make your home fall friendly. For example, remove items in your home that you can trip over.

Besides the pain of having a fracture, patients also face major disruptions in their lives. “About 40 percent of people who get a hip fracture, for example, lose their independence,” he said. “A fall is the enemy.”

True or False? Test your knowledge of osteoporosis

1. Osteoporosis weakens bones and increases the risk of unexpected fractures.
2. Osteoporosis affects only the bones in the spine, or vertebrae.
3. Signs of osteoporosis include sloping shoulders, hunched posture, curve in the back, loss of height and back pain.
4. Smoking raises your chances of getting osteoporosis.
5. Men do not get osteoporosis.
6. A diet low in calcium and vitamin D makes you prone to bone loss.
7. Osteoporosis tends to run in families.

1. True. People with osteoporosis have bones that are weak and break easily.
2. False. Osteoporosis affects all bones in the body.
3. True. All of the above are signs of osteoporosis.
4. True. Smoking harms your bones and lowers the amount of estrogen in your body.
5. False. In the United States, more than two million men have osteoporosis.
6. True. It is important to get enough calcium and vitamin D in your diet to maintain strong bones.
7. True. If a family member has osteoporosis or bone loss, there is a greater chance that you will, too.