As the Bone Health Ambassador for the National Osteoporosis Foundation, I'm going to let you in on a dirty little medical secret:
If you're over 50 and fracture a bone, there's a very good shot you'll be treated and released without first having a simple test that could make the difference between enjoying a healthy, active future . . . or succumbing to a painful, limited one.
A Bone Density Test.
Broke a bone? Uh-oh: The rate for appropriate post-fracture diagnosis and treatment in this country is abysmal. According to a recent report, nearly 75 percent of the time, medical centers -- big and small -- won't suggest the test or a diagnosis, even if you're there because of a fracture. More likely than not they'll put on a cast . . . and send you home.
That kind of thinking can have frightening results. According to new research from Dr. Andrea Singer of MedStar Georgetown University Hospital, "Half the people who break a hip have previously broken something else, and instead of looking at that as a red flag, those people don't get evaluated, they don't get bone density tests. Fractures are just not taken so seriously."
My brush with a bone break: A few years after I turned 50, I fell while walking my dog and fractured my arm. It wasn't a bad break and I only needed to wear a soft cast for about five weeks. But, even though I had a baseline bone density test a few years prior, my primary care physician, who received the report, insisted I get another one. It indicated a slight but measurable change in my bone density, but not yet osteoporotic. My vitamin D levels were increased, I was instructed to eat more calcium-rich foods, and to start an aggressive strength-training program. In other words, my post-fracture care was everything it was supposed to be. I was lucky, but also compliant, because I knew if I did not adhere to the plan, my bones would continue to weaken, pulling me even closer to osteoporosis.
The vast majority of people (especially those over 50) who fracture a bone are not so lucky.
The statistics are shocking. Fractures caused by osteoporosis accounted for over 40 percent of the hospitalizations of women over 55 between 2000 and 2011.
What's more, 25 percent of all people who suffer a hip fracture end up passing away within one year, a much higher rate than many other diseases. Sadly, the remaining 75 percent often end up leading debilitated, severely limited and dependent lives.
It's not only wrong, it's costly. This cavalier attitude towards osteoporosis can not only have a devastating impact on a human life, but a costly one on the health care system. Heart attack, stroke and breast cancer hospitalizations cost the healthcare system $4.3 billion, $3 billion and $500 million per year, respectively. But, fractures led to an estimated hospital cost of more than $5 billion per year.
This is bad medicine and risky medical behavior.
Hmmmm . . . would this happen if you were having a heart attack? Imagine going to the hospital because you're having a heart attack. You survive the heart attack and after a few days you're released. No further tests, no diagnosis, no recommendations for appropriate follow-up care, medicines or lifestyle changes. Nothing.
Of course this would not happen if you were having a heart attack. But guess what? It happens every day when someone visits the ER or other medical facility with a fracture.
Patients -- especially those most vulnerable to osteoporosis, people over 50 -- are not offered appropriate testing or treatment, and the result is almost always the same: many are soon back in the ER with another broken bone, usually more serious, potentially fatal, especially in the elderly.
What's behind this dangerous disconnect? It couldn't be the cost, because the cost of providing a bone density test is under $125, often covered by insurance. The cost of a hospital staff person to coordinate care between appropriate medical professionals and patients is minimal.
Here's the real problem: Not caring enough to do the right thing which is to find out why a patient got that fracture in the first place, then insist the patient get a bone density test, and offer clear recommendations for post-fracture care.
It might be 'magical thinking' to believe that the medical community will take these steps someday, but I remain hopeful.
But here is the harsh reality: According to all available current information, the vast majority of people who enter a medical facility with a fracture, will not be offered a bone density test, will not get a diagnosis, and will not get appropriate post-fracture care.
The best advice? Advocate for your own health, and the health of your loved ones who might not be able to advocate for themselves. Ask for a bone density test if you're over 50 and fracture a bone. Visit www.nof.org to get the most up-to-date information on how to prevent, treat, and live with osteoporosis.
In honor of National Osteoporosis Awareness Month, I want to share some good news, too: It's crazy easy to prevent osteoporosis at any age . . . and building strong bones is not just a priority for people over 50; it's essential for everyone.
But if you do develop osteoporosis, treatment will most likely consist of anti-osteoporosis medication combined with diet and exercise to help manage this disease.
I'm on a mission to make people of all ages aware of just how easy it is to prevent osteoporosis, especially if you start early in life. Take a look at what happens when I quiz a few millennials about their bone health, and offer a few tips.
When it comes to bone health, knowledge is not only key, it could save your life.
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