Bone Health Services
Make An Appointment With Bone Health Services
At Panorama Orthopedics & Spine Center, our goal under our bone health services is to provide patients with a thorough analysis and treatment options for their bone health.
- Care for Delayed Bone Healing
- Non-Union Fractures
- Osteoporosis/Osteopenia Treatment
- Fracture Prevention
- Worsening Bone Mineral Disease
- Failure of Bone Health Treatments
- Work up for all Bone Health patients – treatment or referral plans
Bone Health Services has an approach and care philosophy that rests on three tenets: prevention, diagnosis and treatment. Our goal is to evaluate patients at an early stage to prevent complications of osteoporosis. We also employ top technologies to measure bone density to evaluate our patients.
Our providers personally read all patients’ bone scans to ensure proper diagnosis and management advice.
We provide patients with the most current treatments and medications, as well as, access to resources and information on nutrition, exercise and drug therapies – all with the intent to improve our patients’ quality of life.
Meet Our Providers
Sara Brown has been a PA for more than twenty years. She attended PA school at Southern Illinois University in Carbondale, Illinois. As a PA, Sara has worked in many different medical specialties including: Family Practice, Urgent Care, Orthopedics and now Metabolic Bone Disease. She is certified in clinical densitometry and is qualified to interpret DXA scans. Her passion is preventative medicine where she can help patients live a healthy lifestyle and make choices to prolong their quality of life.
Natalie Gardner received her Master’s in Adult Gerontology Primary Care at CU Anschutz Medical Campus and has experience in Internal medicine. She is certified in Fracture Liaison Services with the Bone Health & Osteoporosis Foundation and Clinical Densitometry with the International Society of Clinical Densitometry. Her time spent in Endocrinology and Chronic Kidney Disease during her internship, contributes an integral knowledge base to practicing metabolic bone health. She also enjoyed her time as an undergraduate adjunct nursing professor and master’s nurse educator for surgical services. Natalie’s passion is to practice up to date medicine, utilizing current evidence-based research within her specialty and plans to receive her Doctorate within the next four years. She enjoys studying, teaching and trail running with her two rescue dogs.
The Fracture Prevention Clinic
As a part of Bone Health Services, we offer a Fracture Prevention Clinic. Through this program we help individuals who have suffered from a fragility fracture, commonly in the hip, spine or wrist, to assess their bone health and create a treatment program to create stronger and healthy bones so that they may avoid any additional fractures in the future.
Did you know that If you suffer a fracture due to compromised bone quality (commonly known as osteoporosis), your risk of breaking another bone in the next 5 years is 55%? If you are over the age of 50 you are at risk for osteoporosis. In fact, one in every two women and one out of every 4 men will break a bone due to osteoporosis. Osteoporosis fractures can be serious. They can actually even be deadly. For older adults who suffer a hip fracture, 25% them die within the year following the fracture. Another 25% go to a nursing home and of the remaining 50% – only 15% of them will return to walking unassisted within six months. So, it’s important to treat osteoporosis so that you can have healthy bones and avoid these life-changing injuries.
Unfortunately, eighty-four percent of our population is not tested or treated for osteoporosis following a fracture, yet we know that half of repeat bone breaks could be avoided with proper diagnosis and treatment. In the last 50 years, great progress has been made in the way we evaluate bone health and how we treat osteoporosis and metabolic bone disorders.
Today we know what affects your bone health. Your medical history (since the day you were born), medications that you take, where you live and what kind of work you do, and how active you are and what genetic makeup you have, all of these will affect your bone health. Many medical conditions and the medications that are used to treat them can contribute to weak bone and predispose you to a fracture. Some of these conditions include:
- Lupus and RheumatoidArthritis
- Celiac Disease
- Multiple Sclerosis
- Gastrointestinal conditions that are related to malabsorption
Our goal at the Fracture Prevention Clinic is to provide a thorough and detailed analysis of your bone health. From there, we create an individualized plan to help you get strong and healthy bones, so that you can avoid another fracture.
Specialized Care to Avoid Future Fractures
You may receive a referral from your doctor to visit the clinic if your doctor suspects that your fracture may be due to fragile or weak bones. Fragility fractures, as they are commonly called, are those fractures that occur from a fall at standing height or less. Our bones should be strong enough to withstand the impact from a fall from standing height or less and individuals would not usually sustain a fracture, unless there is underlying weakness in the bones caused from Osteoporosis. Fragility fractures are a common problem. In fact, there are more than 3 million fragility fractures in the United States each year. The most common areas for a fragility fracture to occur is the hip, the spine or the wrist.
With simple blood tests and imaging, we are able to determine if there is an underlying bone health issue that led to your fracture. We evaluate your unique bone quality, and develop a personalized plan (consisting of both lifestyle modifications and medication recommendations) to improve your bone strength and reduce the risk of future fractures.
You can expect the following services as a part of your evaluation:
- Evaluation for causes of previous fractures (except facial bones, toes and fingers)
- Determine your risk for future fractures
- Develop individualized treatment plans to optimize and maintain bone health and prevent osteoporosis and osteopenia
- Diagnostic testing (DXA and TBS)
- Medication counseling and management
- Nutrition and exercise counseling
Preparing for your appointment
- Please bring any lab reports from the past two years
- If you have had a bone density test previously, please bring a copy of the report, as well, as the images if available.
- Bring a list of all prescription medications – both the name and the prescribed dosage
- Take pictures of the front and back of all supplements that you routinely take.
- Please bring any other recent imaging reports and images, such as MRI, CT, or X-ray
Patient Care and Recommendations
Our providers are a strong advocates for an overall healthy lifestyle to help manage, prevent, and treat metabolic bone diseases. Bone Health Services is a central resource for patients to learn more about changing their lifestyles to have healthier bones. As bone ages it changes and with those changes, people are at a higher risk for fractures – the number one cause of fractures is falls. Our physicians have, therefore, created the following suggestions and materials for his patients to understand how to create a more bone friendly lifestyle, it is our hope that these materials will help you feel better and do more.
What is Osteoporosis?
Osteoporosis is the most common bone disease in humans and it literally means “porous bones.” It is characterized by decreased bone strength and an increased susceptibility to fractures. Bone strength is a measurement of your bone density and bone quality. The clinical diagnosis of osteoporosis is made when an individual falls from standing height and sustains a fracture.
A DXA scan is the standard test to measure bone density and bone health. Bone Health Services has two DXA’s on-site at Panorama Orthopedics & Spine Center (one from each manufacturer of DXA machines, since the two machines can give different results.) This test is simple and painless and can assess the health of the bones.
The World Health Organization’s technical definition of osteoporosis is when bone mineral density (BMD) is less than or equal to -2.5 or greater at the hip or spine, as measured by a DXA scan.
This value is termed a T-score. Osteopenia, the precursor for osteoporosis is defined as “low bone mass,” in which the patients T-score is between -1.0 and -2.5. A normal T-score is defined as being above -1.0. Always talk with your doctor to discuss and interpret your results.
Additional information may be found at The National Osteoporosis Foundation website.
To learn more about osteoporosis, osteopenia, and other bone health, please consult these resources
Nutrition for Strong Bones
Your diet and the foods you eat affect your bone health. You can greatly improve your health by incorporating foods and supplements that build bone strength so that they will support you throughout your life.
A healthy diet for healthy bones means a diet that includes 50-75% fresh vegetables and fruits, grown in a sustainable manner, and a predominance of green vegetables and berries. A plant based diet is not only less inflammatory for the cardiovascular and gastrointestinal systems, but is excellent for bones.
The key players in your diet for bone health are calcium and vitamin D. These are essential nutrients for building bone density and healthy teeth. Because your body can’t manufacture its own calcium, getting it from your food and drinks is important. But a lot of patients forget that we can find calcium not only in animal milk products but also in plant-based milk, yogurts and cheeses.
Our physicians recommend obtaining calcium as much as possible from dietary sources and use calcium supplements as needed. An adult patient over age 40-50 that does not have gastrointestinal disorders or surgeries, needs ~ 1200 mg calcium (divided in 2-3 meals/day). More calcium will not reduce risk for fractures or make bones stronger but will increase the risk for kidney stones.
It is in recent years that research has shown the importance of vitamin D levels and the role they play in allowing the body to absorb the calcium. Recent data shows that many people are vitamin D deficient even when they are getting regular sunlight exposure and drinking milk. Men and women alike need both calcium and vitamin D to maintain strong bones.
Our providers may also suggest that patients increase their vitamin D intake above the National Recommended Allowance due to the growing evidence that suggests it can benefit overall health having higher vitamin D levels than the minimum level necessary for calcium absorption.
Our providers have provided more information on nutrition for strong bones. Please review the following resources to help you better understand the role calcium plays in bone health.
Exercise and Fall Prevention
Exercise doesn’t require new clothes or expensive equipment. You can walk the dog more often, park farther away from the store, find a friend to exercise with you and increase your exercise tolerance gradually. Aerobic exercise is one that gets the heart beating faster than normal and keeps that rate for 20 minutes. Some exercises are better than other for your bones.
At Bone Health Services we recommend that patients practice gentle yoga, pilates and other exercise programs aimed at improving bone density, flexibility, posture, balance, skeletal alignment, aerobic fitness and muscle size.
In addition to exercise, preventing falls is important for any one with osteopenia or osteoporosis. A person with osteoporosis is more susceptible to a fracture when a fall occurs, especially in the hip, spine or wrist. Consider that nine out of 10 hip fractures in older Americans are the result of a fall.
Our providers have provided several resources to help you learn more about exercise and fall prevention.
There is no cure for osteoporosis, but there are steps you can take to prevent, stop or slow its progress. In some cases, with some of the new medications available today, you may even be able to improve bone density and reverse the disorder to some degree.
Getting enough calcium and vitamin D, as well as, appropriate exercise are essential to the bone health of everyone. This includes people treated with an osteoporosis medication.Our providers specialize in finding the right blend of lifestyle modifications and medications to keep your bone health at an optimal level.
Today, thanks to clinical drug trials, we are fortunate to have many new advancements in the medications available to treat osteoporosis and strengthen bones. There are two distinct categories of medications that are used at Bone Health Services:
- Antiresorptive agents also known as the bone strengtheners are the medications available that can help to make the bones stronger – some of the drugs in this category include Fosamax, Bonita or Evista.
- Anabolic agents – this is the newest class of medications that are available to help grow new bone and strengthen the bones
Please see the article here to learn more about osteoporosis medications.
Bone Health Services FAQ
Medication and Prescription Refills
Preparing for your DXA
Letter of Medical Necessity for BMT Testing
Patient Resources & Scholarly Articles