Health Topics

Take-Home Messages

Andrew Schorr:

Okay.  Well, that’s the individualized care that people can get in active dialogue. We may just go a couple minutes over.  I just want to give each of our guests, including Bonnie, a chance to give us really some take-home points.  So, Kori, you’ve been at this a long time.  You see patients every day.  Ideally we want to prevent osteoporosis and we want to empower people both in the dialogue and what they can do following, if they have a medicine, doing it right, doing the exercises, getting the calcium, going to Palm Springs from Seattle so they get the sun or take vitamin D.  What do you want to leave people with so that they really can have as best they can strong bones for life?  Kori? 

Ms. Dewing:

Thank you.  I think that part of this is what we’ve talked about.  Certainly being an advocate for gaining information, knowing their risks, talking to the providers, but also making sure that they are getting enough calcium and vitamin D early in their life to help build up their bones when they can.  I think all of these are very important.

Andrew Schorr:

Okay.  But if the train’s left the station and now they’re 55 or 60 or even older and they said, gee, I didn’t drink my milk, I didn’t have yogurt and I didn’t like the sun and I definitely didn’t take vitamin D much, all is not lost, though, Kori, is it? 

Ms. Dewing:

Oh, no. 

Andrew Schorr:

There’s still things to do. 

Ms. Dewing:

Definitely, there are still things that they can do.  And I think that that’s where a conversation with your provider is so important to talk about your risk.  What is it that you can do?  Is exercise something you can do?  Look at your lifestyle.  Do you need to quit smoking?  What can you do to help to improve your bone strength?  There certainly is a lot that we can do as well as just understanding their own personal risk.

Andrew Schorr:

Julie, put this in perspective for us.  So people know they have to pay attention to their cholesterol, and we’ve been hammering people about paying attention to their blood pressure.  We got 23, 25 million people with diabetes, and we’re telling them to pay attention to their blood readings.  Where does osteoporosis fit in as far as saying, you know, I got to pay attention to that too? 

Dr. Carkin:

Well, as far as common problem, none of us want to, heaven forbid, have breast cancer, we don’t want to have a heart attack, but for women it’s much, much more likely that they’ll suffer from an osteoporotic fracture than they will breast cancer or a heart attack.  There’s 1.5 million fractures a year.  It’s a common problem.  And it’s not as urgent as chest pain.  So if you’re going to your primary care provider and you have angina and you have heart problems, that is going to have to take precedence because that is something that can be acute and urgent. 

But a fracture will change your life.  Bonnie is an incredibly healthy person, and you heard her say that she was on crutches for four months.  Fracture is a big event, and if you can prevent that, that is great.  So I think that you want to ask your primary care provider about your bone health.  If they don’t have time because they think a priority is talking about your cholesterol or anything else, say, that’s fine.  I’ll just make another appointment.  Make a separate appointment and focus on bone health and your risk, especially if you’re someone with rheumatoid arthritis, COPD, emphysema, you’re on steroids for a problem, you have breast cancer or prostate cancer and you’re on antihormonal therapy, you have epilepsy and you’re on antiseizure drugs.  All of the things I just mentioned make you more likely to have a problem and you need to be even more proactive about getting an evaluation and if indicated getting treatment.

Andrew Schorr:

If you have had a fracture, do not pass go, get checked. 

Dr. Carkin:

Correct.  If you’ve had a fracture, and this is a common--a lot of the doctors who are interested in bone health, one of our colleagues said a fracture is a bone attack.  A myocardial infarction is a heart attack.  A stroke is a brain attack.  A fracture is a bone attack, and you need to pay attention to that.  It didn’t just happen and you get your hip surgery and you go home.  You don’t let that happen to your parents.  Your father falls, he breaks his hip, he gets it fixed up and he gets sent home, and he’s going to fracture again.  So you want to figure out, I fractured, it’s going to happen again.  How do I decrease my risk of having a future fracture.

Andrew Schorr:

All right.  I want everyone to pay attention to this for your own life but also think about it for your family members.  Your children, if you have aging parents, think about it for them.  We all need to pay attention to this. 

So, Bonnie, you’ve been so good in your own life in trying to get a handle on this, and also you’ve been listening with me today.  What would you want other patients or people who hope they won’t be patients to just prevent it?  What would you say to kind of empower them and put them in perspective? 

Bonnie:

I think the critical success factor for me--and let me just get to the bottom line.  I love my life, and I love my level of activity, and it was a drag that I was on crutches, and I hate the fact that I broke my hip, but I’m moving on.  And for me to live my life as healthy as possible, frankly, I needed to find a doctor and partner with a doctor who would help me live my life on my terms.  I want to exercise.  I want to be active.  I don’t always want to give up that nightly glass of wine, as Julie knows.  So I think finding the right doctor is probably as critical as anything else, and I got lucky.

Andrew Schorr:

Thank you so much for being with us.  So I hope you’ll start running again sometime, Julie, and we can run together.  I don’t run very fast, but I run, and we can do that.  But I wish you no more fractures. 

Dr. Carkin:

And, Andrew, Bonnie is much more likely--you said you would like to wish me to be able to run.  I’m lucky when I can walk around my neighborhood, but Bonnie is going to get back to running.

Andrew Schorr:

Okay.  Okay.  So, Dr. Julie Carkin, from the Seattle Arthritis Clinic, thank you for bringing your experience with osteoporosis, your knowledge, to us tonight.  And also Kori Dewing, as a role, as a nurse practitioner who has devoted your life to this, thank you, and your message of patient empowerment is so important.  And thank you for your work at Virginia Mason Medical Center, and both of you your devotion to the Washington Osteoporosis Coalition which has a tremendous interest in this in helping broad populations of people understand that you have to pay attention to this.  And, Bonnie, all the best to you, too.  Thank you for being with us. 

Bonnie:

Thank you. 

Ms. Dewing:

Thanks.

Dr. Carkin: 

Thanks for having us, Andrew.

Andrew Schorr:

Yeah, thank you.  Now, I want to remind everybody we’ve finished the live program now.  There will be a replay, then there will be a transcript, and they’ll join right on the website, patientpower.info/strong bones, those wonderful two previous programs, and this is a great resource for you, your family members, your sister who moved across the country, your husband and people with you work with and your teenagers as well.  And mom and dad if they’re aging they’ve got to pay attention to this as well. 

Thank you so much for joining us, and we’re going to be doing future programs I hope in osteoporosis, but, as always, it’s about you being a powerful patient.  Remember, knowledge can be the best medicine of all.  I’m Andrew Schorr.  Good night. 

Please remember the opinions expressed on Patient Power are not necessarily the views of Washington Osteoporosis Coalition, its medical staff or Patient Power.   Our discussions are not a substitute for seeking medical advice or care from your own doctor.  That’s how you’ll get care that’s most appropriate for you.