Bone Up
A look at common lifestyle practices that can become risk factors for osteoporosis
Harvard Health Publishing
Who among us didn’t hear “Drink your milk!” as a kid? We learned early that dietary choices can help build our bones — or sap their strength. But many people aren’t aware that a wider variety of everyday habits can stealthily diminish bone health, creating risk factors for osteoporosis.
As we get older, our bodies lose bone faster than we can rebuild it. About 10 million Americans have osteoporosis, a disease that thins and weakens bones, making them more likely to break. Another 44 million have low bone density, known as osteopenia, placing them at higher risk of developing osteoporosis, according to the National Osteoporosis Foundation.
Half of women and up to 25% of men will break a bone in their lifetime due to osteoporosis. But men don’t tend to be as aware of their risks as women, who are often warned that bone strength begins to wane at menopause and beyond, says Dr. Joy Tsai, medical director of the Endocrine and Osteoporosis Clinic at Harvard-affiliated Massachusetts General Hospital.
8 habits that weaken bones
A variety of behaviors — from what we eat to how we move and more — can contribute to low bone density:
1 Too little calcium
Healthy adults should aim to take in 1,000 milligrams daily. That amount increases to 1,200 mg for women over 50 and men over 70. Foods rich in the mineral include dairy products, leafy greens and fortified plant milks.
2 Excessive caffeine or soda
While evidence is mixed, large amounts of either substance may interfere with the body’s ability to absorb calcium.
3 Inadequate protein
Many of us know to prioritize protein — abundant in poultry, fish, meat and soy — to build and maintain muscle mass. But the nutrient is also integral to supporting bone density, Tsai notes.
4 Heavy drinking
Much research suggests that more than three alcoholic drinks per day can hinder bone formation and raise the risk of fractures.
5 Sedentary lifestyle
People who sit a lot are unlikely to get enough bone-strengthening weight-bearing exercise, which includes such activities as walking, climbing stairs, hiking and dancing.
6 Smoking
Tobacco use is bad for every aspect of health, of course, but it also increases fracture risk.
7 Frequent dieting or restrictive eating
Eating too little can chip away at bone health by depriving bones of important nutrients.
8 Certain medications
These include heartburn drugs called proton-pump inhibitors as well as oral steroids, particularly as used for asthma or autoimmune diseases. And the latter are far more harmful than the former. “If you can manage symptoms through other means, that would be ideal,” Dr. Tsai says.
Signs of osteoporosis
Osteoporosis is usually silent until a fracture occurs. But other situations may alert you to diminishing bone strength:
- Fractures from minor bumps or falls: “If you broke your wrist while walking your dog, you might not think it’s worrisome. But to me, that’s already a red flag your bone quality might not be as good as it could be,” Tsai says.
- Loss of height: “I’m not alarmed until someone has lost 2 or 3 inches,” she says. “That’s considered a good indication to get your bone density checked.” This is done with an imaging test called a DEXA scan. Screening generally begins at age 65 and older for women, or 50 and up for people considered at higher risk of osteoporosis.
If you’re concerned about your bone health, Tsai recommends asking your doctor whether supplements — such as calcium or vitamin D, which promotes calcium absorption — might be helpful.
She also suggests reviewing your medication list to determine if any pose a threat to bone health or make you dizzy or lightheaded, raising your fall risk. “You may be able to stop taking certain medications,” she says.
Hospital units unite to save mom, baby in rare ICU birth
Lillian Palmer
lpalmer@billingsgazette.com
This year was a memorable Mother’s Day for Alyssa Morin.
Now a mother of five, Morin was a mother of four when she went to St. Vincent Regional Hospital in late March, nine months pregnant and struggling to catch her breath. The visit quickly led to a last-minute, fast-action emergency birth in the adult intensive care unit.
And now she and her 5-weekold baby boy Ridge are together and healthy.
“Although we don’t rub shoulders with each other super closely,” ICU nurse Chris Tanner said of the NICU and ICU teams, “that day we did.”
In his six years as a nurse on the intensive care floor of St. Vincent Regional Hospital in Billings, Tanner said this is the first birth he’s seen take place in the ICU.
Morin arrived at St. Vincent late at night expecting labor but soon found herself facing a medical emergency.
“I went into the ER for shortness of breath,” Morin said. “I started panicking, immediately thinking, ‘How am I supposed to deliver this baby if I can’t breathe?’”
Morin has a history of vocal cord paralysis following thyroid surgery, a condition that can make breathing unpredictable. During her pregnancy, severe acid refl ux worsened those symptoms, triggering dangerous vocal cord spasms.
“This had never happened before,” she said. “This was a pretty bad episode.”
After evaluation in the emergency department, she was admitted to the labor and delivery unit at St. Vincent. Morin’s care team quickly recognized her complex condition. Obstetrics, respiratory therapy, the intensive care unit and neonatology specialists gathered to determine the safest course of action for both mother and baby.
As her breathing worsened, Morin said her care team walked through options with her and her husband. She recalled multiple specialists consulting together at her bedside.
“They were talking about what would be the best way to deliver the baby while keeping me safe and able to breathe,” Morin said.
Ultimately, Morin said she trusted the team’s collective judgment. “I was like, ‘Do whatever you need to do.’”
One call and multiple teams were on the move.
“Probably within 30 minutes, we had everything ready to go, moving down to the ICU,” Tanner said.
Morin was going to deliver her baby vaginally in the ICU, while being intubated — a breathing tube was inserted into her windpipe to help her breathe while she was giving birth.
“We were going to do the whole process down here, which is something that is not a normal flow in the ICU,” Tanner said.
As Morin’s oxygen levels dropped, physicians determined the safest path forward was to intubate and sedate her. While under sedation in the ICU, her labor was induced, and she delivered her son vaginally to allow for a safer recovery given her condition.
“The delivery was great; it went very well. And it was all, I would say, driven by the team dynamic,” Tanner said. “The labor and delivery positions that were there were wonderful. They jumped in. They had a great plan. They had backups to the whatifs, and they were prepared for those.”
“Intubation went very smooth, delivery went very well, and everyone had their parts,” he said.
The NICU team came down to the ICU floor to help. ICU doctors were taking care of the labor and delivery. Nurses were taking care of mom. Tanner and other ICU nurses coordinated the sedation.
“Everybody kind of had their own little role,” he said.
Morin woke up the following day in the ICU.
“The first thing I asked — writing on paper because I realized I was intubated — was, ‘Did we have a boy?’” she said.
Despite the complexity of the delivery, Morin’s son, Ridge, was born healthy.
“He came out bright pink, crying; everybody was very excited for that,” she said.
It was a big moment and Morin has been eager to show her gratitude. That happened Friday. Morin and her family delivered lunch to two different floors of the hospital, appreciative and grateful for both teams that kept her and her baby safe and together throughout the procedure.
“My mom’s a nurse, so I kind of know both sides, and they just go above and beyond for everybody. And so, I just wanted to recognize that in a small way,” Morin said. “They definitely saw me as a mother first and made sure that me and Ridge were going to stay together. We were never separated, and I really, really appreciate that.”
Southwest Montana Health Care Directory
