Menopause And Bone Loss And Aging

Menopause seems to be one of those It topics these days. If I’m not talking about it at work, I’m reading about it on the newsstands. The fact that many of my friends are getting their AARP cards in the mail doesn’t help, either. There’s so much written about menopause, and a lot of what’s written isn’t necessarily science-based. All this tends to create confusion about what menopause really means.
One of the concerns I hear about most is bone loss and osteoporosis. I tell my patients that osteoporosis is largely preventable for most patients, and there’s plenty that can be done before menopause to improve your chances of keeping your bone density. Prevention is the key when it comes to bone loss, because while there are good treatments for osteoporosis, there aren’t really any cures.
A combination of steps is the best approach to holding onto your bone density. I make it a point to remind my patients to be sure they get the recommended daily amounts of calcium and vitamin D. National surveys indicate many American women and girls consume less than half of the recommended calcium and vitamin D. Depending on your age, you should have between 1,000 and 1,300 mg of calcium per day. If you’re not getting enough calcium, discuss calcium supplements with your doctor.

Weight-bearing exercise is another great step toward osteoporosis prevention. This includes walking, elliptical exercise, stair climbing, and weightlifting. Doing this type of exercise a minimum of three times each week will reduce your chances of bone loss later in life, and improve your health today.
Of course, you should avoid smoking and excessive amounts of alcohol. This will not only preserve bone, but is also good advice for an overall healthy lifestyle. Enough said on this one.
For some women, a bone mineral density (BMD) test is a great way to detect osteoporosis and estimate your fracture risk. Talk to your doctor about if and when you need one. For women at risk of bone loss, the BMD test is painless, accurate, and another good way to take charge of your health

Communication With The Doctor Better

Communication is the foundation of all good relationships. Sometimes I get a sweet note in my lunch, other times I find a sticky note, “viola lesson at 6”, and sometimes when I pass the chair of internal medicine in the hospital he says, “Let’s talk this afternoon in my office.” Clearly some forms of communication are more direct than others, and others are more desirable.

Likewise, the doctor/patient relationship is also built on the cornerstone of communication. I love it when patients bring a list of questions to their office visit. Those questions give us a chance to talk about issues important to the patient, keep the extraneous chatter about weather to a minimum, and I can send them on their way with peace of mind. The list of questions makes us a team and allows us to work together. If you’ve read an article related to your health, and you’re wondering what I think about it, by all means, bring it with you. Warning: Not all doctors like this, so proceed with caution.

Yesterday I was reminded that listening is a really important component of great communications. I had an adult patient come to her appointment with her mom, which I have to say is fairly atypical. During the actual exam, the mom left the exam room and I asked the patient if there was a reason why she brought her mom along. She said, “We have a rule in our family that no one ever goes to the doctor alone, that way there’s two sets of ears listening to what the doctor says.” Simple and Smart.

Now, there are some patients who skip the list of questions and like to get right to it. Last month I had a patient who started our office visit with, “Hey doc, look at this!” and dropped his pants to show me a festering imperfection which needed some antibiotics. Medical school teaches us a lot of things, but covering our surprise when patients suddenly flash their privates is not one of them—that’s why we always knock on the door before entering the exam room. Doctors are people too; a little warm-up goes a long way.