6 fractures yesterday! Thats aside from the usual sickness, pains injuries patient list to the ER/Expresscare. Funny thing was they were all the same bone. Histories were all the same, older lady was out doing the usual activity. Just so happens the snow fall day before wasn't bad but the temperature and wind chill was very low. All of the women fell onto their butts or forward. Outstretched hand to catch and stop the fall and wrist pop with extreme pain. All came in and had terribly deformed and shortend wrist and hand. Xrays all showed distal radial fracture. 3 were right and 2 were left, (the last fracture of the day was a right hip). Luckily enough for the first fracture, an orthopedic surgeon from M & M orthopedic was outside in the parking lot and came back in to reduce (straighten) and cast. The other 4 women had to be splinted and sent to the ortho office. One of the ladies with HMO had to go the the primary care doc first then get a piece of paper then call to get an appointment to the ortho (an extra few steps that probably took 6 more hours!-is it worth it the extra hassel?)
The final lady with the hip had to stay until surgery (from Castle Orthopedics) to correct the hip.
I had a discussion with one of the nurses, funny about the onslaught of fractures, is there a correlation to time of year? Well, most obvious is the ice condition but my point is would the ladies have tolerated the fall without a fracture if they had better calcium and vitamin D? Much of the new literature states in the states above the imaginary line from virginia to san fran, people in the winter suffer more cardiovascular problems due to decreased sunlight and less vitamin D being made by the skin. It has also been studied with a coorelation ot fractures. More evaluation has to be made but now that the ladies are fractured, they will be on vitamin D and calcium for the next 2-3 months, (none had calcium stone issues). They will probably be in a cast, on pain killers and in physical therapy.
The Saguil Approach would be: prepare for a fall with good traction shoes, snowsalt and shovel access, balance exercise (tai chi is excellent) and increase the vitamin D and calcium supplements from halloween to easter. A blood test for levels before starting and after about 2 months of starting is good. A DEXA scan for a baseline bone density level is always helpful if there is question on bone being thin. The US Preventive Services Task Force suggests:
-all postmenopausal women under age 65 who have one or more additional risk factors for osteoporosis (in addition to being postmenopausal and female)
-all women age 65 and older regardless of additional risk factors
postmenopausal women who sustain a fracture
-women who are considering therapy for osteoporosis if bone density testing would facilitate the decision
-women who have been on hormone replacement therapy (HRT/ERT) for prolonged periods
Once it is found, those medicines that force bone to absorb calcium have to be used for 2-3 years! Takes that long to show effects. Better to be ready and stop smoking, decrease caffeine, weight bearing exercises, Vitamin D and Calcium supplements (if no calcium stones).
(Please see my discussion = Vitamin D in my herbal411review
