A ninety-five-year-old woman walked calmly down the sunny Tel Aviv street to her home. And suddenly she jerked awkwardly and, with a loud gasp, fell to the ground. Then everything happened as if in a fog. The formidable diagnosis is a hip fracture. The sympathetic face of a doctor, unbearable aching pain, a huge operating room …
The family was terribly frightened. Such a “breakdown”, and at her age! Meanwhile, the hardy old woman really surprised the Israeli doctors. In the two weeks after the operation, she was able to restore moderate physical activity, and after a few months – to remove the safety crutch.
Today, three years after the breakdown, nothing reminds her of the terrible injury. “Doctors say she healed so quickly from the fact that she did not have osteoporosis,” say the happy relatives. And they joke vividly: “If he were, they would not have collected the bones!”
The doctors themselves joke no less boldly. To my question about the “gender” of osteoporosis, assistant professor of disaster medicine at Moscow State Medical University, Leonid Kurchinov, immediately replied: “Of course, he is female. Men just do not live up to this age ”.
– What age are we talking about?
– About the age from 50 to 80. More precisely, more often from 60 for women and from 70 for men. This is when you consider that the average age of men in our country barely reaches 60. In women, osteoporosis begins to manifest itself in the postmenstrual period as a result of the leaching of calcium from the body. There is a restructuring of the metabolic process, metabolism is disrupted. Menopause is not so pronounced in men.
– So they just do not have time to live?
– Well, there are certain statistics. At this age, fractures of the extremities in women are three times more common than in men. Although everyone has age-related osteoporosis.
Fragile old people
– How does everyone have it?
– There is a certain “table of his ranks.” Osteoporosis can be mild, moderate, and severe. What we are dealing with is shown by densitometry. The procedure is completely painless. A special apparatus measures bone density. The more X-rays it passes through, the lower its density. This means more pronounced osteoporosis.
– What is the danger for an elderly person inherent in this diagnosis?
– Osteoporosis is a terrible disease of the bones of the skeleton, in which they lose strength and become fragile. The main danger is bone fractures that occur under the smallest loads. An elderly woman lifted her bags, made a little sharper than usual movement – she got a fracture. Or the old man crosses the tram line. Slightly caught a boot on the rail – immediately breakage.
In the depths of reason
– By what signs can you independently determine the presence of osteoporosis?
– For bone pain. They are often confused with the pain of a disease with a similar sounding – osteochondrosis associated with the deposition of salts. But bone pains differ in nature. Let’s say a person’s back begins to ache after standing for a long time. It is worth taking a horizontal position – the pain goes away. With the development of the disease, there is a decrease in growth, the appearance of a “senile hump”.
– Who is more susceptible to the disease?
– There are several categories of risk groups. Long-term use of glucorticosteroid – containing drugs for diseases of the gastrointestinal tract,
anticoagulants, diuretics, anticonvulsants. All this provokes the leaching of calcium, which means the appearance of osteoporosis.
Patients with a forced decrease in motor activity after operations, injuries are also at risk. Chronic patients with diagnoses: rheumatoid arthritis, lupus, gastric resection; with renal diseases, endocrine distention , diabetes mellitus.
– And what is most contributing to the appearance of signs of osteoporosis?
– There are five clear indicators. The first and main one is a sedentary lifestyle. This is followed by: smoking, excessive consumption of coffee and alcohol, lack of calcium in the body as a result of unbalanced diet and, finally, intolerance to dairy products.
Fall from fracture
– What happens after the examination of the patient and the diagnosis of a bone fracture?
– In each case individually. Having found a fracture of the femoral neck, in stationary conditions, as a rule, we impose a spoke skeletal traction for the tuberosity of the tibia. This helps to separate the fragments, to align the axis of the limb. Thus, significantly reduce pain and create conditions for additional examination and preparation for surgical treatment. Then a decision is made to carry out the operation.
Under the condition of a favorable prognosis, in two out of three cases, complete fusion occurs. If the operation for some reason was not carried out, the sad consequences, alas, are irreversible. Aseptic necrosis of the femoral head may occur.
– Are there times when the operation is contraindicated?
We do not always prescribe surgical intervention. If, in addition to fractures, there are concomitant diseases or other serious injuries, it is dangerous to carry out the operation. If there are no contraindications and it is done, then the operated person must observe the most gentle regimen.
– Does “breakage” take equally long to heal in case of mild or severe osteoporosis?
– All other things being equal, the presence of a pronounced form, of course, affects a longer and more difficult healing. After all, if you do not carry out drug treatment on time, the disease will progress. And very soon bones can be compared to eggshells, crumbling at the slightest external influence on it.
By the way, some doctors agree that sometimes in patients with a pronounced form of osteoporosis, a fracture occurs first and only then a fall, although, logically, it should be the other way around.
Walking with bayonets
– Is it possible to somehow prevent a pronounced form of osteoporosis, or does it not depend on prevention?
– Of course, it is necessary to take preventive measures in advance. In addition to taking all kinds of drugs that help the body absorb calcium, in adulthood, you need to be much more careful about your diet.
Everyone knows that the main sources of calcium are dairy products and fish. But this does not mean that liters of milk and herring drunk per day will be of great benefit. Dairy products in old age should also be consumed according to an individual scheme: someone is not shown fresh milk, but for someone kefir. It is good to eat dried fish and always with bones.
Vegetables are very useful – turnip, broccoli, soy, celery. For a day, you need to consume at least 1200-1500 mg of calcium with food.
It is necessary to be in the fresh air as much as possible, thereby saturating with vitamin D, to take long walks without fear of the sun. The elderly, fortunately, have time for this, as well as for moderate physical activity – swimming and gymnastics.
If osteoporosis does overtake you, you need to take all possible precautions. At home, all thresholds are covered with carpets, it is convenient to rearrange furniture. Equip slippery surfaces in the bathroom, arrange lighting everywhere.
For movement along the street in bad weather, it is good to purchase special sticks with bayonets . When climbing stairs, always hold onto the handrails. And be sure to wear only comfortable, soft, but stable shoes!
By the way
Even in the time of Hippocrates, chalk was one of the most popular medicines. It is known that the concentration of calcium in human blood serum is kept at a constant level of 2.25-2.75 mmol / l. Calcium is the main non-hormonal agent used to prevent osteoporosis. The use of calcium helps to reduce the incidence of vertebral and hip fractures in old age.
The risk of osteoporotic fractures over the age of 50 is 39.7% for women and 13.1% for men. One in three women over the age of 65 has at least one bone fracture. Hip fractures result in a 12-15% decrease in life expectancy.