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Ellen Dolgen

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  • Should I Take Medicine for Osteoporosis?

    Posted on Monday, January 18, 2016

    http://fabulously40.com/images/nonono.gifUnless you break a bone, you may not be paying attention to your bone health. Bone loss is a silent process.


    The National Osteoporosis Foundation (NOF) estimates that a total of 54 million U.S. adults age 50 and older are affected by osteoporosis and low bone mass.


    I have received numerous emails from readers who have recently been diagnosed with Osteoporosis. As our estrogen levels decline, bone loss may accelerate. Many women suddenly find themselves in a quandary as to whether to go on medication or not.


    I thought I would share one women's story with you. For the purpose of this blog, we shall call her Jeanne. Jeanne has avoided any pharmaceutical use because her mother took DES while she was pregnant with her. Recently, Jeanne was diagnosed with Osteoporosis. Her doctor says her case is severe and he recommends she go on a drug called, Forteo.


    To help support Jeanne, I turned to osteoporosis expert Diane L. Schneider, MD, a geriatrician, epidemiologist, co-founder of 4BoneHealth.org, and author of The Complete Bone Book.


    According to Dr. Schneider, "Osteoporosis is the result of bone loss that occurs silently and progressively creating a fragile skeleton that puts one at risk of breaking a bone or having a fracture."


    Dr. Schneider graciously shared her review and thoughts on Jeanne's options:


    Jeanne, age 60, was diagnosed with osteoporosis by bone density scan. Her lowest skeletal site was the lumbar spine (low back) with T-score of -3.7 and her total hip was -3.2. The T-score is comparison of your bone density measurement with young women at peak bone mass. The T-score along with assessing risk factors for breaking a bone provides a fracture risk assessment.




    Risk Factors and Lifestyle


    In discussing her risk factors, Jeanne had never broken a bone, she considers herself in excellent health with no chronic illnesses, and she is taking no medicines. She has been diligent in taking calcium supplements, getting regular exercise, and followed a vegan diet for the past six years. She felt that she was doing "everything right" to lower her risk of osteoporosis that debilitated her mother. Her family history is her major risk factor.


    The results of her bone density plus her family history of osteoporosis puts Jeanne at high risk for breaking a bone. One concern is the level of her bone density at her age. A thorough investigation should look to uncover any additional problems that may be contributing to her low bone density. For example, screening for celiac disease, overactive thyroid, calcium loss in the urine and multiple myeloma to name a few.


    Before discussing medicines, other general measures of calcium, vitamin D, nutrition, and exercise should be addressed as well. I find discussion of these areas are often left out of one's interaction with their healthcare professional. So be sure to bring these up with yours.




    Calcium


    On review of her diet, Jeanne was consuming 700 milligrams of calcium a day from various foods and drinks. She took a calcium supplement that contained 600 milligrams twice a day. Her once-a-day multivitamin contained 500 milligrams of calcium. All together her diet and supplements totaled 2400 milligrams of calcium.


    For women over age 50 and men over age 70, the latest recommendation from the Institute of Medicine is 1200 milligrams a day of calcium from all sources. At 2400 milligrams a day, Jeanne was taking double what she needed. Excess calcium ends up in your urine putting you at risk for kidney stones.


    Keeping in mind that Jeanne should only consume 1200 milligrams of calcium, her calcium supplement was stopped entirely. With an average of 700 milligrams in her diet and 500 milligrams more from her multivitamin, she met the 1200 milligram recommended target. Taking the separate calcium supplement put her way over and is not needed; but that's what her primary care doctor had recommended without asking what else she was taking or obtaining a dietary history.




    Vitamin D


    Jeanne had 400 IU of vitamin D in her multivitamin and 500 IU in each tablet of calcium. Since I suggested to stop her calcium supplement, she would need to take a separate vitamin D supplement. The best guide to determine whether she needed more or less than 1000 IU she was getting in the calcium supplement is using a vitamin D blood level.




    Nutrition


    Jeanne considers herself a lifelong healthy eater. She strictly follows a vegan diet and prior to that was ovo-lacto vegetarian. However, in review of her usual foods for meals, she was not consuming enough protein. The recommended daily amount of protein for an average adult women is 46 grams or 0.8 grams per kilogram per day. Remember protein is needed to support your bone, it's not just made up of minerals.




    Exercise and Fall Prevention


    Jeanne walks regularly and practices yoga. Stressing your bone through weight-bearing and weight-resistive exercises are key. The exercise must be of high enough intensity to produce mechanical strain. I recommend walkers change up their speed and intensity intermittently. Try walking up steps or a hill, or walking faster for a block then repeat every couple of walks.


    Yoga is good for improving balance and core strength. Yoga poses may need to be modified to avoid loading the spine in bending forward postures.


    Over 90% of wrist, shoulder, and hip fractures are a result of a fall. The key is not to fall. Improving core strength and balance will help lower the risk of falling.




    Osteoporosis Treatment


    Fortunately, we now have choices for women and older men who have been diagnosed with osteoporosis or are at high risk for fractures. Jeanne had avoided any medicines but she was basically doing well in following healthy lifestyle. My comments above are just small modifications. Unfortunately, these general measures are not enough to lower her risk of fracture and improve her bone density.


    I recommended that she consider starting therapy with Forteo (teriparatide) for the following reasons. Her spine skeletal site was lower than her hip. Forteo has a good response at the spine with an average increase of almost 10% in two years of use. It is the only medicine that stimulates the bone-building cells, called osteoblasts. Connections are made in the bone microstructure that had broken, new bone is formed, and bone volume is increased. As a result, fracture risk is reduced. Forteo is "natural"-it is the first portion of parathyroid hormone. It produces a short burst of parathyroid hormone action that achieves these effects.


    The medicine is a daily injection using a click pen-like device. This route of delivery dissuades some people from starting the medicine but it is simple and is practically painless. In addition, its use is limited to two years then followed by one of the other medicines to maintain the gains achieved on Forteo.


    According to Dr. Schneider, if you are at high-risk for fracture, general lifestyle measures are limited in decreasing fracture risk. Medicines play an important role in the treatment of postmenopausal women and men with osteoporosis. Consult your healthcare practitioner to discuss the best options for you.


    Remember: Suffering in silence is OUT! Reaching out in IN!


    Click here to download my free eBook, MENOPAUSE MONDAYS The Girlfriend's Guide To Surviving and Thriving During Perimenopause and Menopause.


    Shmirshky, Your links have been removed, please consider upgrading to premium membership.


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  • Workplace Health for the Menopausal Women

    Posted on Monday, January 11, 2016

    http://fabulously40.com/images/nonono.gifIt's that time of year when we are all more focused on our health and wellness. I thought I would take advantage of this mini-window of opportunity to help us all create some new, healthier habits!


    For those of you who are sitting at a desk hovered over a computer or laptop, most of the day, this blog is for you!


    My work at EllenDolgen.com keeps me glued to my desk chair working on my computer most of the day and sometimes into the night. Consequently, I find myself experiencing a variety of neck/back challenges that I never used to have.


    I reached out to my wonderful trainer, Daniel Shamburg, MS, CSCS and founder of ShiftFitness, who helps me stay on my path of healthy aging to see how I can best tackle this new work related problem.


    Daniel told me there are a number of tips that can help those of us whose jobs cause us to be glued to the internet, stay pain-free while we work.


    1. Be more aware of your posture. Posture, like muscles, needs to be worked on to improve. When we sit for prolonged periods of time the head, shoulders and torso round forward. This forward posture increases the amount of strain on our neck and spine. Over time, chronic shoulder, neck, and low back pain can develop.


    2. Take a break and stand up! Take a break and stand every 30 minutes (2 – 5 minutes at a time). I now use the timer on my cell phone to remind me to get up and take a break, being mindful of getting my shoulder and neck back.


    3. Exercise during the day. Walk stairs, stretch, and activate your muscles. Daniel recommends establishing a daily step goal using these guidelines:


    • Less than 5,000 steps = Sedentary

    • 5,000 – 7499 = Low Active

    • 7,500 – 9,999 = Somewhat Active

    • Greater than 10,000 steps = Active



    4. Keep track of your steps. You can purchase devices like [Link Removed] which is a pedometer that will keep track of your steps and help motivate you to get up and move. Some of these type of devices can even alert you when you haven't been moving! Don't worry, they don't yell, these are gentle reminders.


    5. Use proper sitting form.


    • Keep your feet planted evenly on the floor.

    • Sit up straight and tall with your shoulders pulled back. (This one is challenging for me!)

    • Align your ears, shoulders & hips.

    • Adjust monitor height so that your web taskbar is at eye level. (This makes a huge difference!)



    6. Utilize Mobility and Strength Exercises.


    • Strengthen your back muscles to help keep you upright and maintain good posture.

    • Sitting for too long can cause your head and shoulders to pull forward, resulting in a "hunched over" position. Focus on strengthening those shoulder and chest muscles.

    • Take a look at this[Link Removed] for an example of these strength exercises.



    These simple changes have truly helped my neck and back issues. Daniel is my healthy aging angel! For more information about Daniel Shamburg go to [Link Removed]!


    Shmirshky, Your links have been removed, please consider upgrading to premium membership.


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  • Become Your Own Menopause Health Advocate!

    Posted on Monday, January 4, 2016

    http://fabulously40.com/images/nonono.gifYou can't leave your perimenopause and menopause symptoms on the kitchen counter when you leave the house.


    You can't pretend to be "fine" when you are dripping wet from a hot flash, sleepless and irritable. Your family, co- workers, loved ones, and friends know when you are not feeling well.


    Here are some simple tips that will help you become your own best Health Advocate:


    1. You are not alone! According to [Link Removed], "An estimated 6,000 U.S. women reach menopause every day. That is over 2 million of us per year. In addition, more women are living beyond age 65. A women's average life expectancy in the western world is estimated at 79. 7 years."

    1. Trust How You Feel! – You know when you don't feel well. If you go to a healthcare provider to get menopause advice and help and your provider tells you, "You're too young to be in menopause", don't sit there and accept it! Do not go home and suffer in silence.

    1. Reach out and get the help you need and deserve!

    • Educate yourself on [Link Removed]! This may not be the doctor who delivered your babies. This is a medical professional that has been specifically trained to help menopausal women.

    • Get the [Link Removed] to measure your levels such as DHEAS, Estradiol, Free and Total Testosterone, FSH, Progesterone, Thyroid Panel, just to name a few.

    • Chart your symptoms. I have worked with doctors to develop a helpful chart that will help you to quickly and accurately explain how you feel to your doctor. You can download it [Link Removed].

    • Understand your options - both hormonal and non-hormonal.

    • Communicate openly and honestly to your loved ones so that you can get their love and support.

    • Remember, if you do not feel better, communicate that with your menopause specialist. If they are unable to help you – find another one! No divorce attorney is needed!



    You CAN get the help that you need and deserve if you educate yourself. Be proactive about your health, rather than reactive.


    For more detailed support, download my [Link Removed]!


    Shmirshky, Your links have been removed, please consider upgrading to premium membership.


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  • Countdown to New Year’s Eve…………….

    Posted on Monday, December 28, 2015

    http://fabulously40.com/images/nonono.gifIt is about this time of year that I begin thinking about my New Year's resolutions.


    According to Wikipedia, the most common reason for participants failing their New Years' Resolutions was setting themselves unrealistic goals (35%), while 33% didn't keep track of their progress and a further 23% forgot about it. About one in 10 respondents claimed they made too many resolutions.


    Does this sound familiar?????


    Then I learned that women succeeded 10% more when they made their goals public and got support from their friends.


    Soooooooooooooo, rather than create a huge "must change" list that I will never achieve. This year, I decided to just have one, achievable (!) New Year's Resolution.


    This was my initial brainstorm:


    • lose weight

    • change up my exercise

    • cut back on my [Link Removed]

    • laugh more

    • be present

    • reduce cell phone time

    • enjoy life

    • reduce stress



    As I ponder over this list, I think that one that jumps out at me most is to "change up my exercise". One day a week, I plan on incorporating a different form of aerobic exercise into my routine! I think this will help many of the other items on my list.


    It will be easy for me to keep track of my weekly progress.


    I read somewhere that we are more likely to reach our goals if we share them. So, thanks for letting me share........... wish me luck!


    Happy Healthy New Year!


    Remember: Suffering in silence is OUT! Reaching out in IN!


    Click[Link Removed]!


    Shmirshky, Your links have been removed, please consider upgrading to premium membership.


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  • Got the Holiday Blues?

    Posted on Monday, December 14, 2015

    http://fabulously40.com/images/nonono.gifThe holidays are often a bittersweet time of year. Amid all of the parties, family gatherings, and general joyousness, there can be some strong feelings of loneliness, financial stress, and annoyance. For the menopausal women, you may experience triple the annoyance when you're the only one having a hot flash while standing in freezing cold weather.

    Here are seven suggestions on ways to beat the holiday blues and get more joy out of the holiday season:


    1. Reduce your stress! Don't bog yourself down with giant to-do lists. Take a critical look at your holiday planning list. Are you expecting too much out of yourself? Be more realistic, pair it down!

    2. Chill out. Try [Link Removed], volunteering may be good for the body and the mind.



    If you think you may be dealing with depression, and not just a case of holiday blues, then be sure to reach out and get help.


    This season, get more joy out of the holidays!


    Wishing you the happiest, merriest, and healthiest holiday ever!


    Remember: Suffering in silence is OUT! Reaching out in IN!


    Click [Link Removed] to download my free eBook, MENOPAUSE MONDAYS The Girlfriend's Guide To Surviving and Thriving During Perimenopause and Menopause.


    Shmirshky, Your links have been removed, please consider upgrading to premium membership.


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  • Happy Cyber Monday!

    Posted on Monday, November 30, 2015

    http://fabulously40.com/images/nonono.gif"Attention K-Mart Shoppers, there is a shopper in perimenopause and menopause on isle three. Be prepared for shoving, dirty looks, and sudden emotional outbursts."


    Let's face it, when our hormones are plummeting, our tempers are rising. Things that used to go practically unnoticed, like our husbands chewing gum, suddenly feel like fingernails scratching on a chalkboard.


    Thank you, Shop.org for the birth of Cyber Monday!


    In the olden days, the day after Thanksgiving was traditionally considered to be the beginning of the Christmas shopping season. Most retailers would have big sales, providing massive discounts to attract Christmas shoppers.


    Thanksgiving weekend is also one of the busiest travel weekends in the U.S. when people travel all across the Country to be with their families. As a result, many customers miss Black Friday's deals and sales. That is why Cyber Monday was born! We can shop anywhere – even on an airplane!Cyber Monday 2015

     In 2005, Shop.org realized that on the Monday after Black Friday millions of Americans, fresh off a Thanksgiving weekend of window shopping, were not busy at work, but instead were on their computers buying up a storm!


    Although the store aisles have been lined with holiday decor even before we celebrated Halloween, the truth is some of us do not get our holiday shopping done in a timely manner.


    That's where Cyber Monday comes in, and why I love it!


    Retailers have become more social media savvy, so they often offer the best deals to those who follow them on Facebook and Twitter, get their Pinterest and Instagram feeds, or sign up for text and email alerts. So make sure you're following your favorite retailers on social media.


    It is so much safer for everyone now that we are shopping on our keyboards rather than trying to manage Black Friday's crazy traffic, overstuffed parking lots, and endless check-out lines.


    [Link Removed]to download my free eBook, MENOPAUSE MONDAYS The Girlfriend's Guide To Surviving and Thriving During Perimenopause and Menopause.


    Shmirshky, Your links have been removed, please consider upgrading to premium membership.


    0 Replies