Cheryl Martin (Host): Strong, healthy bones are important in every stage of life. Here to give us tips on how to keep our bones healthy is orthopedic surgeon Dr. Patrick Mixa. This is BayCare HealthChat. I'm Cheryl Martin. Dr. Mixa, thanks for coming on.

Dr. Patrick Mixa: Thank you so much for having me. Pleasure to be here.

Cheryl Martin (Host): So what are some of the best ways to keep our bones strong and healthy?

Dr. Patrick Mixa: So one of the best ways is diet.So focusing on getting calcium from your diet. Things such as yogurt, cheese, even things like canned sardines or fortified orange juices. We can aim for up to about 1200 milligrams per day, so about three or four servings, and then luckily, we live here in sunny Florida, but a lot of us don't actually get enough sunlight surprisingly, or are actually vitamin D deficient.

So sometimes either just getting out in the sun or having your vitamin D checked for supplements, so usually,supplements around 800 to 1,000 IUs per day. This can help keep your bones strong. Also most importantly is continuing to stay active. Something simple just as walking 20, 30 minutes a day, even if you have a cane or walker, can really help enhance the quality of your bones. Bones like to be stimulated by stress so living an active lifestyle can definitely be important. Also things such as, trying to stay away from things such as smoking and any heavy drinking. Those things really can kind of affect your bones.

Whenever I go in for a surgery, I can tell when those patients have these social lifestyles and it can really affect the quality and put them at a higher risk for fracture. And then lastly, asking your primary care doctor, especially women over 65 and men over 60  should be screened for their bone health and can get things such as a bone density or DEXA scan. And those are all things that we can do to kind of manage and make sure our bones are nice and strong and healthy.

Cheryl Martin (Host): I am glad you mentioned bone density. What reduces bone health and bone density?

Dr. Patrick Mixa: So things like a poor diet. So if you're not eating enough calcium or not getting enough vitamin D, that can definitely weaken the bones. So avoiding any extreme dieting, yo-yo dieting or anything that kind of limits you from having a nice, well-balanced diet keeps the bones from getting the nutrition they need. It's also living a sedentary lifestyle definitely makes an effect. Smoking definitely really affects the bone quality and also healing after fractures. So even just things like smoking patches or nicotine patches can help people quit and can have great effects on bone health.

There are some medications that do, so if anybody's on long-term steroids or if they're on medications for heartburn drugs can cause some of the bones to be weak. So definitely touch base with your primary care doctor if you're on any of these maintenance drugs.

And also things such as thyroid problems, diabetes can also affect the bone quality. So getting regular check upsand getting your lab work done can keep things in check.

Cheryl Martin (Host): You mentioned a bone density test, let's say for those over 65. Should those be done regularly or just one after age 65 or 65 on up?

Dr. Patrick Mixa: Usually getting one at age 65. They say 65 for women and 70 for men. So usually getting one around that time is good to get a baseline and then they can assess your bone quality thenT henafter that, usually they check every about two or three years. Of course they're ever changing their recommendations, but once they get a baseline, if they need to put you on medications or do something to improve the bone quality, they will continue to kind of do repeat scans over time just to keep an eye on your bone health.

Cheryl Martin (Host): Any other thoughts You want to talk about the impact of aging on bone health? You've covered that somewhat.

Dr. Patrick Mixa: After 50, bones kind of just naturally start to get thinner, especially in females after menopause. The estrogen is kind of protective for the bone, so as that decreases, so does the quality of our bones but it can happen in men too. It's not just for women.

Weaker bones kind of  put us at risk for things such as fracture, especially in the hip or the spine or the wrist.  Those are the most common fractures and also the weaker your bones are, the longer those fractures take to heal. So, staying active and keeping your muscles strong is also important.

Because the more better your balance is, the stronger your joints are, and it can keep you from falling and also keep other things such as arthritis from getting worse. So, it's important to kind of, you know, stay active and try to gain as much of your independence and strength. So don't put yourself at risk for fractures.

Cheryl Martin (Host): So, once you've been diagnosed with low bone density, let's say, can you regain bone density?

Dr. Patrick Mixa: So can you regain bone density? You can strengthen your bones, especially if it's caught early. Bones don't really necessarily return to the same quality that we were when we were 20 years old, but you can definitely do things to strengthen the bones and keep them strong.

So some medications help. There's drugs out there like Fosamax or Prolia  that can boost your bone density from up to five to 10% over a couple years. And, a lot of primary care doctors willprescribe these when your DEXA or bone density scans show that you're at high risk. But also eating things like calcium rich foods and doing safe exercises can also prevent falls.

Even doing things like tai chi, yoga, balance exercises and also things that you can do to prevent falls around the house that may involve things like removing bumps on the floor or rugs that may trip over. A lot of people trip over their animals. Not saying you have to get rid of animals, but, make sure everyone's in a safe environment. That puts you at less risk for falling.

Sometimes even, as we get a little bit weaker, putting grab bars around the bedroom or in the bathroom in places that you're at higher risk for falling. But tracking our progress, like I said, they'll do repeat bone scans every  sometimes one yearor if it's really bad or two to three years.

But your primary care doctors will usually adjust that as needed. But in patients as they get into their eighties, staying active is really important because you're just at a higher risk for fracture.

Cheryl Martin (Host): Anything else you'd like to add about bone health and bone density?

Dr. Patrick Mixa: I think it's important to overall just think of your overall health and wellbeing. I think it's important to discuss with your primary care doctors or orthopedic surgeon about any questions that you may have. There's no shame in using a cane and preventing a fall.

I think maintaining your quality of life is most important and having a well-balanced diet, staying active, taking medications if you need them. All these things in constellation together can maintain the best quality of life you can, can prevent fractures and can help

you live a long, healthy life.

Cheryl Martin (Host): And it's good we're having this conversation because it seems like the earlier one does this in terms of lifestyle changes it's just going to be preventive for long-term problems.

Dr. Patrick Mixa: It's never too late to start but even people in their thirties, forties and fifties, it's still time to focus on the future. But even as we get older, there's still things that we can do to make up for lost time or continue to be active and proactive in our health.

And there's a lot of new technology out there. There's a lot of new medications just even holistic or natural things we can do to just improve our health and our bone quality.

Cheryl Martin (Host): Dr. Patrick Mixa. Thank you for educating us on bone health and density. You gave us some   Thank you so much.

Dr. Patrick Mixa: Thank you so much. It's a pleasure to be here and look forward to seeing you next time.

Cheryl Martin (Host): Thank you. That wraps up this episode of BayCare HealthChat. Head on over to our website at BayCare.org for more information and to get connected with one of our providers. Please remember to subscribe, rate and review this podcast and all the other BayCare podcasts. For more health tips and updates, follow us on your social channels.

If you found this podcast informative, please share it on your social media and be sure to check out all the other interesting podcasts in our library. Thanks for listening.  

 [PK2]Quote option

 [PK4]Quote suggestion

 [PG5]This could be a good title option! Typically for quotes, we try to get something that our clinician says, rather than the host.

 [PK7]Delete silence from 8:32-8:33