Re: Osteoporosis
From: Andrew Folley (agfolley@hotmail.com)
Thu Feb 10 19:54:53 2005
Glen, a few extra thoughts for you to ponder. What was her previous T
score? Perhaps she had low bond density to begin with. What is her Z score
comparing her to her peers Make sure there is not something else going on ie
secondary osteo. Consider a Urine NTX to tell you if she is currently
breaking down bone. Continue the fosamax make sure she is getting 1200 to
1500 Calcium in divided doses and up her Vitamin D recommend wt bearing
exercise 30 min 3x per week. Recheck DEXA in 2 years. The fosamax should
increase her BMD over the next 2 years by at least 5-6% Andrew
>From: "Braun, R. Daniel" <rbraun@iupui.edu>
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: RE: Osteoporosis
>Date: Thu, 10 Feb 2005 09:37:44 -0600
>
>She is already on the Therapeutic dose of Fosamax. So the only things
>left are:
>Increase calcium, exercise, and an Internal Medicine Consult. Also
>discuss with her Onc regarding estrogen. If it has been more than 5
>years and especially if E receptor negative, many people think there is
>no risk to estrogen.
>
>Dan
>
>R. Daniel Braun, MD
>
>"If everyone likes you, you're doing something wrong."
>
>Kinky Friedman
>
>I believe a self-righteous liberal or conservative with a cause is more
>dangerous than a Hell's Angel with an attitude.
>
>Andy Rooney
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf
>Of Elrod Darryl G MAJ 48 MDOS/SGOBO
> Sent: Thursday, February 10, 2005 9:36 AM
> To: Multiple recipients of list OB-GYN-L
> Subject: Osteoporosis
>
> I haven't seen many postmenopausal women in the last 4 years, so
>I'm asking for some advice.
>
> I have a 58 yo G3P3 with history of breast cancer and
>endometrial cancer that has been taking fosamax 70mg/wk for her
>'prevention of osteoporosis.' She has had a mastectomy and TVH/BSO in
>the past.
>
> This was the first I had seen her, so I ordered a bone density
>scan since she hadn't had one in several years. Her T score was -2.6.
>
> Obviously, she is not a candidate for estrogen therapy.
>
> Now that she is clearly osteoporotic, what other options do I
>have in her treatment?
>
> Thanks,
>
> Glen
>
> D. Glen Elrod, Maj USAF, MC
>
> Obstetrician/Gynecologist
>
> Maternal Child Flight
>
> 48 MDOS/SGOBO
>
> UNIT 5210 Box 23
>
> APO, AE 09464
>
> DSN (314) 226-8334
>
> Comm 01638-52-8334
>
> Notice of Confidentiality
> Under the Privacy Act of 1974, you must safeguard all
>information reflected on this Email and, if applicable, all attachments.
>Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI
>37-132, AFI 33-219, and PL 93-579"
> This document may contain information covered under the Privacy
>Act, 5 USC 552(a), and/or the Health Insurance Portability and
>Accountability Act (PL 104-191) and its various implementing regulations
>and must be protected in accordance with those provisions. Healthcare
>information is personal and sensitive and must be treated accordingly.
>See <https://sg.usafe.af.mil/HIPAADisclosure.cfm> for full details.
>
|
|
