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Re: Bone density mafiaFrom: HMarchbein@aol.comSat Nov 30 10:39:20 1996
In your response you wrote: "Nevertheless, I find utility in densitometry in those women (they're not sick, so they are not really patients, according to the drivel here) who, despite life style changes including exercise and calcium, are not on ERT and are at risk. Typically, these are thin white women with hunched over mothers and family histories of breast cancer who will not consider the benefits of ERT over the theoretical risk of breast cancer on ERT. Am I missing the boat with that thinking? Garry E. Siegel, M.D. Roswell, Ga. " ---------------------- I agree. In New York, and more specifically Long Island, it is the ---------------------- gynecologist who is usually ordering the bone densitometry and treating with ---------------------- HRT, Fosamax or Miacalcin (for those who can't tolerate Fosamax or can't swallow pills). There is no question that this concept of bone density measurements is media and consumer driven (in addition to some practitioners who do bone densitometry) but I'm not sure that it is a bad idea on a medical basis. I have seen 3-5% reductions in bone loss in only one year on therapy........need more time for further evaluation. I have, unfortunately, seen many women with poor bone densitometry (DEXA machine) despite the fact that they were on HRT, taking appropriate amounts of Calcium (foods and/or supplementation) and doing weight bearing exercises. I have a great concern for these very nice women who, despite doing all the right things, are still at a marked increase risk for fractures. The most serious risk is obviously hip/femur fracture with its attendant risk of pulmonary embolus. If you're missing the boat, I'm on the dock waiting there with you. Harvey Harvey S. Marchbein, M.D. FACOG Syosset, New York
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