Fall is here in our chilly mornings, the leaves beginning to turn and our valley enjoying apple, plum and pear season. But fall brings falls…..evidenced by the an icey film on our sidewalks on the shady side of the street. Sleuthing out your bone health, understanding a Bone Mineral Density (DEXA) scan and then knowing how to help you enjoy brilliant bone health through every age and stage will help you avoid those pesky fall-induced fractures of your wrists, shoulders and hips. Our bone health is based on our body's build, our weight management, our activity level and type/frequency of exercise, our diet, our general health and our age. All of us have our own unique blend of variables; as women, our one commonality is the reduction of bone-protective estrogen as we wander through menopause. Menopause is reached by a natural reduction and eventual cessation women's hormones in our bodies, through surgery (complete hysterectomy) or through taking estrogen suppressing medication (Tamoxifen or other aromatase inhibitors) or simply through the passage of time. Women are typically referred every 3 - 5 years for a DEXA scan, available to us at the EK Regional Hospital in Cranbrook. DEXA is an abbreviation of Dual Energy X-ray Absorptiometry, a targeted xray that measures the bone mineral content or density of your bones, is a reliable predictor of fracture risk. A central DEXA measures the head of the hip and the mid lumbar (low back) spine (most commonly used and most reliable test). A peripheral DEXA measures the forearm, the heel, wrist and hand bones. The modern DEXAs are very low radiation scans, about 1% of a lateral spine xray. Your height is usually measured so that any loss of height is documented in relation to the xray. "Prospective Height Loss" tells us that if you lose more than 2 cm. of height over a period of three years, you may have a new compression fracture in your spine. "Historical Height Loss" tells us that, if you're over 60 and have lost 6 cm. of height or are under 60 and have lost 4 cm. over more than three years, then again, a compression fracture must be considered. An xray tech performs the test which is painless and takes about 15 minutes; from there, a radiologist interprets the results which are then sent off to your GP to discuss with you and to guide your treatment. The DEXA test tells you 3 things about your bone mass: 1. Your bone mass in grams per centimeter squared. 2. A DEXA score comparing you to a healthy control group, often a 30 year old healthy woman, your "T score". 3. A DEXA score comparing you to your peers, your "Z score". Complications to your DEXA score can be caused by osteoarthritis in your spine (pitting or rough joint surfaces can look like bone loss), osteoarthritis in your hip (difficulty rotating your hip inward to the best testing position), compression fractures in your spine (can look like dense bone), obesity (if you're over 350 lbs., some DEXA units can't accurately guarantee that the score won't be skewed by photon passage through extra tissue), being too thin (scores are widely variable for thin women from one test to the next) and switching machines/locations (they are all calibrated very carefully). In the end, you'll meet your doctor again to discuss the score. We usually talk about the Tscore which will tell you a number, hovering just above or below 0.
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