Live Well Dayton: Women's Health

LIVE WELL DAYTON ›› WOMEN’S HEALTH

Getting a Break

Understanding bone health is important as women age

BY JENNIFER PAT TERSON LORENZET TI

DAYTON MAGAZINE . October/November 2019

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but that doesn’t mean it can’t be a more pleasant experience. To that end, Kettering Health Network now offers mammography units with special features designed to reduce anxiety and increase comfort. These features, along with 3D imaging technology, are helping to

A More

calming fragrance. “Standing in an exam room with your breast in compression can cause anxiety in some women,” says Sally Grady, director of Kettering Breast Evaluation Centers (KBEC). “By stimulating two or more senses si-

“There is emerging consensus that 3D

the degree of compression with “We’re developing tools to help guidance from the technolo- women understand what their gist, if they wish. Studies ac- personal breast density level tually show that many women is, how that correlates to their will apply more compression breast cancer risk, and how WOMEN’S themselves than theyHEALTH would to PROFILE mitigate that risk,” says Dr. allow a technologist to apply.

Musser. “This could include using software that assigns a specific density level for each breast and creating educational materials—we hope to have those in place later this year.”

Three-dimensional mammog- To learn more about Kettering raphy is particularly import- Breast Evaluation Centers or ant for women with dense to schedule an appointment, breasts. (dense breasts have visit ketteringhealth.org/ relatively high amounts of breasthealth glandular tissue and fibrous connective tissue and relatively

Extra support for women with dense breasts

technology detects breast cancer more Comfortable accurately than Mammogram 2D mammography.”

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tudies have proven that beginning screening mammograms at age 40 saves the greatest number of lives. However, the Centers for Disease Control and Prevention reported that in 2015 only 65.3% of women age 40 and over had a mammogram within the past two years. Discomfort, fear and anxiety can all contribute to a woman’s hesitation in scheduling her yearly screening.

A mammogram appointment will never rival a visit to the spa, but that doesn’t mean it can’t be a more pleasant experience. To that end, Kettering Health Network now offers mammography units with special features designed to reduce anxiety and increase comfort.

These features, along with 3D imaging technology, are helping to remove the barrier women sometimes feel toward scheduling their yearly mammogram.

Improving the Sensory Experience

Sensory Suite

“As I have grown older, and yes wiser, I have discovered the importance of being one’s own health self-advocate. No one knows your body better than you. There are 8,760 hours in a year, please take one of those hours to get your annual mammogram.”

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patient’s breasts have gentle, rounded corners. The system features comfortable armrests that relax the pectoral muscles to simplify positioning and compression. The new units also allow women to use a remote control device to adjust the degree of compression with guidance from the technologist, if they wish. Studies actually show that many women will apply more compression themselves than they would allow a technologist to apply.

Each new mammography unit comes with a sensory suite that includes a 48-inch flat panel monitor. During a mammogram women have the option to watch a series of images from nature and listen to relaxing music. A scent diffuser infuses with air with a calming Extra Support for Women with Dense fragrance.

Breasts “Standing in an exam room with your mammography breast in compression can cause anxi- Three-dimensional is particularly important for women ety in some women,” says Sally Grady, with dense breasts, which means their director of Kettering Breast Evaluation Centers. “By stimulating two or more breasts have relatively high amounts of senses simultaneously we can distract glandular tissue and fibrous connective patients from the perceived discomfort, tissue and relatively low amounts of fatty tissue. “There is emerging consenpain and anxiety of a mammogram.” sus that 3D technology detects breast Additional features also improve com- cancer more accurately than 2D mamfort. All components of the imaging mography,” says Dr. Meghan Musser, unit that come into contact with the Kettering Health Network breast radi-

Sensory Suite

ologist. Traditional 2D images are flat and breast tissue can be overlapping, making abnormalities harder to detect.

Three-dimensional mammograms produce a layered 3D image of the breast tissue that provides improved clarity and detail.

“We’re developing tools to help women understand what their personal breast density level is, how that correlates to their breast cancer risk and how to mitigate that risk,” says Musser. “This could include using software that assigns a specific density level for each breast and creating educational materials—we hope to have those in place later this year.”

To learn more about Kettering Breast Evaluation Centers or to schedule an appointment, visit ketteringhealth.org/ breasthealth.

LIVE WELL DAYTON ›› WOMEN’S HEALTH

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hances are you don’t think a lot about your bones. This living tissue grows and changes throughout life, supporting one’s body and allowing for all of the activities that we enjoy. Yet, most people don’t realize they are losing bone density until they break a bone.

According to the National Osteoporosis Foundation, “about 54 million Americans have osteoporosis and low bone mass.”

The foundation estimates that “one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis,” with annual related costs soaring to $19 billion every year.

Bone health “is a big public health issue” says Dr. Jennifer Jerele, an orthopedic surgeon with Premier Health. She says that white women of northern European descent and post-menopausal women are the most at risk for loss of bone density.

However, often, “you don’t know until you break something,” she says.

Those breaks can have serious consequences. Most often breaks occur in the hip, spine or wrist, and the break can cause loss of height, changes in posture and decreases in mobility. For many, it is

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DAYTON MAGAZINE . October/November 2019

a life-altering injury. “You can wind up losing independence,” says Dr. Soumya Nadella, a family medicine physician at the Years Ahead Health Center, a part of Kettering Health.

UNDERSTANDING, PREVENTING AND TREATING BRITTLE BONES Osteoporosis is on a continuum that progresses from normal bone to osteopenia before becoming full-blown osteoporosis.

Osteopenia is when bones are weaker than normal but they have not progressed to the point of breaking easily.

Bones are not solid structures; instead, they are made up of a matrix of tissue that looks something like a honeycomb. The body is always in the process of adding and losing bone, with the time of greatest bone density coming at about age 30. If the body loses more bone than it creates the bones become weaker and more likely to break.

This is particularly true of women, who lose the benefit of estrogen after menopause and who tend to live longer than men giving them more time to develop brittle bones. Additionally, Nadella explains that some factors within a person’s control, like

Dr. Jennifer Jerele

smoking, consumption of alcohol, and having a low or high BMI can increase the risk of developing brittle bones.

However, there are steps that can be taken to decrease the risk of brittle bones.

Jerele says that getting enough calcium (1,200 mg. per day) and vitamin D (800 IU per day) can decrease the risk of osteoporosis by up to 25 percent. Nadella agrees, adding that the calcium can come from dietary sources and the vitamin D from sun exposure, or supplements are available.

Both experts also recommend weightbearing exercises like walking, running or other exercises that cause the bones to support weight. The process of making bone support body weight and withstand impact will cause the body to lay down more bone and to increase muscle. Low and no impact exercises are typically not sufficient for this purpose.

Osteoporosis is often called a silent disease because many people don’t realize that they are losing bone density until a broken bone calls the situation to attention.

However, there is one test, called a DEXA scan, that can help measure bone mineral density. Standing for “dual energy X-ray absorptiometry,” a DEXA scan uses two X-ray beams of differing energy levels to measure the amount of X-ray that passes through the bone allowing for a calculation of bone density.

WOME N’ SHE AL T HPROF I L E

LIVE WELL DAYTON ›› WOMEN’S HEALTH Nadella recommends this test for women 65 or older or for patients on certain prescription medications, like prednisone or proton pump inhibitors. Certain kinds of chemotherapy, especially that for breast cancer, can also weaken bones and may warrant closer bone density monitoring.

“Patients will say they’ve never had a fracture, but they still need screening,” Nadella says.

There are several possible treatments for low bone density and osteoporosis.

These range from first-line treatments that also have preventative effects to those that stimulate bone growth and those that replace the hormones lost during menopause.

SIMPLE PREVENTION Dr. Soumya Nadella

Although osteoporosis and brittle bones are relatively common, there are many things people can do to prevent the broken bones that characterize the disease. In addition to weight-bearing exercises de-

signed to build muscle and bone, there are activities that can help improve balance and prevent falls. Yoga and tai-chi are two of these and Nadella says that there are studies supporting these activities’ role in fall prevention.

Additionally, there are simple steps people can take to prevent falls at home, including removing throw rugs, stowing power cords and removing boxes or other items sitting on the floor. Taking care of these at-home hazards means that one is less likely to trip and fall, causing a break and future limitations in mobility.

Brittle bones, osteoporosis and bone breakage may be relatively common, especially among post-menopausal women, but that doesn’t mean that these are inevitable. Taking simple steps ahead of time may ward off those breaks for good.

“Know your family history so you can be more proactive,” Jerele says. When it comes to bone health a bit of prevention really is easier than attempting a “cure.” n

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UNDERSTANDING RISK FACTORS FOR OSTEOPOROSIS Osteoporosis is relatively common, but some factors increase a person’s risk. The National Institutes of Health divides these into risk factors a person cannot change and those they can.

• RISK FACTORS YOU CAN’T CHANGE • SEX: women are at a greater risk due to less initial bone and the effects of menopause AGE: bones become weaker with age BODY SIZE: small, thin boned people are at greater risk ETHNICITY: White and Asian women are at a greater risk

FAMILY HISTORY: those whose parents have a history of fractures may be at increased risk themselves • RISK FACTORS YOU CAN CHANGE • SEX HORMONES: low levels of estrogen in women and testosterone in men

increases risk

• Anorexia nervosa

• Calcium and Vitamin D

• Medication use

• Activity level

• Smoking

• Excess alcohol consumption

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