Osteoporosis

Osteoporosis: A bone disorder characterized by compromised bone strength


Bone Mineral Density (BMD): Function of both peak bone mass and how much is lost
- Peak bone mass @ 21
- Peak bone mass obtained by age 30

T- Score:  Current BMD compared to mean peak BMD of normal.  Negative in late peri or postmenopausal women
Normal T score > or = to -1.0
Low (Osteopenia) T score between -1.0 and -2.5
Osteoporosis T score < or = - 2.5

Z- Score: For premenopausal women, 26 yr old triathlete- want Z score
 
Osteoporosis
Primary: Occurs with age
Secondary: Result of meds or disease
- Steroids (Prednisone)
- Thyroid
- Deficient estrogen

Management Osteoporosis
- Slowing/stopping bone loss
- Increasing bone mass or improving bone architecture
- Maintain or increase bone strength
- Minimize fall factors

Patho
Osteoclast- removes bone tissue.  Promote bone resorption (cells that help eat away at old one0
Osteoblast- building.  Promote bone formation.
Menopause- rapid bone loss r/t estrogen-mediated inhibition.  During menopause because of decrease in estrogen, not getting bone formation at same rate due to blasts. 

Risk Factors
- Age, genetics, lifestyle factors - low calcium and vitamin D, thin (low body weight 154 lb), menopause, meds (glucocorticoids and steroids)

Hx falls, fainting, or loss of consciousness

Muscle weakness

Dizziness, coordination, or balance problems

Difficulty standing or walking

Arthritis of lower extremities

Neuropathy of lower extremities

Impaired vision

medications

Book includes: cig smoking, familh hx, lifetime decreased calcium intake, white, asian 

History
- Symptoms acute or chronic back pain
- Height, calculate BMI
- Vertebral fracture present: Loss >1.5 inches, kyphosis
Percussion tenderness with vertebral fracture

Patient Teaching
- Age 60-65 discuss fall prevention
- Core strengthening, balance

Indications BMD Testing
- If possible, do baseline at menopause
- Women age > 65
- Postmenopause with condition causing bone loss (Steroid use, hyperparathyroidism)

- Postmenopause, age > 50 with Risk factors: Fracture after menopause, Thinness, Hx of hip fx in a parent, Current smoker, Rheumatoid arthritis, Alcohol of more than 2 units/day

- Postmenopause women with fragility fx

A brief evening with candles and the dark

So this evening the lights went out. Well actually all of electricity went out in Westchester and I suppose all the way to Venice and Los Feliz according to 1070 radio when Adam and I were in the car driving over to his parent's house in attempt to save Donald. Well, actually, just give him a ride to work since they could not get their cars out of the garage (electricity needed). This adventure turned out to be a brief one as we drove down the street the lights came flickering back on which would end our blackout evening.

But to start from the beginning of the lights a'flickering and then put-put-ing out. Seeing the whole block turn dark and our awesome Christmas lights flicker off.

Well of course I was studying. I have been so happy about my blog for school and having access to internet to access my notes, I have never even thought about the idea of no electricity and no connectivity to internet the night before a quiz. Hmm, thankfully I did happen to print paper notes since I seem to be one of those people who double-does everything causing extra work to oneself. I mean you guys know me and this comes as no surprise.

So now in looking back it seems that is was just brief moments that the blackout lasted, maybe no more than an hour. We scrambled around the house searching for our flashlights and candles. Adam not a fan of candles and thinks of them slightly as a waste of money, realized.... We need candles. Luckily, we had some from our housewarming this summer and they are specifically designed to keep mosquitoes and bugs away from you and your food- thus the reason for the purchase.

So instead of our house filling with the smell of holiday Christmas candles, warm baked cookies and wintery wonderland, we had the nice fresh zesty citrus smell instead. It actually did not have a bad aroma, just one you would find more at a campsite rather than in a home. I was super bummed because I actually just purchased a holiday green candle that smelled like pine trees and such and to my dismay I could not find it. I was really looking forward to lighting that sucker tonight too!

Either way it is lovely to say we had our first blackout. We sat around to large candles and ate our dinner. Thankfully Adam picked up chicken from costco and he started the rice much earlier so we didn't starve. (More importantly for him his rice was done). It was great and quite fun. Adam is actually looking forward to the next time we get to sit around the house in candlelight. Not that we want a natural disaster or anything like that but it was nice to just be together in our home. Plus now we know we need to get our bleep together for an emergency disaster. :0

But I do thank my lucky stars everyday for the life I have been blessed with. I am so fortunate to spend my days with loved ones and celebrations. From Thanksgiving to Adam & Kenichii's promotional ceremony today and the blackout to help remind us to be thankful for all those things we take for granted, electricity, heat, health. I complain about the gloomy weather and the chills outside since I have horrible peripheral circulation, but tonight I just sit and reflect and smile. I will take a non-disastrous blackout night that only lasts about 1 hour without any serious complications or consequences anynight, except for the nights I am working at the hospital. Well, maybe... I will just take this one specific blackout night.

Lucky :)

I never really have shown these pictures to anyone since I have had them... But it is me catching the bouquet at the first wedding Adam took me too almost 2.5 years ago now (the summer before nursing school began!)... How time flies!

I wrote this on 4/1/2010

I feel really lucky. I get the chance to wake up in glorious sunny California each morning. Sometimes well honestly, I find myself getting caught up in my own vanity. I see flaws, here and there but most specifically within myself. But then I am surrounded by so much love, love from the boyfriend, the family, my brother Jeffrey, love from friends close and far. It is such a blessing. A real blessing to be able to come home to somewhere warm, somewhere I can call home and be able to afford monthly within Los Angeles. (haha)

Today I biked down to the beach and it was remarkable. Simply beautiful. It was a tad windy but the sun was at full rise, a few girls including myself were able to even catch a bit of a tan. It was so lovely and sometimes I wonder how I can ever get caught up in such worrisome things about my own vanity, imperfections, things I look to improve without improvement being needed or necessary. I think sometimes we all get caught up in the little things and sometimes fail to see the beautiful wider picture of how lucky we all are.

As a student nurse, I would find myself in such sad situations. Families dealing with the inevitable death of their 18 yr. old daughter who is dying a death merely from the complications of morbid obesity. How lucky I was to be able to have a family that cared and could support my dreams whether it be playing basketball or doing theatre. How lucky.

With this said I hope everyone can make time in their busy schedules to just stop and enjoy the sun. Enjoy life and appreciate all we have. I go to work and get to see the miracle of a new child introduced into families. I get to see the miracles of families connecting when in all other situations might fight. I get to be there, I get to become part of that family during some of the most important memories those families will forever remember. I use to worry I wasn't using enough of my nursing skills and what kind of nurse was I being in postpartum... Some deem postpartum as one the easiest of the fields in nursing. A year in and not far from beginning labor and delivery, I again look back and wonder how I could doubt myself, my skills and skillset. But again, I am lucky. I love my job. I love being a nurse. I am lucky I can recognize that I appreciate having a job, an income and something I can honestly say I enjoy. I love connecting with people, families, grandparents, friends, co-workers and appreciating how fortunate my life is. I get to give hope and inspiration to families who might have thought the pregnancy otherwise. It is really cool.

We all do things in life that inspire us and keep pushing us along to look for the good out there and more importantly help us to appreciate how lucky we are. Maybe not everyone is in their dream job. But these days living in California, esp. SoCal and having a job is something to feel lucky about.

Well, if you actually read this whole thing well I am impressed and thank you for being a friend of mine. No matter how infrequently we might speak, I can assure I am thinking of you! I really appreciate that I finally have girlfriends! True, genuine, lovely, amazing, smart and talented girlfriends from basketball, UCLA, nursing school, lifeguards, Adam's friends girlfriends ;) and co-workers. It is something I think of often and these wonderful women always make me smile and feel like I am in a warm, fuzzy hug when I think of them. So thank you wonderful ladies and if we are speaking more frequently well we should be! I love much how much happiness you have brought me and I hope you know I really appreciate your friendship and miss you!

LCM

So I have started at Little Company of Mary in Torrance and loving it! So far things that not been too busy or bad and they are treating us new grads well and have a 0 tolerance bullying/eating the young policy... Whoot Whoot!

Well I don't have any good pictures to post, but just wanted to say things are going great!

With love,
Laura

So Shia LaBeouf is Directing

Caption of picture above: This is me holding Adam's board (it's black and to the left) and my matches my coat, jacket and gloves (the nice cream colored one to the right)!!

WELCOME TO LAURA'S BLOG!!!

Alright ladies!

So I should be reading my lump sum of articles or doing something more productive like reading for NRP class... But I am blogging to you. I doubt I will write often, but who knows. I don't see you guys everyday... So this way I can just post things for fun without making it known to the world on facebook :)

Let's Talk Celebrities!
I am not a stalker but definitely someone who loves their celebrity gossip. So I didn't get a chance to watch Oscar's on Sunday night.. But it did come to mind- Where was Shia? Even though I didn't watch the show, I certainly didn't notice or see any red carpet pictures out there of him post- ceremony... Thus the ponderous question, Where'd he go?

Well of course due to my profound researching skills I am gaining from N505A and N501... Now I know.

Shia made his Directorial Debut (this past weekend) for a music video & thus could be an explanation for the no show to the Oscar's...

(in case you care to watch his debut of directing a music video, actually pretty artsy):
http://www.youtube.com/watch?v=lPIhfB-1TUc&eurl=http://www.celebuzz.com/shia-labeouf-five-things-you-s86471/&feature=player_embedded

Also, Christian Bale went crazy during on production of the new Terminator movie. Haha, that clip of him which I am sure you have all heard, he is seriously out of control... But this clip is Family Guy's Peter Griffin versus Christian Bale in conversation, super funny!... (beware lots and lots of curse words from Christian Bale!)
If you just listen to the clip without watching the video, I think it is more funny:
http://www.youtube.com/watch?v=AUibBHeTnE4

So What's In New Your Life Laura?
Otherwise, nothing else is new with me. Snow season seems like it is ending... And I was finally starting to do rails... HAAHAHA, actually i'm not doing rails. But I was starting to improve.

This is what the snow looked like:


Oh and my birthday, we did go to Disneyland for the evening:
This picture is PRICELESS!!! I love my bebe Adam :)

Ohhhhh and for those who care, I have started to run again. Gosh, i truly think it is more entertaining for me to discuss celebrity lives than my own... Sad...

Umm, I start next week at Little Company of Mary and just bought scrubs :)
I can hardly wait to start!

Thinking of everyone often!

xoxo,
laura