Suffering a hip fracture can be the most devastating consequence of osteoporosis. When those crucial bones shatter, it can destroy various aspects of life previously taken for granted - including one's mobility, independence and overall health. In the worst case, the injury may trigger a cascade of negative events and even death.
After a hip fracture, the initial stay in the hospital usually lasts less than a week. It is a painful and confusing time, and a number of complications can arise during this critical period. However, there are crucial steps you and your loved ones can take to help put the odds in your favor as you progress toward recovery.
It is likely the first question you and your family will discuss with your physician is surgery. In most cases, surgery to repair or replace the hip is necessary to regain one's previous level of activity. But not all individuals are good candidates for this intense operation, especially those who are older or suffer from other serious illnesses besides osteoporosis. For this reason you should ensure your orthopedic surgeon and other specialists are aware of your complete medical history as well as any medication you are currently taking.
For example, a chief concern for hip fracture patients and their doctors is the possibility of a thrombotic event, or blood clot. These may form as a consequence of the injury itself, surgery afterward, or the period of immobility following. If a clot reaches the heart or lungs, it can be fatal, and physicians often prescribe blood thinner Lovenox to prevent this problem.
However, some drugs commonly prescribed to patients with heart conditions or arterial stents can cause severe bleeding problems, particularly if the surgeon also prescribes Lovenox. Some of these medicines, such as Coumadin, can be stopped prior to surgery and restarted several days afterward, but others, such as Plavix, continue to affect the body for several weeks after cessation.
In this situation, "You must wait to operate," says Dr. Ramdas Bhandari, an orthopedic surgeon with more than 30 years of experience. In addition, he says it is necessary to monitor the patient's platelet count after surgery in case any internal bleeding does occur. "You have to really be on the ball to manage the risks," says Dr. Bhandari.
For these reasons it is vital to keep your treating physicians fully informed, especially if they had been previously unacquainted with your case. In addition, it is vital to get moving as soon as possible after a hip fracture. While it may seem more tempting - and less painful - to recline and watch television, taking that step is crucial. It will not only help you regain your mobility, but help stave off serious complications such as pneumonia.
"By the next morning, they should be sitting in a chair," says Dr. Bhandari of his hip fracture patients. "Otherwise, they're lying in bed and breathing shallow." Dr. Bhandari emphasizes that it is especially important to eat meals in the seated position to prevent aspiration, a chief cause of pneumonia. And if, despite precautions, a patient begins to cough, run a fever, or become disoriented, alert a nurse immediately so that the doctor may order blood tests, X-rays or other appropriate exams.
In general, the healthier one was before the hip fracture, the better the prognosis. But your time in the hospital can provide an important opportunity to address conditions that may worsen with immobility or could even have contributed to a fall that led to the fracture in the first place. If one has uncontrolled high blood pressure or diabetes, for example, consult with your doctor about an appropriate treatment plan. Getting a handle on these issues can aid in your recovery and may prevent another injury.
It may also be appropriate to discuss with your physician whether you need to take further action regarding your low bone mass. A recent study in the New England Journal of Medicine indicated a yearly infusion of zoledronic acid - known as Reclast - beginning within three months of a hip fracture lowered the risk of recurrence. If you were previously taking bisphosphonate medication, your doctor may explore switching to another kind of drug, such as Forteo, a synthetic parathyroid hormone. Whatever regimen you and your doctor settle on, it is essential that you endeavor to comply and report immediately any adverse effects.
Studies have also shown that individuals with proper nourishment do better after a hip fracture than those lacking in crucial nutrients, so do talk with your physician about the type of well-rounded diet that would be best for you. Of particular importance for healthy bones are proper amounts of calcium and Vitamin D - the National Osteoporosis Foundation now recommends 1200 mg calcium and 800-1000 IU Vitamin D daily for adults over 50. In addition, a recent study published in the European Journal of Epidemiology singled out the importance of Vitamin K in terms of preventing a hip fracture, even when intake of other nutrients was considered.
With proper medical care and dedication to recovery, an osteoporosis hip fracture is a challenge that can be surmounted.
Published On: April 01, 2008