by Dr. C.V Ramana

What is osteoporosis?
It is the “weakening” or “softening” of bones.
Bone consists of a framework or matrix of collagen and other soft tissue elements. It is then “hardened” by deposition of calcium mineral into the matrix. We think of bone as being a “static” component of the body, but this is not true. Bone is constantly formed and broken down throughout our life as the result of a complex interplay of dueling hormones, health, diet, and activity. In childhood and young adulthood, bone growth is faster than breakdown. People generally reach peak bone mass in their late 20’s. After that, bone breakdown tends to be faster than new bone formation. When calcium is taken out of mature (or fully formed) bone and not replaced, the frame left behind is soft or weak, and easily susceptible to fracture.
Why is calcium needed in the body?
Calcium is an important mineral in the body – it is vital to the formation and strengthening of our bones, but also plays an important role in the function of muscles and nerves as well as innumerable biochemical reactions in the body. Calcium is transported throughout the body dissolved in blood, and so, available to all of our organs and tissues in carrying out their functions. The amount of calcium in the blood is tightly regulated by hormones released into the bloodstream from the thyroid and parathyroid glands (located below the Adam’s Apple), pituitary gland (in the brain), as well as the adrenal glands and kidneys.
Our bones serve as a massive reservoir of calcium that can be tapped when calcium levels in the blood are low due to inadequate dietary intake, inadequate levels of vitamin D in our bodies, or the wrong form of vitamin D due to inadequate exposure to sunlight, or as a result of some medications.
How to know if you have osteoporosis?
Unfortunately, this is a “silent disease” and does not become symptomatic until a bone is fractured, or the back becomes kyphotic (stooped) due to slow collapse of multiple vertebra in the upper spine.
How to find out if you have osteoporosis?
Sometimes the diagnosis may be suggested based on the appearance of bones on x-rays or CT scans that you may have for other reasons. The most reliable way, though, is through a test called DEXA which measures Bone Mineral Density (BMD) in various bones in the body.
Blood tests to determine the level of Calcium, Vitamin D, calcitonin and parathyroid hormone can also be helpful, especially in planning treatment.
Risk factors for developing osteoporosis
Factors that can be modified
* Lifestyle – inactive lifestyle or extended bedrest
* Smoking
* Alcohol consumption
* Inadequate dietary intake
* Sex hormones – abnormal absence of menstrual periods or menopause with low estrogen in women, and low testosterone in men
* Medications – long term use of steroids, some seizure medications
Factors that cannot be modified
* Sex – women are more prone to develop this than men
* Age – bone mass decreases in everyone after the late 20’s
* Body size – small boned women are more likely to develop osteoporosis]
Ethnicity – Caucasian and Asian women have a higher likelihood, though African American and Hispanic women are also at high risk.
* Heredity – people whose parents have osteoporosis have an increased likelihood
How can it be treated?
* Smoking cessation
* Decrease alcohol consumption
* Lifestyle modification – weight bearing exercises such as walking, jogging, hiking, climbing stairs, playing tennis and dancing are all good. Resistance exercises such as weight lifting or weight training machines are good
* Increase dietary intake of calcium and vitamin D
* Recommended levels – calcium – more than 1000 mg/day after the age of 30, and 1200 mg/day for women after the age of 50. Vitamin D – more than 600 IU/day for adults up to age 70, and 800 IU/day for men and women beyond the age of 70.
Medications
* Supplemental calcium and Vitamin D
* Prescription medications that work in a variety of ways to interfere with the rates of bone formation and breakdown balance
* Bisphosphonates (which bind to calcium for deposition in bone)
* Estrogen and estrogen analogues
* Estrogen receptor modifiers
* Calcitonin – hormone
* Parathyroid hormone blocker
Who can treat Osteoporosis?
A primary healthcare provider should be contacted for diagnosis and development of a treatment plan. In some cases, they may refer to a specialist for the treatment. Specialists can include endocrinologists, rheumatologists, and women’s health specialists such as an Ob/Gyn.
Dr. C.V Ramana is a vascular and interventional radiologist with more than 20 years of practice experience. He has expertise in all areas of vascular and interventional radiology. Dr. Ramana has a Ph. D from Yale University and MD from CWRU in Cleveland, Ohio where he subsequently completed his fellowship in Vascular and Interventional Radiology at the Cleveland Clinic. https://naadihealthcare.com/

1 NW 64th Street 73116 Oklahoma City, OK Phone: (405) 608-8884

Oklahoma City Zoo is exclusive stop in OKC for the Adult Swim series’ “Don’t Even Trip Road Trip” tour

You won’t need a Mr. Meeseeks to make the perfect Date Night a reality. After a successful introduction in June, the Oklahoma City Zoo and Botanical Garden is pleased to announce the return of Date Night on Monday, October 14, from 6 p.m. to 10 p.m. Doors open at 5:30 p.m.
The Zoo will be open exclusively for adults 21-and-older to explore, enjoying the beautiful Oklahoma fall with a multitude of activity options, including a special appearance by the Rickmobile, making its only Oklahoma City stop on the nationwide “Don’t Even Trip Road Trip” tour. The Rickmobile is like the Oscar Meyer Weinermobile, but instead of a hotdog, the vehicle is shaped like Rick and Morty’s mad scientist, Dr. Rick Sanchez. It opens to reveal a mobile merchandise shop, with t-shirts, figurines, toys and more from Rick and Morty and other classic Adult Swim series. The Rickmobile mobile shop accepts only credit/debit cards for purchases, no cash or checks.
“Rick and Morty is an absurdly awesome animated series and we’re thrilled to host the Rickmobile’s only stop in Oklahoma City,” said Greg Heanue, OKC Zoo chief marketing officer. “The Zoo’s successful Date Night event series connects adults with wildlife in bold new ways, so hosting the wildly popular series’ tour at this event makes complete sense.”
In addition to Rick and Morty team trivia, Date Night attendees can explore the Zoo, attend a sea lion presentation, sing along with karaoke, play outdoor games, ride the endangered species carousel and enjoy drinks at multiple locations throughout the park. Special menus will be featured at Zoo eateries.
Date Night tickets are now available at okczoo.org/datenights for $25. Each ticket includes one free drink. Food is not included. No one under 21 years old will be admitted. Official federal, state or tribal identification showing both date of birth and a photo is required for entry. Attendees are welcome to dress as their favorite characters from the series, but no face masks or weapons (real or fake) will be allowed.
Rick and Morty is an animated series from Dan Harmon (Community) and Justin Roiland that follows a scientist and his grandson through a multiverse of adventure, calamity and comedy. Its upcoming fourth season premieres on Adult Swim in November.
Wubalubadubdub… don’t miss Date Night fun featuring the Rickmobile at the OKC Zoo! The Zoo is a proud member of the Association of Zoos and Aquariums, the American Alliance of Museums, Oklahoma City’s Adventure District and an Adventure Road partner. Hours of operation are 9 a.m. to 5 p.m. daily. Regular admission is $11 for adults and $8 for children ages 3-11 and seniors ages 65 and over. Children two and under are admitted free. Stay up-to-date with the Zoo on Facebook, Twitter, Instagram and YouTube or by visiting the Zoo’s Blog. To learn more about these and other happenings, call (405) 424-3344 or visit okczoo.org.

My favorites are the foliage colors and of course the temperature and the weather.

Rosa Knight

I can work in my garden again and there’s no mosquitoes.

Melanie Wright

The coolness and the Oklahoma State Fair.

June Cavendish

OU football and tailgating.

Vicki Bailey

The Administration for Community Living (ACL) recently awarded a three-year grant to the Oklahoma Healthy Aging Initiative, part of the Donald W. Reynolds Department of Geriatric Medicine. ACL is part of the United States Department of Health and Human Services.
The grant will help fund implementation of a statewide program for falls prevention.
Lee Jennings, M.D., geriatric medicine specialist, will coordinate the program, which integrates complimentary components: Tai Chi Quan: Moving for Better Balance (TCQ: MBB), and Stay Active and Independent for Life (SAIL) in an effort to decrease the likelihood of falls and improve mobility among older Oklahomans and those with disabilities.
“In addition, OHAI will train volunteer class leaders to enhance program sustainability. Our objective is to build sustainable partnerships with organizations, such as hospital systems, long-term care facilities and insurance providers,” Jennings said. She is also principle investigator on a study related to the grant-funded program.
National Falls Prevention Awareness Day, Monday, Sept. 23, is about preventing fall-related injuries. Among older adults, falls are the leading cause of fatal and non-fatal injuries, posing a threat to life and quality of life.
In connection with the national emphasis, OHAI will host a Facebook live event from 9 a.m. until 2 p.m.
The event will include healthcare professionals in a discussion of the adverse impact of falls, how to prevent them as well as practical tips for creating a more secure environment. The event will also feature video demonstrations of TCQ and SAIL classes.
Keith Kleszynski, Ph.D., associate director of OHAI, explained that the SAIL program is new to OHAI and relatively new to Oklahoma. “We selected this program for its emphasis on physical activity and its appeal to those inclined toward more rigorous exercise,” he said. “It represents a strategic move to reach more male participants.”
Currently, 79 percent of OHAI tai chi participants are female; however, the risks associated with falls and injuries are not limited by gender.
SAIL was developed to improve strength, balance and fitness – all critical components in one’s ability to remain physically active and reduce the risk of falls. It can be done seated or standing. Tai chi incorporates slow and controlled movements that also increase balance and flexibility.

by Susan Price – www.NursingHomeAbuseCenter.org

Individuals who have limited mobility or who are confined to a bed or wheelchair are at a high risk of developing bedsores. What starts as inflammation can quickly turn into a painful wound that is difficult to treat. What’s more, once bedsores are established, the patient is at risk for infection, sepsis, gangrene, and amputation. These complications can be fatal.
Bedsores most commonly develop on bony prominences, or parts of the body that come into the most contact with a bed, chair, or other surface. Common places bedsores develop include the heels, elbows, tailbone, and shoulder blades.
Fortunately, bedsores are preventable. Caregivers who follow the standards of care for repositioning, skin care, diet, and exercise can help prevent bedsores among patients.
Exercise to Prevent Bedsores
Exercise is a great way to help prevent bedsores. Exercise increases blood flow throughout the body, including to the skin. This helps prevent bedsores by keeping skin and underlying tissue healthy and well oxygenated. Exercises don’t have to be strenuous in order to be effective. Here are some examples of the type of exercises that can help prevent bedsores. · Ankle Stretches – Ankle stretches are a great way to improve circulation and range of motion. Caregivers assist with ankle stretches by holding the heel and ankle, and slowing bending and moving the foot around. · Arm Lifts – Arm lifts can be done with assistance, or solo. Raise the arm as high as possible (and comfortable), and hold it for ten seconds. Arm lifts can be easily customized depending on the patient’s needs. · Leg Lifts – Leg lifts are a great way to improve circulation and encourage flexibility and range of motion. These exercises can be done with the patient on their back or side, depending on what is most suitable. The leg is slowly raised even with the hip, and is held there for 10-20 seconds as is comfortable and appropriate. · Palm Stretches – Palm stretches are a simple way to improve circulation in the lower arm and hand. With this exercise, the patient opens his or her hand as wide as possible extending the fingers. Then, the patient touches each finger to their thumb slowly before extending the finger again.
Doing these exercises a few times each day, or even once a day, can reduce the risk of a patient developing bedsores.
Exercise as Part of a Healthcare Plan
Exercise is most effective at preventing bedsores when it is part of a comprehensive healthcare plan.
Caregivers can also help prevent bedsores by making sure patients have adequate food and hydration, access to medical care, and assistance with hygiene.
Bedsores often develop on parts of the body that are covered with clothing or linens. Caregivers should perform routine skin checks to look for signs of a developing bedsore. Once a developing bedsore is stageable, it is dangerous and needs immediate medical attention.
Of course, you should never start an exercise regimen for yourself, or for someone you are caring for, without talking to a doctor first. Exercise should be performed with the guidance of a doctor who knows about the overall health of the patient.
Sources: www.nursinghomeabusecenter.org/bedsores/
www.accessrehabequip.com.au/blog/post/21-how-to-prevent-bedsores%3A-exercises-for-pressure-care-patients/
https://advancedtissue.com/2015/06/4-effective-exercises-for-bedridden-patients/
https://www.nursinghomeabusecenter.org/stages-of-bedsores/

Each year, across the country, thousands of educators, caregivers, health and aging professionals, and older adults focus their efforts on one goal: preventing falls. That’s why the Oklahoma State Department of Health (OSDH) is partnering with the National Council on Aging (NCOA) and the Falls Free® Coalition to celebrate Falls Prevention Awareness Day, Sept. 23. This year’s activities will focus on the teamwork needed to prevent falls effectively.
Every second of every day in the United States an older adult falls, making falls the number one cause of fatal and nonfatal injury among older Americans. Every week in Oklahoma, approximately 124 adults age 65 and older are hospitalized and 11 die from a fall. Acute care hospital charges alone total more than $250 million a year.
Falls are not a normal part of aging, and an individual has the power to prevent them. The OSDH offers the following tips on simple tips to prevent falls:
Exercise regularly. Exercises that improve strength, balance, and coordination are the most helpful in lowering the risk of fall-related injuries.
*Speak up. Talk to your doctor about fall risks and prevention. *Ask a doctor or pharmacist to review both prescription and over-the-counter medications for side effects and interactions. The way medications work in the body can change with age. Some medications or combinations of medications can contribute to drowsiness or dizziness, which increases the risk of falling. *Have vision screenings at least once a year. The wrong prescription eyeglasses or health conditions, such as glaucoma or cataracts, limit vision and may increase the risk of falling. *Reduce hazards in the home that may lead to fall-related injuries. *Keep floors clean and clear of clutter where people walk.
*Maintain adequate lighting throughout the home, especially near stairways. *Remove throw rugs or use non-skid throw rugs in the home, and use non-slip mats in the bathtub or shower. *Install handrails on stairways and grab bars in bathrooms. *Keep regularly needed items in easy-to-reach places that don’t require the use of a step stool.
The Tai Chi: Moving for Better Balance program has been proven to reduce the risk of falls. Throughout Oklahoma, many individuals have been trained as Tai Chi instructors and teach Tai Chi: Moving for Better Balance classes to older adults. This exercise program focuses on improving functional abilities, such as balance and physical function, to reduce fall-related risks and frequency of falls. Oklahoma seniors are invited to join one of the more than 90 open Tai Chi: Moving for Better Balance classes across the state.
To receive more information on classes and how to prevent falls, contact the OSDH Injury Prevention Service at (405) 271-3430 or visit http://falls.health.ok.gov.

Gov. Kevin Stitt signed a bill on that enhances requirements for health care providers who perform mammograms to notify patients about their test results. The measure is part of Oklahoma’s ongoing efforts to fight breast cancer.
Known as Nancy’s Law, the legislation is named for Nancy Simpson of Edmond, who lost her life to breast cancer in 2018 at the age of 69. The law focuses on dense breast tissue, which can interfere with efforts to detect breast cancer.
“Mammograms are vital tools for detecting breast cancer,” said Sen. Adam Pugh (R), Edmond, who co-authored the bill. “But for some women, they may not tell the whole story. Nancy’s Law will equip those women with the knowledge they need to take charge of their health and, in some cases, save their lives.”
Dense breast tissue affects as many as half of all women and can obscure basic mammography scans, making cancer more difficult to detect. Under existing Oklahoma law, if a patient is found to have dense breast tissue, when she receives her mammography results, the health care facility that performed the mammogram must advise the patient of this fact and provide information on additional testing options.
The new legislation requires those mammography results and notification to be emailed to the patient if she so elects.
“Our wives, mothers, sisters and daughters depend on breast screening to detect cancer,” said the bill’s co-author Rep. Lewis Moore (R), Arcadia. “This new measure will give more Oklahoma women the chance to live their lives cancer-free.”
Simpson worked for 30 years as a laboratory technician at the Oklahoma Medical Research Foundation, searching for effective ways to control fats that play a major role in heart disease and stroke.
Although she underwent yearly mammograms, Simpson’s dense breast tissue hid her cancer until doctors discovered it at stage 4, when it was too advanced to respond to treatment. At the end of her life, she wrote a letter to Pugh and Moore that served as the catalyst for the new legislation.
“Nancy dedicated her career to helping make discoveries to benefit people she would never know,” said OMRF President Stephen Prescott, M.D. “Even in the fight for her own life, she did what she could to ensure that future generations of women could take control of their own breast health and live longer.”
“We are so grateful to Sen. Pugh and his staff for what they’ve done in Nancy’s memory,” said John Simpson. “Nancy was a caring, empathetic person. She would love knowing that Nancy’s Law will save lives.”
“This law is a major step for women’s health in Oklahoma,” said Stitt. “It ensures that all women can take advantage of advances in breast cancer detection and treatment that can spell the difference between life and death.”
Nancy’s Law will take effect Nov. 1.

Women’s Veterans Monument Sets the Standard for Honoring America’s Best

Story and photos by Darl Devault, Feature Writer

With the privilege and opportunity approaching of honoring all military service on upcoming Veterans Day more than 300,000 women have volunteered to serve our country in Iraq and Afghanistan.
The little known Del City monument created as America’s only inclusive bronze monument honoring women veterans patriotically illustrates this pride.
Dedicated in 2014, this Women’s Veterans Monument honoring the two million women who have served and are serving in the armed forces is our nation’s first inclusive-of-all-services tribute.
Sculpted by Luther, Okla. artist Joel Randell, the monument honors women who today make up 16 percent of the enlisted forces, and 18 percent of the officer corp.
In the years since its unveiling, this first-of-its-kind public art has engaged the art community. Oklahoma’s most famous illustrator and fine art painter, Mike Wimmer, sought out the monument as a visitor.
“Joel Randell celebrates the poise, dignity and strength of the women serving in our armed forces,” Wimmer said recently. “Its patriotic expression of figurative realism gives honor to the women who stand up with uncommon valor to serve and protect their nation, community and family. He captured every figurative detail in meticulously representing and honoring the achievements of real women in their chosen branch of military service.”
The polished black granite monument depicts five bronze slightly-larger-than-life uniformed Army, Marines, Navy, Air Force and Coast Guard women.
It also features an Oklahoma Army National Guard uniformed woman speaking with a little girl inquiring when she can serve. The mother and daughter are sitting at a reflecting pool before the mother’s departure to serve her country.
The centerpiece is the servicewomen in intricately-correct dress uniforms and caps. They are facing outward in a circle, holding hands. Planners said this represents the strength and unity between them to form a symbol of strength and purpose around a flagpole with a large American flag.
An all-woman committee of eight veterans guided the artist during the $1.5 million project, spending three years planning the monument.
The women, who had attained all levels of military rank and responsibility, designed the overall look and paid attention to the greatest detail. They made sure their service uniform depictions could pass any critical dress inspection a fellow veteran might make of the bronze statues.
Oklahomans SSgt Laurel “Chip” Chambers, MSgt Barbara L. Curry, Capt. Jennifer Grant, Sp4 Linda Kiselburgh, SMSgt Deborah L. McQuillar, AZCS Carolyn Mischke, SSgt Dorothy Rimbold and Lt. Col. Julie Wende served on the committee.
The monument stands in Patriot Park, the site of several veterans’ memorials and monuments and a Veterans Day ceremony each year opposite the Del City Community Center just off I-35. In 1995 the city built the first monument to honor all of Del City’s war dead since World War II. A Fallen Soldier Battle Cross honors veterans who served in Iraq and Afghanistan. A Blue Star Mothers Memorial joined the Vietnam War artwork and soldier mausoleum in 2011.
This newest monument—to those who take the oath to serve their country, allows Del City citizens and leaders to make a strong statement that women veterans deserve honors. This monument says ladies do their share—from the initial historical commitment to provide support, to the now dangerous duty of combat. The folks from this small city next to Tinker AFB celebrate the patriotism that binds them to the goal, keeping America free.
By depicting a youth conversing with a role model, the monument also conveys the multigenerational relationship between women who have served and now younger generations.
With owner John Free Jr., supervising, The Bronze Horse Foundry in Pawhuska, Okla., cast the monument’s bronze figures.
“These seven patriotic figures in one masterpiece are really something,” Free said after installing the statues. “People really like that the artist researched these subjects so strongly for accuracy, because this bronze art is going to stand here forever.”
One Lawton, Okla. combat veteran saw firsthand how a fellow female soldier made the ultimate sacrifice in combat.
Eleanor McDaniel, 67, a veteran of Operation Desert Storm/Desert Shield as the first Comanche woman to serve in U.S. combat as the highest-decorated Comanche woman recalled Army Spec. Lori Ann Piestewa. Piestewa, a Hopi, died after an ambush in March 2003 in Iraq.
Piestewa was the first Native American woman killed in combat on foreign soil. McDaniel said the monument honors the sacrifices of all military women, whether in combat or during peacetime.
“This monument is well deserved and long overdue,” McDaniel said in 2014. “Other communities should follow the example. Recognition of this magnitude for our women in the military is uncommon, but many extraordinary women have served and deserve that recognition. I am deeply grateful to the people of Del City and all those that made it possible to recognize and honor the service and sacrifice of all the women of the U.S. military.”
Arizona’s government renamed Squaw Peak in the Phoenix Mountains as Piestewa Peak in 2008 and renamed the freeway that passes nearby in her honor.

OGE Energy Corp. will join forces with United Way of Central Oklahoma during its annual fundraising campaign to double new, first-time company contributions.
“United Way agencies provide such valuable services to our communities, and we’re only as strong as the communities we serve,” said Sean Trauschke, chairman, President and CEO of OGE Energy Corp. “We identified this as a way to help support and grow the missions of these agencies where we live and work.”
This opportunity comes at a critical time as United Way of Central Oklahoma begins fundraising efforts for 57 local nonprofits, serving hundreds of thousands of clients each year who need us more than ever. The gift will help Partner Agencies serve more central Oklahomans by providing life-saving services to those in need.
“OGE Energy Corp. is known for giving back in big ways, and we are truly grateful that they thought of United Way – that says a lot about the caring nature of their organization,” said Debby Hampton, United Way of Central Oklahoma president and CEO. “It takes all of us to make this a more compassionate community, and OGE’s support is one of the big puzzle pieces that makes that possible throughout central Oklahoma.”
Donations may be made online at unitedwayokc.org or by giving through your workplace campaign.
About United Way of Central Oklahoma
United Way of Central Oklahoma researches human needs within the communities of central Oklahoma and directs resources to accountable health and human services agencies to meet those needs by improving the health, safety, education and economic well-being of its most vulnerable citizens. For more information about United Way of Central Oklahoma, please visit unitedwayokc.org or call (405) 236-8441.