Nurse’s doom and gloom spring from kernel of truth about fracture risk

DEAR DR. ROACH »

I am a 73-year-old woman. I recently fell in my house broke my left hip. Before the fracture

I was active and in excellent health. I walked daily, went to the gym and did weight resistance and aerobic workouts. I am on no other medications other than a thyroid pill that I take daily, because my thyroid was burned out many years ago due to being overactive. I am 5 feet, 3 inches tall, weigh 115 pounds and eat healthy foods. Before surgery, the surgeon’s nurse told me, “You will die sooner now, probably 30% sooner because you broke your hip and you will never be the same.” The doctor decided to pin it rather than give me an artificial hip because he said my bones looked well enough to hold the pins. I resumed as much physical activity as I could in a short period of time. Am I really destined to have a shortened life now?

— S.P.

DEAR READER » First off, what the nurse said may be true, on average, for a large group of people, but is NOT necessarily true for an individual. Second, what a horrible thing to say! Many patients, usually women but some men, do very well after hip surgery. The fact that you were so active and healthy before the fall is a very good sign for your recovery and long-term prognosis, as is the fact that you have been able to recover activity quickly after surgery. Only time will tell how much function you will recover, but it could be nearly complete.

You have at least two possible risk factors for a hip fracture. The first is that you are quite thin, with a body mass index of just 20.4, which is well below average. This puts you at higher risk for a hip fracture, especially if you are white or Asian. The second is your history of an overactive thyroid.

At your age, you should have an evaluation of your bone density. That number, combined with your clinical risk factors, will give an estimate of your risk for fracture. Women and men at high risk for fracture should be treated with calcium and vitamin D, if necessary, and recommended medication treatment if lifestyle measures proved inadequate at lowering your risk.