Saturday, December 30, 2023

Bone health and falls

 I don't think a lot about fractures or bone health--until--a friend falls after stepping on a stone or sidewalk irregularity, or my friend Cindy fractures her thigh after taking the same med I do for osteoporosis, or Karen a woman I met at the gym fractures her foot playing pickleball, or Jim's wife falls over the leaf blower in their garage, or I fall in the shower.

That last fall happened a week ago, Christmas Eve morning.  I fell in the shower.  It wasn't the usual slip on the soap or not having a grab bar.  I had the brilliant idea that in order to protect the paint on the bathroom walls when I use hair spray, I'd spray my hair inside the shower stall where it could be washed off.  So, I was completely dressed, except for shoes--I was wearing light slippers.  My hair (which is thinning) was just the way I wanted it. I picked up the container and stepped inside the shower, which was still damp. It was a little awkward, but I could see the mirror and sprayed my hair.  Then as I stepped out--holding on to the door and the other hand on the opening with 2 fingers while holding the spray--the slipper stuck briefly on the floor of the shower.  That was enough for me to lose my balance and I went down. As I knelt there with my right knee on the slightly raised marble frame and the other pressed against the glass, I had to struggle to get up. My legs are weak but my arms are fairly strong--even so it was a long haul to get upright. A few bruises, but no sprains or fractures.  Whew!

Four other bad falls come to mind.  In the 1990s (I was in my 50s) I was walking briskly down the hall in the old Sisson building of the Veterinary College at Ohio State where I was the librarian. I didn't know that one of the labs on the second floor had a leaking faucet, and water had run under the door and into the hall.  The halls were not well lit, and as I hit that water (in those days I wore high heels to work), my legs flew out and I went splat landing on my back with one leg forward and one back.  It knocked the breath out of me, momentarily paralyzing me. The halls were empty--nothing to use to pull myself up and no one to help--so I just waited to catch my breath and then gradually using the walls for support and grabbing the doorknob to the lab stood up. Nothing broken, but I was so sore I could hardly move.  I recall looking into filing for Worker's Comp, but it was way too complicated, and I never followed through.

Then after I retired and we were spending the summers at our lake house on Lake Erie, I fell down the last four stairs in the basement carrying a laundry basket--probably in 2007.  I seem to remember the date because I wore the bruises to a class reunion. I was alone in the house (the last time I ever went to the basement without someone in the house). Again, nothing broken.  I crawled up the stairs, and into one of the bedrooms to lie down.  I eased off my shoes and my jeans.  I had bruises from knees to toes, and the shoestrings of my athletic shoes had left bruise marks on my feet in a crisscross pattern.

Also at Lakeside was my last bicycle ride when I was 70.  I was leaving a morning meeting at the hotel on Third Street, Fountain Inn, got on my bicycle (a no-speed from 1968), wobbled a bit, and fell--into a stop sign at Third and Maple, about 15 ft from where I got on it! The stop sign made a loud noise as I hit it--Boing, Boing. And people came running from their cottages to help the old lady on the ground. I lived just two blocks so someone (don't remember who) walked me home, wheeling the bike which I never rode again.

But the worst fall of my life wasn't actually my fall, but when my horse fell on me! It was probably 1952 so I was 12 years old, and had owned the horse only a few days. The bit was too tight (I figured out later) and the horse kept backing up, then started to rear, I began to slip off the back, but the horse lost his footing and fell--on top of me.  That REALLY hurt. The horse strolled away, and my mom came running out of the house. Nothing was broken, and I lay around for a few days, and today each time I get a back spasm I blame my horse.

Falls in the elderly statistics by CDC are all over the place and don't make a lot of sense.  Illinois elderly seem to be less likely to fall than Ohioans.  Whites more than minorities, women more than men, but the death rate for men is higher than for women. Of course, the statistics don't reflect the falls that are never reported--like mine--because I didn't get medical help.  Even so, 14,000,000 for people over 65 is nothing to be sneezed at.  The age adjusted fall death rated increased by 41% from 55.3 per 100,000 older adults in 2012 to 78.0 per 100,000 older adults in 2021. I personally attribute that to the fitness craze--people are taking more chances and think they are 40 instead of 80.

Ladders are really dangerous. According to the CDC each year in the U.S., more than 500,000 people are treated and about 300 people die from ladder-related injuries. The estimated annual cost of ladder injuries in the U.S. is $24 billion, including work loss, medical, legal, liability, and pain and suffering expenses.

It’s National Ladder Safety Month | Blogs | CDC

Nonfatal and Fatal Falls Among Adults Aged ≥65 Years — United States, 2020–2021 | MMWR (

Hip Fracture Overview - StatPearls - NCBI Bookshelf (

Falls and Fall Prevention in Older Adults - StatPearls - NCBI Bookshelf (

The risk of falls among the aging population: A systematic review and meta-analysis - PMC (

Lifestyle Approaches to Promote Bone Health - Bone Health and Osteoporosis - NCBI Bookshelf (

Nutritional Supplements and Skeletal Health - PubMed (

Vitamin K as a Powerful Micronutrient in Aging and Age-Related Diseases: Pros and Cons from Clinical Studies - PMC (

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