- OrthopedicsGeneral Page Tier 3BlogOsteoporosis is a disease that happens when your body loses too much bone, makes too little bone or both. This leads to weaker bones that can break more easily. In honor of World Osteoporosis Day, Mandy Fawcett, a physician assistant in Luminis Health Orthopedics’ Osteoporosis Program, sat down for a Q&A to discuss her work treating patients with osteoporosis and why it’s so important to take good care of your bones. Mandy, you work with Orthopedic Surgeon Dr. Christina Morganti at Luminis Health Orthopedics in the Osteoporosis Program. What got you interested in the field? I was originally a finance major and, when I graduated, worked at Legg Mason in Baltimore. But I quickly became bored and decided I wanted to change careers. What better way to do that than to become a health professional? So I went back to school and became a physician assistant. I was hired to help Dr. Morganti with the Osteoporosis Program at Luminis Health Orthopedics as a new graduate, and got on-the-job training in osteoporosis. I have learned so much since I started here. Treating patients with osteoporosis is especially gratifying because osteoporosis is a disease that affects so many people. Fifty percent of women and 25 percent of men over the age of 50 will experience an osteoporotic fracture. Unfortunately, the reality is that 80 percent of people who need treatment for osteoporosis do not receive it. READ MORE: True Story: What I wish I had known about my bones when I was younger What are some of the issues you see osteoporosis patients worry about the most? The biggest obstacle that we have to overcome is that many patients are very afraid of the side effects of the medications we prescribe. I find that there is a lot of misinformation in the general public about these adverse reactions. In fact, the chance of having one of these side effects is extremely rare. Some studies estimate it’s one in 100,000. However, the chance of having an osteoporotic fracture can be really high. What are some of the more interesting new things in osteoporosis treatment or nutrition? Dr. Morganti and I firmly believe that everyone should maximize non-pharmaceutical treatment for their bones. For example, all postmenopausal females should consume a total of 1200 milligrams of calcium, preferably from food sources. Many people also benefit from vitamin D supplements. We usually start with about 1,000 international units (IU) daily, and adjust the dose of vitamin D based on blood work. There is new medication on the market as well. Recently, a new bone-building drug came to market that may be a cheaper and promising alternative to the other two bone-building drugs now available. Dr. Morganti and I are monitoring it now that is on the market and will make a decision as to whether we think it is a good option for our patients. What type of exercise should patients do? Exercise is important. Everyone should do an enjoyable, lower-intensity exercise like walking at least 30 minutes daily, perform weight-bearing exercise two to three days per week, and balance train one to two days per week. Learning the proper technique to do exercise is extremely important in order to avoid injury. In general, you should avoid exercise that involves forward flexion of the spine, like when you do crunches, or too much rotation. Osteoporosis patients should only attempt higher-impact exercises like jumping with great caution, and only if good, strong muscle has been developed to protect the bones. Patients should be careful with contact sports or sports where you can slip, like skating, since falls can lead to fractures. What are some of the worst things you can do for your bones? Smoking cigarettes is very bad for your bones. Studies have also shown that drinking more than three units of alcohol a day or drinking excess caffeine can be harmful as well. Authors Mandy Fawcett is a physician assistant with the Osteoporosis Program at AAMC Orthopedics. She can be reached at 410-268-8862. Christina Morganti, MD, is an orthopedic surgeon and medical director of the Osteoporosis Program at Luminis Health Orthopedics. She can be reached at 410-268-8862. Originally published May 23, 2019. Last updated Oct. 19, 2020.0
- Community, News & Press Releases, UncategorizedGeneral Page Tier 3BlogRecently, AAMC pharmacists Adrienne Belton and Lucretia Jones used their professional expertise to help a patient on the oncology unit understand how and when to take her medications. They talked with her at length, providing guidance on when to take them, how often, which medications should be taken with food, and possible side effects to look out for. Then they went a step further and assisted the patient in obtaining her medications at the lowest available cost so she could afford them. The patient left the hospital feeling confident in her ability to follow her new medication regimen. These pharmacists embody an emerging role of the pharmacist in the hospital, directly interacting with patients, families and care teams to provide needed medication reconciliation and medication education. Previously, pharmacists spent the majority of their time in the centrally-located inpatient pharmacy performing tasks including dispensing medication, monitoring drug therapy, preparing IV medication, and sterile product preparation. They consulted with physicians and nurses via phone about patients’ therapy, but they almost never visited the units or talked directly with patients and families. Besides the obvious benefits of having a pharmacist do face-to-face consults with patients, families and providers, other potential benefits include decreasing drug costs, reducing hospital re-admissions and increased patient safety and satisfaction. But workflow inefficiencies weren’t providing pharmacists time to talk with patients. Their responsibilities were too broad, leaving them little time for face-to-face patient interactions. So, a team made up of pharmacy leaders, physicians, a nurse, a performance improvement specialist, and an IT specialist, worked together to redesign the pharmacist’s workflow to prioritize work and allow for greater patient interaction. Some of the improvements they made are: They worked with physicians and nurses to increase awareness of pharmacists as an available resource for medication utilization review, medication reconciliation and patient education. They enhanced Epic, the electronic medical record system, to make it easier to prioritize high-risk patients for medication review and education. They collaborated with the charge nurses to improve communication around patient discharges so that the pharmacists could prioritize educating patients who are ready for discharged about their medications. The goal is to free up a total of six hours per day for up to 30 patients to be seen on the units by pharmacists. This will help to ensure these patients receive the appropriate medications while they are here and understand their medications before they go home. They are also spending more time reviewing drug utilization with physicians, educating them on newly available drugs, risks and interactions. This has helped improve medication safety, lower drug costs and increase physician and patient satisfaction.0
- Orthopedics, Senior Care, Women's Health, UncategorizedGeneral Page Tier 3BlogFor some people, having a heart attack can be life changing, spurring them on to healthier life choices, like regularly exercising, starting a heart-healthy diet and taking medication. A bone fracture is not unlike a heart attack — they are both a sign that something is wrong. In the case of a fracture, it could mean you have osteoporosis or a weaker form of bone loss called osteopenia. Bones shouldn’t break with low-energy falls such as from standing height or less. When they do, your doctor may want to run blood and bone density tests to determine if you have osteoporosis. If diagnosed, you should learn about weight-bearing exercise, fall prevention and nutrition for healthy bones. In addition, you may be a candidate for an osteoporosis medication. There are several medications available to treat osteoporosis: Bisphosphonates make up the largest class of drugs. This includes Fosamax (Alendronate), Actonel (Risendronate), Boniva (Ibandronic acid), and Atelvia, which are pill form, and Zometa and Reclast (Zoledronic acid), which are once-yearly injections. These drugs have been studied in large clinical trials for up to 10 years, and complications are rare. We typically recommend patients cycle on and off bisphosphonates in three- to five-year cycles. You can take a “drug holiday” with careful follow up and strict attention to weight-bearing exercise and good calcium and vitamin D intake. Prolia (Denosumab) is a newer treatment option administered through a shot every six months. It is very effective in protecting bone mass and is well tolerated by patients. There is a slight risk for patients who are prone to infection or who are on immunosuppressive therapy, since it is an antibody therapy. It acts on the same cells as bisphosphonates, so it could have similar risks. Hormone replacement therapy for women after menopause may help protect bones. Evista (Raloxifene), a pill taken daily, affects the estrogen receptors on breast and bone tissue and helps protect against both breast cancer and osteoporosis. Forteo (Teriparatide) is the only medicine currently available that builds bone. It is an injection self-administered daily. It is limited to two years of use. Once the two years of therapy are complete, you switch to one of the other medicines to maintain the gains you made with Forteo. Most of the medications reduce the risk of having a new fracture by about 50 percent. If you’ve had a fracture from a low-energy injury and you have osteopenia, you’re also a candidate for one of these medications. Osteoporosis is one of the most undertreated diseases of modern times, despite the abundance of good treatments. Fractures from osteoporosis lessen your quality of life with each new fracture. We must treat fractures as a life-altering event triggering treatment of osteoporosis, just like a heart attack triggers treatment of cardiac disease. Author Christina Morganti, MD, is an orthopedic surgeon at Anne Arundel Medical Center. She has opened a dedicated osteoporosis program at her practice, AAMC Orthopedics. To reach her office, call 410-268-8862. Originally published Sept. 25, 2015. Last updated Aug. 26, 2025.0
- Orthopedics, Women's Health, Pediatrics, UncategorizedGeneral Page Tier 3BlogOsteoporosis: It’s a disease that manifests later in life, but the foundation of healthy bones begins at a young age. Characterized by weak bones, osteoporosis can cause fractures and chronic pain. Here’s how it works: Your body is constantly breaking down and rebuilding your bones. For the first 25 to 30 years of your life, your body makes more than enough new bone to replace the bone it loses. Around this time, you reach what’s called “peak bone mass,” meaning your bones are at their strongest. But after age 30, the pendulum swings the other way and you start to lose more bone than you gain. This process continues for the rest of your life. For women, the most rapid bone loss is in the years around menopause. For those who haven’t built up their bones enough during those first 30 formative years, that’s when osteoporosis can set in. Known as the silent disease, osteoporosis can strike without warning. In fact, many people don’t know they have it until after they suffer a fracture. And while there’s no cure for the disease once you get it, there’s plenty you can do to prevent it in both yourself and your kids. A Parent’s Role to Prevent Osteoporosis in Kids As a parent, you can greatly reduce your child’s chance of developing this disease later in life. Christina Morganti, MD, orthopedic surgeon at Anne Arundel Medical Center (AAMC), says, “The fact of the matter is, the exercise and dietary habits you instill in your children can either be a powerful mechanism to prevent osteoporosis or a perfect storm for the disease to develop.” There’s no surefire way to determine whether or not you or your children will develop osteoporosis later in life. The best solution? Do everything you can to prevent the disease early in life. If you’re a parent, make sure you’re helping your kids build strong, healthy bones. Your guide to building strong, healthy bones Luckily, preventing the disease isn’t complicated. But it does require some self-discipline and, depending on your current habits, shifts in your diet and exercise routine. Here’s what you can do for yourself and your children to help fend off the disease: Know your family history. “If you have a parent or sibling with osteoporosis, you’re at a higher risk of developing it yourself,” says Dr. Morganti. Knowing empowers you to take extra measures to ensure you’re keeping your bones as strong as possible. Exercise! The more you use your muscles, the stronger they become. Same goes for your bones. Weight-bearing exercises help improve your bone density to form stronger bones. This includes any exercise that uses resistance to make you exert effort. Resistance can come from dumbbells, your own body, fitness machines, etc. The result? New bone tissue forms as your muscles push and pull on the bones around them, strengthening both bone and muscle.Your action plan: Mix it up! Variety keeps exercise exciting and ensures you’re using a variety of muscles. Try a stair workout, hiking, running, walking, weight training or dancing to reduce your risk of osteoporosis. “While swimming and biking are great low-impact exercises, they don’t have the same effect on your bones as weight-bearing exercises do,” says Dr. Morganti. “Children should be active for at least 60 minutes a day. For adults, the recommendation is at least 30 minutes a day of aerobic exercise like walking, supplemented with strength training two to three days a week and balance training one to two days per week.” Know what to avoid. While there’s plenty you can do to keep osteoporosis at bay, don’t forget about what not to do if you want strong, healthy bones. “Some studies have linked salt, caffeine, carbonated soda and alcohol consumption with accelerated bone loss,” says Dr. Morganti. “If your children have a diet heavy in salty, processed food or drink caffeinated or carbonated drinks, this could affect their bone density.” And add this to your list of reasons not to smoke: Multiple studies reveal that smoking can actually limit your body’s ability to absorb calcium. Calcium, calcium, calcium. We’ve heard it all before. Drink your daily glass of milk to nourish your body with adequate calcium. But did you know there are plenty of non-dairy sources of calcium? Or that your body needs a certain amount of vitamin D in order to absorb the calcium you consume? “To make the most of the calcium you eat, pair calcium-rich foods with foods high in vitamin D, like tuna, shrimp and eggs (yolk included),” explains Ann Caldwell, nutritionist and registered dietitian at AAMC. Sunlight can also help the body produce more vitamin D, which is why it’s not uncommon for people to be vitamin D deficient in the winter. If you have a desk job, try taking a walk or eating your lunch outside to soak up some rays. Just don’t forget the SPF. No Dairy, No Problem Besides the beloved trio of milk, cheese and yogurt, there are plenty of non-dairy sources of calcium out there, including: Canned salmon. Half a can contains 23 percent of your daily value of calcium. It’s important to note that other forms of salmon won’t reap the same calcium-rich benefits as canned salmon. Figs. Pick up a bag of dried figs for a sweet, fibrous snack to keep bones strong. Cut them up into small pieces and mix with nuts and other dried fruits for a homemade trail mix your children will love. Kale, spinach, bok choy and turnip greens. There’s a reason why leafy greens are one of the healthiest foods you can eat. But there’s no need to limit yourself to the same green salad. Sauté greens with some sea salt and olive oil, or add them to a stir-fry. If you’ve passed the 30-year mark of your body making plenty of new bone tissue, taking preventative measures against osteoporosis can still be effective, and are vital to maintaining healthy bones. But the reality is that calcium and weight-bearing exercises will have a more dramatic effect on the strength of children’s bones than those of older adults. “The lesson here is to make sure you’re helping your children develop habits that create strong bones to last a lifetime,” explains Dr. Morganti. Recipe: Salmon Pasta Salad This pasta salad includes a healthy dose of calcium from the canned salmon. Plus, it’s easy to pack up the leftovers for a healthy work-day lunch the next day. Dietitian’s tip: For added calcium and health benefits, serve this on a bed of baby spinach. It’s delicious! INGREDIENTS (8-oz.) package of farfalle or bow tie pasta heads broccoli, chopped into florets carrots, peeled and chopped teaspoons soy sauce tablespoons olive oil tablespoons red wine vinegar cloves of garlic, crushed/pressed ¼ cup fresh lemon juice Salt and pepper to taste 10-oz. canned salmon, rinsed, drained and broken into small pieces INSTRUCTIONS Bring a large pot of water to boil. Add pasta and cook until al dente, 8-10 minutes. Bring a separate large pot of water to boil. Add broccoli and carrots, cook in boiling water for 2 minutes and drain. Combine soy sauce, olive oil, vinegar, garlic and lemon juice in a sealable container and shake vigorously. Add salt and pepper to taste. Toss together the drained pasta, vegetables, salmon and dressing in a large bowl. Store in the refrigerator. Want to eat healthier but not sure what to cook? Try more of these healthy, delicious recipes from our registered dietitians. Contributor Christina Morganti, MD, is an orthopedic surgeon at Anne Arundel Medical Center and has developed a dedicated osteoporosis program at her practice, Luminis Health Orthopedics, 410-268-8862. Contributor Recipe author Ann Caldwell is a registered dietitian and nutritionist. Originally published November 29, 2016. Last updated July 5, 2023.0
- NutritionGeneral Page Tier 3BlogAs technology advances, we continue to search for ways to make life just a little easier. Over the past century, food has been at the center of this mission. While we have gained time and energy as a result of processed foods, we have also gained many health issues such as obesity, diabetes and heart disease. The word “processed” often causes some confusion. Most foods we eat are processed in some way. Apples are cut from trees, ground beef has been ground in a machine and butter is cream separated from milk and churned. However, there is a difference between mechanical processing and chemical processing. If the food contains a single ingredient, with no added chemicals, it is still real food. On the other hand, food that have been chemically processed and made solely from refined ingredients and artificial substances are processed foods. Processed foods are addictive and designed to make you overeat. Studies show that the “reward system” in our brain can sometimes allow us to consume more of our favorite foods than our bodies need. Sugar, salt and fat are the ingredients that make these products highly rewarding, tempting us to go back for more. Below are the four food groups to avoid as much as possible: Deli meat, bacon, hot dogs and sausages. Processed meats have been linked to an increased risk of cancer. Sodas and sweetened beverages. Sugary drinks contain more added sugar than you should consume in a day. Sodas are linked to an increased risk of heart, kidney and liver disease, stroke, diabetes, pancreatic cancer and osteoporosis. Quick meals. Jarred, canned, frozen and microwavable meals often contain too much sugar, sodium and preservatives. They also typically contain too little vegetables and too many refined carbohydrates. Commercially baked goods. Besides sugar and saturated fat content, packaged cookies, cakes and desserts often contain trans fats. So, let’s consider the benefits of shopping at farmers markets to minimize reliance on the grocery store and processed foods. You can taste real flavors. Fruits and vegetables ripen fully in the field and then brought directly to you. No long-distance shipping. No sitting for weeks in storage. No preservatives. They are simply fresh from the farm. You can enjoy seasonal food. Farmers markets allow for variety and perhaps a chance to try new fruits or vegetables including some “ugly produce” that may not look as nice as the produce we are accustomed to, but taste just as good. You can also find produce often not available in the grocery store, such as red carrots, a rainbow of heirloom tomatoes, purple cauliflower and much more. You can learn cooking tips, recipes and meal ideas. Farmers are often passionate cooks with plenty of free advice about how to cook the foods they are selling. READ MORE: 6 reasons to shop at a farmers market Enrich your healthy food options and explore local farmers markets by visiting www.aaedc.org. Authors Ann Caldwell and Maureen Shackelford are nutritionists and registered dietitians at Anne Arundel Medical Center. To reach them, call 443-481-5555.0
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