Nurse’s bleak words concern woman

Dear Dr. Roach: I am a 73-year-old woman. I recently fell in my house doing housework and surprisingly broke my left hip. Before the fracture I was in excellent health and extremely active. I walked daily, went to the gym and did both 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 to maintain it. 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.

Answer: 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 their 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.

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 the average. This puts you at higher risk for a hip fracture. The second is that you have a history of an overactive thyroid.

At your age, you should have already had an evaluation of your bone density. That number, combined with your clinical risk factors, will give an estimate of your risk for fracture. All women over 65 and postmenopausal women under 65 who have additional risk factors like yours should be screened with a dual-energy X-ray absorptiometry (DEXA) scan. 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.