News from your Patient LibrarySeptember – October 2018

www.uhnpatienteducation.ca

Osteoporosis: The Silent ThiefAccording to Osteoporosis Canada, 2 million Canadians are affected by osteoporosis. The condition can cause bones to weaken over many years without any signs or symptoms – until a bone breaks. This is why it is referred to as the “silent thief.”

If you have osteoporosis and you have a fall, you can easily break a bone (most commonly the wrists, shoulders and hips). It is important to know what the risk factors are for osteoporosis so that you can talk to your doctor about your bone health.

Risk factorsThere are several well known risk factors for osteoporosis and osteoporotic fractures, such as:

• Age – risk increases after 50 years of age

• Sex – females have a higher risk

• Low body weight

• Low bone mineral density

• Past fragility fracture

• Having a parent who had a hip fracture

• A past history of fall(s)

Some medications and conditions can increase your chance of developing osteoporosis or having a fracture related to osteoporosis. Ask your health care provider if you are at risk due to your medications or health conditions.

Are you at risk? Take the quiz at osteoporosis.ca/risk to find out what your risks are and questions to ask your health care team.

DiagnosisOften people do not find out that they have osteoporosis until they fracture a bone, but there is a screening test that can be done if you are at risk of the disease. To find out if you have osteoporosis, your doctor or nurse practitioner may do a test called bone mineral density (BMD).

At UHN, a BMD test may be done at the TGH Osteoporosis Clinic, in the Orthopedics Department at TWH, at Princess Margaret on the 3rd floor, or at Mount Sinai in the Nuclear Medicine Clinic.

Osteoporosis and cancerSome types of cancer, like multiple myeloma, can cause osteoporosis. Certain cancer treatments may also increase your risk by weakening your bones.

Hormonal therapies: used to treat breast, uterine, ovarian, and prostate cancers, which block or lower the body's production of certain hormones related to keeping bones strong

Treatments that cause early menopause: including chemotherapy, surgery to remove the ovaries, or radiation therapy to the pelvis could lead to early, or treatment-induced menopause

Anticonvulsant medications: these medications may be prescribed to patients with brain tumours to prevent seizures

Corticosteroids: used to help reduce swelling and lower the body's immune response for patients with brain or spinal cord tumours

Keeping Your Bones StrongNutritionCalcium is a mineral the body needs to maintain life. Calcium helps to build strong bones and teeth, and helps to

prevent osteoporosis. If you do not have enough calcium you may also have muscle pain, spasms, tingling or numbness in your hands and feet.

Food Sources of CalciumMost of your calcium should come from the food you eat every day. Most people need 1000 milligrams (mgs) of calcium each day. You can get your daily calcium needs from foods such as:

• yogurt• skim milk• cheese• green leafy vegetables, such as spinach

and kale• fish, such as sardines

You can also get calcium supplements in a pill form. While you are taking calcium, your doctor or nurse practitioner may recommend that you also take vitamin D, because vitamin D helps your body take up calcium by as much as 30 to 80 percent.

When taking a supplement, be sure to follow the dose instructions from your health care provider. Too much calcium can lead to kidney stones, mineral imbalances, and abnormal heartbeat.

Vitamin D helps your body take calcium from the foods you eat.

Most people need 2000 international units (IU) of vitamin D every day. Most foods have very little vitamin D, and the main food source of vitamin D is fortified milk. During the summer months, the sun is a main source of vitamin D, and you may get enough without needing supplements. But, you may need to take vitamin D supplement (pills or drops) during the winter months.

When taking a vitamin D supplement, follow the dose recommended by your health care provider. Too much vitamin D can actually lead to more bone loss.

ExerciseExercise helps protect your spine, slows the rate of bone loss, and builds muscle strength. These

results can help to prevent falls, and to prevent breaks when a fall happens. An exercise program that combines strength training, balance training, aerobic training and posture training is ideal for building strong muscles, bones, increasing mobility and improving heart health.

Talk to your doctor before starting any new activities. You may consider meeting with a

Sources: Osteoporosis Canada: osteoporosis.ca Canadian Cancer Society: cancer.ca

physical therapist or certified kinesiologist to create a plan for you that is safe and effective.

Visit the Exercise for Healthy Bones section on Osteoporosis Canada’s (osteoporosis.ca) website for more information.

Learn moreVisit your UHN site’s Patient Library to explore and borrow these titles and more.

*Register at any site and ask for your personal access code to use our Digital Library via OverDrive.

Quick reads Pick up or ask for a print-out of these brochures at a Patient Library, or visit www.uhnpatienteducation.ca to read or download your own copy.

Bone Mineral Density (BMD) Scan

Read this information to learn:

• what a bone mineral density scan is

• how to prepare

• what to expect

• who to call if you have any questions

Your bone mineral density scan has been scheduled for:

Date:

Time:

Place:

Information for patients and families

Please visit the UHN Patient Education website for more health information: www.uhnpatienteducation.ca© 2017 University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only.

Author: JDMI Nuclear MedicineRevised: 03/2017Form: D-5316

Building Strong Bones

For men taking androgen deprivation therapy (hormone therapy) for prostate cancer

This pamphlet explains:

• How androgen deprivation therapy (ADT) affects your bones

• What puts your bones at risk for fracture

• How to strengthen your bones

• What you can do to prevent osteoporosis

Note: All underlined words are explained at the end of the pamphlet.

Form: D-5953

Calcium, Vitamin D and Bone Health

Information for patients and families

Read this brochure to learn about:• Getting enough calcium and vitamin D• How to get calcium and vitamin D in your diet• How much you need• Who to ask if you have questions

If you have questions about calcium and vitamin D, please talk to your doctor or nurse practitioner.

Please visit the UHN Patient Education website for more health information: www.uhnpatienteducation.ca © 2016 University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medi-cal condition. A single copy of these materials may be reprinted for non-commercial personal use only.

Author: Alma Nadaffi, RN, BSCN, MAEd, ACNPRevised: 01/2016Form: D-5092

UHN

Bone health during cancer treatment How to keep your bones strong during cancer treatments• As you get older, your bones naturally get

thinner. Some cancer treatments (like hormonetherapy) and steroids (like prednisone anddexamethasone) can make your bones thinearlier than normal.

• When your bones get too thin it iscalled osteoporosis.

• Thin bones are weak and fragile. They canbreak easily from simple falls or movements.

• If your treatments put you at risk ofosteoporosis you need to do things tokeep your bones healthy.

For more information about osteoporosis go to www.osteoporosis.ca

Follow these tips to keep your bones healthy and strongExercise often:• Exercise helps to lower your risk of falls

and bone breaks.• Do light to medium exercise for 30 minutes,

5 times a week. Try walking, dancing, or aerobics.• Do strength training at least 2 days a week.

Try lifting light weights or other weight-bearingexercise. Ask your healthcare team aboutexercises that are right for you.

Avoid Smoking:• Smoking makes your bones weaker.• Quitting smoking may reduce your risk

of osteoporosis.• Ask your health care team for support

if you want to quit smoking.

Limit alcohol:• Drinking too much alcohol can weaken

your bones.• Women should have no more than 1 drink a day.• Men should have no more than 2 drinks a day.

Visit www.uhnpatienteducation.ca for more health information.Use this material for your information only. It does not replace advice from your doctor or other health care professional. Do not use this information for diagnosis or treatment. Ask your health care provider for advice about a specific medical condition. You may print 1 copy of this brochure for non-commercial and personal use only. Form: D- 8674 Author: Cancer Care Ontario Created: 06/2018

Bone Loss and Breast Cancer Treatment: Are You at Risk?

For women having breast cancer treatment

Read this pamphlet to learn about:

• What causes breast cancer treatment induced bone loss

• What to do and how to manage it

• Where to get more information

Form: D-5598

Book at TW Book at TG DVD at PM

Book at TG, TR, TW

Book at TWeBook available*

DVD at TW, TR,available online*

EventsMonthly Talk: Osteoporosis Date: Friday, September 28 from 1:00 – 2:30 PM

Location: Toronto Western, 2nd Floor Auditorium

To register: call 416 603 6475 or email Evangeline.Roldan@uhn.ca

Please note that there will be no September health talk at TGH, and no October talk at TWH.

Health Literacy MonthOctober is Health Literacy Month. Stay tuned for more details on events that will be happening throughout the month aimed at building your health literacy.

Special FeatureGet a copy of the Health Literacy Month issue focusing on “How to partner in your care to stay safe.” Available in English, Spanish, Portuguese and Chinese.

Contact usOur Patient Libraries and Resource Centres are located in the lobbies of the following UHN sites. Visit or contact us to learn more about our information and services.

Princess Margaret (PM)416 946 4501 ext. 5383patienteducation@uhn.ca

Toronto General (TG)416 340 4800 ext. 5951tgpen@uhn.ca

Toronto Rehab, University Centre (TR)416 597 3422 ext. 3558TorontoRehabHealthInfo@uhn.ca

Toronto Western (TW)416 603 6277 twpfl@uhn.ca

UNIVERSIT Y HEALTH NET WORK

Patient and Family Education Program

Patient Education

Understand …the information

Get …good quality health information

Communicate …about your health

Use …the information to take part in your care

Special issue

How to partner in your care and stay safeUse this “health literacy roadmap” to help you manage and make decisions about your care, navigate the health care system and stay safe.

October is health literacy monthHealth literacy refers to the ability to access, understand and use information and services to make informed decisions about health.Rootman et al., (2008)

Our non-medical seniors home care division, Seniors for Seniors, can provide you or your loved one with:

• Driver Companions

• Live-In/Drop-In Companions

• Overnight Companions

• Hospital Bedside Companions

• Handypersons

• House Cleaners

Our non-urgent patient transfer division, Spectrum Patient Services, can provide you or your loved one with:

• Stretcher Transfer Services

• Pediatric Transfer Services

• Wheelchair Transfer Services

• Dialysis Transfer Services

• Bariatric Transfer Services

• Hospital and Patient Shuttle Services

Our home health care division, Spectrum Health Care, can provide you or your loved one with:

• Nursing

• Personal and Home Support

• Palliative and Advanced Illness Care

• Wound and Ostomy Care

• Physiotherapy

• Foot Care

• Family Caregiver Support

• Immunization Clinics

Our diverse health care solutions include:

WORKING TOGETHER TO ADVANCE HEALTH CARE

As Ontario’s leading provider of client centred health care solutions, we are committed to providing clients with integrated services that seamlessly adapt to their current and future health care needs.

Home Health Care Services

Patient Transfer Services

Companion Services

spectrumhealthcare.com • TORONTO 416.964.0322 • PEEL 905.272.2271 • YORK 905.771.2766

spectrumpatientservices.com • 1.866.527.9191

seniorsforseniors.ca • 1.844.422.7399

Disclaimer: The University Health Network (UHN) thanks all the advertisers whose support has made this publication possible. The appearance of the advertisements in this publication should not be taken as an endorsement by UHN of any particular goods or services and UHN cannot be responsible for the goods and services which appear in those advertisements.

Editor: Erin Culhane | Contributors: Po-Lin Cheung-Leung, Lisa Cunningham, Valeria Raivich, Michelle Snow, Melissa Yan | Design: Kristin FosterThis newsletter is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only. © University Health Network – Patient Education and Engagement Program – 2018