Bones in your 40s

By the time you are in your 40s you’ve reached peak bone density, and bone loss begins to exceed the rate of bone formation. While you can’t regain full bone mass, you can slow the decline.

Bone health is important for everyone, but people assigned female at birth have a few extra considerations to keep in mind, including the tendency to have smaller bones than people assigned male at birth. A decrease in the hormone estrogen can cause bone loss, which in turn can trigger osteoporosis (brittle bones). And people experiencing menopause should be extra careful as hormonal shifts and lifestyle choices can contribute to osteoporosis or other bone health issues.

The most at-risk group for osteoporosis is white people assigned female at birth. Other risk factors include smoking, a family history of bone conditions, and eating disorders, even in your younger years.

Bone health tips

1. Calcium and vitamin D – Ask your doctor to check your calcium and vitamin D levels. They may tell you to take a supplement or add different foods to your diet. Dietary vitamins are best, but sometimes more is needed to keep us healthy.
2. Exercise – Weight-bearing exercises like walking and lifting weights are excellent for bone health. Aim for 30 minutes a day at least three to four times per week.
3. Quit smoking – Stopping smoking is one of the best things you can do for your overall health, and it can slow the loss of bone mass.

Talk to your doctor

Talking with your regular doctor can help you stop age-related bone loss. They can prescribe medicines, order tests and help you make a plan to keep your bones in top shape for as long as possible. You can also see a specialist in orthopedics.

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How to increase energy after 50

Exercise and nutrition

Try hiking, kayaking, biking, swimming or taking an exercise class. Find a form of activity you enjoy and will want to pursue regularly. Weightlifting can help preserve bone and muscle density. Consume nutritious food and hydrate yourself. Proper nutrition will help energize you throughout the day. Foods like celery, cucumbers, strawberries, peaches and watermelon have higher water content and can help keep you hydrated.

Mental stimulation

Keep your mind sharp with puzzles like sudoku and crosswords. Read books, magazines or newspapers that interest you and discuss them with friends and family. Engage in conversations and debates that challenge your critical thinking and recall skills. Staying mentally active will give you energy and motivation to accomplish any task you set your mind to!

Sleep

You may find that you need more sleep to feel rested. Strive for seven to nine hours of sleep each night. Develop and maintain a consistent sleep schedule. Too little sleep is linked to chronic diseases and conditions, including Type 2 diabetes, heart disease, obesity and depression. Difficulty falling asleep? Avoid using electronics while winding down for the night.

Alcohol consumption

Drink in moderation. Alcohol can negatively impact your brain function and overall quality of life. It may be more difficult to feel energized if you are a heavy drinker.

Mental health

If you can’t shrug off feeling sluggish, check in on your mental health. Take a few minutes to observe how you are feeling. Regular exercise and nutrition can help improve your outlook. If you are experiencing mood swings, significant distress, anxiety or stress, talk to your primary care doctor about potential treatment options.

Joshua Bentley, M.D., is a family medicine physician with Norton Community Medical Associates primary care – Mid City Mall.

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“Like many young people contemplating military service, I saw it as a chance to reorient my focus on the future,” Tom said. “The upshot of my nearly six years in the service was the knowledge and experience gained from living in a foreign country, adapting to a new culture and witnessing an event as momentous as the fall of the Berlin Wall — all while working in an environment where my work was deemed invaluable to the nation.”

Tom spent 1 1/2 years learning Czech and Slovak at the Defense Language Institute Foreign Language Center in Monterey, California, before deploying to Germany.

Tom is now a digital content manager in Norton Healthcare’s marketing and communications department. The values of teamwork and collaboration for the sake of a greater good also prove invaluable for Tom in his work.

Tom was instrumental in Norton Healthcare’s Engage initiative to provide employees with vital information ahead of the 2020 election. In working with this team, Tom helped promote voter registration, helped voters find polling locations and provided unbiased information on the candidates and their stances.

When away from the office, Tom enjoys working with Dare to Care’s monthly food bank through his parish, St. Agnes Catholic Church, and with St. Vincent de Paul Louisville to provide food baskets to those in need. He and his family also enjoy working with Down Syndrome of Louisville, where he says his teenage son has spent so many enjoyable hours with his peers learning about friendship and being part of the community.

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Parents are used to keeping track of vaccines for their children, but what about their own immunizations? How can adults, who may not have seen their vaccination records for decades, be sure they’re protected against preventable diseases?

Christina M. Breit, M.D., internal medicine physician with Norton Community Medical Associates – Mallard Creek, explains what adults should do if they are concerned about whether they’re protected against diseases. According to Dr. Breit, here’s what you should know:

What’s the Most Common Vaccine That Adults May Be Missing?

The most common vaccine that we see in our practice that is not up to date is the Tdap. This is a tetanus, diphtheria and pertussis booster that should be given every 10 years.

How Can Adults Find Out If They’re Protected From Certain Diseases, Especially If They Don’t Have Access to Their Immunization Records?

A primary care provider can order titers, which are available for most diseases that vaccines protect against. A titer is a blood test that shows whether your body is immune to a disease. For example, if you had the MMR vaccine to protect against measles, mumps and rubella, a titer blood test will show that you have the antibody for measles, mumps and rubella, and are therefore protected.

Related Content: What age is the MMR vaccine given to fight measles, mumps and rubella?

Since Measles Has Been in the News, There Was Some Concern That Some Adults May Not Be Protected, Even If They Received a Vaccine in the Past. Who Should Be Concerned, and What Do Doctors Recommend They Do?

MMR vaccine has been a hot topic since measles has been seen in our community and around the nation. We have been receiving a lot of questions from our adult population on whether or not this is a vaccine that they need to get; this depends on their vaccination status.

If the patient grew up in Kentucky and went to schools in Kentucky, their vaccination status should be up to date.

If the patient is not sure and would like to be checked for their immune status, this can be done with blood draws in the office for titers.

Is There a Recommended Vaccine Schedule for Adults? If So, Where Can I Find It?

The Centers for Disease Control and Prevention (CDC) has a recommended adult vaccination schedule that includes guidelines for the flu vaccine, Tdap, MMR and others. You can find the adult vaccine schedule here, or ask your primary care provider.

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The importance of checkups is illustrated by Norma Mosier’s story. Just over a year ago, Norma headed in for a yearly physical and check-in with her regular physician. Norma had been seeing Patricia L. Isaacs, M.D., for years.

“She is so thorough. She had been watching a spot on my lung for a while,” Norma said.

After the visit, Dr. Isaacs, a family medicine physician with Norton Community Medical Associates – Clarksville, sent Norma for further testing. The spot turned out to be cancerous. In a scheduled surgery, doctors removed the upper lobe of Norma’s left lung and nine lymph nodes. If it hadn’t been for Dr. Isaacs and Norma’s insistence on getting regular checkups, the cancer may have been discovered too late.

Primary care and telehealth appointments

Our primary care offices are open with normal business hours. If you are experiencing symptoms of illness and are unsure whether you should make an appointment with your provider, you can call the office or send a message through MyNortonChart.

Norton Telehealth appointments with your provider may be available and are billed with the same copay as an in-office visit.

Call or message your provider’s office if you are interested in a telehealth appointment.

Other Norton Healthcare options

If you need urgent care and it is not an emergency, there are also several options for same-day care that don’t involve a trip to the Emergency Department.

Norton eCare

If you are not feeling well for any reason, Norton eCare offers 24/7 urgent care video visits and eVisits with a Norton Healthcare provider. These online visits mean you can stay home, without the risk of spreading infection to others or being exposed in a waiting room in a health care setting. Video visits are billed through your insurance, similar to an office visit. For a $40 flat fee, eVisits offer you the opportunity to fill out an online questionnaire about your symptoms. A Norton eCare provider will review your information and discuss with you via a phone call.

Sign in or sign up for a MyNortonChart account to get started.

Norton Immediate Care Centers

Our Norton Immediate Care Centers remain open at their regular hours for in-person treatment by a Norton Healthcare provider. To practice social distancing, you can reserve your spot online and wait at home, reducing the risk of exposure. We’ll text you when it’s close to your turn, so you can avoid the waiting room. After you arrive and check in, you also have the option to wait in your car until the office is ready. At Norton Immediate Care Center – Preston, 24-hour care and pediatric after-hours care are available.

Click here to view wait times and reserve your spot at a Norton Immediate Care Center near you.

Norton Prompt Care at Walgreens

Norton Prompt Care at Walgreens locations are open at their regular, extended hours. You can schedule same-day appointments online, seven days a week at eight convenient locations, and arrive at your appointed time. You can pick up any needed prescriptions in the same place using Walgreens’ drive-thru. Our providers will meet with you in a private room for well visits, physicals and care for minor injuries or illnesses. Most insurance plans are accepted, and self-pay options are available.

Norton Prompt Care at Walgreens is operated by Norton Healthcare. The health care providers at Norton Prompt Care at Walgreens are employees of Norton Healthcare. The health care providers are not employees, associates and/or agents of Walgreen Co. or any Walgreens subsidiary or affiliated company.

Additional safety measures

You may be curious about what to expect when arriving at any of our urgent care locations. There may be restrictions on who may accompany you. For your safety, pre-screening for COVID-19 symptoms to include temperature screenings may be conducted. Protective face masks or coverings are required for all patients, visitors and staff. Our locations are taking extra precautions when it comes to providers using appropriate protective equipment as well as enhanced sanitation procedures. If you are unsure of where to seek care, please reach out to any of these options. Our providers will be happy to direct you to the appropriate place to get the care you need now.[templatera id=”144533″]

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According to the World Health Organization, more than moderate alcohol consumption can increase your risk of COVID-19.

Try to keep the limit to one drink a day for women, two drinks for men, according to Michael Petry, M.D., family medicine physician with Norton Community Medical Associates – Crestwood.

“Alcohol can impair your judgment, for starters. Drinking too much might cause you to forget about hand-washing or to be in a risky social situation, getting exposed to the virus or exposing others,” he said.

Alcohol also changes your body in ways that make you much more susceptible to COVID-19 by inhibiting your body’s natural defenses against viruses and bacteria.

In addition to killing beneficial bacteria and damaging immune-fighting cells in your digestive system, alcohol disrupts the natural barrier that helps protect us from viruses and bacteria, according to Dr. Petry.

He noted that a study on alcohol and the immune system found that alcohol can increase susceptibility to pneumonia.

“Alcohol can disrupt the tiny, hair-like projections in your lungs — cilia — that protect you from pollution, bacteria and viruses. That can make you more susceptible to pneumonia. Viral pneumonia is one of the major complications of COVID-19, causing a lot of sickness and death,” he said.

A single episode of binge drinking can reduce your ability to recover from trauma, illness or surgery. If you binged on alcohol and then got exposed to the coronavirus, there’s a good chance your immune system would function so poorly you’d have a worse outcome, according to the doctor.

“As a family physician, I know coping with the isolation, job loss and other stresses from this pandemic can be difficult. People not normally at risk for alcohol abuse may be more likely to have issues with it,” he said. “Even so, this is not the time to use alcohol as a coping mechanism. You still need to take care of your mental and physical health.”

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Respiratory viruses, like the one that causes COVID-19, get passed along when you breathe, sneeze, cough or speak — tiny droplets are released into the area around you. When others come into contact with the droplets, they can become infected when the virus enters through their nose, mouth or eyes. As more people unknowingly carry the virus, they increase the chances of making more people sick. This “symptomless transmission” is part of why the virus has been able to grow into a global pandemic.

According to the Centers for Disease Control and Prevention (CDC), the virus that causes COVID-19 seems to be spreading easily through “community spread” in some affected geographic areas of the United States.

Stay safe

• Stay at home as much as possible.
• When you go out in public, keep away from others who are sick, limit close contact with others (stay 6 feet away) and wash your hands often.
• Avoid crowds. Do not attend community gatherings. Do not host small gatherings or have guests over.

• Avoid all non-essential travel. Do not fly. Do not participate in cruise travel.

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The average American takes 5,117 steps a day, which is equivalent to walking just over 2 1/2 miles. That may sound like good exercise, but 2 1/2 miles a day is far less than how much you need to walk to improve your health.

Researchers define those who walk 2,000 to 3,000 steps per day as sedentary. Boosting that to 6,000 steps a day significantly reduces health risks, and 8,000 to 10,000 steps a day promotes weight loss, even without changes in your diet.

It doesn’t matter how you get your steps — whether it’s from walking on a treadmill or vacuuming laps around the couch; it all adds up.

To get an average accounting of how active you are, wear a pedometer for several days. Then, set that as the minimum and plan to increase your daily steps incrementally until you reach 10,000 per day.

Steps for Success

• Get properly fitted for a high-quality walking shoe. Pay now or pay later — the wrong shoe can cost you comfort and lead to injuries.
• Buddy up with a walking partner for accountability, safety and support.
• Post your progress on your computer, phone or a simple paper chart. Have fun with it — try plotting an imaginary journey, such as a virtual half-marathon or walk along the Appalachian Trail.
• Plan rewards for meeting daily, weekly or monthly goals.

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“Things were different back then, and it’s just what you did,” she said.

She was what you would call a heavy smoker, smoking at least a pack a day for at least 30 years. She finally quit in 2007.

A retired nurse, Margaret credits a simple screening for detecting her lung cancer before it had gotten past the early stages. She now tells everyone she knows about this important test.

Margaret had three friends diagnosed with stage 4 lung cancer within six months of each other. All had smoked, and none had any symptoms of lung cancer. One had a swollen lymph node in the neck. One was thought to have allergies that caused swelling in the face. The other’s was found by accident. They all died.

Shortly afterward, she saw an ad in the newspaper. The ad, coupled with the friends’ deaths, caused Margaret to ask her primary care provider if he could refer her to Norton Healthcare for a screening.

“I didn’t have any symptoms, but I knew I should check,” she said. “I go to the gym every day. I wasn’t short of breath, and I wasn’t coughing.”

Catching Lung Cancer Early

She had her first screening at Norton Healthcare, which was clear, and continued screenings for the next three years. Then two small nodules appeared. Three months later the nodules had changed, and Margaret had surgery in February 2019 with George J. Mikos, M.D., cardiothoracic surgeon with Norton Cardiothoracic Surgery. The nodules were cancerous.

Nationally, the American Lung Association reports that only 21.5% of lung cancers are caught at an early stage, which is when the cancer is most treatable.

A recent report from the American Cancer Society shows that from 2016 to 2017, cancer deaths declined 2.2%, with lung cancer deaths also declining. Kentucky also is seeing a drop in deaths attributed to lung cancer. Lung cancer screenings can help make these numbers decline even more.

“Because of the screening, my cancer was caught early,” Margaret said. “I didn’t have to have chemo or radiation, but I will keep going back for scans. So far the two I’ve had have been clean.

“The screening saved my life. If you’re a former smoker, you need to know about this.”

About Lung Cancer Screening

A computed tomography (CT) scan of the lung is painless, noninvasive and fast. The scans are available at Norton Cancer Institute’s Comprehensive Lung Center for individuals at high risk for developing lung cancer. You may be a candidate if you are age 55 to 74 and are a current smoker or have a 30-pack-year smoking history. This means you smoked one pack a day for 30 years, or two packs a day for 15 years, etc.

You also may qualify for a screening if you have a family history of lung cancer or have signs or symptoms of lung cancer. Talk to your physician to determine if you should have a screening.

Most insurance companies cover the cost of a lung cancer screening. Medicare Part B also generally covers the screenings for those who meet the criteria above. A physician referral is required.

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After the wreck and later, a hysterectomy, Lori’s once active lifestyle slowed and her food choices started affecting her weight. On her petite 5-foot frame, even a small gain affected how she felt.

“My upper body strength just wasn’t there anymore, and I got to the point that I was scared to be active because I knew it was going to hurt,” she said. “It was so easy to slip into not doing things.”

Dissatisfied with her loss of energy and inability to lose weight by dieting, the once-slim 42-year-old grandmother discussed her concern with her nurse practitioner, who referred Lori to Jeff W. Allen, M.D., bariatric surgeon with Norton Weight Management Services.

Lori met the criteria for gastric sleeve surgery, which reduces the size of the stomach by making a small pouch. Afterward, the patient needs less food to feel satisfied.

Lori had the surgery on July 13, 2019, and returned to her job at an insurance agency one week later.

In just a few short weeks after surgery, Lori’s weight loss had improved her health enough that doctors discontinued her blood pressure and diabetes medications.

Although Lori considers the gastric sleeve instrumental to her weight loss, she said the supportive services available to her afterward are just as important.

“There are dietitians and counselors who can support you and help you do things differently. They’re there for you anytime you slip up and get back into old habits,” she said. “Once you learn to eat healthier, even small portions of something unhealthy aren’t worth the way they make your body feel.”

In Lori’s case, a gastric sleeve was the impetus for new eating habits that helped her lose weight and recover the necessary energy to lead an active lifestyle with her husband, Mark. And now she doesn’t need blood pressure medication.

“The heart is one of the first organs impacted by significant weight gain,” Dr. Allen said. “Being overweight makes the heart work much harder. The good news is, just like in Lori’s case, even a small amount of weight loss can give the heart a boost.”

It takes about 5% to 10% loss of body weight to begin to reduce the risk for heart attack and stroke.

Lori said she hopes her positive experience helps others realize they don’t have to be dramatically overweight to benefit from weight loss help.

“I’m not going to be embarrassed about this,” she said. “I couldn’t do it on my own. I reached out for help before it got worse, and I don’t regret a thing.”

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