Preventing Fractures, Preserving Quality of Life

Many people talk about active retirement, but Don and Loutricia Redding stay too busy living theirs to do much talking. 

Anne Lake has a visit with Earl and Loutricia Redding.Some of the credit goes to the fracture prevention program at Atrium Health Wake Forest Baptist. Studies show that a person age 50 or older who has a fragility fracture (broken bone sustained in a fall from standing height or less) is 2 to 5 times more likely to have a second fracture. The odds go even higher for someone who has had two fragility fractures. The fracture prevention program takes a preventive, multispecialty approach to promote bone health. 

“They are the very epitome of what we want our osteoporosis patients to be doing,” says Anne Lake, DNP, fracture prevention program coordinator and clinician for Atrium Health Wake Forest Baptist. “They look like what I want an osteoporosis patient to look like: Nobody knows they have it because they are being treated and they’re not fracturing.”

As an example, Don, now 81, and Loutricia, 74, took a river cruise during 2022 that encompassed five countries in 14 days, during which their step counters showed between 9,000 and 16,000 steps each day. That included mostly cobblestone streets, lots of stairs and going up- and downhill. 

“It was absolutely wonderful,” says Don. “And we were able to do it without any problems.

“After going through Atrium Health Wake Forest Baptist’s fracture prevention program, we’re able to do about anything that we want to do,” he says. “We love to travel, we love to walk, we love to garden, we like to hike. We go to Stone Mountain at least once a year to go to the top and test our stamina and see if we’re able to do it. So far, we’re still able to do it!”

Lake and the Reddings met in the mid-2010s when Don was referred to the fracture prevention program after his second compression fracture in his spine. Both times, it happened when he was picking up something heavy – something he had done many times. Lake described these as fragility fractures, low- to no-trauma fractures or a traumatic fracture that would not have occurred in a healthy adult. They generally are caused by osteoporosis.

“Statistics are that when a patient has one vertebral fracture, they’re 9 times more likely to have another one, and once they’ve had 2, they’re 15 times more likely,” says Lake. “Once you’ve had a fragility fracture, you are at very high risk for another fracture in the 1 to 3 years after.”  

While they were doing Don’s exam, Lake asked Loutricia if she had ever been screened for osteoporosis. She had not, so a few months later, she came back to see Lake as a patient, and her bone density scan showed osteoporosis, too.  

Osteoporosis is a bone disease that happens when the body loses too much bone, doesn’t make enough bone or both. Bones become weaker and may break easily. An invisible, silent disease, there are few to no symptoms other than breaking a bone, losing height or the upper back curving forward. And it’s common: Approximately 54 million Americans have osteoporosis or low bone mass, but very few know it.

The fracture prevention program came about because there traditionally is a large treatment gap between when a person has a fracture and when they are diagnosed with the osteoporosis that caused it. Lake says that before 2010, only about 20% of such patients were identified and treated. Wake Forest Baptist was one of the first academic medical centers in the country to establish a formal program in 2013, and it has received a Star Performer designation from the American Orthopaedic Association for participating in the association’s Own the Bone program. It also is the first health system in the country to receive The Joint Commission’s Gold Seal of Approval of Osteoporosis Certification

“We are helping patients improve their quality of life, reduce their health care costs and maintain their level of independence,” says Lake. “It’s a care-coordinated model, and we provide a multidisciplinary approach. And that’s the integral part of the success of our program implementation.”

Loutricia and Don certainly attest to the quality of the program and the impact it has had on their lives. First there were 2 years of daily shots of medication to rebuild bone, combined with daily exercise and nutrition advice, and today they receive shots every 6 months and have regular lab work. 

“It’s a change in lifestyle,” says Don as Loutricia agrees. “I don’t pick up anything real heavy, and we exercise every day, usually walking, that’s our main exercise. We also do work outside – Loutricia will work in the garden and I’ll drive the tractor.

“The program has been absolutely wonderful, and it was a life-changer.”

Loutricia and Don call Lake their cheerleader and coach, celebrating the good things with them and nudging them when they need to make changes. And they agree she has been a good influence, because the only fracture they have had since joining the fracture prevention program was not related to osteoporosis.

“When we were traveling in China, it was dark in our room,” says Loutricia, “and I was walking around a table that stuck out. I caught the little toe of my right foot on it and broke the toe. So, it really wasn’t any failure of the program.”

“She was reorganizing the furniture with her foot,” interjects Don. “But it did give her a chance to try acupuncture!”

The Reddings laugh at the memory, but both recognize that the fracture prevention program has helped them continue taking such trips. When Lake first asked them to describe their idea of successful aging, they agreed it was to be able to travel and to stay active. Fractures would impact that significantly. 

“We’ve been very, very blessed,” says Don. “I know I won’t be able to travel forever, so we’re trying to do what we can as much as we can.”

Next up for the energetic couple is a trip to Thailand – with maybe their annual trek to the top of Stone Mountain first. 

Atrium Health Wake Forest Baptist’s fracture prevention program is part of the Atrium Health Musculoskeletal Institute, which provides nationally-recognized experts and care. Atrium Health Musculoskeletal Institute’s fracture prevention programs at Atrium Health Carolinas Medical Center, in Charlotte, and Atrium Health Wake Forest Baptist Medical Center, in Winston-Salem, North Carolina, both have received a Star Performer designation from the American Orthopaedic Association for participation in the association’s “Own the Bone®” program. Both programs provide a multidisciplinary approach to bone health.