Welcome to the Centre for Osteoporosis & Bone Health!

Pre-visit Requirements

To be referred to this program you will need to have a bone mineral density test performed. This test can be performed at Women’s College Hospital. Please see the Tests tab for more information, and for the referral form.

Once a completed referral has been received, you will be notified of an appointment date and time by a member of our administrative staff.

What to Expect

We would ask that you plan to arrive at least 10-15 minutes before your scheduled appointment time so that we can complete your registration.

Please remember to bring your Ontario Health Cardopens in a new window with you to this appointment. Please Note: If you do not have a valid Ontario Health Card, you will be required to pay directly for the clinical service(s) provided at the time of your visit. Details are available from any of our program secretaries.

Remember to bring a list of your medications including any vitamin or mineral supplements and herbal remedies. You will be assessed by a Multidisciplinary Osteoporosis Allied Health team member; there is also a pharmacist available if necessary to discuss your medication options. You may be asked to complete some blood work or have an X-ray of your spine at the conclusion of your appointment. These tests can be done at the hospital right after your appointment (usually there is no preparation for these tests).

If you are unable to keep your appointment, please notify the program scheduling secretary at 416-323-2663 to cancel and/or re-schedule your appointment.

The Multidisciplinary Osteoporosis Allied Health team members include:

Athletic Therapist
Athletic therapy is a profession specializing in the assessment, prevention, immediate care, and reconditioning of musculoskeletal injuries.  Our certified athletic therapist is also Bonefit Trained and is now offering education classes on safe and fun exercise for patients with lowered bone density.

Classess offered include:

Exercise class

• To provide appropriate exercise and education based on Osteoporosis Canada’s Bonefit program to aid in the management of osteoporosis resulting in improved posture, strength , balance and self esteem
• This class is offered once a week on a variety of days and times lasting approximately one hour  for 6 weeks

Education for exercise

• To review guidelines for safe exercise in people who are already active and want to ensure they have a complete and safe  program
• This is a one-time class offered for one hour several times per month.

Nordic Pole Walking

• Offered once a month, this class is an introduction to the sport of Nordic Pole Walking.  Information is provided on pole fitting and correct technique in an indoor setting

Bone Densitometry Technologist
Our Bone Densitometry technologists are all Medical Radiation Technologists (M.R.T.) that have specialized in Bone Densitometry and have all been certified by the International Society for Clinical Densitometry (ISCD). They provide the highest quality of testing in BMD. They have a comprehensive quality assurance program in place to assess the machines stability as well as the technologist’s technique.

The patients are given a BMD questionnaire that is reviewed by the technologists prior to being scanned. The technologists will also assess the patients to determine the appropriate site(s) for scanning.

Please visit our Test tab to learn more about BMD testing.

Clinical Nurse Specialist (CNS)
The Clinical Nurse Specialist plays an important role in the coordination of patient care as the liaison between patients, physicians and other health care professionals. The CNS is involved in patient education on osteoporosis management and links patients to resources in their communities. In this advanced practice role, the CNS can provide ongoing assessment, advice and support for patients and their families.

Occupational Therapist
Consultation with the Occupational Therapist (OT) involves assessment and education to prevent osteoporotic fractures, such as:

• Fall prevention strategies, including assessing your specifci fall risk factors which may be physical, behavioral and/or environmental
• Education on proper body mechanics throughout your daily acitvities to diminish the incidence of vertebral osteoporotic fractures. The majority of these fractures are painless; therefore preventing them from happening in the first place is essential

Pharmacist
The pharmacist plays an important role in helping patients make a more informed decision on the medication options used for the treatment of osteoporosis. Patients receive counseling and education on how medications work, their safety and effectiveness, and potential side effects. Individualized assessment is provided to address potential drug interactions, to optimize medication adherence, and to facilitate financial assistance when needed.

Physical Therapist
The goals of physical therapy are to maintain bone health, improve posture, and reduce the risk of falls/fractures. A physical therapy consult involves an individualized activity plan that will be tailored to your fracture risk and fitness level. A program may include:

• Strength-training protocols appropriate for osteoporosis
• Review of weight-bearing activities
• Activities to improve balance
• Education to improve posture and body alignment
• Review of exercises to avoid

Physician Specialist
The physicians specialize in a wide variety of disciplines, including endocrinology, rheumatology general internal medicine, and women's health.

Registered Dietitian
The dietitian will assess your specific nutritional needs and design a nutrition prescription for your bone health. Did you know that maximizing your overall nutritional intake can improve muscle strength, balance and bone health? The optimal eating plan for bone health should include:

• Adequate calcium and Vitamin D
• Adequate dietary sources of B12, Vitamin K, and magnesium
• Adequate fruit and vegetable intake
• Appropriate intake of dietary protein
• Minimizing caffeine, sodium and alcohol intake
• Achieving and maintaining a healthy body weight

Bone Mineral Density Testing

Women’s College hospital offers Bone Mineral Density tests using dual energy X-ray absorptiometry (DXA).

• For health professionals interested in referring a patient for a BMD Test, please complete a BMD Appointment Referral Form.
• For patients scheduled to have a BMD test, please fill out the BMD Questionnaire and bring it to your appointment.

What is a Bone Mineral Density Test?

A bone density scan is a simple, non-invasive and painless exam to measure bone mass in areas such as your spine and hip. The standard test uses a low dose X-ray to detect signs of bone thinning. While the patient is lying on the machine bed, an X-ray is emitted from underneath the bed and passes through the body. These X-rays are captured by the machine directly above the patient and measured. An image is produced and calculations are made to determine the density of the bone. The denser (thicker) the bones, the less X-rays pass through. If the bones are less dense (thin), more X-rays will pass through.  By measuring the density of the bones, we can:

• evaluate for low bone mass or osteoporosis
• determine future fracture risk
• determine your rate of bone loss or monitor the effects of treatment.

Preparing for your BMD Test

A bone density scan requires little preparation. You may eat normally and take medications as prescribed by your doctor the morning of your test. However, we advise that patients do not take any calcium tablets on the day of the test. If a calcium tablet is taken just before the BMD test it may not be fully dissolved and may affect the results. Clothing with no zippers or metal buttons are recommended. The actual procedure only takes a few minutes to complete.

Patient Resources

There are many resources available for both patients and their healthcare providers.  The following are leading websites that will provide the answers to many of the questions you may have about Osteoporosis and how to maximize your bone health:

Osteoporosis

• Osteoporosis Canadaopens in a new window | Tel:  416-696-2663  /  800-463-6842
• Beyond the Break Education Seriesopens in a new window
• OTN Webcasting Centreopens in a new window
  Go to Archived Events » Public » search Osteoporosis
  
• National Osteoporosis Foundation (US)opens in a new window | Toll Free Tel: 800-231-4222
• International Osteoporosis Foundationopens in a new window | Tel:  800-624-BONE
• Centre for Osteoporosis & Bone Health Brochure

Nutrition for Healthy Bones

• Dietitians of Canadaopens in a new window
• Eat Right Ontarioopens in a new window
• Government of Canada, Healthy Eatingopens in a new window
• Health Canada Nutrition Serviceopens in a new window
• Health Link BCopens in a new window
• National Library of Medicineopens in a new window

Physical Activity & Exercise for Bone Health

• Osteoporosis Canada
  Exercise for Healthy Bonesopens in a new window
• Mayo Clinic: Tools for Healthier Livesopens in a new window  
  (Enter osteoporosis exercises into SEARCH box)
  
  
• Growing Stronger: Strength Training for Older Adultsopens in a new window
• Strong Women: Lifting Women to Better Healthopens in a new window
• Canada's Physical Activity Guide for Adultsopens in a new window
• Active Living Coalition for Older Adultsopens in a new window
• MelioGuide: Exercise Programs to treat & prevent Osteoporosisopens in a new window

Living Safely – Preventing Falls & Fractures

• Osteoporosis Canada
  Preventing Fallsopens in a new window

• BC Seniors’ Fall Preventionopens in a new window
• StopFalls.org - Basicsopens in a new window
• SmartRisk.caopens in a new window
• HIProtector.com - Fall Prevention Hip Protectorsopens in a new window

Self-Management Support Programs

• Chronic Disease Self-Management Workshop offered by the Toronto Central Self-Management Programopens in a new window | Tel: 416-462-2910 - FREE -
• Living a Healthy Life Workshop: Take chargeopens in a new window – and get the most out of life with long-term conditions | Tel: 866-971-5545 - FREE -
• Patient Decision Aidsopens in a new window 
• Institute for Optimizing Health Outcomesopens in a new window
• Taking Charge of Your Health & Wellbeingopens in a new window

Newsletter

• COPING: E-Newsletter of Canadian Osteoporosis Patient Network (COPN)opens in a new window

Patient Referral

Patient Questionnaires

Bone Mineral Density Test

Telemedicine Appointment