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Home improvements, exercise can reduce life-threatening injuries

| Sunday, Nov. 20, 2011

Like clockwork, Linda Mariotti, 73, can be seen each midday strolling through Butler.

She has walked a mile in 20 minutes before, but she's usually not in much of a hurry, especially when Molly, the cheery cocker spaniel she rescued from a shelter eight years ago, is at her side.

"I walk every day," says Mariotti, who described herself as "always being sports-minded," having played softball and been a cheerleader earlier in life. "It keeps you in shape. And it's great to be outside."

Her daily routine almost came to an end when a fall at home cracked her thigh.

Doctors say her recovery from not one, but two hip procedures in recent years spotlights a new trend — a bad break after 65 doesn't mean the end of life.

Nationally, the numbers are still scary, but not like they used to be.

Of the 300,000 people age 65 or older who fracture a hip each year, 20 to 30 percent will die within 12 months of hurting themselves, according to a 2009 study published in the Journal of the American Medical Association.

Dr. Barbara Swan, division director for Physical Medicine and Rehabilitation for the West Penn Allegheny Health System, says, as bleak as those statistics are, they're also an improvement from just 15 years ago. Many hip treatments now can be done less-invasively, reducing both recovery time and the risk of infections that often made recovery more difficult, Swan says.

"Back then, (the mortality rate) was closer to 50 percent," she says. "People don't necessarily die as a direct result of their injury. It's the diminished mobility that is usually the most detrimental."

"The trend is escalating because our population of Baby Boomers is getting older faster," said Dr. Nicholas G. Sotereanos, director of Adult Reconstructive Surgery at Allegheny General Hospital.

Each year, more than 11 million senior citizens fall. Treatment of injuries, infections and other complications associated with falls costs more than $20 billion annually, according to the American Association of Orthopedic Surgeons.

Exercise is the body's best defense against injuries resulting from a fall, says Dr. Vonda Wright, an orthopedic surgeon and founder of the Performance and Research Initiative for Masters Athletes at the University of Pittsburgh Medical Center.

Bone density naturally declines as a person ages, making breaks and fractures — particularly those in the hip and thigh — especially hard to recover from. Resistance activities, such as walking in a pool in chest-deep water, leg lifts, walking on a treadmill, even exercises on a chair, can help strengthen your muscles enough to lower some risks, no matter a person's age.

"Most people in this country do nothing to stay strong or fit. That gives you bad bones and makes you weak overall," Wright says. "It doesn't take a fancy machine or a gym membership to guard against significant injury."

Mariotti was playing in her home four years ago with Molly when she turned and lost her balance.

"I went down really hard," she recalls. "I knew immediately I had broken something."

It turned out her left femur was broken in three places.

The fall occurred just a few years after doctors treated her right leg for an avascular necrosis (arthritis in the hip bone). This time, doctors installed three titanium rods into her left leg during a minimally invasive procedure that kept off her feet for months. She now is able to walk without the use of a cane or walker, and doesn't walk with the distinctive limp that often results from some hip surgeries.

"They told me it would take a year for me to heal enough to go walking again, but in nine months, I was back at it. I was determined," Mariotti says. "I'm 73 years old. I don't have time to not do things."

Eva Damianos, 76, exercised regularly at the gym before injuring her right hip in a fall this summer.

Daytime temperatures were well over 90 degrees as Damianos worked in the garden of her Edgewood home in July. When she walked inside to get water, she felt dizzy and fell hard onto her right leg.

"I was dehydrated and started to pass out," Damianos recalls. "I knew I was falling. I couldn't catch myself."

She had surgery to have a screw, four pins and a metal plate put into her leg, but decided against hip replacement. And that has meant a potentially lengthier recovery.

Her husband, Sylvester, had to take over driving and many of the household chores in the meantime.

"I still use a cane, but one of these days I hope to get rid of this thing," Damianos says.

Who's most at risk?

• Women have two to three times as many hip fractures as men.

• Caucasian or Asian

• Small-boned, with slender bodies

Other risk factors

• Diets that are low in calcium

• Smoking or drinking alcohol excessively

• Having arthritis, poor balance and coordination and poor eyesight

Reducing the risk

Falls are the leading cause of injuries to older people in the United States, according to the American Association of Orthopedic Surgeons. About 70 percent of these falls occur in the home. While some factors, such as heredity and age, can't be changed, research shows that simple changes at home substantial reduce the risk of falling:

In the bedroom

• Place a lamp, telephone and flashlight near your bed.

• Sleep on a bed that is easy to get into and out of.

• Replace satiny sheets and comforter with products made of nonslippery material; i.e., wool, cotton.

• Install a night-light along the route between your bedroom and the bathroom.

• Keep clutter off the bedroom floor.

In living areas

• Keep low-rise coffee tables, magazine racks, footrests and plants out of the path of traffic.

• Install easy-access light switches at entrances to rooms so you won't have to walk into a darkened room in order to turn on the light. Glow-in-the-dark switches may be helpful.

• Keep electric, appliance and telephone cords out of walkways, but don't put cords under a rug.

• Secure loose area rugs with double-faced tape, tacks or slip-resistant backing.

• Don't sit in a chair or on a sofa that is so low it is difficult to stand up.

• Repair loose wooden floorboards right away.

• Remove door sills higher than 1/2 inch.

• On stairs, replace patterned, dark or deep-pile carpeting with a solid color, which will show the edges of steps more clearly.

• Put nonslip treads on each bare-wood step.

• Install handrails on both sides of stairways. Each should be 30 inches above the stairs and extend the full length of the stairs.

• Repair loose stairway carpeting or wooden boards immediately.

In the kitchen

• Remove throw rugs.

• Clean up immediately any liquids, grease, or food spilled on the floor.

• Store food, dishes, and cooking equipment within easy reach.

• Don't stand on chairs or boxes to reach upper cabinets.

• Use nonskid floor wax.

In the bathroom

• Place a slip-resistant rug adjacent to the bathtub for safe exit and entry.

• Mount a liquid soap dispenser on the bathtub/shower wall.

• Install grab bars on the bathroom walls.

• Use a rubber mat or place nonskid adhesive textured strips on the tub.

• Replace glass shower enclosures with shatter-proof material.

• Stabilize yourself on the toilet by using either a raised seat or a special toilet seat with armrests.

• Use a sturdy, plastic seat in the bathtub if you cannot lower yourself to the floor of the tub or if you are unsteady.

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