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Osteoporosis Fear vs. Facts: Why Many Patients Avoid Treatment

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Osteoporosis is often called a “silent disease.” But its consequences are anything but quiet. The condition weakens bones, making them thinner, more fragile, and more likely to break, and a hip or wrist fracture after a minor fall is often the first warning sign. Understanding your risk and treatment options could prevent a life-altering injury.

Who Should Be Screened?

Screening for osteoporosis remains a major gap in care. Bone density testing is generally recommended for all women age 65 and older and for younger postmenopausal women with risk factors, such as family history of hip fractures. However, several high-risk groups are frequently overlooked:

  • Men over 70, particularly those with risk factors such as low testosterone levels. This includes men receiving androgen-deprivation or other hormone-lowering therapies for prostate cancer, which accelerate bone loss.
  • Women taking aromatase inhibitors for breast cancer, which significantly increase the rate of bone loss.
  • Individuals who are underweight (BMI ≤19) or women who are under 127 pounds, consume more than three alcoholic drinks per day, or smoke.
  • People taking chronic steroids.
  • Individuals with rheumatologic disease, including but not limited to rheumatoid arthritis, lupus, alkalizing spondylitis psoriatic arthritis.
  • Individuals with endocrine disease, including: type 1 diabetes, hyperthyroidism, parathyroid disease.
  • Women who experienced menopause before age 45.
  • Adults over 50 with a personal or family history of fragility fractures, particularly fractures of the spine, hip, forearm, humerus, or pelvis.

Recognizing these often-overlooked risk factors can mean the difference between preventing a fracture and responding to one.

The Treatment Gap

Dr. Eric Rudin

Even after a fracture occurs, treatment rates remain surprisingly low. Many patients who experience a hip or wrist fracture never receive osteoporosis medication, despite clear evidence that they are at high risk for another fracture.

This treatment gap has serious consequences. Beyond mortality, fractures often lead to:

  • Loss of independence
  • Chronic pain
  • Long-term disability

Putting Medication Risks into Perspective

One of the main reasons patients decline treatment is fear of side effects. Media coverage and online discussions often highlight rare complications such as atypical femur fractures and osteonecrosis of the jaw. While these risks are real, they are extremely uncommon.
In contrast, the benefits of osteoporosis medications are substantial. Many approved therapies reduce the risk of spine fractures by up to 50–70% and hip fractures by approximately 35-40%. For patients at high risk, the reduction in fracture risk far outweighs the rare possibility of serious side effects.

The Good News

Osteoporosis is both detectable and treatable. Bone density scans are simple, noninvasive tests that provide valuable information about fracture risk. Medications are effective, and lifestyle measures, including weight-bearing exercise, adequate calcium and vitamin D intake, smoking cessation, and fall prevention strategies, further support bone health.

While osteoporosis may be silent, its consequences are not. If you or a loved one has experienced a fracture, has risk factors, or is receiving cancer therapies that affect bone health, it’s important to speak with a physician about screening.

With appropriate screening, informed discussions about medication risks and benefits, and proactive treatment when indicated, we can significantly reduce the burden of this common and often underestimated disease.

Insights from an Oral Surgeon: A Parent’s Guide to Preparing for Wisdom Teeth Removal

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As parents, we are always thinking ahead. From school schedules to extracurricular activities, planning plays a key role in supporting our children’s well-being. One important milestone that often gets overlooked is the evaluation and potential removal of wisdom teeth. Taking a proactive approach can make a meaningful difference in both the experience and the outcome.

Wisdom teeth, also known as third molars, typically develop between the ages of 16 and 25. In many cases, there is not enough space in the jaw to accommodate them properly. This can lead to impaction, crowding, infection, and damage to neighboring teeth. What makes this more challenging is that these issues do not always present with obvious symptoms. Problems can develop quietly, which is why early evaluation is so important.

When wisdom teeth are assessed early, we can identify potential concerns before they become more complex. In many cases, removing wisdom teeth during the late teenage years allows for a smoother procedure and a more predictable recovery. The roots are often not fully developed, which reduces surgical difficulty and lowers the risk of complications. Patients also tend to heal more quickly at this age, making the overall experience easier for both the child and the family.

Summer is an ideal time to plan for this procedure. With school out of session and schedules more flexible, families have the opportunity to approach surgery without the added pressure of academic responsibilities. This allows for proper rest and recovery without interruption. For students preparing to leave for college, summer timing is especially beneficial, ensuring they are fully healed before starting a new chapter.

Preparation is an important part of the process. Scheduling a consultation early allows time to discuss the procedure, review imaging, and answer any questions. It is also helpful to talk with your child about what to expect. Understanding the process can ease anxiety and help them feel more comfortable. Planning ahead for recovery, including time at home and a supply of soft foods, helps set expectations and creates a smoother experience.

On the day of surgery, the procedure is typically completed in less than an hour. Patients are cared for in a controlled and comfortable environment, with anesthesia options tailored to their needs. Our team provides clear post-operative instructions and remains available to support patients throughout the healing process.

Taking a forward-looking approach to wisdom teeth removal helps prevent unnecessary complications and supports long-term oral health. By planning ahead and utilizing the summer months, families can ensure a more relaxed and successful experience.

If your child is approaching the age for a wisdom teeth evaluation, now is the right time to take the next step.

My Home Looks Clean … Why Doesn’t It Feel Clean?

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What’s behind that “something’s off” feeling and how to fix it

This is the season when we want our homes to sparkle! The weather has changed, entertaining is upon us, there are events to consider, and a clean home really matters!

You know that feeling when your home is technically clean, but it still doesn’t feel clean? Counters wiped. Floors done. Bathrooms shining. And yet something’s off. Like the house never quite lands in that fresh, settled place you wanted.

If you’ve ever thought, why does this still feel dirty? You’re not imagining it. Because “clean” isn’t just one thing.

There’s the technical side: surfaces, air, residue, wear. And there’s the human side: how your home feels in your body and your brain.

That’s why a home can look clean and still feel sticky, stale, dusty, or just a little off.

1. Residue changes everything
Sometimes the problem isn’t dirt. It’s buildup. It can come from grease, soap scum, or even cleaning products, especially those meant to add “shine.” So, things look fine until you touch them. Floors feel tacky. Counters feel dull instead of smooth. Shower walls stay cloudy.

What helps: Use less product. Choose cleaners that don’t leave film behind, like a diluted all-purpose cleaner, dish soap and water for grease, or rubbing alcohol on glass and shiny surfaces. And every so often, go back with plain water and a cloth to remove buildup.

2. Light shows all
Bright light is not forgiving. Natural light, LEDs, big windows reveal streaks, fingerprints, and smudges you’d never notice otherwise. That doesn’t necessarily mean your home is dirty. It just means you can see more.

What helps: On shiny surfaces, do a quick final pass with a dry microfiber cloth.

3. High-touch spots matter
Light switches. Cabinet pulls. Faucet handles. Door knobs. If those spots don’t feel clean, the whole house doesn’t feel clean. You can walk into a spotless kitchen, touch one sticky handle, and your brain is done.

What helps: Spend one minute hitting the spots your hands touch most.

4. Floors set the tone
If the floors don’t feel right, nothing feels right. Even after cleaning, there can still be grit in corners, dust along the edges, pet hair, or residue from too much product.

What helps: Vacuum before mopping. And sometimes, skip the floor cleaner and use just water to cut buildup.

5. “Dusty” may be in the air
Sometimes what feels dusty isn’t dust sitting on furniture. It’s dust moving through the air. That’s usually about airflow, filters, and fabric.

What helps: Change HVAC filters regularly and open the windows when you can. Fresh air does a lot.

6. Clutter blocks the clean feeling
A home can be tidy and still feel crowded. Too much stuff on surfaces creates visual noise. Your brain reads that as unfinished.

What helps: Clear one surface in each room. Not the whole room. Just one.

7. Scent can fool you
People often connect “clean” with fragrance. But fragrance isn’t clean. It’s just fragrance. It covers odors instead of removing them.

What helps: Focus on fresh air and removing the source of odors. A truly clean home smells like nothing at all.

8. Sometimes it’s wear, not dirt
Scratched floors. Worn grout. Dull cabinets. Old caulk. These things can be completely clean and still not look fresh.

What helps: Know when you’re looking at dirt and when you’re looking at age.

The bottom line
If your home looks clean but doesn’t feel clean, you’re not being picky. You’re noticing something real. The answer isn’t cleaning harder. It’s making a few smart changes in the places that matter most. That’s what turns a home from looking clean to actually feeling clean too.

Ask a Pulmonologist: What to Know About Chronic Cough

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Dr. Bushra Mina with his team

With spring upon us–and summer fast approaching–the last thing you want is a lingering cough keeping you down. As a pulmonologist, I’ve seen firsthand how a chronic cough can disrupt quality of life, making even the simplest conversations or a good night’s sleep feel impossible.

What is chronic cough?

Many people think of a cough as a temporary annoyance, perhaps from a cold or the flu. But there’s a distinct difference when a cough becomes chronic, particularly when it lasts two weeks to a month, or longer.

It’s crucial to understand that a chronic cough isn’t the problem itself. It’s a symptom; a signal from your body that something deeper needs attention.

Why does chronic cough happen?

It’s not one-size-fits-all when it comes to understanding a chronic cough–some investigation is needed. The first thing your doctor will ask you is whether it’s a dry or wet cough. A dry cough doesn’t produce mucus or phlegm–it’s typically due to irritation or inflammation. A wet cough does produce mucus or phlegm and is typically caused by an infection. Once that is determined, a physical examination, imaging scans and further studies might be needed to find more answers.

Dr. Bushra Mina

It’s equally important for your doctor to understand the occurrence of the cough and if there’s an underlying condition in play, which may include:

  • Post-nasal drip: Mucus dripping down the back of your throat can irritate airways.
  • Asthma or emphysema: These conditions can present primarily as a cough and are especially common in smokers.
  • Allergies: Seasonal changes or exposure to certain environmental triggers, including smoke, dust or chemicals should be considered.
  • Gastroesophageal reflux disease (GERD): Acid from the stomach can irritate your throat and airways, causing chronic cough.

Less commonly, chronic cough may be a sign of a more serious lung condition, vocal cord disorder or neurological condition that affects motor function (such as Parkinson’s disease), which is why a thorough evaluation is so important.

When to seek medical care–and where to start

If you’ve been experiencing a persistent cough for weeks, months or even years, our multidisciplinary team at the Chronic Cough Clinic in Westchester provides comprehensive care to help you get the relief you deserve.

After a comprehensive evaluation, we’ll connect you with a specialist who best meets your needs in areas such as pulmonology, gastroenterology, immunology, ear, nose and throat (ENT), neurology and speech therapy.

Let’s get to the bottom of your cough together. Call (914) 821-6389 to schedule an appointment today.

Colorectal Cancer: A Growing Concern for Younger Adults

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Dr. Eric Silberman

A quiet but significant change is underway in colorectal cancer trends, one that is increasingly affecting adults well before traditional screening age.

Colorectal cancer includes cancers of the colon and rectum, the last segments of the gastrointestinal tract. Colorectal cancers begin as polyps – small growths inside the intestine – that slowly develop into cancer over time. When detected early, colorectal cancer is highly treatable, which is why timely screening and early recognition are so critical.

Since the mid-1990s, rates of colorectal cancer have declined among older adults. In contrast, the rate of colorectal cancer diagnosis among adults under the age of 50 have steadily increased, with an annual rise of approximately 2% among adults ages 20-39. In fact, colorectal cancer is now one of the fastest-increasing cancers in young adults.

And it’s not just a numerical increase; there are increasing cancer burdens as well. Studies have shown that younger patients are more likely to present with later-stage disease and, in some cases, more aggressive cancers. Younger patients may also face unique challenges compared to older adults, including concerns related to fertility, family planning, career development, and financial stability.

In response to these rising rates, screening guidelines have evolved. In recent years, both the American Cancer Society and the U.S. Preventive Services Task Force have lowered the recommended starting age for colorectal cancer screening in average-risk adults from 50 to 45 years.

Encouragingly, these updated screening recommendations are already making an impact, with more adults between 45 and 49 undergoing these life-saving tests.

While expanded screening has improved early detection, researchers continue to investigate why colorectal cancer rates are increasing in younger populations. Several theories are being explored, including:

  • changes in diet and lifestyle
  • alterations in the gastrointestinal microbiome
  • rising obesity rates
  • environmental exposures

A major ongoing challenge is in patients younger than the screening age of 45 years old, in whom gastrointestinal symptoms may still be dismissed or attributed to stress, diet, or benign conditions like hemorrhoids or irritable bowel syndrome. Increased awareness of the symptoms of early-onset colorectal will be essential in guiding patients to the proper care going forward.

The symptom most strongly associated with early-onset colorectal cancer is rectal bleeding; other concerning symptoms include persistent changes in bowel habits, unintentional weight loss, and unexplained abdominal pain, cramping, or bloating. When these symptoms persist, they warrant medical evaluation.

Individuals with a family history of colorectal cancer or inflammatory bowel disease are at higher risk and may need earlier screening. However, many young adults diagnosed with colorectal cancer have no known risk factors, highlighting the need for vigilance among both patients and healthcare providers.

Colorectal cancer screening is typically performed with a colonoscopy, which allows a gastroenterologist to sample or remove concerning polyps during the same procedure. Blood-based and stool-based tests are also available for average-risk patients, though any abnormal result will need to be followed with a colonoscopy. Importantly, anyone experiencing concerning symptoms should be evaluated by a gastroenterologist regardless of age or screening history.

Early detection saves lives. Understanding symptoms, recognizing risk, and knowing when screening is appropriate can make a profound difference as the demographics of colorectal cancer continue to change.