Episode 85: Dr Andy Bush: A New Approach to Bone Health Part 1

Stronger Bones Lifestyle Podcast: Take Control of Your Bone Health

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[3:12] His bone health practice and background as orthopedic surgeon
[5:49] The old fashioned way of medicine and how his practice works
[9:18] REMS and DEXA scans
[13:40] Stiffness index and fragility score
[16:58] Disempowerment of DEXA
[18:59] Working with bones
[21:22] Bone structure
[23:45] The forces of a fall
[24:36] Why Dr. Andy uses the fragility score to assess bone health

From DEXA to REMS: New Frontiers in Bone Health Assessment

Welcome back to the Stronger Bones Lifestyle Podcast. In Episode 85, host Debi Robinson welcomes esteemed orthopedic surgeon Dr. Andy Bush to delve into groundbreaking advancements in bone health diagnosis and management. Together, they explore innovative techniques like REMS (Radiofrequency Echographic Multi Spectrometry) and discuss how these advancements are pivotal in more accurately assessing and managing bone fragility.

Dr. Andy has a diversified background, transitioning significantly into bone health practice during the pandemic. He’s known for integrating a holistic approach into his practice, which not only includes surgical interventions but also comprehensive lifestyle assessments and complementary therapies. During this episode, Dr. Andy highlights the limitations of traditional DEXA scans, revealing how the REMS technology he employs can offer a more detailed understanding of bone strength through a fragility score.

Join Debi and Dr. Andy as they explore the pros and cons of current bone health diagnostics, and the importance of evaluating bone health beyond mere density. 

"That’s why I like REMS, the fragility score, the ability to look at the structure of the bone not just the density." [15:55]

"DEXA can be so disempowering and it pulls the rug out from some many women." [16:58]

"REMS can give you the same information that a CAT scan can as far as the structure of the bone." [27:05]

"I think REMS gives us a tool that we can then use to give a better idea to somebody about what's happening because bone structure really is what determines fracture rise, density does not." [31:34]

Listen to more episodes on Bone Health and Osteoporosis

Frequently Asked Questions (FAQs)

REMS (Radiofrequency Echographic Multi Spectrometry) scans use ultrasound technology to measure bone structure and generate a fragility score, providing a more comprehensive assessment of bone strength compared to DEXA scans. Unlike DEXA, which focuses solely on bone density, REMS evaluates multiple properties of the bone, offering insights into fracture risk by comparing ultrasound results to a database of bones from individuals who have sustained fractures.

DEXA scans provide a T-score based on bone density, which can feel disempowering because it doesn’t account for other structural properties of the bone. This narrow focus can create fear and a sense of hopelessness about bone health, especially when the results suggest osteoporosis or osteopenia without providing a full picture of bone

DEXA scans are typically performed once every two years, but Medicare can cover them annually if requested. However, the frequency might vary based on individual health concerns and doctor’s recommendations.

Dr. Bush integrates a holistic approach in his practice, combining surgery with lifestyle assessments, dietary advice, exercise recommendations, and other therapies. He believes in evaluating patients’ overall lifestyle and health, rather than just following a problem-solution model.

REMS technology provides patients with detailed insights into their bone structure and fragility, helping them make more informed decisions about their bone health. This comprehensive assessment can alleviate anxiety about unknown health conditions and guide more effective treatment plans.

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