MAKING A DIFFERENCE IS IN HER BONES

One in five men and even some boys now develop osteoporosis and need to be made aware of the dangers. Prof Moira O’Brien, founder and chairwoman of the Irish Osteoporosis Society, tells Michelle McDonagh.

Most people regard osteoporosis as a woman’s disease, but one in five men now develop the “silent killer” and there is a need for an increase in awareness of this fact, according to one of Ireland’s leading experts in the area, Prof Moira O’Brien.

One in three women will develop osteoporosis and more women will die following hip fractures than from cancers of the ovary, cervix, and uterus combined. The incidence of osteoporosis in men has risen from one in 12 in 2004 to one in five in 2005 and this, Prof O’Brien believes is probably due to an increase in the numbers being examined for the disease.

“We were told before that men and children couldn’t have osteoporosis, but it is being picking up in more and more men and children. It’s often found in men with back pain or with a family history and when we examine children, we find quite often that boys, not girls, have osteoporosis or osteopinea” she explains.

Ireland has an ageing population and the incidence of osteoporosis and osteoporosis-related fractures is expecting to increase- a European study has predicted that hip fractures in women over age 65 will increase from approximately 41.7 million in 1990 to 74.5 million in 2050. It is estimated that worldwide, the annual cost of hip fractures will reach €132 billion by 2050.

As founder and current chairwoman of the Irish Osteoporosis Society, Prof O’Brien has a special interesting osteoporosis diagnosis and management, specifically in post-menopausal women, children on long term steroids or with chronic illnesses and patients suffering from anorexia.

Her impressive 25 page CV is a veritable tome that bears testament to a very full and active career which has involved speaking at hundreds of conferences around the world and contributing to over 120 medical and academic journals.

After qualifying in medicine at the Royal College of Surgeons of Ireland, Prof O’Brien did her internship at the Meath Hospital in Dublin and in Manchester and got her general hospital experience in the UK and Dublin. After getting married, she worked as a GP locum in Sheffield before returning to Dublin as lecturer and Assistant Professor in Anatomy at the RCSI.

She was Associate Professor of Anatomy at the RCSI from 1959-1984 where she ran a free student health and sports clinic at the College for many years. In 1985, Prof O’Brien was appointed Professor of Anatomy at Trinity College, where she set up the Human Performance Lab for the testing of sports people. She established the Osteoporosis Unit at Trinity in 1990, the Osteoporosis Research and Service Centre at Trinity in 1992 and the Irish Osteoporosis Society in 1998. She was also Chair of the Irish Menopause Society from 1993-96.

A keen sportswoman herself, Prof O’Brien played hockey and tennis and swam. She was Honorary Medical Officer to the Irish Olympic Council from 1979-89 and team doctor for the Moscow, LA and Seoul Olympic Games. She was also founding member and President of the Irish Sports Medical Association in 1981. She retains the title of Honorary Director of the MSc in Sports Medicine at Trinity College, a course she was instrumental in establishing in 1991.

On top of all these achievements, Prof O’Brien had visiting professorships in colleges around the world and was an external examiner for many of these institutions. She was a member of countless academic bodies and international organisations over the years. It was through her own involvement in sport and her work with athletes that Prof O’Brien first began to develop an interest in osteoporosis and its prevention.

It was through her own involvement in sport and her work with athletes that Prof O’Brien first began to develop an interest in osteoporosis and its prevention. Her unit at Trinity College had the very first DEXA scanning machine in Ireland, now regarded as a key tool in the diagnosis of osteoporosis. When the authorities at Trinity decided to close down the osteoporosis lab in 2005, much to Prof O’Brien’s dismay and disappointment, she had a full list of patients booked a year in advance for testing.

Two years later and well into her 70’S, Prof O’Brien is still working full-time with no intention of retiring in the near future. She greatly enjoys her work, in particular dealing with people. After leaving her post as Professor of Anatomy at Trinity, she went to work for the Charlemont Clinic in Dublin as a Consultant in osteoporosis and sports medicine. However, before long, she was head hunted by the Charter Medical Group to establish a centre of excellence in conjunction with Charter Diagnostic Imaging in Dublin.

Professor O’Brien is leading the advancement of research, training and clinical practice at the Smithfield based centre. She ways “I was impressed by the fact that Charter Medical had software for the scanning of children and people with anorexia. Many centres have basic machines, but this software is not available anywhere else in Ireland that I know of”.

“Dexa scanning cant just be a money-making racket, but a lot of Dexa machines are bought as a way of making money.   Unless you get the patient to fill out a questionnaire and explain what they should and should’nt do from the point of view of exercise, diet, medication etc….as we always did in Trinity, you cant have a good service. I am hopeful that Charter Medical can be a model for other centre’s”.

Osteoporosis truly is a silent killer, explains Prof O’Brien and many people don’t realise that they have the disease until they fracture or break a bone, at which stage their condition is often very advanced. It is estimated that there is an osteoporotic fracture every 30 seconds in the EU. One fifth of people who fracture a bone are dead within a year while half are never able to loo after themselves independently again. Prof O’Brien stresses the fact that osteoporosis is preventable and treatable but its vital to find the cause of the disease and treat it. This is why its so important to have patients fill out the questionnaire and identify their risk factors.

“The good news is that it is a disease that really can be very well managed and if detected early, the risk of fractures can be greatly reduced. Diagnostics are key here and I’m delighted to be working in partnership with Charter Medical who have state of the art diagnostic facilities, previously only available in a hospital setting”, says Prof O’Brien.

Charter Medical has agreed to provide free scans to the Irish Osteoporosis Society every year and Prof O’Brien is currently in discussions with the company on the number of scans that will be provided. Despite a hectic career, an indomitable septuagenarian dynamo still tries to find the time to swim regularly and just taken up Nordic walking. “I’m always up and down the stairs, meeting people, keeping busy and taking exercise. I love what I’m doing. If you enjoy what you’re doing, its not work and when you can help somebody to change in their life, it makes all the difference” she remarks.