E. Michael Lewieck , MD is Clinical Assistant Professor of Medicine at University of New Mexico School of Medicine and Director of New Mexico Clinical Research & Osteoporosis Center.
He is a consultant in osteoporosis and metabolic bone disease, supervisor and interpreter of bone density studies at his center, and an educator with a special interest in the management of osteoporosis and metabolic bone disease. He is principal investigator for the center's osteoporosis clinical trials and author of many peer-reviewed scientific publications on osteoporosis and bone densitometry.
Dr. Lewiecki is past-president of the International Society for Clinical Densitometry (ISCD).
He is a faculty member for the ISCD educational programs in bone densitometry and vertebral fracture assessment, and is on the Editorial Board of the Journal of Clinical Densitometry. He has received national and international awards, including "Young Internist of the Year" by the American Society of Internal Medicine in 1986, "Physician of the Year" by the ISCD in 2002, the ISCD "Paul D. Miller Service Award" in 2006, and the "Laureate Award" of the New Mexico Chapter of the American College of Physicians in 2006.
He is a fellow of the American College of Physicians and the American College of Endocrinology.
Dr. Lewiecki is president and founder of the Osteoporosis Foundation of New Mexico and director of its educational activities. He is past-president of the New Mexico Society of Internal Medicine and past-president of New Mexico Medical Group. He established and is program director of the annual Santa Fe Bone Symposium.
Dr. Lewiecki, who was raised in the Boston area, is a graduate of Amherst College and Northwestern University Medical School.
He completed postgraduate training in internal medicine at University of New Mexico Health Sciences Center and is board-certified in internal medicine. After serving two years as a medical officer in the United States Air Force, he settled in Albuquerque, where he has remained ever since.
Lance A. Rudolph, MD
Research Director. Biography:
Lance A. Rudolph, MD, is a board-certified internist in Albuquerque, New Mexico.
He is Research Director of New Mexico Clinical Research & Osteoporosis Center and Clinical Assistant Professor of Medicine at the University of New Mexico School of Medicine. His responsibilities include the development and supervision of the clinical research program, interpretation of bone density tests, and management of the clinical practice.
He has conducted research studies since 1988 and has been principal investigator for a wide variety of studies
including diabetes, arthritis, hypertension, chronic pulmonary disease, asthma, gastrointestinal disorders, headache, osteoporosis and ambulatory infectious diseases. He is certified in bone densitometry by the International Society for Clinical Densitometry. His special interests include bone structure and metabolism, and osteoporosis in persons with disabilities.
He is a member of the American College of Physicians - American Society of Internal Medicine and served on the council of the New Mexico Chapter from 1985 through 1998.
He has served as President and Treasurer of New Mexico Medical Group, Inc., a large multi-specialty medical group. While in this group, he co-founded and directed the New Mexico Medical Group Research & Education Foundation, a non-profit foundation to conduct clinical research, physician and patient education. He is a member of the American Society for Bone and Mineral Research, the International Bone and Mineral Society, and the National Osteoporosis Foundation.
Dr. Rudolph was raised in Southern California.
He earned his undergraduate degree at UCLA, and a medical degree from USC. He served on the staff of the Albuquerque Indian Hospital from 1976 through 1984 and was Medical Director of Outpatient Medicine for 6 years. In 1984, he established a private practice in internal medicine and started a clinical research program. Through his leadership this program has been developed into the New Mexico Clinical Research & Osteoporosis Center, one of the largest independent clinical research facilities in New Mexico. He is married with 1 son. He enjoys bicycle racing, swimming, and long distance running.
Julia Chavez, RN, MSN, CFNP
Adult Medicine Women's Healthcare. Biography:
Julia R. Chavez is a certified family nurse practitioner who is a registered nurse with a master's degree in science and nursing.
She is experienced in the practice of adult medicine, with a special interest in women's healthcare. She will provide primary care services and also be involved in our clinical research trials and osteoporosis studies. She is now accepting new patients.
Julia, whose maiden name is Pacheco, has a fascinating family background.
She is a 10th generation New Mexican, with roots in this part of the world since the early 1700s, when her ancestors came here from Spain. Julia comes from a family of 12, many of whom have gone on to successful careers as physicians or nurses.Other siblings have entered academic careers, with one rising to be a university president and another becoming a college president. After raising 12 children, her mother still had the energy to go to college, getting a bachelor's degree at the age of 59.
Julia was valedictorian of her high school class in Maxwell, New Mexico.
She served in the Peace Corps in Bolivia for two years, and has done volunteer medical work for the needy here in New Mexico. She is fluent in Spanish.
Julia's family was selected as Southwest Hispanic Family of the Year in 1992.
The entire family traveled to Washington, DC, for an award ceremony and reception with First Lady Barbara Bush at the White House.
Julia is married with 3 children and 2 grandchildren.
In her spare time she enjoys reading, listening to music, and doing volunteer work for Mothers Against Drunk Drivers (MADD).
Valerie Barton, CCRC
Clinical Research Manager. Biography:
Valerie Barton has her associate's degree in Liberal Arts.
She has been a certified medical assistant since 1976. Her current position is Clinical Research Manager. Her responsibilities include the operation and performance of the Clinical Research Program.
She has conducted research studies since 1988 and has been the clinical research coordinator for a wide variety of studies including diabetes
arthritis, hypertension, chronic pulmonary disease, asthma, gastrointestinal disorders, headaches, osteoporosis and ambulatory infectious disease. Her certification is from The Association of Clinical Professionals since January 1, 1997. She was recognized by the Academy of Clinical Research Professional at the National conference for maintaining her certification over a ten (10) years period. Without her commitment to high quality research trials, potentially life-saving therapies would not be available to the patients who need them.
She is the Co-founder of the New Mexico Chapter of Association of Clinical Research Professional.
She has served as the chapters Secretary/Treasure and Chapter President.
Valerie's maiden name is Martinez; she was born and raised in Albuquerque, New Mexico.
She is the 12th generation New Mexican with roots in Northern New Mexico since 1598, when her ancestors came here from Spain and England. She has three sisters and one brother, all who have achieved successful careers as teachers, business owners and management. Her father Lloyd served bravely in World War II and again in the Vietnam War along with her brother Lloyd. He retired from Kirtland Air Force base as a Civil Engineer. He was ordained as a deacon by Archbishop Robert Sanchez in 1976. He serves as a deacon for Sangre De Cristo Catholic Community. Her mother along with her father was commissioned by Archbishop James Peter Davis as Acolyte ministry to the sick. Her sister Cathi Moya has her master's degree in Education and was honored with the National Teacher of the year award. She along with her husband traveled to Washington DC for an award ceremony and reception with President Clinton.
Valerie has one daughter, a granddaughter and grandson.
In her spare time she volunteers for Project Love, which feeds and clothes people who are in need. She enjoys studying the bible, cooking, painting, scrape booking, hiking, biking and spending time with her family and friends.
We are deeply committed to educating healthcare providers and the public on issues relating to osteoporosis and bone metabolism. Our physicians are board certified in internal medicine, certified in bone densitometry by the International Society for Clinical Densitometry, and on the clinical faculty at University of New Mexico School of Medicine. They are clinicians with a consultative practice in osteoporosis, researchers investigating new treatments for osteoporosis, and educators with an interest in a variety of osteoporosis-related topics. They have lectured on osteoporosis and taught bone densitometry courses throughout the US. Our trained bone densitometry technologists and staff members are also skilled osteoporosis educators.
Dr. Lewiecki and Dr. Rudolph have prepared osteoporosis educational presentations for healthcare professionals and the public. Staff members have presentations targeted to staff of other healthcare providers and the public. Upon request, a CV, biography, disclosure statement, and sample introduction will be provided for Dr. Lewiecki or Dr. Rudolph.
Each presentation typically takes 40-50 minutes and is usually followed by open time for questions and answers. The presentations are frequently revised to reflect advances in the field. The length and format may be adjusted as needed. Other presentations can be developed to meet the requirements of the audience.
Most presentations are given by PowerPoint with a laptop computer. We will provide the computer and laser pointer, and may be able to bring a projector, depending on availability. We request that you provide a screen, appropriate audio equipment, and an LCD projector when necessary, unless other arrangements are made in advance. Some presentations can be made with a standard carousel slide projector.
Upon request, a printout of the PowerPoint presentation and supporting educational materials can be provided in advance, so that they can be copied and distributed to the audience.
For scheduling, arrangement of sponsorship for presentations, or additional information, contact Yvonne Brusuelas, Osteoporosis Education Coordinator, at telephone 505-855-5525, fax 505-884-4006, or email firstname.lastname@example.org. Due to the great demand for osteoporosis presentations, we appreciate scheduling as far in advance as possible.
Topics for Presentation
"The Osteoporosis Revolution."
This is a very popular talk for the public- civic organizations, retirement centers, the elderly, mid-life groups, and even high schools. Osteoporosis is a disorder that impacts all of us, either directly through low bone density and osteoporotic fractures, or indirectly by contact with friends or relatives. Osteoporosis results in a tremendous cost to society from health care expenses, loss of productivity, pain, disability, and even death. The definition, consequences, recognition, prevention and treatment of osteoporosis are presented.
"Celiac Disease and Osteoporosis."
Patients with intestinal malabsorption due to gluten-induced enteropathy, inflammatory bowel disease, or short bowel syndrome are at high risk for osteoporosis and fractures. General information about osteoporosis is presented; current research is reviewed; and evaluation and treatment is covered.
Patients with organ transplants are at high risk for osteoporosis due to chronic debilitating illness, nutritional factors, and immunosuppressive medications. Resulting osteoporotic fractures may impair lifestyle and cause loss of independence, despite a successful transplant. Prevention and treatment of transplantation osteoporosis is discussed, and protocols for managing this problem are presented.
"Nutrition and Osteoporosis."
Nutritional factors play an important role in the development of peak bone mass and in preventing bone loss later in life. Dietary and supplemental intake of important minerals and vitamins is discussed. The evidence for nutritional involvement with bone metabolism is presented.
"Osteoporosis in Persons with Disabilities."
It is often not recognized that persons with disabilities are at high risk for osteoporosis. Fractures resulting from osteoporosis can cause even greater disability and loss of independence. The importance of this problem to society and to individuals is presented, and approaches for management are discussed.
Vertobroplasty & Kyphoplasty
There are 28 million Americans with osteoporosis or osteopenia, resulting in 1.5 million fragility fractures per year with direct health care costs of approximately $13 billion(1). About 700,000 of these fractures are vertebral compression fractures, of which about 270,000 are clinically diagnosed(2). New vertebral fractures that are not clinically detected nevertheless cause a two to three-fold increase in back pain and functional limitation(3). Five percent of 50 year-old women and 25% of 80 year-old women have had at least one vertebral fracture(4). Clinical consequences of vertebral compression fractures include pain, loss of height, deformity, reduced pulmonary function(5), disability, diminished quality of life(6), and a 15% increased mortality rate(7).
Treatment of vertebral fractures
Conventional medical therapy for vertebral fractures includes bed rest, narcotic analgesics, salmon calcitonin, external back bracing, physical therapy, hospitalization, and skilled nursing care. Unfortunately, medical management of painful fractures may itself compound the problem, since lack of mobility can increase the rate of bone demineralization and increase the risk of additional fractures(8). Although most patients respond to conservative treatment and heal within weeks or months, a minority of patients continue to suffer pain. When there is concurrent spinal instability or neurologic deficit, open surgery with fracture reduction and stabilization has been used. Due to the high risk of surgery, minimally invasive techniques, such as vertebroplasty and Kyphoplasty(tm) have been developed.
This procedure was first performed by interventional radiologists in France in 1984, and in the USA in 1995. The minimally invasive procedure involves the high-pressure injection of bone cement (polymethylmethacrylate) through a 10 or 11 gauge needle through both pedicles into the vertebral body, usually using biplane fluoroscopic control(9). Vertebroplasty has been used to treat fractures caused by osteoporosis, metastatic tumors, multiple myeloma and vertebral hemangiomas(10). It is a safe and effective method of treating disabling pain in selected patients who are refractory to conservative measures. Pain relief often occurs within one hour of the procedure, which can be performed with local, regional, or general anesthesia. In a series of 80 patients with osteoporotic vertebra l fractures treated and followed for one month to ten years, more than 90% had immediate results that were excellent, with complete relief of symptoms within 24 hours(11). There was one complication an intercostal neuralgia treated by local anesthetic infiltration. In another study(12), 29 patients with 47 osteoporotic vertebral fractures were treated over a period of three years. Twenty-six (90%) of patients treated experienced pain relief and improved mobility with 24 hours after treatment. The only clinical complications were two nondisplaced rib fractures resulting in limited chest pain which subsequently resolved. As many as 7 vertebral bodies have been injected in one patient, with excellent results(13).
Painful osteoporotic vertebral fracture(s) refractory to medical therapy; associated major disability (failure to walk, transfer, or perform activities of daily living); painful vertebral fracture or impending fracture related to benign or malignant tumor; painful vertebral fracture associated with osteonecrosis; unstable compression fracture that demonstrates movement at the wedge deformity; conditions where reinforcement of the vertebral body or pedicle prior to a posterior stabilization procedure is desired; patients with multiple compression deformities from osteoporotic collapse in whom further collapse would result in pulmonary or GI compromise; chronic traumatic fractures in normal bone with non-union of fracture fragments
Asymptomatic stable fracture; patient clearly improving on medical therapy; no evidence of acute fracture and no planned spinal destabilization procedure; osteomyelitis of target vertebra, acute traumatic fracture of non-osteoporotic vertebra; uncorrectable bleeding disorder.
Radicular pain significantly in excess of vertebral pain; retropulsed fragment causing significant spinal cord compromise; tumor extension into the adjacent epidural space with significant spinal cord compromise; very severe vertebral body collapse ( 70%); stable fracture known to be more than two years old.
Kyphon Inc. has developed a bone tamp which can be inserted through a small cortical window in the vertebral body or pedicle and inflated to reduce vertebral compression fractures. The procedure can create a void in the trabecular bone and restore vertebral body height, thereby allowing a stabilizing material to be injected under low pressure. This device is similar to other devices that have been used for other types of fractures for many years, and on this basis received FDA approval in 1998. Preliminary reports have shown that this procedure is similar to vertebroplasty in safety and efficacy, with the added benefit of vertebral fracture reduction and partial reversal of skeletal deformity. A randomized controlled study is now underway at approximately 30 centers in the USA, comparing Kyphoplasty(tm) to conventional medical therapy for the treatment of acute osteoporotic vertebral fractures.
Indications, Contraindications & Risks
Similar to vertebroplasty, although Kyphoplasty(tm) can be expected to have the greatest potential to correct skeletal deformities in the setting of an acute, rather than chronic, vertebral compression fracture.
Pain relief, fracture stabilization, fracture reduction, correction of skeletal deformity.
Ray NF, Chan JK, Thamer M, Melton LJ III. Medical
expenditures for the treatment of osteoporotic fractures in the United States in 1995: Report from the National Osteoporosis Foundations. J Bone Miner Res 1997;12:24-35.
Cooper C, Atkinson EJ, O'Fallon WM, Melton LJ III.
Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985-1989. J Bone Miner Res 1992;7:221-7.
Nevitt MC, Ettinger B, Black D, Stone K, Jamal SA, Ensrud K, Segal M, Genant HK, Cummings SR.
The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Int Med 1998;128(10):793-800.
Melton LJ III, Kan SH, Frye MA, Wahner HW, O'Fallon WM, Riggs BL.
Epidemiology of vertebral fracture in women. Am J Epidemiol. 1989;10:283-96.
Schlaick C, Minne HW, Bruckner T, Wagner G, Gebest HJ, Grunze M, Ziegler R, Leidig-Bruckner G.
Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporos Int 1998;8:261-67.
Cortet B, Houvenagel E, Puisieux F, Roches E, Garnier P, Delcambre B.
Spinal curvatures and quality of life in women with vertebral fractures secondary to osteoporosis. Spine 1999;24(18):1921-25.
Office hours are from 8:30 AM to 5:00 PM on weekdays.
The receptionist will ask to verify your insurance information, address, and telephone number at the time you check in for your appointment. This is necessary in order to correctly process your insurance claim.
In most cases, we will bill your insurance company or health plan. You are responsible for payment of your deductible, co-pay, and any non-covered services. These charges need to be paid at the time of the office visit. If you have any questions about the billing process, please call our billing department at (505) 855-5525.
A physician is on-call 24 hours per day if you have an emergency. If you need help when the office is closed, call the answering service at (505) 857-3844. If you have a serious medical problem that requires immediate medical attention, dial 911 or proceed to a hospital emergency room. We are on the consulting medical staff for Presbyterian Hospital and Lovelace Medical Center. If you need to be hospitalized, physicians called "hospitalists" will manage your care while you are in the hospital. We prefer that you use one of the downtown hospitals, because they are full-service facilities that can handle all types of problems.
After Office Hours
If you have a medical problem or concern that cannot wait until regular office hours, then call the answering service at (505) 857-3844. You will be called back by your physician or the physician on-call.
Your medicine may be an important part of your treatment. It is vital that you understand as much as possible about your medicines, and that you take them properly. 1. Learn the name and dose of each medicine you are taking. If you cannot remember this, keep a list with you at all times, or bring your medications with you to each office visit. 2. Never stop taking a regular medication without checking with the physician first. 3. If you think you may be having a serious side effect from a medicine, call right away. 4. Plan ahead. Make sure you have enough medication to last until your next appointment. If you are taking a trip out of town, take along an ample supply of medicine.
We will always try to give enough medication to last until your next regular appointment. If you run out of medicine, it usually means you are late for your appointment. If you must call for a telephone refill, please allow up to one week for the request to be processed. Antibiotics and narcotics will never be prescribed over the phone.
Appointments are made by calling the receptionist during office hours. If you have an urgent problem that cannot wait until a routine appointment time, please tell the receptionist so that we can arrange to have you seen as soon as possible.
We are on the consulting medical staff for Presbyterian Hospital and Lovelace Medical Center. If you need to be hospitalized, physicians called "hospitalists" will manage your care while you are in the hospital. We prefer that you use one of the downtown hospitals, because they are full-service facilities that can handle all types of problems.
If you think you need a referral to another physician for a consultation, you must first make an appointment to see your primary care physician for evaluation. If a referral is necessary, we will contact your health plan within a few days. You need to call the office of the consulting physician to arrange the appointment. If you wish to confirm that your referral went through, then the day before your appointment you can call the physician to whom you were referred, or you can call your health plan directly. Referrals will be made by phone only in cases of emergencies. *Referral requirements are dependant on Health Plan Benefits.
We receive a tremendous number of telephone calls every day. We must ask for your help in keeping the calls to a manageable level. If you have to be put on hold when you call, we will do our best to make the time as short as possible. Please do not call us to check on the status of referrals to other physicians (see previous section for the correct way to do this). We will call you within a week of receiving the final report of any tests that are done, unless arrangements are made for a follow-up visit to do this. If you do not hear from us on any test, do not assume that it is normal. Call the office to be sure we received the report and get the results.
Our mission is to provide the highest level of service for our patients, with special interest in clinical research, osteoporosis care, and bone density testing. We offer consultations for osteoporosis and metabolic bone disease.
New Mexico Clinical Research & Osteoporosis Center, Inc. is an organization dedicated to clinical research, the diagnosis and care of osteoporosis, and medical care in the specialty of internal medicine. This web site tells you about the doctors, their organization, and office policies and procedures.