Now let me ask you a question there’s something called the DEXA scan can you tell us what that is and the radiation involved and into patients be worried about that so the DEXA scan is what we commonly refer to as the bone density charge so it is the only way that we use to detect bone density and to determine if a patient has osteoporosis it can also help us determine if the bone health is normal so the density is normal or if a patient has what’s called osteopenia which is not quite osteoporosis but it is on the way there and the radiation is actually very small in fact they say it’s equivalent to your environmental exposure for the day okay you just mentioned something we follow-up you mentioned osteopenia you’re not quite at the osteoporosis level yet so if you do discover a patient might be suffering from osteopenia what can kind of be done to hopefully prevent them from developing osteoporosis great question and in that case I do see a lot of patients who have osteopenia and I do advise them if they haven’t already to optimize their diet intake of calcium and vitamin D if they haven’t already to incorporate bone weight-bearing exercises to stop smoking to reduce alcohol consumption and also very importantly to make sure that they are being careful of their surroundings and protecting themselves from a fall fall precautions are exceedingly important to discuss because most of us don’t have enough time in the day or nowadays multitask and walk around with our phone and miss a curb and and that’s not a great way to find out that you have osteoporosis