Dr. Kimberly Zambito backstory

Greetings, Bone Babes! This is Dr. Kimberly Zambito. I’m happy to share my story about Bone Health and the Echolight REMS technology. I am an orthopaedic surgeon with a subspecialty in hand surgery. My interest in bone health began when I was a medical student. During 3rd year of medical school, students choose specialty pathways to guide their clinical rotations in the 4th year of medical school. I chose to combine two pathways- orthopaedic surgery and women’s health. Some people did not understand why, since orthopaedic surgery is such a male dominated field, and really, what does women’s health have to do with ortho? I listened to what critics had to say and I listened to advice from the few supporters who thought I had an interesting idea. I chose to follow my heart, my gut, and some great advice from women advisors who believed I could combine the two. To make a long story short, I completed a 5 year residency training in orthopaedic surgery, a one year fellowship in hand surgery, then embarked on my career in orthopaedic surgery/hand surgery and military service in the US Army Reserves. I absolutely loved serving our country. Caring for the men and women who have made incredible sacrifices on our behalf was an incredible honor. I deployed multiple times over the first 9 years of my career. The multiple deployments made continuity of care for my patients challenging. As a result, I developed relationships with colleagues (rheumatologists, endocrinologists, OB/Gyns, etc) who were able to serve patients in need of bone health optimization following orthopaedic surgery. Once my military career ended, I decided it was time for me to really engage my patients regarding their bone health. Yes, I fix broken bones. As much as I like fixing broken bones, I feel I have not provided complete care for my patients unless I can help my patients prevent the next fracture.

As I began to build a bone health program to engage my patients, I thought about the things I want. After all, I am at the magic time in life when a gal wakes up in the morning and ask, “what is going on…ugh…what’s starting to sag today…why aren’t my arms long enough to read the menu anymore…and man, now I understand why my grandparents cherished conversations about bowel movements?” I apologize for getting off track. What do I want for myself? I want to live life well- grateful for every blessing bestowed upon me. I want to age well with an appreciation that aging is a normal part of life and it is okay to evolve and grow on many levels. I want to optimize the things I can optimize…without medications.

Then I listened to the bone health community…just listened and read and learned from patients, from people who took a different approach to bone health, and to professional organizations.

Common themes surfaced. One theme was that no one really likes DXA because it has been fraught with errors. I researched different options including REMS technology. REMS technology has been available in Europe for many years. It was approved for use in the United States in late 2018. Echolight established a team in the US in 2019, then in March 2020, life was changed by COVID-19. For those individuals who want to know why there aren’t many REMS units in use in the US and why more doctors don’t know about it…here is your one simple answer. For those of you who have been living under a rock, there was a pandemic which crushed the world for two years. Trying to move forward with anything has been a challenge- no travel, no professional meetings to offer face-to-face engagement with other professionals, etc.

When I learned about the technology, I contacted the Echolight US team. In March 2021, I acquired the unit. I have performed scans on over 200 patients who come from all over the US and Canada. The information about bone quality as reflected in the Fragility Score is information patients cannot obtain from any other type of technology available. Someone may mention TBS, but that is a topic for another discussion. The technical aspects of REMS are for other posts. For this post, I really want to share two things. When I scan a patient, I get to spend time with my patient talking about whatever comes to mind- sometimes questions about REMS, sometimes about kids and life events, sometimes we have a good laugh about the last time we had “goo” on our bellies for ultrasound, sometimes we talk about gardening. I. Get. Time. With. A. Patient. Let that sink in. As a physician, that time is not valued by administrators or insurance carriers who would rather I cut and cure and see a patient every 5 minutes, then spend quality time with a patient. This is a criticism of healthcare in the US, not a criticism of former employment structures. The Echolight REMS technology allows me to engage patients. Its portability will allow me to reach out to underserved people who may not be able to get a DXA for various reasons.

The second thing I want to share is this- women with small bone structure who have lived healthy lives have been told they have osteoporosis and need to go on medication. Women who have never broken a bone. They have been scared…and I mean SCARED…that they are going to crumble and become disabled because a physician scared them. The REMS Fragility Score is a reflection of the QUALITY of bone. There are many women with low bone density and NORMAL quality of bone. Acquiring this information gives these women peace of mind that they will not disintegrate or crumble. In fact, it opens their minds and hearts to develop a relationship with their doctor and engage their doctor to develop a comprehensive plan for their bone health, rather than just simply taking medication. While some patients will benefit from medication; there is so much more to bone health- nutrition, exercise, balance, fall prevention, etc. Those are topics for The Bone Matrix group.

I believe REMS is ground-breaking technology that will change bone health conversations from a “you’re going to fall apart because your T-score is negative infinity” to “yeah, you have low bone density, but your bone quality is normal…and you’ve never broken a bone, let’s talk about how we can help you age well and prevent fractures…and no, you don’t need a medication at this point in time.”

That’s my story, Bone Babes. As for the nay-sayers, I’ve dealt with nay-sayers before…and in the sage words of Forest Gump, “That’s all I have to say about that.”