An interview with Susan Ott, MD

Dr. Susan Ott received her BA degree from Stanford University and her MD from the University of Washington. She did a combined residency in Family Practice and Internal Medicine at the University of California at Davis and further training as a nephrology fellow at the University of Washington, after which she joined the faculty.

She is currently Associate Professor of Medicine, with adjunct appointments in Radiology, Orthopedics and Pathology. Her career has been in metabolic bone diseases, including renal osteodystrophy, osteoporosis and rickets. She also does research into factors involved in bone strength and the quality of bone.

Visit Susan Ott’s educational website with Osteoporosis and Bone Physiology info: http://courses.washington.edu/bonephys/

Many people wonder how a nephrologist (a kidney specialist) came to be working with orthopedic surgeons in a bone and joint center and treating osteoporosis. When I was a fellow I wanted to take care of kidney dialysis patients and became especially interested in the bone disease that occurs in almost all patients who receive dialysis.  At that time I was working with Dr. Donald Sherrard, and we discovered (along with some of our colleagues in Los Angeles and Denver) that aluminum could deposit in the bones and cause a terrible bone disease which was painful and deforming.  The disease did not respond to any of the usual medications.  This aluminum was in the water used for dialysis.  Once the problem was identified nephrologists used water purifiers that eliminated the aluminum, and now we rarely see that problem.  Doing these studies caused me to become interested in research about bones, and the next study was done with Dr. Chesnut.  We wanted to know if calcitriol (a hormone related to vitamin D that is made in the kidney) could help with osteoporosis.  It turned out not to help, but in the meantime I also became interested in osteoporosis.  Since then I have remained on the faculty and have done studies with osteoporosis and kidney bone disease.

What do you most enjoy about your work?

I like the challenge of trying to understand what is happening to make someone's bones become weak and break easily.  I like to teach the residents and fellows that rotate through my clinic; often these young doctors learn things by listening to me explain them to the patients.

What is your treatment philosophy?

The most important thing is to learn all the details in an individual patient that could affect the bones, and then to use medical knowledge to design the best treatment plan.  This requires constant reading of medical journals and going to meetings to keep up with new findings.  But that is not enough; nothing will work if patients do not not follow their treatment plan. I think they are more likely to work at improving their bone strenght if they understand why the medicines and other treatments are beneficial, so I try to explain this to patients and to answer their questions.

What are your interests outside of medicine?

I love to hike in the mountains, especially at Mt. Rainier.  I also like origami and reading literature.  While my daughter was in school I spent one day each week working in the school libraries, and have helped the teachers with their web pages.

My web pages go all the way from middle school to medical school.  I am a permanent member of the education committee of the American Society for Bone and Mineral Research and am the webmaster of their educational curriculum about bones.  I give lectures to doctors here in Seattle and around the world.  Young medical students and residents work with me in the clinic on a regular basis. 

I am also part of the "Bone and Joint Decade" and gave a program for the public at the Seattle Public library, along with Patricia Barker, a ballerina at the Pacific Northwest Ballet company.  I recently was involved with planning and participating in a program about aging, which was on public television (KCTS) January 10 - called the Art of Aging.
 

What do your most recent research efforts focus on?

• Effect of bisphosphonates on bone quality in women with breast cancer.
• Effect of contraceptives on bone density and fracture rates - I am a member of a research team heading by Delia Scholes, an epidmiologist.
• Treatment of renal osteodystophy.

What is the focus of your clinical efforts?

Osteoporosis, Osteomalacia, Paget's Disease, Transplant bone disease, Renal Osteodystrophy, Fibrous Dysplasia, Hypercalciuria, Hyperparathyroidism, Osteosclerosis.  I am on an international committee to make guidelines about treating patients with chronic kidney diseases.

Selected bibliography of Dr. Ott recent publications:

•             Ott SM, Oleksik A, Lu Y, Harper K, Lips P. Bone Histomorphometric and Biochemical Marker Results of A Two-Year Placebo Controlled Trial of Raloxifene in Postmenopausal Women. J Bone Mineral Res 2002;17:341-348
•             Scholes D, LaCroiz AZ, Ichikawa LE, Barlow WE, Ott SM. Injectable hormone contraception and bone density: results from a prospective study.  Epidemiology 2002;13:581-7.
•             Ott SM. Histomorphometric analysis of bone remodeling. in: Bilezikian JP, Raisz LG, Rodan GA, eds, Principles of Bone Biology, Academic Press, San Diego, CA. 2002:303-320.
•             Ott SM, LaCroix AZ, Ichikawa LE, Scholes D, Barlow WE. Effect of low-dose thiazide diuretics on plasma lipids: results from a double-blind, randomized clinical trial in older men and women. J Am Geriatr Soc. 2003;51:340-7
•             Ott SM. Bone Mineralization Density.  Advances in Osteoporotic Fracture Management. 2003;2:1-7.
•             Stehman-Breen C, Anderson G, Gipson D, Kausz AT, Ott SM.  Pharmacokinetics of oral micronized ß-estradiol in postmenopausal women receiving maintenance hemodialysis.  Kidney Int 2003; 64:290-294.
•             Roudier MP, Vesselle H, True LD, Higano CS, Ott SM, King SH, Vessella RL.  Bone histology at autopsy and matched bone scintigraphy findings in patients with hormone refractory prostate cancer: the effect of bisphosphonate therapy on bone scintigraphy results. Clin Exp Metastasis. 2003;20:171-80.
•             Reed SD, Scholes D, LaCroiz AZ, Ichikawa LE, Barlow WE, Ott SM. Longitudinal changes in bone density in relation to oral contraceptive use. Contraception 2003;68:177-82.
•             Boivin G, Lips P, Ott SM, Harper KD, Sarkar S, Pinette KV, Meunier PJ. Contribution of raloxifene and calcium and vitamin D3 supplementation to the increase of the degree of mineralization of bone in postmenopausal women. J Clin Endocrinol Metab 2003;88:4199-205.
•             Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM. The association between injectable hormone contracetion and bone mineral density in adolescent women. Contraception 2004;69:99-104.
•        Bauer DC, Black DM, Garnero P, Hochberg M, Ott S, Orlos J, Thompson DE, Ewing SK, Delmas P. Reduction in bone turnover predicts hip, non-spine and vertebral fracture in alendronate-treated women: The fracture intervention trial. J Bone Mineral Res 2004;19:1250-8.
•         Roudier MP, Corey E, True LD, Hiagno CS, Ott SM, Vessell RL. Histological, immunophenotypic and histomorphometric characterization of prostate cancer bone metastases. Cancer Treat Res. 2004;118:311-39.
•             Scholes D, LaCroiz AZ, Ichikawa LE, Barlow W, Ott SM. Changes in bone density among adolescent women using and discontinuing depot medroxyprogesterone acetate contraception. Archives Pediatric & Adolescent Medicine 2005;159(2):139-44.
•      Ott SM. Long-term safety of bisphosphonates. J Clin Endocrinol Metab. 2005;90(3):1897-9. 
•       Ott SM. Editorial: Sclerostin and Wnt signaling - The pathway to bone strength.  J Clin Endocrinol Metab. 2005;90(12) 6741-3.
•             Matsen FA, 3rd, Clark JM, Titelman RM, Gibbs KM, Boorman RS, Deffenbaugh D, Korvick DL, Norman AG, Ott SM, Parsons IMt, Sidles JA Healing of reamed glenoid bone articulating with a metal humeral hemiarthroplasty: a canine model. J Orthop Res 2005;23(1):18-26.
•             Faibish D, Ott SM, Boskey AL. Mineral Changes in Osteoporosis: A Review. Clin Orthop Relat Res. 2006;443:28-38.
•             Moe S, Drueke T, Cunningham J, Goodman W, Martin K, Olgaard K, Ott S, Sprague S, Lameire N, Eknoyan G. Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006;69(11):1945-53.