Dem bones

 

It was 2007.  I was on my way to teach Dance Movement Therapy in Warsaw, and I needed to park my car in some budget airport car parking.  I decided, before following the nice man to where I was meant to park it, to go to the loo inside their portacabin.  When I emerged, I saw that others were also waiting to be directed, and I was holding them up.  In my haste, I tripped on the way down the steps. I heard a snap, and felt intense pain.  I knew that I had broken my foot, but all I could think of was that I would be letting everyone down if I did not go to Warsaw.  Knowing my husband would question my decision to go if I rang him, I simply asked the kind men in the portacabin if they could organise a tubigrip for me.  One of them parked my car for me, and we agreed my son would come for it during the week.  It was not until I had gone through security that I rang my contact in Warsaw, told him I had hurt my foot, and asked him if he could arrange to take me to hospital at the other end.  Only then did I ring my husband.

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I had broken my fifth metatarsal – a classic footballer’s injury, as it turns out.  Being a clumsy oaf (you would never know I am a dancer!), I had had several fractures before, but I knew enough about osteoporosis to know I should ask for a DEXA scan when I returned.  I did.  It never came.  I asked again.  The results were delayed.  Finally, some time in 2008, I discovered I had osteopenia (which is basically like osteoporosis, but not so bad, ie the bones have started to lose density and so might be more inclined to break).  And so, two years later, I asked for a repeat scan, and then I learned I now had osteoporosis in my spine.  Progress of the disease had been quite rapid.  I was 58 years old.

I reacted by feeling frightened, and very sorry for myself.  My mother had osteoporosis, but her first fracture was at age 67 (she was not diagnosed until years later).  Here I was, having fractured at 56 years old, and diagnosed with osteoporosis at the age of 58.  My mother, who by now was in her 90s and bent double and contorted after repeated spinal compression fractures, had been given the most common drug for osteoporosis some years previously, then simply left to take it for the rest of her life.  There were no repeat scans, and no medication reviews.  When, after her death in 2011, I looked into the drug that I knew I would be offered if I asked for it (the one she had been on), I realised that the daily vomiting after breakfast that she had experienced for years was almost certainly due to this drug.  There was no way I was going to go on the same treatment, despite being terrified of ending up contorted and in constant pain, like her.  The drug had not prevented her spinal fractures, and in fact recent research suggests it might actually increase the risk of fractures if taken for too long!  I felt caught between the devil and the deep blue sea.

It took me some time to get my head round how to help myself, but eventually I found support on Facebook and through the National Osteoporosis Society (NOS, https://nos.org.uk/). According to NOS, one in two women and one in five men over the age of 50 will break a bone due to osteoporosis.  I am not alone, though I felt it until I found these sources of support.

Through my research, I discovered that diet and exercise can do a lot to help.  In fact, I already knew some of this, because I am interested in both.  Having studied nutrition as part of my BSc hons in physiology and biochemistry in the 1970s, I had told Mum’s GP years previously that she needed to prescribe vitamin D with the calcium (calcium alone has since been shown to predispose to heart attacks).  And, my work and research as a dance movement therapist had led me to read up about weight-bearing exercise and bone density. And so, gradually, I began to weave some self-help strategies into my daily life, reassuring myself that if my T score got as bad as -3 I would reluctantly go on the medication.  What happened, was that although by 2013 my spinal score was dangerously close to that value, by 2015 (with a few more tweaks to my self-care) it has begun to reverse ever so slightly, to the extent that it was no worse than the 2011 values.  I felt very pleased with myself, no longer as scared and out of control.

But then, my GP dropped a bombshell.  I was to be allowed no more DEXA scans, and was urged simply to go on the medication, since I had been shown to have osteoporosis and this was the recommended treatment.  I ignored him.  And so, still tweaking my diet and supplements, and with more yoga than ever in my week, I cross my fingers.  But how long, I wonder, before I get one of those spinal fractures?

And then, there is the other bony problem.  Mum had lots of osteoarthritis, which along with the multiple fractures and the stroke, disabled her and meant she was in constant pain.

Last year, at the beginning of 2016, I went on a post-retirement trip with my gorgeous husband.  We went to India (where I had a conference, taught a Dance Movement Therapy workshop, and then we travelled around southern India), then to Melbourne, to stay with my oldest friend who I have known since I was four and a half, then to New Zealand. New Zealand was the jewel in the grand tour, since we were going to see my daughter, her partner, and their toddler.  Our youngest son was also in NZ, having a kind of gap year.  After NZ, we visited my niece and her family, in Perth, before returning home to the UK.

We had an amazing time, and were away for just over two months.  During that time, we did some serious walking, particularly in NZ.  This included climbing a mountain (Ben Lomond), and walking part of the Abel Tasman Trail, not to mention more than one trek up my beloved Queenstown Hill.  The first picture shows me relaxing inside the Basket of Dreams, which is an art work positioned on top of QT hill. The second shows a view from the top of Ben Lomond.   Finally, part of the Abel Tasman Trail, which is probably one of the top two walks I have done in my life.

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While I was away for those two months, I noticed that the occasional pain I got in my right hip had become a daily occurrence, and I resolved to speak with my GP on my return.  For some months prior to my retirement, I had also noticed a pain in my right buttock when rushing for the train at the end of the day, and wondered why I was getting what I assumed were spasms in the muscle.  I hadn’t thought much of it, and certainly had not related it to the pain I got in my groin.  That association came much later.

I did indeed eventually speak with my GP, and by now the pain had worsened a bit.  He sent me for an x-ray, which I had a couple of weeks before going on yet another walking holiday, this time to the Pembrokeshire Coast Path.

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This one rates in my top two walks ever, along with Abel Tasman, but my enjoyment was marred by the pain in my hip, which by now was bordering on agony.  We aimed for about eight miles a day – nothing too long for someone as fit as me, but with a lot of ups and downs.  I took painkillers each day with my lunch, but they didn’t really touch me.  One day, somewhere near my 64th birthday in June of 2016, the walk turned into an eleven miler, and I was in tears before the end of it.  It was that day that I rang the surgery, to discover that the diagnosis was osteoarthritis.  Another of my mother’s conditions, which caused her almost unbearable pain.

Once again, I was consumed by images of my aged mother, and again I realised my diagnosis had come much earlier than hers.  If she was in the agonising pain she was in before she died, on morphine derivatives for years, then what was my destiny?

I got a referral to the local musculo-skeletal service, which led to an MRI scan, which confirmed the diagnosis, and eventually I saw an orthopaedic surgeon.  It took until very recently, in March 2017, for him to inject my hip with steroids (partly due to my own deliberate procrastination).  Content that this had given me some degree of temporary relief, he discharged me this week.

The truth is, though, that by the time I had got to see him, I had managed to develop a state of relative ease, once again using a range of self-help approaches. I continued with some modifications with my yoga and dance (including a contemporary dance performance with a community dance group to which I belong), and started doing acquasise classes.  I reluctantly reduced the length of my walks to five miles (I recently did seven, and was pretty chuffed with myself until the pain kicked in when I tried to sleep at night).  In terms of diet, I decided to follow the Mediterranean diet, cut out red meat first, then stopped drinking alcohol on January 1st, and finally I recently became pescatarian.  I have never again had the kind of pain I experienced last summer, though I am not complacent.  I have a degenerative condition. One day, I might find my mobility is severely impaired, but I am ready with my argument; if you don’t give me a hip replacement, I will find I cannot exercise as much as I normally do.  Would the NHS prefer to give me a hip, or for me to develop one of the many diseases associated with a sedentary lifestyle?  Of course, that is if we still have an NHS by then …

This has been a long blog, and not a particularly happy one.  Am I angry that I have these conditions?  Well, no, actually.  Despite being at times terrified of what the future might hold, I am not one to ask the ‘why me’ question.  The fact is, that we all get various conditions as we get older.  If we did not slow down, who would our grandchildren have, to walk at their pace?  We would still be rushing past all the flowers and trees and wonders of this world in which we live.  And I would probably not have given up alcohol.  Which is another story.

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