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Carol - Interview 15

Age at interview: 71
Age at diagnosis: 70
Brief Outline: Following a wrist fracture Carol's GP sent her for a DXA scan and put her on medication for osteoporosis as a precautionary measure. She is on Bonviva (ibandronic acid) 150 mgs, once a month plus Adcal D3 twice a day. She fasts for six hours before taking Bonviva.
Background: Carol is married, works part-time and has two sons. Initially she felt devastated by her diagnosis but now she feels lucky because she can take control of her osteoporosis.

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Following a wrist fracture Carol’s GP contacted her because she felt Carol needed a DXA scan to find out whether or not she had osteoporosis. As a precautionary measure her GP prescribed Bonviva. After her diagnosis she has continued taking Bonviva (ibandronic acid) 150 mgs, once a month plus Adcal D3 twice a day. Carol follows the instructions which apply to Bonviva and takes one on the same date every month. After overnight fast of at least six hours and at least one hour before first food, drink, oral medication or supplements (including calcium) of the day. She swallows Bonviva whole with a plain glass of water whilst standing or sitting and does not lie down for an hour after taking it. She hasn’t noticed any adverse affects after taking this medication.
 
Carol appreciated the fact that her GP took that much interest following her wrist fracture, but at the time, she felt confident that she didn’t have osteoporosis. She was very active and as she put it ‘fit as a fiddle’. In March 2007 her diagnosis was confirmed and Carol felt devastated and saw herself in a wheelchair within months. In retrospect, she put her fears for the future down to ignorance about her condition. Carol says that it took her a good three months to get over her initial shock.
 
Her GP and her niece who is a specialist osteoporosis nurse provided her with lots of support, advice and information about diet, exercise and where to go to find out more about the condition.
 
Carol has made significant lifestyle changes. She makes sure that she has a balance diet full of the necessary nutrients she needs to keep healthy. Also she attends three exercise classes per week of Thai Chi and Chi Kung which she says are good for the body and mind. She also practices her exercises at home everyday for thirty minutes. In addition, she no longer drives but walks to and from the city centre. On average she walks about eight miles per week.
 
Carol feels lucky to have been diagnosed when she was because she is able to take control of her condition and make sure that she does all the necessary things she needs to do, to keep herself healthy and active. Carol also feels fortunate to have a GP whom she describes as ‘brilliant’.
 
 

Following a wrist fracture Carol’s GP send her to have a DXA scan. But while waiting for the test...

Following a wrist fracture Carol’s GP send her to have a DXA scan. But while waiting for the test...

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Well it was in October 2006 and I did a very silly thing. I stepped on a very slippery ramp. It was wet and I put one foot on it and went over the side. And I ended up with broken wrist. I broke the ulna and the radial bone. So I was in plaster, obviously for a few weeks and fortunately I have an excellent doctor who actually called me a month later and asked me to go down to the surgery because she felt that that I should have a DXA scan.
 
So I went down to see her and she was going to arrange the DXA scan but she said obviously that might take three months. So in the meantime she prescribed the Adcal D3, which is the calcium medication and also Bonviva which is the ibandronic acid. And she said, ”The reason I’m prescribing this is because the DXA may take three months and you may not have osteoporosis but if you do at least we’re three months’ ahead with the medication.
 
So I appreciated the fact that she took that much interest following a fracture. And at the time I was quite confident that I did not have osteoporosis. I felt as fit as a fiddle. I was very active. I could lift extremely heavy things. I have concrete garden ornaments and I could lift those and they were extremely heavy. So I felt, well, yeah I’ll take the medication and I’ll have the DXA but I know I’m fine.
 
So in, I didn’t have the, the DXA scan till, I think it was January and then I had to wait for the results. And the results came through March 3rd 2007. And I went to see my doctor and she gave me this news that I had osteoporosis. And I was absolutely devastated.
 

Carol believes exercise is important. She walks regularly, does Tai Chi and Chi Kung weekly but...

Carol believes exercise is important. She walks regularly, does Tai Chi and Chi Kung weekly but...

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So what I did in the January, I joined a Tai Chi class because my niece, amongst all the leaflets that she’d sent me was this book from the National Osteoporosis Society, which talked about exercise. I had heard that Tai Chi was really good exercise. So I joined this class January 2007 and I go once a week. And I also practice at home very day. And then in the July I joined a Chi Kung Chinese exercise class, which again is very good. It’s all good for the body and the mind. So I’m still attending that one. And I also attend another Tai Chi class, which is a different form. I joined that in January of this year. So I’m doing the three types of Chinese exercise, three times a week, plus I do it every day at home myself.
 
So I thought that at least will hopefully help. And because obviously exercise is important. We live a mile from the town and whereas I used to take the car now I’ll walk down and walk back.
 
Yes, so I just feel that the exercise is important. And whereas I thought my life had come to an end, I mean, obviously it hadn’t come to an end at all, I just had to be really careful. So it’s the sort of thing where I wouldn’t take unnecessary risks like roller skating I wouldn’t go ice skating or rock climbing because, yeah, I think you have got to be sensible. And avoid taking unnecessary risks.
 
And when I was attending, will I still attend tai chi. But where it was, and I’m sorry they’ve moved because that was two miles. So I used to walk the two miles there and the two miles back. As well as doing the tai chi in the middle. But I didn’t feel any ill effects. I felt quite good actually.
 
So do you do brisk walking?
 
Yeah. I don’t walk slow. I think, I think, yeah. I can’t walk slowly. If I go out with my husband, he’s trailing behind me [laughs].
 
And how many times do you that, how many times a week do you walk?
 
Walk? I was… I say I was doing it because obviously at this time, there’s been a lot going on. Usually I’ll do that three or four times a week.
 
But I’m also very active. I never sit down, only in the evening. I’m just on the go all day. And when I do sit down to watch something I’ll go to sleep [laughs].
 
So on average you are walking something like eight miles a week?
 
Probably.
 

Carol said that the NOS booklet on exercise is excellent. She is thinking of becoming a member...

Carol said that the NOS booklet on exercise is excellent. She is thinking of becoming a member...

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I had decided to become a member. I’ve not got around to it yet. But I will do it I know. I think that’s important too… very important. Hm.
 
And would you like to sort of join a local group or?
 
A local osteoporosis group?
 
Hmhm.
 
I wasn’t even aware that we had one. We probably do. I probably would like to. It depends how much time you have to commit to that. Because if I’m going to join something I like to put everything into it, rather than just be a member and not participate. Yes I probably would like to do that.
 
But this National Osteoporosis Society I definitely would do. The only reason I haven’t done it is because I know it sounds ridiculous to say you haven’t got time. You make time don’t you? But yeah in the book I had from them it’s an excellent book on exercise. Absolutely excellent.
 

Carol is very satisfied with her GP who she says is proactive rather reactive.

Carol is very satisfied with her GP who she says is proactive rather reactive.

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How do you rate your experiences with the health services, about how your osteoporosis is being managed?
 
Well I think it’s excellent. I think it was excellent the fact that as soon as I broke my wrist, well it was virtually within four weeks, my doctor actually contacted me. And asked me to go to the surgery. Whereas I don’t think that happens very often. Maybe it does in some areas. So I thought that… I thought she was brilliant. And then when I went the fact that she suggested I have this medication in case I had osteoporosis because we didn’t want to loose those months. And then she’d arranged for this DXA scan. I thought she was excellent. Yeah brilliant. I’m very lucky.
 
Yeah she’s excellent. She really is absolutely, 100%. Hm.
 
So you, you have trust in her?
 
Yes she’s really on the ball. And she’s proactive rather than reactive. Yeah she’s very good.
 
For how long have you had her?

 

 

Well funny enough, she’s one of a group. And obviously when you make an appointment you tend to see anyone of the group. But I happened to see her when I had the fracture. So it was fate really [laughs]. I mean the others maybe as good. I don’t know because I’ve only been involved with her. But yeah she’s excellent and I’m very lucky.  
 
It… I mean we’re, we’re considering moving and it, it sort of makes you… those are things that you have to consider when you make a move. If you change your doctor, if you have doctor that you totally trust, are you going to find another one that you totally trust? Yeah she’s excellent.
 

Carol drinks soya milk every day and eats plenty of fruit and nuts and she takes a few supplements.

Carol drinks soya milk every day and eats plenty of fruit and nuts and she takes a few supplements.

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I mean, diet’s obviously important. And perhaps I wasn’t as careful before with what I ate and drank. And I must admit I used to hate milk, even when I was child in school. The smell of the milk in the school, it used to make me feel sick and I used to hate it. And that stayed with me right from sort of infants’ school. So I never drank milk. Now I’m drinking lots of soya milk every day and I drink skimmed milk and I have lots of fruit and vegetables and some of the things that were recommended to me were apricots, which I didn’t like, but I have them in my breakfast bowl. And brazil nuts. So I have quite a lot of fruit. I have sort of with my breakfast, I’ll have the muesli with the grapes, strawberries, apricots, dates, sultanas. That sets me up for the day really.
 
Yes, so I’m more aware of my diet now than I ever was. You think you can just get away with it when you’re young. What you don’t realise is that you’re going to pay for it when you’re older.
 
So I don’t know, yeah, I mean, to be quite honest, now I have come to terms with it, as one does, and I do forget that I have osteoporosis apart from the fact that I’ve got my medication lined up in the morning and apart from the Adcal and the ibandronic acid I also take selenium one a day and B-complex one a day. And also the high strength chondroitin and Glucosamine. And I never ever took a tablet before in my life. But these things, I think, probably are good for this condition. So I line them all up in the morning and if I forget whether I’ve taken them or not I just look at the little bowl with them in and I can see whether one’s missing or it isn’t.
 

Having information which was easily accessible stopped Carol from thinking negative thoughts when...

Having information which was easily accessible stopped Carol from thinking negative thoughts when...

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How much did you know about osteoporosis when you were diagnosed with it?
 
Nothing. Nothing at all. Well when I say nothing, in my mind I thought it only happened to old people. Where as obviously it doesn’t. And I knew that obviously it was a problem within the harder casing of the bones. That this sort of mesh gets very sort of thin.
 
But I didn’t really know anything about it. I always associated it with old people. And I suppose people would look at me and say I’m old. But I didn’t consider myself old because I’m so fit. Hm. And I think you’re as young as you feel. So I didn’t know anything.
 
Hence I was very lucky to have a contact who deals with osteoporosis patients. And I immediately got all the information I needed from her in leaflets, books.  
 
But also she was able to talk to me about it. And she gave me tremendous support, which I think is so important when you are diagnosed because the fear that sets in. I just visualised myself in a wheelchair, not in ten years time, perhaps in six months time. And I honestly thought my life had come to end. I really did. And I was very depressed about it.  
 
So having the information easily accessible, it was so important to me, because I was just at a very low ebb. And the person that gave me the information, they were very positive, encouraging. And I was made to realise that it wasn’t the end of the world.
 
So having got the information obviously then I read up about it. I think it’s like any condition you always know more about it if you have the condition. Not always, but generally because you make it your business to find out, more about that condition. Yeah.
 

Carol's doctor made her aware that thyroxine; the medication used to treat her thyroid problem is not good for her bones. But she feels much better on it.

Carol's doctor made her aware that thyroxine; the medication used to treat her thyroid problem is not good for her bones. But she feels much better on it.

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Are you having treatment for that?
 
I am. I’m on 25 microgram, which is a very low dose a day of thyroxine. The reason… to begin with the, the doctor didn’t want prescribe it. She said it’s bad for your bones. But because I was so depressed with the double fracture, the osteoporosis, the under active thyroid and my hair was falling out, she said, “Well can’t have you getting so upset.” So she agreed to give me this 25 microgram of thyroxine. And I feel a lot better. I don’t feel so tired.
 
And I was very constipated. And another doctor in the surgery had been following up this constipation over a period. And I had all sorts of tests and whatever. And it turned out to be this under active thyroid. And since I’ve been the thyroxine, the small dosage, I haven’t been constipated. So yeah I mean obviously if you’re under active thyroid you feel very sluggish don’t you? Weary. So yeah I feel a lot better since then. So she agreed to put me on that.  
 

Carol felt very depressed and fearful for the first three months after she was diagnosed.

Carol felt very depressed and fearful for the first three months after she was diagnosed.

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Well when I was diagnosed with osteoporosis, I’d already been on the medication for six months. So yeah I got used to the medication. But I obviously thought that it was going to come to an end because I was convinced that I didn’t have osteoporosis.
 
When my doctor told me I had, I was totally devastated. I honestly thought my life had come to end because what little I knew about osteoporosis. It just meant lots of broken bones, wheelchair, not being independent, having to be looked after. Maybe ending up in a home.
 
Not being able to do all the things I’d taken for granted. Like leaping into a car and driving. Walking. Running. Yeah lift, lifting heavy things. I thought I’m not going to be able do this anymore.
 
And I thought that the fact that I’d broken those two bones so easily, I thought my whole body was so fragile that the slightest knock, not necessarily a fall. I thought the slightest knock or overexertion would break a bone in my back. Or if I bumped into something I’d break a bone in my body.
 
And I was just terrified. I was terrified. I was very depressed. And I was in tears most of the time. I was desperately, desperately depressed. And this went on I would say for about three months, because I really couldn’t see that I was going to have any quality of life.  
 
Whereas when you are fit you take it all for granted. When this comes it has a hard knock effect. And I just felt that my life was really finished. So this probably went on for three months.  
 
Fortunately with the support and the tremendous support and the information that was accessible, and I was able to read about it, I eventually came to terms with it. And I started then to focus not on osteoporosis only, but I was then able to focus on what I could do about my quality of life.
 
And that is when I decided that yeah the exercise I have to obviously do exercise everyday. And this is how I came to get involved in the tai chi and Chi Kung. Yeah.
 
I think because I was able to focus on positive things for this condition, rather than think well this is what I’ve got and just let it take it course. I was able to come to terms with it, more easily.  
 
But I’ll never forget the fear and the depression that I felt at that time. And the fear and depression it’s within you. Other people don’t realise how you feel. And you feel totally isolated at times with your fear.  
 
But I must admit now it’s just over a year since I was diagnosed, and one a daily basis I can almost forget it. I do my exercise. And my, my diet is different.
 
But I can get on with my life. And my life style has not really changed.
 
I think what happened at the time it changed in here. And I had to I had to get it sorted out in here before I could sort my body out.
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