Dennis - Interview 13

Age at interview: 59
Age at diagnosis: 55
Brief Outline: Dennis was diagnosed with osteoporosis in 2004. In 2007 his spine 'collapsed' and he had two operations. He has to wear a supportive back brace for the next nine months. Until recently he was on Pamidronate but his treatment for osteoporosis is under review. He takes Calcichew D3 Forte and cod liver oil and Co-codamol for pain relief.
Background: Dennis is married and has two adult children. He has had depression for over twenty year. He said he is very lucky because he has the support of his family, GP and consultants.

More about me...

Dennis was diagnosed with osteoporosis in 2004 after he fell down the stairs and started to experience intense back pain. His GP acted swiftly and within a month Dennis was referred to a consultant, was diagnosed with osteoporosis and put on treatment. He was put on Pamidronate infusions every three months. His drug therapy is currently under review. Every year he is given a bone density scan (DXA).
In December 2007 Dennis underwent two major spinal operations. He said that the hospital consultants and surgeons told him that his spine had basically ‘collapsed’. The surgeon did was Dennis described as a ‘scaffolding’ operation. His consultants are hopeful that his spine will fused and he will be able to walk without the supportive brace.
His GP thinks that he was put on the wrong medication for his osteoporosis and that’s the reason his bone density deteriorated rather than increased during the period he was on Pamidronate. The GP wrote to the consultant about her concerns.
Following surgery Dennis is wearing a supportive back brace for up to a year. He also uses two walking sticks to aid himself around the house. He can’t walk far and when he goes to the shops near his house he needs to stop and rest several times along the way. Walking short distances is fine but standing up can become very painful. For instance he can’t standup and do the washing up and he limits gardening to half an hour before taking a rest.
He his philosophical about his present physical problems and said that he has coped well. Due to his depression he hasn’t worked for the last twenty years and thinks that somehow this has prepared him for his long convalescence and restrictions on his everyday life. He acknowledged that for someone with an active working life the physical problems and limitations he has endured may be more difficult to accept. The one thing that gets him down is his back, legs and knees pain. Having several rest periods in the day helps.
His depression is well controlled with his current medication. Plus the support from his wife, brother, sister-in-law and friends are helping him to cope very well with the medical troubles he is facing due to his osteoporosis. His wife has been his ‘rock’ throughout all the years he has battled with depression. Consultants have suggested that his osteoporosis might be linked to his medication for depression' Phenelzine and Olanzipine.
Until four years ago Dennis used to smoke up to sixty cigarettes a day. He gave it up because he was having chest pain and coughing a lot. He no longer has those symptoms.
Dennis can’t praise enough the care he has received from the health service. In his experience the hospital staff; consultants, surgeons, nurses, physiotherapist, etc, have all been as he put it ‘marvelous’ and ready to help him in any way they can. His own GP has been very, very supportive to him and his family. About his GP he said; ‘she fights my corner’.

It was very painful when Dennis first had physiotherapy after his fracture but now he has no pain...

I get more pain now, than I did, because I was on total bed rest I did nothing until the physios came and then that was very painful. But on total bed rest I was fine. But the moment I got up the pain was horrendous.
So you were in bed rest for about six weeks?
And then the physio came…?
… and started you to walk around and …
Just putting my feet on the ground was horrendous. The pain. It really was painful. But the second day it wasn’t as bad and as the days went on they got me to do more, it got better.
What did they ask you to do?
Well I had to do a couple of exercises whilst I was in bed. They had me going up and down stairs which is quite painful, and still is. And doing exercises in their physiotherapy department. Very, very minor exercises quite easily done. And in the end it was literally taking me up and down stairs. And walking round the wards. And as I say it got better and better until the day I was discharged.
At home, yes. Walking on occasions I've been told I have got to walk every day. And I can’t walk far. I can only walk about fifty yards. And that's about my limit. I potter round the house. I need sticks to walk with. I try and do without them in the house but I can’t always especially going up and down stairs. I can’t go up and down without my sticks and just hopefully it's going to get better if my spine fuses.
Did they send you home with a list of exercises to do or not?
Just two exercises which I do lying flat on the bed. They're very easy. Just really to keep my mobility up I suppose.
And how often do you need to do them?
[laughs] I'm meant to do them every day, but I'm afraid I don’t.
So how often do you do them?
I would say it's probably once a week [laughs].
Why don’t you do them?
I forget about them. No. It doesn’t hurt at all. They're so simple. I just forget about them. And then when I think about them I do them. They're very gentle exercises, just lifting your buttocks off the bed and lowering it down and raising your legs up and that's all there is to it.


So they're not time consuming or …?
No. No. I only have to do about ten at a time. They're not time consuming at all. I should really get into a routine of doing it before I get up in the mornings.

Dennis is very happy with the care he received from his GP.

How is your GP, how is your relationship with her?
She's absolutely marvellous. The only thing is you can’t get an appointment very often.
How long have you been with her?
Well I've been with the surgery longer than she's been there. Oh thirty years. I would say. And all the doctors there are marvelous you know. If you can’t go to see your normal doctor, there is always an appointment free for another doctor. And they're all very good. They look after me. They really do. If I've got any qualms at all I just have to go there and they sort me out. You know,
Oh definitely, yes, every time I see the consultant he writes to my GP. And my GP has written to Professor [name] at [name] Hospital about changing my drug, so I'm just waiting to get an urgent appointment to see what they're going to put me on. But I was told a couple of weeks ago when I had the infusion that I would be put on a new drug once I've had my annual consultation. So they are just pulling it forward for me.
So when is this annual consultation?
Well it was, it's coming up in June, but I think they are going to try and get me in sooner in view of the letter my doctor wrote, because she feels I shouldn’t have had this happen. I should have been on a drug that would prevent this happening. But whether that’s the case or not, but that is what she wrote anyway. Well that is what she told me she was going to write.


So everything was quite fast kind of the whole thing?

Oh yes, my doctor doesn’t let the grass grow under her feet. She's marvellous. [laugh]

So it was sort of, she referred you straight away?

Straight away yes.

Straight to the hospital?

And she'll also said if you haven’t heard within a fortnight let me know. She's really good. Well, the whole surgery's the same.

Dennis has been on the anti-depressive drug, Phenelzine for over twenty years and his consultant...

I think it first occurred when I was on medication for not sleeping and I fell down the stairs twice. And hurt my back. And I just went to the doctors and said, “And my back hurts.” And it snowballed from there. So now I attend [name] Hospital every three months. But my doctor, said, that, she thinks I was on the wrong drug because it should have stopped this happening with my spine collapsing.
Which drug were you on before?
Well my depression drugs. I'm on Phenelzine and Lanzipan. And I've been on Phenelzine for over twenty years. And the Lanzipan about five years. And they suit me. Phenelzine is a very old drug and they don’t like prescribing it because there are restrictions with it. I can’t eat cheese, yeast extract, anything fermented. Yoghurts. I have to avoid them. Gravy is another thing. I just can’t have them. But they suit me, I have been in hospital and tried to come off them. And tried other drugs, but they just made me worse. And I think it's those drugs that have caused the osteoporosis. They can’t think of any other reason why.
The consultant explained to you that the factor in your case was the medication for depression?
They know. They said it could be. They haven’t definitely said it is. But they said I've been on it so long it could well be a factor in getting the osteoporosis.
Any other ideas why you might have got it?
None whatsoever. 

Dennis is unable to take stronger painkillers because he is taking anti-depressants.

And what gets you down regarding osteoporosis?
The pain.
The pain?
Yeah. You know, when I first was diagnosed with it there was no real pain. I had a slight backache because I thought I'd fallen down the stairs, but that went and as I say I just woke up one morning with this horrendous. I went to get up and the pain was excruciating from the top of my spine down to the back of my knees and my knees. I couldn’t stand. But with bed rest and Co-Codamol it eased it off a bit… and there are many drugs that other people can take but I can’t because of my depression tablets. And so all I can take is Co-Codamol because they interact and one fights the other. So I probably have to bear more pain than most people would do. Well the consultant said that to me as well because of the (depression) drugs. I mean there is no way I can give them up. No way.
I can’t take other painkillers because of the Phenelzine for depression. I take Co-Codamol, Phenelzine, Lanzopine, Calcichew, and cod liver oil capsules. And that's it. It's enough [laugh].

Dennis and his wife are going on holidays abroad and he is comparing quotes for an insurance that...

Well I'll have to have insurance where they will cover my ailments. And I got details through, from one who'll do it and I mean [sister-in-law] has a special one as well, so I shall get two quotes and see, but I will tell them everything and all the drugs I'm on and have to pay the premium. So, but I'm not gonna to do that until I have to pay for the holiday [laughs]. Which is the end of this month.
Are they particularly expensive, these insurances?
If you just take out normal insurance no. It's about £40 each, but with my ailments but I don't know what it's going to be.
So you haven’t done it before?
No never. No. When I've been abroad before I've just bit my tongue and got on with it, but I don’t think I can do that now [laughs]. So as I say I'm going to get a couple of quotes and see what it comes out. And whatever it is I'm going to have to pay. Because there's no way I want it affecting me in case anything happens.

Pain affects Dennis’s ability to do everyday activities around the home.

It's literally, literally get on with it. Live your life. And do as much as you can and stop when the pain comes. And which to me, I like my garden and I can do about half an hour sitting down. I have a little stool and after half an hour the pain is acute, especially down my legs, but if I rest for about an hour I can go and do another half an hour and I do that two or three times a day, but it is painful.
Okay. So there are things you have had to change to your daily routine?
Oh definitely.
Can you tell me more about those?
Well just going down to the local shops, you know, that, that’s hard, you know, and I've got to be quite truthful, most of the time I drive down there, but it's a point of being able to park. That's one good thing I can drive. Otherwise I'd be a prisoner. You know, I get down to the local shops and I have to sit down before I start on my trip back and that's only about a hundred yards away. But it does get very painful. And when I sit down the pain eases off but it takes about half an hour to go completely. But it really does affect your knees. When you go to stand up you get a lot of pain in your knees. And in the backs of your legs. Hopefully if the spine fuses that will all go.
Okay so what else do you do when you have this pain apart from resting?
If it's really bad, I go to bed and lie out flat, but most of the time I can get rid of it by just sitting down on a comfortable seat, on a soft seat. I can’t sit on hard seats. In the dining room we've to load it with cushions for me to sit there because anything hard pushing in the back of your legs is very painful.
Okay. So doing some leisure activities like gardening has changed?
Oh definitely.
Going to … walking to the shops?
Shops definitely, yeah. Going up and down stairs as well that is quite painful. But I, I do it quite often.
Anything else that you needed to change with sort of doing things around the household?
I can’t do anything. I can’t do any decorating or anything like that. We were putting curtains up in the dining room. My wife couldn’t reach so I said I'll do it. So I went to tread on the ladder and I couldn’t lift my leg up and I fell backwards. Luckily enough I had the brace on and I hit the dining room table and it stopped me from falling. So I can’t climb a ladder. I haven’t attempted it since [laughs]. It didn’t really hurt. I didn’t hurt myself, it's just that I couldn’t balance on one leg and get pressure to pull myself up on the ladder.
Were you worried you might have broke something after that?
No, because it was the fall was taken by this brace, so I wasn’t worried about it. I did come and sit down for about an hour before I attempted to move again, but I had no additional pain or anything through it.
But it literally stops you doing everything, even washing up, most of it goes in the dishwasher, but things that can’t. I can’t stand at the sink and wash up for my wife. Because if I stand for about five minutes I'm in agony. I'm much better walking although after about 50 yards it gets painful. It does make an awful lot of difference to your life. I suppose I don’t notice it as much, suffering with depression and being agoraphobic, slightly agoraphobic I have b
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