Laurence - Interview 07

Age at interview: 62
Age at diagnosis: 54
Brief Outline: Diagnosed in 2003; was initially put on Didronel and then on Actonel and currently on weekly alendronic acid. He has doubts about the effectiveness of his medication. He suffers from severe back pain. Last DXA scan showed that he has three vertebral fractures. Recently he was referred to a consultant.
Background: Laurence works in a dairy farm, is married with two adult children. His mother had osteoporosis and his brother has the condition. He was thinking about early retirement or part-time work.

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Back in 1987 he had a fall at work, an x-ray showed that his lower vertebra were wearing away. But his diagnosis came about only in 2003 after his brother – who had already been diagnosed with osteoporosis - suggested that Laurence have a DXA scan to find out if he too had the condition.
More recently, Laurence has been suffering from severe back pain but kept postponing seeking medical advice. He went to see his GP when the pain spread from the lower back to his upper back. A locum doctor at his practice noticed that he was two years overdue for a bone density scan and referred him for one. The DXA scan showed that that he has three vertebral fractures. He was then referred to the hospital to see a specialist. On that first occasion the consultant was unable to assess his medical situation because his medical records were incomplete. So he had to wait for another appointment while the consultant waited for the missing medical information. 
Despite his back pain Laurence continues with his full-time job on the farm. He says that the pain can hit him at any time' when he is standing up not doing any manual work, doing  physical activity and even when just sitting down and resting. At work when he feels the pain, he copes by leaning on something until it subsides and then he continues doing his physically demanding farm work. He says that he has a sympathetic boss who is willing to help.
In the meantime, Laurence takes pain relief medication and he is looking forward to having a treatment that could improve his quality of life. He says that living with pain can get you down and makes your feel depressed. He values his independence and doesn’t want to become dependent on others. He also wants advice about what he should do regarding his physically demanding job.
His wife who is fifty-five, also has a maternal history of osteoporosis and wanted to have a DXA scan but their family doctor declined her request on the basis that she is not sixty yet and hasn’t had a fracture. Laurence’s daughter who is in her thirties has also been told that she is ‘too young’ to have a scan. Laurence feels that his family is not receiving the advice and information the entire family needs from their doctor and says ‘it is all down to money isn’t it’.

Despite having a maternal history of osteoporosis, Laurence’s wife was denied a DXA scan on the...

Getting back to the wife she went to the doctor and asked him about going on HRT and could she have a scan as well because her mother had osteoporosis and, you know, blah blah blah. He said he’d find out. Anyway he rang up three weeks later and he said, ‘Very sorry, [wife] you cannot have a scan because you’re not old enough.’ She’s fifty five means in apparently you’ve got to he sixty now before you have a scan unless you break a bone. So if she decides to fall down and break her neck or break a bone they’d have her in tomorrow to give her a scan. But because she hasn’t, then no she can’t, not until she’s sixty I suppose. It’s just their way of saving money isn’t it?
Yeah she’s concerned that she’ll get is as well, you see. I think they’re all me family are concerned yeah they’re they might end up with it, yeah. They are getting to that stage, yeah.
Well yeah, they have and then they get told, I mean me daughter especially and they say, ‘You’re too young.’ You know. I mean surely if I’ve got it, my mother had it, mother-in-law had it surely that they would check the wife see if she’s got it even though she’s only fifty five and perhaps check the daughter as well, perhaps check me sons. If, it’s so hereditary you know, I mean [sighs] I don’t know. 

Laurence doesn’t think that his one tablet a week treatment is helping because his back pain has...

Yeah, I was on that Didronel. It was it a double pack thing it was… Forty, bit like Alka Seltzer you had to dissolve in water and take them every day. Then after that forty you had to take anti acid tablets every day. Then I went on to Actonel and now I’m on alendronic, one a week instead of one every day. You know, I often wonder if that one tablet a week it it’s as good as the ones I could take every day [sighs].
Have you discussed that with your?
Well yeah, no.I go to the doctor, and she just said, ‘Well tough.’ Basically and that’s what, you know, that’s what you’ve got to take and that’s it basically.
Because it I mean as I said it’s I’ve had pain for a long time but, you know, I was just contend to take the Actonel or whatever that has been prescribed but it’s only the last, you know, I said I’ve learned to live with the pain basically what I had then like, you know, because I know where it hurts it hurts. It’s always in the same place, the bottom of my back. But as I said six months ago I started getting pain in the high higher up me back and I thought, ‘Hello. This is, you know, different thing.’ And in as I said I get it every day basically for months anyway and it’s only after, you know, long time now that I decided well, I’ll go down. Because it’s like you see like you get over it. [sighs] Well if you’ve got toothache so you make an appointment to go to the dentist and nine times out of ten you go down that dentist on the same day the tooth pain goes. And that’s the same I suppose over me back I suppose I think, well I sort of go down, make an appointment go down and see the doctor about me back get down there and the pain be gone. But it didn’t it wouldn’t you still I’ve still got still got it and. Still getting it basically [laughs].
More time to discuss your case, to discuss your problems and concerns?
Yeah. I mean, is alendronic as good as… which you take one a week, which as good as Didronel or Actonel which I took every day. I mean to me they can’t they can’t be as good. Or is it a cheap a cheap option then?
So you need more information about medications?
Well yeah, yeah. I mean like said you read, as I said the wife reads in the paper that it people can get this and that to promote bone growth blah blah blah because it costs five hundred quid or something too much money basically.

Laurence would like advice from his GP about whether to have physiotherapy and how much exercise...

Well I when I had I had physiotherapy…. after I fell off the hay trailer about four years ago, told her what told this woman what job I do. She said, ‘Even though you’re going, you know, I take my hat off to you really doing what you’re doing with it with the situation what it is.’ She admired me in a way because what I do with the bending and all that I’m doing is doing me own physiotherapy really.
I could have physiotherapy, physiotherapy again because the first doctor I saw, this woman, another lady doctor who was a bit sharp she said to me about physiotherapy but I’ve been in contact with the physiotherapist from the [hospital] she wanted to know if I wanted it or not and I said. I don’t really know. I would rather the doctor say yes or no before I have any because I don’t want it to be detrimental, you know, to me basically.’
Like I say I mean I don’t want to seize up. I mean, perhaps why, you know, as I said in physiotherapy you’re bending a bit aren’t you, all over the place and I’m actually doing that now so really. In fact in 1987 when like I say hurt my back first of all I was on physiotherapy and it was hurting and I told the woman physiotherapist you know that I was working at the mill then chucking rubber at the mill. And she said, ‘But you’re doing your own physiotherapy. It’s a waste of time me giving you physiotherapy because you’re getting your own physiotherapy by doing what you’re doing.’ I suppose basically that’s what I’m doing now really. You know.
But you would like to find out whether you are doing too much.
Well yeah I suppose in a way, yeah. I mean if it’s. I’m sixty two now and I’m not sixty five for another three years. I suppose in a way yeah. Only if he (doctor) said to me advised you know, advised me to work part time then I would work part time. I suppose I you know. 

Laurence’s pain in his back makes it hard some days to do his physically demanding job.

Four years ago when I had an accident on the farm when I fell off the hay trailer but 1987 was when I first it hurt my back first of all in the [name] when I worked in the [name] It’s got a lot just I’ve had back trouble for years at the lower back but I’ve been getting back high trouble higher up my back and I’m on painkillers now. I have to take them when I need them.
How often do you need them?
Well I’m supposed to take them three times a day but I some days I take two a day all depends what pain I get.
What else do you do apart from taking painkillers? Do you rest? Do you lie down?
Well it’s [sighs] not really no because I mean at work I’m using a, you know, somedays I’ve got to pressure wash the parlour and stood working, backwards and forwards over the wall to clean all the cow crap off. Then me back start aching and I put up for so long then I end up having to put everything down and just leaning on something just, you know, relaxing it isn’t really but it’s something.
At work you lean on something?
Well, yeah, I lean on hay or anything, you know, you know, or even on a wall, you know, just leaning on and just relax basically, you know, until the pain just goes away a bit. I it’s gets to that part sometimes when I think, ‘Well I must be still alive because if I wasn’t I wouldn’t be able to feel a thing.’ You know, stupid way to put it but. Anyway the job I work at do on the farm it’s like what I’m doing is cleaning out feeders like with a shovel about a seventy foot long feeder, cleaning out the feed, what they don’t, you know, what’s not been used or ditching like, you know, cleaning out mud with a shovel bending and that [sighs] I still do I’m determined I’m not going to give in, know what I mean? I just got to keep going as far as I can. I mean it’s doesn’t matter when it hurts even sat in a chair some days it hurts so whatever I do, you know, if I stands stand at the kitchen sink washing up in one place, the muscles tighten up and then I go and sit down or whatever, you know. So I mean it’s [sighs].
But it is affecting you at work?
Yeah, yeah, yeah.
A lot most of the time, not most of the time feel it quite often [sighs] but, you know, as I said when it get. Damp weather, damp cold weather it hurts, like this past week hasn’t been too bad.
I had I had a couple of times like I take a painkiller [sighs] relax like, you know, if I go home get dinner and what have you it goes off and then I go back to work start again and that. Some days it comes back on again like and I, you know, take another painkiller but I don’t want to appear, you know, proper pill popper, taking them willy nilly, you know.
Yeah, I don’t want to turn up, you know, like I said if I had that conscious thing where I’d hurt my back then I wouldn’t do anything. I won’t, you know, I say, ‘I can’t do that might hurt me back.’ You know, you know I just want to do it and if me back hurts well tough well, you know, yeah. And that that’s what’s annoying really that I’m trying to do what I want to do and I get this trouble in me back and I get and it’s a vicious circle sometimes [sighs].

Laurence gave up smoking ten years ago on his doctor’s advice.


It all come comes down to will power, self-control doesn’t it. I mean it’s like regards to smoking ‘Oh, I can’t give up smoking, have a fag.’ I used to smoke cigarettes and I’ve never I went... I had pleurisy and gastric flu and I went and the doctor said to me, ‘How many cigarettes do you smoke, Lawrence?’ And I said, ‘About ten a day.’ ‘Oh You’ll be dead by the time you’re twenty five.’ He said to me.


I used to sort of roll me own and went playing bowls we had an inter-departmental bowls match once in [pause 5 seconds] on the telly they had this programme about this bloke will all his lungs in it and he [doctor] mentioned it, ‘That could be yours, Laurence.’ He said. So I’ve put me fag down, stubbed it out, you know and, used to smoke cigars and. Our dad used to smoke cigarettes and he was [coughs] and I think, ‘Well, that’s supposed to be pleasure.’ You know, I always said I’d pack up smoking cigars if I had a cough like him but I did inhale see, you’re not supposed to inhale a cigar which I did do and I started getting pains in me chest so I thought, ‘Sod this.’ So I packed in.

So you gave up?
Give up.
How long ago? Long time ago.
About yeah about ten year ago I expect. 

Laurence’s family is concerned that they might also develop osteoporosis and he wishes that...

I mean my daughter hopes that she won’t get it but she it’s hereditary you know what I mean. My mum had it as I’ve said and my wife’s mum had it right. My wife she went down to see a doctor and she wanted to go on HRT because she didn’t want to get it right she, she thought HRT strengthens the bones blah, blah, blah but she really she doesn’t want to have to put up with the burden of having to look after me. Because when my mother before she died she was like really round, round shouldered like you know. I in especially I suppose my wife doesn’t won’t want me to get like that for having to look after me that’s what I reckon anyway [laughs].
I wish I’d I was under the club or something or other it might be in me back then when I was first in, [wife] said to me, ‘What you whistling for can’t be nothing wrong with you.’ She said, ‘When are you going back to work?’ [laughs]. I said sometimes I wish I, you know, I had a broken arm and I had it in a sling or something so people could see I’d got something wrong with me. But when it’s the back people can’t see that, you know. What you got wrong with you because it’s inside, you know, yeah.
Yeah she’s concerned that she’ll get is as well, you see. I think they’re all, all me family are concerned yeah they’re they might end up with it, yeah. They are getting to that stage, yeah. 

Laurence wants to keep working full time on the farm for as long as possible because of the...

Well that’s it’s I’ve not stopped altogether so my boss says to me, ‘Let me know what you can’t do and what you can do so we know.’ What it is. Like as I said I told her, ‘I can do most things. I can, you know, I can I, you know, do most things basically.’ But not at a rate of knots that I could when I started there partly because of me age I went in to the [work place] when I was fifty five, I wish I’d started on the farm when I was twenty five really. You know, partly because of my age because I’m sixty two now and partly because of me back, back.
I get a pension from the [former workplace] right and I get a wage. Basically, I’m earning what I was when I left when I worked at the [former workplace] like that. The salary I’ve got now and I, you know, I don’t go, we don’t go drinking and what have you blah blah blah but by the end of that month I basically breaking even or just in the red right. So if you want any, you know, if any extra and that all [wife] s money goes into the savings account I just draw out some of that her money to put in, the current account to tide us over blah blah blah which I mean I don’t like doing really because it’s hers but she said, ‘It’s what it’s there for.’ So in a way, you know, if I did go on part time I don’t know I suppose I’d have to manage.
So are you planning to retire in 2010? Or kind of?
I’d like to carry on. I’d like to do part time. Sometimes I wish I could retire, I suppose but then I like working and then you know, enjoy it basically. 
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