Linda - Interview 21

Age at interview: 62
Age at diagnosis: 60
Brief Outline: Diagnosed in 2005 and prescribed Fosamax 70 mg, once weekly and calcium tablets twice daily. A bone density scan in 2007 revealed that her bone density has improved and that she is osteopenic rather than osteoporotic. Linda continues taking her medication.
Background: Married; two grown up sons; works part-time. She is a keen gardener but since diagnosis she regularly does weight bearing exercises. Maternal history of osteoporosis.

More about me...

Linda had her first bone density scan when she was about fifty-seven years old. At that time, she had been taking hormone replacement therapy (HRT) for about ten years but decided to come off it. Her GP sent her to have a bone density scan (DXA scan). The DXA scan indicated that her bone density was a bit below normal, but just a bit. She was given no medication.
In 2005 Linda’s mother was diagnosed with osteoporosis and the GP suggested she had another DXA scan because the condition tends to be hereditary. This second DXA scan indicated that she too, had osteoporosis. Her GP prescribed Fosamax 70 mg weekly and calcium tablets twice a day. She admits that isn’t always easy to remember to take the medication because of her dislike of taking pills but she persisted steadily.
After her diagnosis Linda became more conscious of the need to do weight bearing exercises and that's why she goes to the gym twice a week. She finds the gym experience a bit boring but knows that the exercise routine is good for her. Her favorite keep fit activity is gardening and she does lots of it. Her diet has also changed a bit, mostly regarding an increase of calcium rich food and of vegetable and fruit intake.
Her last DXA scan in 2007 indicated that her bone mass has increased since starting her drug therapy and she now has osteopenia rather than osteoporosis. She is obviously pleased with the news and to know that the medication is working. Her GP has told her to continue with the treatment.
Although her condition does not affect her daily life in any way, she admits to be cautious and no longer willing to do certain things. For instance, she has stopped skiing for fear of falling and breaking a bone. She is also more aware of posture when lifting moderately heavy things.
Even though her initial reaction to her diagnosis was one of shock and of anxiety about her future, now she feels lucky that her osteoporosis was found out when they did rather than in ten or twenty years time. Linda feels that she has been given a chance to take care of herself through medication, diet and exercise.

Linda had a DXA scan after stopping HRT which showed a slightly below normal result. Three years...

I had my first bone density test done I think when I was about fifty seven. I’d come I’d decided to come off my HRT and my GP suggested I have the bone density test which I did. And when the result came in she said that I was below normal, my bones were just a bit below normal just a bit below normal but she didn’t give me the impression that it was anything to worry about. So I really sort of forgot about it. And it was only about three years ago when my mother, aged eighty three, suddenly got osteoporosis and her posture changed radically.
And she was in a great deal of pain and her GP who was also from the same practice as the GP that had given me my first bone density but was a different doctor, said I should have a that she had osteoporosis and that he put her on some pills and that would help and anyway, she died about six months later of something completely unrelated. And then my GP said that I ought to have I ought to have a bone density test again to see whether I had it because he said it was hereditary.
So I had that test done, I think it would have been July O in July 05. And again I was a bit lax about going and getting the result and it wasn’t until September that I found out that I actually had osteoporosis which was quite a shock, actually, I was quite upset. I remember being quite upset about it. And I hadn’t really put two and two together with the previous bone density. That sort of dawned on me later that actually I should have been given some preventative advice at least like, “Come back in a year. Have another one. Let’s keep an eye on it.” Something like that but anyway.
If you take me through to the first when you had your first bone density scan, were you given calcium?
No, I wasn’t given anything at that point. I was just told that it was a bit below average and that’s all I can remember. I wasn’t given any pills or any calcium or any particular advice. I wasn’t even told maybe I should come back and have another test in a year’s time so.


But my doctor said, “I think you’d better have a bone density test because your mother had osteoporosis and it does run in families.” And he sent me off for that and that’s when they found it was osteoporosis. So it had obviously gone got quite a lot worse in whatever it was, two or three years, three years probably.

Although Linda’s bones have become stronger with Fosamax, she is concerned about the long term...

So he put me straight on to Fosamax. I take it once a week and quite a high dose of calcium which I take every day, two tablets every day. And then said that I should have another test in a year or two’s time which I did last year, I had another bone density test and I’m now my bones have improved. I’ve gone back to being osteopenic so obviously the Fosamax works. But he said to carry on taking the pills and the calcium and I go to the gym twice a week.
The Fosamax I take once a week. It’s quite difficult to remember to take a pill once week. I really have I have missed I think in two to three years, I think I’ve missed three Mondays but I always take it the following day. And what’s the other thing? And the calcium, I’m always forgetting to take my calcium and always having to sort of force myself to remember. I find taking pills very difficult to remember because I’m not a pill taker [laughs].
The only one that slightly concerns me is the Fosamax because you, I don’t know, you hear things. I mean a friend of mine said cheerily the other day that her mother had died of cancer of the stomach and she’d been taking this pill for years and maybe I should be careful and find out more about it. I feel that you’ve got to die of something in the end but [laughs] I don’t know, I have no idea about the side effects of this pill. Suffice to say I feel absolutely normal and fine and I don’t have any side effects. But God knows what it’s doing to me inside but if it’s making my bones stronger that’s something. But how do we know. How do we know what all these chemicals in our bodies do to us?  

Linda has made some changes to her lifestyle and she is now more cautious.

I’ve always eaten quite healthily but now I’m a bit more conscious of I suppose more, more calcium, yeah, so more milk, more cheese. And try not to get and try not to get [laughs] overweight.
Yeah, I think well, certainly from a point of view of going to the gym. That’s made me it’s certainly made me more conscious of the need to take exercise whereas I was a bit lazy before and now I try not to be lazy. Physically lazy that is. And then, what’s the other thing, I’m sort of wary now of physical of taking any risks. I’m much more careful. I mean I mean I would not run for a bus. I don’t do anything in a terrible hurry.
And I don’t go skiing anymore because what’s the point, if I break something it might not mend so easily. I mean all the doctors say, “Oh, don’t just carry on as normal.” But I think, “Well, why, why take that risk?” I’m not I’m not prepared to take that risk. Anyway, it’s no great hardship. So, yes, I’ve changed my lifestyle a bit but not very much.
What about things like lifting heavy objects? I mean you do gardening?
I still lift but I lift very carefully. I bend my knees and I try and do things very slowly. But I wouldn’t I wouldn’t lift anything ridiculously heavy on my own. I would get someone to help me.  No, I’m more cautious. 

Although Linda finds her regular visits to the gym boring, since she has been diagnosed with...

I think I am quite active and I walk I walk as much as I can. But I do more since I’ve been diagnosed. I make myself do more.
Like what, more walking?
More walking, more going to the gym, the more activity. I can remember when I was first diagnosed going for very long boring walks doing absolutely nothing but walking and I thought, “Oh, this is so boring.” Then I went then I thought, “No, gardening is just as good.” So I prefer to do something with a purpose. That’s why I found the gym quite hard. Just going there and walking on those machines and it’s quite boring but anyway. And the other thing of course I believe very strongly in is staying flexible and mobile and I think, you know, as long as we can keep our muscles strong then presumably that keeps the bones protects the bones.
Tell me about the types of exercise you do?
When you go to the gym?
I go on the well, the running machine but I walk on it but I walk quite hard and I walk up. I sometimes run for a minute here just to get my heart beat up but I don’t run a lot because I gather that’s not particularly good for bones. I then use there’s about half a dozen machines I use where you sit and you push your legs backwards and forwards on one with a with weights on and the same with the arms. I use that Swiss ball and do sit-ups on that. I do weight with weights I do things above my head. I do that thing of leaning against a ball against a wall and going up and down. I just try and vary it as much as possible.
Who has provided you with advice about the type of exercise you do?
Well, when I first got diagnosed I went to the gym and I said, “Is there anybody here who knows anything about osteoporosis?” And I got this girl who gave me these exercises and then every sort of six months or so I get somebody else just to get some different exercises. I don’t whether many of them know much about it. It’s hard to tell really.

Linda saw a private doctor to find out information about the type of exercise and diet she should...

Where did you get your information from?
Well, I started I went to my I’ve got a private doctor that I that my husband’s got a private doctor and he uses when he’s, you know, in an emergency when you can’t get an appointment and so I thought, “Well, I’ll go an see him.” Just out of curiosity, just to find out a bit more because I had very little from my GP apart from the prescription. And when I went to my, the private doctor, he looked at the test, I took a copy of the test with me and the pills I was on and he said, “No, what you’re doing is absolutely right.” And I said, “Should I be taking any exercise? Any specific exercise?” And he said, “Yes, I should go to the gym and don’t do any running but do lots of weight bearing.” Which I never really understand what weight bearing is but so I did that.
So that that made me feel a bit better. At least I was on the right track. I didn’t need to go and see a specialist or anything. Then I think I went on to the web and went and had a look at the osteoporosis society website and I tried to get exercises from I thought maybe they’ll have a sort of list of exercises. That wasn’t terribly successful. And a diet I thought at that point there might be a diet but there didn’t seem to be much information on that side, not a great deal. And after that I just sort of carried on with the pills, the calcium, the exercise and that’s it really. That’s all I did.
What information specifically you wanted at that time?


I wanted to know I wanted to know about exercise and diet I think. Anything that I could add to the medication really. That’s what I wanted to know. And then, [sighs] I don’t know, I don’t think there was anything else particularly I needed to know. I just sort of felt there might be more I could do apart from take pills.

Provide written information including a list of resources of where to find out further...

I think they should tell you more. I think it’s in a doctor’s position to tell you a bit more about the disease. I know they have they’re, they’re restricted with their time but if they haven’t got the time they should they could provide you with a leaflet, a book. Anything, they could provide you with a list of diet, exercise and what is osteoporosis and how it might turn out or not turn out. I don’t know. I think there is there’s always been a lack of good information from GPs but I think it’s just the, it’s probably just our economics of our times really. But that’s what we should have is a bit more information to take home and look. And, and it’s no good just talking to you. You need to be able to think about it afterwards and if you’ve forgotten half of what they’ve said you’ve got nothing to go on. So I think, you know, maybe just a news sheet. Just one piece of A4 paper would help. Maybe with some website information or some good books or something so that you can find out a bit more about the disease. Because actually, you know, unless you get it at, at my age why would you know anything about it?
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