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Valerie - Interview 03

Age at interview: 67
Age at diagnosis: 63
Brief Outline: Diagnosed in 2004 following complains of back and neck pains; on alendronic acid, 70 mg once weekly. She has had three bone density scans and there was improvement on the second but the third revealed a small deterioration of bone density.
Background: Works as a freelance interpreter. To include walking into her daily routine she uses public transport. On average she walks around seven miles or more per week.

More about me...

Valerie was diagnosed in 2004 following complaints of back and neck pain. Two years previously she had a dislocated shoulder. She has had three bone density scans and there was an improvement in her condition but the third showed further deterioration. Following her first bone density scan she expected to be contacted by her practice if there was ‘anything wrong’ and they didn’t so, she assumed that everything was fine. It was by chance a year later when she went to her GP for another thing that she found out her diagnosis. She has been on alendronic acid, 70 mg weekly, calcium and vitamin D since then.
 
Her diagnosis came as a ‘shock’ and her initial reaction was of feeling fragile ‘as if I was made of glass’. Until then she has enjoyed very good health. She lived abroad for many years so says that she has enjoyed a healthy Mediterranean diet and plenty of sun. She comes from a family with long longevity and says that there is no maternal history of osteoporosis but her father developed it in his mid 80’s. She smokes around fifty cigarettes per week.
 
Valerie attends an-all women’s practice and feels happy with the service there. In the past she felt discriminated by a male GP because of her age. Says that age discrimination of older women is widespread in contemporary Britain, and that it is also reflected amongst health professionals.  
 
Valerie says that she has had little advice and information about osteoporosis. She would like to know if her treatment is able to reverse or stabilise her condition. Valerie has found it harder to find anything she thinks is useful information.
 
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Valerie talks about her experience of having a DXA scan.

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I initiated the bone scan because having been initially told that HRT prevented bone loss I just counted on that and continued to drink all my milk and I have an extremely good diet. I eat no junk food.
 
 
Well that was why I felt that since his death was precipitated by what seemed to be osteoporosis that if I was not taking the HRT I wanted to know. So I didn’t get diagnosed through a breakage which seems to be the way that most people get diagnosed. So I’m feeling quite lucky about that.
 
 
I’ll say it from that point of view my doctor is excellent. She’s very sympathetic and I had the scan within about 10 days in the local hospital which depends on a teaching hospital. And there was. They make an appointment. You do not queue for it. This, it has been mentioned to me by a friend needs some scan and she won’t do it because she has to go into one of these tunnel things and she’s claustrophobic. Well it’s not that kind of scan anyway. You just you lay down and there’s a kind of block which goes backwards and forwards over you but you’re completely outside. You’re not in anything.
 
And how long, do you remember how long this test takes?
 
It takes about, less than 10 minutes. So you lay down on the table. The operator who seems to be medically, medically qualified doctor or at least a very highly qualified nurse, sits at the screen. And it doesn’t seem to have a great deal of radiation because she doesn’t get behind a screen or anything. So, she turns it on and it’s like a block about [phew] ten inches wide and the width of the table that goes slowly up your body and slowly back again. And that’s all there is to it. Well no I don’t know what distance but it’s probably 30 cms from you. It doesn’t go near your face. And seemingly because they then give you percentages for bone loss in different areas it then goes on to the computer and the operator can read the percentage of bone loss in each area as it goes over it and it apparently records it. Because when I went to see the doctor when I hadn’t bothered and she said that I had that wrong with me, she brought it up on the screen so it had been sent to her over the Internet from the hospital and she had all the details on screen.
 
 
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Valerie who was diagnosed four years ago waited ten days to have her first DXA and had her second...

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And the second scan was done two or three years after?
 
Three years after. I asked her about after a couple of years and she said, “Oh we wouldn’t see anything after that length of time.” So I reminded her this time that last year when I went the operator had said that I could come back, that I would get a notice to come every year. That doesn’t seem to be the information that my doctor has. She thinks it’s every two years or something. Anyway this time the person doing the scan didn’t mention when the next one would be but because I told the doctor she had said I could have one the following year she said, “Ok here you are. I’ll write it out for you.” So and I had that also within two weeks.
 
Ok and this second scan showed what? Can you tell me?
 
Well I, I wasn’t listening and I didn’t write it down but basically that my back seemed to have slightly improved and but. And my, the worst seemed to be in my thigh area and that seemed to have stabilised. I had a scan about a week ago and I shall go into the doctor soon and find out what the result was of that. And see if there’s any improvement or not.
 
Did the doctor mention or explain or say anything about why the improvement has happened?
 
No. I think to give her credit that probably because I talk a lot and I seemed quite well-informed she probably didn’t think that I needed to have any more information. And you know it’s obvious I can use the Internet.
 
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Valerie found ways of doing things differently to manage her pain. When she is busy she doesn't...

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I’ve stopped wearing anything with shoulder straps. I wear strapless bras. I started to do that when I had put my shoulder out because as soon as I had anything on my shoulders I had pain across my back and that is still the case. I can’t wear anything. I can’t wear straps that. So I now. I hated backpacks but I have a handbag which is, which goes on, is a back pack and that’s ok. But carrying things on my arm or over my shoulder.

 

The other thing is that I’ve got into the habit of reading lying down... Initially when I put my arm out I couldn’t sit at a table and read because my neck would lock. So whether that was the arm or whether that was the osteoporosis I don’t know. But as I didn’t know I had it I assumed it was all the arm. So I don’t read sitting up. I always read lying down and I try not to sit up too much. I don’t have television. So I read instead of watching television. So I actually spend quite a lot of time lying down [china clunk] when I’m entertaining myself. And if I watch a film on the computer I’ll lie down with it as well.

 
So you find it easier that way?
 
Yes.
 
Ok.
 
No because having had these very bad pains trying to sit like that. I mean I can do that now and I do it for work, interviews and everything. But initially it was quite painful and now it’s not very painful I would say probably on the scale of things. But as a person who hasn’t had a lot wrong with me for any extended length of time a small ache I find extremely tiring.
 
I don’t have it all the time. I had a, I had a bit of a pain. I think it’s when I don’t have enough to do on the whole. When, once I’m working and out and about and I’m talking to people and concentrating I don’t notice any pain. Or if I was walking along with a heavy bag or something. So I’ve cut down on the size of bag that I was carrying to quite a small bag and I’ve even been putting it round my waist but with the backpack I can carry much more without having backache. 
 
 
 
 
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For Valerie drinking alcohol is a question of quality rather than quantity.

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What about drinking alcohol?
 
Yes I drink. I smoke, yes. I have, I to some extent I binge drink but I, normally I drink with meals. I drink less than I used to at the moment. But as I say I lived in France and I would say that I drank normally. You often have a four or five hour dinner several times a week and when you’re having a four or five hour dinner you probably drink a bottle of wine. But I, I now drink with my neighbours more frequently but that tends to be without a meal. So I mean I try to eat before I go there or drink some milk. So I still drink most weeks. Yes.
 
How many units would you say per week?
 
Well I would say it’s more than they tell you, you can. Yeah. I mean I’m not very clear about this but I. One thing I notice before they started mentioning it in the papers because I do know a little bit about wine and I noticed the big glasses they give you in a pub they’re usually the colonial wines, and they are 14º or more, very frequently and I found before I drunk more than a few sips I had a headache. So now I look as if I’m being quite precious when I go into pubs and restaurants because I want to see the label. I want to see if possible that it’s no more than 12½. I would prefer it to be more than a year old and I do not drink wine that comes from what one could call the ex colonies. I drink European wine.
 
And I don’t usually drink white, I drink red wine. I don’t generally drink red wine from Spain unless it’s a very good vintage.
 
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Valerie has smoked since she was in her early twenties and had no idea that smoking could be a...

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Well I tried. I cut it down a little bit but I’m not really motivated to stop smoking. Occasionally I think about it but I have rationed myself. I, for probably since my early 20s I had smoked 20 a day. I have cut it down in the last few years and I have a ration of five a week, five packets a week, not cigarettes. So if I’m working I can’t smoke. I smoke more when I’m not working as you can’t smoke in workplaces and things. Years ago I worked in a place where you couldn’t smoke. I ended, actually ended up smoking two packets a day because I couldn’t smoke at work. So forbidding you smoking at work it doesn’t necessarily cut down the amount, like the wine this may sound very odd to people who are very anti-smoking but I smoke the cigarettes which have a very high tobacco content and they haven’t got so many chemicals to keep the tobacco burning as the lower ones. I just think that there’s more chemicals in the lighter ones and anyway you smoke more of them so you smoke more chemicals because you’re going to smoke more of them because there’s not enough in them anyway.
 
No I had no idea that it could. I mean I was perfectly aware, and my mother was aware in her 20s of the fact that it causes cancer and everything. That’s never stopped anybody from smoking in fact. But I didn’t, never heard about osteoporosis or anything of that kind. 
 
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Valerie would go to her local support group if they ran a class on the benefits of weight lifting...

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If a doctor sat down and told me that, you know, there’s certain stages and that you know I may or may not get them and I might be able to prevent them etc. that would perhaps be quite interesting or. But I don’t want to go to a support group type of thing' people telling too many bad stories. So I say I’m lucky that I didn’t break anything and I’m aware that I’m potentially fragile so I can be careful about that.
 
So you are not interested in sort of finding out about support groups and what they do or they don’t or?
 
Not really unless it, they have things to contribute which are sensible.
 
Like what?
 
Well I mean I heard a programme on the radio funnily enough a few years ago which I found quite fascinating which was suggesting that if you went. They did a programme where people were doing weight lifting with osteoporosis even in their 70s and that they had quite a high percentage of reversal of bone loss doing weight lifting. Now if there were some possibility of going to a class which was specifically directed to that. But when I went to the gym and I said that, you know, I gathered weight lifting was quite good for what I had, they were quite reluctant to have me weight lifting actually.  
 
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Valerie feels happier with an all female GP practice because she believes there is a lot of age...

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Well I think that given that I’m in an inner city area it’s better than I anticipated especially with the GP I have now. I say, he does express sympathy and she does give you whatever tests you ask for.
 
Ok so your expectations were lower?
 
Well yes especially after the first man. In fact I tried two GPs in the area. The first one who wouldn’t look at my back and then. I went along to another one and that one closed down shortly afterwards because the doctor was struck off and it was being run by a practice nurse in fact who was quite good so then having had this experience I wrote to the Health Authority and said I’d heard of this practice which is all female so I said that I needed to go somewhere where they were all female. So they could have draw whatever conclusions they want from that. So I went to see the practice and they said, “Well we’re full up but if you write to them they, they might impose you on us.” Which they did so I got that quite quickly.
 
So you identified this practice?
 
Yes friends who’d being going there and they said it was an all female practice and they were very nice. So I went there and I usually. I don’t go more than once a year and so far I’ve usually seen the same doctor. Once I didn’t, I saw one of the other doctors who was equally charming and sympathetic.
 
So why an all female practice?
 
Because I feel whenever I’ve done anything like dentists and eyesight, whenever I have to do with males they look at your age and discount you. They treat you like an old lady. And the women are like seeing a school friend. I feel more comfortable. I didn’t have this experience in France. I always had male doctors and I always found them to have a different attitude towards women. Women are finished once they’re getting older here whereas the French doctor and no doubt a Spanish one will flirt with a woman of 100 and say, “Oh no we can’t have that, no that doesn’t look nice. You know you’re still a woman.”
Here no. I feel that strongly actually which is one of the reasons I’m not keen about mentioning my age and things. But once people see it written down you’re written off. But the continental thing, I mean most countries in the world you’re a woman. People can still treat you like a woman. Treat you as if you might be attractive even older. It is a bit of a joke but here it would be called harassment. So a very different point of view. But I’m not comfortable dealing with men in this country.  
 
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Valerie feels that her age and being single has had more of an effect on her social life than...

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Well I do make an effort the days that I’m not working I do walk, make an effort and go out and walk around. So I would say that normally I probably walk for at least seven hours a week. An hour a day at least and often longer. I walk to the main bus stop, I’ve measured it, it’s a mile. So I mean usually if I’m going for buses I probably walk two miles there and back to the buses and then I’ll walk quite a bit when I get somewhere. And if it’s an interesting area I’ll walk, walk quite a bit. And I go, around looking at London and churches and stuff like that. I’m interested in architecture and history [cough]. So I go around looking at things quite frequently.
 
And apart from your leisure activities, your social activities involve going out with friends?
 
Yes going out, going to the cinema, things of that kind and again to dinner and whatever. Yeah. I mean if possible but I do go and do things on my own if people aren’t available but I prefer to go out with other people and I prefer to eat with other people as frequently as possible because I live on my own.
 
So how often do you manage sort of like eating with other people?
 
Sometimes I might go a week or so without. But other times say about several times a week.
 

Ok so it just varies?

 

It varies.
 
From one week to another?
 
Yes. I have no pattern and my friends are quite diverse in fact. Obviously it’s easier if I can find women who don’t have any ties at home who are available to go out. There’s quite, quite a wide age range between the sort of women who are available to go out.
 
Do you think that osteoporosis has an effect on your social life?
 
No I think age is restricting, I mean it would have, perhaps it would affect me if I thought there was still possibilities of getting boyfriends to feel that I couldn’t really go out on the market with something wrong with me. But I say I mean I have problems with my teeth and I feel that that’s more of a bore in a way [laugh]. Not having nice teeth these days yes. 
 
 
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Valerie worries about the effect that osteoporosis may have on her ability to be independent and...

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How did you feel about having osteoporosis? I mean you said that at the beginning you felt fragile?
 
Yes. No I mean I’m very annoyed about it [laugh] actually. I’m, now I’m feeling less fragile. I’m hoping it’s repairing itself. I was encouraged when I heard that the second scan that it seemed to not be progressing. So I’m looking forward to getting the results of this last scan to see if it’s stabilised. I keep a very close eye on my height. I try to measure myself. That’s virtually impossible [laugh]. I don’t want to shrink.
 
 
So that worries you? Concerns you?
 
It would really worry me because I’m absolutely incapable of being dependant on people and you know, people say, “Oh my god.” You know but quite logically if I got in the state where I was completely dependant on people I would really have to think very strongly about committing suicide because I, my quality of life would be zero. Even the fact that I have no habit of watching television' I anticipate going out for most of my entertainment and things of that kind. Being mobile is essential to the way in which I’ve always lived. And the same thing if I felt I’d got Alzheimer’s because my brain is absolutely essential and so whether one would have the courage or not but I really cannot envisage being in the situation where I have to be dependent etc. And I have no one to look after me anyway. So you know, there’s nobody who’s going to do it except yourself. I don’t want to be a poor old thing. No one’s going to look after me for love so.
 
 
Well I mean I’ve tried not to think about it too much but I say with the general thing of being taken as an old lady here. No I’m certainly very concerned about being handicapped in any way. And you know, if I broke something and it didn’t mend very easily. I’m hoping as long as there’s work around you know, theoretically there’s no time limit on how long I can work if my brain is ok and I can hear. And there’s one woman I’ve come across in professional meetings, she’s about 84. She still works a bit. She doesn’t look all that healthy. She has a stick but the problem about that is that I have come across when I went into a job and they said, “Oh my god we had this woman, we thought she was going to drop dead.” You know, that people are judging you on your age if you look decrepit. So that wouldn’t be a very good idea.
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