A mammogram may break your bones

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Sounds unlikely? Read on —

This Autumn – a full two years and more since breast cancer treatment – has been assessment time for me. For the last six weeks or so, I have been off both my injections and my pills in order that my natural hormonal status can be checked. Having had the second of two blood tests today, I await the outcome, and if I have gone through the menopause, then I am done with the monthly injections which have made me post-menopausal. This would be good.

Today I also had a bone scan to check the effect of these medications. I feel so well, and am more active than I have been for years, but as Zoladex (the jabs) and Arimidex (the pills) both carry a risk of reducing bone density above what would normally be expected at my time of life, I shouldn’t really have been too surprised at the findings. My hips have lost 6% of their density – which is just OK – just in the normal range apparently. But I have lost a centimetre in height in two years, and my spine has lost 13% of its bone density. Which means I have osteoporosis.

I have tried. The gym, walking, swimming, good eating (mostly). But I have a small frame which puts me at greater risk (all my big-boned, well-padded friends out there – rejoice for yourselves). And swimming is good for you but doesn’t count as weight bearing. Cycling doesn’t count either. Damn. Better start dancing.

The advice is to take care with lifting. Avoid falls, so no going up ladders. The scanning person (don’t know the term but she was very nice) even said not to go out if it was icy! Shit, housebound in bad weather at 56??! The accompanying booklet I have been given suggests that even small movements (like lifting a shopping bag) or small bumps could cause a fracture. That’s not cheerful reading.

And then of course the medics will recommend more medication (I have to see my GP in two weeks’ time): alendronate, which by all accounts messes with your gut; and calcium tablets which just may be associated with a higher risk of heart disease. That’s why I have avoided them so far and just eaten my kale and my almonds.

So I have more difficult choices ahead. Shall I just not go back on Arimidex, which keeps me oestrogen-free (so reducing the risk of  recurrent breast cancer), but thereby increases my bone loss? Shall I just up my calcium intake through food – I would have to eat more dairy products with their possible association with breast cancer – and refuse the tablets?

The pity of it is that maybe all these mental and emotional gymnastics could have been avoided, not to mention the current fragility of my bones. It feels as if one thing leads to another once the medics get hold of you. It makes it hard to be grateful, and I should be so grateful for all this care and medication which is free at the point of delivery. God bless and preserve the NHS, I still say.

So – anyone considering a mammogram out there – remember: it may have long term effects, and cause you problems you never thought of. Possibly for no good reason. Though that you will never know, and living with the uncertainty is hard. Sometimes very hard.