My Bone Health Turning Point
By Sally Crandall
Sally Crandall
One winter afternoon, when I was 16 or so, my mom and I took a walk around our block. In the middle of an argument, we stepped off the curb, and I said something mean. Being a teenager, I was good at that. My mom whirled around and, as she did, she slipped, fell on the ice, and broke her arm. She wouldn't let me drive her to the hospital, so I stewed in deep regret at home. That was not the first break for my mom, and it wasn't her last. Osteoporosis was never discussed even though she did drink a glass of buttermilk at least once a week. It was not talked about when her own mom broke her hip on the ice in Wisconsin, walking out her front door toward the taxi waiting to carry her to the airport for a much dreamed of trip to Ireland. After all my mom's arm and wrist fractures, osteoporosis still was never mentioned and not even when she broke her hip falling in the retirement home.
I sat in the rheumatologist's office not long ago and nodded enthusiastically as he recommended treatment for my borderline osteoporosis. He said the treatment was expensive, but insurance might cover it. I was surprised when Medicare and my insurance rejected the request and required my doctor to write a special letter to reverse their decision. I was more surprised at the final cost, even with a revised insurance coverage decision. There was talk of the donut hole, a term I had, up until now, been able to ignore. I made calls to the specialist pharmacy run by my insurance company, to Medicare, to my own pharmacy. I investigated and was rejected by all the programs that offered support. How could I, at 73, be asked to pay so much for a medication that was explained to me as my best chance to prevent fractures?
For 10 years or so I have been in the osteopenia range and have tried to slow the progression of bone loss with a weighted vest, exercise, and diet awareness, but I have not taken any medication. If the money had been readily available to fund the medication the doctor prescribed, I would have started immediately, but facing the expense and the difficulty in attaining the prescription made me wonder why I needed to go to the final solution first. I read the potential side effects and required lifelong commitment and was unsettled.
I began to think about getting a second opinion. Clicking onto the NOF website, I spent several hours that day and the days following, watching videos, and reading the forum and finally asking others in the forum about the recommended medication. My website visits felt like small doses of relief. Each time I learned something and each time I felt I was with people like me who could help.
Both my sister and mother-in-law had lifelong illnesses and relied on their doctors like family members. My mother, on the other hand, was not interested in telling a doctor anything, saying it was up to him to find it. The thought, for me, of getting a second opinion made me uneasy. Would it be a waste of time? Would the doctor say the same thing the first doctor said? Would I feel stupid? Would my insurance pay for a second opinion? What if I didn't like the second doctor? I called the insurance company who said a second opinion was included in my coverage. I got a recommendation for a second doctor and even a quick appointment due to a cancellation. Speaking to the second physician, I expected him to say the same thing as the first, but he didn't. He was more thoughtful in his approach and recommended a less aggressive form of treatment. I felt better about that and decided to start taking medication.
Last winter, the ice built up, and I worried about falling. Every day, going out for a walk, I slowly made my way up the middle of the street where the cars carved a small open path to the school. At the school, the janitor shoveled and salted the parking lot every day. I crept home again along the same narrow space to our front gate and held tight onto the black wrought iron gate as I climbed over the ice on our front steps to the door. Feeling very aware of the dangers of falling, the memory of the women in my family was never far from my mind.
When the first doctor confidently prescribed the medicine he did, I was more than open to his recommendation. I pictured the future me with healthy bones and without the walker my mom needed. In the name of the women in my family, however, I'm glad I listened to my doubts about the place of that treatment in the progression of my bone loss. I'm glad, in their name, for the confidence and knowledge I received from the NOF website and I'm especially glad, for all the women before me, I saw my concerns through to a comfortable resolution. Something, for me anyway, easier said than done.
This story is part of a support initiative called Voices of Osteoporosis: Stories of Hope and Inspiration. If you have experienced osteoporosis as a patient or caregiver, we invite you to share your story. Your story could inspire others to learn how to protect their ability to live their best life and stay bone strong. Click here to learn more.