A postcard from Limboland

A month ago, if you asked me how tall I was, I’d say I was a six footer.

It seems I’m not. I’m a five-foot-ten-and-a-half short-arse apparently, so essentially I’ve lost an inch and a half (4cm) in height. Even if you consider I may have always rounded up by half an inch, and I may have always measured my height first thing in the morning when I’m at my stretchiest – that’s still quite a lot of height to lose.

Let’s say it’s an inch or slightly less. It’s quite a reduction, and I feel like I’ve lost some of my identity along with that inch. There’s an inch of Dave that’s gone forever.

I was measured just before I lay down for my DEXA scan, so it was something to ponder as the technician asked me to shuffle uncomfortably this way and that on the scan-table.

A DEXA scan is a type of x-ray to measure bone density and it’s used to determine if you have osteoporosis.

My GP has already pre-empted this as the diagnosis and the scan should either confirm it or show that I have osteopenia which is basically osteoporosis-lite.

So it seems I’m back in diagnosis limboland.

This is not a happy place to be in. I’ve been here before, of course, but back in 2008 I caught the flight out of Limboland Airport to a new life in MS-ville instead of Brain Tumour City, so when my emotional baggage rolled around on the carousel, I was able to deal with it all and load it up myself onto my trolley. My family, other MSers (some of whom follow this very blog), a few but not all of my friends, and some health professionals were also there in baggage reclaim to help me push it along until I was able to manage it all by myself.

Now I’m back in the departure lounge, sitting down with some egg-mayo sandwiches (the only ones left in the shop) and looking for somewhere to charge my phone, wondering why the screens aren’t showing my destination yet.

So why could it be osteoporosis?

Well, the type of fracture I have is only really seen with weaker bones. Spinal compression fractures, along with wrist and hip fractures are the commonest types of fracture in osteoporosis. If you see elderly people walking with a stoop, osteoporosis of the spine is a likely cause.

It’s most common in post-menopausal women, of course, and it’s a risk due to the reduced oestrogen resulting from ‘the change’. Hormone replacement therapy (HRT) is a commonplace treatment for women at that stage in life. Male sex-hormones tail-off on a shallower trajectory, so we fellas don’t show signs of osteoporosis until much later in life. It’s a silent condition; you don’t have any symptoms until you fall over and break something, which, as I documented in my last post, is exactly what I did last September.

So, you might be wondering why a fifty year old bloke with MS has osteoporosis.

Well, I’ve not been feeling right for some time and I’ve been honest with myself recently and I’ve come to the conclusion that I’m actually quite depressed. If you do an internet search for low testosterone, without going into too many gruesome details, I pretty much tick all the boxes. Hormones have a pretty nasty way of letting you know something’s wrong.

To put it bluntly, I feel pretty shit!

It’s definitely not a mid-life crisis. That’s something completely different. I made some pretty crap decisions in my younger life and I haven’t set the world on fire (yet), but I’m largely happy with who I’ve become. I think I’m pretty cool. I’m generally at peace with myself. I’d still like to have a challenge in life, but I have no urge to grow a ponytail (again) and buy a sports car.

I had already asked my GP for a blood test to check my testosterone levels at the same time as she booked the DEXA scan.

Being the consumate professional, she also booked about 5 other tests at the same time, ranging from liver function to diabetes tests.

Everything came back fine, apart from one tagged “ABNORMAL”.

And so it’s almost confirmed. It looks like Mr T isn’t pulling his weight, and it could be due to a lesion in my brain.

I still have to do a fasting blood test in a month to confirm it for some reason, and then I’ll be sent to an endocrinologist for treatment, which Dr Google advises could be anything from injections to pills and patches. Once they start to work I should start looking forward to becoming a sexy beast again complete with a slimmer waist a hairier head (maybe?), a gold medallion and hopefully a more positive outlook.

So, what now? I’ve been necking the chunky calcium pills to build my bones up like a pelican gulping down fish. I’ve started walking a couple of miles every day before breakfast just to keep my body moving and get some natural endorphins flowing. I have to swallow some painkillers first to get me going, but it’s a chance to have some me-time with my headphones in the fresh-air of the pre-dawn.

I’ve also seen a physio. A muscolo-skeletal (MSK) one this time.

They were happy with the stretches I’ve been doing and gave me a couple of new ones to try to counteract my sedentary job. They were pleased when I said I’d asked for an occupational health referral at work as it’s been a few years since my last one. They also seemed pleased that I was walking first thing, saying that’s exactly what I should be doing. They adjusted my walking stick so I don’t lean into it as much. They also said any thoracic fractures shouldn’t really affect how I move as that part of the spine doesn’t really move much anyway. The concern I should have is with my lumbar region.

They had my x-ray on their screen so I asked to have a look.

What I saw surprised me. I had expected to see that my spine had crumbled like the last biscuit in the tin. Instead, I was shown what looked, to my untrained eye, like relatively normal vertebrae. There were areas on a couple of bones that weren’t as sharp on the image as they should be, and I was told that these were likely to be the fracture zones, but I struggled to see from these where I’ve lost the inch. Other than these little grey fuzzy patches, it looked fairly normal to me. What I wasn’t prepared for though, was the loss in disc space. It looked like there should be plenty of healthy looking discs for sure, but there were at least two intervertebral spaces in my lumbar spine that looked like someone had let the air out. They looked more like they should be filled by pancakes than rubber rings.

It’s still sinking in a bit, and it’s funny how visualising something helps. I wasn’t aware of anything wrong in the lumbar region until I woke up on the morning after the appointment and felt the ball of pain at the base of my spine. This is pain I obliterate automatically with strong painkillers in my half-asleep state. I’d been focussing on the larger and sharper ache halfway up my back without even noticing anything else was going on.

And when I do my sideways stretches, it suddenly makes sense.

So here I am, like I said, in the departure lounge at Limboland Airport waiting for Mr T to show up, and wondering if I’ve got what I need in my mental suitcase to cope with whatever’s at the end of the flight.

Wherever it is I’m off to, I just hope that this time I have a soft landing.

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