Hi all, back during the early part of July I posted detail of my being prescribed Alendronic Acid and your suggestion was to request a DEXA scan. I visited my GP who said 'Yes, but you are alright because you are on Alendronic Acid'. I said, 'No, I am not taking it, until I know if I need it'. My GP's attitude then changed. I was told 'You will need it, your bones will be affected by steroids, you will get fractures, you should be taking it'.
I tried to explain that I have had no fractures, even though I have fallen three times recently in the garden. I then asked if I should have had a test in the beginning to show if I had any bone thinning, the GP said, 'we do not normally give test to anyone over the age of 70 as we expect you to have bone thinning'. The GP was not at all happy at my refusal to take it, repeating to me again and again that I must and should take it. and then, and only then, when filling out the DEXA scan request form, asked me if there was any history of osteoporosis in my family, I said 'no, no one neither my mother, nore my grandmother', then I was asked had I had any fractures,I said 'one, leg fracture twenty years ago'. The GP then said that there would be a two to three month wait for the scan'.
The atmosphere was somewhat unpleasant, I was left feeling a little shaken, and upset.
Hi Mrs Mac. What is it with some doctors and the magic age of 70. We are the brigade that have paid into our NHS for years yet they give the impression that the NHS closes down for us once we reach that magic age. I am 65 and have stopped taking A.A for the time being after what I have read on this forum so don't get put off by your doctor. Well done for confronting him and getting your scan. Best wishes Dave (tavidu).
This discussion was posted twice so I have deleted the other one. Below is the one reply from that discussion from LodgerUK NE
Stick to your guns and good on you for insisting on a scan.
Also there are other bio-phosonates if necessary and you can look them all up on the National Osteoporosis site.
If you can afford it you can have a Dexa Scan done privately, but me I would just wait it out.
You could also ring the Dexa Scan dept in the hospital you have been booked into and tell them you are willing to go at short notice if someone cancels.
'we do not normally etc' does not apply in your case, you have PMR and it is in the guidelines issued by the BSR and available on the NHS website on the Diagnosis and Treatment of PMR.
When I filled in the Dexascan form it specifically said I had priority if I had PMR. I suppose this mayvary from county to county of course. The Alendronic Acid and no Dexascan comes from the current British Society of Rheumatologist guidelines for PMR/GCA that say if you are over 65 you should take AA with no Dexascan. They are supposed to be producing new guidelines soon.
Good for you for holding firm. It is rattling-- and tiresome-- to contend with physicians who seem to believe that we know nothing about our own bodies. Wouldn't it be great to feel as if you were collaborating instead of having to push against all the time!? Le sigh.
Good for you, sticking to your guns. I am in a similar position to yourself. My new gp is not happy that I am not taking A Acid. Her words "what if you fall and fracture your hip" I wasn't quick enough to say "what if I fall and don't fracture my hip" I want to have a say in my treatment of PMR. Well done.
MrsMAC, I do both sympathise and empathise. When I asked for a DEXA at the outset of steroids, I was refused by both my GP and my rheumy, both informing me that there was a 12 month wait! So why not even put me on the waiting list then?! I was desperate to get a baseline reading to know the state of my bones before Pred got in the way, so I arranged one privately. Totally different story two years down the line when I asked and was sent for the scan within a couple of weeks.
So not fair to be left feeling upset following your appointment, but well done for standing your ground.
I think I had to wait a couple of months or so for a Dexascan even though I had helped fund raise for the scanner! If you are already on steroids at least it shows if the steroids are having any effect if you have to wait a few weeks.
Mrs O! I don't know whether I am being presumptuous, but do you think it would be in order to let people know how much a private dexascan might cost? They may then be able to think about saving to have one done.
You should be able to get a Dexascan for less than one hundred pounds, Southampton Hospital for example charge fifty five pounds. I think it is a case of shopping around.
Hi Mrs Mac-UK, I think it is appaling an unwell patient who makes a logical and informed request about a baseline test/scan should be have to deal with an "unpleasant' atmosphere in the surgery and leave it 'feeling a little shaken' . I felt really sorry to hear this. Anyway, just stick to your guns, and defer taking any bone meds. until you are confient that your bones really need them. This may require that you see a rheumatologist with your scan readings, since this GP should be avoided in the future - if at all possible. In this health system the guidelines are - that if a person is taking a steroid med. ( Pred.) of 7.5mg. or greater for more than 3 months, they should have a bone scan. Your bones could be just fine but then you establish a baseline for the future and recheck in a couple of years.
Finally, well done to your for taking a stand. Kind regards, J
Constance, although I cannot remember the cost of my private DEXA (well it was almost 10 years ago now!), I understand from the National Osteoporosis Society that the present cost is around £100 but can vary slightly depending on the area. BUPA on the other hand charge £445!
Yes, there is some variation, so definitely worth shopping around for anyone who is looking for reassurance and is having difficulty getting the scan done on the NHS.
I suspect I'm about to have the same argument with my GP - she started giving me Prolia injections (another type of osteoporosis prevention treatment)18 months ago and I've only just really considered the side effects - I won't be having any more. I am also going to request a DEXA scan.
My GP can be a little 'difficult' at the best of times, so this visit should be interesting lol