RUTH SUNDERLAND is so fit she runs four miles to the office every day. But after a broken shoulder led to a shock osteoporosis diagnosis, she declares… I’m the proof it isn’t just an old ladies’ disease

Of all the things to change my life, I didn’t expect it to be a gnarly, dusty old tree root on Clapham Common.

But when I tripped over it one Saturday last summer while training for a half-marathon, it was a small misstep with big consequences.

I fractured my left shoulder, gave myself a black eye and badly bashed my leg. I looked as though I’d just gone ten rounds with Anthony Joshua. But that was only the start of my worries.

I’m a fit and healthy woman in my 50s at the peak of my profession. The last thing I anticipated to come from a sporting injury was to be diagnosed with osteoporosis – the bone-thinning disease usually associated with frail, hunched old ladies like the one on road signs. That day on the Common, I picked myself up and walked the mile or so back home where I cut myself out of my running gear with kitchen scissors, my left arm unable to move.

Instead of going to A&E I went to meet my mum, who was visiting for the weekend with my niece and nephew, and as I didn’t want to spoil our time together I swallowed a pile of painkillers and we whirled around the sights.

RUTH SUNDERLAND: I’m the proof osteoporosis isn’t just an old ladies’ disease

An X-ray at St Thomas’ Hospital in Central London later on confirmed the fracture, and after that it was back to work as the head of a busy business desk for The Mail on Sunday and Daily Mail.

I couldn’t use my left hand to type and, since I couldn’t do my hair or get my bad arm into smart clothes, I looked like a bag lady. Still, I was childishly proud of using a voice-activated gadget to write a front page story.

A fractured shoulder, I thought in my naive vanity, wasn’t going to derail my life. It didn’t dawn on me that it was a sign there was something wrong with my bones.

As I am now well aware, everyone loses bone density from about the age of 30 – and women more so than men due to hormonal changes. When you lose too much, as I have, you are more prone to fractures. I got away lightly, it turns out, but these can be devastating.

You don’t have to be a pensioner or female to get osteoporosis. Tens of thousands of working-age women suffer from the condition. So do men, including the broadcaster and author Iain Dale, who found out after breaking his hip in a fall at a Tube station last year.

More than 81,000 working-age people suffer fractures every year, according to the Royal Osteoporosis Society, and a third have to quit their job as a result.

With my Business Editor hat on, that is terrible for the economy, particularly when we have some nine million people economically inactive. Greater awareness and earlier diagnosis would help people keep their lives on track.

I was lucky to be diagnosed quickly after the fracture. At first I was shattered by the news, which I was given by Jude Powell, a clinical nurse specialist in the Fracture Liaison Service at St Thomas’.

Jude and her colleague Molly have been a huge source of support and reassurance. I was, and remain, terrified I might not be able to look after my mum if she needs me in the future, as well as my husband, Michael, who is suffering the after-effects of cancer treatment. As with any major health shock, it is an intimation of the mortality we would all like to deny. Particularly so for me, because my family is still grieving the death of my stepfather last year. Losing him rocked my foundations.

BREAKING NEWS: Radio host Iain Dale found he had osteoporosis after a fall in the Underground

BREAKING NEWS: Radio host Iain Dale found he had osteoporosis after a fall in the Underground

I’m now acutely aware of time passing and that we all grow older before we are ready, but I definitely wasn’t ready for osteoporosis. It felt as though I had been hurled from robust, capable maturity to being labelled frail and feeble.

I was offered a bone-density scan known as a DEXA, which is made available to anyone over 50 who has had a ‘fragility fracture’. This is defined as a broken bone after a fall from standing height.

Frankly, I was insulted. As a northern woman who likes to think she has more grit than the M1, words such as ‘fragility’ and ‘frailty’ now bandied about with reference to me were an affront.

I’m glad I didn’t follow my first impulse to refuse the scan, though Jude says quite a lot of people do.

If only the doctors would say ‘low-impact’ fall instead of ‘fragility’ or ‘frailty’, which have incredibly negative connotations.

The DEXA is a painless X-ray procedure that takes about 15 minutes. Your bone density measurements are compared with those of a healthy 30-year-old and given a score.

Between +1 and -1 means healthy bones. Anything between -1 and -2.5 is defined as osteopenia – which means your bones are weaker than is ideal, but not yet osteoporotic.

A score of -2.5 and below and it’s full-blown osteoporosis.

My scores were -1.5 on my hip and -2.7 on my spine.

STRONG SUPPORT: Ruth after a run with her friend Alan Wilson

STRONG SUPPORT: Ruth after a run with her friend Alan Wilson

Why I have it is a bit of a mystery. I have no family history, and other risk factors such as lack of exercise, drinking, smoking and poor diet don’t apply.

A string of tests for underlying causes such as coeliac disease or thyroid issues all came back fine.

It is galling to have had a healthy lifestyle and still fall prey, though it might have been much worse if I had bad habits.

Nurse Jude says: ‘We know cutting down on alcohol and smoking has a positive impact for bone health. Ensure you have a good healthy diet with plenty of calcium and take Vitamin D3 in the winter. Weight-bearing exercise is essential. You need the stress through your bones to maintain strength with light weights, for instance.’

Early diagnosis is also key. As Jude says ‘Capture the fracture’ – in other words, try to make the first broken bone the last.

People have asked me if I will give up running, and the answer is a firm no.

Jude has advised that it is an excellent thing to do and may be the reason my hip score is better than my spine.

Running, by myself or with my friend Alan, will remain a big part of my life. So will the long hikes my husband and I enjoy.

Though I try to banish dark thoughts, there are bleak moments when I fret over what my life will be like if I suffer a string of crippling fractures when I’m older and less able to manage. Lack of diagnosis is an enormous problem. I didn’t exactly welcome mine, but it is better to know. Osteoporosis is often called a silent disease, because there are no symptoms until you break a bone.

The silence is also social. We use bones and posture as a metaphor for character. If someone is morally weak, we say they lack backbone, or are spineless. Decent folk are upright and upstanding.

We need to challenge the stereotypes and remove the stigma.

The reality of osteoporosis is far more nuanced. While the impact for some is severe, others can manage the condition and live a good life.

I don’t know what my future will be, but armed with the knowledge my diagnosis has brought, I can at least take action.

Weight-lifting and a new antibody injection are rebuilding my bones

There is no cure for osteoporosis, but it is possible to slow it down through lifestyle and drug treatments.

I’m one of the first women at St Thomas’ to be offered a new drug called romosozumab. The treatment was developed by British scientists working in Slough for Belgian firm UCB, along with US company Amgen in California. Only 2,000 patients have received it since it was approved in England in 2022.

Romosozumab works in two ways: it accelerates the cells that build new bone, called osteoblasts, and slows down the ones that break it down, which are known as osteoclasts. Injections are delivered to a patient’s house, and I will be trained to inject myself once a month.

Other treatments include bisphosphonates, usually taken as a weekly tablet. These too put the brakes on osteoclasts.

But not everyone can have drug treatments if they suffer from other medical conditions.

If you have certain types of chronic kidney disease, for instance, bisphosphonates can’t be offered. Romosozumab isn’t suitable for those who’ve had a heart attack or stroke either, as the drug might increase the risk of another.

The focus, if you aren’t on medication, is on preventing falls through exercises to improve balance and minimising trip hazards to limit the possibility of suffering a fracture.

And some people don’t want to take any drugs and instead rely on diet and exercise.

I’m opting for both. Finding time is a struggle but I have added upper body strength workouts, weights and pilates to my running and hiking. Getting enough Vitamin D and calcium is also a priority.

The Royal Osteoporosis Society (theros.org.uk) is a mine of clear, reliable information. It has a great risk-checker and its specialist nurse advice service is excellent.

One in two women over 50 and one in five men will have a ‘fragility’ fracture – let’s start saying ‘low-impact’ instead – so early detection of osteoporosis is vital.

I was lucky to go to A&E at St Thomas’, where a Fracture Liaison Service (FLS) – with two specialist nurses and a consultant that provide support to patients like me – has been running since 2008. But FLS is not yet in every hospital, so it truly is a postcode lottery. Hopes that the Chancellor would give more funding for the service in the Autumn Statement were dashed.

Without FLS, myself and many others are at a greater risk of suffering multiple fractures before finding out they have osteoporosis. I hope Jeremy Hunt provides more funding in his Budget in spring.

Reference

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