Growing pains
by Teresa Tumminello Brader
Image by Saurabh Narwade for Pexels
Sensing I’d been blaming myself, my new gynecologist said it likely happened because of who I am—a small white woman. She ordered my refill. On my third visit with her, the most recent, the nurse greets me by declaring the doctor can’t advise me on osteoporosis, my listed “main concern” on the required form. Though I haven’t asked, the doctor confirms this upon entering the room. I’m baffled, and quiet, as I sit on the examination table wearing only a medical gown. I fear being labeled a problem patient.
At the relatively young age of fifty-five, I wasn’t worried when my old gynecologist sent me for a bone-density test. The results showed osteopenia in one hip and osteoporosis in the other, as well as in the lumbar spine, and he prescribed once-a-month risedronate. I dutifully followed its instructions and still I wasn’t worried. He retired before the no-more-than-five-years for the treatment was over.
Determining how long I’ve been on the risedronate is my particular “main concern,” I venture to my now-newish gynecologist. She says she’ll consult with my internist and she orders a bone-density test, my first with her, my third overall. After the results and the consult, I’m told to choose an endocrinologist. I meet with the latter via telehealth. I access my supplements when she asks about their specifics. She describes the “specialized” medicine she recommends—if the ensuing tests show no contraindications. After a 24-hour urine collection and multiple vials of blood sent to labs, two in faraway states, my endocrinologist reports the five years of risedronate have resulted in a “failure of treatment, no known reason”.
Marketing propaganda, aided by the U.S. federal government’s efforts starting in 1937 and continuing through today with public-school free-lunch programs, promotes cow’s milk as essential for healthy bones. At my Catholic schools in the 1960s and ‘70s, milk was the only beverage choice at lunch. When the elementary-school teachers instructed us to finish our milk, I’d take a sip then mash the carton before discarding it. In high school, I usually opted for the soup-and-salad line and found the tastes of Italian dressing and tomato soup incompatible with milk. No thought was given to other sources of calcium.
Because of irregular menstrual periods, one as long as 109 days, I didn’t realize I was pregnant until the first trimester was over. Nauseated, unable to finish my glass of champagne on the last day of 1981, I had my first welcomed suspicions. Despite so-called morning sickness, which arrived throughout the day, I forced down plain yogurt with fresh fruit, switched to whole-grain bread, settled into other healthy eating habits. Decades later, when irritable bowel syndrome and silent reflux stopped me from eating certain calcium-rich foods, like broccoli, I was already on calcium supplements with vitamin D. When a skin disease increasingly kept me out of the sun, I added a separate vitamin D supplement. The lab work ordered by the endocrinologist shows my vitamin D and calcium levels are good, even high. She has me cut my calcium-supplement dosage in half.
During my periods I’d be plunged into a deep nighttime sleep I didn’t experience otherwise. As a teenager, in the days before winged sanitary-napkins, I safety-pinned disposable bed pads, left over from my father’s ostomy issues, to my underwear. I’d wake up in despair and disgust that my clothing and sheets were bloodied anyway. As I approached the seventh or eighth day, the heavy flow didn’t lessen much; not in subsequent years when I took birth-control pills, which I was assured would help; not during perimenopause, which I learned I was undergoing from a library book. I desperately wanted early menopause. I needed my periods to stop. Did my fervently heartfelt wish, often spoken aloud, cause their cessation at age forty-nine? Be careful what you wish for, my husband once said.
Framing it as a quality-of-life issue, my old gynecologist explained hormone replacement therapy was no longer as over-the-top as what his older partner had prescribed for my mother. At sixty years old, she’d developed breast cancer, not part of our medical history, which didn’t recur after a lumpectomy. I didn’t want to take the risk. Instead, I stood at the opened front door in the middle of our rare chilly nights; I lowered the summer thermostat to previously unheard-of temperatures for me. For my new dips into depression, I took evening-primrose supplements; rejected Xanax after a half-dose made me sleepy during the day; graduated to a short-term regimen of Zoloft, marketed for premenstrual dysphoric disorder, a syndrome I hadn’t heard of before. When I’m advised of the risedronate’s “failure,” I’m sixty and I wonder if it’s always something, no matter what you do or don’t do.
Before menopause, I’d upped my exercise routine: yoga; daily walking; upper weight-bearing exercises—some of it specifically to ward off osteoporosis. Maybe I didn’t start early enough. Maybe I’m still blaming myself. Doctors ask about my balance and I’m confident, it’s good. Friends who know of my diagnosis and haven’t seen me in months, in years, are surprised that I’m as agile as ever, that I’m not decrepit, though they don’t say that. Because of my sun issues, I used to joke about being a vampire. Now I joke about being the movie character Elijah Price, aka Mr. Glass, and how my husband will be pushing my wheelchair one day. He gives me a wry look, but doesn’t say to be careful what I wish for: He knows it’s not a wish.
A new addition to the gallery of my morbid thoughts arrives, unbidden, as they all are. Its shockwaves hit me in the shower over several consecutive nights. I’m not bothered about injecting myself every day, for no more than two years, with the tiny needle attached to the “delivery device” for the new prescription, teriparatide. (The irony is not lost on me that teriparatide is a hormone.) Even its possible side-effects don’t bother me: In studies rats have contracted bone cancer, though not humans. No, the shock arises from the medicine’s objective of growing bone, a strange phenomenon for someone my age, and I feel as if I’m in a fairy tale, hesitating before imbibing a mysterious potion, knowing I have no choice but to consume it.
During the first few months of injections, my legs feel heavy, occasionally achy. I recall my grandmother saying the shooting sensations my siblings complained of were growing pains. Then, as the oldest and a voracious reader, I dismissed the axiom as an old wives’ tale. Now, though I don’t feel old, I still love tales, even fairy tales, and I decide to embrace my grandma’s notion as a hopeful sign of realization.
Teresa Tumminello Brader (she/her) was born and lives in New Orleans, the source of much of her inspiration. Her first book, hybrid memoir/fiction titled Letting in Air and Light, is forthcoming from Belle Point Press. Her poetry and stories appear in Halfway Down the Stairs and Deep South, among others.