Osteoporosis

Keith - Interview 38

Male
Age at interview: 55
Age at diagnosis: 54

Brief outline: His diagnosis came about in 2007 after medical investigation for a lump on his breast. The lump proved to be benign but the blood tests indicated that he had low testosterone levels and a DXA scan revealed mild osteoporosis. He was put on HRT treatment (testogel).

Background: Keith works full-time as a statistician and he is also a concert pianist; single. He was aware of breast cancer in men but thought that osteoporosis affected women only.

Audio & video

Keith was prompted to go and see his GP after he found a lump on his breast. He was aware of breast cancer in men because he knew of someone dying of the condition. His GP referred him to the breast clinic and the tests revealed that the lump was benign and most probably made of fatty tissues. But the clinic requested blood tests to try an established what had caused it. Keith was told that the test results would be sent to his GP and was asked to make an appointment to go and see her. The blood tests showed that he had low testosterone level but still within the normal range. The GP decided to send the result to an endocrinologist for further investigation.
 
The endocrinologist requested further blood tests and sent him for a bone density scan. The scan results revealed that he has osteopenia in the hips and osteoporosis in the spine. An appointment was made with the specialist who told him that he only has mild osteoporosis. Keith’ mother has osteoporosis and the specialist indicated that most probably his condition resulted from the hereditary factor but it was exacerbated by his low-ish testosterone level. The specialist put him on HRT – testogel to rectify the hormonal imbalance. He is also taking calcium tablets and vitamin D; a thousand milligrams a day. He was told to repeat the DXA scan in two years time.
 
Keith started his HRT treatment three months ago and said that initially he felt a lot better and noticed that his energy levels and his sex drive have increased. But after a few weeks on the testogel he became aware that he was feeling more irritable. Also, a close friend and fellow musician commented that the HRT treatment was affecting his piano playing and making him a bit hyper ‘always on the go’. His piano playing is very important to him and he is concerned about the emotional side effects of his treatment. Keith decided to reduce the dose from once a day to twice a week and is waiting to see his GP and discuss this with her. He said that since reducing the dose he feels less irritable. Keith has now seen his GP who was entirely on favour of the change and said that adjusting the dose was commonplace with women on HRT.
 
Keith’s lifestyle has not at all been affected by his diagnosis of osteoporosis. His GP has reassured him that his quality of life didn’t need to change because he is fit and healthy. Besides, he knows that there are osteoporosis treatments available if and when he might need them. From his mother’s experience of osteoporosis, he also knows that treatment can be effective at improving the condition. He is concern, however, about the side effects of his hormone replacement therapy. He hopes that his GP will agree with him for the need to reduce the HRT dose to a level which is beneficial for his osteoporosis without the emotional side effects.
 
Keith thinks that there is not enough awareness about the fact the osteoporosis can affect men as well as women. He didn’t know he was at risk even though his mother has osteoporosis and thinks that the most effective way of preventing and/or early diagnosis is to have a screening programme for men over the age of fifty.
 

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