Mrs Maria Margarida Orcesi Pedro, 80 years old, is a retired history teacher.
Margarida experienced premature menopause at age 39, and did not receive hormone therapy at the time. Once menopause begins the body produces lower levels of the bone-protecting hormone oestrogen and the rate of bone loss increases rapidly. Normally this occurs at around the age of 50, but with early menopause this process of rapid bone loss starts earlier. As well as early menopause, a major risk factor for osteoporosis, Margarida led a sedentary lifestyle which can also increase the risk osteoporosis.
The diagnosis of osteoporosis came in 2009, when at the age of 69 Margarida suffered a hip fracture after falling from standing height. She underwent surgery and immobilization and then had physiotherapy and rehabilitation sessions for more than six months. It was a difficult time and Margarida was glad to have the support of her family. Although she recovered successfully from the fracture, she only regained partial functional recovery. Due to these limitations she now uses a walker as an aid to getting around and requires help with some daily activities.
Fortunately, Margarida’s daughter Adriana is a gynaecologist and obstetrician with expertise in osteoporosis and so she has helped to ensure that her mother received the osteoporosis treatment to prevent further fractures. Having been on osteoporosis treatment for more than 10 years and with attention to proper nutrition, Margarida’s hip fracture has been her first and hopefully last fracture!
Osteoporosis often runs in families, and this family was no exception. Around Christmas 2011, Adriana too sustained a fracture. She slipped and fell from standing height and broke her right wrist (known as a Colles fracture). It was a major fracture which required surgery with open reduction and internal fixation. Immobilization of the forearm, wrist and hand for three weeks, followed by three months of physiotherapy was required so that she could recuperate fully without any limitations. This was a hard time for her, because she could not work in her practice for three months. Patients with scheduled elective surgeries and medical consultations had to be postponed. As an obstetrician, Adriana had to refer her pregnant patients to a colleague for continued pre-natal care and delivery assistance. Adriana recalls:
“I did not expect to sustain a fracture so early in life, but genetic predisposition is an important risk factor and anyone with osteoporotic fragility fractures in the family needs to keep this risk in mind.”
Ironically, the family pet Maltese ‘Patty’ also suffered a broken leg which required surgery and immobilization. After a complete recovery she now loves to ride along in Margaridas’s walker!