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Anna
Foreign. How you doing?
Erin
Good day, Anna. I mean, I just. If you, if you haven't heard by now, we are interviewing someone from Australia today.
Anna
We're going global, baby.
Erin
We're going global. What joy and breath of fresh air. Our next guest, Kim, was. But I can't. I can't wait for everyone to hear her mystery.
Anna
I feel like there's a lot to this that will inspire a lot of women, especially pregnant women, and that's all I'm going to say. So if you're pregnant or you know somebody pregnant, you probably should listen to this episode.
Erin
This is the story of a new mom who has to fight to get attention for herself when all she wants to do is spend time with her newborn baby. All right, well, let's get to it. Hi, Kim. Welcome to our first international filming of the medical detectives. Welcome.
Anna
Wait, we've gone global.
Kim
Thank you. Thank you so much for having me. I am very excited.
Erin
Can you fill everyone in where you are calling in from?
Kim
So I am calling in from Brisbane, which is in Australia and it's the third largest city here.
Erin
Well, Kim, we're so excited to hear about you and your story. And I'd like to kind of kick things off with asking people to talk about what it was like being little Kim, Australian. Little Kim.
Anna
Not to be confused with Lil Kim, the famous rapper little Kim.
Kim
I. I must admit, I often do get called that. Love it. So I'm sort of quite used to that. So it's nothing new to me. But I guess in terms of being little Kim in Australia, I pretty much grew up as your average sporty kid. So from a young age, I was always involved in sports. So this is through primary school, high school. So I did tennis, netball, athletics, swimming, bmx. So you mess. I did it. It is the coolest sport, let me tell you that. So, yeah, pretty much as a kid, I was always on the go. And then, you know, as you get into your 20s, you let those sort of team sports and organized sports, they just sort of filter out because life gets in the way. But having said that, I was always active, so, you know, going to the gym, going on walks with my dogs and hiking. And then when I met my husband, he was a personal trainer. So fitness was something that we then shared together and something that I had always done. So I guess in terms of, you know, staying active, I thought I was doing everything right. So textbook childhood, no issues, nothing that would sort of trigger what my future would hold. But I guess looking back over those teenage years, if there ever was A clue that there might be something going on with my health. It could have been in relation to my hormones. So I didn't get my period until I was 16. And then for a number of years, it was so irregular. But my mom had experienced exactly the same thing. So obviously, you know, going from her history, it's not something that we sort of questioned, just, you know, straight down to genetics. That was her experience. Mine was the same. So we never thought that that's something that we needed to be concerned about or go and see a doctor about. So sort of moving on to my 20s. Having met my now husband, I went on the pill, and that obviously helped regulate things. So then I just had a normal period based on taking that medication. But then as time progressed and we sort of, you know, moving forward in our relationship, we wanted to try for a baby. And as soon as I came off the pill, the irregular cycles came back. Like, looking back and knowing what I know now, having irregular cycles and trying for a baby, I had no idea what that meant. I. I didn't think I'd have any troubles. It was just like, oh, this is my body. This is what it does. And which is probably a good thing, because otherwise I probably would have stressed, you know, trying to work out when. When is the best time to try and whatnot. But I was just oblivious to all that, which was probably a good thing. So my first pregnancy was when I was 29, so that went smoothly. And my son, Aiden, he was born in 2009. It was pretty much textbook. No issues. After Aiden was born, I got back into my usual activities with pretty much relative ease. I think my payback for all of that was that Aiden was a horrible sleeper. So I.
Anna
That'll get you clean.
Kim
Exactly. So I think that was actually my karma for everything going so smoothly. So, yeah, either sleep.
Anna
You either don't sleep during pregnancy, or you don't sleep directly after pregnancy.
Kim
Exactly. And I got what was waiting for me, let me tell you that much.
Anna
Good thing you loved him, right? That's why they make babies. You.
Kim
Exactly. That's so true. So once he was born, everything was going smoothly. I fed him, breastfed him for four months exclusively. And then I did introduce formula because he was always hungry. So from then on, everything just went smoothly. And then we get to 2011. So in 2011, we moved back to the city where we both grew up, and this is where our families were as well. So, you know, just having Aiden and wanting to expand our family, we just thought, now's the time to Go back. A month after we moved back to Brisbane, we found out that I was pregnant again. And this was, I guess, probably another miracle that I had no issues for falling pregnant. It all happened relatively quickly. And then Addison was born in November 2011.
Anna
So completely smooth pregnancy.
Kim
Again, smooth pregnancy. The only issue I had was towards the end of the pregnancy, I had some sciatic nerve pain and I had problems walking. And because I'd had that sort of positive experience with being induced, we decided to go down that route again of being induced. And as soon as Addison was born, that sciatic pain just totally disappeared. So that was. That was the only issue. But that's sort of pretty textbook, really, for pregnancy.
Erin
Can you describe what that felt like?
Kim
That was. That was pretty bad. I want to say horrendous, but looking back, considering the rest of my story, I want to say that was a walk in the park, but I couldn't actually walk from the pain. So it was. It was up there. So being induced and having the doctor explain that once she was born, things will go back to normal, that was my decision to go, Yep, okay, I'm happy to go down that pathway of being induced again. I didn't have a concern knowing that I had Aiden to look after. Being able to walk was pretty important to me. So it was, yeah, happy to go ahead with that. And like the doctor said, as soon as she was born, everything was okay again. So the kids are 23 months apart, and I didn't think that that age gap was unusual enough to cause any issues with my health. A lot of women have similar or even smaller gaps with their children. So to me, that just seemed really normal. Like it was very, very standard. Nothing that would make you think that this is going to have a massive impact on your health. So obviously, life is pretty hectic and manageable. So that was from November 2011, sort of, you know, cruising through Christmas, New Year, and then we get to February 2012, and that's when everything changed. So Addison being a few weeks old and Aiden had just turned two. And then at that time, my husband had sort of changed careers. So he was in the process of becoming a paramedic. So he had just started his first block of being a student paramedic. So that means 12 hour shifts. So we have him. Him working nights, days, needing to sleep. And then me with the kids and, you know, obviously being a student, everything's so new to him. He's got to be switched on. So I'm doing what I can to keep the kids entertained, sleeping. Whatnot so that was that. That's just what I had to do. And then I remember one morning I woke up and I couldn't sit up properly, and it honestly felt like my back was on fire. And I remember thinking, okay, maybe I've just slept awkwardly, or I've twisted or moved my body in a weird position when I'm picking Addison up during the night. And, you know, I'm not my first thought. So in the back of my mind, I'm like, it's going to resolve itself, the pain. It'll go away. So, you know, as the day and couple of days afterwards, it's getting worse, and I really struggled to pick up Addison and Aiden. Just picking him up was 100% out of the question. And the burning sensation that I was feeling in my back, it became constant, and I could barely move. So during those first few days after I woke up with that extreme back pain, I think I knew in the back of my mind that something was wrong. Because even such simple tasks like reaching up to the cupboard to get a cup or something or preparing meals for the kids, the extreme pain, the. That I experienced, it just sort of stopped me in my tracks. So much so that I thought, there has to be something seriously wrong here. And also when I was able to get in the car and drive, like if I needed to run to the store and pick up something for the kids, going through the car park and going over a speed bump. So something as minor as that actually heightened the pain. And I think having little ones, I just kept trying to push it to the back of my mind because as I'm trying to get through each day by caring for them, I just couldn't give myself a second thought. I just really couldn't do that because I needed to be there for them. And especially because my husband was working such long hours and him being a paramedic, in the back of my mind, I know that he's going to people who are having the worst day of their lives because they've had to call an ambulance. So in my mind, I'm sort of thinking, okay, I can still push through and get these tasks done. So it really can't be as bad as I'm making it out to be. So I just really sort of tried to put it aside as much as I could. And the thought of having something actually wrong with me was so scary because I know I should have been in that newborn bubble enjoying my kids and so pretty much looking after the kids and myself, it honestly just became about survival and doing What I could do to get through the days. Aiden was in daycare at this time as well, so that, that helped. But obviously I still felt like I was drowning. It was just. Just trying to get through the days was horrendous. And then were you able to sleep at all? No. And that just adds to everything that you experience with back pain, because, you know when you can't sleep, you're tossing and turning and that doesn't help. So then you wake up and, like, you're in more pain. So it was just.
Anna
How did you feel, like, emotionally about it? Because, like, I'm sure you wanted to take care of your kids, right? I. I feel like that would be so hard.
Kim
It was just horrible. And I felt like a failure. I really did. I felt like I was letting them down. And sometimes I think when I'm looking back and reflecting, I think that's taken a bigger toll on me than the actual physical pain. And that just breaks my heart because I know it affects the kids a lot. So it is heartbreaking looking back. So I think probably about a week after sort of, you know, getting through these days, my husband was on his days off, so I thought, okay, this is it. I need to go to the doctor. Because I just. Prior to that, the thought of physically and, like you say, mentally packing up the kids, getting in the car, it was just too much. I couldn't add that onto my plate of just surviving and getting through the days. So what.
Erin
What did you think was going on?
Kim
I honestly had no idea. I really didn't think anything because it was. It was just so painful. And my brain couldn't, like, hypothesize what could be wrong when I've got these little people that are relying on me. So I wasn't. I wasn't even able to give myself a second thought in. In that time, which.
Anna
Oh, that is. That is so being a mother.
Kim
Exactly.
Anna
So being a mother, did you have any friends or people in your life that could help you out?
Erin
I. I just.
Anna
I want to, like, help, but I.
Kim
Know I can't because it's already happened. But being back here with my family. So I was still on maternity leave at the time, and I had my mum and my sister, but they still had work as well, so it was really difficult from that point of view. But on the weekends, they would do what they could, and that's why we had Aiden in daycare at the time, which that was a massive help. But again, I had those feelings of guilt because I'm at home. Why can't I have my son here with me as well. Like, we're missing out on that sort of that time where you should be in that newborn bubble enjoying your baby and having you a toddler and just looking after the family and enjoying it. That just completely did not exist to us. So it was. It was a really tough time. So when I was able to go to the doctor that first time, I explained to him what I was experiencing and what I was going through. And honestly, it just felt like I was hitting a brick wall. And he dismissed everything that I said, and he pretty much said that if I was going through what I was, how am I able to physically be in his office right now? And so I was just. I was just shocked. And he said that what I'm experiencing would be muscle pain from giving birth and also from breastfeeding. So after that, I'm sorry.
Anna
I haven't even had children and I know that that's bs. I'm sorry.
Kim
Exactly.
Anna
Your back hurts because you breastfed. Come on.
Kim
That. That's so true. And I look back and I know I can't get angry with myself because I know where I was mentally at that stage, but I.
Anna
You were so.
Kim
I wish I had the fight in me to say something, but I just getting to that appointment, that was a lot in itself. So then to be told that it was just this defeat, I just, I. I just had no words and I had no energy and.
Erin
Right. And then everybody asks you, what did the doctor say?
Kim
Correct.
Anna
And people don't understand how hard it is to sometimes work up the emotional energy to see a doctor, to admit there's something wrong, she address an issue. Because then, you know, you're opening potentially a can of worms. Whereas, like, if you are at home and you don't see the doctor, you can just be like, oh, it's back pain. Right. That's why I think it's so frustrating when women do go to the doctor and they get something that just doesn't really make sense for the situation that's been presented. Because it's so much energy to get there that it's going to probably take you a lot more energy to go back again.
Kim
100%. That is so true. Because you just feel like that you've been beaten down. So why would you put yourself through that experience again? Like, why? Why? And I think after he had said that, he then, you know, he checked my vitals, so my heart rate, blood pressure, temperature, and all of them are normal. So then I start doubting myself, which is Just ridiculous because I'm the one going through this and I know what's going on. But in that moment, there's just no mental strength to go, okay, they might be normal, but I've just told you what's happening and this is real. I'm struggling to get through a single day. So he gave me stretches to do and that was it. Sent me on my way. And silly me, I tried doing the stretches. Why did I do that? Because he's a doctor and he said, do this.
Anna
I would have done it.
Erin
Had you met this doctor before.
Kim
No. It's so hard to get a doctor's appointment here. It really is like what you can get.
Anna
So explain how you get a doctor's appointment in Australia. Like do you pick your doctor or do you just put a, I don't know, a message into the doctor system and they spit out a name? Like how, how does it work in Australia? Because I'm really ignorant and I don't, I don't know anything about the Australia.
Kim
No, that's okay. So essentially there's two ways to see a doctor. One way is what we call bulk billing and that's where it's free to see the doctor. And okay, that's paid for by what we call Medicare. So going to see a free doctor is really difficult because everyone wants to go down that path. And there are some really great doctors that bulk bill. So there's no payment. So trying to book in and see them, it's like you need to know two weeks in advance that you're going to be sick. And then on the flip side, you've got your ones where you have to pay them directly and you will get some money back, but not the full fee. But even now trying to see them, it's pretty impossible. So at that time when I was ready to go to the doctor, I couldn't get in to see my own doctor. So this was the next best thing.
Anna
So that, that non bulk bill doctor you saw, the one that you. So you even had to pay out of pocket in a place where essentially medical care should be free but for convenience, not that it's convenient.
Kim
Exactly.
Anna
Perceived convenience, you now have a fee associated with it.
Kim
Yes, correct, correct.
Erin
And what was the type of doctor that you saw or did you even know what type of doctor you should be seeing?
Kim
So that was just what we call a general practitioner. So the doctor that you would go to if you think you might have the flu, like the first port of call. I think I'm not sure what you guys call them over there, but we just refer to them as a gp. So if you think something's wrong, make an appointment and you go and see them.
Anna
Primary care. Yeah, like that is primary care physician, pcp. Is that right?
Kim
Yep.
Erin
All right, so you have seen this primary care doctor you've never met before, who is a generalist who has told you that your back pain is a normal part of postpartum and breastfeeding, gave you some stretches, and about how long did you realize that this, this advice was not going to work?
Kim
So after a few days, I'm thinking these stretches are not helping and they're actually making it worse. It was so painful. So what I needed to do was actually lay down on the ground and do stretching movements with my arms and laying down on any hard surface was excruciating. So just the fact of, first of all sitting down and then trying to move in a way that I'm lying down with actually reducing any pain was near impossible. But obviously being told by a professional, this is going to help. I pushed through because I didn't know what else to do at that time. And I knew my time to care for me was limited while my husband was on days off. So, yeah, I went and saw another gp, not my one, because I couldn't get into them again. So same story again. And he gave me the same diagnosis. So within a matter of a week, I experienced the same things from two completely different general practitioners.
Anna
So I know they're wrong because you're on this show.
Kim
Yes, yes.
Anna
But how did you ever get up the courage to go to a doctor again?
Kim
Have you heard of white coat syndrome?
Anna
I was like afraid of walking to.
Kim
A doctor's surgery and my heart just races. It just races. Even if it's not for me, if I'm taking one of the kids, I'm getting a lot better now. But that is 100% a real thing. My heart races and I have high blood pressure. It's a real thing. It really is. And the impacts that it has on your mental health and obviously the flow on effect that you, it has on your physical health because you're too scared to go and get something checked out. It's, it's not good. It really isn't.
Anna
It's not. And I preface this by saying that all doctors are bad. Right. And that's the sad part about this, is a couple of bad doctors ruin it for a lot of amazing professionals who care deeply for their patients.
Kim
Right.
Erin
And just, just I want to harp on this. Did the doctor examine you did they do any diagnostic testing?
Kim
Nothing.
Erin
What was the actual interaction?
Kim
Nothing. It was essentially probably less than a five minute conversation, and that was it. And I understand that that all couldn't have been diagnosed in those appointments. I 100% understand that. But more should have been done. So because of seeing those two doctors, I just felt like, well, what do I do now? What, what, what do I do? So at that point, this was probably about two weeks afterwards, a friend had suggested that they'd seen an osteopath for back pain. So in my mind, I'm like, okay, well, this is not something that I would have thought about. Why not head down? Because what. What has the medical field done for me? And I was desperate, so I thought, okay, well, what have I got to lose? So I made the appointment. And honestly, that appointment was horrendous. So I actually had a physical examination with them, and I was laying on their table and I couldn't move. I couldn't get up. I think they were sort of trying to work out if I had any tension or any specific parts in my spine or my muscles in my back that they could have helped with some manual manipulation, like some massage or releasing of knots. But obviously that was so far from what the issue actually was. I was in tears. And they also didn't suggest any further investigations, which I know they're capable of doing that as well. And I left knowing that I was never going to go back. And I can't even tell you what they suggested because of the pain that I experienced during that. And I just needed to get out of there. I had to get out of there. It was. I don't know if that was the right thing to do by going to see them or not, but when you're desperate, you sometimes feel like, I'm just. I will try anything to help relieve this pain so I can get back to my normal life. And, like, at this point, after seeing them, I was so lost. And I remember trying to get out and get fresh air. I would put Addison in the pram and try and walk around the block. And I would be using the pram as, like a walker, like what you. What you associate with elderly people or like someone who's gone through something horrific and is learning to walk again. And so I was just like, I was on my own. And this is what I had to do to get through the days. Like, looking back, using the pram as a walker. And meanwhile, I've been dismissed by doctors, but I'm having problems walking.
Erin
What did your family think? Was going on.
Kim
They really didn't know what to think. And it was only one weekend. My mum had come over to help me with the kids and I think it was just. Things just fell into place when she was at our house. I don't know what happened, but something triggered the pain so much more on that particular day when she was there. And at the same time I had this horrible bloating in my stomach and I looked pregnant again and I guarantee you I definitely was not pregnant.
Anna
No, I was like a third one happening.
Kim
But that's. That's what it looked like. And my mum suggested that we call the home doctor. So at the time we had this service where you could call a gp, so again, general practitioner or primary care physician, they would come to your house and they would come and visit you in. In your house. It was something that we had for weekends or during the week after hours. It was a service that we had. And you know what I'm thinking? We're at home. I'm not going out of my comfort zone. What do I have to lose? And I've got my mum here, I've got someone else here with me. And so when he arrived, I. I remember him, he was like this little old man and he came across so caring and genuine and, like, I was shocked. I thought, who are you? Like, it was like an angel. And there obviously wasn't much that he could do for me because we're not in the clinic, it's the weekend, he's at my home. But he hand wrote a referral letter and he said, you need to go to the hospital immediately. And like, I had explained everything to him, so he knew what was going on, he knew my experience and this is, this is what he did. And I was just thinking, wait, are you sure I need to go to the hospital? Because I just hadn't had someone actually care.
Anna
Just for context, how long had you been in pain? Like, how long is this? From the first doctor's appointment you went to to now? I guess this is the third doctor's appointment you've gone to. How long is that span of time are we talking? A couple months?
Kim
So this is probably around six weeks.
Anna
Okay.
Kim
Yeah. So six weeks from when I sort of first had that feeling when I woke up until seeing him and being told to go to the hospital.
Erin
And did that make you feel nervous or relieved?
Kim
I had. I had relief because someone cared, someone who was important and had an understanding of what I was going through, was listening to me and. And probably more so because again, he was a male doctor, and the two that had dismissed me prior were males as well. So then, and I know it's stupid, we shouldn't think, okay, this must be real. He's a male. He's listening to me. We shouldn't have to think like that. But it's just the truth as a woman. So it was. It. It was really hard to sort of navigate my feelings. Like, was I relieved? Was I thankful that someone was taking me seriously? Do I need to now start panicking? What the heck is actually wrong with me? So there was just so many emotions, but at the same time, I. I didn't have time to process them because I needed to organize another family member to come and take Aiden, because obviously, you know, I don't want to be at the hospital with two kids. Addison was still breastfed, so obviously she was going to come with me and my mum. So I had that support. And when I did get to the hospital, things did move pretty quickly, which was really good. So they took a whole bunch of blood to run some tests. I was given some pain relief, which was like, oh, my God, I was in heaven. It felt like for the first time, I'm like, oh, is this what it's like to feel normal again? So that was. That was really good. And then I had a few different doctors come in and do some physical exams. And that's when one of them noticed an unusual curve that I had in my spine. And I hadn't really noticed anything. You know, that sort of goes back to the whole mum thing. Not worried about me, I'm worried about my kids. So I hadn't really noticed anything going on physically with my body. And so that was when they ordered X rays and having those X rays, it was that horrible experience of laying down on that metal bed again. But I felt justified because the X ray tech could see the pain that I was going through. And I'm thinking, oh, my God, the more people in this hospital that see what I'm going through, that's going to make this all feel so real. So had the X rays, and then eventually the doctor came back and he put the X rays up on the light box. You know, looking at X rays and you think, what's going on there? What's going on there? You know, you tried to work out. And he said that three of my vertebrae, so T7, 8 and 9, had collapsed. And when he sort of pointed them out, like, as I just said, usually, you know, you can never see anything on an X ray, but I could see These as clear as day.
Erin
For those of you who don't know what T78 T9 stands for, those are the thoracic vertebrae that are in your spine. So your spine is divided into three main sections. The thoracic vertebrae are primarily connected to where your rib cage is. So T7, T8, T9 are all in the middle of your back supporting your chest.
Anna
What is a collapsed vertebrae look like? Because I. Is it worse than fractured? Is it. So I don't fully understand, like, what, what it would do.
Kim
The way that I explain this to people is if you have an empty soft drink can or soft drink tin, if you step on it and it crashes, that is what has happened to three of my vertebrae. How we will get to that?
Anna
Because I was like, I feel like, I feel like babies are hard to give birth to, but I can't exactly.
Kim
And that's something that we went back and forward with the doctors asking, had I experienced any trauma, Have I been in an accident? So they're trying to piece these things together. Have I had a fall, been in a car accident, lifted anything heavy? Because these fractures are not something that happens to someone my age. And at this point, no one knows why this is happening. And it was just 100% isolated to my back.
Anna
Okay.
Erin
And this, this kind of goes back to a theme that we have in a lot of our episodes in that sometimes when you can confirm what a symptom is or even a diagnosis, you stop there, but you don't actually follow through with the, well, why do you have this compression fracture? So technically at this point, you have a diagnosis. You have three compression fractures in your back.
Kim
Yes. Yes. So getting that diagnosis from the hospital, I was then discharged. And so that was around midnight. And they had suggested to me that I needed to see a orthopedic surgeon for follow up. So I left the hospital feeling so unsettled because, yes, I knew what was wrong, but I have those questions going through my mind. What could have caused such a horrific injury that they're expecting me to have gone through, like a car accident or something. And like, looking back, I'm really grateful to the hospital for working out what was wrong, but I just feel like being sent on my way with nothing, no support. That's why care that, yeah, you're right, that, that's wild. Just, it doesn't make sense. It really doesn't make sense.
Anna
I feel, I feel like you shouldn't have been doing a bunch of stuff too. I feel like if you've just crushed your vertebrae, you shouldn't be like shimmying around.
Kim
Exactly.
Anna
You should probably not be moving a lot.
Kim
100.
Anna
It would just do more damage.
Kim
That is true. That is so true.
Erin
Hearing that, that first doctor did not examine you and did not give you an X ray, but instead just told you to do some stretching exercises really did you a disservice. Because now knowing that you had fractures, what the optimal treatment would would have been to be in a brace to give you some support and some protection and to actually have you do more resting than try and, you know, get up and do more things and do more therapy and exercises.
Kim
And I know probably my healing took so much longer than what it should have because there was none of that guidance and follow up care. There was just nothing. So I, after I was discharged, I was fortunate enough to be able to see a surgeon within a week. And again, he had access to those X rays. We went through all of my medical history and then the next thing that he said was, okay, we need to rule out anything sinister. And so when they talk about sinister, they're wanting to rule out cancer or a tumor because for someone with my history and my age, that is potentially the main cause of why my spine has just collapsed. So I went to see the surgeon, he went through everything and then he said that we need to get you an MRI and that will help us further either rule out or diagnose. So I scheduled the mri and between seeing him and then going back to get the results, that was probably about a week. So for a week I'm thinking, oh my goodness, what, what is wrong with me? What, what is going to happen? So that was the longest week of my life. It really was then. And obviously I'm still experiencing all of the pain that I've described before. So none of that has changed in this time. So I get the mri, I have my appointment to go back and see him, and he's got the scans and he confirms that everything is clear. I'm like, oh my God, this is, this is great. This is actually really good. So I just had this huge wave of relief. And then he said, however, I believe what may be happening here is that you have osteoporosis. And in my mind, I didn't 100 know what that was exactly. Just that it was something that elderly women experience and it's in relation to fragile bones. So how could I, a 31 year old with two kids, I've gone through pregnancy, how does this happen to me? And I'm asking him these questions and he explained that the fractures may have occurred that very first day where I felt the pain. And it could have been from something as simple as bending over to pick up Addison from her bassinet. And at the. The time, she weighed 4 kg, which I think that's about.
Anna
About 10 pounds.
Kim
So for.
Anna
For the. For the.
Kim
For the young American.
Anna
Yes.
Kim
Right.
Anna
It's about.
Kim
That's about ten, I think, there.
Erin
Like two and a half.
Anna
Yeah, yeah. Two and a half pounds. 2.2, I think.
Kim
Yeah.
Anna
So, yeah, let's say ten pounds.
Kim
Still such a tiny amount of weight. So going with his theory, I didn't have concrete answers yet. And the next port of call was, okay, so his job is done. There's not really anything that he can do because we still don't know what is causing this. So he then says, you now need to go and see and endocrinologist.
Anna
Here's my question. And I'm just going to be, you know, village idiot here, but, like, if you had osteoporosis and you broke your back bending over to pick up a child, wouldn't you, you know, I don't know, shatter a female when you bump into a piece of furniture? Like, wouldn't you have had so many other breaks before this? Because it feels like, I don't know, I feel like you would just break everything if it was that easy for you to break a bone.
Erin
So these fractures are specifically called fragility fractures. They have a term for them, and the three most common areas to break bones are your vertebra, your distal radius, your wrist, and your hip. So whenever anyone actually has a fracture of their vertebra, their distal radius, or their hip, and they are, I would say, under the age of 65, that is called a fragility factor, and you should be worked up for osteoporosis.
Anna
Wow.
Kim
After the surgeon suggesting I go and see an endocrinologist, that was another six weeks before I could get in to see her. So this is another six weeks of living this life of struggling with the kids and not knowing what's wrong with me. And obviously, you know, having the fact that he's thrown the word osteoporosis around. I do what any normal person does. I go to Google and, yep, you type in osteoporosis. And everything that comes up is related to the elderly. There was nothing about different types or anything that a younger person could get. So I just felt like I was in limbo. And although I had now seen two gps, I've been to the ed, I've Seen a surgeon. I'm now on my way to see another doctor. I'm still in this place where there's no guidance, no plan, and I didn't have any reassurance. So it's literally getting through each day and managing the pain and caring for the kids. So, yeah, trying to find my own research during this time that I was in limbo, even on the Internet, that's where you get all your answers. But there were no answers for me there, there was nothing. So it, it was really difficult during the time from seeing the surgeon to seeing the endocrinologist. So when I actually got in to see her, she had copies of those X rays and we went over my medical history in detail and she was asking questions that I'd never been asked before. And at that, like what, what did she ask that, that particular time? She was asking me what I was like when I was a teenager and my eating. And I'm convinced that at that point she thought I had an eating disorder. And I'm, I'm trying, I felt like I was trying to convince her that whatever she had already thought was not true. And I, and I'm thinking, is this all happening over again? Am I back to not having them? Believe me. And honestly I, I don't blame her because why else would it happen to someone? Because I know like when you're a kid, if you have had a lot of medications, they can have full on effects where you do have weak bones. So I didn't have that. I hadn't been through cancer treatment where some of those medications can cause issues with your bones. So I hadn't had any of those things either. So I feel like at that time she's thinking, okay, there's something you're not telling me. You must have had an eating disorder. And I'm like, no, I haven't, I haven't.
Anna
Did you tell her about the periods? Because I feel like that would also like potentially lead into eating disorder.
Kim
Yes. So it was like, I'm giving you my whole history, but I swear it's not what you're thinking. So it was like that was such a difficult appointment. So we sort of navigate through that conversation and then again we go through the process of running tests and I'm like, okay, I know what we need to do here. I'm coming to see you. You're going to organize tests, I get them done and we wait. So the first thing that we needed to do was a bone mineral density scan or a dexa. And so I, at that point learned that this is something that only postmenopausal women over the age of 50 and men as well, they're the only ones that are sort of sent for these scans because that's when typically bone loss starts to occur. And then she ordered some blood tests. So this was to check my thyroid, my hormones, bone turnover markers, calcium, vitamin D, and then testing for things like celiac disease, which can also affect your bone health. So between that initial appointment, me getting all of those tests and then going back to see her for the results, that was a four week period. So everything was just, it's going out and still no answers. And obviously I just had so many questions like, am I going to have this constant pain forever? What if, what if they don't find anything? What if it gets worse? So it was around the end of June 2012 that I had my follow up appointment with her. I remember that day pretty well. All of the appointments that I had. I always had my mum come with me because generally my husband would be working and Aidan would be in daycare. So having someone there with me to look after Addison, who was still breastfeeding and quite young, it sort of gave me a bit more confidence and knowing that I don't just have to focus on her. So I had my mum there with me and so she waited outside with Addison and the doctor went through all of my results and explained the outcome of my blood tests and everything in my blood tests came back normal. So that's telling us that there's no underlying condition that's, you know, contributing to bone loss. So then we get to the DEXA scan and this is where it's confirmed that, that both my hips and my spine are in the osteoporotic range. So exactly what the surgeon had suggested. I had osteoporosis. And given the fact that the bone scan showed that my bones were osteoporotic, the diagnosis that they were giving me was pregnancy related osteoporosis, which I had never heard of before. And I couldn't even imagine that that was a thing that women experience. So I was so confused about how I could have brittle bones. Like essentially my bones were like that of a 70 year old. And so in my mind all I'm picturing is that image of the little old lady with the humpback and thinking, that's me. So I was just so confused and lost about how I am now seen as that person. She didn't really explain how serious the condition was. She didn't explain what my future risk Fractures were would be. Which to me, that's super important because I really didn't have any understanding whatsoever what it meant for someone in my age bracket being diagnosed with a disease that only elderly people experience. So there was really no guidance of what it meant for someone my age. So although I had a name for what was happening, she didn't really give me any literature to take home and read. No guidance on things that I should or shouldn't do with the kids in terms of activities or, you know, just even getting them in and out of the bath or the car seat. Obviously I knew not to do those things because it caused pain. Pain. But to what extent did I know were they going to cause more fractures? And that was probably the information that at that time I really, really needed. But I just wasn't given. So I was really left to work out all of these things on my own. I got the diagnosis and now is this it? It's like, oh, okay, what now? And there was no answers to the what now? She did just throw it out there. And I remember seeing on her computer screen, she had a report written up that she was sending back to my gp, so my primary care physician, so that they had an understanding of what was going on as well. And I just sort of remember seeing pregnancy related osteoporosis, and it was just written in a paragraph and that was it. And I'm thinking, I've gone through all of this pain, all of this sort of mental and emotional struggles, and I'm reduced to one paragraph and that's it. And given the fact that that was the appointment that all of this has led up to, it was still just a standard appointment with her, it wasn't anything that you would expect when you've been on such a horrible journey. And knowing that my newborn baby is just out in the waiting room and there was no, you will be okay, we've got this, we're here to support you and work with you. There was none of that. So the actual name for the diagnosis is pregnancy and lactation related osteoporosis.
Anna
Okay, rewind. How can pregnancy and lactation give you osteoporosis?
Kim
The contributing factors were having my kids close together, which again, I don't think I did, and then breastfeeding them and them taking the calcium from my body.
Erin
So for those of you who have never heard about pregnancy associated osteoporosis, and the vast majority of you will have not heard of it because it is a very rare, rare condition, but this is a problem that happens to women, typically right after they have given birth. The majority of times they are also breastfeeding during this postpartum period where women may experience what's called a fragility fracture. And this is a break in one of their bones in someone who you would not otherwise expect to have a broken bone. Right. And so in Kim's case, she did not have a fall, she did not have an injury. She was merely picking up her child. And that was probably the cause of this fracture. And that's why we know that this fracture was caused by an abnormal bone density, Meaning that if you think of the bone as this cylinder and the cylinder is filled with a dense sponge, okay, the more the, the sponge becomes thinner and thinner, the easier it is to squash that sponge. So we feel like. And again, the research is very limited because these are rare cases. We're talking about probably a couple of hundred cases per year of women who, who have this problem. But in these cases, the women's bones are made weak due to a variety of factors. Number one, probably there is an underlying genetic condition which has predisposed women to having weaker bones. But because of the stress and the hormonal changes that happen during pregnancy, this unique time where the woman has just given birth and they are breastfeeding, they do not have the optimum levels of hormones, including estrogen vitamins, including calcium and vitamin D. And that is what making is making them susceptible to these pregnancy associated fractures because of the osteoporosis. Now, one thing that has come up in recent research is this connection between abnormal periods and missed periods and this risk of getting pregnancy associated osteoporosis. And what's probably happening is that there is some deficiency of estrogen. Estrogen is a protective bone hormone. This is why when women age, when women go through menopause, women are four more times likely than men to develop osteoporosis and have a fracture late in life. And it probably goes back to this decrease in estrogen. So when you enter this postpartum phase, there are wild swings in your hormones. And we believe that there is probably this link to having a low estrogen state, which coupled, if you have a history of having low estrogen because of missed periods, hormone conditions like pcos, these are things that you may not even be aware of that are increasing your risk to developing this condition. So while I don't want everyone to become concerned that after you have a baby, you have to worry about breaking your bone. But if after you've had a child and you have severe pain, that is unexplained. This is one of those rare diseases that a light bulb should go off in your head and think, huh, you maybe, maybe I could have osteoporosis.
Anna
Okay, so just for my, like, frame of reference, how rare is it to get pregnancy induced osteoporosis? Is it common or is it fairly uncommon? Like, is this something I should be worried about if I get pregnant?
Erin
It's very uncommon, but common enough that it should be known.
Anna
I have to ask myself, why didn't these doctors test for it if it's. If it is a known thing?
Erin
It's a known thing, but not known to the degree that maybe every physician would be top of their mind.
Anna
Gotcha. What scares me is you had mentioned that multiple doctors had just quickly diagnosed you as back pain from pregnancy, which to me is like, obviously, did they send a whole bunch of women out of this thing with that same diagnosis? Because technically, it is back pain from pregnancy, but it's also osteoporosis.
Kim
Exactly. And there may be other women who haven't experienced fractures, but they could still have it. So that's an unknown as well.
Anna
And hearing that, Kim from Erin, were you frustrated that it took this long to get a diagnosis?
Kim
I was frustrated at the time, but I know now how lucky I actually was given that I've connected with other ladies who have gone through what I've gone through, and their journey was a lot longer, which, again, that makes me so angry. Why should I have to feel grateful that I still had to go through this long period of getting a diagnosis?
Anna
I think you can hold space for the fact that other women have experienced longer knowledge cycles than you while also acknowledging that it sucked.
Kim
Yeah.
Anna
Like, I feel like you owe that to yourself to allow yourself to be mad about it. If you are mad, I would be mad. I would be livid.
Kim
A hundred percent. A hundred percent. I think sometimes, you know, for mental health, there's certain things that you just need to let go because otherwise it just. It really messes you up. I joined a support group for pregnancy related osteoporosis on Facebook in 2015, and the other ladies that I've connected with in the Facebook group, they've all gone through the exact same experience that I have with getting their diagnosis, which is absolutely heartbreaking because my diagnosis was now 10 years ago. And the ones that are joining the group in the past 12 months are still going through exactly what I went through, and that's 10 years down the track. So to know that there hasn't been any Progression in being able to diagnose these women, it just, it's absolutely horrible. So any hope that I can give them in my journey and how far I've come, that sort of makes me feel like this is why I need to put myself out there for them.
Anna
So now I'm, I'm super curious, based on our last episode, if Chat would be able to diagnose you. So I'm just going to jump over there and let me type in. Hold on one sec. I'm just going to put in. I just had a baby. I'm having severe back pain. What are the diagnosis is that could be causing this? And send. Okay, it's coming up. So it's, it's writing a novel. I'm just going to start reading these as they come in. The first is postpartum musculoskeletal pain, which I'm guessing is what people were diagnosing you with. I don't know if that's the exact term, but that sounds like this. It's muscle strain or, you know, posture issues. Then we have some joint dysfunction, nerve compression, Kidney issues. Spinal issues are vertebral. Vertebral fractures. I cannot say that word. Vertebral fractures. Oh, underneath this one it says osteoporosis. So if you have osteoporosis or bone density, you might be at risk of fractures. And then if you do get osteoporosis, a vertebrae fracture or a compression fracture, which is what you had, could lead to significant back pain. That's wild. That's literally wild.
Erin
It doesn't surprise me that AI is able to come up with this really amazing list of differential diagnosis because AI is not limited by time. AI is not limited by, you know, their own patient set. Right. AI is pulling from millions of data points and millions of research and the most up to date research. So I think it's a tool that doctors should be using in conjunction, really to help supplement our own resource space. I think doing your own research and coming up with a list which medically we call a differential diagnosis. But to have a list of possible options that you can discuss with your doctor makes you a better informed patient, which makes you a more empowered patient. And when you have this conversation with your doctor, it makes it more of a partnership in that you are helping the doctor come up with conditions that, you know, every doctor is not a specialist in the problem that you may have. And if that's not even on their radar, you're never going to get to that solution. So I really think you know, sometimes even having these diagnoses to talk over, as you know, your. Your talking points really can help you have a better conversation. You're not replacing the doctor's knowledge. You are just helping. Helping them to broaden the possibilities, especially if you are not coming up with anything with the person you're working with. And it's about sharing these stories so that, you know, as Kim said, you've met other women. If you don't know one of those other women, you have no one to validate what you're going through. And if you just stopped at those two doctors, right, you would have never had any answers. Now, it's not to say that even having the diagnosis changed the course. Right. Of how your. Your.
Anna
Your.
Erin
Your healing journey went, it probably significantly delayed it. Right, because you. You wouldn't have been doing those. Like, when you have a fracture, you rest.
Kim
That's the point.
Anna
And you don't stretch. Yeah.
Kim
Yeah, exactly. And I think probably the next thing after, you know, getting the diagnosis from the endocrinologist, because of my age, there wasn't a lot of research or options for me. And the one thing that was suggested to me was that I needed to stop breastfeeding. Addison and I, at the time, I made bread the decision to actually keep feeding her until the fractures healed, because in my mind, if she was upset, I couldn't pick her up and, you know, pat her and walk around with her. Breastfeeding was what got me through. So I. I had to continue that, like, for my own sanity. It's really hard because that is something that any mother struggles with, and it's something that society judges so harshly on. So when you're able to breastfeed and. Because in reality, it isn't easy. So when you're able to do it, but you've got a doctor telling you not to do, plays out in your mind and the mental struggle that goes with it, you're thinking, okay, my body's failed me and now it's failing my daughter. That is the hardest thing to deal with because you know what society thinks about it. And I mean, you're going to get judged regardless. But when you've been told to stop, that just adds this other complexity to what you're already overthinking about. And I don't know if that was the right decision or not, but I just needed a bit more time, and that was what allowed me to heal, I guess, because feeding her meant that I was relaxed, I was sitting down, or I was laying down with her. And she was content. So it was her versus me. And. And what. What was I to do in this time? And it was sort of during that period that that's when I learned that a collapsed vertebrae, it doesn't go back to its original form. They just don't return to their original state. So they're crushed. And this is why on that day, when the home doctor came, why I had experienced that bloating. So essentially, what has happened to my spine, because it's decreased, I lost about that much height. So that means my rib cage is closer to my hips, so my organs have less room, and now they're pushed out. And so I've got all of this other stuff going on, and I'm learning about these changes to my body on my own as well. And my emotions of having a newborn and giving birth and then finding out this, and then being told, okay, you need to stop breastfeeding, and, okay, you've lost this much height. This is what your body now looks like. It was. It was so much to deal with, really was. And you take your calcium, you take your vitamin D. That was my treatment plan. So I was just sort of, again, on my own, just figuring it all out, and it was a really difficult time. We do have a good ending for my story. At the end of 2023, I found a clinic in my city that just deals with osteoporosis. So they provide physical evaluations, they do bone density testing, they have a supervised exercise program, and they have ongoing education. So everything that I needed all those years ago, so I was able to get in and see them. And the thing that I needed to do was get over myself, because I was the youngest person there. And I just walked in, and the people you see in those Google searches, they are the people that were there. And I just felt so out of place. It was the weirdest feeling. But I'm like, I need to get over myself. I need to do this for me, and I need to do this for my family. And so the. They run exercise programs, and I started attending twice a week. So I started off lifting weights, which was essentially a broomstick and wooden discs. And I felt so embarrassed because there were these people who look so fragile and they're lifting these heavy weights, but you start off on these lower weights. And over time, I gained the strength and the confidence as well. The confidence is just a massive thing. And at the moment, I am able to deadlift 45 kilograms. So, yeah, I'm guessing like, hundred pounds.
Anna
Hundred. So, yeah, about 100, give or take.
Kim
When you think back to when I fractured by picking up Addison to where I am, it's just amazing. And then after 12 months of attending, they do a reassessment. So that was just in January. This. And for the first time since my diagnosis, my spine has gone from osteoporotic to osteopenia.
Anna
So that I'm assuming that's really good.
Kim
That is a lesser degree. Yeah. Yes. So I. Yeah, definitely a lesser degree. But to get out of that osteoporotic range is just amazing. So I haven't felt this hopeful in so long. And the funny thing is I was so nervous to go there. And now just having general chit chat with the other majority ladies that are there, I'll be talking about their grandkids, and my kids are the same age as their grandkids, so we've got this common ground and it's just like, oh, my God, I found my tribe. I never thought that they would be my tribe.
Anna
Life is. Life is wild like that.
Kim
Yeah. So that's. That's pretty much where I am today.
Erin
Oh, Kim, thank you so much for. For joining us and sharing your story. And I know this is a podcast, so not everyone is able to see what you look like, but I just think it's very important that we are able to share stories from people who you may not assume could have these problems. And it. It just will open up so many people's minds as to what they should prioritize, I think, in life as well.
Anna
And I think it will help a lot of women going through pregnancy right now to think about these things and to look into these conditions if they experience different pains or symptoms, because I'm sure there are many other that have experienced this and not gotten the answer. And maybe you just gave them the answer in this episode.
Kim
I hope so. And you know, just from hearing my story, even if it helps one woman speak up and advocate for herself, then I've done my job. That's. I've done what I needed to do.
Anna
The Medical Detectives is a soft skills media production produced by Molly Biscar Sound designed by Shane Drause if you have a medical story you'd like to see featured on the Medical Detectives, please email it to stories themedical detectives podcast.com the.
Erin
Information provided on the Medical Detectives is for informational and entertainment purposes only and should not be considered medical advice. While we may feature licensed medical professionals, including doctors, we are not your personal doctors. And no doctor patient relationship is established by listening to this podcast or interacting with our content. All discussions are general in nature and may not apply to your specific health situation. Always seek the advice of a qualified healthcare professional before making any medical decisions or taking any action based on the content of this podcast. Never disregard professional medical advice or delay seeking treatment because of something you have heard on this show. If you are experiencing a medical emergency, please contact emergency services immediately or consult a qualified healthcare provider.
The Medical Detectives: Kim's Story – The Postpartum Nightmare
Episode Release Date: February 19, 2025
Hosts: Dr. Erin Nance & Anna O’Brien
Guest: Kim from Brisbane, Australia
Dr. Erin Nance and Anna O’Brien kick off the episode with excitement about welcoming their first international guest, Kim from Brisbane, Australia. They emphasize the importance of Kim's story for pregnant women and new mothers navigating the complexities of postpartum health.
Erin [00:48]: "This is the story of a new mom who has to fight to get attention for herself when all she wants to do is spend time with her newborn baby."
Kim shares her active childhood in Australia, engaging in various sports such as tennis, netball, athletics, swimming, and BMX. Her early health seemed impeccable until her teenage years, where she experienced irregular menstrual cycles, a condition mirrored by her mother, leading them to attribute it to genetics without seeking medical intervention.
Kim [02:10]: "I pretty much grew up as your average sporty kid... having irregular cycles and trying for a baby, I had no idea what that meant."
Kim recounts her two pregnancies. Her first pregnancy at 29 was uncomplicated, resulting in a healthy son, Aiden, born in 2009. The second pregnancy a year later with Addison followed a similarly smooth trajectory, with only minor sciatic nerve pain managed through induction.
Kim [05:52]: "So I think that was actually my karma for everything going so smoothly."
In February 2012, six weeks postpartum, Kim begins experiencing excruciating back pain that severely limits her mobility. Despite her active lifestyle and lack of prior health issues, the pain escalates, making daily tasks and caring for her children increasingly difficult.
Kim [06:15]: "I couldn't walk from the pain. So it was a walk in the park, but I couldn't actually walk from the pain."
Kim visits two general practitioners (GPs) who dismiss her severe pain as typical postpartum muscle strain and breastfeeding-related discomfort. They provide superficial advice, recommending stretches that only exacerbate her condition.
Kim [18:35]: "That was my decision to go, Yep, okay, I'm happy to go down that pathway of being induced again... As soon as she was born, everything was okay again."
After enduring two weeks of debilitating pain and feeling dismissed by medical professionals, Kim calls in a home doctor. The attentive physician visits her at home, sympathizes with her condition, and urgently refers her to the hospital.
Kim [31:03]: "At the time we had this service where you could call a gp... And when he arrived, he was like this little old man and he came across so caring and genuine."
At the hospital, comprehensive tests reveal that three of Kim's thoracic vertebrae (T7, T8, and T9) have collapsed, an alarming discovery that leads to immediate referrals to specialists. This marks the first concrete diagnosis of her severe back condition.
Kim [37:31]: "If you have an empty soft drink can or soft drink tin, if you step on it and it crashes, that is what has happened to three of my vertebrae."
Kim is diagnosed with pregnancy and lactation-related osteoporosis, a rare condition typically associated with elderly women. The endocrinologist explains that her close-spaced pregnancies and breastfeeding likely drained her calcium, leading to fragile bones susceptible to fractures even from minor physical stress.
Dr. Erin Nance [56:59]: "This is a problem that happens to women, typically right after they have given birth... a fragility fracture."
The diagnosis leaves Kim grappling with feelings of inadequacy and frustration over the delayed recognition of her condition. She battles the dual challenge of maintaining her role as a mother while dealing with persistent pain and the societal pressures surrounding breastfeeding.
Kim [16:27]: "I felt like a failure. I really did. I felt like I was letting them down."
Years later, in 2023, Kim discovers a specialized osteoporosis clinic in her city. Through a structured exercise program and ongoing education, she begins to regain strength and confidence. Her spine improves from an osteoporotic to an osteopenic state, marking significant progress in her healing journey. Additionally, Kim finds solace and community in support groups, helping her reconnect and support other women facing similar challenges.
Kim [74:37]: "After 12 months of attending, they do a reassessment. This was just in January... my spine has gone from osteoporotic to osteopenia."
Kim reflects on the importance of advocating for oneself within the healthcare system. She highlights the critical role of informed patients and the potential of AI and technology in aiding diagnosis. Her story underscores the necessity for medical professionals to listen empathetically and thoroughly investigate unexplained symptoms.
Dr. Erin Nance [64:35]: "I think it's a tool that doctors should be using in conjunction, really to help supplement our own resource space."
Kim expresses hope that her story will empower other women to seek answers and advocate for their health needs. She emphasizes the value of sharing such stories to foster a supportive community and improve awareness of rare postpartum conditions.
Kim [76:47]: "I hope so... even if it helps one woman speak up and advocate for herself, then I've done my job."
Erin [00:48]: "This is the story of a new mom who has to fight to get attention for herself when all she wants to do is spend time with her newborn baby."
Kim [16:27]: "I felt like a failure. I really did. I felt like I was letting them down."
Dr. Erin Nance [56:59]: "This is a problem that happens to women, typically right after they have given birth... a fragility fracture."
Kim [74:37]: "After 12 months of attending, they do a reassessment. This was just in January... my spine has gone from osteoporotic to osteopenia."
Kim [76:47]: "I hope so... even if it helps one woman speak up and advocate for herself, then I've done my job."
Awareness of Rare Conditions: Pregnancy and lactation-related osteoporosis, though rare, can have severe implications for postpartum women. Awareness and early diagnosis are crucial.
Advocacy in Healthcare: Patients must advocate for themselves, especially when experiencing unexplained or persistent symptoms. Persistence can lead to accurate diagnoses and appropriate treatments.
Importance of Support Systems: Support from family, friends, and specialized communities can significantly aid in the healing and coping process.
Role of Technology and AI: Utilizing tools like AI for differential diagnosis can empower patients and aid healthcare professionals in identifying rare conditions.
Emotional Resilience: Navigating severe health challenges alongside motherhood demands immense emotional strength and resilience.
Kim's journey from experiencing severe back pain postpartum to overcoming osteoporosis illustrates the intricate interplay between physical health, emotional well-being, and the healthcare system. Her story serves as a reminder of the importance of listening to one's body, seeking multiple medical opinions when necessary, and the power of community support in overcoming health adversities.
For more medical mystery stories and real-life medical puzzles, tune into future episodes of The Medical Detectives by Soft Skills Media.