Weak arms: Bake off contestant Val Stones
Her habit of holding up her cake tins to listen to her bakes earned Val Stones the nickname ‘cake whisperer’ in The Great British Bake Off 2016.
Yet it wasn’t just this that caught the attention of viewers: the retired head-teacher also dropped her pans and trays with alarming regularity.
In fact, this was more than simple ‘butterfingers’. Like three million others in this country, most of them women, Val has osteoporosis and has twice broken her left wrist and her right humerus — the long bone in the arm — which has weakened her grip.
It was a fact 67-year-old Val decided to keep secret from fellow contestants, producers and the show’s presenters, including Mary Berry.
‘I didn’t want it to affect how people treated me,’ she says. ‘I was cheery on screen, but actually I was gritting my teeth sometimes.
‘People thought I was a bit dippy dropping things, but that was because of my weak bones. At home, I now have very light tins and trays, but the ones in the Bake Off kitchen were heavy.’
With osteoporosis, the dense structure of the bones becomes peppered with holes, like honeycomb, and so can fracture with even a minor injury.
In the UK, half of all women and one in five men over 50 will suffer a fracture, many as a result of osteoporosis.
‘In those with osteoporosis, old bone is broken down by cells called osteoclasts quicker than cells called osteoblasts produce new bone, so more tissue is lost than is being replaced,’ explains Sarah Leyland, nurse consultant at the National Osteoporosis Society. ‘The mesh-like scaffolding inside the bone starts to break down and big holes may appear.’
The condition is common among post-menopausal women due to the drop in oestrogen, a hormone thought to have a protective effect on bones, but there are other triggers, too.
‘Some medicines, including corticosteroids, used to treat inflammatory conditions such as rheumatoid arthritis, are thought to slow down the action of the osteoblasts and speed up the osteoclasts,’ says Sarah Leyland. ‘Low levels of activity may also have an impact. Bone likes being given work to do. Being mobile puts a pull on the bone that keeps it renewing itself. ’
What makes Val’s case unusual is that it was detected quickly, when she was in her early 50s — for, according the National Osteoporosis Society, many cases go undiagnosed for years.
Val was 52 when she fractured her left wrist, having taken a tumble over a stile near her home in Somerset. ‘I put out my hand to save myself and landed on it,’ she says.
Val’s arm was put in a plaster cast up to her elbow, and she was referred for an osteoporosis check, an MRI scan and a FRAX (fracture risk assessment) questionnaire, and it was confirmed she had the condition. Val was then put on medication to try to prevent further fractures.
She was one of the lucky ones: osteoporosis is often thought of as a condition of older people, meaning people in their 50s or younger don’t get referred for checks after they’ve had a fracture — so miss out on the advice and treatment that could prevent further injuries.
‘Some people can suffer many fractures before medical practitioners put two and two together and diagnose osteoporosis,’ explains Sarah Leyland.
Val was 52 when she fractured her left wrist, having taken a tumble over a stile near her home in Somerset
The National Osteoporosis Society estimates that one in five women breaks a bone on three or more occasions before being diagnosed. It has called for everyone over 50 who breaks a bone to be assessed for the condition. NICE (The National Institute for Health and Care Excellence) recommends assessment in women over 65 and men over 75 — and in people aged 50 and over only if they have a risk factor for osteoporosis, such as a previous fracture or an early menopause.
But the National Osteoporosis Society claims only 42 per cent of NHS Trusts have such a measure in place. ‘It is shocking that for financial reasons — or simply an unwillingness to implement it —more than half of health authorities have no measure to prevent secondary fractures,’ says Cyrus Cooper, professor of rheumatology at the University of Southampton and president of the International Osteoporosis Foundation.
In his role as director of osteoporosis services at Southampton General, he sees 1,000 women a year in his clinic. ‘Half have a first fracture and the condition has been picked up, so they have not fallen through the net,’ he says. ‘The other half may have had osteoporosis for an indeterminate number of years.
‘They may have other conditions which make them high risk — or they may have had several undiagnosed vertebral fractures. These can happen when they’re bending over to pick something up.’
Once diagnosed, those with osteoporosis may be given bone-strengthening medication, such as bisphosphonates, which work by slowing down the action of the osteoclasts, or given lifestyle advice.
Sarah Leyland says improving balance can also help, as it reduces the risk of falls. ‘Even little things, such as standing on one leg while brushing your teeth, can help,’ she says.
After her diagnosis, Val made sure she kept as active as she could. She was treated with alendronic acid, a bisphosphonate drug. ‘I took a tablet weekly and had to sit vertically for 30 minutes afterwards to help prevent gastric reflux,’ she recalls.
Then in 2013, after 11 years on the tablets, Val was swapped to a bisphosphonate given intravenously once a year. ‘It gave me freedom from heartburn, which was magical,’ she beams.
But in the same year, she broke her left wrist as well as the humerus in her right arm in a fall. This left her with reduced strength in her wrist and arm, which is why she kept dropping her trays during Bake Off.
Today, Val is determined her condition won’t hold her back. She has just walked part of the Great Wall of China this month to raise money for charity.