An Endocrinologist treats conditions related to the body's hormone issues. Apparently some hormonal part of my body forgot to tell the Osteoclasts to quit with the TNT sabotage or perhaps my Osteoblasts went on vacation?
Emily, the PA, was excellent at going over everything and asking the questions she needed to. She spoke directly to me and looked me in the eye. She did not stare at the keyboard and just type.
She then told me what she was writing as she typed it into my visit notes.
We discussed the severity of my Osteoporosis. A score of -2.6 is severe. That is in my right hip joint. You know the part that swivels the hips? But wait!
GO Big or Go Home!
My low back has a score of -4.4
And what does that mean? Kinda like my bone loss is equivalent to a really really old lady?
So some medication choices were discussed. The first med I tried made me extremely sick but is generally the first line of medication choices and works well. They are in a class of bisphosphates which my system doesn't like much.
So we discussed alternatives. Two meds that actually help rebuild bone use daily injections for 18 months. After 18 months, a med that is supposed to maintain the Osteoblast Guys and prevent the Osteoclasts from blowing me up is taken for the rest of my life.
So hmm. The rebuilders are called: Foteo and Tymlos. Average cost with no coverage per month for these meds are about $2000. I don't see it in the formulary for my medications. However the doctor has someone doing some research.
The alternate maintenance med is in the formulary.
Osteoporosis is not painful. It is arthritis that hurts along with fractures. The diagnosis really threw me for a loop. I'm supposed to be Superwoman, right?
Exercise in the proper way, good diet, and positive outlook are all helpful ingredients that cannot be found in a pill.
Because of the severity, I have a few recommendations. No skydiving, no jumping rope, no box jumps, no running~like distance running, and no twisting with weights or heavy weights over my head.
Good recommendations. Continue daily hiking, do weight bearing exercises, fresh air. Walk the dog, enjoy everyday.
Well, you've got the recommendations covered!! I learned some new Osteo terminology & options. Glad you have options, that is important. There is no one size fits all with health related solutions.
ReplyDeleteI liked that little picture at the top, it sort of explains what is happening. Of course there are no absolute ways to tell me exactly why it happens but that is life.
DeleteI like to try and understand what is going on.
I must say, this PA was extremely excellent. She took the time and the energy to carefully help me understand my options.
You are so right, we are each so individual aren't we?
Gosh, I have learned more from your post than I did visiting my own doctor! I hope you don't mind, but I am bookmarking this post for my next visit (which is not going to be soon). I don't know about you but I am pretty upset my bones are letting me down. Your numbers are even more scary than mine. After my initial shock, I have decided to follow the same protocol as you. Eat healthy, take my vitamins, moderate exercise, no sky diving (LOL). The injectible my doctor suggested was around the same price. It is a tier 3 Medicare drug and I tried shopping all kinds of Plan D coverage in my area. I actually don't really want to try injections yet so I will put that on the "worry about it later" list. I love the graph. I am going to print that, too. You really found a wonderful PA.
ReplyDeleteThe medication called Fosamax was the first line of defense which is pretty standard for bone density loss. I didn't tolerate it.
DeleteIt was a huge mental blow to find out my Lumbar and one hip were in such bad shape. Mainly because I just had arthritic pain and not all of the time.
The fact that I have been very active has helped me. Funny thing is that I don't have to take supplements all those tests came back normal!
I hope you can find someone that will actually listen to you. My husband had the same kind of doctor you did. She was curt and just wrote him off as a complainer.
So I fired her sort of. Now I am hunting for a Community Care PCP for him that was approved through the VA.
It IS a job to juggle healthcare and paying attention!
I always make a list of questions going in and take notes during our consults. Good luck! Stay moving and well!
NO skydiving! :)
At least you have answers. I am sending you an email this morning cause I have a question for you. Keep on keeping on!
ReplyDeleteGot it and answered!
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