@windyshores

Thank you for your insight!! It helps me to feel that I'm not going crazy feeling like osteoporosis is the most complicated of his issues (with PMR and GCA there are such limited options for treatment it's more cut and dry. Though some is also still new, such as prescribing Actemra that was recently FDA approved for GCA.)

We finally have an endocrinologist who is testing him to see if he's a candidate for Forteo. We have an issue that has paused us on wanting to start treatment - he has horrible teeth and while he has zero pain in his mouth, we know he needs a lot of work done. I wouldn't be surprised for it to be upwards of $20,000 at this point. When he went in 2007 he needed over $5,000 worth of work done and they are so much worse now.

He's refused to go back to the dentist and has kept how bad it's gotten from me, which you think would be harder than it is. He has an uncanny way of not showing his teeth, especially the bottom ones, when he talks or even when he smiles. Anyway, he finally showed them to me because of my concern over dental work before starting Fosamax (which was first prescribed, now I've learned Forteo would be a better choice for steroid-induced osteoporosis.) All the smaller bottom teeth are very discolored and decomposing, for the lack of a better word. Much of the teeth are gone and they look so odd. Many other teeth have major issues, including needing a new bridge. I finally convinced him to go in early July to have them checked so we really know what we're looking at, and if his mouth is stable enough for years of treatment with these drugs.

What I've read and been told is that if he were to need an extraction of other serious dental work done while on Fosamax he could develop some kind of jaw infection that could lead to major jaw issues down the road. So I paused and during that pause, learned about Forteo and Evenity. I'm still not sure the order of what's best and for how long but we can figure that out as we go along. For now, his bone scan came back on his lumbar spine at -3.4 so I know he needs treatment.