Thank you Chris and Babbsjoy for your information.

My 8/16/22 DXA showed the following T scores:
right femur neck .5
right total hip -.5
left proximal radius -2.6
lumbar spine - not valid due to degenerative changes

My 7/16/24 REMS
spine -3.5 fragility = 62 5 yr risk >100%
left femur -3.6 fragility = 54 5 yr risk >59%

Hence I've been in a state of panic. I've read much of "Great Bones" and also learned alot from this blog. Thank you all! What an amazing resource!

Today I met with the NP at a local endocrinologist (Naples, FL). Surprisingly the meeting went well. She recommended Evenity; however I fear the side effects - especially as my husband has cancer and I am the caretaker. I requested Tymlos, which she agreed to. She also agreed to request the baseline CTX and P1NP tests.
So thankfully I think I won't be needing the virtuals with either Mayo or Orlando Health. However I may still want to do a virtual with Keith McCormick - I'm shocked at the extreme degradation in less than 2 years.