Really helpful post -- thank you.

After my bariatric surgery, the only thing that got worse instead of better were my bones -- not a surprise, given the amount of weight loss. My spine and femurs moved into osteoporosis territory. Due to the surgery, any oral treatments were contraindicated, so I started with IV reclast in 2019. It gave me a fever for several days and a knee arthritis flare for several weeks. After that, they switched me to prolia injections, which had no side effects in my case. My scans are now showing me to be on the borderline between osteopenia and normal.

I would encourage anyone to ask about the pros and cons of each option, as well as the issues associated with switching from one to the other in the future. Your personal medical history might, as mine did, dictate that some have greater risks of side effects than others in your particular case, or are more or less likely to be effective. Unlike the oral drugs, these stick around, so switching is a long-term play. But in fact, it is always an option -- there is even such a thing as revision surgery.

The side effects question is always something we wrestle with, right? As we should. Unfortunately, nothing that works well is going to have zero risk of side effects -- heck, even placebos produce side effects.

I've made a lot of medical choices (surgery, drugs, therapy) knowing that there were small risks of large side effects. And some of the side effects have been really unpleasant for longer than I would have liked. I'm 72, and recently had my first ever permanent side effect that qualifies as truly serious. The studies show that this one occurs in fewer than 4 patients in a thousand. I never took that particular side effect seriously when I decided to move forward with the drug originally. Once it happened and was finally diagnosed (which took several doctors and too many tests to eliminate other causes of the problem), I switched drugs and the side effect stopped getting worse. It may or may not ever go away -- I suspect it never will.

Realistically, if I had let those odds dominate my decision-making, I would probably never have used any medical treatment ever. Although I wish the nerve damage had never happened, I don't regret the choice I made -- modern medicine has let me live a full life, and if I hadn't taken those medical risks, I suspect I would have spent a good chunk of my adult years in a dark bedroom suffering. Statistics caught up with me (so to speak), but I knew that was likely to happen eventually.

Having said that, at this age with a fairly complex medical situation, I'm now researching my choices more thoroughly, comparing the side effect risks with the likelihood of successfully solving the problem, and taking into consideration how each of my treatment options might impact the other issues I'm grappling with (meaning that I'm treating all my physicians and NPs and PAs as a team, and sometimes consulting several of them). I always love it when I hear from someone who is owning their choices and making them with evidence-based insight.