@dmshope - Sorry to hear about your osteoporosis diagnosis. Yeah it sucks. As @njx58 mentioned, I did put together a presentation just for people like you new to osteoporosis https://youtu.be/OVRiiyHXeh8 .

If you didn't have any fractures, based on your T-Scores, I too would say Fosamax would be a solid choice (except for the GERD). But with the past fractures, I strongly recommend an osteoanabolic (bone forming agent) like Tymlos, Evenity or Forteo to build back some bone structure before moving to a anti-resorptive like Fosamax. I would lean toward Tymlos though any of the three would probably work well.

Good luck!