WOW.....I totally get your concerns. Pros and cons to everything. We can't tell if our bones are healing without testing. Too bad it's not like a blister that you can watch heal. So everything needs a trip to the doctors office. And you have to take the meds for quite a while before you know if they are helping. It's a roll of the dice and trusting your doctor.
I started with Fosamax and within just a few weeks had indigestion 24/7. I went off of that and started Prolia. I took Prolia for two years with modest improvement. I had to stop Prolia to have dental work done. Then everything went downhill and downhill fast!! Six spine fractures in about eight weeks. Two surgeries. Then I went to an osteoporosis/bone specialist (I never knew there was such a thing) Fortunately, she knows a lot more than my OB-GYN did. The specialist recommended the two year treatment of Tymlos. I was hesitant but after lengthy consultations with her, my husband and I decided to go with it. First I had a DEXA SCAN so we had a base line. It was bad...at the one year mark, I had a second DEXA SCAN and my number were amazingly improved. I have six months left and am anxious to see the numbers at the two year mark. I too have the rapid heart beat after injections and the belly fat (which most comments say goes away after stopping Tymlos). I have also had high ALK phosphate numbers in my blood work. However, Tymlos can throw those numbers off. After adding magnesium to my daily meds, that number has very slightly improved. The doctor is confident it will go back into the normal range upon completion of the full treatment and I have no other symptoms to justify the high numbers.
So....bottom line for me, this has worked and I will finish the two years. After that, I think reclast but I am not sure. She may recommend something else. My back will never be the same and I don't think it will ever be pain free again but hopefully, no more breaks!!

Do your research, get a second or third opinion, ask a lot of questions and do what you feel is right for you. No one knows your body better than you (no matter what the doctor says).
Stay on this forum. You will get more information here than anywhere.

Take good care of yourself and keep us posted on how you are doing.
All the best to you.