Need advice for wife

@maryandnans Lisa Moore's YouTube channel is great! It's the most organized set of videos I've ever seen. Besides some introductory videos, she has a 52-week exercise plan! Yes: one video for each week. I assume she starts you off slow and then gradually progresses week by week. Very impressive.

@njx58 yes I love DR. LISA MOORE and all her videos on brick house bones.

@gently We went to the doctor, and I admit that I'm a little hesitant. First, the doctor is recommending Evenity because it's "the best" and it's only for 12 months. Second, she doesn't test the bone markers because she said "we already know that this has to be treated." Hmm... I think we may seek a second opinion.

@njx58
I encountered the same thing today re bone markers. When I replied that I am not comfortable starting any treatment without a baseline, the bone markers were magically ordered.

@njx58, you might fax the office and ask what your wife would transition to after Evenity. If the doctor is wanting to transition to Prolia that might change the perspective.
Njhornung's experience is of great value here. Nj was straight forward.
You could borrow her line.
You might also explain that Evenity doesn't work for every patient. The markers would save her a year of additional bone loss by using bone markers, but you'd need the markers now and again after the first month of use of Evenity.
At least ask for a prescription for Forteo, If your wife, say were delaying dental work with an eye to root canal or implant, a doctor might more easily be convinced that Evenity especially Evenity to Prolia or Evenity to Reclast would not be a good way to go.
I can understand why a doctor would advise Evenity. It lays down heavier bone the fastest of any of our medications. If your wife were on the verge of fracture, and we haven't a good way of knowing, you might want the fastest protection, even if you were forfeiting stronger more resilient bone.
It doesn't help to say that if I were in her position, or when I was in her position, I would choose, did choose Forteo.
You have to look closely. She seems to be in good physical condition and not falling down or doing things like deadlifts. She is less likely to have joint pain with Forteo, quite likely with Evenity, though some few don't.
You might not want to wait for several months for a second opinion. I'd try to secure Forteo with the current doctor.
You can order and pay for bone markers. I like to have CTX and P1NP but at least P1NP with the anabolics. I get markers every three months, but I need more so I use Jason Health

Order Total: $148.00
Item code Item Name Item Price
qt16609 Procollagen Type I Intact N Terminal Propeptide $80.00
qt17406 Collagen Type I C-Telopeptide (CTx) $50.00
Lab Collection Fee $18.00
Grand Total $148.00
Could you get her into your endocrinologist sooner?
It's good you are protecting her.

@gently The problem is that my doctor is in NYC, and beginning January, my wife will be on an ACA plan and she cannot see an out-of-state doctor. I could possibly get her in to see him before January, but then what?

I only see him once a year in the office. He orders blood tests online, so we can go locally for that. We can get DEXA scans locally. He can prescribe Forteo - I assume it doesn't matter if he's not in her plan when ordering a medication?

Personally, I’d go with the doctor’s suggestion of Evenity. I’ve done all three (Tymlos, Forteo, and Evenity) and Evenity has been the most tolerable from the perspective of side effects. Plus, not having to inject myself daily and worry about traveling with a medication that has to be cooled (Forteo) better fits my lifestyle.

It’s also only a year of treatment vs. two years.

As for exercise, my endocrinologist actually recommended running so I think she’s fine there. I’d add some resistance training and focusing on diet to ensure she’s getting enough protein. I don’t take any calcium supplements as my serum calcium has tended to be high. I do take Vitamin K and magnesium as well as collagen with Fortibone.

I’ve been on HRT for years but still had declines in BMD so I don’t know if it’s helpful. I understand that it can be of some help to some people. I am 64.

Since Evenity comes with 2 syringes for each treatment, it is possible to ask to receive only one of them. Getting thar request honored is another matter. However, as one doctor (another field) shared with me, it is possible to leave before the second injection. I intend to push for that as the standard dosage for me would be 5 mg/kg whereas for the average woman (167lb) that is only 3 mg/kg. I do not want to be overdosed.

I've decided to extend my wife's COBRA coverage for another nine months. That will allow her to see my doctor in another state, and get somewhat better benefits. Then she'll have to manage for a year until Medicare kicks in.

I'm going to get her to see my doctor as soon as he's available. He's pretty flexible about squeezing people into his schedule, and given that I'm his patient, I think he'll make an allowance for my wife.

We're both hesitant on Evenity. I think we'd rather try Forteo (or the generic) first and see how that goes. But we'll see what the doctor says. He's very reasonable - and he does pay attention to bone markers!

@njx58, if your wife starts Forteo in December, her new ACA doctor will be likely to continue the prescription. I always get three pens per script. Is Forteo covered under her new formulary. Her new plan may not cover a prescription ordered by a doctor not in their contract. I suspect. You might enquire. Worth a try.