I am new to this forum but searching for answers. I am in a dire situation. I started on Prolia at age 42 with a T score spine -4.1 and hip -1.8. I was recovering from anorexia nervosa and had been in surgical menopause for a number of years. I was already on an estradiol HRT patch (still am) but it did not stop bone loss. I was in a weight gain process so was advised to start prolia instead of an oral bisphosphonate. This was April 2014. I have been on Prolia since April 2014. I was due for my next prolia injection on January 28th, but was informed insurance denied approval because my dxa scores are too high. In 2024 they were -2.0 T score spine and -.8 T score hip. This is after 10 years of prolia. I now have to wait until late February to "consult" with my nurse practitioner who prescribes the prolia, to discuss Reclast. It is uncertain whether insurance will cover this or not based on my now higher scores. Two days after the denial and cancellation by my NP of my appointment for prolia, I went to urgent care with pain in left buttock, left leg, and groin. It is nearly impossible to lay down and hard to sit long. Initial xray showed wedge shape of my L5 and orthepedic dr. suspected compression fracture. However, next day MRI did not show that, but shows L5-S1 disc degeneration with bulging. There is a wedge in L5 but no fracture and they are not calling it a compression.
I am waiting with complete and total anxiety with the clock ticking now one week past the six month point when I was due for Prolia. I have three more weeks to wait for consult and who knows how long after that for approval of and given Reclast. I am not sure what to do. I am 53 years old, just lost my husband last year to lung cancer and now my elderly father is moving in for me to take care of. What will I do with rebound fractures in my spine? I am scared to death. Insurance is not budging on the Prolia. I am at high risk of rebound as I have been on it for 11 years and had severe scores when I started, hence a greater more dramatic loss to bear now off it. With my spine vertebra now already in a weakened state what are my chances? Who can I turn to and how can I fight this alone?