I was diagnosed with ET CALR+ gene with platelets over a million a year ago. I also have had osteoporosis for years. I am 74 and the hematologist changes the dosage of hydroxy between 500 once a day every day to twice a day depending on the platelets and white blood cell count. I get a cbc monthly which he reads and then determines my dosage. I see my hematologist every six months. My platelets are now vary between 300 - 600. I am also on a daily aspirin and get Prolia every six months. I’ve been on Prolia for 4 or 5 years. Prolia has been great with no side effects compared to Fosamax which made me feel the worst I’ve ever been in my entire life. Yes, i sometimes feel tired, achy or upset stomach from the Hydroxy or lactose intolerant. All of that is minor compared to blood clots or a stroke. I bike, exercise, play with my grandchildren, go on visits with my therapy dog , ride my horse and spend time with friends. Off to the Netherlands to do a bike and barge trip so blood cancer and the side effects is just part of my life now.