If you are really lucky, you won't fall and break a hip.

If you are less lucky, you'll break a hip and get a hip replacement. It's not a fun process.

If you are old enough and unlucky enough, you'll fracture a spine and be crippled. Or, you'll break a hip and die in a nursing home. That happens all the time. A broken hip for an elderly person is usually a death sentence.

Don't stick your head in the sand. -3.8 is a really bad score. Don't be scared of all the talk of side effects. Here's what I am doing. I took Tymlos for two years and made great gains. I don't even have osteoporosis anymore. I'm now taking Fosamax. The plan is to take it for a while (as yet undetermined), then take a "drug holiday." Then, we'll play it by ear. BYW, I agree that meds like Prolia and Reclast can be daunting. I'm much more comfortable with the path I've chosen.

P.S. Although it is helpful, all those things you are doing aren't going to make a big dent in a -3.8 score, not by a long shot. Calcium + vitamins + walking will not make a big difference, I promise you.