Need Help With Asking PCP Again for a Referral to a Specialist

Thank you for this info kb1942.

Last fall I believe, I anguished over my most recent bone density scan aka DEXA scan bc it said my spine is 13% worse and hips 14% worse than my prior scan. They consider 2‰ change to be significant. I will be 68 in a few days and have already broken 3 pelvic, 1 rib and other bones spontaneously.

I have a lot of diseases and take my share of toxic meds.

I have the best, sweetest, most patient Rheumatologist who spent several discussions with me about Osteonecrosis meds. She sent me links to studies.

I learned that the studies are usually funded by the Manufacturer of the drug in the trial! And, often they are small studies.

My dentist told me alarming things about specific osteo drugs and the same about one remaining in the body for 10 years or so, they just don't know, it could be longer.

I lost 200# by a very low calorie diet, not realizing I was robbing my body of nutrients it needed thus furthered my osteoporosis. I didn't do it intentionally but I didn't have dairy for probably 3 years! I was taking what I thought was a great bone strength supplement but have since learned it wasn't the best so changed to a much better one by a company recommended by a blog member here. Canadian company called, AOR.

I have changed my diet completely so I am hoping my next scan will be better or at least not worse.

I couldn't bring myself to take any of the osteoporosis meds. I couldn't risk the unwanted potential side effects, some of which are dangerous.

Warm regards, Sunnyflower

I have osteoporosis and in November, I fell and broke my hip. Breaking my hip had less to do with the osteoporosis than it did with the way I fell. I'm fairly certain I would have broken my hip even if I didn't have osteoporosis, but unfortunately, statistically my break will be blamed on osteoporosis. I rejected Reclast as well as the rest of the bisphosphonates because side effects were unacceptable. I do a lot of exercising, which paid off in my recovery. It's less than 3 months and I walk unaided. If anyone knows of can effective treatment, I'd certainly be interested. BTW, I'm 82.

I have osteopenia and I am 85. Two years ago I fell and cracked a bone in my shoulder. I recovered with physical therapy. I have always drunk lots of milk and love cheese and yogurt. I have always had a positive bone scan until the last few years, and now I don't do much lifting or exercise because of back surgery four years ago. I rejected the meds because of side effects and reports that some don't help much. I am very careful and work on my balance and do not use a walker. I work hard on having a straight back but some days I slump. I intend to keep on with the dairy and the balanced diet. I can't expect to keep this old body perfect until I die, so I guess I will wear out eventually, but I don't look for any more surgery, pills with side effects, or drugs. Dorisena

Hello trishanna and @kb1942, trishanna, I am very sorry to hear about your fall and broken hip.

I was trained as an EMT and they said "it's not that the patient fell, it's why they fell" and that "frequently they fell bc their hip broke".

It is good that your hip didn't break.

I agree about the bisphosphonates!

Warmest wishes, Sunnyflower

Thanks for your kind words. I'm very grateful for my recovery, and I need to stress to everyone how important some kind of exercise program is so that if something does happen, one is able to handle it. Also, muscles help to protect those bones!!

You're right trishanna, and physical therapy can work wonders for that! Warmest wishes and many blessings, Sunnyflower

@contentandwell, Yes, JK, having a good relationship with the doc does make a decision to change much harder...especially for one who dreads change anyway. smiles Thanks to the confidence building suggestions from you, @johnbishop, @merpreb, @sunnyflower,@sueinmn, @colleenyoung, I am happy to report that my pcp approved my second request for an endo. referral! Started with 1 Big Thk U and 1 Big Request, I read to doc my "Plea statement/reasons for referral request" lol and she said "yes" to the referral! BIG relief and you guys get the credit.

No reference to her earlier denial and the fact that she had a young intern shadowing her may have contributed. I also said another opinion might not change anything during my yr off from Reclast but it would help "the worry wart's" peace of mind to know I'd tried all I could to add to my bone tool box. I wonder if she realized how stressful her first denial was and if reading out my family history and reasons for wanting another opinion made the difference.

Had placed 2 direct calls to Endo. offices about requiring referrals and accepting new patients and both required referrals and had closed practices.

A good friend suggested that the denials might be due to the fact that I was in a "managed care system". That sent me for more info. on "managed health care" and I learned more from: https://www.fool.com/investing/general/2015/10/06/what-is-managed-care.aspx.

My state retired teachers plan started at retirement with Aetna, moved to Humana, and recently changed to United Health. The last two are Medicare Advantaged Plans. I'm still not sure if it is just a local decision to require doc referrals to specialists or my particular ins plans but neither of the 2 endo offices asked about my ins. just my name and birthdate.

Local friends with other ins and direct requests for other specialists have also been told referrals were needed. It seems odd that members in other locations have suggested that Medicare patients might not need a referral. Just happy that the doc agreed to the request and will now play a "wait & see" about how the next year goes. Sending cyber hugs to each of you for your help and reassurance. Fiesty

I saw an orthopedist yesterday because I have fallen twice and have little strength . He told me I need to exercise:”what is strong is what is used”. Where to start? All I want to do is sit and knit or read! But I can’t concentrate and certainly feel afraid to go out and try to walk. Where do you get your determination?

Can you share a little more about where you live, whether you can walk in hallways or a courtyard where other people are around, whether you use a walker or cane...It might help us make some suggestions for you.
Sue

My fear of being put in a facility provides my determination. I live alone and if I don't cook, do laundry, and take care of myself they would put me somewhere where I can be cared for because they aren't going to come in an do my care and chores for me. I like the cooking, I like the laundry, and only hate the sweeping and dusting. They do pay my bills for me and keep the checkbook balanced. Some doctors don't count chores as exercise. I do my stretching while I wait on the toaster to pop or the microwave to cook some food. I do exercise in the shower carefully. Mental exercise is also important so you can concentrate. I do Sudoku puzzles. I like math. I can't walk far but I try to increase the distance a little outside. I would prefer to walk with someone. My grandchildren will walk with me to buy something.
It is a struggle but it is better than a wheelchair, I think. I use a walking stick instead of a cane. Dorisena