Hello WindyShores, It was definitely negligence on the part of the "bone health" people who were supposed to be monitoring me while on the Tymlos. It was about five months and after massive spinal surgery that they finally rechecked the blood chemistry even though I had an elevated calcium of 13.3 and other crises during the hospital stay for the surgery. The neurosurgeon set me up with the negligent bone health group and then put the blame for the mess on me ignoring my request to refer me to a different endocrinologist. It has been exactly three years since the surgery and I'm still trying to get help to monitor bone health with an elevated N-Telopeptide level that needs to be resolved. Normal is 6.2 - 19.0 uM BCE. My last three values were 33.2 uM BCE, 25.5, back up to 29.9. If anyone has any knowledge about elevated N-Telopeptide values, I would dearly love to hear about it.