@janflute I also see a doc at MGH and have seen Dr. McCormick over the years. He will recommend either Reclast or alendronate with a preference for Reclast, if he suggests for you what he suggests for me.

I have kidney issues so my endo is doing a 20% dose of Reclast as a test dose. I had to push for IV hydration. Nephrologist wants me to hydrate with salty fluids including Pedialyte, before during and after. I can't drink that much Pedialyte! Also ask for a slow infusion and take tylenol before and after.

I know many people who have done full dose with no problems, including my frail immune compromised friend who just did chemo. The only reason for caution with me is my kidney disease.