Treating Osteoporosis: What works for you?

My lowest was hip at -3.9 before Tymlos. And I had 3 fractures of lumbar spine, with one unusual movement. Added to 3 fractures from a 2006 fall. Spinal fractures are painful and disabling. With a spine at -4,3 I would not waste any time on getting on Forteo, Tymlos or Evenity.

How did you do on Forteo? My Endo has recommended Forteo for me - my spine is at -4.3. I am 63 years old. What was your bone density in your spine before you began Forteo?

I was on Forteo for 2 years. Had 12% increase in Spine and 6% in hip. Now on Reclast with no adverse reaction, and will see how my numbers look in a year. I agree that exercise, diet and supplements are so very important… and is what I did for 25 years to hold off Osteoporosis. But at 65, with extra “help” from menopause, it was time to add that pharmaceutical assistance. Be informed and do what is truly best for yourself and your stage in this process.

@sueinmn That was what was confusing to me, that being a federal program the states might have different rules for administering it. When I was much younger I actually worked in Blue Cross in Boston, within the Medicare administration department so I am somewhat familiar - things haven't changed that much.

When I went for PT, and I went a number of times for different things, at least monthly I had to fill out a form that was sent to Medicare showing my progress. It was difficult to fill out because not remembering what I had said the prior month I sometimes checked boxes that would indicate I was worse than I had been the prior month! Judging your ability and your pain is very subjective. I went to more than one PT place too and all three required that.

My relative in MA never had any of that! He went for quite a while after a hip replacement too so it just seemed strange. I realize the basic rules cannot vary but perhaps the administration of them can?
JK

You mentioned "I think the restrictions may somehow vary by state though because my experience with PT in NH does not match the experience that a relative in MA has had."

Medicare rules are the same for everyone, put in place by the Federal government. The "reporting" discrepancy in PT is most likely based on the terms of your supplementary Medicare policy, which may vary by state, because that is who regulates the health insurance companies. But underneath it all, the policy must comply with Medicare rules, which covers PT policies. It is an enormous, complex web, and part of what contributes to the high cost of our insurance and medical care. Medical practices and facilities have entire departments that do nothing except deal with Medicare and private insurance coverage and the complexities of coding each segment of care so that it gets paid for.

But if there is no progress, or the patient is deemed "non-compliant" (like failing to do the at-home exercises, or failing to show up for appointments) Medicare payments will stop.
Sue

@gigiray I know that Medicare will pay for some PT if you have osteoporosis. I was about to have some to get me started on the best exercises when the pandemic hit and the PT place closed down for a while.

I think the restrictions may somehow vary by state though because my experience with PT in NH does not match the experience that a relative in MA has had. In NH there is constant reporting on how much progress has been made and that did not seem necessary in MA.
JK

Did I understand you to say that medicare will pay for physical therapy when diagnosed with osteoporosis?

I have severe osteoporosis. I am on my 3rd year of seeing a wellness coach at a local physical therapy place. I started doing an hour twice a week of strength and resistance training. Then I dropped to an hour a week and Medicare will pay for physical therapy for resistance training. So I do an hour with a wellness coach (individual training) and intense. Then 40 minutes with a physical therapist. Not on the same day. After 1 1/2 years with the wellness coach and a year with the physical therapist, it stopped the osteoporosis in my spine but not my hips. I cannot take the Boniva, Fosamax of the world. My only resort now is for Prolia. But my first bone scan was in 1999, the year I turned 50 and my spine scan was -1.44 then. . It took until 2018 to get to -2.5 in my spine. My total left hip was scanned in 2008 at -2.5 and in 2019 it was -3.4. I am still weighing whether I want Prolia at 70 years old.

Try ginger with it. Ginger tea or candied ginger are the forms most like best.