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Confused by doctor options to choose, including Keith McCormick
I’m still learning and navigating my Osteoporosis diagnosis and trying to get my healthcare providers lined up. I’m 51.
I have a PCP who I will only be using as a “sick doctor” going forward. She is aware of my diagnosis and is not up to date on care or treatment.
I have a neuro-kinetic therapist who I work with (recovering from a back injury) who is extremely knowledgeable in osteoporosis exercise. So I will continue to work with her for strength building.
I have a gyn who is not knowledgeable about osteoporosis and referred me to a local endocrinologist.
Those are all of my current health care providers.
Here’s where I’m getting confused….
I really am drawn to Keith McCormick. I prefer functional medicine but like that he also is incredibly knowledgeable about meds and doesn’t hesitate to use them when needed. I have no problems with video appointments.
I have a consultation with the Mayo Clinic in July - the endocrinology team.
They will review my case and decide if they will provide a treatment plan for my local docs or if they will accept me as a patient. So that’s up in the air.
There is a local functional doctor, who specializes in healthy aging and osteoporosis that I am considering.
The endocrinologist that my gyn referred me to doesn’t have an opening until August.
My questions….
Do people use Keith McCormick to completely manage osteo? Or do you also have a local endocrinologist and they work together? Furthermore, when McCormick orders labs, is that done at a local lab or through my regular doc? Thinking costs…..and insurance (I have Cigna - too young for Medicare) for all of those lab tests.
Does anyone have a functional doctor that manages osteoporosis in collaboration with Keith McCormick?
Does anyone see a dietician? I eat a whole foods plant based diet, so am realizing that I am deficient in quite a bit of protein and calcium according to “Strong Bones” teachings. Both of the functional med doctors have nutritionists on board that could help with that.
I’m so overwhelmed just choosing providers! What do you suggest?
Cost does matter - it isn’t the driving factor at this point (understanding and knowledge is the highest priority now).
As of now - I’m flying solo until the end of July, when I meet with Mayo. Wish I had some solid medical guidance before then, but so far have not been able to get earlier new patient appts.
What are most people doing - especially those who have seen or talked to Keith McCormick for a consult or care?
The more I read, the more confused I get. I have time to make decisions, but half a year will have passed before I actually see someone, let alone make any decisions about care. Need to get my ducks in a row.
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@mcallister1002
Yes. We're pretty sure it is a combination of things that led to my osteoporosis: Menopause, not enough Vitamin D and protein in my diet and the SSRI medication I've been taking for nearly 30 years. We discussed HRT, but I have a high risk of breast cancer and I don't want to "feed" any cancer cells if I develop it. We both agreed that an anabolic would be best for me since my TBS is severely degraded and only the anabolics can help with that. I'll have to follow it up with a course of alondronate and possibly Evista. I'm also doing strength training and I'm making sure I'm getting enough protein, Vitamin D and calcium. I'm hoping I can improve my bones or at least stop them from getting worse!
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5 Reactions@soggybones Have you decided which anabolic you will go on?
@mcallister1002 I'm hoping to do Tymlos. We'll see what my insurance says.
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3 Reactions@soggybones Best wishes to you on your bone journey!
@ stacibw
I believe a team approach will give you the best results. Osteo is a complex disease and so many paramenters must be considered for best possible result.
I consult with Dr K McCormick and use that information to help me work with 'bone speicific' endocrinologists and a general local endo. I also see a specialed GYN as I am considering HRT at age 71 as further support for my situation.
My local endo is the center of my wheel and writes lab scripts so they are covered by insurance. but that said they must be coded correctly. I live in an area with great medical care so I am lucky to have specialiest available. Now that said I have been thru a few bone endos to find someone who I can relate to. I also have a DO for structural support of recovering fractures.
SOme people will need a Gut doctor, some will need nutrioanl eval, some will need other support. The book Great Bones is a comprehensice reference and should be read to help you navignate this. My best to you God bless you with healign light.
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2 Reactions@dmshope awesome comment. Thanks for sharing. May I ask your general location of residence? Not sure if that’s allowed so no worries if you choose not to share. Take care!
@shocknot26
I live in the Northeast and I travel to 3 states for my osteo care.
(Yale BONE, HSS NYC Bone included). I am not recommending these specifically for everyone ; there is a great difference in endos in the same facilities. SO if you go one place and dont find what you need, you may just need to switch docs within the same facility. It is most important in my mind to work with someone who respects the use of Bone turnover Markers- and of couse someone who speicllizes in bone. And now that said, I have severe refractory osteoporosis with fractures so my situation is unusual.
Sendign positive energy for your healing.
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2 Reactions@dmshope thanks so much for sharing and right back atcha on your journey too:)
@dmshope Could you clarify examples of bone turnover markers? Also by respect, do you mean order and utilize the results of Bone turnover markers in treating osteoporosis? I know my endocrinologist doesn't use them, or at least not for me.
The primary bone trunover markers ( BTM) are CTX measuring bone breakdown and P1NP measuring bone building.
CTX is very senitive and must be taken early morning ( 6- 7:30am) after 48 hours of no collegen, no bone broth, no biotin. CTX should be drawn about the same time repeat tests are taken for most accurate comparision. P1NP has no restriction I am aware of. Every person is differnt with different conditions. A CTX of 150 for me may be good while a CTX of 300 may be best for another person so it is necessary to know how to evaluate. When I said respect BTM, I meant even if the doc does not do the test, if he/she is aggreeable to consider their importance, then that works. for me. I have one endo who doesnt do these, however is receptive to what others say concerning these test. CTX is often not paid for by insurance unless coded correctly; I use the CTX to moniter therapy ( check how medication is working) Baseline BTM are highly recommeded before starting any treatment. AND baseline BTM gives so much inofmariton on how the processes of breakdown/build up are balanced in your body. Please read and educate yourself as best youcan and you will be be a good advocate for youreself. BTM are regualrly used in other countries but just gaining use in US.
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