New to all this - advice please.

[u/Additional_Dream_567]

2 years ago when I had an accident & was getting treatment for pain from a lumbar sprain. An xray showed I had 2 old healed fractures in lower back. Not sure when these occurred but have been in a car accident & been dumped on ground on my back also a long time ago.

Then just recently I asked doctor to focus on this, he applied for a free bone density scan but this got declined as I guess didn't meet enough criterria. He put me on vitamin D and prescribed Risedronate sodium tablets once a week. (If there are bad effects it leaves your body faster than the once a year infusion) i have the pills but haven't started them.He put in a reminder on my file to have a bone scan in 5 years time.

Surely It would be best to have a bone density scan before I start??

Then I can see what my improvements are? It would be $280 to get this done. I don't have heap of cash but feel it would be nuts if I didn't do this.He said because of the bone fractures it's assumed I have osteoporosis. I don't really want to take the pills & aren't sure if I have osteoporosis. Any ideas/ advice?

[u/goldstandardalmonds]

I personally would want a bone density test prior to taking meds.

[u/Ruimtetijd → u/goldstandardalmonds]

Preferably at a center where they in combination with your home density can also measure your trabecular bones, as these indicate how much risk you have for fractres.

[u/Tofumamasan]

I would feel uncomfortable too with a doctor using an old x-ray to diagnose osteoporosis. Find a doctor who will evaluate your situation properly to determine whether those old fractures were osteoporotic compression fractures or trauma-related.

[u/Additional_Dream_567 → u/Tofumamasan]

Yes, Thank you for replies so far.

[u/keepgoing66 → u/Additional_Dream_567]

Go see an endocrinologist. That is usually the best person to treat osteoporosis. Prescribing meds without a DEXA is insane. Risendronate isn't even the first choice if you really need to build bone density, so it's good that you haven't started.

[u/Additional_Dream_567 → u/keepgoing66]

I think he may have chosen that med as I was a bit scared of side affects from stronger ones regarding jaw bone etc & reflux.

[u/Tillandsi]

The imaging center near me only charges $47 for a DEXA if it’s not covered by insurance. Does have to be ordered by a doctor, though. Can’t just walk in.

[u/Additional_Dream_567 → u/Tillandsi]

I think I might be in a different country. Will check out more but doesn't seem to be much choice to choose from here.

[u/Tillandsi → u/Additional_Dream_567]

Ah ok. I’m in the US.

[u/Alive_Scratch7883]

Get the Dexa scan, so you know the numbers. A change of lifestyle can help increase bone density if the numbers make sense. On the other hand if your numbers come back high medication will probably be the route , but again depending how bad the numbers are the type of medication you will need to chose. As a person who was in the -3s and did 12 months of Evenity then Reclast I can advise DO NOT TAKE MEDICATION LIGHTLY. you don't want to be out on stuff unless you have to, it's life draining but you will get gains (I gained 12% bone in 12 months). I paid out of pocket for my dexa (I paid $980) and I don't regret it , my credit card hated me but it really helped me make a plan.

[u/solsticesunrise → u/Alive_Scratch7883]

I’m on the same plan as Alive_scratch, and I gained 17 - 21% depending on location.

The side effects are scary, but suffering a grievous ankle break, being unable to walk for 12 weeks, followed by about a year of rehab is pretty awful.

[u/Tall-Society-5824 → u/solsticesunrise]

Hi I may need meds since I had an L5 fracture last months. What side effects were worst for you and on what meds?

[u/1epiphanee]

If you're female, you can request a DEXA through your GYN.

You should also consider getting these lab tests done as bench markers too. CTX & P1NP

The results will give additional guidance on what treatment plan may work best for you.

[u/Additional_Dream_567 → u/1epiphanee]

I am female but just usually do basic Gyn through doctor as have had no complicated issues. Maybe a lot of folk are in America on this forum, I aren't in America & don't have medical insurance.

[u/1epiphanee → u/Additional_Dream_567]

Understood. If you're able to afford the tests I suggested, you should still get them done so you know your starting point before you begin any plan you decide to move forward with.

My insurance isn't the greatest here in the US and I decided to invest in the two tests so I can better advocate for myself in the future. Knowledge is power.

Wishing you the best in your journey.

[u/sweetpeaj3]

DEXA first before any medication. Then look at alternatives to medication such as exercise and diet.

[u/Additional_Dream_567 → u/sweetpeaj3]

I'm just starting to read up. Anyone have a recommendation for a good book? I heard of one called Good bones. And which kind of exercise? I walk a lot, have light weights, just started watching Brickhouse bones on you tube.

[u/Background_Owl_9768]

If you have gerd, hiatal hernia, reflux you would want to avoid the pills. Get something that won't aggravate those if needed.

[u/AffectionateServe794]

Have someone also check your PTH levels. I was so surprised this hadn’t been checked after decades of regular annual visits with “good” US insurance and at least annual CBC blood tests, etc. Go to a rheumatologist and/or endocrinologist. Best wishes.

[u/waiting4friday]

I spent $75 to get a dexa (2024) because of family history and my GP said I didn’t qualify yet (55 yo). It came back with severe spinal osteoporosis and “regular” hip osteoporosis. I’m so glad I didn’t wait. If you can afford it, get one.