endocrinologist or rheumatologist ...

[MayGodBlessYou]

Mum's endo retiring soon, so, feeling lack of continuity of care, plus she was after a second opinion,

is a rheumatologist worth consulting?

mainly a question about stacking forteo on prolia,

that's the plan, as Mum had a prolia dose, then endo wanted to start forteo straight away, for at least 9 months, no longer than 18 months.

and is that to have a drug holiday from prolia?, because, i'm concerned that the forteo doesn't prevent the severe bone loss after stopping prolia.

furthermore it's been said that 4 weeks delay between prolia doses is acceptable,

when i've read that there's no detectable level of prolia in 53% of participants' systems at 6 months.

and what about at 5 months?

and also the dose interval is 6 months -

a month of forteo doses means 28 days.

is 6 months of forteo 26 weeks (calendar months), or 24 weeks? (rhetorical question!)

[MayGodBlessYou]

rheumatologist wait list is 4 months, but could be put on a sort of priority list

[Bluebell999 in reply to MayGodBlessYou]

If you ring up the relevant department, ask to be put on the cancellation list. It has worked for me many times, as long as you and/or mum are prepared to go at short notice like the next day or within a few days.

Is your mum seeing an endo for thyroid or diabetes? I am just wondering why you think a rheumatologist would help you. If your mum's endo is retiring then you will automatically be put on the list of the endo taking over.

When I had my spinal fractures I was moved from spinal/orthopaedic department to the osteoporosis department which was closely linked with rheumatology.

I am under rheumatology anyway because of my autoimmune conditions, but I did not see a rheumatologist that time, I saw an osteoporosis specialist.

After refusing the hard sell to go on to Prolia, I decided to have the Zolendronic infusions, which are yearly. The side effects of the first one almost put me off the second, which fortunately was not as bad. I had the third in April and felt achy bones and a headache for a few days and that was it.

It is personal choice but it is a hard decision to make when there are so many conflicting reports. You cannot stop Prolia without another medication to take over. My choice of the infusion was because it is yearly, so no forgetting taking oral meds or injections daily.

In my own case, I definitely feel stronger in my spine and have more movement in my joints. I have yet to have another DEXA scan to see the improvement but if the score is better, then I will have a break from it.

A simple enquiry to the relevant departments over your mum's continuing care, should point you in the right direction.

Good luck.

[MayGodBlessYou in reply to Bluebell999]

Mum started seeing endo for over 65s checks, and he saw that bone health had to be addressed.

part of the situation currently is that a fracture has occurred while on prolia, endo wants her to start forteo,

i can see forteo could help,

but he wants to bridge prolia treatment with the forteo,

that hasn't been shown to work,

how do i address that with him?,

unless he is thinking at this stage that the prolia isn't working anyway,

it's causing me great concern

[Bluebell999]

It sounds like he realises Prolia is not the right medication for your mum, so is bridging until a better med can be found which is more suitable.

Perhaps you could explain to him that your mum wants to start A, B, or C instead of the Forteo. This is really difficult to choose as ALL the bone meds have side effects, some worse than others, as you have found. A phone call to his secretary should alert him to this and may involve a return call to your mum and /or you, without having to attend the clinic.

Would you be able to find out which med you think would suit your mum best and which she is most agreeable to and then be ably prepared to speak to the consultant should he ring.? It would mean a lot of research but it means you find the best possible solution for her.

Since your mum already has had a fracture, going through the non medication route, with extra dairy, supplements and weight bearing exercises may not be effective enough.

Don't be pressurised into doing something that doesn't feel right, which at the moment seems like you have concerns.

Be aware too that osteoporosis can be genetic and you could be at risk as you age. In this case prevention and forethought may prevent you having facing the same dilemma.

Ringing the ROS is good as they offer support and also help with the decision making, although of course it will be your mum who has the last say.

Good luck to you both.