I do not post often, but do follow the forum on a regular basis. I am very grateful to have you all as sources of information.
According to the latest DEXA scan, I have severe osteoporosis (-3.7 AP spine, -2.7 femoral neck, total hip -2.5, total forearm -3.7). Both the rheumatologist and endocrinologist are pushing Tymlos or Prolia. I have not started any meds yet, trying to maintain (or maybe increase) bone density through exercise, diet, and some supplements. I do a lot of walking, some weight training and stay pretty active. I have no fragility fractures, that I know of.
On a short walk yesterday, I fell. It was a middle of the day walk to the post office near my office. I did not notice the uneven sidewalk and took a tumble onto the pavement. I landed on my hands, scraped my left knee and hit my right knee. At first, I thought "oh boy, this is it", but as I got up and assessed the situation, I realized that I could continue on my walk, even though the scraped knee hurt. Got back to my office and continued working.
Today, my hands still hurt, my left knee is scraped, but the bone is fine. My right knee does not hurt.
I can't tell you how many sleepless nights I have had worrying about falling since I have been told I have severe osteoporosis and I have chosen not to take the meds recommended. Perhaps there is some truth in the fact that bone density does not translate into bone strength, yet we are not told any of this. Only speaking of myself. Of course, if my bone density continues to decline, I will absolutely consider the medications. For now, I will continue on the path that seems to keep me OK, even if I fall.
Many thanks to everyone for their contributions.