Yet Another Approach to Osteoporosis Rx

[k9ophile]

I saw my endocrinologist and we went over my labs and Dexa scan. I show another 6% loss in my spine. We've tried Boniva and Forteo. My Vitamin D was high and my TSH was low. Instead of trying yet another treatment for osteoporosis, I'm changing the dosage of vitamin D and thyroid. He insisted on Synthroid due to the unknown variables that can exist in generics. Tricare is my medication insurance. I will have to jump through some hoops to get the brand name, yet I'm up to it. ( I think.) It sounds better than taking another osteoporosis med with all the nasty side effects.

He also said that with my WLs it is more difficult to treat me due to the malabsorption. Again, I'll deal with it. It has to be better than being SMO.

 

[Petunia]

I'm on my second dose of Prolia for Osteoporosis but won't know how effective it is until my scan next year. Haven't had any side effects yet, the pills I was on always made me sick. I've also increased my K2, calcium and boron.

 

[JackieOnLine]

I hope your insurance will pay for what you need, and that it works.

 

[k9ophile]

I hope your insurance will pay for what you need, and that it works.

There is a form that can be completed to appeal for name brands. I think with my history, a good case can be made. I just hate the fact that insurance companies overrule medical decisions just because they can. It makes me so angry that too many of us are initially denied and have to go through an appeals process to get WLS. Cosmetic surgery is often done for vanity, yet too many treat WLS as cosmetic. What morons!

If all else fails, I'll just do the alternative available to those who can afford it; I'll pay for it myself. It would be roughly $400.00 a year.

 

[southernlady]

I'm due for my second Reclast infusion this coming Friday after we get home. I didn't get better from the last one 2 years ago but also did NOT get worse. My PCP wasn't gonna and I asked to have it a second time.

From my understanding of previous discussions in here, any med that has to go thru our gut doesn't work as well as one that goes into our blood stream.

 

[DSRIGGS]

I hope they approve your synthroid K9.

I am wondering if as a 50 year old male if I need a Dexa Scan for a baseline? As a DS patient I think I probably should but I am wondering if a Dr has to have some reason other than a baseline scan to order and justify a dexa scan with insurance?

 

[southernlady]

I hope they approve your synthroid K9.

I am wondering if as a 50 year old male if I need a Dexa Scan for a baseline? As a DS patient I think I probably should but I am wondering if a Dr has to have some reason other than a baseline scan to order and justify a dexa scan with insurance?

Maybe if your family has a history? I had my first baseline back in 2004 at age 50. My ob/gyn set it up.

 

[DSRIGGS]

No history so I am not sure. I will ask Dr K his thoughts on it because I don't think my OB/GYN will order anything for me.

 

[k9ophile]

I want to note that last year I wasn't taking anything specific to osteoporosis. After this holiday from drugs, I guess I should have expected a change, yet I was a bit surprised. Also I've read so many posts about people struggling to get their D up that I never thought I'd have the opposite problem. But then, I don't need to take supplemental iron. This is one wacky post-op life.

No history so I am not sure. I will ask Dr K his thoughts on it because I don't think my OB/GYN will order anything for me.

Heaven help me, I love smart asses.

 

[southernlady]

I will ask Dr K his thoughts on it because I don't think my OB/GYN will order anything for me.

Yeah, I suspect not but just letting you know that 50 is not too young for the baseline ESP if WLS is involved.

 

[DSRIGGS]

Yeah, I suspect not but just letting you know that 50 is not too young for the baseline ESP if WLS is involved.

I agree that it would be a good idea, but not sure they will cover it. Btw is the machine like a CT and approximately how long does it take to do the scan?

 

[Clematis]

It's just a special X-ray machine that takes one pic of your lower spine and one of hip. Position, zap. Position, zap. Three minutes.

 

[k9ophile]

I agree that it would be a good idea, but not sure they will cover it. Btw is the machine like a CT and approximately how long does it take to do the scan?

At my exam, it was a huge wand that was passed over my body. My CT scans were conducted in a tubular scanner which can be a bit intimidating for any one with claustrophobia. I think I was done in about 15 minutes and that included waiting for the print out to take to my appointment. Insurance varies, but you can ask about price. I was warned that most insurances will only pay for one every other year yet may make exceptions for people who are under treatment for progressive osteoporosis. My local PCP has the equipment in his office. All I had to do was schedule the exam and the tech got my doc to order it. I didn't see him at all. I did ask about the charge if my insurance didn't pay and was told it was around $250.00.

You'd have to wear sweats of something without a zipper.

 

[Clematis]

At Cleveland Clinic: $361 for DEXA scan (insurance negotiated rate $216); plus $66 for radiologist interpretation. (Both were 100% covered by Anthem.)

One of the questions on the Risk Factor form along with family history of osteoporosis, use of PPI, current/former smoker, and if I'd ever weighed less than 127 as an adult, was if I'd had WLS, so they are well aware of the connection of WLS to osteoporosis. I think your doctor and insurance company would consider it prudent to have it checked.

 

[k9ophile]

At Cleveland Clinic: $361 for DEXA scan (insurance negotiated rate $216); plus $66 for radiologist interpretation. (Both were 100% covered by Anthem.)

One of the questions on the Risk Factor form along with family history of osteoporosis, use of PPI, current/former smoker, and if I'd ever weighed less than 127 as an adult, was if I'd had WLS, so they are well aware of the connection of WLS to osteoporosis. I think your doctor and insurance company would consider it prudent to have it checked.

That's a bit more yet not unreasonable. I didn't have to pay for interpretation. It's read by software and it even compared this year's results to my scan from last year. I asked about price just I case my insurance didn't pay. As of yet they always have.

I find it interesting how prices vary from one provider to another and how things get paid.