Keeping bones healthy and knowing what is best for me?

Kathleen, I have no answers, just my own opinions. So, for what those are worth: There is probably no single right decision, only best-guess decisions. I don't agree with Aristotle that it's necessary to have "complete certainty" in one's mind as to the rightness of one's choice. Some people are temperamentally disposed toward achieving complete certainty; others simply aren't. I fall into the latter category; I suspect you do as well. Having regrets is human nature. The best we can do is to try not to dwell on them.

As I wrote yesterday in another post, preventing falls seems to be critical to avoiding fracture, regardless of whether one has or doesn't have osteoporosis or does/does not take medication. My admittedly unscientific sense of T scores (based on what I've gleaned from reading) is that they are somewhat arbitrary. Possibly their main information is that derived by comparing subsequent scans with those made at baseline. There does seem to be some consensus, in the various studies I've seen, that the meds are more preventative against fractures of the spine than those of the hip ... and I'm still hoping someone can shed some light on the question of whether this is due to falls vs. meds or bone density being more predictive of hip fracture. Though spinal fracture could also be sustained in a fall, I've read quite a few anecdotal reports describing spine fracture upon little-to-no impact or motion. By "spinal fracture" I'm going on the assumption -- correctly? -- that what is meant is compression fracture. I saw an experienced PT a couple of years ago who claimed that compression fractures "are no big deal," which I suppose means that such fractures can be painless and may result merely in loss of height (though latter isn't a trivial affect from the standpoint of vanity). Yet numerous posters have described debilitating pain from spinal fracture. So perhaps there's a wide gamut of effects, ranging form negligible to major, in relation to spinal fracture? Also have read accounts of some type of minimally invasive procedure that is sometimes used to repair spinal fracture. (Need to research this more.)

Yet another opinion re: "Can natural vitamins and exercise replace the drugs or just help?" If the natural route could achieve benefits equivalent to what the drugs (sometimes) can, very few people would opt for these particular drugs, given their questionable safety profile.

As for a new drug in the pipeline, best to keep in mind that it, too, is bound to come with some caveats that give one pause about taking it. Though if it had a different mechanism of action than Fosamax, Prolia, etc., that could be advantageous, since the current drugs seem to accomplish their "gains" by forming new bone that is denser but NOT stronger and to interfere with osteoclast turnover -- hence its propensity to become brittle over time, paving the way for the catastrophic side-effects that the medical establishment insists are "very rare."

The short answer to your question, I guess, is, only time will tell. We all want the same things. To have no breaks, to have no pain and to enjoy the rest of our lives.  As I read more of your post, I want to ask you, are you certain you have not had an undiagnosed fracture in the lumbare area? It is just that your pain sounds so like what I experienced. I did not fall, but I lifted something too heavy, at a twisting angle. It was a few months before I had an MRI and both my GP and I were surprised to find this fracture on L4. (my second )The rest is history. Once something is no right it knocks everything else out and that has a domino effect. Also, look into the basics of the Alexander technique. It needs commitment, but it sounds like you have that.