OK, my mom had a osteo condition. She was on a daily injection drug to build bone mass. It worked. I do not know the name and can't ask her (passed a few years back - COPD). I hope he can find a treatment ...
Twist shifters are fine when adjusted properly. Dual lever shifters really clutter the cockpit. And can be a snag on thumbs and fingers ...
I'll bet he'll take it for a spin and just leave it in one gear