Hoping for a GID diagnosis

[Caith721 (imported)]

So, it's almost two months now. The scar tissue beneath my incision site has slowly been getting smaller. I've been certain to massage it every time I shower to encourage the re-absorption. I woke up with a semi-erection at 5:30 am a few days ago and this was a total surprise. I don't know how long the pituitary gland tries to overdrive the adrenals to produce more T, but I suspect that's happening now that I've not taken Cyproterone Acetate for almost two months. Two recent side effects I've noticed are mild hot flashes if I wait too long to take my evening dose of E. The other has been a series of mild depressive days once or twice a week for the last few weeks.

I've suffered clinical depression (major depressive disorder) for many years now. For the first several years, Prozac managed it well then started providing less benefits. I switched among a few different SSRI drugs and settled on Cymbalta (Prozac's younger, smarter brother) about six years ago. To address both these issues, I have a doctor's appointment with my GP next Monday morning. I'll be asking her to increase my daily dosage of E, and also to add Abilify (aripiprazole) to the Cymbalta. It seems my depression is "treatment resistant". It's not unbearable, but my work situation will be getting worse later this year as my client migrates off the current software I maintain onto a different one. During the transition, the number of people and interruptions bothering me each day will more than double. I figured I'd better address the depression before my work situation makes it worse.

To see what's happening with my current levels of E and T, I'll ask my GP for blood tests measuring E, T, LH, LHRH, and FSH. That should indicate what's actually going on, and whether my request for additional E is justified.

[kristoff]

So, it's almost two months now. The scar tissue beneath my incision site has slowly been getting smaller. I've been certain to massage it every time I shower to encourage the re-absorption. I woke up with a semi-erection at 5:30 am a few days ago and this was a total surprise. I don't know how long the pituitary gland tries to overdrive the adrenals to produce more T, but I suspect that's happening now that I've not taken Cyproterone Acetate for almost two months. Two recent side effects I've noticed are mild hot flashes if I wait too long to take my evening dose of E. The other has been a series of mild depressive days once or twice a week for the last few weeks.

I've suffered clinical depression (major depressive disorder) for many years now. For the first several years, Prozac managed it well then started providing less benefits. I switched among a few different SSRI drugs and settled on Cymbalta (Prozac's younger, smarter brother) about six years ago. To address both these issues, I have a doctor's appointment with my GP next Monday morning. I'll be asking her to increase my daily dosage of E, and also to add Abilify (aripiprazole) to the Cymbalta. It seems my depression is "treatment resistant". It's not unbearable, but my work situation will be getting worse later this year as my client migrates off the current software I maintain onto a different one. During the transition, the number of people and interruptions bothering me each day will more than double. I figured I'd better address the depression before my work situation makes it worse.

To see what's happening with my current levels of E and T, I'll ask my GP for blood tests measuring E, T, LH, LHRH, and FSH. That should indicate what's actually going on, and whether my request for additional E is justified.

A word to the wise from someone who's been there - Abilify can be a miricale drug or it can cause hell. Side effects can be enormous - the worst I experienced was akasthesia so bad I couldn't walk. We switched to Geodon. Another mistake. Once my eyes stopped crossing and blurred vision was done after about a week, the headaches started, along with chronic nausea. In both cases, withdrawal syndrome was painful at best with the severity of headaches and the frequency of panic attacks. Be Careful and choose slowly with some one who can advise you that isn't just trying to push pills.

[Caith721 (imported)]

Much appreciated, Sister Krister. It's my request to my GP, not some psych doctor's suggestion. When used as adjunct therapy together with SSRI anti-depressants, Abilify is prescribed at very low levels of either 2mg or 5mg per day, rather than the much higher levels prescribed for other more serious mental conditions. Having evaluated other psychiatric drugs, I'm keenly aware of their effects on my personality. Zoloft kicked my depression's ass into the ditch, but left me with absolutely zero range of emotions. After a few months, I couldn't take it any more. Wellbutrin and Buspar did absolutely nothing and allowed depression to ruin several weeks of my life. I spent over eight months evaluating these drugs, until Cymbalta worked very well to manage my depression and not impact my emotions and personality.

I won't be surprised if my GP declines my request and suggests I re-visit my psychiatrist for this script. After the ridiculous delay my p-doc forced me to endure for my second surgery referral letter, I'd rather not visit her again. We'll see what happens, come Monday.

[rammer (imported)]

I've taken 2.5mg abilify per day for a year along with Cymbalta. It has helped. No side effects yet.

[Wolf-Pup (imported)]

I have a doctor's appointment with my GP next Monday morning. I'll be asking her to increase my daily dosage of E, and also to add Abilify (aripiprazole) to the Cymbalta. .

Curious Caith,

What dose of E are you on now? Do you take two doses 12 hours apart or just when you get up and in the evening? Also what kind of E? Estradiol or Premarin?

[butterflyjack (imported)]

Caith, thanks for the ongoing insight into the recovery and wonderment of your orchiectomy. By the way...your avatar...Is that you? She's lovely... smooches Jackie

[Caith721 (imported)]

Jackie, if that were me, I wouldn't be here, I'd be married and getting my eyes banged out, at least twice a week. I'm 53 years old, 6'2" tall, and 265 pounds, with male pattern baldness in the form of an extended forehead, no bangs, and thinning crown. My next major surgery will be hair transplantation, costing almost as much as full SRS.

I do have pale Irish skin with freckles, and my reddish brunette hair was bright red as a child from playing outside in the sun all year long.

[Caith721 (imported)]

Went to see my GP today, got a prescription for Abilify (aripiprazole) 2.5 mg/day. Updated her on my orchiectomy two months ago. She was surprised I couldn't find a local urologist to perform it. I would guess anyone here who has cold-called multiple urologists and urologic surgeons in their local area (like I did) isn't the least bit surprised. They took blood to get E and T measurements, as it's been two months since they're gone. I suspect my E is lower than I'd prefer, and have absolutely no idea about how much T is still coming from my adrenal glands.

[Caith721 (imported)]

What dose of E are you on now? Do you take two doses 12 hours apart or just when you get up and in the evening? Also what kind of E? Estradiol or Premarin?

Wolf-pup, I offer apologies for having not responded to your question, sooner.

I currently take 2 mg Estradiol in the morning, and 2 mg in the evening, for a total of 4mg/day. The minor hot flashes come in the evening, when I neglect to take my evening dose soon enough. I think upping it to 6mg/day will eliminate this problem, taking 4mg in the morning and 2mg each evening.

[Caith721 (imported)]

T is 10.99 ng/dL, or as low as humanly possible.

E is 68.60 ng/dL, or in the very low normal range. :-\

My GP doesn't think I need any more E, but personally I do.

I'll be adding an extra 2mg to my daily intake soon (courtesy of InHouse Pharmacy)

At least I don't have to worry about purchasing cyproterone anymore.