My Experience...

[DavidB (imported)]

My urologist has been great, and saved my life by being overly thourogh, as the saying goes goes your milage may very, your urologist may be in a position to assist you in multiple ways, but its not a bad idea to see an Endo as well.

[feedback (imported)]

My endrocrinologist worked with my family doctor on HRT levels. I now use just a little gel and control the amounts myself. Mostly using one pump or 1.25 grams a day but use 2 if I need more energy. If I use more I start having erections etc.

[Woggler58 (imported)]

Here’s some HRT Info to get you started on replacing or improving on what you lost with your recent bilateral orchiectomy. Feel free to let your interest and curiosity take you beyond the scope of these suggestions, and milk this interesting journey for all it’s worth to you.

Dr John Crisler, D.O., has an anti-aging and hormone replacement clinic, “All Things Male”, in Michigan, and is prominent in the anti-aging “A4M” medical society. His website has a FAQ section that covers many of your present concerns, and I recommend it, at http://www.allthingsmale.com/faq.html . His description of health effects of low testosterone is consistent with what I experienced during a spell of way-below-normal T levels, both total T and free T, for two years following my regimen of radiation for prostate cancer in the fall of 2007. And his description of the benefits of obtaining a well-above-average level of testosterone via HRT is consistent with the effects I obtained from being on HRT in generous amounts since early 2010.

Other writings by Dr Crisler were very informative during 2009 as I was waiting for my prostate cancer treatment to show a track record of success via steady, very low PSA blood test results in the 0.3 and 0.2 range – down from 11.2 pre-treatment. Two years were sufficient to show that happy result to the satisfaction of myself plus my radiology oncologist. I knew that obtaining HRT meant being under the continuing care of a prescribing doctor, hopefully someone convenient to my Northern Calif residence. Dr. Crisler was out of range in that regard. Further, for many decades, accepted medical wisdom held that giving a prostate survivor any additional testosterone was bad practice, so I needed an open-minded hormone specialist who was up to date and not a herd follower.

My online HRT research led my browser to feature paid ads for several HRT-specialist clinics. I clicked on them and discovered that one, “BodyLogicMD”, had an office in the city where I live, and specialized in exactly what I was interested in from long before I knew I had prostate cancer, but after I’d obtained tests on my own initiative that revealed low testosterone and (later) low thyroid levels. Of those two hormones, only the thyroid supplementation was un-controversial and readily obtained.

Before discovering HRT specialists in my city I’d seen an article in Life Extension Fdn’s monthly magazine www.lef.org that covered a then- brandnew book on HRT by Dr. Abraham Morgentaler of Havard Medical School who, like Dr Crisler, has a private practice in HRT for men. I obtained a copy right away and in it was a breakthrough. More on that is in my EA post of July 16, 2011, following up on EA member janekane’s mention of Dr Morgentaler in the Men’s Health Article thread in the EA Castration in the Arts (etc) Forum. It’s here http://www.eunuch.org/forums/showthread ... post184796 Note: Another way to find my postings is to click on my user name, Woggler58, to get and review my profile, then click at the left on “find all posts” to see a list of all my EA posts, most recent on top. Some other posts therein also pertain to HRT and to the effects of low T, well-established because of so many tens of thousands of men with uncured prostate cancer having to be surgically or chemically castrated to chill the cancer’s advance for a few more years. (You can look up any current EA member’s past posts that way, via their profile page.)

Don’t miss the many posts by Jesus in EA’s Cancer, Testicular, Prostate forum. Also, Kristoff posted a multi-part essay published by Prostate Cancer Research Institute on the many effects (and mitigations of them, if any) of living with castrate-levels of testosterone on a prolonged or permanent basis. It’s in the Jan 2008 Cancer, Testicular, Prostate forum.

When I made contact with BodyLogicMD (BLMD) in late 2009, my inquiry was routed through the practice’s Florida HQ, and then to their Dr. Ghelfi in my region. I explained up front that I was approaching two years since prostate cancer treatment and had quarterly lab tests and follow-up visits with my oncologists to back my idea that I was eligible for HRT. They weren’t spooked and I attended an evening seminar held here for prospective new patients. What I saw and heard was consistent with Drs. Crisler, Morgentaler, and other sources including EA member postings. I was persuaded and was found acceptable by them too. Five main points were that, [1] I would be 100% self-pay because Medicare (I’m over 65) rejects covering this (in my case, maybe not yours) discretionary HRT; [2] BLMD would evaluate and balance all of my other hormones before dealing with my low-ish testosterone, [3] I would need PSA testing to continue several times a year to detect any possible cancer recurrence; [4] results would be gauged both by lab results and by how I’m feeling subjectively; and [5] testosterone administration would be by any of three forms, to be supplied by a compounding pharmacy to BLMD’s specification: daily rub-on crème having a half-life similar to one’s own testosterone, ie, less than one day, or self-injected weekly shots of about 10 days half-life, or many little MD-implanted (under the skin) time-release pellets good for several months before being refreshed.

Because setting an initial dose is patient-peculiar guesswork adjusted by trial-and-error, the daily crème is the most appropriate to start with because too much quickly clears away and too little is easily remedied. I liked that version and have stayed with it, the initial dose being very satisfactory and the rub-on product having no annoying practical effects, as it dries and absorbs promptly with no mess. It is supplied monthly in a clever, dose-calibrated dispenser called a “Topi-Click” www.topi-click.com . It is shaped like a small, oval-shafted erect penis and when you twist its base a click-defined quarter turn, it ejaculates a quarter ml of white crème out the hole in the center of its rounded glans onto that same surface, to be rubbed into the skin of one’s inner forearm and/or upper chest. My daily dose is 1.0 ml of 5% by weight bio-identical testosterone, so I apply the prescribed 4 clicks per morning at breakfast, two on my inner arms and two on my chest. The monthly supply is generous enough that most days I apply a 5th click’s dollop by finger to my scrotum, as done for the Australian Andromen Forte testosterone crème I read about first in EA and then on their website.

My monthly cost to University Compounding Pharmacy in San Diego CA is $46.95, charged to my credit card as a standing refill order. My other recurring costs are for lab tests and the monitoring visits to the doctor every 4-6 months. I order the agreed-upon lab tests and receive the results first, through Life Extension Fdn, which contracts with Lab Corp for the blood draw and lab assays at very good rates. I’m the paying customer of all these service providers and no self-interested insurance company has anything to say about what my providers are doing for me. I regard the results as an excellent value and everything I’d ever hoped for, even though because of my cancer treatments’ side effects and other prejudicial circumstances, nobody will pay me lucrative stud fees to defray the cost of my newfound vitality in life.

I hope this long saga will help you find your own route to the HRT you soon will need so much more seriously than I ever did. I should add that, while surgical castration dropped your blood Testosterone to nil in less than 24 hours, it takes a lot longer for the effect of that decrease to manifest itself in changes you can notice, such as loss of libido and robust erections, let alone shrinkage of your several sex organs still present and your ability to orgasm. Whether you wish to wait and experience your own eunuch-like andropause before going on HRT is up to you. I got part way there at my testosterone nadir of 210 for over a year so I can sort of appreciate what women experience. You’ll go deeper into it quicker than I ever did, and I suggest you abort the deprivation experience before incurring penis shrinkage and internal physiological damage in its erectile tissues like I did. (Others on this forum of course covet many of those effects, which the do-nothing option will surely get you if you prefer.)

Best wishes…

[gandalf (imported)]

- I feel no less of a man.

- Prosthetic's I am not sure about because if my body rejects them then it cost extra to get them taken out and no refund on the "install" and as far as I can see it so far the wife has no issues with the appearance and since she is the only one seeing it then thats all im worried about.

- I guess the nurses that were in the room know, my doctor, and my wife. Not on my first list of things to do... Don't beleive it is anyones business.

- Wife has been very supportive

- Surgery was necessary. Multiple torsion incidents along with vericocile and extreme pain constantly just about

Unlike you, I informed the family of what was going to happen. Scared one nephew because he thought "Cancer" but it wasn't. I told him it was just uncontrollable pain. Vioxx didn't even work and at the time it was supposed to be the strongest thing available.

My daughter's response was " Dad, at your age you don't need those things any more anyway". My Son was a little more unsure (being male and newly married) but he accepted it also. Only ones in the family that did not find out were the three grand children.

Personally, I am very happy with no balls. I didn't want artificial ones and ultimately three years later had the scrotum removed. I would not mind getting a urethra reroute now due to shrinkage of my penis.

I am prescribed 2.5 grams daily and that gave me a reading of T at 425 which the Dr was happy with. I am now only using 1.25 grams three days a week and 2.5 grams on four days. I plan on trying the 1.25 daily when I finish getting the leaves from 20 trees picked up this fall.

[janekane (imported)]

You’ll go deeper into it quicker than I ever did, and I suggest you abort the deprivation experience before incurring penis shrinkage and internal physiological damage in its erectile tissues like I did. (Others on this forum of course covet many of those effects, which the do-nothing option will surely get you if you prefer.)

Oh, well, biological diversity may yet triumph. After 25 years with castrate testosterone levels, I have yet to get to penis shrinkage or any hint of erectile tissue damage. What is nearly perfectly certain almost all the time may never happen some of the time. Had I wanted to not have erections, or had I wanted penis shrinkage, I suppose I might be disappointed to the degree of being devastated.

What I did want, were it to become possible, is to be a decent, living husband and dad for about as long as my so being would be useful to my wife and daughter. So far, so good. Tomorrow has yet to happen, though.

Of course, I had no way to know whether my orchiectomy would result in my experienced quality of life being improved or severely impaired following the orchiectomy; the best I could do was to make the best guess I could make and learn what happened. I did not expect my quality of life, in the absence of testosterone, to subjectively improve as much as it did, nor did I necessarily expect to be alive now. To me, life is quite profoundly iffy, and it is the iffy aspect of life that I find makes life an intriguing, sometimes freaky, adventure.

For me, there was a significant psychological pain that came with testosterone, psychological pain that left me when testosterone left me.

Having been through very painful cancer preventive surgery (the total colectomy), a nurse once asked me whether physical pain or psychological pain was more severe in my experience.

My personal and subjective experience, then, before then, and since then, is that psychological pain has, at times, been incomprehensibly more severe than physical pain has ever been. If the limit of physical pain I have known were put on a scale of ten on a zero-to-ten scale, I do not know what number to assign to the worst psychological pain I have experienced. On a scale of zero-to-ten, perhaps ten thousand might be a decent guess.

So, I will not tell anyone else what to expect as a result of an orchiectomy or as a result of anything else; I will merely describe my life experiences on the chance that someone may find my descriptions useful.

Severe psychological pain may sometimes find expression in so-called referred pain.

Pain, however, no matter of what form or from what aspect of life, simply is painful, and I hold that anyone with any useful semblance of self-respect will do whatever is necessary for bringing unmanageable pain of any sort into something manageable.

Tell me that I need testosterone to prevent bone fractures as I get older, and I will tell you that I will take the pain of fractures over the pain of testosterone...

[jockey_elance (imported)]

If it turn$ out the $urgery wa$ unecce$$ary, can you $ue the doctor?

There I fixed that for you Jockey_elance.

I swear, some people are always looking for a reason to sue.

--LT

I'm sorry if my comment about lawsuits offended people. His post was kind of confusing but he said something about the doctor misdiagnosing a tumor that wasn't really there. I see now that there was more to his situation. If a doctor removes part of your body and it turns out nothing was wrong, that could be a legitimate reason for a lawsuit, no? It wouldn't have to be just to get rich, the money might be needed to pay addition medical costs or even psychological counseling.

To the op, I hope everthing works out. You are lucky to have a wife who is supportive.