Hi Folks, Thanks for all the good wishes!
Busy at work, so this is the first chance to talk abou the T appointment. The doc had his resident come in and examined me first (including a nifty part where he gave the twins a good squeeze-yowww!). Then he reported everything to the Big Chief T doc.
When I had the PSA drawn, I also asked to have a T level, too. When I sat down with the T doc, he told me the new level was 166. He said that was not good (Really!). He suggested that I start on gel supplementation again. He looked over my post op pathology report, and was confident that,because of negative margins, nodes, and vesicles, I could start on supplementation. I said, what about any occult cancer cells that could have gotten out during the surgery. He said he didn't think that happened, BUT, in case it did, it is better to know earlier than later. He said starting on the T is a "provocative test," but in case there is any cancer still there, it is most likely in the prostate bed area, and would be better treated with radiation earlier, than if it lay there and then broke away and went somewhere else. So, he started me on one tube of Testim 1% each morning. I had some Androgel left from before, but it was just a month over expiration date. He said to check the pharmacy to see if I could still use it (expensive to throw away, and I have 2 boxes (months) worth). He gave me week of Testim samples. He told me to come back in one month, and I would have another PSA (the fateful test!) and a T level to see how well I am absorbing it.
While I was getting around to call the pharmacy, I started the Testim. It is new. Has anyone tried it? I don't know what testosterone smells like, but this stuff has the scent of a musk cologne that I used in college (ca. 40 years ago). I grew not to like that cologne, and this gel has a stronger scent that lasts all day! I looked on the package insert and it didn't say that they added fragrance to gel (who needs scented medicine, anyway?). I found out that the Androgel may be okay for another two or three months, so I am going to use it up, and talk to the doc about changing back to the Unscented Androgel for long-term. It is a little thing, but the only place you can apply Testim is on your shoulders and upper arms, and this is close to your nose.
He asked about erections and I told him nothing doing, even with meds. He is the one that wrote a paper about needing T for the neurovascular bundles to recover and that T helps Viagra and the other oral medications to work. He thought this might help me recover faster, but told me to stay on my 25mg of Viagra every night, six or so nights a week, but go to 100mg for sex, and to add to it the 1000-microgram MUSE application. He said, which I hadn't been clear on, that I needed to have the Viagra on an empty stomach because any food will delay absorbtion or make it useless. He also said to use a pump every day but not to use the ring, just leave the thing pumped up for 5 or 10 minutes to keep the tissues inflated.
So, now I am in this experiment on my own body to see if the PSA is going to rise with the magic gel. After 5 days of supplements, I haven't felt any different - no increase in energy or strength, but it may take a while, since I am so low to begin with. I am also on Cymbalta, and that hasn't lifted my mood yet, but I am not lower, either. The low PSA did a lot to raise my mood, and hopefully it'll stay low, even with the T.
Will keep you all posted, and thanks so much again!
PSA (10/04): 2.9; PSA (2/06):4.4, on Androgel (serum T about 450) at age 56; negative DRE, no symptoms.
PSA (5/06):5.7 with a free PSA% of 8, OFF Androgel (serum T 163).
Biopsy (5/06): 4/12 samples positive; postitive samples only on right side; max Gleason 4+3=7 (in 2 of the 4 -from area nearest bladder. One was 40% of sample, the others less than a mm. thick.
DaVinci robotic-assisted laparoscopic radical prostatectomy + bladder lift + Right nerve plastic surgery (8/23/06).
Catheter out 4 weeks postop, due to internal pinhole leak at bladder-urethra junction.
Pads-Not needed after about 2 weeks post-cath, but gotta go a lot more often.
Final pathology report:T2c-both sides,but in capsule; neg. margins, neg. lymph nodes, neg. seminal vesicles; final max Gleason still 4+3=7.
1st Follow-up PSA (11/7/06): <0.008 !!!; serum T: 195 - still OFF Androgel (at present). Low T may delay return of erectile function (in presence of one damaged nerve).
2nd Follow-up PSA (3/19/07): <0.003 !!!; serum T: pending
Testosterone Level (3/19/07): 163, down from November 2006!
Uro-Endocrinology Consult (3/28/07): Prescribed Testim gel 1% once a day, and recheck PSA and T-level in a month.