Doc Update

2 days removed from my doctor appointment with one of the top endocrinologists in my region. She came highly recommended by my endo (who I feel wanted me out of his hair; can’t blame him)

Regardless, my appointment lasted 1.5hrs. It was basically this:

Results:
-my pituitary cyst is realistically not causing my testosterone problems and is probably just coincidence. I agree…except
why isn’t my body producing TRH/TSH or prolactin normally?? Her answer=IDK…
-My ED is in my head
-You have a complex thyroid problem but it appears to be fine since your labs are all in the normal range.
-Explained away all my symptoms as to other things (cold feet=cold room, constipation=bad diet, dehydration etc, no morning wood, fatigue=sleep apnea, low libido=mental problems)
-Despite having 4 labs that showed low testosterone and one lab taken when I was 12 with total testosterone at 24ng/dl(!), said that FT is more impt and since my FT was basically middle of range, my problem wasn’t due to low T. I didn’t help my situation by walking in with a massive beard.
-Shortening the T injection interval will result in polycythemia and enlarged prostate (?)
-If I’m taking Cialis and it works, what’s the problem?
-She rarely sees patients with TT>700 that aren’t on TRT.

She basically concluded (without specifically saying so) that I am a hypochondriac. By focusing on my problem, I make it worse. And you know what? I actually agree with her. I do! I think she’s right to some degree. I see so many guys panic and that makes themselves worse and I am probably one of them. However, I am single, thankfully, so the pressure to perform I felt with 3 other girls is off!

Regardless, I made myself a promise to feel better because I have ONE life and all of us have the obligation to ourselves to make sure we feel our best so we can focus on other things in life.

My conclusion/take away:
-I personally am avoiding medical/research hospitals. IMO, they have less flexibility to treat patients since all of the doctors are employed by the university, which requires them to be more conservative. Not their fault, but not going to get the “optimized treatment” I seek out. It’s like they use a shotgun vs a sniper rifle approach. They use “one size fits all”.
-The best referrals are usually patients with similar problems, not an esteemed colleague of the doctor haha! I noticed some subtle antipathy from this doctor that I would dare question my original endos professional opinion!
-Urologists are much more aggressive. In my one appt with a uro, I got Cialis. In 4 appts with my original endo, I got nowhere. I’m sticking to a uro for my T issues.
-Im going to overcome this BS regardless. This appt is just one bump in the road. On to the next doctor!

HAN-I can’t afford a trip to Philly.

JEZUSS

it really is almost criminal how most doctors act, misdiagnosis, refuse to listen to their customers, refuse to consider something that they themselves did not think of first, demean their customers, undermine their customers, talk down to their customers, refuse to run simple blood tests to confirm or deny a possible diagnosis (they know better after all), insist on using the lab ranges printed on the lab charts despite muerous studies indicating those are bogus ranges, have extremely fragile egos and can not stand to engage in discussions regarding their recommendations (and god forbid you ask for a second opinion).

compounding pharmacies can usually give good referrals to doctors who think more outside the box, but be careful, because there is such a thing as too far out of the box.

No wonder medical errors, misdiagnosis, etc. are one of the top causes of death each year.

Here is an old article about it. Some say it could be the #1 or #2 killer nowadays.

The JOURNAL of the AMERICAN MEDICAL ASSOCIATION (JAMA) Vol 284, No 4, July 26th 2000 article written by Dr Barbara Starfield, MD, MPH, of the Johns Hopkins School of Hygiene and Public Health, shows that medical errors may be the third leading cause of death in the United States.

The report apparently shows there are
2,000 deaths/year from unnecessary surgery;
7000 deaths/year from medication errors in hospitals;
20,000 deaths/year from other errors in hospitals;
80,000 deaths/year from infections in hospitals;
106,000 deaths/year from non-error, adverse effects of medications

  • these total up to 225,000 deaths per year in the US from iatrogenic causes which ranks these deaths as the # 3 killer. Iatrogenic is a term used when a patient dies as a direct result of treatments by a physician, whether it is from misdiagnosis of the ailment or from adverse drug reactions used to treat the illness.

and just how the heck would having stable T levels cause polycythemia??? Does she think that TD Test cause polycythemia??? OMG… I just read about it on Wiki…

“People whose testosterone levels are high because of the use anabolic steroids, including athletes who abuse steroids and people whose doctors put them on doses that are too high, as well as people who take erythropoietin may develop secondary polycythemia.”

so basically she is saying that just because you asked about injecting more frequently means you are a steriod abuser and apparantly want T levels of 2000+. That is just plain asinine.

My endo was worthless as well. After bloodwork he told me my low t symptoms were in my head and to see a psychologist/psychiatrist. It’s so frustrating just keep searching for help like your doing. Good luck and keep us posted.

[quote]PureChance wrote:
No wonder medical errors, misdiagnosis, etc. are one of the top causes of death each year.

Here is an old article about it. Some say it could be the #1 or #2 killer nowadays.

The JOURNAL of the AMERICAN MEDICAL ASSOCIATION (JAMA) Vol 284, No 4, July 26th 2000 article written by Dr Barbara Starfield, MD, MPH, of the Johns Hopkins School of Hygiene and Public Health, shows that medical errors may be the third leading cause of death in the United States.

The report apparently shows there are
2,000 deaths/year from unnecessary surgery;
7000 deaths/year from medication errors in hospitals;
20,000 deaths/year from other errors in hospitals;
80,000 deaths/year from infections in hospitals;
106,000 deaths/year from non-error, adverse effects of medications

  • these total up to 225,000 deaths per year in the US from iatrogenic causes which ranks these deaths as the # 3 killer. Iatrogenic is a term used when a patient dies as a direct result of treatments by a physician, whether it is from misdiagnosis of the ailment or from adverse drug reactions used to treat the illness.

[/quote]

30 million guys with Low T. 5% probably seek treatment. 0.5% of that 5% probably get it. 0.1% of that 0.5% probably get the right treatment.

Yeah. I basically drove 10hrs in two days to see that doctor hahaha!

Pure, I agree. The problem is this: they’re academics. They teach. They can’t close the gap between reality and academia. I would love to interview their TRT patients and see how well they feel on their regimens. My guess as to their choice: 5g Androgel every day OR 150 mg Test Cyp EOW.

Typical Endo Appt (This is very tongue in cheek and only about 30% is true)
Okay Mr. Wilson, you say you’re having problems “downstairs”, you’re not waking up with…“morning…wood”? You mean nocturnal erections right? Eh…those go away with age. At 24, you’re not exactly young anymore, ya know? How’s your libido? Non-existent? Me too buddy! Gotta hate that stress from work, right? Hell, my libido goes down every year I’m with my wife, HEY-O! HANG TEN! I mean…High Five! You know what I’m talking about? Extreme fatigue despite the fact you’re getting 8-10 hours a night? You must drink too much.

Okay, let’s look at your blood work…TT was flagged as extremely low, and by a little low I mean you’re basically a castrated pre-pubescent child but your FT is normal for an adult male. 80 year-olds count as adults right? Well, Mr. Wilson, I’m not going to give you those steroids you asked for, “testosterone cypionate”, despite the fact that countless studies have proven that their benefits outweigh their risks, they’ll give you…PROSTATE CANCER! Ooooooh! Well…you really look like you’re suffering since you’re crying like a little bitch out of pure desperation and low testosterone levels…and I NORMALLY don’t do this for my patients…buuuuuut I’ll give you 2.5mg of Androgel daily. This should definitely shut down your entire testosterone production and make you feel much worse than you did previously and get ya back on your feet. Do NOT tell anyone I did this despite the fact that it’s becoming more common practice. I don’t want to get my license revoked.

Mr. Wilson, before you attempt to pull out that study you printed out from a much more authoritative source than me and photocopies from an endocrinology textbook that totally disproves every piece of medical advice I have ever given, I’ll remind you that I, NOT YOU, am an MD, I went to medical school in the Caribbean, class of 1958, and not much has changed since then except the discovery of AIDS. I don’t come to your work and tell you how to do whatever it is that you do, though I’d likely get my ass kicked if I showed up there considering all the horror stories your co-workers have heard about me and the equally shitty care I provide them. You have no other choice because you’re poor and have shitty insurance. That’s why you get shitty care!

Patient #515088, I mean, Mr. Wilson, I can’t believe you would have the NERVE to research your condition extensively, understand the advantages and disadvantages of each method of delivery, have attempted to rule out everything except TRT and have come to me as a last resort in a last ditch effort to solve your problem. You don’t know what to do? Well, Neither do I. You’re screwed…I mean…It’s all in your head. WHOA!!! Look at the time! I’ve spent 7 minutes with you, that’s 5 minutes longer than I wanted to, and I got at least 37 other patients to see today so I can hit the links before lunchtime. Alll righty, let’s see, we’ll see you in 6 mos…here’s your lab order form for TSH…and that’ll do it! (DOOR SLAM)

Damn…this board is therapeutic.

Either way, I’m going to private practice (both Uro and Endo). They have much more flexibility, have more patient experience, are probably more aggressive, and will more than likely develop a better relationship with me than my endos, who scolded me and took my full beard and broad shoulders as an indication that my testosterone levels were normal and I just wanted a hand out for Test. If I wanted test, I could get test. I just wanted their knowledge and wanted to see what CAUSED the damn problem before I resorted to self treatment like I already did! What’s causing the damn problem?! Ohhh wait, I know…it’s in my head. Yep, I imagined everything. LMAO.

[quote]JLWilson wrote:
Yeah. I basically drove 10hrs in two days to see that doctor hahaha!

Pure, I agree. The problem is this: they’re academics. They teach. They can’t close the gap between reality and academia. I would love to interview their TRT patients and see how well they feel on their regimens. My guess as to their choice: 5g Androgel every day OR 150 mg Test Cyp EOW.

Typical Endo Appt (This is very tongue in cheek and only about 30% is true)
Okay Mr. Wilson, you say you’re having problems “downstairs”, you’re not waking up with…“morning…wood”? You mean nocturnal erections right? Eh…those go away with age. At 24, you’re not exactly young anymore, ya know? How’s your libido? Non-existent? Me too buddy! Gotta hate that stress from work, right? Hell, my libido goes down every year I’m with my wife, HEY-O! HANG TEN! I mean…High Five! You know what I’m talking about? Extreme fatigue despite the fact you’re getting 8-10 hours a night? You must drink too much.

Okay, let’s look at your blood work…TT was flagged as extremely low, and by a little low I mean you’re basically a castrated pre-pubescent child but your FT is normal for an adult male. 80 year-olds count as adults right? Well, Mr. Wilson, I’m not going to give you those steroids you asked for, “testosterone cypionate”, despite the fact that countless studies have proven that their benefits outweigh their risks, they’ll give you…PROSTATE CANCER! Ooooooh! Well…you really look like you’re suffering since you’re crying like a little bitch out of pure desperation and low testosterone levels…and I NORMALLY don’t do this for my patients…buuuuuut I’ll give you 2.5mg of Androgel daily. This should definitely shut down your entire testosterone production and make you feel much worse than you did previously and get ya back on your feet. Do NOT tell anyone I did this despite the fact that it’s becoming more common practice. I don’t want to get my license revoked.

Mr. Wilson, before you attempt to pull out that study you printed out from a much more authoritative source than me and photocopies from an endocrinology textbook that totally disproves every piece of medical advice I have ever given, I’ll remind you that I, NOT YOU, am an MD, I went to medical school in the Caribbean, class of 1958, and not much has changed since then except the discovery of AIDS. I don’t come to your work and tell you how to do whatever it is that you do, though I’d likely get my ass kicked if I showed up there considering all the horror stories your co-workers have heard about me and the equally shitty care I provide them. You have no other choice because you’re poor and have shitty insurance. That’s why you get shitty care!

Patient #515088, I mean, Mr. Wilson, I can’t believe you would have the NERVE to research your condition extensively, understand the advantages and disadvantages of each method of delivery, have attempted to rule out everything except TRT and have come to me as a last resort in a last ditch effort to solve your problem. You don’t know what to do? Well, Neither do I. You’re screwed…I mean…It’s all in your head. WHOA!!! Look at the time! I’ve spent 7 minutes with you, that’s 5 minutes longer than I wanted to, and I got at least 37 other patients to see today so I can hit the links before lunchtime. Alll righty, let’s see, we’ll see you in 6 mos…here’s your lab order form for TSH…and that’ll do it! (DOOR SLAM)

Damn…this board is therapeutic.

Either way, I’m going to private practice (both Uro and Endo). They have much more flexibility, have more patient experience, are probably more aggressive, and will more than likely develop a better relationship with me than my endos, who scolded me and took my full beard and broad shoulders as an indication that my testosterone levels were normal and I just wanted a hand out for Test. If I wanted test, I could get test. I just wanted their knowledge and wanted to see what CAUSED the damn problem before I resorted to self treatment like I already did! What’s causing the damn problem?! Ohhh wait, I know…it’s in my head. Yep, I imagined everything. LMAO.

A classic. Should be a sticky.

[/quote]

[quote]JLWilson wrote:
Typical Endo Appt (This is basically reality and about 99% is true)
[/quote]

I fixed it for you.