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Thread: Urologist suggested taking a 3 month medication 'vacation'. Thoughts?

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    TestingMe is offline Associate Member
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    Urologist suggested taking a 3 month medication 'vacation'. Thoughts?

    I've been on TRT for about 10 years..I inject .25 2x per week of Cypionate .

    My numbers are all good but on the last CBC the PSA was 3.95. It's creeped up the last 2-3 years from 2, 3 and now this.

    I'm 63 years old, no history of prostate cancer in my family. health is good.

    I've only been seeing this doctor for about 2 years and only have seen him twice.

    No one would be surprised by fast doctors who do not like questions. He really was an asshole. No other way to put it.

    i was polite and know how to handle myself around doctors, have friends who are doctors and am respected always..I wasn't used to the way he was staccato firing off things and really not listening to me.

    The sign of an arrogant ass.

    He forgot to order the urine test..he was too busy asking me "Who is the doctor here? you or me? WTF?

    Who speaks like this?

    OK, i vented!

    Here's the question i wanted to put out there.

    He said that if I had a 2-3 month 'drug vacation' i woudn't have to worry about donating blood or keeping track of iron, etc.

    I gently asked if he was suggesting it based on my results and he fired back. NO THIS IS WHAT I DO FOR ALL OF MY PATIENTS.

    Then he went into a speech about how no one knows if it is safe to be on TRT as there's no history over time. He preached about heart attack risk, stroke, prostate cancer. The works...As if i didn't know this and as if he wasn't prescribing it in the first place! Another wtf moment. it was really bizarre.

    The 'funny' thing is that I just wanted information and to undertand his reasoning and all he did was launch about 'drug vacation' and how we can stop it and then get baselines. and he can explain the dangers again and I can do what I want.

    He really sounded as if he couldn't care less if i dropped dead of a heart attack or stroke, as long as he knew he had explained the risks.

    Meanwhile I have noticed my urine seems cloudy but of course he didn't want to give a urine test because he forgot in the first place and didnt like the fact that I asked if he wanted me to have one.

    Clearly this is the wrong doctor for me. I was furious but didnt show it.

    They took blood for labs and new PSA.

    Thanks for reading what is mostly a rant.

    Any insight into the wisdom of taking a 'medication vacation' is very appreciated!

    Oh, I'll add that when i asked how his patients tolerated being on 2-3 month testosterone 'vacations', he looked at me with a blank stare and said, "they are all fine"

    I said, no problems? He said, "None"

    He then said if i stopoed and it bothered me too much I could start up?

    I do undersatnd that if my prostate is a concern then maybe we'd do this but a mandatory 'vacation'? Never heard of this ever.

    Oh, he also said. You inject .5 a week, I wanted you to inject once a week but you wanted to do it 2x a week. Now I prescribe .5 one time every 10 days.

    Genius!
    Last edited by TestingMe; 03-11-2020 at 09:38 PM.
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  2. #2
    Youthful55guy is offline Senior Member
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    The doc seems like both a jerk and an incompetent one at that. First off, did he check you for prostatitis? I recently had a very bad case of it and my PSA, which has be <<1 for over 10 years, suddenly shot up to over 87. I also had difficulty with urination. My urine did not show any signs of a bladder infection. My PCP (a really good doc) prescribed 40 days of ciprofloxacin and my PSA came down to my normal low values almost immediately (see the graph below). Most guys don't have such a bad case of acute prostatitis like I did. Usually it's more chronic and less severe, that may be what is pushing your PSA up.

    I would consider getting a second opinion and ask about the possibility of a chronic low grade prostatitis. The problem is that there is no reliable method of detection. The main method is somewhat unpleasant, which is why they don't do it regularly. The doc needs to insert a lubed finder up your rectum and aggressively massage the prostate until fluid comes out your penis and then they culture the fluid. My understanding is that it's only about 50% effective at detecting an infection. It may instead be worth simply doing a 30-40 day course of ciprofloxacin and see if your PSA goes down.
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  3. #3
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    Quote Originally Posted by Youthful55guy View Post
    The doc seems like both a jerk and an incompetent one at that. First off, did he check you for prostatitis? I recently had a very bad case of it and my PSA, which has be <<1 for over 10 years, suddenly shot up to over 87. I also had difficulty with urination. My urine did not show any signs of a bladder infection. My PCP (a really good doc) prescribed 40 days of ciprofloxacin and my PSA came down to my normal low values almost immediately (see the graph below). Most guys don't have such a bad case of acute prostatitis like I did. Usually it's more chronic and less severe, that may be what is pushing your PSA up.

    I would consider getting a second opinion and ask about the possibility of a chronic low grade prostatitis. The problem is that there is no reliable method of detection. The main method is somewhat unpleasant, which is why they don't do it regularly. The doc needs to insert a lubed finder up your rectum and aggressively massage the prostate until fluid comes out your penis and then they culture the fluid. My understanding is that it's only about 50% effective at detecting an infection. It may instead be worth simply doing a 30-40 day course of ciprofloxacin and see if your PSA goes down.
    He did the finger in the butt and said prostate was smooth.

    I'll get another doctor after I get the tests back.

    30-40 days of Cipro for me is not something I'd do unless there were no other options.

    I never heard of stopping TRT for a 'vacation' as he said he does for all of his patients...as if it's a non issue!

    THank you for the response!

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    Quote Originally Posted by cylon357 View Post
    The doc did 10 days of Doxycycline for my prostatitis but my PSA was only 5.3. It did bring my PSA down to its more 'normal' range of 3.5 to 3.8 though.

    Definitely agree about punting this doc.

    'Vacation' might make sense if he might 'you are blasting right now, and you need to cruise at your TRT dose'. That isn't what it sounds like here though. Sounds like he read an article that scared him (probably from some obscure liability perspective) and he is overreacting.

    Or maybe he is just a d!ck
    Thank you for the post.

    I got the PSA results with a message from the doctor at the same time..DANGEROUS RESULT PSA 5.0..REFER TO PROSTATE SPECIALIST.

    Fine with me. He is right this should get checked out but there are so many ways in which he was a prick to me I cant even remember them all.

    Oddly, he has great reviews.

    It doesn't seem unusual for urologists to be thorny assholes when it comes to TRT. Each doctor except one has been prickly and defensive and aggressive in being the expert and act in ways that show they are insecure and actually bothered so easily.

    I'll get it checked out but not going to take the medication vacation so fast.

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    Quote Originally Posted by cylon357 View Post
    The doc did 10 days of Doxycycline for my prostatitis but my PSA was only 5.3. It did bring my PSA down to its more 'normal' range of 3.5 to 3.8 though.

    Definitely agree about punting this doc.

    'Vacation' might make sense if he might 'you are blasting right now, and you need to cruise at your TRT dose'. That isn't what it sounds like here though. Sounds like he read an article that scared him (probably from some obscure liability perspective) and he is overreacting.

    Or maybe he is just a d!ck
    How did the doctor determine you had prostatitis?

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    C27H40O3 is offline Admin Sent Me Away.
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    If you just stop your TRT cold, you will not feel like getting out of bed for awhile. it will be worse than before you started it to begin with. it will be a noticeable difference in quality of life..
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    Quote Originally Posted by C27H40O3 View Post
    If you just stop your TRT cold, you will not feel like getting out of bed for awhile. it will be worse than before you started it to begin with. it will be a noticeable difference in quality of life..
    I was fine before i started but I hear you! I never heard of stopping for 3 months, just to stop and get numbers.. Not for TRT at least....Has anyone?

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    Quote Originally Posted by cylon357 View Post
    To be honest, he just took an educated guess based on my previous numbers and this somewhat sudden spike. I don't like to use antibiotics unless I have to, but it turned out to be a good call in this case. BTW, there was no apparent reason for my prostatitis. He says it just happens sometimes. With a sudden spike like I think you said you had, you might ask about it. It's probably cheaper and definitely easier than any test there might be (I don't even know if there is one).

    Edit: actually, I don't see your previous PSA score. Do you have it for comparison?
    Edit 2: Ok, I do see your previous PSA was 3.95. I would probably still give the antibiotics a shot.
    Do you by chance have your DHT numbers?
    Here's the previous test results

    I think there's more labs coming but don't know if he ordered DHT. Probably not.

    I will see a specialist next week to follow up on this.
    Attached Thumbnails Attached Thumbnails Urologist suggested taking a 3 month medication 'vacation'. Thoughts?-screen-shot-2020-03-13-12.07.15-am.jpg  
    Last edited by TestingMe; 03-13-2020 at 09:47 AM.

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    Quote Originally Posted by cylon357 View Post
    Looks like a pretty typical progression to me, based on age and the addition of TRT. I'll be interested to hear if you try the antibiotics.
    I went to see a surprisingly informed Nurse Practitioner yesterday. I did a urine sample and a swab test and get the results tomorrow. The hope is for an infection but I doubt it.

    If no infection then I have to schedule an MRI and then a biopsy..Good thing it's not a tense time and not something like a pandemic...umm.. It's nuts out there and I feel bad I have to do this when there's such a shortage of health care workers.

    I told her what the doctor had suggested about a 3 month 'vacation' from TRT..She'd never say anything about him of course as it's all part of the same practice but she was stunned. I had to repeat it three times. In fact, she did not encourage me to stop Testosterone either.

    But I do think there's a reasonable liklihood of Prostate Cancer and if that is the case they would want me to stop until after treatment. She stressed that they would not insist or want me off testosterone necessarily.

    Regardless, I have reduced the dosage 50% to .25 on Mondays. Not sure it matters to break that much into 2 doses.

    I'll do that and then probably stop altogether until this is sorted out.

    At least it's a state of the art hospital and I am getting top of the line information at this point.

    The nurse practitioner was amazing although the DRE was pretty rough to check for infection. I told my gf last night next tine I will say to the nurse to put her finger in, the way she would like it. I got a good laugh out of that..but my gf didn't find it all that funny for some reason.

    I asked the nurse to pick out another doctor for me and she found a specialist in prostate cancer and that is who will be doing the biopsy. She also said I'd be seeing another nurse practitioner for Test in the future.

    She felt the last PSA of 5, was likely incorrect. I'd like to think that too but I don't.

    This does all suck but the alternative sucks more!

    She said men get BPH and Prostate Cancer because we are living longer.

    I'd like to continue in that vein.

    Wish me luck and I will post how this all pans out.

    PS: she prescribed and i started Flomax last night. Didn;t get up one time for the bathroom but when i did, I got lightheaded as expected..that should calm down I hope!
    Last edited by TestingMe; 03-19-2020 at 08:27 PM.

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    Quote Originally Posted by cylon357 View Post
    To be honest, he just took an educated guess based on my previous numbers and this somewhat sudden spike. I don't like to use antibiotics unless I have to, but it turned out to be a good call in this case. BTW, there was no apparent reason for my prostatitis. He says it just happens sometimes. With a sudden spike like I think you said you had, you might ask about it. It's probably cheaper and definitely easier than any test there might be (I don't even know if there is one).


    Edit: actually, I don't see your previous PSA score. Do you have it for comparison?
    Edit 2: Ok, I do see your previous PSA was 3.95. I would probably still give the antibiotics a shot.
    Do you by chance have your DHT numbers?


    -------

    The doctor who i saw actually called me. He said, "You left two messages?" I said, actually no I didn't. I sent you an online message asking for my T results. He said he was busy and it takes 4 days to approve the release of them. I don;t know what is wrong with this guy but something is off with him. I said, since you called, can you order a DHT test? He said, he doesn't order DHT tests as they are hard to interpret and I should see an endocrinologist if I wanted one. He's just a nasty little shit and clearly he doesn't like me anymore than I like him.

    Even the T test he ordered was bare minimum..I don't know what is wrong with him. In the past I'd get a full workup. This time it was just Testosterone and Free Testosterone.

    I made sure to low key badmouth him to the NP and will do it for the rest of my life, which I hope is long!
    Attached Thumbnails Attached Thumbnails Urologist suggested taking a 3 month medication 'vacation'. Thoughts?-screen-shot-2020-03-19-7.48.08-pm.jpg  

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    Quote Originally Posted by cylon357 View Post
    Oh one other thing: see if you can find out which lab the doc uses for bloodwork. If it is Quest or Labcorp, you can register on their sites and get your results directly from them, typically. If they use their own in house lab, you might be SOL but maybe not, if there is a way to register through them separately. Key is to use all the same info to register so the records match.
    I am registered with mychart and it's usually great because my doctors release test results quickly and I have access to them. The urologist is the exception of course.

    This is a pretty high end state of the art hospital so at least I will be seeing great doctors with exceptions of course.

    The NP is 32 and very attractive. Seriously, really well dressed and commented how much she liked my Pepsi Rolex before giving me easily the most harsh DRE ever, bar none.

    So I guess be careful what we wish for? She was so bad it seemed likely part of her being 'professional'. Someone should talk to her about 'foreplay'.

    I had a Russian female doctor who first prescribed T..She gave me a rudimentary exam and said "When we get to know eachother better I will do a DRE". I said, "Doc, just stick the finger in and get it over with".

    I really don't want that NP to violate again!
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    Quote Originally Posted by cylon357 View Post
    And as Y55Guy and I both have suggested, I would damn sure give the antibiotics a shot BEFORE doing a biopsy. I think those have risks of their own.
    If you don't mind me asking, what were your numbers like to indicate you needed or wanted to try antibiotics? Age, PSA?

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    Quote Originally Posted by cylon357 View Post
    The doc did 10 days of Doxycycline for my prostatitis but my PSA was only 5.3. It did bring my PSA down to its more 'normal' range of 3.5 to 3.8 though.

    Definitely agree about punting this doc.

    'Vacation' might make sense if he might 'you are blasting right now, and you need to cruise at your TRT dose'. That isn't what it sounds like here though. Sounds like he read an article that scared him (probably from some obscure liability perspective) and he is overreacting.

    Or maybe he is just a d!ck
    Ah i see you did include your PSA. What was it in the years prior?

    The MRI doesn't sound fun but I will do it for sure. The biopsy is done if the score they determine from the MRI is about a 1 (I think)

    The NP and this place in general sounds like that don't fool around with this stuff. It's a major hospital that has money to burn it seems. I'd love to think they are over reacting but I'd be foolish to not do the MRI at the minimum and I do know there are some risks to the biopsy as well. I get the urine and the swab results tomorrow but really don't expect much in the way of good news or any real news from them.

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    C27H40O3 is offline Admin Sent Me Away.
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    Quote Originally Posted by cylon357 View Post
    Oh one other thing: see if you can find out which lab the doc uses for bloodwork. If it is Quest or Labcorp, you can register on their sites and get your results directly from them, typically. If they use their own in house lab, you might be SOL but maybe not, if there is a way to register through them separately. Key is to use all the same info to register so the records match.
    Absoluitely. I logged on and got the results of my CT scan and called the doctor to ask him about it. He called me the day before with the urine and blood work, but not the CT scan. he seemed surprised that i had the results in front of me.

    Its really a good time to be a patient who likes to take charge of his own healthcare and stay informed. The online lab signups for quest and labcorp found old labs from 5 years ago.

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    Quote Originally Posted by C27H40O3 View Post
    Absoluitely. I logged on and got the results of my CT scan and called the doctor to ask him about it. He called me the day before with the urine and blood work, but not the CT scan. he seemed surprised that i had the results in front of me.

    Its really a good time to be a patient who likes to take charge of his own healthcare and stay informed. The online lab signups for quest and labcorp found old labs from 5 years ago.
    I have access to all test results but the doctors have to release them to get posted to mychart. Most of them do so pretty quickly but we never get to see results before them.

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    C27H40O3 is offline Admin Sent Me Away.
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    Quote Originally Posted by TestingMe View Post
    The nurse practitioner was amazing although the DRE was pretty rough to check for infection. I told my gf last night next tine I will say to the nurse to put her finger in, the way she would like it. I got a good laugh out of that..but my gf didn't find it all that funny for some reason.
    Talk about jokes. My guy suggested that exam a couple of years ago when I had blood in the toilet. When I am leaning over his desk, and he was putting the lube on his glove, he wanted to break the ice. He said, during the test, you will feel my hand on one shoulder. If you feel my hands on both shoulders during the test, you can call the cops.

    Just as i started to crack up, he snuck the finger in. The diversion worked.
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    C27H40O3 is offline Admin Sent Me Away.
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    Another good joke for the doctors office. Before my son was born, I would go to the OB/gyn doctor with my girl. When the female doctor was looking in there with her speculum, I said "See if you can find my college ring while you're in there. I havent seen it in years." She was like "oh my God, you're kidding, right?"

    I told the doc that she probably heard that one a hundred times, she said "actually, never".

    i saw it in a movie years ago and i always thought it was hysterical.
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    Quote Originally Posted by C27H40O3 View Post
    Talk about jokes. My guy suggested that exam a couple of years ago when I had blood in the toilet. When I am leaning over his desk, and he was putting the lube on his glove, he wanted to break the ice. He said, during the test, you will feel my hand on one shoulder. If you feel my hands on both shoulders during the test, you can call the cops.

    Just as i started to crack up, he snuck the finger in. The diversion worked.
    Nothing quite like doctor visit jokes. I can use all the laughs I can get as I do have expected anxiety about all of this, more than ever during such bizarre times!

    I made the appointment for the Prostate MRI, as I want to get as much of this over as fast as I can considering this pandemic.

    After I made the appointment I got a message from the NP: "Urine culture is not final yet, but it does seem to have a very slight bacteria, should finalize today or tomorrow. I'll give you a buzz once I have final results. Might want to wait a couple weeks for the symptoms to resolve and recheck your psa and get an MRI

    Again we'll chat once it is finalized"

    I almost wish I said that DRE joke and I am sure she would have handled it well but these days you never know! I can make fast wisecracks without thinking...Glad I didnt; suggest she do the DRE the way she'd like it done to her...but I still laugh everytime I think about it.

    My gf said "WE WANT BACTERIA!" Then she rubbed her finger on the bottom of her shoe and said "Are you ready for this?"
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    I messaged the NP and said I have some discomfort and mentioned maybe antibiotics. She immediately prescribed Cipro for 5 days. She did it so fast as I think she might had done it anyway.

    The swab and urine test results came in too. Not sure what i was hoping for but..starting antibiotics today and wonder that she may have prescribed them as a routine for after the DRE prostate 'massage'.
    Attached Thumbnails Attached Thumbnails Urologist suggested taking a 3 month medication 'vacation'. Thoughts?-post-2.jpg   Urologist suggested taking a 3 month medication 'vacation'. Thoughts?-post.png  
    Last edited by TestingMe; 03-20-2020 at 04:01 PM.

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    Before giving up the test, I would try dutasteride and if its too harsh go with finasteride.
    -
    A blood test following a DRE will show inaccurately inflated PSA numbers.
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    balin is offline Junior Member
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    Does he suggest the same for his patients on insulin . Or women on birthcontrol?
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    It's going to suck coming off it being on for that long. One "vacation" you'll want to avoid.
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    I stopped the Flomax and actually have less inflammation or a sensation of burning. Had no idea that can be a side effect!

    The NP prescribed Uroxatral but I don't think I need anything and certainly not now.

    So the plan is another PSA at the end of May, then depending on results the MRI.

    All of this has been a bit of a mind fvck as I start to worry.

    Thank you for all the replies. I'll update this when I get the results of the tests!
    Last edited by TestingMe; 04-27-2020 at 12:54 PM.

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    Figured it's time to update.

    I have an appointment for a CT Scan tomorrow and a meeting with the doctor Monday.

    The MRI revealed some inflammation with in his words, "Low likelihood of prostate cancer" along with "Let's get the CT scan to find out what might be causing PSA to be rising" and finally, "I don't see any reason to do a biopsy".

    As I was talking to the doctor trying to explain the feeling I have been having when I urinate, I said that I have a history of kidney stones and maybe that's what is causing this. He looked at my chart and said 3 years ago I had a 5mm stone and let's see where it is on the CT scan.

    Lo and behold...I passed a kidney stone last night! WTF. I've had them twice with hospital visits. I didn't have any of that sort of pain and my guess is that it's because I started up the Flomax again.

    Amazingly I saw the stone when I was not even looking for it. Fished it out. Took a picture and send to the NP who wrote back, "Ah, that might answer a lot of questions"

    To soon for a victory dance but I have to admit I've been pretty damn nervous.

    I'll update this thread once I get the next test and see the doctor.

    I guess a 3 month Testosterone vacation won't be called for...Unbelievable.
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    Quote Originally Posted by TestingMe View Post
    Figured it's time to update.

    I have an appointment for a CT Scan tomorrow and a meeting with the doctor Monday.

    The MRI revealed some inflammation with in his words, "Low likelihood of prostate cancer" along with "Let's get the CT scan to find out what might be causing PSA to be rising" and finally, "I don't see any reason to do a biopsy".

    As I was talking to the doctor trying to explain the feeling I have been having when I urinate, I said that I have a history of kidney stones and maybe that's what is causing this. He looked at my chart and said 3 years ago I had a 5mm stone and let's see where it is on the CT scan.

    Lo and behold...I passed a kidney stone last night! WTF. I've had them twice with hospital visits. I didn't have any of that sort of pain and my guess is that it's because I started up the Flomax again.

    Amazingly I saw the stone when I was not even looking for it. Fished it out. Took a picture and send to the NP who wrote back, "Ah, that might answer a lot of questions"

    To soon for a victory dance but I have to admit I've been pretty damn nervous.

    I'll update this thread once I get the next test and see the doctor.

    I guess a 3 month Testosterone vacation won't be called for...Unbelievable.
    Have you ever had one of your stones analyzed to see what it is composed of? Sometimes it is caused by an imbalance in your body chemistry.

    3 month vacation from T....I probably/ doubtfully would do that.

    Make a dietary adjustment or take an additional med... probably so if they got to be very frequent. Kidney stones can be ridiculously painful.

    Good luck.
    Last edited by almostgone; 06-07-2020 at 06:29 PM.
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    I had kidney stones 10 years ago..the hospital actually lost them, so they never were analyzed.

    This one I will bring in to be analyzed on the next visit.

    I can't find much or anything if a kidney stone can cause PSA to rise. I will get the CT scan and another test in a couple of weeks but for now I am relieved I don't have prostate cancer.. I really was starting to worry.

    My diet is fine and I drink a lot of water. I'll have more information when the stone is checked out and teh other tests are done.

    Thank you for the response!

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    Test result

    Well, got the test result on the suspected kidney stone..My girlfriend was convinced it was from a candy bar but seems to be mostly Uric Acid.

    I'm still relieved the MRI prostate test wasn't bad.

    Still need the CT scan but I'll get it done this summer.

    Wish i could find definitive connection to the way the PSA has risen and the kidney stone being a cause..

    Maybe get the CT in July and not wait too long.

    Time to close this thread out..

    Oh the asshole Urologist that got me started on making this thread. Hasn't prescribed the Test..He's really the worst.

    Luckily I probably have a years supply or more, just knowing I will never let a doctor lord over me as he is trying to do now.

    I'm considering filing a complaint with the hospital he is affiliated with. But I want to wait till after the CT scan is done and I get the all clear.

    This guy went too far too many times. Who the f stops Test to ALL of his patients every two years??? I can't believe it or have heard anything like this ever.

    I'll post when I get the final tests and hope they go well.

    The new Urologist is light years ahead of the jackass doctor but he doesn't get involved with this.
    Attached Thumbnails Attached Thumbnails Urologist suggested taking a 3 month medication 'vacation'. Thoughts?-screen-shot-2020-06-22-11.53.24-pm.jpg  

  28. #28
    C27H40O3 is offline Admin Sent Me Away.
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    Ask him if he would recommend that a transvestite girl, who is changing into a man, stop her testosterone for three months.

    If he wouldn’t stop her because she needs it to stay healthy, why would he think you don’t need it to stay healthy.


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  29. #29
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    Quote Originally Posted by TestingMe View Post
    Well, got the test result on the suspected kidney stone..My girlfriend was convinced it was from a candy bar but seems to be mostly Uric Acid.

    I'm still relieved the MRI prostate test wasn't bad.

    Still need the CT scan but I'll get it done this summer.

    Wish i could find definitive connection to the way the PSA has risen and the kidney stone being a cause..

    Maybe get the CT in July and not wait too long.

    Time to close this thread out..

    Oh the asshole Urologist that got me started on making this thread. Hasn't prescribed the Test..He's really the worst.

    Luckily I probably have a years supply or more, just knowing I will never let a doctor lord over me as he is trying to do now.

    I'm considering filing a complaint with the hospital he is affiliated with. But I want to wait till after the CT scan is done and I get the all clear.

    This guy went too far too many times. Who the f stops Test to ALL of his patients every two years??? I can't believe it or have heard anything like this ever.

    I'll post when I get the final tests and hope they go well.

    The new Urologist is light years ahead of the jackass doctor but he doesn't get involved with this.
    A dietary adjustment may help with the uric acid issues of it gets to be a chronic problem. Have you ever had any problems with gout?
    There are 3 loves in my life: my wife, my English mastiffs, and my weightlifting....Man, my wife gets really pissed when I get the 3 confused...
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    Never had gout problem. This was by far the mildest passing of a kidney stone but still I had inflammation and some symptoms I believe caused by the stone. About 3-4 years ago I had some imaging test, i forgot the name and the stone was if I remember 7mm. The one that passed I think was 4mm and guessing it's the same one. The CT scan should give more information if there are more. I think the doctor had said this might be the old 7mm that has slowly broke apart but no real idea yet.

    I had started and stopped taking the Flomax and the second Urologist agreed until we figured out what was going on..BUt..instinctively I started back on the a few days before passing the stone...hours after a video appointment where I mentioned I had a feeling maybe it was all caused by a kidney stone..He didn't want to guess. Can't blame him..Going for CT test soon..Be happy to put this experience behind me!

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    Thank you for all the support and replies as always. THought I should update the thread.

    2020, what a year for all of us!

    I finally got a CT scan and hopefully what was found is the reason for the high PSA, frequency and urgency of urination...A 1.25cm bladder stone!

    I do have a history of kidney stones and it's possible/likely that one made it's way into the bladder and with prostate being enlarged, 65 grams? and perhaps with not drinking enough water or who knows what, either a small kidney stone turned into a bladder stone or it just started on it's own.

    I have a laser outpatient surgery set up for January 4th.

    No guarantees of how much this will improve things but the doctor did say it's not small and while some men have stones that size and larger with no symptoms, the stone, if not causing the issues is at least likely to be making them worse.

    I nervously asked him about TRT, as the original idiot doctor wanted me off TRT, for no reason whatsoever.. He said, well that would mean we dont want to give you drugs to reduce prostate as it causes loss of libido, energy, etc..I forgot the name of the drug.

    Well, in summary for this long story, I guess it's all the best outcome. Not cancer, treatable in outpatient, almost zero recovery time and no stent.

    My only concern is prostate size of 65 grams, which might be one of the causes of the bladder stone.

    I clearly do not want to stop TRT but am concerned about prostate size but he didn't suggest stopping but I am making an educated guess the other new urologist might very well suggest stopping TRT due to this concern..

    Hope everyone has a happy holiday and New Year!

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    What is your TRT regimen?

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    Quote Originally Posted by TestingMe View Post
    I nervously asked him about TRT, as the original idiot doctor wanted me off TRT, for no reason whatsoever.. He said, well that would mean we dont want to give you drugs to reduce prostate as it causes loss of libido, energy, etc..I forgot the name of the drug.

    Probably Finasteride or Dutasteride. Remember that prostates can grow, either from AAS usage or simply from aging.
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    Quote Originally Posted by The Deadlifting Dog View Post
    What is your TRT regimen?
    .25ml twice weekly. Getting blood work done next week.

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    Quote Originally Posted by kelkel View Post
    Probably Finasteride or Dutasteride. Remember that prostates can grow, either from AAS usage or simply from aging.
    I think he said Dutasteride and when I mentioned Testosterone , he said then you probably don't want that. He did reference prostate size being big a few times.. His specialty is stone removal but the new urologist who i only had one video chat with, was wondering why i was taking Testosterone in the first place. The way he asked, it sounded like it was so unusual.

    My hunch is he will suggest stopping it and I just want to be best educated if and when he does.

    I'll be 64 in March...My guess is this 1.25 bladder stone is the main reason for the changes in urination..the doctor agreed..

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    Quote Originally Posted by TestingMe View Post
    I think he said Dutasteride and when I mentioned Testosterone , he said then you probably don't want that. He did reference prostate size being big a few times.. His specialty is stone removal but the new urologist who i only had one video chat with, was wondering why i was taking Testosterone in the first place. The way he asked, it sounded like it was so unusual.

    My hunch is he will suggest stopping it and I just want to be best educated if and when he does.

    I'll be 64 in March...My guess is this 1.25 bladder stone is the main reason for the changes in urination..the doctor agreed..

    No reason to stop TRT. Lower the dose, maybe. When doctors make blanket statements like stopping TRT it irritates the hell out of me. They're the same ones who say just accept getting older. Bullshit. Makes you wonder why they become doctors and get advanced degrees in medicine only to discourage efficacious use of them.
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    Quote Originally Posted by TestingMe View Post
    I think he said Dutasteride and when I mentioned Testosterone , he said then you probably don't want that. He did reference prostate size being big a few times.. His specialty is stone removal but the new urologist who i only had one video chat with, was wondering why i was taking Testosterone in the first place. The way he asked, it sounded like it was so unusual.

    My hunch is he will suggest stopping it and I just want to be best educated if and when he does.

    I'll be 64 in March...My guess is this 1.25 bladder stone is the main reason for the changes in urination..the doctor agreed..
    Dutasteride is a type 1 blocker. Meaning it blocks about 90% of test turning to DHT via the 5AR enzyme. Finasteride is a type 2 blocker and cancels out about 70% of turnover from T to DHT. I've been on 5 mgs Fina for years due to BPH. Zero side effects. That said, sure some can get sides from it just like they can any other drug. We all respond differently. Finasteride is the same drug guys are prescribed (in a lower dose @1mg) to help curb hair loss.
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    Quote Originally Posted by kelkel View Post
    No reason to stop TRT. Lower the dose, maybe. When doctors make blanket statements like stopping TRT it irritates the hell out of me. They're the same ones who say just accept getting older. Bullshit. Makes you wonder why they become doctors and get advanced degrees in medicine only to discourage efficacious use of them.
    I was thinking the same thing and I will reduce it starting tonight as I am on Monday/Friday. The idiot first urologist and I mean idiot in the truest sense was the one who wanted me to stop just for the sake of stopping...you can't make this shit up..it's very disturbing, I'd like to see him do that to himself.

    He also almost spit at me when I told him I take the test 2x a week..He was offended and I mean it...his response was "Now I have a new protocol for my patients, I have them take it every 10 days".

    For no good reason, as I am very well spoken and respectful, he seems threatened and challenged by me and is a smirky smug POS.

    The new urologist is very different. Top of the food chain and respectful but my educated guess is he will suggest to stop Test. I'll do my own research and cross that bridge if it comes to that.

    Thanks for the post

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    Quote Originally Posted by kelkel View Post
    Dutasteride is a type 1 blocker. Meaning it blocks about 90% of test turning to DHT via the 5AR enzyme. Finasteride is a type 2 blocker and cancels out about 70% of turnover from T to DHT. I've been on 5 mgs Fina for years due to BPH. Zero side effects. That said, sure some can get sides from it just like they can any other drug. We all respond differently. Finasteride is the same drug guys are prescribed (in a lower dose @1mg) to help curb hair loss.
    Wow, that is hugely helpful to hear this. It will also be interesting to see how PSA is effected after things settle down when stone is removed.

    Has the Finasteride helped with the BPH? Did you get a prostate MRI and if so do you know the prostate size? I don't even know if i have BPH as the issue was first the prostate MRI which slowed low likelihood of cancer.

    The high PSA as the doctor confirmed might be a result of the stone as well as there are a couple of small kidney stones around too.

  40. #40
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    Quote Originally Posted by kelkel View Post
    Probably Finasteride or Dutasteride. Remember that prostates can grow, either from AAS usage or simply from aging.
    I used flowmax for a while and besides giving me IBS for almost 3 months it did nothing for me having to get up 5x a night. My BPH is only at 2.2, 2.0 in 2019 and 1.34 in 2018. I think I am going to give the Finistride a try since I have that. If not maybe the ciprofloxacin wouldnt hurt for 30 days?

    Sorry, not trying to hijack your thread, just seem to have some similar questions.

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