First Endo Appointment - Discussion

[StinkyFinga]

I had my appointment, overall I think it went "ok" but I let my scatterbrain take over and now I'm confused.

I explained to her my history, she explained to me it could be depression, it could be the anti-depressants, it could be a mixture of everything so she is going to run blood tests. I didn't realize until I got home that she left some key tests off the list

Here is what she has ordered:
Complete Metabolic Panel
Iron Profile
CBC no Differential
Cortisol
Estradiol
FSH
LH
Prolactin
Testosterone - Bio Available (no total or free test checked...only bio available)
ACTH (no idea what this is)
Vitamin D 25-Hydroxy


No SHBG? She has recent thyroid tests so she isn't ordering those again. I don't understand why no SHBG. Is it important when she is doing bio-available? Maybe she isn't ordering total testosterone because she has my results from a few months ago. Uggghhhh. I hate being a dumbass scatterbrain.

[powerlifterty16]

I had my appointment, overall I think it went "ok" but I let my scatterbrain take over and now I'm confused.

I explained to her my history, she explained to me it could be depression, it could be the anti-depressants, it could be a mixture of everything so she is going to run blood tests. I didn't realize until I got home that she left some key tests off the list

Here is what she has ordered:
Complete Metabolic Panel
Iron Profile
CBC no Differential
Cortisol
Estradiol
FSH
LH
Prolactin
Testosterone - Bio Available (no total or free test checked...only bio available)
ACTH (no idea what this is)
Vitamin D 25-Hydroxy


No SHBG? She has recent thyroid tests so she isn't ordering those again. I don't understand why no SHBG. Is it important when she is doing bio-available? Maybe she isn't ordering total testosterone because she has my results from a few months ago. Uggghhhh. I hate being a dumbass scatterbrain.

relax and stop insulting yourself.
i dont think shbg is really important if she is ordering bioavailable t anyway.
Overall that is not a bad list, but she should have run tsh, free t3, and free t4, and total t would be nice to know.
If i were you id call her and ask her about those. PSA should be checked prior to trt too, and dhea sulfate is another thing that should be checked.

[EverettCD]

Relax Stinky, Dr's can be overwhelming with all of the information & questions they throw out in a short period of time. I can always tell when the Urologist I see is either in a hurry, has a over full PT schedule or both. What I do is I make a list of all questions I have & notes of anything I want to discuss with him prior to going to my appointment. I am terrible at forgetting these things when I go to the Dr, with my "cheat sheet" I make sure I don't forget to ask anything. There have been times when I have had to say directly yet politely, "Doc I know you're a busy man but I need a few minutes to discuss these concerns I have with you". He always takes a few extra minutes & discusses things with me.

If you like this Dr & you are starting to build trust with her at your next appointment make a list & take it with you. Also have you seen this sticky? http://forums.steroid.com/hormone-re...physician.html I would make a list of the labs & show it to her, ask her to run these labs as well. If she refuses ask her why she does not feel they are necessary. Don't take the standard "I'm the Dr & I do what I want" answer. Politely ask for the specific reasons why she will not run the labs you are requesting & why she feels those labs are not necessary for your particular situation.

Good luck, hopefully she will work with your & get your situation on the right track.

[bass]

Stinky this would have been better to post in your original thread.

[StinkyFinga]

sorry bass, wasn't sure if I should keep it going or not

[bass]

we prefer it to continue in the same thread in case we want to go back and refresh our memories of what was said. no biggie.

[EverettCD]

It makes it a lot easier for everyone to follow your story when it's all contained in one thread, not spread out. No need to start a new thread each time you have new information. You can always go back & edit any of your posts to add BW or anything else.

[StinkyFinga]

Can a moderator combine them?

[Rusty11]

It's not a big deal.....THIS TIME!! j/k.
I agree with simply calling your doc and requesting what you want tested. Can't hurt.

[powerlifterty16]

It's not a big deal.....THIS TIME!! j/k.
I agree with simply calling your doc and requesting what you want tested. Can't hurt.

the concern I hve is that even if the dr is compliant and gives p the tests he reqests, the fact that she didnt know to test those in the first place suggests limited knowledge with respect to trt. Im facing this dilemma myself. I cant shake the feeling that shippen didnt order nay thyroid labs for me for the price im going to be paying him until i had to call his office. yes i know he is knowledgable but still.

but yeah op if you have a checklist style blood sheet ask the secretary if you could check it off...say ''hi i noticed on my blood sheet, total testosterone and tsh werent checked off, would it be alright if i checked those as i have been wondering what those are''
If they say yes, you can then check those off, and even ''accidentally'' check free t3 and t4 off by mistake thinking it was tsh.

[Rusty11]

I agree. My excuse for not looking for a specialist is that everything-test, e2, hemocrit, etc... is great. As long as I remain stable, I'll stick with him.

[powerlifterty16]

I agree. My excuse for not looking for a specialist is that everything-test, e2, hemocrit, etc... is great. As long as I remain stable, I'll stick with him.

you dont need an excuse for not looking for a specialist. There really are NO specialists in trt besides the top few(crisler, shippen, mariano). After that, there are no specialists. If you have a GP that is up to date on protocols, he is better than any half assed endo any day of the week! If you have an orthopedic surgeon that likes trt and knows about it he is a better specialist than a urologist.

what kind of doc do you see and does he prescribe everything?

[StinkyFinga]

Well, had my blood drawn this morning at 6am. Curious to see the results. The doc told me no workout or anything before. I usually feel good in the morning and usually work out in the morning.

I talked with my wife last night, she see's how unhappy I am, how tired I am, I easily annoyed I am and basically, if this doc doesn't treat me, I'm going to self-medicate. I'd prefer not to but this is having a large impact on my family life and I'm simply not having it. I feel guilt every day because by the time I get home from work, I'm completely spent and can't gather the energy to play with my daughter. Even if I could, I feel so down I don't want to. It's disturbing. Anyway, I will try again another time with a new doc. As of right now, my plan would be to taper off the cyp from my self medication, switch to test prop and before an appointment once the long ester clears, stop the prop. I'd rather crash fast than drag it out over 3, 4, 8 weeks. I'm willing to do blood work on my own every couple months to dial in.

Oh and a question. Lately I've become super annoyed. I lose my cool easy and that is not like me. Could having lower than normal test levels cause this? For those that need a reminder. I was running a prop cycle for 8 weeks and stopped just over a week ago. No PCT as I was waiting for this appt. I'm assuming I'm shut down as shit right now and my mood/emotions are a train wreck. They have been a train wreck but it's a bit more magnified at the moment

[powerlifterty16]

Well, had my blood drawn this morning at 6am. Curious to see the results. The doc told me no workout or anything before. I usually feel good in the morning and usually work out in the morning.

I talked with my wife last night, she see's how unhappy I am, how tired I am, I easily annoyed I am and basically, if this doc doesn't treat me, I'm going to self-medicate. I'd prefer not to but this is having a large impact on my family life and I'm simply not having it. I feel guilt every day because by the time I get home from work, I'm completely spent and can't gather the energy to play with my daughter. Even if I could, I feel so down I don't want to. It's disturbing. Anyway, I will try again another time with a new doc. As of right now, my plan would be to taper off the cyp from my self medication, switch to test prop and before an appointment once the long ester clears, stop the prop. I'd rather crash fast than drag it out over 3, 4, 8 weeks. I'm willing to do blood work on my own every couple months to dial in.

Oh and a question. Lately I've become super annoyed. I lose my cool easy and that is not like me. Could having lower than normal test levels cause this? For those that need a reminder. I was running a prop cycle for 8 weeks and stopped just over a week ago. No PCT as I was waiting for this appt. I'm assuming I'm shut down as shit right now and my mood/emotions are a train wreck. They have been a train wreck but it's a bit more magnified at the moment

if i weere you id fly to crisler or shippen as opposed to medicating or join lowtcom...yes they are expensive but beats possible prison time and hospital visits from tainted gear..''oh my source is legit'' mmhmm..

[StinkyFinga]

I don't disagree with you at all but the reality is, I can't afford it. Mortgage, car payments, kid in preschool/daycare. It adds up and unfortunately I don't have unlimited funds. Sadly, you can self medicate for cheap. It's a risk for sure and if I could afford the extra $200 per month for a lifetime, I would. I'm going to have to keep trying until I can find a doc and go through my insurance.

I seriously just want to be open with my doctor and tell them what I told my psyciatrist. "Listen, I was feeling like crap, I did a cycle of steroids and realized how great I felt" I felt so good I cut my anti-depressant dose by half, and then some. When I normalized, I needed my anti-depressants again. I'm too scared of the insurance implications of doing that. I wish all docs were as understanding as my psyciatrist. As a matter of fact, I wish SHE would treat me. I wish she would treat me for the depression aspects alone and work with an endo to monitor me. Why can't our medical system work together like this. It blows my mind. In a way, I almost wish I never did that cycle. I was given a taste of something I had not felt in a very long time. I felt like I was born again. I felt like the old me. When that stopped, it hit harder. It's like an addict relapsing. Only difference is, I relapsed on the happy times before my life when in the shitter, before my mom died suddenly, before I began opiates and anti-depressants, then suboxone. Shit, the endo said it straight out, the opiates and even more so, suboxone will kill test levels.

Sorry, just venting. I'm so unbelievably stressed out. Not to get to personal but I've been such a fruitcake, my wife wanted to leave me just over a week ago. I finally got her to understand where I'm coming from but my family means more than anything to me, I'll do anything to make sure I don't lose them. I can't be a weekend father. No offense to those that are out there. Sometimes it's unavoidable but I can't do it.

[powerlifterty16]

im curious what your new blood work shows too..one blood test of 429 is not enough to show low t.. i prob wouldnt treat.

[StinkyFinga]

exactly. They treat a number and not symptoms. This will be the true first lab because I was only previously checked for total test. Nothing else.

[StinkyFinga]

I had labs drawn a week ago and they still do not have the results for the bio-available test. Evidently they do not do that on site and send it off site for testing. I'm very anxious.

[bass]

sucks don't it?! yea they get the results pretty quick and since you're not the only patient you have to wait to get your turn.

[powerlifterty16]

I had labs drawn a week ago and they still do not have the results for the bio-available test. Evidently they do not do that on site and send it off site for testing. I'm very anxious.

stinky, (lol) if i were you id just go to labcorp..they always email me my results....id be a nervous wreck if i didnt use their email service...and yes i get scripts from drs..i dont pay for bw.

[Rusty11]

I don't know where you live. Forgive me if I missed that part or the following has already been discussed...when I get bw, I fill out a short form to have it mailed to me. Laws may be different where you live. My endo takes 2+ weeks to call with results. All he says is, "everything looks good". That's not enough info for me. If you can, do this next time.

[StinkyFinga]

I will look into it. Thanks. The waiting sucks...ADD and patience do not go well together.