VA doctors could care less.

[dlhoulton]

New member here. Have been reading and collecting lots of information to give to my doctor. I'm 54 y/o male and try to stay active. Going to the gym three times a week for past five years. After reading the signs and symptomes of low "T" I decided to ask my doc to get some tests done. My doc is a "Nurse practitioner" (female). So I printed off lots of information that I got from here and we sat and talked about it. She decided to get as much of the tests that she could or the VA would do or send out and have done. We talked about the symptoms of low "T" and right away she wanted to send me to "PTSD" counseling. Well the tests came back and the results are as follows:
Total Test: 2.59 (259)ng/ml (ng/dl) ref range: 1.68 - 7.81 (168 - 781) ng/ml (ng/dl)
Free Test: 7.7 pg/ml ref range: 7.2 - 24.0 pg/ml
LH: 6.34 mIU/ml ref range: 1.2 - 8.6 mIU/ml
TSH: 2.50 uIU/ml ref range: 0.34 - 5.6 uIU/ml
DHEA-Sulfate: 142.0 ug/dl ref range: 44.3 - 331.0 ug/dl
Estorgen: 105 pg/ml ref range: Adult Male: 40 - 115 pg/ml
All other blood test: WBC, RBC,HGB, etc. were well withen normal limits.

She stated that all tests results were withen normal limits for age and that she was not going to refer me to endo. She admitted she new nothing about TRT or HRT and if tests results were abnormal would refer me. Even though we talked about trying to reach "Optimal Range", she stated that all were withen normal and would not do anything about it, but would send me to "PTSD"(psych) counsling and the "Nutrition" clinic for weight control.
Feel like the VA let me down and just rather settel to have a Vet live a life of normal and deal with what comes up instead of accheaving "Opitmal Health" and living a more productive life.

[sirupate]

I would never have thought that the VA would have a reputation for top flight care...sorry. Is the VA your only available medical insurance? Sadly, many primary care physicians also feel that if your numbers are in the normal range, then no further treatment is necessary.

Sometimes patients need to call attention to their symptoms to get treatment. Not sure how you approached that in your appointment. Counseling is an easy and cheap out for them...also anti-depressant meds.

You could try to pay "ala carte" for some better treatment, or self-medicate which can be both risky and tricky.

[APIs]

Sorry to hear. She's obviously just a walking textbook. I would try & push the matter if you can. Can you somehow bypass this Nurse and see someone else? Preferably a male Doctor if possible? Personally, I think there are certain things that a female practitioner simply cannot relate to...

[bass]

Sorry to hear. She's obviously just a walking textbook. I would try & push the matter if you can. Can you somehow bypass this Nurse and see someone else? Preferably a male Doctor if possible? Personally, I think there are certain things that a female practitioner simply cannot relate to...

couldn't agree more. demand that you need to see an endo to make that determination not her! tell her you are not depressed just tired all the time, no energy, no sex drive, etc... its not her place to conclude that your hormones are in balance, she is not an expert. demand that you see a specialist so you can be taken care of properly.

[JohnnyVegas]

There have been a few guys that have posted about having decent luck with their VA doctors. Maybe there is someone else within the system you can talk to?

[dlhoulton]

Thanks for all the replies. I'm a 100% disabled vet so the VA is my only source of medical care. We are assigened to teams for our primary care and the team may have a MD, DO, PA or Nurse practitioner. I had a male MD just up untill last month and we had good communication. I was very supprised a couple weeks ago when I went in to find out that he had quit and I had been assigned a female Nurse Pract. I brought it in a respectfull way that my free test was .5 from falling off the chart of her normal range and that my Estrogen was 10 points from maxing out on the normal range. She said that according to protocall that all results were within normal stantards and did not warrent refering me to Endo. I was somewhat shocked and asked her why my BP was just slightly higher than normal and she had no problems perscribing hypertension therapy. And that my cholesterol was slightly elevated but still withn normal range and again no problem correcting that. But hormonal problems that are eather very low or high and she and the VA was ok with that and I should leard to live with.
I guess I'm going to take the advice given here and contact someone withen the VA with the lab results in hand and in a respectful and profesional way have something done about it.

[bass]

Thanks for all the replies. I'm a 100% disabled vet so the VA is my only source of medical care. We are assigened to teams for our primary care and the team may have a MD, DO, PA or Nurse practitioner. I had a male MD just up untill last month and we had good communication. I was very supprised a couple weeks ago when I went in to find out that he had quit and I had been assigned a female Nurse Pract. I brought it in a respectfull way that my free test was .5 from falling off the chart of her normal range and that my Estrogen was 10 points from maxing out on the normal range. She said that according to protocall that all results were within normal stantards and did not warrent refering me to Endo. I was somewhat shocked and asked her why my BP was just slightly higher than normal and she had no problems perscribing hypertension therapy. And that my cholesterol was slightly elevated but still withn normal range and again no problem correcting that. But hormonal problems that are eather very low or high and she and the VA was ok with that and I should leard to live with.
I guess I'm going to take the advice given here and contact someone withen the VA with the lab results in hand and in a respectful and profesional way have something done about it.

good for you. its your health and well being you are concerned about, who cares about numbers! keep us posted.

[JohnnyVegas]

Sucks that you have to deal with a NP. You would think our veterans would have constant access to doctors. So frustrating.

You are correct about them prescribing drugs for blood pressure or cholesterol with no problem. Tell them you are depressed and they will put you on an anti-depressant and an anti-axiety without giving it a second thought. It will take a while before a lot of doctors see testosterone as anything other than voodoo. Funny, because the side affects seem less harmful than many of the drugs that millions of people are on unnecessarily.

[bass]

Sucks that you have to deal with a NP. You would think our veterans would have constant access to doctors. So frustrating.

You are correct about them prescribing drugs for blood pressure or cholesterol with no problem. Tell them you are depressed and they will put you on an anti-depressant and an anti-axiety without giving it a second thought. It will take a while before a lot of doctors see testosterone as anything other than voodoo. Funny, because the side affects seem less harmful than many of the drugs that millions of people are on unnecessarily.

heck even 400 mgs Advil a day is far more harmful than testosterone abuse!

[dlhoulton]

The funny thing about this is I use to work at this VA. I was a floor nurse on general/surgical floor then worked in a Surgical consultation clinic at this VA. When I sat down with my NP we talked a little to get to know a little history on each other then I presented her with some facts, stats and information that I had collected. She also stated that I knew more about the subject than she did and even agreed to do all the test that I told her we should get. I asked her if they were abnormal or did not fall into the 'Optimal ranges" that we talked about would she be able to prescribe treatment. She said that if the results were off that she would put in a consult to Endo. Just goes to show you they would rather go the norm, treat the symptoms but not try to find the cause and treat that.

[txnhb]

Thanks for all the replies. I'm a 100% disabled vet so the VA is my only source of medical care. We are assigened to teams for our primary care and the team may have a MD, DO, PA or Nurse practitioner. I had a male MD just up untill last month and we had good communication. I was very supprised a couple weeks ago when I went in to find out that he had quit and I had been assigned a female Nurse Pract. I brought it in a respectfull way that my free test was .5 from falling off the chart of her normal range and that my Estrogen was 10 points from maxing out on the normal range. She said that according to protocall that all results were within normal stantards and did not warrent refering me to Endo. I was somewhat shocked and asked her why my BP was just slightly higher than normal and she had no problems perscribing hypertension therapy. And that my cholesterol was slightly elevated but still withn normal range and again no problem correcting that. But hormonal problems that are eather very low or high and she and the VA was ok with that and I should leard to live with.
I guess I'm going to take the advice given here and contact someone withen the VA with the lab results in hand and in a respectful and profesional way have something done about it.

I was told the exact same thing, except my speech was about the "standard of care." And if my results come back in normal range theres nothing to worry about. They have no problem prescribing viagra, bp meds etc

[Brohim]

To bad the gov. is eager to sign up folks to fight but are unwilling to properly fund the VA.

[Big Roy]

Find a new doc on the civilian side if you have to. I'm active duty & pay out of pocket for me HRT. HRT IMO is taboo for vets & military dr.

[Times Roman]

I'm a vet, and can go to any VA hospital.

My opinion?

If i were homeless, or didn't have insurance, then I'd go. Other than that? No thanks!

[ecsaaron]

Looks like to me your estrogen is way to high and would warrent treatment or am I reading it wrong.

[gmantheman]

Find a new doc on the civilian side if you have to. I'm active duty & pay out of pocket for me HRT. HRT IMO is taboo for vets & military dr.

As do I. I wont even ask a military doc for HRT/TRT TX. 1100 per year for weekly injections and bw is worth it.

[PetrX]

I had that minor problem..I went to the va and me and the dr talked and he ran my test for my test levels..came back very low but he wanted to do another test in 2 months to see if they improved...well they didn't improve so we talked , I'm studying medicine at usc so I was able to educate him alittle on the subject and we came to the conclusion that I needed trt..but he took his time to see if there were any other problems affecting my tests before he felt confortable prescribing the test..he ran an mri to see if I had a brain tumor in the pt gland ...my point is yes some drs at the va are clue-less and don't care about patients , if you get a dr like that change drs, my first dr I was given was an arrogant moron so I asked for a different dr and turned out to be great..there are great drs in the va system you just have to find them.

[dlhoulton]

Well after several weeks of waiting I finely get to see an Endo. Problem is it's still in the VA system and 2 hours away at 8:00 am. I've got some concerns going to this appt. One being that I called to see if I needed to fast for any testing and was told NO! I posted my inital test at beginning of this thread but I fear they were not enough for proper evaluation. My Doc. (Nurse Pract.) did not have a clue what to order. I had gathered info from here and the stickies, but she did not put any real effort into it. What we did get was: Free Test, Total Test, LH, TSH, DHEA-Sulfate, Estrogen, and a complete CBC profile. Eventhough I asked her specific on some I feel she did not know what she was selecting on the computer and just got the first thing that looked like what I was asking for and had writen down. From what I've read here there should be quiet a few more indepth test done for evaluating and finding what the cause for Low "T" and high E2. There are only four Doc's that are in the Endo clinic. Three are male and one female. I pulled up info on them and it dosen't look good. "Info" being, where they got there education and where they are licensed in. When I asked which Dr. I would be seeing I was told that I would be assigned one when I got there. All the Doc's have MD's but one that has a name with just about every letter in the alphabet in it and only has a "MBBS" he is from India. I just have a problem when I get a Doc and there is a sever comunication problem, and the VA has lots of them. I've read and re-read all the stickies at top and have printed out lots of information from here and Dr. Crislers site. I want to be well informed and able to have an intelectual/intelligent conversation with them. Hope everything goes well. I'll post back in a day or two with the outcome.

[bass]

just in case you haven't seen this one,

http://forums.steroid.com/showthread...-TRT-Physician

Kel listed all the tests you will need. good luck with your endo's visit and please keep us posted.

[txnhb]

Well after several weeks of waiting I finely get to see an Endo. Problem is it's still in the VA system and 2 hours away at 8:00 am. I've got some concerns going to this appt. One being that I called to see if I needed to fast for any testing and was told NO! I posted my inital test at beginning of this thread but I fear they were not enough for proper evaluation. My Doc. (Nurse Pract.) did not have a clue what to order. I had gathered info from here and the stickies, but she did not put any real effort into it. What we did get was: Free Test, Total Test, LH, TSH, DHEA-Sulfate, Estrogen, and a complete CBC profile. Eventhough I asked her specific on some I feel she did not know what she was selecting on the computer and just got the first thing that looked like what I was asking for and had writen down. From what I've read here there should be quiet a few more indepth test done for evaluating and finding what the cause for Low "T" and high E2. There are only four Doc's that are in the Endo clinic. Three are male and one female. I pulled up info on them and it dosen't look good. "Info" being, where they got there education and where they are licensed in. When I asked which Dr. I would be seeing I was told that I would be assigned one when I got there. All the Doc's have MD's but one that has a name with just about every letter in the alphabet in it and only has a "MBBS" he is from India. I just have a problem when I get a Doc and there is a sever comunication problem, and the VA has lots of them. I've read and re-read all the stickies at top and have printed out lots of information from here and Dr. Crislers site. I want to be well informed and able to have an intelectual/intelligent conversation with them. Hope everything goes well. I'll post back in a day or two with the outcome.

Well my friend I had started this post and it turns out my dumbass VA doc was going by the old normal numbers from Lab Corp and I've called and left messages to say wtf since I'm below normal. I ended up getting health insurance and went the civilian side. Hope you have better luck.