One of my apprehension about HT

David: First of all it hasn't been determined that you are going to need HT but if you do here's my thoughts.

I guess what I can't get beyond with your thinking is that if any of these terrible side effects set in you can quit at anytime you want, I've been on lupron for one year and don't think that I've turned into a 12 year old girl or Ted Bundy yet.  The medicine does effect everybody in a different fashion but if you have issues that you can't put up with, just quit.  There of course would be a period of time that it would take to get the medicine out of your system but at least you would know that you gave it a shot and it wasn't for you.

Once again I guess I have been one of the lucky ones because the side effects have been minimal for me. 

Good luck with everything.

The other David

 

the other david - thanks for your thoughts, of course its not known if i would be in need of HT at this point, but like all others here, I dont like to be caught off guard, thats why I have been researching the subject at this point, although its has not been my intention to ever go the HT route, I have said in other posts, that until I know for sure that I would need it to stay alive, I have the luxury of not having to make the choice.

casey - its not just the rise of .02 in the PSA, that's just a tiny portion of the whole picture. i have enough sense, believe it or not, to know that until i get another reading or two, i won't know if the srt failed or not. my wife, my uro/surgeon, and i discussed depression on my last visit last week, and he prescribe a med. unfortunately, it was too overwhelming a sedative to me, and make me feel in a drug induced trance. i am waiting to see if i can get a more familiar med, or a much lower dose then he put me on. so again, i don't think i am as dumb as i look.

i think most people's treatments do not deal with the mental and emotional side of having cancer. i am not a stranger to cancer, this is the 4th time for me. and it does take its toll, and it can break you down. i have been a patient advocate for years trying to see that side of cancer being dealt with, though most doctors dont want to take the time to deal with it, just like many doctors really dont want to deal with men on the ED side.

mabe it was just pain talking today, or another day staring at the walls pretending to have something important to do, or a combination of that, if so, excuse my emotional posting. i can only write about how i feel, doesnt get any more real than that

Hi David,

I'm really sorry how you've had to wade through all these challenges, day by day.

Depression aside, I do know you have enough wisdom inside your heart and in your mind to keep all options open for you and your bride.  Your are a smart fellow.

'Still hoping and wishing the best for you, my friend.

Thanks for sharing again.

Barry

 

Hey Dave I cannot fathom walking in your shoes and various cancers, treatments, drugs, intolerable side effects, urinary on going issues and constant pain. Constant pain for the duration as you are dealing with it, is probably like going onto a medival rack with the wheel turned once a day, I mean torture at a high level, probably nobody has walked in that same pathway. It  has to improve over that.

You may feel differently after this next surgery is over and working out. Hope so for you and yours.

Post Edited (zufus) : 8/25/2010 12:10:25 PM (GMT-6)

Casey 59:

Four questions -

1. Is Purg's tentative decision to forego hormone therapy irrational or evidence that his thinking is being affected by depression?  In my opinion, no.

2. Should Purg "step outside his comfort zone" (as you so aptly phrase it) and have his surgery performed by a national expert instead of his local urologist?  In my opinion, yes. 

3. Do my opinions matter in these very personal issues?  No.

4. Does Purg understand that if - heaven forbid - his upcoming surgery does not go well as a result of the decisions he has made, at least part of the responsibility will rest on his shoulders?  Judging from his posts, I believe so.

So maybe it's time we give Purg a break from this additional pressure.  His life is going to change radically, one way or the other, in a few weeks.  He has made his decision.  Alea iacta est.

 

With respect,

Zen9

 

well said Zen.  David is going through a rough patch and just needs to vent. 

F8

kak,

i always appreciate the woman's view or the wife's view here. Sephie was one of the earliest womem I had contact here with at HW, and her advise has always been sound, and shes a comfort to be around. Your husband is on a rough ride, and I can appreciate much of what you wrote and feel. I wish the two of you only the best. i am married to a very dedicated and caring nurse, and that helps

david in sc

Zen9, you appeared to send me four questions.   It wasn’t clear if you were asking for me to answer the questions or not, since you also provided your own answers…but I’ll assume you were seeking my input.   In this reply, I’m going to focus on the first question because I feel in my heart that it’s the most important and the others are largely rhetorical.   In my answer, however, please note that I will draw directly from my earlier posts in this thread, repeating and emphasizing some points for clarity. Zen9 said... 1. Is Purg's tentative decision to forego hormone therapy irrational or evidence that his thinking is being affected by depression?  In my opinion, no. In my opinion, no, too.   In my opinion, other aspects of his posts show clear signs of deep depression.   Speaking from my heart, as one who loves his fellow human being, these writings sound like a “cry for help.”   ·          “…and now not being medically fit or physically able to work, I already feel like I have nothing left of value.” ·          “… leave me staring at the walls for endless hours…” ·          “Most of my former business "friends" and colleges, have written me off, they don't call, don’t want to go to lunch anymore…” ·            “It's like I feel my life has no value or purpose anymore.” Apparently, David’s doctor also recognized signs of depression, but unfortunately he merely prescribed a pain relief medication (according to David’s post).   The doctor's  chemical solution may have been a misguided response by someone operating outside of his area of knowledge (urologist/surgeon).   Depression from dealing with chronic medical issues (a “reactive depression”) is not typically a chemical imbalance problem.   The solution doesn’t match the problem.    Dealing with chronic medical issues—especially cases as prolonged and compounded as David’s—is a frequent cause for depression, yet sadly, many people like David suffer needlessly from depression because they do not seek proper treatment.   As one speaking from the heart, I don’t wish for those that I love to suffer needlessly.   I’m confident that you, Zen9 and others who also feel a love for David, would join me in hoping that the issues within David’s control get optimally addressed and treated.   David mentioned that he is not a participant in any local support groups, which can be a wonderful source of holistic care information.   (For example, my local UsTOO chapter, provides information on psychological support for cancer patients.)   Recognizing depression is the first step in treating it. Zen9, if it’s ok, I’ll just skip your other questions. ---------------------------- later edit:  added the word "deep" Post Edited (Casey59) : 8/25/2010 1:14:16 PM (GMT-6)

David,

I can appreciate your thoughts about HT because I share those same feelings. I know that at some point I will need to go on HT and I, too am fearful of the side-effects. The one thing that I find helpful is knowing what the side effects are and bracing myself to deal with them as they will not come as a total surprise. I believe there are some partial remedies for the hot flashes. The weight gain and the fatigue (one would seemingly feed off the other), must be approached with forced exercise, including walking daily. As to the mood changes, I will only go on anti-depressents in a last case scenario. I DO know that most men are able to conduct their normal lives despite the side effects.

I think the one thing I fear the most is the knowledge that HT is sort of a crap shoot. It may add years to my life; it may not. Further complicating the issue is the possibility that some of the "second line" therapies may actually be better than the first line. But since such second line approaches are all deemed as experimental, one clearly must go with the label approach before trying what drug fits best.

I know that in the end you will make the decision that best serves you and your loved ones. PCa is a a horrible disease not only because it can kill but because there really is no set in stone approach that fits every man equally.

Joey - your post and answer was a good one, and well appreciated.

Mel - I think you perfectly get what I was trying to say. Who wouldnt be depressed at this point. No job, no ability to work right now, no income on my end at all (all my disability claims are still up in the air, and I have used up all available unemployment ments), a lingering cancer, the possibility of the SRT failing (I was only given a 20% chance of it working to begin), constant pain from a badly radiation damaged bladder and bladder neck, thousands of bladder spasms, etc etc. Considering what I go through, the people that know me in real life are surprised I am as together as I am, and that I don't sink in dispair or lash out at others, and amazed that I am so dedicated to our on line family here.

casey - you assume too much, you think you got it all figure out on somebody, but you really didnt. my dr and I and my wife, discussed my previous history of antidepressents, and we discussed several options, and he suggested a trial of this particular antidepressent, been around since 1960, very inexpensive $2.75 for 30 tablets 100 mg. He thought it would serve two purposes, to help on some depression issues, and since it doubles as a pain killer, it might help me, as for weeks now, my pain actually elevates at night, when before, I would get a break at night from most of the pain. The dose was started higher than normal knowing that I have been on steady diet of pain meds since Oct 1, and he was afraid a smaller starting dose might not be effective. Its that simple.

Yesterday, I had the blood work for an annual physical with my PCP/GP of some 15 years. I passed on it last year. Now I want him back in the loop to make sure the rest of my systems are still in order. I have that physical next Tuesday, and the results will be forworded to my Uro/Surgeon, in case anything shows up that could change the impending surgery. Makes sense to me.

_______________________________

I think in this thread, my intention was to say the things that many of us feel every day, and afraid to say out loud or share. All cancers and magor medical maladies come with emotional and mental baggage, and that side is often neglected or put on the back burner. You have to heal the whole body, not just the part that is broken at the time.

I will ask my GP next week what he thinks about my level of depression, he was the one that original got me on those kinds of meds years ago when my depression was clinical and out of control.

It bothers me when some folks here are quick to judge, quick to decide, on the matters of others. We are suppose to be a patient to patient support group, none of us are in medical school or current practicing doctors. We share our experiences, we seek knowledge, and we help the endless line of new brethren go through the rites of passage with the monster Prostate Cancer. Thats how I see this place, perhaps I am wrong.

I consider you all my friends.

I guess my read on this is that David is clearly cognizant of his situation.

But, as you said, you are speaking from the heart and one can't fault that!

Mel

Thank you Bronson for your input, I really value it

Tony, my only regret so far is SRT, but the rational side knows that without it, I had no chance. Just too bad it went so sour with me in so many ways.

An, thanks. A good doctor years ago, told me that the best way to help myself, was to reach out and help others. I still believe she was correct