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Preparing for ADT SE's

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Posted 4/19/2017 7:27 AM (GMT 0)
After a two year break and with a fast rising PSA, I am now back on ADT (Zoladex).

Knowing this was likely to happen, I have over the last month or so started trying to prepare for the likely SE's. Last time around I was fairly lucky in that I didn't suffer too badly. Had hot flushes, zero libido and some weight gain, but not too bad on fatigue or mood swings. Pretty sure I lost some strength, but really only measured by noting the distance I could hit my golf ball, and that could also be due to lack of practice and increasing age.

Determined not to add any more weight (I am not much overweight at 5' 8" and 185lbs) and want to retain as much strength as possible. So I am watching my diet very carefully and have already lost a couple of pounds and have stepped up my daily exercise and included some weight and reistance training. My RO arranged for a baseline bone density scan and that came back exceptionally good. Not sure what numbers are worthy of reporting here, but my "Age Match" was at 150% which I think means that my bone density is 150% better than the average for my age.

So all in all I think I am as well prepared as possible for the onslaught, but would be interested to know what steps others have taken to minimise the effects of ADT SE's.

Chas
Posted 4/19/2017 1:17 PM (GMT 0)
Sorry you have to be back on ADT. My wife was sweating in bed last night and the discussion turned to my experience with hot flashes and sweating. What a miserable time that was.

Anyway, it sounds like you have a good plan. My RO put me on Effoxor when I complained I was waking up every hour at night sweating and couldn't get a restful night's rest. I thought I could control my appetite but that didn't work out very well rolleyes . Maybe have a bunch of low calorie snacks ready when you get the munchies.

Hope you don't have too many SEs.
Posted 4/19/2017 1:26 PM (GMT 0)
Megace helped me with hot flashes. Not completely, but maybe 75% reduction. Some suggest low dose estrogen patches, or DES, but I never tried them.

Fatigue is rough. Naps at lunch time help, but the stamina is just not there. That's the most debilitating side effect for me. Exercise, oddly enough, does help with it.

Weight is difficult to control. Serious calorie control is the only thing I found to work. I'm 6', 200 lbs, and to stay there I can only consume about 1300 calories/day. That's like 1/2 to maybe 2/3 of what a normal male my size should be able to eat. Activity helps that too, but not much. Weight is really managed by intake management. You can spend an hour on an elliptical machine and burn the calories of one donut, so it's not very effective. The "Lose It" app is quite easy to use as a calorie management tool. It interacts with the database my FitBit uses too, so you can see the whole diet/exercise combo.

Nothing helped with sexual side effects. You lose ability, and yet you don't care anymore. If you go on ADT permanently, I guess it doesn't matter trying vacuum things, pills and so on. To me, that simply brings the curtain down on that part of life, sadly.

All the best to you.
Posted 4/20/2017 7:54 PM (GMT 0)
Gents, thanks for the tips on Effoxor and Megace. I'll keep those in mind if the flushes become too unpleasant.

It is just 3 weeks since I had the Zoladex injection and so far only a couple of fairly mild flushes, but they will get worse!

The weight issue is probably my biggest worry. I agree with you Redwing in that intake is the key, and while it does take a lot of activity to burn calories, I do think exercise is also key to boosting metabolism and from what I have read, it is metabolism that is affected by ADT.

Sexual activity is not really a worry. My wife has recently come off Hormone Replacement Therapy, so her libido has also declined (and she is also experiencing hot flushes). We have a very loving and harmonious relationship, so sex while having been very important in the past has now faded into the background.

One interesting side effect which I recall from my previous treatment is the elimination of night leg cramps. I have suffered from thses all my life, yet while on ADT they completely disappeared. Even though I am only 3 weeks in, they have already gone. A small but nice little bonus.

Chas
Posted 4/20/2017 9:12 PM (GMT 0)
Hi Chask
My husband also suffered from leg cramps for years and I put him on magnesium and potassium supplements last year and they went away within a few weeks. A real life changer for him! You should check with your doctor as the magnesium can lower your blood pressure and if you are taking meds for that you will have to adjust.
Posted 4/20/2017 9:37 PM (GMT 0)
Hi JoJoLa, yes I am aware of the magnesium solution, and I have been taking a supplement for a couple of years now. They were very effective at the start, and while they still help, I was getting mild cramps again.

I have now stopped taking them just to see if the ADT would have the same effect as last time and sure enough I haven't had the mildest sign of a cramp for the last 4 or 5 days.

Chas
Posted 4/21/2017 1:39 AM (GMT 0)
I found that the estradiol patches changed twice weekly ( every 3 days or so) stop hot flushes particularly at night. Weight gain can only be stopped by decreasing input and stopping bad carbs. I went on the South Beach Diet. Exercise is helpful for maintaining strength , bone health and mental health. Calcium and D3 plus prolia also help stop osteoporosis. Cabergoline helps with breast enlargement.
Bob
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