I haven't posted about the course of my treatment here for a while. I think because I live with the minutia of it daily, sporadic updates are all I really want to document.
For a while, I was having problems with communication between the primary care doctor and the endocrinologist. My PCP initially diagnosed the hypogonadism and wanted to kept in the loop with the specialist to know how best to treat me. I'm being treated for certain specific issues by one doctor, you see, and what is beyond her sphere of knowledge is then the domain of the specialist. My endocrinologist wasn't returning requests for his doctor's notes from the PCP, nor my e-mails and phone messages asking him to please comply with the request. He did, however, apologize profusely at our last appointment, stating he was deeply sorry for being busy, while promising to be more accessible in future. I believe him. So it was good to get that resolved, hopefully for good.
Regarding specific treatment, the course of treatment the endocrinologist has chosen to take is to focus on one particular area at a time. Sensible enough, since juggling multiple variables often makes it difficult to clearly observe the effects of specific processes and procedures. As always, I wonder how long this entire process is going to last from start to finish. In the meantime, he
has agreed to prescribe an aromatase inhibitor called Femara (Letrozole) that is newer than prior medications used to treat the same condition. This will effectively lower Estradiol (Estrogen) levels, boosting my testosterone in the process. One only has to take one pill a week, which is convenient.
He first wished to attain a peak level of testosterone, plus a base level of Estradiol, a sample taken only two or three days after the last testosterone injection. I provided that bloodwork Thursday. Then, on Tuesday, I will return to the lab to provide a second level that will measure the so-called nadir level of testosterone and resulting level of Estradiol. After both measurements are recorded, I will begin taking the Femara. Interestingly, the endocrinologist thinks that once Estradiol levels are lowered sufficiently, there may not be any reason to continue with testosterone therapy.
He also cautions me not to expect too much. Of course I hope to feel better, but I know that this is only one area being examined and treated. There are likely others that need to be considered. He's going to eventually check for thyroid antibodies via another test to locate the source of the swollen thyroid. That will see precisely what autoimmune condition is to blame for the symptoms reported. The thyroid ultrasound, as I suspected it would, revealed only that my thyroid gland was larger than it should probably be. That was good news. At least I don't have a goiter or some sort of node.
Since it's never simple for me, apparently, I've also developed something else, it seems. A gland on my lower back along the base of the spine has become severely infected. I kept hoping it would go away on its own, but that was not the case. I've been prescribed a very intense round of antibiotics lasting a week. Those may take care of the troubles eventually, but my GP believes that surgery will likely be needed to remove it. Such things, as she explains it, are rarely relegated to just one particular place on the body. All of this is related somehow, but the process, as explained to me, is much like untwisting a very complicated knot.
Here's for the final unraveling.