I can be a bit grumpy. I'm full of angst, and hormones.
-- Nicholas Hoult (1989-), English actor, interview in The Mirror, 2 February 2012
I find myself dosed with hormones, but not so full of angst.
On Friday 29 January I travelled to Northwestern to see my surgeon, Dr William Catalona, for my post-surgery follow-up. It turned out to be a hectic day as I spent 3 hours there. I signed up for all of Dr Catalona's research studies and I had 3 vials of blood drawn. This included a PSA test (just 2 days since my last check), and the result came back as 0.03ng/mL -- welcome confirmation that my PSA is "undetectable", well below the 0.10 threshold.
A big part of the appointment was ensuring that I have recovered well from my surgery (I have). I'm now cleared to resume activities that I'm comfortable with. I'll get back into running and swimming forthwith, and will work my way back into Tae Kwon Do.
Another part was introducing me to the direct-injection treatment that is meant to relieve the ED side effects of the surgery. That part went as well as could be expected. I'll continue this treatment at home 2 to 3 times per week for the next 18 months, or until it is no longer necessary.
But for me the most important part of the appointment was discussing my on-going treatment, and getting started on Hormone Therapy (HT). In this case, the HT is Androgen Deprivation Therapy (ADT). It starts with a 30mg shot of Lupron, which is meant to shut down my body's production of testosterone for 4 months. This treatment will be repeated to maintain the ADT for at least a few years.
Lupron, when it first kicks in, actually causes a "testosterone flare", a spike in testosterone production. Over a period of about a week the flare subsides to pre-treatment levels; at three weeks after treatment my testosterone level should drop to near zero. To counteract the flare, I'm spending 10 days taking Casodex (bicalutamide), which blocks the uptake of testosterone.
I've been concerned about the side effects of ADT. Right now I'm at the peak of the "flare" period, so it's too early to tell. But I'm optimistic that side effects will be minimal. I understand that exercise is the best way to counter these effects. I'm signed up for this year's YMCA Survivor "get-in-shape" program, and this is the second week. After work today I'll go for a 3-mile (or thereabouts) run on a treadmill. I hope to work my way back up to the 5-mile runs I did 3 times per week when I was preparing for the 2014 Illinois Half Marathon. My near-term goal is a 5K run in May; longer term, I'm shooting for my first marathon in Spring 2017.
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