Thanks for the detailed response.
Their protocol is ancient. They'd be injecting me once every two weeks with 20g needles if I let them.
R. Ouch!
It wasn't until I found a Yahoo group specifically dedicated to secondary hypogonadism that I got stable levels. Now, I'm on 80mg E3D….sometimes a little less, sometimes a little more.
R. About the same here, 350IU or about 70mg twice a week I figure.
They will not Rx HCG to a man unless you are of a certain (reproductive) age. Don't even bother.
R. That's why I got my HCG/Clomid from other sources. Wouldn't ask them for it as it is likely off-label use to the VA, even tho both raise Test levels. Same with anti-estrogens (AI), they won't prescribe AI's to males 50+ unless they have breast cancer. They won't use AI's for excessive estrogen in males...? But I guess the VA Docs have their hands tied by VA rules?
As far as i know, they don't have the sensitive E2 test for men in their system.
R. I haven't seen one yet from the VA? Usually estradiol, but the sensitive test is more accurate.
You would have to have it tested privately and bring in the labs and make your case.
R. Which is what I had to do out of pocket, no insurance.
I've had endos want to take me off because I once (once!!) got a normal T lab (400-something).
R. Like if they take you off TRT, your Test levels are supposed to stay at 400 or something? Ridiculous thinking, Lol.
I've never had an elevated PSA in 15 +/- years of TRT.
R. That's interesting, although many clinicians say TRT may raise PSA levels or may cause/exacerbate testicular or prostrate cancer. Which could happen, but usually its the 50+ guys who develop elevated PSA levels. Due to elevated estrogen levels. 50+ males have higher estrogen than females.
Never heard of a young guy having elevated PSA levels, prostrate hypertrophy or prostrate cancer issues? As most young males have higher Test and lower estrogen levels than 50+ males.
“Borderline” or high/low-normal will get you nothing at the VA. Most times, it's not the Drs fault as they have protocols they must abide by. Private Drs can whatever they want, but not the VA. They have to answer for the things they prescribe (in your chart).
R. I agree. The VA doesn't understand what is low for a person who has had higher T levels most of their life (700-900). Then when they drop down to 400 or so, they don't look at it as a 50% drop in Test. They look at it as "You are within the range", your okay. The patient is like...but I don't feel okay? Then has to resort to his own means.
They will do my labs at least twice a year, no questions asked. They will often do labs that my private Dr requests. They will honor some Rx he requests, assuming I have a lab to back it up and the med isn't off-label. They will x-ray or MRI just about anytime I need it.
R. Same. Labs are costly and add up, so appreciate that.
I've been to the ER a couple of times in the last 2 years for bursitis and cellulitis and gotten antibiotics within 20 mins.
R. Going to a non-VA emergency room can cause a "who is going to pay for the very expensive emergency room bill issue?"
I was advised by a visiting nurse who took my BP where I live, to go to the emergency room because of a high BP reading. I sat in the ER for 4 hours, then the ER Doc tells me it could be caused by any number of things and shrugged his shoulders? They didn't advise me to do anything, didn't prescribe any meds, then gave me several pieces of empty papers with nothing related to high BP and sent me home.
Even tho I told the ER intake I had no insurance and was with the VA soon after my ER visit I got a $600.00 ER bill I couldn't pay. They had a credit collection agency come after me for payment. Took awhile before I found out the VA has a department (Forgot the name) that pays for non-VA ER visits. The VA paid the bill, but the FN collection agency still hassled me for overdue payments, something like $21 or something...WTF?
I qualify for everything but dental (perhaps Vision, too. I'm unsure). I don't have a co-pay for Rx.
R. If you need glasses they will send you to a VA optometrist. That's where I got my glasses from. I don't have a co-pay either, lucky me. The VA will also give you hearing aids if needed, which are very expensive.
Thanks, again.
