Sunday, May 25, 2008

Bicycle Thief

Start with the classic video

The one everyone thinks about nowadays...

But hey, things are just as bad in the Land of the Stumps of Mystery:

And, how you wish it were:

(Of course the Sprockettes are a Portland legend...)

T plus One Week

All the authorities say that you should expect T therapy to show results after about three weeks. This seems really reasonable to me. Even in this era of fiber optic Internet, PayPal, and instant gratification, some things just take some time.

Nevertheless, I've seen some interesting psychological changes even in the short time since my one injection.

I guess the first thing I noticed was the morning after my injection, hanging around waiting for everyone to get ready to start our English century. I saw an acquaintance walk up with my friend, and the unbidden thought, "hey, she's pretty!" came to mind. Not that I ever lost my appreciation for the fairer sex, I just didn'

About four days later I was sitting in a deli when an attractive woman walked in and my eyes tracked her as she walked up to the counter. Guys, you know what I'm talking about. It's pretty much involuntary, sort of like sneezing. Your girlfriend/wife hates it and thinks there's something wrong with you. You and I know it's just part of a normal healthy well-adjusted adult man. Only I'm guessing it's been somewhere between six months and a year since the last time it's happened to me.

As of today I'd call my sex drive "low normal", which is to say that I would be satisfied and could cope if it stayed at this level. It really does feel like it's come back after a hiatus, so things really aren't "normal" yet. I'll call it normal after it's stabilized for a period of time.

My mood has also improved. Toward the end of the week I found myself just grinning for no reason. Not that I'm that downbeat in general, but I could tell that I was just in a really good mood. I wouldn't characterize it as "manic"; the pshrinks use that term when your elevated mood interferes with your life. I was definitely more productive than I'd been in a few months.

Late in the week we had a fairly active meeting at my work. At one point a woman (a terrifically bright engineer and a competitive bicyclist to boot) asked a question and about two other workers (men) talked over her so her question got drowned out. I wanted to hear her question and the answer.

ONE MEETING! I yelled. (That's an Intel term by the way when there's too much side talking so that ideas are getting lost.) Embarrassed silence. Not the least of which was myself. I belatedly realized I'd just out-testosterone'd everyone in the room. Oops. At least it was in the defense of the testosterone impaired.

Towards the end of the week: I was eyeing this woman I was familiar with, one that I really enjoy looking at since I see her around regularly. (Such a simple pleasure in life!) I got a shock. Eewww!! Yucch! How did I ever think she was attractive?

This was a definite surprise. Over the last oh, five or ten years I've gotten a lot more universal in my appreciation of women. My understanding is that this is pretty common in men as they get older, and I've considered it a side benefit of being married: I don't have to be picky or choosy in my appreciation of women. I can enjoy them all since there's absolutely no intent and no decisions to be made. I don't remember being so picky about women since my early 30's. I'm not characterizing this as good or bad, I'm just reporting it.

Moving away from mood issues, the injection site was sore for about three days. I really didn't like it being achy for so long. Part of it might have been all the biking on Saturday. However, I think I may have had some weight on my leg when I got the injection. I will make a point of relaxing that muscle before the next shot to see what happens.

After my English century, I noted that my resting heart rate (RHR) was in the high 70's. This seemed a bit high, so I've been waiting for it to go back down, and it hasn't dropped to its previous levels. That's the one interesting physical effect so far. Allow me to explain that my RHR is higher than average, and my physician says a lot of that is genetically predetermined. However, since I've started biking I saw it drop into the low 60's, and in the last year or so I've seen it drop into the low 50's. Since the injection it's now somewhere in the mid 60's. I now suspect that my metabolism was starting to tank. Perhaps now I can start to lose some of that weight I've gained in the last three years.

The bottom line is that so far I'm very pleased with the treatment. We have to be very careful that my blood doesn't turn into molasses due to overproduction of red blood cells, and other serious physical side effects are still possible. However, I am very optimistic that this is going to mean a significant improvement in my quality of life.

I even found out that my bicycle racing aspirations might not be over. There is a procedure called a "therapeutic use exemption" by which I can get formal dispensation to allow me to race even though I'm receiving treatment. Of course, it's way too early to consider it. I need to adjust to the treatment and lose about fifteen pounds. Also, there's no guarantee that USADA will grant it; I'll have to demonstrate that I'm not enjoying an unfair advantage because I'm being treated. But, hey, perhaps I'll be able to get back on the race team!

Tuesday, May 20, 2008

Like an old car...

So, I'm still having fun and games with the doctors. It's so much like a used car: the older it gets, the more "quirks" it has and the more maintenance it takes to keep it running. If I had a choice, I think I'd start considering trading this one in while it's still reliable :-)

No news on the MRI. That doctor is pretty busy, but I think I'm not high on his list because, frankly, it's not an imminent danger. The stress did give me a sinus infection, but I'm recovering from that finally.

Friday was absolutely beautiful California lotus-eater weather, highs in the low 80's, beautiful sunshine.

I rode to the doctor's office and then to work in shorts and short sleeves, had a hard time concentrating while indoors. At the doctor's office we discussed my hypogonadism. He started by discussing therapy options, and I interrupted him:

"So, have we done our due diligence to determine the cause?"
"Yes, it's primary testicular failure. Your pituitary hormone levels are not low enough to cause this."

Hmmm....I'd put together this entire explanation involving a concussion I'd had to explain what's happened to me, and the truth is actually even more chilling: Things wear out. I guess if ovaries can give it up, causing menopause, then it's not outside the realm of reason that male andropause can have a relatively sudden onset. You just don't think of your body giving out on you. Another sobering moment that I'm still processing.

We discussed treatment options. He started by listing all the benefits of T therapy: increased energy, increased mental clarity, better bone density, increased muscle mass, reduced body fat percentage, increased interest and performance sexually.

I laughed and asked "Where do I sign up?" Seriously, I'm an athlete, so I think the perceived benefits might actually be greater for me than for a Joe "Budweiser" Sixpack with the fastest TV remote in the West. "I want to hear about the risks and how we manage them."

The bottom line is that we'll have to do quite a bit of monitoring at first to look for acute side effects, reducing the blood draws after we're certain that I'm stable. Next we discussed the different types of therapy. Basically, how does one administer it? Options include pills, shots, patches (either dermal or buccal (gums)), or a cream. BTW they all suck for different reasons. Doc knew I'd done a bit of research on this, so he asked for my opinion.

"Well, the only one that I'm dead set against is oral." He started smiling as I finished the sentence: "We don't even offer that in our practice." (When you ingest T 90% of it gets snagged by the liver and kidneys without making it to the blood stream, and that 90% proceeds to cause measurable hepatic and renal abnormalities. Not acceptable if I'm going to be on it for 20 years.)

"The problem with cream is that it's not a good fit with my lifestyle [you're supposed to use it in the morning and then not shower for five hours--that kinda screws up my lunchtime run], and I've seen reports that it increases the DHT to T ratio in your bloodstream, so it's probably not a good match for me." He smiled again: I've done my research! DHT is a metabolic byproduct of T, and though it's a necessary hormone, higher levels are implicated in BPH, from which I already suffer mildly.

"So, that leaves injections and patches. What's your experience with these?"

"Although patches should theoretically be superior, I've not seen any advantage in my practice, and they are considerably more expensive."

So, I'm trying the injections. Since they're two weeks apart, I'm going to get the injections at his office,e though I could theoretically start administering them myself after everything is stable.

That afternoon I went by and got my first injection. Just call me Floyd Landis now. (I'm not even assuming that he's innocent, but more on that later.) It's an IM (intramuscular) injection, so the clinic nurse picked the biggest muscle I've got. Yup, the gluteus maximus. Oh, and that sucker hurt. I felt a wasp sting and then she said she was done. Wasp sting? Heck, make that a yellowjacket. "You are?" It felt like she'd broken off the needle and left it in there.

The rest of the afternoon was a minor panic. I had to get the Montero serviced to prepare it for Clarkie and Rachel to drive it to the beach. Then I had to go home, pack, and prepare my bike for Reach the Beach.

Saturday morning came way too early at 5 AM. I went out to get the newspaper and saw that the weather was going to be gorgeous. I opted for arm warmers, but not even a skullcap or leg warmers. After an insufficient amount of coffee, I tiptoed out of the house and rode about three miles towards the RTB starting point and waited for Cecil and Lynne to show up. We rode the rest of the way to the starting point without incident...though Lynne's back route on SW 150th Avenue is definitely not any flatter than staying on Murray down to Scholls. Hey, it says "Hills are my Friends" right on my RoadID.

It's always a good idea to ride down to the RTB starting point. The congestion and traffic at the new staging area is even worse than it was at the old middle school. Diving in and out using a bicycle is the right way to go. We managed to get on the road around 7:15 and found ourselves in the middle of the thick pack. Lynne got caught by traffic early on, so it was just Cecil and me for about 45 minutes. Then I looked back and saw Cecil wasn't there either. "She must have decided to stick with Lynne." I figured I'd hang with Lynne in the afternoon, but I wanted to put a few miles in while I was fresh and the weather was cool.

I waited at a rest stop for them to show up and then stayed closer for the rest of the day. Cecil told me that she hadn't dropped back by choice; I'd flat out dropped her. That was when I had to 'fess up: "Cecil, just call me Floyd Landis." Lynne and Cecil both got a kick out of that. After all, it is "The Rabbit Formerly Known as Floyd" who sits on top of her Carradice bag!

The temperature was steadily rising all morning. Now, I don't have any warm weather acclimation yet, so I was very worried about how much water I was drinking. I don't think I've ever been so diligent about my water. Through the entire day I probably drank something on the order of a gallon of water.

When we left Sheridan we got our first hint of what the afternoon was going to be like. As we crossed the river and turned west, BAM the headwind hit us. Can you say "onshore flow?" There. I knew could. The air was cooler, which was a welcome relief. In Sheridan it was almost 90 degrees F, and as the rest of the day progressed it got cooler. However, whenever we weren't sheltered by hills, the wind was strong. Our friend Edna relates a report that it was around 35 mph in Grand Ronde.

The climb into Pacific City had a pleasant surprise. The last two years the locals marked off the bike lane on the wrong side of the road (the "cones of death" as Cecil calls them) and had us climbing Brooten Road facing oncoming motor traffic. This year I think they must have heard us, because they just made Brooten one way. We were still on the wrong side of the road, but with an entire lane to ourselves I can live with that. The finish line at the Pelican Pub was pleasant and sunny, temperature in the low 70's. We had food and beer, then headed for the rental house.

This house belongs to a friend of Clarkie's friend. It has absolute perfect location near the beach. It's very charming with room for seven, and we filled it. There was a hot tub, books, VCR/DVD, and a jigsaw puzzle that Rachel promptly dumped on the floor and started. We all went our separate ways for dinner (the three of us had a wonderful seafood dinner at our favorite restaurant there) and then us cyclists collapsed. Rachel and Clarkie stayed up and watched a movie, but I have no recollection of this.

Next morning I saw Diane, Lynne, and Cecil off bright and early; they had planned an Unreach the Beach, making it a 200+ mile weekend. (The Unreach is an unsupported unofficial route that many of us enjoy. Lynne and I did our own a few years ago when Clarkie couldn't make it; we carried our overnight gear in panniers and rode back with Diane on Sunday.)

I knew from the way I'd been feeling that I wasn't up for an Unreach, and I wanted to hang out with my family that weekend anyway. Ron's family came by later to rescue him. When my girls finally got up we had a very pleasant and leisurely breakfast at The Grateful Bread. Rachel: "Was the Grateful Dead some sort of hippie band?" After we managed to stop laughing, we confirmed that and asked her how she guessed that. "All of the workers are wearing tie-dye shirts."

We got back into town just before dinner, dropped off everyone's bags at Lynne's (we portered their overnight gear which served everyone well), and had a very relaxed evening.

The short term effects of the T injection have been interesting. Of course I don't expect any substantive changes for three or four weeks, but as of this morning I'm certain that the mental effects are taking effect. Did the shot actually make me faster on Saturday? Hey, maybe so, but that's arguable. Am I noticing pretty women more now? Hell yes! And that's really what I want to end with here.

It's a biological fact that men live with the incessant effects of testosterone since before we are mentally mature. It's a constant drone, every moment, waking and sleeping. It seems like a large part, for a man, of growing up emotionally is learning how to function with this constant noise trickling in from the cerebellum. Having lived without that solid backdrop for about a year, I want to try to provide some insight, for both men and women, of what the difference is like.

I'm going to make an analogy here to eating. When I tried to explain this to my wife, she was puzzled, "but you need to eat in order to live." Yes, but your cerebellum, the reptilian part of the brain, doesn't reason like that. Eat, sleep, breathe, reproduce. These are all basic urges generated by the same part of the brain.

So suppose one day you discovered that you just weren't hungry any more. Just didn't feel the urge any more, and you didn't really need to eat. Not only that, when you did eat, you didn't really enjoy it that much any more? Not that you couldn't eat, you just didn't have any enthusiasm for it? Not interested in smelling it, looking at it, talking about it. No interest in making time for it, making any effort to do it?

That's kinda how it is. And, to continue the analogy above, I saw it as a genuine quality of life issue. I like to eat. It's a great part of life. It also has a significant social aspect. Finally, what the dickens happened that I lost interest in eating? Yeah, that's kinda how it is.

So back to the mental effects. Last night there were erotic elements in my dreams. I can't even remember the last time that happened. And this morning, in the bagel shop, my eyes were tracking the pretty women. Excuse me? This isn't a conscious thing. Don't tell me there's something wrong with me; that's normal healthy male response. It's what men say and do that they need to be held accountable for; the visual response is down there in the cerebellum again.

I guess the last thing I want to say is, if this is the way women are normally, it's a good thing men have testosterone or else no one would ever get laid. It gives me a new insight into what men contribute to a healthy marriage, and I hope I've given you some insights as well.

Thursday, May 15, 2008

Naww, that's not an optical it?

Which way is the dancer spinning?

I stared at this for about ten minutes before I could see it both ways. I was just about ready to call in a neighbor to tell me that this was a bunch of horse manure when...she started spinning the other way.

Go here for the full article...

Monday, May 12, 2008

On Mortality...

I've spent a week thinking about a very old and profound subject. I know I should write about it, but I've hesitated. It seems like everything I could say would be so trite, and so many philosophers and poets have written about it...what could I possibly add? So, I've decided to limit it to my personal observations and what has jumped out at me.

The one thing I start with is my gradual appreciation of my mortality; you know, "we're only immortal for a limited time." That our time here is limited, and that things must end. As I enter my 50's, I feel like I have a good grasp of that, at least intellectually.

The other thing I've been thinking about before all of my latest scares is that your body is a lot like a car. As it gets older, it gets more quirks. It needs more maintenance, more care, and it just doesn't run as well.

So, the MRI results had two things in it that got me to really thinking. Oh, the good news? My pituitary is healthy. No tumor, not even anything nearby. The bad news? A strange "blip" in a ventricle of my brain. Oh, and there's some brain damage in my parietal lobe. It could be an ependymoma (a kind of brain cancer)?

So, here I am looking at one radiologist's assessment, that suggests that if the brain cancer doesn't get me, the Alzheimer's will. (Did I mention that my father's mother died of Alzheimer's?) I had to cogitate on these results for bout a day before hearing a neurosurgeon's opinion on that same MRI.

During that time, I realized that not only does our body change (wear out) over time, we ourselves change in a profound manner. If my brain changes, am I even the same person? It reflects life as a changing experience, where our circumstances and our outlook are never the same twice. My testosterone is really low now, and I see the attitudinal changes. It will change back when I (finally) get some treatment. Who am I, really? Fortunately I don't define myself through my sex drive, but the last few months have given me a significantly different way to view myself.

Suppose I only had an 80% chance of living five years. What is my legacy? What will people remember me for? God, I know it sounds trite, but what will people remember about me 25 years later? (No, I'm not going to answer that here .)

Finally, I heard once that death is truly lonely; that no matter what else happens beforehand, it is quintessentially a solitary experience. I see that now.

P.S. -- the neurosurgeon says that the parietal lobe damage is consistent with ischemic disease i.e., aging. The blip? He says it's not consistent with any common pathology, so he wants more tests. I've decided I can't worry about it; I'll just take the tests and see what happens.

Thursday, May 8, 2008

Taking the Lane

About a month ago I was discussing a difficult traffic situation with Hal Ballard. I was concerned about how closely people passed me when there really wasn't any room to share the lane safely another vehicle. He asked about my lane position, and said that was the problem.

"You need to take the lane."

Note that Hal is a League of American Bicyclists LCI (League Certified Instructor). The LAB is fairly far over in the Vehicular Cycling camp, which doesn't bother me, but this advice was somewhat more aggressive than I had been willing to practice.

Over the last month I've been trying to apply his advice, trying to learn the appropriate application of circumstances, caution, and courtesy. It's been a learning experience for me, but overall I've concluded he's right. Motorists are occasionally surprised, but it seems to me that they seem to understand what I'm doing. I want to share some of the things I've learned.

Westbound Barnes Road to Southbound Cedar Hills Boulevard

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This intersection is important to me because of the shopping center southeast of the light. For the last several months, I've made my left turn by proceeding in the right-most turn lane (of course), and then hugging the right side of the through lane until I could enter the shoulder. I've had a number of scary moments, including one where a motorist cut me off trying to get around me to get onto US-26.

For the last month I've started staying fully 75% over from the right hand side of the lane, requiring motorists to either stay behind me or to move over into the next lane. This actually allows motorists to get onto the US-26 ramp earlier though it requires southbound through traffic to wait for me. In practice, I've been surprised at how well it works. Southbound motorists either wait behind me until I'm on the shoulder or find an opportunity to move into the left lane.

Blind Corner on Butner Road

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This is a blind turn with no shoulders. I've found that if I drift out into the lane well before the turn, I can prevent people from taking their lives (and mine) into their hands as they swing around the corner. Eastbound in the evenings, I find a lot of heavy westbound traffic, so I often stay in the lane all the way to SW 130th Avenue.

Narrow Two Lane Bridge

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There is a creek that parallels 126th Ave and empties into Lake Commonwealth. The road as it passes over the bridge is so narrow that pedestrians are instructed to take the walkway (visible on the south side of the street). There is a lot of traffic in both directions. When I take the lane before the bridge, I keep people trying to pass me on the bridge itself with oncoming traffic.

Cedar Hills Boulevard Between Hall and Walker

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This is a really difficult stretch of road. I can usually avoid this length (either by taking SW Hocken or SW 123rd), but sometimes it is downright necessary, especially if I'm coming in from Old Beaverton. The challenge here is that there is absolutely no bike lane. However, there are two traffic lanes. Traffic is very fast (35 mph). By taking the lane here, I prevent people from buzzing me so close I feel the wind as they go by.

Wednesday, May 7, 2008

Hungarian PSA

It's a shame you could never put this public service announcement on the air in this country.

Warning: use headphones if you're at work!

Here is a translation of the dialog (though it's not really needed):

Text on biker lady’s bag: "Bike to Work"

Woman: "Would you like some tea?
Man: "Thank you, that would be lovely."

As she is listening to the noises coming from the other room, woman mutters under her breath: “you should rather be biking, too, Rezso”.

Tag line at the end is almost the same: "You should rather be biking, too", or more literally, "Ride your bike instead as well".

Originally from

There are irregularities in my MRI. My primary care physician thinks it might just be related to my head injury, but she wants a specialist to review the results. More information on Friday. More stress and worrying. (Did I mention I'm prone to anxiety?)

Monday, May 5, 2008

Drive Your Bike!

Had my MRI done today. Ain't medical technology wonderful? Now I just have to wait for the doctor to call me on Wednesday.

Cecil published a cute link on her latest blog. I'm going to add what may be the very first Vehicular Cycling media ever made. Enjoy!

Friday, May 2, 2008

Health Issues

I'm having a serious medical issue, and I think it's time to share it with you. It's
been building for some time, and I've finally figured out what's going on.

You know, when I lay it out here it's going to seem really obvious to you, but life
really isn't so cut-and-dry. There are events that happen every day that we don't pay
attention to, or dismiss as not pertinent. So, when I distill out the basic facts, it's
going to seem really obvious to you, so I'm going to try to walk you through the
confusing steps so you can see how I arrived at this.

When it comes to ignoring physical symptoms, I believe men are more likely to dismiss things about their bodies than women. Women identify with their bodies, and we are more likely to judge them by their appearance. Men are more likely to regard their body like a pair of sneakers: something you value and take care of, but not something you worry a lot about.

So...I think I'll start the story last October (2007) when I went for my annual physical. My doctor told me I was really healthy, which was good news. But...

"Hey, it feels like my sexual libido is a bit low."
"OK, let's order a testosterone test."

When the T results came back, they were low-ish, but within normal range. My libido was low, but hey, don't fix it if it ain't broke, right? After all, I *am* 50 years old, so I shouldn't expect to act and feel the way I did when I was in my 20's, right?

Well, over the winter my libido dropped significantly further. Whereas last fall I would have given it a "3" on a scale of 10, where 10 was how I was as a crazed 14 year old teenager, it dropped to somewhere just above a "1".

I went back to my doctor, and took another T test. This time it came in *below* normal.

"Ah-HAH!" I thought. "Looks like things might be wearing out."

I told my doctor that I wanted to do our due diligence, to try to figure out *why* my T had gone low, so he ordered another test. This time he wanted to see if my pituitary was screaming like mad at my gonads to create testosterone and they weren't producing, or if something was wrong further upstream. So, he ordered the FS/LH/Prolactin measurement, and there I was, back at the lab giving more blood.

As I waited for the blood results, I started thinking about my athletic performance over the last year. Low testosterone is *so* nonspecific. I spent the late part of the winter running as well as biking and dieting, and my weight wouldn't go very far down.

But, hey, I'm 50 years old, right?

My running never seemed to get much faster, but I just figured that I'm not much of a runner. But I never seemed to be able to affect my strength or my speed much.

I've spent all fall and winter biking, but I don't feel much stronger. And my strength training in the gym has been...insipid.

When I did the Birkenfeld brevet, it seems like it took an extra day or two for me to recover.

I had a serious phase about three weeks ago where I was incredibly *grumpy*. I mean, I have some cool little pink pills I take for anxiety and OCD, but this was very different. I upped my dose of the little pink pills, but all that happened was that it made me sleepy.

A couple of days this last blood test, I woke up at about four in the morning. Usually I have to make a trip to the bathroom about once a night, but I noticed that I was covered in a cold sweat. And, I recalled this had happened the previous night as well, and that I'd had this happen very occasionally over the last few months.

Hot flashes! (Insert menopausal woman joke here.)

So, I called the doctor's office yesterday, anxious to hear the results of the blood work. Hey, if I need testerone replacement therapy, I want to get on with it.

The FSH/LH levels were low.

They've ordered an MRI scan to look for a brain tumor, which I'll have Monday, and the doctor will consult with me on Wednesday.

This is when my Internet research went into high gear. If it is a tumor, I have about an 80% chance of living another 5 years. Did I mention that I'm prone to anxiety?

Whatever's happening to me, I've fallen off the tail of the bell curve. Pituitary tumors usually cause overproduction of hormones, but*they occasionally cause hypopituitarism. Pituitary tumors usually cause headaches and occasionally visually disturbances, but not always. See what I mean?

So, here's some optimism. One of the causes of hypopituitarism is...head injury. In fact, some endocrinologists estimate that hypopituitarism may present in as many as 25% cases of traumatic brain injury (TBI).

Why is that pertinent? Well, in the summer of 2005 I had concussion in a bicycle fall. I suffered a half minute "gap in the Nixon tapes" (short term memory loss), and I was a bit woozy for about two weeks after that. They scanned my head at that time and determined I wasn't going to die, and after that I didn't think much about it.

But...I think that by the time summer of 2006 rolled around, I was noticing slight effects in terms of my libido.

So, back to the Internet research. One study analyzed about 500 cases of PHTH (post head trauma hypopituitarism) and had a bunch of intriguing statistics. Most patients presented with profound symptoms in less than a year (though there were indeed ones who presented longer after the fact).

Most interesting is that fully ninety percent of these patients had hypogonadism. (The pituitary also generates TH (thyroid hormone), HGH (human growth hormone), and some other thingies I don't remember. They even speculate that the gonadotropic cells in the anterior pituitary may be particularly susceptible to damage.

Again, about 50% of the patients in this study presented symptoms of this really strange thing called diabetes insipidus. Look it up. Never heard of it, it certainly doesn't fit any symptoms I've had. So, here I am, at the tail end of the bell curve.

Now I'm waiting to take the MRI and to get the results. Odd, how I would regard the absence of a brain tumor as good news. They *do* have reasonable treatments for secondary onset hypopituitary hypogonadism. (Ironically, it's generated from the urine of post-menopausal women, who have high FSH and LH levels in their bloodstream.)

But still, it's making me crazy. It's the waiting and not knowing that's the worst.