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.