SO MANY DOCTOR APPOINTMENTS

PROSTATE:  I am finally being scheduled for partial removal of the prostate. It is not a big deal.  Men are foolish about the surgery. Yes, it is possible I may not fully recover my use of the prostate.  There is a good chance I will not be able to get someone pregnant. That is actually good news.

The surgery can cause Retrograde Ejaculation.  This is yet another natural form of birth control.  The ejaculatory experience is the same as a regular ejaculation in terms of pleasure; the sperm just goes into the bladder.  

It will be several days using a catheter, but in most cases, the patient has a lot better quality of life after the surgery.

If the biggest side effect of the surgery is not getting someone pregnant, I say it is a win. 

Prostate health has changed.  There are noncancerous reasons to remove part of the prostate.  During this process the doctor can visualize the prostate for possible cancer. Unless you are in a medical emergency it seems to be the best way to assess the man for prostate cancer.  The painful prostate biopsy in many cases is no longer needed since the doctor is going into the prostate anyway to remove part.  If the doctor sees anything unusual, they can biopsy it while removing part of the prostate for unusual inflammation. 

I will say with 100% certainty, a man's PSA is not a reliable test for cancer or inflammation. There are all sorts of PSA testing.  The doctors do not agree as to the relevance of any of the test results.  Endocrinologist will tell you, a man on a high dosage insulin can have a false low PSA.  The urologists are clear, that is junk science. 

My issue is, most doctors believe Andro gel can grow prostate cancer.  But I need my Andro gel to reduce my blood sugar and improve my sleep.  It is also believed to have positive cardiac properties.

So, who do I believe?  If I have cancer and use the Andro gel, I can make it worse.  So now after more than a decade of being told how dangerous Ando gel is, I am now being told the science does not support Andro gel increasing the chances of cancer.  In the past I had doctors yell at me telling me if I continue the Andro gel I would get prostate cancer.  Now today I am told that was all junk science.

The good news without the old fashion biopsy my doctor will get a good look at the prostate during the partial removal. I am cool with how my doctor is proceeding.  But doctors need to understand it is confusing to the patient when one doctor claims Andro gel can cause or make cancer worse, and another says it is all junk science.  Then there is the issue of the doctors saying high levels of insulin can cause the PSA to be artificially low thereby causing the doctor to miss the cancer diagnosis., and then another doctor calls that junk science.

THE THROAT

It took some 22 months, but we finally know the problem.  The TMJ is for sure inflamed, making things worse.  But the throat doctor just listening to me speak, and to what I do to start breathing again was certain as to the problem.  She scoped me while stimulating a spasm of the vocal cords.

The vocal cords are damaged.  The damage GERD has caused the entrance of the throat is very visible. It has been so long in the making my voice has changed.  In fact, my pronunciation in Spanish has changed.  Yesterday while eating lunch, I ordered salsa verde to go with my meal.  No matter how many times I said it she could not understand.  It sounded like someone for the first time trying to pronounce words in Spanish. 

The diagnosis is Laryngospasm. 

Here is a short video.  To see how the vocal cords cause the spasm. Go to the end, it is about a minute.

I am waiting on the VA to approve the speech therapy.  Without it things will only get worse.

HOW DID THIS HAPPEN?

Medicine is about balancing the good and the bad.  Normally a doctor would blame this on the GERD.  The GERD is the secondary issue.

If someone has a hiatal hernia any medical recommendation must take the hiatal hernia and its related GERD into consideration.  Before I started Ozempic I was already diagnosed a long time ago with a hiatal hernia and gastric paresis. Doctors love to blame Ozempic for the problem, when in fact the problem was well in place before use of Ozempic or any similar medicine.  I will admit the Ozempic was horrible for me.  It did not help with my blood sugar and in fact increased the GERD big time.  I am now on Mounjaro; the difference is night and day. 

For years the doctors insisted I should shrink my stomach as a way to reduce how much I eat.  I did well at shrinking my stomach.  But such as Ozempic does when you shrink your stomach, you increase the amount of acid going up into the esophagus.  You cannot win.

I do not know if the therapy will repair my vocal cords.  I am regularly doing the one exercise the doctor gave me.  It seems to have reduced the amount of GERD.  Of note she recommends Gaviscon to help control the GERD.  She is the first doctor ever to embrace my use of Gaviscon since age 19. I will reduce the amount of acid with Gaviscon and peppermint tea.

THE DIABETES

For me there is so much debate about how to treat diabetes the patients needlessly worry.  The doctors recommend the medications but are not very good at guiding the patient through the process.

I have been treated for sleep deprivation for more than 20 years.  Mind you, October will make 2 years since they started treating my diabetes.  Only in the last few weeks do we seem to have it under control. 

No one told me if you have sleep problems you should take your insulin in the morning while fasting.  It made a big difference with my sleep.

I am on a high dosage of insulin, and the lowest dosage of Mounjaro.  The combination seems to work.  But the appointments are too far apart.  So, I have to manage the diabetes based on what I have learned about dosages. FYI, Mounjaro has no impact on my weight.  You can starve yourself, but if you have no metabolism, you cannot lose weight.  In my case it causes a "food coma," which knocks me out if I eat the wrong thing.  I truly limit myself to two very small meals twice a day. 

After three weeks of very good BS, I will now decrease the amount of insulin I use.  I will go from 140 units in the AM to 136.  If I stay well within normal for two weeks I will go to 132 units.  It is a process, I have learned.  I am assuming the long delay between appointments is an insurance issue.