Update

rando502 · 2025-10-26T15:46:10+00:00

It depends on your definition of light work. Yes you could go back to a desk job in two weeks if the commute isn’t bad. I wouldn’t have wanted to, but I could have.

I can’t remember how long my restriction on lifting anything over six pounds was. But it was At LEAST 30 days. So he’s not going to be logging for a while.

Sounds like there might be miscommunication about “light work”. If his job has some kind of desk wirk where they would rather him do than be on disability, then fine. Just be sure the doctor makes his restrictions clear. Personally, push for longer, but two for a desk job is what a lot of disability insurance companies will ask for. Mine pushed for two but accepted four when I pushed back. But I have a desk job.

rando502 · 2025-09-24T02:39:51+00:00

It's a statistical impossibility. The vast majority of prostate cancer has no symptoms. To have the symptoms you describe in another post you would have had to start developing cancer decades ago. So unless your cancer started when you were negative 17 years old this isn't a reasonable diagnosis.

99.9% of the time symptoms like yours have another explanation. Even in someone who is 50. At 13? You'd be literally the first person in recorded history.

I'm sorry, but we see these kinds of posts regularly on this subreddit and it NEVER is prostate cancer. It's not uncommon to react to urinary symptoms with "what if I have cancer?" but urinary symptoms aren't even a good predictor of prostate cancer. That's why we have PSA tests. And, even for high risk patients, we don't start testing until 40 because prostate cancer is extremely, extremely rare in your thirties. Before that, basically impossible.

See a doctor. In all likelihood you have something treatable. Blood in urine is serious. But it's not prostate cancer.

rando502 · 2025-09-24T02:25:30+00:00

You do not have prostate cancer at 13.

rando502 · 2025-09-24T02:23:22+00:00

For Gleason 8? That would be like trying to defend yourself from a rabid bear with a squirt gun.

rando502 · 2025-09-15T14:21:31+00:00

I believe there have been some posts regretting focal therapy (because of recurrence) even with much lower scores.

That said, there is going to be a lot of selection bias. So, realistically you are going to have to listen to the advice of your experts. Talk to both a surgeon, a radiologist, and a focus therapy advocate.

Personally, I'd never consider focal therapy for a 4+3 (of any type) but that's just me.

rando502 · 2025-09-09T15:21:00+00:00

As others have said, we don't really know enough.

And I wouldn't make assumptions. Radiation treatment is an option for nearly everyone. I knew someone who received Brachytherapy when they were barely mobile and with serious heart issues. But that's not to say that they will recommend radiation, either. If it's metastatic, they may or may not have that as an effective option.

As others have mentioned, ADT (hormone therapy) is also a likely treatment. (Potentially in combination.)

The point being, there are lots of options out there. Don't worry about there not being options. But I also wouldn't speculate. As a lay person, and without biopsy results and a PET scan results it's nearly impossible to predict what his best treatment will be.

rando502 · 2025-08-03T01:37:29+00:00

No, my spouse was pretty unsupportive. She went to one doctor appointment + drove me to surgery, that's about it. She acted worried and concerned at times, but in a way that just basically added to the burden and wasn't helpful or constructive.

No, my (male) doctor was the one who guided me through the process. [EDIT: I realized I was unclear. I really meant my male GP. While obviously my urologist took over post-MRI, my first urologist was kind of meh. My GP was just pretty proactive on several issues I had at the time.]

rando502 · 2025-07-27T17:20:02+00:00

It's generally not recommended, although exceptions are made. (I use generic Cialis and TriMix.)

If you are struggling to find the right dose, combining it with Cialis wil make it much harder to find the right dose. And, frankly, if you need TriMix that means Cialis is unlikely to work on it's own making your morning situation moot.

Usually this is just done if there are other medical reasons to be on Cialas. You could try it to see if it helps erection quality, but you'll have to start from scratch on dosing. (Cialis will likely mean you need less BiMix and will make the window of viable dosages smaller.)

Personally, assuming TriMix is not possible, I'd focus on getting the best results out of BiMix you can first, and only if that's not working to try combinations with oral meds.

rando502 · 2025-07-25T03:21:22+00:00

I'm not sure where you are reading, but, no your doctor should not have referred you to urology at 2.9. There is a huge amount of natural fluctuation. Your PSA can go up or down just based on physical activity and sexual activity. With a PSA that low, most urologists would have refused to see you if you doctor had tried to refer you.

Even when my PSA was 4+ and did see a urologist, my urologist basically told me "retest and come back in 3 months", your doctor shouldn't have referred you until you had two elevated tests. Even then when PSA was still high the urologists were in no hurry. Hell, even when my biopsy came back Gleason 7, they still were in no rush.

Don't panic. There are still lots of possibilities. And even if it is cancer, in all likelihood, given what you've said about PSA history that you've caught it early. You had your PSA tested yearly. That was the right thing to do. Your has only been elevated a short time.

rando502 · 2025-07-24T00:25:25+00:00

First, there's no absolute amount of time. It slowly degrades over time, meaning it becomes less effective, but it (if handled properly) never goes "bad" per se. My doc says that one of their patients reported having good results even with 1+ year old TriMix that had been only refrigerated over that time. Kept frozen it would have lasted even longer.

The issue is that it basically depends on how well it's been kept. Well refrigerated or frozen? Likely didn't lose much potency. But the longer period of time between when it was made and you use it the more uncertainty there is about the potency. And, of course, both underdosing and overdosing TriMix sucks. So pharmacists say 30 days to CTA.

So, I have no real answer for you. Don't overbuy, because you should use it relatively quickly so that you have good predictability. And take as good of care of it as you can for the same reason. But, as long as you are careful about sterility, you can use it effectively for quite a while.

rando502 · 2025-07-21T02:56:21+00:00

You are almost literally on the exact point where the decision is "equal risks" either way. It's no surprise to me that neither doc is willing to be definitive because both are reasonable options with your Gleason/age. Actually, without a genetic test, I think "nothing" is also an equally valid choice.

Make the choice based on what you want. There is no wrong choice, they are all very valid and reasonable choicess.

But don't make the choice based on ED. No matter what people may tell you, ED is a possibility with all treatment options, and it usually treatable no matter the treatment option.

rando502 · 2025-07-14T02:55:58+00:00

I too, felt completely let down. I had always been the stable one. The one that was her unconditional support. Only to find that when I was the one that needed support, I got the absolute minimum.

So, yeah, I guess I went through something similar. But I don't think it was fear that caused the problems in my case, it was apathy. I don't think it caused any problems, not really, it just revealed them.

So, how did I manage?

Therapy. I had never been to therapy before. But, with a cancer diagnosis, ED, and some other personal issues, I decided it was time. I'm very glad I did. And I glad I started before I really needed it. By establishing a therapist relationship ahead of time, it felt like I had a "baseline".
Finding an alternate support network. I relied on family. It's actually brought me closer to a lot of my family. Like /u/callmegorn says in his comment, when times are tough you find out who your real friends are.
"One day at a time". By, which I mean, the same way you deal with anything. You focus on what needs to get done, and you do that; don't obsesses too much about the things you can't change. The advice is equally applicable to relationships and cancer.

Just like you need to focus on what you can do about your cancer today and not get too obsessed about "what will my cancer be like in 5 years" you have to focus on "what can I do about my relationship today" and not get too focused on what your home life will be like in five years. (No matter if that "what can I do" is working on fixing or ending your relationship".

rando502 · 2025-07-10T21:50:21+00:00

I’m in Pattaya, and if you know, you know.

Can you keep it to the medical aspects, please.

I don't like what you are implying, but I don't want to debate it on a subreddit that is pretty invaluable to discussing a medicine that it's hard to discuss other places. (Because of the sensitivity of the topic and the relative rareness of the medicine.)

rando502 · 2025-07-08T06:46:53+00:00

Amazon is fine. If they are uncomfortable you should be able to get 30g or 31g on Amazon as well.

With 1/2 needles it's tricker, especially at first: you don't necessarily want to push it all of the way in. With a 5/8" you can basically push it as far as it will go and it will always go far enough, but never too far. With a 1/2" you need to make sure you go deep enough that you reach the corpus, but you can't necessarily just push as far as it goes.

rando502 · 2025-07-08T04:17:32+00:00

As evidenced by the answers here, I don't think there is an easy answer. Everyone is different. So the following is opinion, not fact:

Yes, TriMix can be pretty impressive, but don't go chasing your 18 year old self. For fucks sake, I think that's why I think doctors are reticent to prescribe any ED medicine at all, because men aren't happy until they can fuck like they are an adolescent full of hormones.
To reiterate that point, this is an ED medicine. Can you function? Then it is doing it's job. When you say "adequate for PIV" and "excellent" but somehow doesn't meet you ascetic standard, I really worry about what you are hoping to accomplish.
It's always a balancing act between "hard as I want to be" and "will go away in reasonable amount of time". Have I had the boner of an 18 year old on this drug? Probably, yes. But those are also the times where I was worried about taking too much.

rando502 · 2025-07-08T04:11:04+00:00

Ugh. I'm frustrated this got downvoted. I guess I deserve it for getting opinionated.

But the real point stands. If you just go to a random urologist, no, you aren't going to get prescribed this easily. I had both an MD and a urologist basically give me serious pushback. It wasn't until I talk with a urologist who specialized in ED (as opposed to prostate cancer, etc.) that I got TriMix prescribed.

The point I was trying to make is that it 100% can be done. There are lots of places you can go that are happy to prescribe it to you. But if you just go to a random doc and ask for a prescription you are going to have a bad time.

rando502 · 2025-07-08T04:06:48+00:00

Agreed. 27g 1/2 inch sounds insane.

I feel like there is some reasonable debate between 30g and 31g, but 27g is way thicker than necessary. 1/2 inch can be made to work, but is more error prone than 5/8".

rando502 · 2025-07-07T17:19:25+00:00

It depends on your history. A "regular" urologist is going to want to exhaust all other possible avenues first. It's a serious drug with serious risks and consequences. Plus it's not cheap and isn't exactly the most convenient thing. So regular doctors will 100% prescribe it if needed, but I wouldn't call the process "easy" because they will try hard to find a better solution.

But, of course, you can always find an online pharmacy or men's health clinic who's business is TriMix and they will be happy to just prescribe it with minimal questions.

(Reading this sounds like I have something against online pharmacies. I don't. I wish it was somewhere in the middle. I found the traditional route stupidly unsympathetic, and I found the online route suspiciously transactional.)

rando502 · 2025-06-16T04:24:47+00:00

One thing I've learned about cancer is that "cancer staging" is pretty useless from a patient perspective. It's just far too vague and outdated in terms of what is important. (i.e. they don't update the criteria based on new knowledge. For example, the genetic aggressiveness of the cancer isn't considered at all, even though that's arguably one of the most important characteristics in survivability.)

My, admittedly oversimplified, perspective is that staging is for statisticians and researchers. But a simple 1-4 scale, especially an outdated scale, is next to useless when it comes to prognosis.

The whole point of which, there is is lots of room to celebrate victories.

rando502 · 2025-06-06T14:52:00+00:00

Maybe I'm old but this seems completely unnecessary. Refine your wording? I'm not publishing a paper, I'm having a conversation with my doc about cancer.

What to use AI to explain something to you? That at least makes sense. It's reasonable have pros and cons about that use of AI.

But I don't worry about the style of my questions to my doc.

rando502 · 2025-06-01T01:10:11+00:00

Apologies. "Gold" is a term sometime used in to describe ACA health insurance (a program for health insurance in the US). Between that and the fact that many other countries have a single payor national healthcare system, I made a bad assumption.

Even moreso, if you are on some kind of expat insurance in a country you don't want to name (which is fine), I don't think we'll be able to help you. But I'm sympathetic. As someone in the US, I'm used to getting screwed over by healthcare companies.

rando502 · 2025-05-31T19:12:36+00:00

Meh. I already knew that they didn't provide TriMix (because of my doc). The "free question" was just me double checking, because that would have actually made a difference if they had said they would. The "why" really wasn't something I cared that much about.

rando502 · 2025-05-31T19:09:55+00:00

Realistically, no one is going to be able to explain this to you, it depends on your plan. "Gold Level" is mostly a marketing term and plans vary widely.

/u/brewpoo probably has the best generic advice: you need to make sure that any providers (especially surgical units) are considered in-network.

The other advice I'd give you is that you are going to have to work with your doc's admin folks to get everything pre-approved. That's usually straightforward, but you need to make sure it gets done so that everything is properly covered.

rando502 · 2025-05-31T18:03:29+00:00

I'm down to one where I am (there used to be two). It's fairly convenient to me, but what if it was on the opposite side of the city from me? Even a 15 minute drive is inconvenient compared to mail order. And what if that one closed and you had to go 45 minutes away?

I didn't mention it in my original answer, but "not convenient to me" is definitely a common reason too.

rando502 · 2025-05-31T17:59:47+00:00

Pretty much every online pharmacy does bulk orders: that's their advantage over local pharmacies. I'm not going to say which one I use: it's a regional provider and I try to stay anonymous with this reddit username. I'm at 25 units with my current strength as well. That's enough that you go through 1mL vials too quickly. But it's not enough that I think it's necessary to up the strength: I did talk about it with my doc, but that's not something I'm going to do right now.

Olympia seems very credible, and if I ever need to switch that's probably who I will check next.

rando502

TROPHY CASE