Testosterone Friend Or Foe For Those ... - Advanced Prostate...

Advanced Prostate Cancer

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Testosterone Friend Or Foe For Those On a Drug Vacation

Nalakrats
Nalakrats

Using myself as an example---ONLY--I am reporting below some interesting personal Testosterone numbers, and how things may have occurred.

First I was diagnosed in Dec. 1993 as being Low T. under 320 ng/dl of blood. I was prescribed the shots, which became Androgel, and then Compounded Nature Identical. All authorized by Urologists until my Pca DX in 2015. I even took vacations, and after 30 days my T would drop back to 320. Under Supplementation, I maintained 800 ng/dl, for 22 years. and all my Docs. and I agree that T supplementation does not cause Pca. We are of the opinion that Low T is a sign that you may be getting Pca at some time.

The theory is---that just because you supplement---the body does not recognize you as normal T or high T--but considers itself Low T at all times. Even though you can build muscle like crazy, and go every day with the ladies, you are still Low T.

So after 22 months of ADT, now 75 years old--starting at age 71 my T averaged about 20. Discussions with my MO and Uro--all indicated that after such a time even though I had sex nerve sparring surgery---that My Leydic Cells were dead, or should be, and any T would probably just come from the Adrenals, and not my Testicles; anymore.

Well delving into my Supplemental Knowledge Base, as soon as I went on my ADT vacation---PSA on ADT and off/vacation--has now accumulated to 32 months of undetectability. So as to the supplementation, I added 2 supplements: Stinging Nettle, caps and Tea, and the real winner in my opinion, Avena Sativa. and made a drug adjustment and got my T3 Thyroid number up well over the mid-point of the range. Now Avena Sativa--is Green Oat Grass--which is what they feed Studding Horses to keep them going after the Mares, day and night. So the Chemistry on this is that 90% of our Testosterone at most times is bound to our SHBG[Sex Hormone Binding Globulin], And the supplements unbind the T from the SHBG, which dramatically increases your Free T, Which is what really counts. If you have a 1000 ng/dl T but almost zero Free T you are mostly worthless, if it is all bound up.

OK on to the numbers --now maybe I do not have them all, exact, but as I went on vacation, over the months my T went from 20--105--155--215--310--405--550--630--to last week 759. I had never had my Natural T ever be over 340 in 20 plus years. My 42 Year old MO asked, are you supplementing?---no I said---just using things in nature, as God has provided. He continued you know your T is 200 points more than me. I just shrugged. This plan was hatched with my Integrative GP--he took care of the Thyroid, and I took care of the rest

This is just a report. That one can keep their Leydic cells alive with--- the right Supplemental program, and by go easy on them if you use the Vantas Lupron type implant while on ADT. There is no harsh up and down shocks to the body--from the shots--especially when they load you up with a 3 or 6 month shot. These tend to kill the Leydic cells IMO.

NOW CAUTION/WARNING--I AM NOT RECOMMENDING, NOT ONE READER TO DO WHAT I HAVE DONE. AND THERE IS NO WAY THAT I WOULD ATTEMPT ANYTHING AS DESCRIBED ABOVE. I DID IT BECAUSE I ACCUMULATED MANY MANY MONTHS OF UNDETECTABILITY--RE: PSA, AND NEGATIVE BONE SCANS. SO PLEASE NO ONE THINK FOR A SECOND THEY CAN DO THIS. BUT THERE ARE MEN THAT HAVE BEEN PSA UNDETECTABLE OR IN A DURABLE REMISSION, FOR MANY YEARS, WHO HAVE THOUGHT ABOUT GETTING THEIR T BACK. I AM JUST REPORTING. AND AS USUAL, I MAKE THE CLAIM THAT I AM NOT A DOCTOR.

Interesting as I finish up, the hair under my arms have not come back, the pubic hair is still very sparse, hair on back gone---thank God. And I do not need deodorant, as it appears, my body is not making male Pheromones yet. But I got to admit the Dry Orgasms while not like the old days--are pretty damn good--and available daily. What a way to end a Post.

Nalakrats

43 Replies

So wonderful to have you back. I admire your writing style, your knowledge and most of all I admire you as a human being. Thanks for encouraging me.

PS my testosterone level is 12 and my psa 0.029.

PS

My new doctor is cancer.ucsf.edu/people/prof...

Nalakrats
Nalakrats in reply to IgnatiusN

Glad your PSA is in the undetectable range---I am still writing on paper a post on undetectable PSA's and trying to kill off that which we cannot detect--coming soon--need some more meta-data---will be asking our group for some of the data---soon.

Available daily at age 75 after PCa surgery and time on ADT.

I am mightily impressed!

Alan

Nalakrats
Nalakrats in reply to AlanMeyer

Alan, my Integrative Md, and I were working on my low Thyroid T3--as my T4 was fine , but I was not converting the T4 to T3---so in the complicated world of Body Hormones and how they all work together--we added synthetic T3, and to a high normal level. Boy the afternoon naps stopped--I purposely took them. Then I went after my Free T, not being on ADT, I knew and used Green Oat Grass, and Stinging Nettle which I knew released bound T from the SHBG molecule----so my interest was to increase free T--the total T flying up as it did, was a surprise, yet pleasant--I did not fear for one moment that High T would bring my cancer back. No one really knows how this happened. I have a free Docs, thinking on it we even had blood sent to the Mayo Clinic--yes I am a gym hog, and I may post a picture.

But something kicked into gear--and my supplemental program being so complex--we may never find an answer. Ben you are loaded with T as a 30 year old, as long as you have enough blood support--and my Sex Nerves were sparred--you can every day--but at 75, once a week is fine.

Nalakrats

I took magnesium, B6, zinc and added one small portion of grass fed beef ,once a week, also did 50 pushups every third day for four months after finishing salvage radiation and Lupron. My PSA is now .05 and testosterone went from 20 to 750.

Hidden
Hidden in reply to Egerdes

Wow!

Nalakrats
Nalakrats in reply to Egerdes

Well I take all that you do and another 30---and I do 2 hours in the gym 4 times a week.

But I still cannot identify how, I got to where I did--glad there was someone else--pjoshea13---our Patrick Researcher, I think called me a freak.

Nalakrats

So I have a question- much has been made in your posts re: low PSA and high T. But from what I have read, merely have low PSA is not a good indicator for cancer progression. Normally with HT one will achieve low PSA and thanking their lucky stars thinking they have cancer under control, only to find out later that HT is not a cancer killer, thus rendering the low PSA a false indicator re: the state of cancer. Now you have added in T supplements to the equation, resulting in high/moderate T.

Lets assume that T doesn't increase Ca, but are we to assume that high T along with low PSA does have some "killer" effect on Ca, or are we to assume that one will still have the slow pregression of Ca, but now at least he can enjoy the benefit of high T while he is slowly cruising down the cancer route?

Hidden
Hidden in reply to arete1105

Great questions!

Nalakrats
Nalakrats in reply to arete1105

Not quite sure where you are going--read your reply twice--I am sorry--I was being confused somehow. Maybe you need to separate Low T as a subject relative to Pca, and High T, relative to Pca.

Nalakrats

Hidden
Hidden

A real happy ending! , daily, great for you! You fascinate and intrigue us ,Thanks!

I do not do it daily---like once a week--but can if required.

Nalakrats

Hidden
Hidden

How long did it take for T to get to 105, from 20?

I recently stopped Lupron to see if my SRT worked!

Nalakrats
Nalakrats in reply to Hidden

30 days

Nalakrats

Hidden
Hidden in reply to Hidden

I wasn't looking for that, but I found that the RT did not work, probably like thousands of others would if they dropped the Lupron. I quit Lupron because of the man boobs. My T went over 200 and my PSA went to 36 and they found spots on 12th vertebra and pelvic bone all in about 100 days. The speediness due to my suppressed immune system due to liver transplant. So I'm now on Lexapro. Supposedly spots will go away and hopefully so will the excess fat. P.S. You're playing with fire.

Nalakrats
Nalakrats in reply to Hidden

I am not taking any supplemental T--My T went up naturally after 22 months on ADT. My Doctor--GP--adjusted my Thyroid Hormones up as they were low--and I went from low to High Normal--and my T went up from 20 to 758 in about 10 months. And during the vacation, thank God, my PSA remains undetectable.

Sorry things did not work out for you--I am not playing with fire--just living life naturally!!!

Nalakrats

Great to hear, glad your doing well. But due miss the hair under my arms. 🙏🙏🙏🙏🙏

No I do not miss it---looks great.

Nalakrats

I left you a DM follow up Re the T issue

Great summary, thanks. Glad it worked so well for you. There's definitely something about low T and PCa progression. I never measured before but can tell that I had all signs of low T prior to DX: I couldn't gain muscle no matter how hard worked out and ate, was progressively tired, had no body hair and pretty thin even where it was. Yet, I had extremely high sex drive and even now after 8 months on ADT can have it everyday. So, if all my T was SHGBed, then the ratio of free T to estrogen was just right for fueling PCa (if this theory holds). Add to that systemic autoimmune disease with constant inflammation and we got a perfect setting for an aggressive PCa development. Now I wish to get back to square one and experiment with hormone levels and T specifically. But my MO is very cautious about it. His opinion is with my aggressive GS 9 and tumor volume I had at DX it would be very risky to take ADT vacation. I'm debating now if I should take another 6 months Lupron only or Lupron with Zytiga added and only then try it.

I waited 22 months undetectable before vacation, some more modernist MO's suggest 12,13, and 18 and 20 months---quoting some of their numbers. Because of my G-9, and having the rare Ductal Cribriform--some wanted me to go 36 months--I cut bait, and rely on my supplemental program, and a program that controls DHT and E2.

If you decide to go--and I am not a Dr. or recommending---I found that the use of Avena Sativa, by Swanson's, and Stinging Nettle Caps, and Tea, while keeping my T3 at high normal levels was key to unlock bound T. and increase total T----> Thyroid really key.

How long have you been PSA undetectable

henukit
henukit in reply to Nalakrats

I haven't had undetectable PSA. I went from 500 at DX to 0.43 in 8 months (more details here healthunlocked.com/advanced...). My T is below detectable.

I don't believe it's feasible to achieve undetectable PSA with prostate still there. MO recommends next step RP or/and SBRT and then triple blockade and only then wait and see.

Nalakrats
Nalakrats in reply to henukit

I agree strongly. I personally like the old fashioned open RP by a surgeon who has done at least 1,000 of them--mine had done 1,700

Nalakrats

henukit
henukit in reply to Nalakrats

I'm trying to avoid RP/RT. We still want to have a child. I have a following plan as an option: add Zytiga for 6 months and then take a break, boost T and then see where PSA is going. If we get to conceive in this window - great. Otherwise, as soon as PSA raises over 2.0 I'd go for a sensitive PET scan (C11 choline or other) to pinpoint exact places where cancer is actually active (and it may not be even in prostate as observations show). Only after this I would make decision to go after those sites with precision therapy: be it brachy, cryoablation, SBRT or even RP. But that's my plan, we will see what clinical panel recommends.

Nalakrats
Nalakrats in reply to henukit

Truly understand--at 75 I am long past Kids--but the creation of new life is an imperative.IMO.

Nalakrats

Welcome back, and what an entrance. I'm 3 months following the discontinuance of triple blockade, after RT and brachy (finished 7 months ago) but staying on Avodart for now on RO's advice. Testo is minimal to undetectable and PSA is still undetectable. My testes seem to have shrunk into oblivion. I understand that testo can take a year or more to return, and in some case, it will never return. I was on Testosterone replacement (topical cream) for more than a year, after years of low normal levels, when my PSA started going up, and DREs and prostate USs were negative. I'm not sure what to think about whether or not the testo replacement contributed to or exacerbated my situation. I'll be following your progress with interest, if you're willing to share it.

Thanks

Nalakrats
Nalakrats in reply to yamobedeh

My testes shrunk, as well as my tool. And my T was about 20 for 24 months--PSA Undetectable for 22 months on triple blockade--plus 3[Proscar, DIM, and Arimidex]. On vacation 10 months--but still on Avodart Proscar DIM and Arimidex. At age 75 my T came from 22 up to 758, last week,--which is normal for a 35 year old. So as I said, its the combo[I believe] of getting the Thyroid hormones up and taking the supplements I suggested to free the Bound T. My Medicos, do not know, but not overly interested. My Uro, says I am just weird. I think he thinks I am on the T cream.

Nalakrats

"But I got to admit the Dry Orgasms while not like the old days--are pretty damn good--and available daily". ???

Okay rub it in.... 😥

Good Luck and Good Health.

j-o-h-n Friday 10/5/2018 6:35 PM EDT

Nalakrats
Nalakrats in reply to j-o-h-n

Well when your natural T is at 758, you got to do something with it--cannot always spend my time in the gym.

Nalakrats

j-o-h-n
j-o-h-n in reply to Nalakrats

I see, not in the gym... more in the Jane....

Good Luck and Good Health.

j-o-h-n Friday 10/5/2018 8:48 PM EDT

Nal...i like the thing about no deodarant....i to am a non user any more...and also living in houston where we gave mosquitos with saddles...the just fly on bye....lupron it aint all bad....now if i can remeber how to drive i have a drs.apt....

Put the key in the ignition, turn it on and hit the pedal---please do not hit any living thing.

Nalakrats

Nalakrats,

First off, Thanks to you for the rich information you provide to the rest of us. In fact, after several years of reading, I recently joined the community, in part because of your return from your sabbatical and also because I felt it was time to share my own experiences. (In the hope that it may be useful to others.)

I would be interested in what you make of my recent “enigmatic” disease condition as noted below. The first part of this history is taken from my initial introductory post (New Member – Hoping to be able to contribute to the rich knowledgebase here! ) earlier this week:

____________________________________________________________________________________________

I had robotic NSRP in August 2013. Final biopsy staging was Gleason 4+3, 30% cancerous, non-confined, extracapsular involvement, rt seminal vesicle invasion and a staging of pT3a/3b pNx. Since my CLL likely caused some lymph nodes to light-up on pre-surgery scan, 5 lymph nodes (4 on right side + 1 on left) were biopsied at start of RP procedure. All were positive for CLL, but negative for PC. My surgeon obviously did a respectable job as my PSA fell to "undetectable <0.1" within 30 days post-surgery.

With a pathology showing 3 out of 4 negatives (all but LNI), I chose to do adjuvant radiation as soon as possible after the surgery. That entailed 8 weeks of IMRT radiation in the Spring of 2014. (34 treatments = 63 Gy total) My PSA remained undetectable until March 2016. (about 30 months after surgery and 24 months after IMRT - so it’s not clear that I got a "major" benefit from the radiation.)

When my PSA began its rise in March 2016, it did so with a vengeance - with a doubling rate of about 45 days! From the time I got my first lab +0.2 until I stated ADT 6 months later it had rapidly risen to 25+. During that time my cancer center got me into the Strata clinical trial. This was trial that tested about 125 genetic defects to match patients with targeted drug trials. Considering a family history where both parents and each of my 4 siblings has either died from or been treated for cancer, I was surprised, to say the least, that I was negative for all 125 defects. (The testing used tissue from my final biopsy, so I guess there is always the possibility that there could be some genetic evolution since then??)

____________________________________________________________________________________________

And while some of the known defects for PC were not tested, some were; i.e., AR, BRCA1/2, TP53, PTEN, KRAS, NOTCH, MYC, MTOR, PIK3CA, EZH2, ERG, ETV1, ETV4, ETV5, etc. I also had two set of CT/bone scans during my PSA rise which were both negative for tumors.

I should also add that I maintain a very active lifestyle (at least for a 71 year old), hitting the gym daily. But at my current 145+ pounds, I can hardly be considered a “body-builder”. Most significantly in my case, after the radical rise in my PSA after my biochemical recurrence, I started IADT (3 months on/3 off was the plan) in August 2013. After 3 months my PSA was “undetectable <.1” and my T was 9! (Not a typo; i.e., Welcome to my new life as Cujosephine – Get out the training bra & silk lingerie for hangin’ out on the Wild Side with Caitlyn J!) After 3 months off ADT, my PSA remained <0.1 and my T had risen to 586! (Toss out ladies wear and get out the macho muscle shirts!) That is the highest T level I have ever tested. At that visit my doctor referred to me as an “enigma” - due to the contradictory nature of the undetectable PSA and rapid rise in T. Also at that time, and with my complete approval, we decided to forego the next round of ADT and see if the results were sustainable over another 3 months.

I have now had two additional visits with similar results of “undetectable” PSA and T in the normal range. At my most recent visit, we agreed to extend my appointment interval to 4 months, which puts my next visit in late December. Of possible significance, my last labs showed a definite downward trend in my T levels, most recently dropping all the way down to a level of 190. So, if the PSA remains “undetectable” in December (which would get me to 1+ yr off treatment), I will be looking to see if my T continues its downward trend, especially since that would likely take it out of the normal range. That would definitely seem to be something to pay attention to and try to understand.

I also have a indolent blood cancer (CLL), but for the 12 years since diagnosis I have so far not needed treatment. I am currently very stable stage one with blood work that is much improved over that when I was first diagnosed. I began a personally directed program of diet/lifestyle/supplements for that disease and have continued and modified it over the years for PCA and as I learned more. (Thanks in part to people like you.) I eventually went to a mostly vegan diet and am now about 95% with it all the time. When I started ADT I did a major revamp to my supplements, adding a lot of plant powders, and spices to my daily routine. And while I have no proof that any part of that has contributed to my “enigmatic” medical status, I’m not planning on changing it anytime soon.

Having seen it up-close and personal, I am not the greatest proponent of chemotherapy. In fact, at my last visit, my oncologist said that one member of my treatment review team recommended that we do chemo now while the cancer was “weak”. (My words, not his.) I deferred considering that for the time being, partly because with the return of my T to normal levels, I feel so damn much better than I did for my even short time on ADT. I realize that that could mean I am choosing short-term quality over longer-term quantity - and I am completely comfortable with that possible outcome.

I look forward to the results of you sabbatical “research” and your recently initiated survey.

Be Well and Keep That Gator Blood Flowing,

Cujoe

Nalakrats
Nalakrats in reply to cujoe

I had the same thing happen with my T-after 22 months Undetectable with ADT-6, and my supplemental monster program, I did vacation now 10 months, and I do have 2 Nasty Gene mutations, and my T shot up to 758, as of 2 weeks ago. Also the highest number in 25 years--as I was low T---so I measured my free T, saw it needed a nudge, and added Avena Sativa and Stinging Nettle, and my Free T in about 30 days went right into the middle of the range as I dislodged the Bound T from the SHBG.

Nalakrats

Part one as you sent me a lot---water under the Bridge--I would have had all those Nodes removed--and not rely on a lab biopsy in the middle of surgery. You just needed a few undetectable cells to come back 3 years later---I will be addressing this soon--as to some research I have been doing over the summer. Where undetectable does not mean that there is not anything there. Just because you cannot detect, does not mean there is nothing there our scans and blood test cannot get down to the single remaining cancer cell. And if given the right conditions this one cell will split its nucleus and then itself creating a daughter cell, and the race is on--all while being undetectable.

As to having Gene Mutations later, when none were detected is not plausible. BRCA 1-2 and PTEN are common with agressive cancers--and yes it is possible for mutations to skip a generation as to activation. My mother was clean her Sister and their father not, and yet both my brother and I got Pca--with Gene mutations. I had 328 evaluated with Foundation One Not from a biopsy but from the Gland that was removed.

I will continue a bit later--going to eat.

Nalakrats

cujoe
cujoe in reply to Nalakrats

Nalakrats,

Thanks for your comments. They are appreciated and always insightful.

In recent history, cancer has not seen fit to skip any generations in my family. Both parents (bladder & bile duct) and two of my siblings have died from cancer. (brother from pancreatic and sister from breast and/or ocular melanoma) My other two sisters have also been treated for breast cancer, with the triple-negative flavor the second time around. Two of them were tested for BRAC1/2 and both came back negative. Since all three were on estrogen replacement therapy at menopause and/or on estrogen-based birth control, I believe that was the likely trigger for their breast cancers.

The next generation is getting cancer earlier, as I have two nephews (from two different sisters) who have had prostatectomies while still in their 40s. I guess this is the main reason I was surprised with the Strata results. With all that cancer, I expected to light up the board. I never fathered any kids, so at least I’ve not had to personally worry about passing C along to future generations.

The negative results from Strata confirm my opinion that if genes load the gun, it is diet and lifestyle (along with a lifetime of exposure to environmental toxins) that pulls the trigger. Most of my family likes to “blame” genes for their cancer. That way they can go on with their unhealthy lifestyles without feeling any guilt for not making changes.

As for the lymph nodes, I don’t disagree that doing a clean sweep would have improved the likelihood of picking up any stray cells. I am also suspicious that the surgeon knew from the pre-op scans that the cancer was out of the capsule on the right side and likely in the seminal vesicle. I was pretty sure my nodes would probably light up on the scans (due to the CLL) and he told me in advance that had the lymph nodes been positive for PC, he would abort the surgery and treat with radiation. As I recently said elsewhere, I am happy that the surgery went ahead, as it removed the source of the cancer and provided a better definition of its extent. It also allowed for a complete biopsy of the gland and related plumbing. BTW, the tissue used for the Strata trial was from my prostate gland final biopsy done after it was removed.

I mentioned the possibility of cancer-causing genetic “evolution”, as that is a recognized risk with my other cancer, CLL, so I would expect the same to be the case for PC.

I assume you are dinning with Gusgold on a menu of various flavored BIM smoothies laced with Proscar, Avodart, and Arimidex. Bon appétit!

Be Well, Cujoe

Nalakrats
Nalakrats in reply to cujoe

You should read Dr. Friedman's book Testosterone Prostate, Breast cancer and Alzheimer's---this molecular biologist with 40 years or research, and backed with over 200 bibliographies in this book------identifies----->E2, as the culprit, loved by the Membrane Androgen Receptors of the Pca cell. ---too complicated to discuss--as it must be read. It will make you change your diet---I.E. I will not eat Yams as they contain Phyto-Estrogens, which can metabolize to E2---so you know why I look to Avodart, DIM, and Arimidex---Arimidex is a protocol for women with Breast Cancer---see a link?

And the only one I dine with on a regular basis is Patrick--as we live close by to each other. Gusgold lives in the Mid-West---and last I checked there were no Alligators there.

But I plan to be with my friends in Florida---where I winter over--and plan to enjoy their blood! Lots of Fishing---and in the Intercoastal, and Canals, you can find me dining on Gar, and Blood.

Nalakrats

Nalakrats
Nalakrats in reply to cujoe

Also you may want to discuss with Foundation One their Gene Mapping--as they check 328 genes---and your old test did not show PTEN--unless you left it out. In the test they today can add the AR-V7--i believe, and the Pd-1 test, all at one time---again from a sample--or they can do a liquid biopsy---800 number on their web site--you get really intelligent people when you call who can answer a lot of your questions. My first call, I was on the phone with them for an hour.

Nalakrats

cujoe
cujoe in reply to Nalakrats

I will definitely get Friedman's book and consider the Foundation One Gene Test. I seem to remember seeing that Medicare will cover some testing from them.

I hope you are not headed for areas of FL hit by Michael. It looks really bad down there. I just saw some drone footage with devastation in Mexico Beach that looked like that from a tornado. Back in 2002-3 I worked for a design/planning firm out of Tallahassee and Panama City Beach. Most of our work was on development along the Gulf Coast, so I know the area hit pretty well. I'm now located on the coast of your warm weather home state (NC?) and was the dead center target for Florence. I live on a boat, so I was prepared to be homeless. As anticipated, my location was/is the most protected local location to be for the NE wind that hurricanes generate. I had no damage to my boat or a car in a storage building. Surge here was big issue and not the 150 mph winds + surge of Michael. Just as with medical issues, we don't usually have to look very far to find others with much larger problems than ours.

Hope the gator wrestling goes well for you this winter.

Thanks again for the input. Be Well, Cujoe

Nalakrats
Nalakrats in reply to cujoe

My favorite Isle to Fish in N.C. Topsail was wiped out. I do not go to Fla--until Xmas, and I am in Ormond Beach, for the winter---so at night I have time to respond on this site--as I will be fishing during the day looking for gators.

Foundation One accepts Medicare---My 328 Gene Mapping was totally free--they do all the work--getting Biopsy or saved Gland Material if you had surgery--if radiated--I think they need to do a liquid biopsy--they will explain it all. If in Asheville you can join Patrick and I for lunch. We get pretty wonky though!

Nalakrats

cujoe
cujoe in reply to Nalakrats

My local newspaper's website had post-Florence photos of damage at North Topsail and it looked to be significant.

newbernsj.com/photogallery/...

NTB was front and center for the most powerful NE quadrant of the hurricane winds as it came ashore. Once Florence made a left turn (never seen that before) after coming ashore, the winds transitioned to mostly off-shore so barrier island development (in northern NC and most of SC) actually fared better than if the storm had headed north along the coast. As with Floyd (1999) the inland flooding caused by the rainfall (coupled with the surge) caused much of the damage to coastal NC.

I'm in New Bern which got surge at or near that of Hazel (October 15, 1954). I remember my dad driving me downtown after Hazel and seeing a small power boat go by on the first street off the waterfront in the downtown. While I was out of town for Florence, I sure I could have seen the same thing this time around. During Florence I was up in New Hampshire for a once-a-year reunion with old workmates and good friends. This was year 23. No TV and I am still the proud user of an old non-netted "dumb" phone, so I took the attitude of Florence being "out of sight and out of mind". During the weekend of the storm, the weather up in NH was spectacular, with 86 degrees on Sunday and since there would have been nothing useful to do here in NC, I traded being here for being in a great place with great friends enjoying good food and good times with very good friends. What's not to like.

I did get several texts from boat neighbor who were monitoring social media and passed along info that our boats were doing fine during the storm. The biggest concern for us was that the surge would be high enough to float the docks off of the pilings. In that case the phrase "all is lost" would likely have applied. Roller marks on pilings after the storm indicated that in some parts of the marina we had about 18-24" to spare. I've heard surge numbers from 10 to 11 feet. Three boats sank in my marina, but a marina across from us got completely destroyed, with most of the boats that did not leave either sunk in the marina or scattered about on dry land. Two local boat yards had many boats float off their stands, with some ending up in residential neighborhoods on the opposite side of the Neuse River. So it turned out that hauling out (which I considered) did not guarantee a better outcome than staying in the water. My marina is fronted on the north by a series of 4 to 5 story buildings that help dampen the NE wind generated by the counter-clockwise hurricane rotation. That has saved the day for this marina during Florence and Irene 7 years ago.

When I found out you were seeing an oncologist at Levine, I considered trying to orchestrate a get-together with you and a stage 4 PC patient (being treated at Duke) I know through my nephew in Charlotte. My oldest sister was a patient at Levine for metastatic (at diagnosis) breast cancer. She beat the odds and made it 12 years, passing away last year at Thanksgiving. Her three kids all live in the area, so I will continue to spend Thanksgiving with them in Charlotte.

I have a old college roommate and later work collaborator who lives in Asheville. He had a heart transplant at Duke about two years ago and I owe him a visit, so if I get over there when you are not chasing gators in FL, I would be honored to join you and Patrick for lunch in one of the most fun cities on the East Coast. Definitely won't happen this year, but I will see what I can do in 2019.

Be Well. Cujoe

PS Wind is just now starting to pick up here as TS Michael heads north. As expected it is coming in from the SE, so I will get the brunt of the wind today will look forward to a rock and roll day on the water.

Fantastic results! Congratulations! How did you choose when to stop ADT (why 22 months, not 6, 12, 18?) and could avena sativa be useful for having high SHBG but before treatment of prostate (or it is dangerous because T gets higher?

Nalakrats
Nalakrats in reply to Myriammole

I would not be playing around with Avena Sativa. It is only useful when Free T is low, and you have normal Total T.

Vacation was determined by me, 2 of my Docs. and the work of Dr. Liebowitz, and Dr. Meyers. The more aggressive the cancer, the longer you want to keep it undetectable before taking a Primary ADT Vacation. Recommendations for me went from 18 months to 24 months to 30 months. I just stuck my finger in the air and said time to stop, and see what my body will do.

Nalakrats

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