I thought I'd provide an update. Some info may be of help to others. I met with Dr Sartor of Tulane University, Jan 10, 2023. He said my bloodwork was excellent. I had some questions. Can I go snow skiing in March? Yes. When do I have to worry about bones breaking. Dr Sartor said his recent experience using the Eligard, Abiraterone + Prednisone combo, was not as hard on bones as past treatments. He did recommend that I get a DEXA scan and take Oscal 500+D 2 times a day. As far as I know the Oscal company is out of business. I found a substitute. It contains, 10 mcg which equals 10 iu which Dr Sartor says is the minimum. For me, he recommended 2 pills a day. I take one in the morning and one at night.
I also told him that I sleep very poorly getting up 3 or more times a night to urinate. I suggested Merbetriq as I heard about it on this forum. He recommended 5mg Oxybutynin 2 times a day instead. He said it also helps with hot flashes. While sitting there he called in my prescription to my local Florida drug store. I've never had a doctor do that. When I got home I picked up the prescription, took one pill at lunch and another before bedtime. Amazingly I slept better and felt more relaxed when I got up. When I do urinate a stronger stream comes out. Hot flashes appear to be gone. The only downside is extremely dry mouth. My dental assistant turned me on to some over the counter products, mouthwash and spray. They can be found in the dental department. They appear to work.
After my initial discussion with Dr. Sartor I wanted to know what happens after my PSA goes up. I had a list. The first thing he talked about what getting a PSMA Pet scan and subjecting any hot spots to SBRT. He was interested in searching out those hot spots after my PSA gets up to 0.2. It's 0.05 now. Interestingly I talked to him about similar things 6 months ago. He didn't think other strategies were worth pursuing until PSA got up to 2. One other trick he mentioned was switching Prednisone to Dexamethasone. Two treatment strategies he said were dead, Thorium Th 227 anti-PSMA monoclonal anti body and Amgen AMG 509. Here's hoping for another 2 years.
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Skippy3
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could you elaborate on what he said about the switch from prednisone to dexamethisone. Are you making the change or only preparing for the eventual change if PSA rises?
It’s only if PSA goes up. Why a different steroid would help in that regard I don’t know. In any case I’m staying the course for now. It does beg the question, if your PSA goes up and a different steroid fixes it, are you really castrate resistant?
my husband sees Dr. Sartor also. Very personable and gave me his cell number to text any and all concerns I have. Our urologist in Mississippi recently told us Dr. Sartor is not taking any new patients. Not sure if that’s true, but thankful we are under his care. We go back to see him in February after a PSMA scan the end of the month. Good luck to you in your journey
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Just been told I have two years to live. 
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2 years of ADT counting from end of IMRT versus first injection 6 months before?
First ever PSMA scan shows two small bone lesions 
