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Help trt is terrible

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Find a new doctor.
Hard to do these days. I work as a GP and have patients driving 45 minutes each way to see me. They simply can't find doctors in their own communities. For a variety of reasons, not exclusively financial, comprehensive family practice has become an unattractive option for doctors. This means that the problem is only going to get worse...The reality is that there are a lot of bad docs out there and many folks are stuck with them.
 

gondar1

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Thanks for the answer @canadian-anabolicdoc ,

I don’t care about the legalities man- otherwise we’re all in the wrong for using PEDS. It’s bullshit regardless of who owns the right to disclose or not.
I put it that way because some guys ( like possibly @EastCoastMuscle ) are gonna care when in the position he is currently in. With the right info he can prove that it's bullshit and demand access to his info which is his right.

You have the right to any medical information that pertains to you, including test results, period. There are circumstances in which you can be charged a small fee for that information e.g. if you want your MRI images on CD, the hospital will typically charge a small fee for this. Here, you're not paying for the information per se, but for the time it took to put the images on CD and for the CD itself. The same applies to medical records. It takes quite awhile and often a shit ton of paper to print off someone's medical records, particularly if they're elderly and quite ill. Here again, you're not paying for the information per se but for the time it took to gather the information and print it off.

Ask your doctor for a copy of your test results. If he balks at this, I would ask him point blank "why not?" There's no sensible reason for him to be unwilling to provide you with a copy.
How about the bonus question Doc? Sorry to be a pain in the ass, I looked this up somewhere a while ago but I can't remember where I found it.

The answer was pretty much the same as yours above, something like 'the patient has the right to access any and all results in a timely manner as that info is considered his property, the caretaker may charge for reasonable production costs' . I have gotten around those costs before by simply asking very politely to see my file and taking pictures of what I needed. Always play nice with the office staff gents :)

Thanks again
 
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Patient Access to Records

Patients have a right of access to their personal health information that is in the custody or under the control of a HIC, including any information that has been stamped o rindicated as confidential, unless an exception applies. Physicians should consult section 52 of PHIPA for a comprehensive list of such exceptions and should seek the guidance of the CMPA or their legal counsel if unsure about how to respond to a request for access. Physicians cannot refuse to grant a patient access to theirrecords for the purpose of avoiding a legal proceeding. If a physician has refused a patient access to his or her record, the patient is entitled to make a complaint to the IPC under subsection 54(8) of PHIPA.

CPSO Policy Statement 4-12: Medical Records
 

Sorbate

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I'm fine with patients doing the shots at home, but only if they're comfortable with aspiration. Most patients aren't and come into the clinic every 1-2 weeks. I know, I know, q 2 weeks dosing is hardly ideal, but some patients prefer this.
I thought aspiration was not taught anymore?
I personally don’t care, I inject sub q.
 

xpac2

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I thought aspiration was not taught anymore?
I personally don’t care, I inject sub q.
When I was prescribed TRT my dr said not to aspirate as even if I did inject test into a vein it wouldnt cause any issues. This is a well respected mens clinic dr
 
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When I was prescribed TRT my dr said not to aspirate as even if I did inject test into a vein it wouldnt cause any issues. This is a well respected mens clinic dr
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205107/

Your doc is wrong on this one.

Injecting oil into a vein may result in a pulmonary embolism. Picture it - you inject 1/2 cc of oil into a vein in your right delt, that oil is transported to the right atrium via the superior vena cava, enters the right ventricle, and then is pumped directly into the pulmonary circulation. Although a small amount of oil won't cause a massive PE, it's hardly desirable. At the very least you'll be left coughing and feeling short of breath for a few days. Incidentally, if you had a right to left shunt in your heart (which could occur with right ventricular hypertrophy secondary to inadequately treated sleep apnea, for example), the oil could make its way to the left ventricle only to be pumped into the cerebral circulation, causing a stroke.
 

Jdave

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@gondar1 fair enough man I was just bitching being a cranky fuck screaming injustices at my phone lol

I need to stay out of these TRT threads - they’re ironically turning me into a grumpy old man reading how fucking stupid the healthcare system is and how callously ignorant doctors are - the word hubris comes to mind. Don’t aspirate... wow
 
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Your doc prescribed 250 mg a week? I'm guessing your T levels are well into the supraphysiologic range on that dose....
@canadian-anabolicdoc the value was 5 (don't remember the unit of measure) I was originally told this was next to almost absent. 250mg/week brings it to 38 (which is on the high end but this was titrated over 2 years from 100mg/week originally, and went as high as 350mg/week to find the optimal level)
 
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@canadian-anabolicdoc the value was 5 (don't remember the unit of measure) I was originally told this was next to almost absent. 250mg/week brings it to 38 (which is on the high end but this was titrated over 2 years from 100mg/week originally, and went as high as 350mg/week to find the optimal level)
Perhaps it's your size, or a particularly rapid steroid metabolism, that allows you to handle such doses Never encountered a patient who required such high doses.
 

gondar1

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@gondar1 fair enough man I was just bitching being a cranky fuck screaming injustices at my phone lol

I need to stay out of these TRT threads - they’re ironically turning me into a grumpy old man reading how fucking stupid the healthcare system is and how callously ignorant doctors are - the word hubris comes to mind. Don’t aspirate... wow
No issues bro, I feel the same way about some of the Dr's I've seen, the "top notch, best in the area, head of the department endo's" being the worst. I had to explain to one of them how 1/2 lives work because he couldn't understand why I didn't want to change from 2x a week and start running on a shot every 10 days. I drew the chart out for him and showed him where I was pretty near zero'd out. He said something like "well I'm just going by what the product monograph says but I guess what you're saying does make sense".

For Fuck sakes, is this your first time Doc?

PS - I never aspirate ;)
 

xpac2

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https://www.ncbi.nlm
.nih.gov/pmc/articles/PMC3205107/


Your doc is wrong on this one.

Injecting oil into a vein may result in a pulmonary embolism. Picture it - you inject 1/2 cc of oil into a vein in your right delt, that oil is transported to the right atrium via the superior vena cava, enters the right ventricle, and then is pumped directly into the pulmonary circulation. Although a small amount of oil won't cause a massive PE, it's hardly desirable. At the very least you'll be left coughing and feeling short of breath for a few days. Incidentally, if you had a right to left shunt in your heart (which could occur with right ventricular hypertrophy secondary to inadequately treated sleep apnea, for example), the oil could make its way to the left ventricle only to be pumped into the cerebral circulation, causing a stroke.
I understand what you are saying. How come Aspiration is no longer taught anymore though? Other than my dr, when I got a flu shot from my family gp there was no aspiration either. When I asked why he said they no longer teach it or use it. This was in the shoulder too not even the glute med where there is little risk of hitting a vein
 
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I understand what you are saying. How come Aspiration is no longer taught anymore though? Other than my dr, when I got a flu shot from my family gp there was no aspiration either. When I asked why he said they no longer teach it or use it. This was in the shoulder too not even the glute med where there is little risk of hitting a vein
Most injectable meds, including vaccinations, are water-based, and readily dissolve in the blood. Oil, on the other hand, does not. It forms globules in the bloodstream that can block blood vessels.
 

Mnemonic

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He probably saw that the result was in the normal range, posted it to the chart, and forgot about it. Not unreasonable to have you come in and discuss the results, but it would've been preferable for him to have a staff member contact you and let you know that he'd like to go over your test results.
It was more-so the fact that the office typically calls me within 48 hours of standard bloodwork if anything is out of range.
I told him my symptoms and requested to see my levels from the get-go, heard nothing in return.
I had to go out of my way to contact, book to speak with him and saw him a month after the fact. All he said was he thought it was fine all while leaving me in the dark considering I requested to hear about my levels.
 
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It was more-so the fact that the office typically calls me within 48 hours of standard bloodwork if anything is out of range.
I told him my symptoms and requested to see my levels from the get-go, heard nothing in return.
I had to go out of my way to contact, book to speak with him and saw him a month after the fact. All he said was he thought it was fine all while leaving me in the dark considering I requested to hear about my levels.
Definitely frustrating. It's amazing how often even critically important test results are not communicated to patients. I see it all the time...
 
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