Re: Please help me gather some information for my husband...

July 21, 2008

As most people will tell you on this forum and who do shot that every two

weeks is old school, he needs to cut his dose in 1/2 and do his shots weekly

(100mg once a week.) I started all this when I was 37 and did the patch and

gels but switched to shot about a year ago I'm now 39. Did he get a

diagnoses of Secondary? From what you are saying his LH/FSH where also down

with his T levels this would indicate that his pituitary was not functioning

correctly. Did he get an MRI of his pituitary and have his prolactin levels

checked? You need to make certain he dosn't have tumor!

He would also want to keep his E2 (estrodiol levels checked) if they are

high there are ways to bring this down also. What other blood work has he

had done?

On Mon, Jul 21, 2008 at 11:08 AM, amck12 <ryannladen@...> wrote:

> Hello,

>

> I just joined this group today looking for information to help my

> husband. We are both so overwhelmed and having a difficult time

> lately. About a year ago my then 30 year old husband started feeling

> more fatigued when training for a triathalon. He was always a

> healthy, active person but started noticing that it took him longer

> to recover from workouts. Around the same time he started losing

> interest in sex and had difficulty sexually. I thought it was

> because I was pregnant and that the stress of becoming soon-to-be new

> parents and my physical changes were difficult for him. It took us

> over two years and a surgery for a varicocele and an IUI to get

> pregnant, by the way. The reasons for infertility were thought to be

> difficulties with his sperm morphology and my hypothyroidism.

> Anyhow, we finally got him to a urologist in January and they checked

> some levels... LH was 0.7 (low), FSH was 0.6 (low) and testosterone

> was 24 L (very low - reference was 225-972). Anyway, my husband,

> bless his heart, hates talking about this stuff and I know very

> little about all of this. At one point this spring his liver numbers

> were also high (even before starting androgel) but now they are

> lower. Anyway, he did not like the gel or the patch and is currently

> on week 3 1/2 of the shots (getting 200 injected every 2 weeks). He

> is an emotional rollercoaster, poor guy, and it has been very tough

> on us all. I want to help him so badly but don't know how. Another

> issue is his appetite. He goes on these eating binges has difficulty

> stopping. He has lost interest in almost everything and is so down.

> I recently read online that testosterone replacement therapy can

> cause men to become sterile? Is this true? Also, has anyone else

> had experience with binge eating issues? I have read once or twice

> where testosterone can affect appetite. Any help and support would

> be appreciated!!! Thank you!

>

July 21, 2008

I forgot to mention - they don't know what has caused his

hypogonadism... Thanks for any help you can provide!

>

> Hello,

>

> I just joined this group today looking for information to help my

> husband. We are both so overwhelmed and having a difficult time

> lately. About a year ago my then 30 year old husband started

feeling

> more fatigued when training for a triathalon. He was always a

> healthy, active person but started noticing that it took him longer

> to recover from workouts. Around the same time he started losing

> interest in sex and had difficulty sexually. I thought it was

> because I was pregnant and that the stress of becoming soon-to-be

new

> parents and my physical changes were difficult for him. It took us

> over two years and a surgery for a varicocele and an IUI to get

> pregnant, by the way. The reasons for infertility were thought to

be

> difficulties with his sperm morphology and my hypothyroidism.

> Anyhow, we finally got him to a urologist in January and they

checked

> some levels... LH was 0.7 (low), FSH was 0.6 (low) and

testosterone

> was 24 L (very low - reference was 225-972). Anyway, my husband,

> bless his heart, hates talking about this stuff and I know very

> little about all of this. At one point this spring his liver

numbers

> were also high (even before starting androgel) but now they are

> lower. Anyway, he did not like the gel or the patch and is

currently

> on week 3 1/2 of the shots (getting 200 injected every 2 weeks).

He

> is an emotional rollercoaster, poor guy, and it has been very tough

> on us all. I want to help him so badly but don't know how.

Another

> issue is his appetite. He goes on these eating binges has

difficulty

> stopping. He has lost interest in almost everything and is so

down.

> I recently read online that testosterone replacement therapy can

> cause men to become sterile? Is this true? Also, has anyone else

> had experience with binge eating issues? I have read once or twice

> where testosterone can affect appetite. Any help and support would

> be appreciated!!! Thank you!

>

July 21, 2008

Sorry to hear about your husband. I am sure Phil will jump in here and give you

lots of good information to read up on. Just my 2 cents is that his pituitary

gland is not working correctly. Maybe a MRI is in order. Those LH, FSH, and T

numbers are very, very low. The 200mg of testosterone every two weeks is sending

him on a roller coaster ride. Take a look at Dr. Crisler's Web site and

read his paper on TRT and HCG. He recommends starting with weekly 100mg

injections. A lot of us do the injections at home and it isn't really a big

deal.

http://www.allthingsmale.com/index.htm

http://www.allthingsmale.com/publications.html

Please help me gather some information for my husband...

Hello,

I just joined this group today looking for information to help my

husband. We are both so overwhelmed and having a difficult time

lately. About a year ago my then 30 year old husband started feeling

more fatigued when training for a triathalon. He was always a

healthy, active person but started noticing that it took him longer

to recover from workouts. Around the same time he started losing

interest in sex and had difficulty sexually. I thought it was

because I was pregnant and that the stress of becoming soon-to-be new

parents and my physical changes were difficult for him. It took us

over two years and a surgery for a varicocele and an IUI to get

pregnant, by the way. The reasons for infertility were thought to be

difficulties with his sperm morphology and my hypothyroidism.

Anyhow, we finally got him to a urologist in January and they checked

some levels... LH was 0.7 (low), FSH was 0.6 (low) and testosterone

was 24 L (very low - reference was 225-972). Anyway, my husband,

bless his heart, hates talking about this stuff and I know very

little about all of this. At one point this spring his liver numbers

were also high (even before starting androgel) but now they are

lower. Anyway, he did not like the gel or the patch and is currently

on week 3 1/2 of the shots (getting 200 injected every 2 weeks). He

is an emotional rollercoaster, poor guy, and it has been very tough

on us all. I want to help him so badly but don't know how. Another

issue is his appetite. He goes on these eating binges has difficulty

stopping. He has lost interest in almost everything and is so down.

I recently read online that testosterone replacement therapy can

cause men to become sterile? Is this true? Also, has anyone else

had experience with binge eating issues? I have read once or twice

where testosterone can affect appetite. Any help and support would

be appreciated! !! Thank you!

July 21, 2008

First I need to tell you with a low level of LH and FSH like this I feel his

Pituitary is not working right this can happen from a tumor don't get worked up

up this is rare it's cancer. If he was over doing his training for this

triathlon this can shut down his HPTA function.

It would take a dam good Dr. to test this and treat it to try to get it going

again. It is much like what happens to men that do steroids but in his case it

can be from over training.

First thing that happens is the Adrenals get over worked and we get Adrenal

Fatigue Dr.'s don't look for this in labs if they tested his Cortisol levels as

long as he is in the normal range to most Dr.'s he is OK. This is not true.

Here is a reply by Dr. nco on over training.

================================

Lab findings consistent with adrenal fatigue include:

1. low normal cortisol

2. low DHEA

3. low to low normal progesterone

4. low sodium

5. low potassium

6. high albumin

7. etc.

Bodybuilding is a severe nervous system, endocrine system, immune system stress.

The bodybuilding literature has numerous articles about the need for rest to

allow muscles to recover from the damage induced by weight training, to grow in

adaptation to the progressively higher stress levels due to progressively higher

weights used. It is important to avoid OVERTRAINING - since overtrained muscles

may fail to adapt to the stress and shrink rather than grow. Some of the top

bodybuilders give each muscle about a week of rest between intense weightlifting

exercises.

What is not often realized is that the nervous system, endocrine system, and

immune system also have to rest and recover from the stress of weight lifting.

Central to this are the adrenal glands - which is a component of all three

systems. Just as one's muscles fatigue, the adrenals fatigue in response to

weight lifting.

One symptom of adrenal fatigue is hunger or a sensation of low blood sugar -

since one's body has more difficulty during adrenal fatigue in producing blood

sugar and in burning fat and protein for energy. Many people get the munchies

after weight traning and gain a lot of fat rather than muscle.

Other symptoms include the sensation of being " burned out " , lack of sex drive,

impaired attention, depression or anxiety, insomnia, etc.

Adrenal fatigue is a sign of OVERTRAINING.

Adrenal fatigue indicates one has not recovered their neuroendocrine and immune

system well enough before embarking on another round of weight lifting stress.

Each person has a unique time for recovery of the adrenal glands.

One cannot goad or force the adrenal glands to recover faster. The elements of

treatment are time and stress reduction.

The treatments of adrenal fatigue essentially reduce the adrenal glands'

workload/stress, thus allowing them to rest while one is still active and

stressed in life. But the adrenal glands will still need time to recover.

Often, a common time frame for recovery from moderate adrenal fatigue is about 6

months of rest.

More severe adrenal fatigue (e.g. where one cannot exercise or at worse, where

one is essentially nonfunctional and bedridden) may take up to two or more years

of total rest without stress to fully recover.

Reducing one's stress during the recovery period is highly important to improve

the rate at which the adrenal glands recover from fatigue. Some bodybuilders

take periodic time off from bodybuilding (e.g. some take at least 6 weeks off)

to recover from signs of overtraining (e.g. hitting a wall or plateau, feeling

burned out, etc.).

It is interesting how many bodybuilding products contain stimulants (such as

caffeine). These not only work in the brain, but they also goad the adrenal

glands to work harder against the stress of weight lifting. These stimulants,

however, are a significant stress, to the adrenal glands. Eventually, adrenal

fatigue may occur. One adrenal fatigue occurs, the stimulants stop working or

don't work well at all.

__________________

Any statement I make on this site is for educational purposes only and will

change as medical knowledge progresses. It does not constitute medical advice,

does not substitute for proper medical evaluation from physician, does not

create a doctor/patient relationship or liability. If you would like medical

advice, please ask your doctor. Thank you.

==================================================

This Dr. is one of the best he come to this site searching for info about low

testosterone for his new book. So in the process of us helping him he help us

posting about the different problems we have. Some of the guys copied all his

posts into a book it's full of good info about health.

So this maybe his problem I have talked to a lot of men that messed there selves

up over training. They ended up with low testosterone, low cortisol " Adrenal

Fatigue " and some even Thyroid problems. One of the big problems they all had

was finding a good Dr. up on this to treat them. Not just put a band aid on it

like giving then Testosterone because there levels are low. A good Dr. runs

more tests trying to find out why one is low.

Now about his shots this is so dam old doing big shots every 2 weeks this puts

him on a roller coaster ride up after the shot only to fall back down days

before the next shot.

It's even in the AACE Guildlines page 11 to do shots every 7 to 10 days.

http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf

It will be very hard now to find out why he is low because he is on TRT. And

don't let a Dr. send him to see an Endo they are not good Dr.'s for this. And

will only make him feel worse taking him off the T meds to do what they call a

base line lab. There is not such thing once we go on Testosterone are mind

shuts down sending the LH and FSH messages to the testis to make testosterone

and there is no way it will start working again in the time Endo's take you off

TRT meds.

To help him feel better he needs to start doing his own shots doing say 100 mgs

a week to start retest in 8 weeks and go by his lab and how he feels. Also add

in HCG doing 250 IU's a shot on the 5th and 6th days each after his T shot this

will keep him leveled and keep his testis working.

He needs to try to get his levels up into the upper 1/3 of his labs range for a

young man for both Total and Free Testosterone. Also from doing them big shots

this will drive up his Estradiol levels and higher levels undoes the good TRT

dose for us. So do get this checked and try to keep it down at about 20 pg/ml

one thing that happens when this is to high is we get ED and have a loss of

libido a good way to tell is if he has night time and morning wood if not this

can be way.

Yes being on T meds can make him sterile but it's not permanent most men that

are Secondary and I feel he is the pituitary is not sending the LH and FSH

message to his testis to make testosterone.

If you read the link I gave you the AACE Guildlines read about doing an Clomid

or HCG Stim. test. If his testis do work doing this test his levels will go way

up. It's after this he should have an MRI done on his Pituitary Gland.

When we are very fatigued some of use eat a lot to get more energy.

I could go on for hrs. about this but this is getting long. Your HB needs to

get on the forums here is a link to a forum I am also a mod at for one of the

best Dr.'s on male hormones Dr. . He needs to go there and talk to the

other men that are in his shape do to over training.

http://www.musclechatroom.com/forum/private.php

I don't know where you live but Dr. is in MI. a lot of men drive or fly out

to see him he only needs to see you once and can test and treat you by phone or

Email.

Dr. nco is in central Ca. he also only needs to see him once. He is a Dr.

of Psychiatry that believes most health problems are do to bad hormones and his

new book will change the way Psychiatry will be practiced.

If you need more just ask.

http://definitivepsychiatry.com/services/services.html

Co-Moderator

Phil

> From: amck12 <ryannladen@...>

> Subject: Please help me gather some information for my

husband...

>

> Date: Monday, July 21, 2008, 11:08 AM

> Hello,

>

> I just joined this group today looking for information to

> help my

> husband. We are both so overwhelmed and having a difficult

> time

> lately. About a year ago my then 30 year old husband

> started feeling

> more fatigued when training for a triathalon. He was

> always a

> healthy, active person but started noticing that it took

> him longer

> to recover from workouts. Around the same time he started

> losing

> interest in sex and had difficulty sexually. I thought it

> was

> because I was pregnant and that the stress of becoming

> soon-to-be new

> parents and my physical changes were difficult for him. It

> took us

> over two years and a surgery for a varicocele and an IUI to

> get

> pregnant, by the way. The reasons for infertility were

> thought to be

> difficulties with his sperm morphology and my

> hypothyroidism.

> Anyhow, we finally got him to a urologist in January and

> they checked

> some levels... LH was 0.7 (low), FSH was 0.6 (low) and

> testosterone

> was 24 L (very low - reference was 225-972). Anyway, my

> husband,

> bless his heart, hates talking about this stuff and I know

> very

> little about all of this. At one point this spring his

> liver numbers

> were also high (even before starting androgel) but now they

> are

> lower. Anyway, he did not like the gel or the patch and is

> currently

> on week 3 1/2 of the shots (getting 200 injected every 2

> weeks). He

> is an emotional rollercoaster, poor guy, and it has been

> very tough

> on us all. I want to help him so badly but don't know

> how. Another

> issue is his appetite. He goes on these eating binges has

> difficulty

> stopping. He has lost interest in almost everything and is

> so down.

> I recently read online that testosterone replacement

> therapy can

> cause men to become sterile? Is this true? Also, has

> anyone else

> had experience with binge eating issues? I have read once

> or twice

> where testosterone can affect appetite. Any help and

> support would

> be appreciated!!! Thank you!

>

> ------------------------------------

>

July 21, 2008

My husband is going to start shots of Testosterone Cypionate today. I

talked to the doctor about what I had learned here and he thought I

was insane to even be reading any of this. I am so concerned about

him becoming sterile as well. So if a man has secondary, this will

happen but will not be permanenet? We are trying right now to get

pregnant.....

TIA Heidi

>

> > From: amck12 <ryannladen@...>

> > Subject: Please help me gather some information

for my husband...

> >

> > Date: Monday, July 21, 2008, 11:08 AM

> > Hello,

> >

> > I just joined this group today looking for information to

> > help my

> > husband. We are both so overwhelmed and having a difficult

> > time

> > lately. About a year ago my then 30 year old husband

> > started feeling

> > more fatigued when training for a triathalon. He was

> > always a

> > healthy, active person but started noticing that it took

> > him longer

> > to recover from workouts. Around the same time he started

> > losing

> > interest in sex and had difficulty sexually. I thought it

> > was

> > because I was pregnant and that the stress of becoming

> > soon-to-be new

> > parents and my physical changes were difficult for him. It

> > took us

> > over two years and a surgery for a varicocele and an IUI to

> > get

> > pregnant, by the way. The reasons for infertility were

> > thought to be

> > difficulties with his sperm morphology and my

> > hypothyroidism.

> > Anyhow, we finally got him to a urologist in January and

> > they checked

> > some levels... LH was 0.7 (low), FSH was 0.6 (low) and

> > testosterone

> > was 24 L (very low - reference was 225-972). Anyway, my

> > husband,

> > bless his heart, hates talking about this stuff and I know

> > very

> > little about all of this. At one point this spring his

> > liver numbers

> > were also high (even before starting androgel) but now they

> > are

> > lower. Anyway, he did not like the gel or the patch and is

> > currently

> > on week 3 1/2 of the shots (getting 200 injected every 2

> > weeks). He

> > is an emotional rollercoaster, poor guy, and it has been

> > very tough

> > on us all. I want to help him so badly but don't know

> > how. Another

> > issue is his appetite. He goes on these eating binges has

> > difficulty

> > stopping. He has lost interest in almost everything and is

> > so down.

> > I recently read online that testosterone replacement

> > therapy can

> > cause men to become sterile? Is this true? Also, has

> > anyone else

> > had experience with binge eating issues? I have read once

> > or twice

> > where testosterone can affect appetite. Any help and

> > support would

> > be appreciated!!! Thank you!

> >

> > ------------------------------------

> >

July 21, 2008

I the labs you gave us were before he started on Testosterone then I would say

he can't make a baby with his LH and FSH this low. But there are things that

needed to be done before going on T meds like have his sperm tested then if it

was good freaze it in case he can't later on TRT. If his LH and FSH are this

low with high Estradiol it's the high Estradiol that did this to the LH and FSH

but now he is no TRT and it's to let to tell. All you can do is a clomid or HCG

stim. test. If his pituitary is doing this then going on HCG will make his

testis make testosterone and you might be able to have a kid. You need a Dr.

like Dr. for this what state do you live in.

Co-Moderator

Phil

> From: idhides <hides13@...>

> Subject: Re: Please help me gather some information for my

husband...

>

> Date: Monday, July 21, 2008, 3:50 PM

> My husband is going to start shots of Testosterone Cypionate

> today. I

> talked to the doctor about what I had learned here and he

> thought I

> was insane to even be reading any of this. I am so

> concerned about

> him becoming sterile as well. So if a man has secondary,

> this will

> happen but will not be permanenet? We are trying right now

> to get

> pregnant.....

> TIA Heidi

>

> >

> > > From: amck12 <ryannladen@...>

> > > Subject: Please help me gather

> some information

> for my husband...

> > >

> > > Date: Monday, July 21, 2008, 11:08 AM

> > > Hello,

> > >

> > > I just joined this group today looking for

> information to

> > > help my

> > > husband. We are both so overwhelmed and having a

> difficult

> > > time

> > > lately. About a year ago my then 30 year old

> husband

> > > started feeling

> > > more fatigued when training for a triathalon. He

> was

> > > always a

> > > healthy, active person but started noticing that

> it took

> > > him longer

> > > to recover from workouts. Around the same time

> he started

> > > losing

> > > interest in sex and had difficulty sexually. I

> thought it

> > > was

> > > because I was pregnant and that the stress of

> becoming

> > > soon-to-be new

> > > parents and my physical changes were difficult

> for him. It

> > > took us

> > > over two years and a surgery for a varicocele and

> an IUI to

> > > get

> > > pregnant, by the way. The reasons for

> infertility were

> > > thought to be

> > > difficulties with his sperm morphology and my

> > > hypothyroidism.

> > > Anyhow, we finally got him to a urologist in

> January and

> > > they checked

> > > some levels... LH was 0.7 (low), FSH was 0.6

> (low) and

> > > testosterone

> > > was 24 L (very low - reference was 225-972).

> Anyway, my

> > > husband,

> > > bless his heart, hates talking about this stuff

> and I know

> > > very

> > > little about all of this. At one point this

> spring his

> > > liver numbers

> > > were also high (even before starting androgel)

> but now they

> > > are

> > > lower. Anyway, he did not like the gel or the

> patch and is

> > > currently

> > > on week 3 1/2 of the shots (getting 200 injected

> every 2

> > > weeks). He

> > > is an emotional rollercoaster, poor guy, and it

> has been

> > > very tough

> > > on us all. I want to help him so badly but

> don't know

> > > how. Another

> > > issue is his appetite. He goes on these eating

> binges has

> > > difficulty

> > > stopping. He has lost interest in almost

> everything and is

> > > so down.

> > > I recently read online that testosterone

> replacement

> > > therapy can

> > > cause men to become sterile? Is this true?

> Also, has

> > > anyone else

> > > had experience with binge eating issues? I have

> read once

> > > or twice

> > > where testosterone can affect appetite. Any help

> and

> > > support would

> > > be appreciated!!! Thank you!

> > >

> > > ------------------------------------

> > >

July 21, 2008

Providing that your husband really has secondary Hypo, fertility is not out of

the picture.

This is where having a doctor who will prescribe HCG is vital and HMG is even

better.

These two drugs can be used on a regular basis to keep the testicles working

and from

shrinking down to rasin size.

Assuming that your husaband was fertile before he started TRT, while there are

no

guarnetees, fertility can often be restored.

Any doctor who does not monitor your husbands E2, levels and check for prolactin

levels

before starting TRT is not up to date on male TRT. Search the files section of

this group

for the AACE guidelines for treating and diagnosing hyo. If your doctor has an

open mind

and a bit of humility, give him or her a copy to read. If his or her ego is

bigger than their

desire to truly treat your husband, then find a new doctor

July 21, 2008

Sounds like it might be time for a second opinion from a good DO.

Please help me gather some information

for my husband...

> >

> > Date: Monday, July 21, 2008, 11:08 AM

> > Hello,

> >

> > I just joined this group today looking for information to

> > help my

> > husband. We are both so overwhelmed and having a difficult

> > time

> > lately. About a year ago my then 30 year old husband

> > started feeling

> > more fatigued when training for a triathalon. He was

> > always a

> > healthy, active person but started noticing that it took

> > him longer

> > to recover from workouts. Around the same time he started

> > losing

> > interest in sex and had difficulty sexually. I thought it

> > was

> > because I was pregnant and that the stress of becoming

> > soon-to-be new

> > parents and my physical changes were difficult for him. It

> > took us

> > over two years and a surgery for a varicocele and an IUI to

> > get

> > pregnant, by the way. The reasons for infertility were

> > thought to be

> > difficulties with his sperm morphology and my

> > hypothyroidism.

> > Anyhow, we finally got him to a urologist in January and

> > they checked

> > some levels... LH was 0.7 (low), FSH was 0.6 (low) and

> > testosterone

> > was 24 L (very low - reference was 225-972). Anyway, my

> > husband,

> > bless his heart, hates talking about this stuff and I know

> > very

> > little about all of this. At one point this spring his

> > liver numbers

> > were also high (even before starting androgel) but now they

> > are

> > lower. Anyway, he did not like the gel or the patch and is

> > currently

> > on week 3 1/2 of the shots (getting 200 injected every 2

> > weeks). He

> > is an emotional rollercoaster, poor guy, and it has been

> > very tough

> > on us all. I want to help him so badly but don't know

> > how. Another

> > issue is his appetite. He goes on these eating binges has

> > difficulty

> > stopping. He has lost interest in almost everything and is

> > so down.

> > I recently read online that testosterone replacement

> > therapy can

> > cause men to become sterile? Is this true? Also, has

> > anyone else

> > had experience with binge eating issues? I have read once

> > or twice

> > where testosterone can affect appetite. Any help and

> > support would

> > be appreciated! !! Thank you!

> >

> > ------------ --------- --------- ------

> >

July 22, 2008

On Mon, 21 Jul 2008 15:08:23 -0000, you wrote:

>Hello,

>

>I just joined this group today looking for information to help my

>husband. We are both so overwhelmed and having a difficult time

>lately.

You have come to the right place. The good news is T shots and proper

treatment will fix all of this. There are also readily available ways

to keep his fertility (assuming he is secondary hypogonadic- that is

that his testicles still work but are not getting the necessary

signals from the pituitary. The low FSH and LH suggest that is the

case.The bad news is you have to work to get the proper treatment. The

condition is rare enough that most doctors are not up to speed on the

state of the art treatment and are doing cook book treatment from the

70s. Even endocrinologists (or especially endocrinologists) are not

good at treating this condition. They work mostly with diabetes,

women's issues and thyroid issues. They are mostly relying on their

old textbook knowledge when treating low T - and its woefully out of

date.

You are going to have to get educated some to be able to get the

treatment he needs and deserves.

A simple read on some of the issues is

Dr. Shippen's book :

The Testosterone Syndrome

http://www.amazon.com/Testosterone-Syndrome-Critical-Sexuality-Reversing-Menopau\

se/dp/087131858X/ref=sr_1_1?ie=UTF8 & s=books & qid=1216752025 & sr=8-1

This will clue you in to what behaviors are due to your husband's low

T. One of the major problems is that low T diminishes your drive to do

things. It also takes away your caring about things. It can make you a

couch potato or slug. This means he likely will not have the energy

and drive to seek the change he needs. But he is already on shots so

you've likely gotten past a lot of that.

Start with the AACE treatment guidelines:

http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf

These are slightly out of date - they don't look at estrogen/estradiol

issues much. But they are a huge help in learning what your doctor

should do.

There is also the endo society treatment guide:

http://www.endo-society.org/guidelines/Current-Clinical-Practice-Guidelines.cfm

Testosterone Therapy in

Adult Men with

Androgen Deficiency Syndromes:

(I note this was updated in 2006!)

For starters note they say injections should be every 7 to 10 days to

avoid the high peaks and low valleys of the two week cycle with it's

roller coaster mood swings.

You should note your husband needed a prolactin test. Did they do one?

One of the principle causes of secondary low T is small adenomas on

the pituitary. These are virtually always not cancerous - and benign.

But it's scary to hear that tumor word. Most good docs will do an MRI

or cat scan if you have insurance to rule out their presence and see

if there are other anomalies to the pituitary. (Mine for example has

been knocked out of its bone " saddle " ) All the treatment in the world

will not help his mood and energy if he has high prolactin. If he has

it, it usually responds to medication and T gets back to normal

without shots, etc. Occasionally surgery is used.

Also he definitely needs a estradiol test. Estradiol is the strongest

of the estrogens- known as E2. In men T is converted to E2 by an

enzyme (aromatase). If mens levels of this get high they lose some

erection ability, some libido. They get weepy, lethargic, emotional,

and more. It is in many ways like low T and just as debilitating. In

some men just controlling high E2 brings their T levels back up as

much as 200 to 300 points. (Your husbands numbers are so low this is

unlikely to be enough for him). Also when T is as super low as your

husbands it is possible that E2 is actually low before T therapy, as

there is not enough T to convert to E2 in meaningful amounts.

When he started on T his body converts a certain amount of it to E2.

It's very common to produce too much E2. This is especially so on the

gels, and on longer shot cycles like the two weeks. The higher the T

dose the more " spill over " there is into E2. SO if you're husband is

still feeling down, has some libido and erection issues he's almost

certainly converting enough to have E2 levels that are too high. E2

also out competes T for numerous bonding sites in the body and brain

and thus robs the body of the full benefit of T therapy.

He definitely needs an E2 test. Once you get a number people can talk

with you about how to reduce it if it is high. There is a common

medication that is extremely effective (though hard to get some

doctors to prescribe) and also a supplement that can reduce milder

cases into an acceptable range.

It is true that T therapy can reduce fertility. This is easily fixable

in secondary cases with supplementation with HCG

(http://en.wikipedia.org/wiki/Human_chorionic_gonadotropin)

HCG mimics LH output from the pituitary and signals the testes to make

more sperm. Many men mix small doses of this several times a week

with their T therapy.

High cortisol levels also sometimes drive T levels down and should be

tested.

Keep in touch here. It's a tough ride, but he will get better and

soon. Faster if you get good advice here to help you evaluate the

doctor's knowledge and plans. (Probably 80% of us had doctors add to

our suffering rather than help initially.)

Your husband may be down and unmotivated with high E2 or prolactin.

You will need to supply the energy in that case. It's not easy. And

you're dealing with his " masculinity " sex drive and ability and the

rest. (Be aware when he gets well and gets T up and E2 down he will be

chasing you around the house like a teenager. You'll have different

issues then!)

There are some women who have come through here before. Vickie comes

to mind. Search the messages via the web site for " husband " and you

can find e-mails for women who have come through seeking help. You

could likely e-mail them directly and get the benefit of their

experience. (They stop posting and visiting when things get better, so

personal e-mails will likely do better.) Hang in there. It will get

better. And so will he. It just takes a bit of work. It can come

together quickly with the right tests and therapy. A few weeks and

he'll be good as new or better.

It can put strains on a relationship. You need to work on that a lot

till you come out the other side. Getting well presents issues too.

For me it was a tough go. I was sick for years before they found it,

and so there was a lot of baggage to overcome. My wife thought I was

lazy, depressed, or otherwise a problem. When I got well I wanted

everything fixed right away - all that new energy - and that meant her

too. It was a struggle but we're better and stronger for it. Married

28 years now. SO hang tough. The fact you're here for him says a lot

about you.

He's lucky to have you in his corner. He's going to need it.

>About a year ago my then 30 year old husband started feeling

>more fatigued when training for a triathalon. He was always a

>healthy, active person but started noticing that it took him longer

>to recover from workouts. Around the same time he started losing

>interest in sex and had difficulty sexually. I thought it was

>because I was pregnant and that the stress of becoming soon-to-be new

>parents and my physical changes were difficult for him. It took us

>over two years and a surgery for a varicocele and an IUI to get

>pregnant, by the way. The reasons for infertility were thought to be

>difficulties with his sperm morphology and my hypothyroidism.

>Anyhow, we finally got him to a urologist in January and they checked

>some levels... LH was 0.7 (low), FSH was 0.6 (low) and testosterone

>was 24 L (very low - reference was 225-972).

>Anyway, my husband,

>bless his heart, hates talking about this stuff and I know very

>little about all of this. At one point this spring his liver numbers

>were also high (even before starting androgel) but now they are

>lower. Anyway, he did not like the gel or the patch and is currently

>on week 3 1/2 of the shots (getting 200 injected every 2 weeks). He

>is an emotional rollercoaster, poor guy, and it has been very tough

>on us all. I want to help him so badly but don't know how.

> Another

>issue is his appetite. He goes on these eating binges has difficulty

>stopping. He has lost interest in almost everything and is so down.

>I recently read online that testosterone replacement therapy can

>cause men to become sterile? Is this true? Also, has anyone else

>had experience with binge eating issues? I have read once or twice

>where testosterone can affect appetite. Any help and support would

>be appreciated!!! Thank you!

July 22, 2008

Wow reto great post you are the man.

Co-Moderator

Phil

>

> >Hello,

> >

> >I just joined this group today looking for information

> to help my

> >husband. We are both so overwhelmed and having a

> difficult time

> >lately.

>

> You have come to the right place. The good news is T shots

> and proper

> treatment will fix all of this. There are also readily

> available ways

> to keep his fertility (assuming he is secondary

> hypogonadic- that is

> that his testicles still work but are not getting the

> necessary

> signals from the pituitary. The low FSH and LH suggest that

> is the

> case.The bad news is you have to work to get the proper

> treatment. The

> condition is rare enough that most doctors are not up to

> speed on the

> state of the art treatment and are doing cook book

> treatment from the

> 70s. Even endocrinologists (or especially endocrinologists)

> are not

> good at treating this condition. They work mostly with

> diabetes,

> women's issues and thyroid issues. They are mostly

> relying on their

> old textbook knowledge when treating low T - and its

> woefully out of

> date.

>

> You are going to have to get educated some to be able to

> get the

> treatment he needs and deserves.

>

> A simple read on some of the issues is

> Dr. Shippen's book :

> The Testosterone Syndrome

>

http://www.amazon.com/Testosterone-Syndrome-Critical-Sexuality-Reversing-Menopau\

se/dp/087131858X/ref=sr_1_1?ie=UTF8 & s=books & qid=1216752025 & sr=8-1

>

> This will clue you in to what behaviors are due to your

> husband's low

> T. One of the major problems is that low T diminishes your

> drive to do

> things. It also takes away your caring about things. It can

> make you a

> couch potato or slug. This means he likely will not have

> the energy

> and drive to seek the change he needs. But he is already on

> shots so

> you've likely gotten past a lot of that.

>

> Start with the AACE treatment guidelines:

> http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf

> These are slightly out of date - they don't look at

> estrogen/estradiol

> issues much. But they are a huge help in learning what your

> doctor

> should do.

>

> There is also the endo society treatment guide:

>

http://www.endo-society.org/guidelines/Current-Clinical-Practice-Guidelines.cfm

>

> Testosterone Therapy in

> Adult Men with

> Androgen Deficiency Syndromes:

> (I note this was updated in 2006!)

>

> For starters note they say injections should be every 7 to

> 10 days to

> avoid the high peaks and low valleys of the two week cycle

> with it's

> roller coaster mood swings.

>

> You should note your husband needed a prolactin test. Did

> they do one?

> One of the principle causes of secondary low T is small

> adenomas on

> the pituitary. These are virtually always not cancerous -

> and benign.

> But it's scary to hear that tumor word. Most good docs

> will do an MRI

> or cat scan if you have insurance to rule out their

> presence and see

> if there are other anomalies to the pituitary. (Mine for

> example has

> been knocked out of its bone " saddle " ) All the

> treatment in the world

> will not help his mood and energy if he has high prolactin.

> If he has

> it, it usually responds to medication and T gets back to

> normal

> without shots, etc. Occasionally surgery is used.

>

> Also he definitely needs a estradiol test. Estradiol is the

> strongest

> of the estrogens- known as E2. In men T is converted to E2

> by an

> enzyme (aromatase). If mens levels of this get high they

> lose some

> erection ability, some libido. They get weepy, lethargic,

> emotional,

> and more. It is in many ways like low T and just as

> debilitating. In

> some men just controlling high E2 brings their T levels

> back up as

> much as 200 to 300 points. (Your husbands numbers are so

> low this is

> unlikely to be enough for him). Also when T is as super low

> as your

> husbands it is possible that E2 is actually low before T

> therapy, as

> there is not enough T to convert to E2 in meaningful

> amounts.

>

> When he started on T his body converts a certain amount of

> it to E2.

> It's very common to produce too much E2. This is

> especially so on the

> gels, and on longer shot cycles like the two weeks. The

> higher the T

> dose the more " spill over " there is into E2. SO

> if you're husband is

> still feeling down, has some libido and erection issues

> he's almost

> certainly converting enough to have E2 levels that are too

> high. E2

> also out competes T for numerous bonding sites in the body

> and brain

> and thus robs the body of the full benefit of T therapy.

>

> He definitely needs an E2 test. Once you get a number

> people can talk

> with you about how to reduce it if it is high. There is a

> common

> medication that is extremely effective (though hard to get

> some

> doctors to prescribe) and also a supplement that can reduce

> milder

> cases into an acceptable range.

>

> It is true that T therapy can reduce fertility. This is

> easily fixable

> in secondary cases with supplementation with HCG

> (http://en.wikipedia.org/wiki/Human_chorionic_gonadotropin)

> HCG mimics LH output from the pituitary and signals the

> testes to make

> more sperm. Many men mix small doses of this several times

> a week

> with their T therapy.

>

> High cortisol levels also sometimes drive T levels down and

> should be

> tested.

>

> Keep in touch here. It's a tough ride, but he will get

> better and

> soon. Faster if you get good advice here to help you

> evaluate the

> doctor's knowledge and plans. (Probably 80% of us had

> doctors add to

> our suffering rather than help initially.)

>

> Your husband may be down and unmotivated with high E2 or

> prolactin.

> You will need to supply the energy in that case. It's

> not easy. And

> you're dealing with his " masculinity " sex

> drive and ability and the

> rest. (Be aware when he gets well and gets T up and E2 down

> he will be

> chasing you around the house like a teenager. You'll

> have different

> issues then!)

>

> There are some women who have come through here before.

> Vickie comes

> to mind. Search the messages via the web site for

> " husband " and you

> can find e-mails for women who have come through seeking

> help. You

> could likely e-mail them directly and get the benefit of

> their

> experience. (They stop posting and visiting when things get

> better, so

> personal e-mails will likely do better.) Hang in there. It

> will get

> better. And so will he. It just takes a bit of work. It can

> come

> together quickly with the right tests and therapy. A few

> weeks and

> he'll be good as new or better.

>

> It can put strains on a relationship. You need to work on

> that a lot

> till you come out the other side. Getting well presents

> issues too.

> For me it was a tough go. I was sick for years before they

> found it,

> and so there was a lot of baggage to overcome. My wife

> thought I was

> lazy, depressed, or otherwise a problem. When I got well I

> wanted

> everything fixed right away - all that new energy - and

> that meant her

> too. It was a struggle but we're better and stronger

> for it. Married

> 28 years now. SO hang tough. The fact you're here for

> him says a lot

> about you.

>

> He's lucky to have you in his corner. He's going to

> need it.

>

> >About a year ago my then 30 year old husband started

> feeling

> >more fatigued when training for a triathalon. He was

> always a

> >healthy, active person but started noticing that it

> took him longer

> >to recover from workouts. Around the same time he

> started losing

> >interest in sex and had difficulty sexually. I thought

> it was

> >because I was pregnant and that the stress of becoming

> soon-to-be new

> >parents and my physical changes were difficult for him.

> It took us

> >over two years and a surgery for a varicocele and an

> IUI to get

> >pregnant, by the way. The reasons for infertility were

> thought to be

> >difficulties with his sperm morphology and my

> hypothyroidism.

>

> >Anyhow, we finally got him to a urologist in January

> and they checked

> >some levels... LH was 0.7 (low), FSH was 0.6 (low) and

> testosterone

> >was 24 L (very low - reference was 225-972).

>

> >Anyway, my husband,

> >bless his heart, hates talking about this stuff and I

> know very

> >little about all of this. At one point this spring his

> liver numbers

> >were also high (even before starting androgel) but now

> they are

> >lower. Anyway, he did not like the gel or the patch

> and is currently

> >on week 3 1/2 of the shots (getting 200 injected every

> 2 weeks). He

> >is an emotional rollercoaster, poor guy, and it has

> been very tough

> >on us all. I want to help him so badly but don't

> know how.

>

> > Another

> >issue is his appetite. He goes on these eating binges

> has difficulty

> >stopping. He has lost interest in almost everything

> and is so down.

> >I recently read online that testosterone replacement

> therapy can

> >cause men to become sterile? Is this true? Also, has

> anyone else

> >had experience with binge eating issues? I have read

> once or twice

> >where testosterone can affect appetite. Any help and

> support would

> >be appreciated!!! Thank you!

>

> ------------------------------------

>

July 22, 2008

On Tue, 22 Jul 2008 15:07:37 -0700 (PDT), you wrote:

>Wow reto great post you are the man.

>

>Co-Moderator

>Phil

Thanks. I just felt it was important to get her as much good info at

the start as possible. It took a couple days to find the time. I

admire wive's who care and work like this for their guys. We should

all be so lucky. (I am.)

July 23, 2008

Yes and when the women post for the HB I bend over backwards for them. My wife

was not like this just the opposite. And it's people like you and others that

make this site out last all the others.

Co-Moderator

Phil

>

> >Wow reto great post you are the man.

> >

> >Co-Moderator

> >Phil

>

> Thanks. I just felt it was important to get her as much

> good info at

> the start as possible. It took a couple days to find the

> time. I

> admire wive's who care and work like this for their

> guys. We should

> all be so lucky. (I am.)

>

> ------------------------------------

>

July 23, 2008

He is a very lucky man! My wife doesn't understand or really want to at all.

When the pay checks quit coming, maybe that will perk her up?

Re: Please help me gather some information for my

husband...

Yes and when the women post for the HB I bend over backwards for them. My wife

was not like this just the opposite. And it's people like you and others that

make this site out last all the others.

Co-Moderator

Phil

>

> >Wow reto great post you are the man.

> >

> >Co-Moderator

> >Phil

>

> Thanks. I just felt it was important to get her as much

> good info at

> the start as possible. It took a couple days to find the

> time. I

> admire wive's who care and work like this for their

> guys. We should

> all be so lucky. (I am.)

>

> ------------ --------- --------- ------

>

July 23, 2008

I hear ya my wife turned into a monster when I got sick and could not work yet I

got sick pay never lost any money just overtime. Then as time went on and they

could not figure out what was wrong with me. I was labeled with having Major

Depression and had to go along with this because I was on sick leave and needed

a Dr. to keep my job and get my sick pay.

Some don't have any idea how hard it is to be sick and not know what is wrong

and have a wife bitching at you telling you your worth less might as well kill

your self. Yet heard this many times after being treated for this for 5 yrs my

BCBS through work wanted to know from the Dr. why after 5 yrs I was not getting

better. This A-Hole told my job and my BCBS I don't want to get better and will

never get better. I then got a letter from work saying they were stopping all

my sick pay and locking me out of work pending some kangaroo court they were

planning on. They even denied me unemployment pay.

My wife left me and I ended up going to the EEOC and pressing charges against my

Job and the Union I was a member in for discrimination against this sick. They

took my case and sued them I won. It was just about this time I found out I was

not depressed but have low testosterone.

My wife come back but we will never be the same as we were before I got sick.

Later some 23 yrs we found out way I was in a bad auto accident and had a head

injury that damaged my pituitary.

I can't tell you how lucky he is to have a good women that stands by her man.

Co-Moderator

Phil

> >

> > >Wow reto great post you are the man.

> > >

> > >Co-Moderator

> > >Phil

> >

> > Thanks. I just felt it was important to get her as

> much

> > good info at

> > the start as possible. It took a couple days to find

> the

> > time. I

> > admire wive's who care and work like this for

> their

> > guys. We should

> > all be so lucky. (I am.)

> >

> > ------------ --------- --------- ------

> >

July 23, 2008

Your wife is a lucky lady because if she was my wife treating me that way I'd

have dumped her sorry unsupportive a$$ to the curb quick.

My GF supports me and I her or its not worth it. My ex acted that way and she

will stay an ex. You have a lot of patience and forgiveness in you Phil. I hope

it pays off!

Sent from my Verizon Wireless BlackBerry

Re: Please help me gather some information for my

husband...

I hear ya my wife turned into a monster when I got sick and could not work yet I

got sick pay never lost any money just overtime. Then as time went on and they

could not figure out what was wrong with me. I was labeled with having Major

Depression and had to go along with this because I was on sick leave and needed

a Dr. to keep my job and get my sick pay.

Some don't have any idea how hard it is to be sick and not know what is wrong

and have a wife bitching at you telling you your worth less might as well kill

your self. Yet heard this many times after being treated for this for 5 yrs my

BCBS through work wanted to know from the Dr. why after 5 yrs I was not getting

better. This A-Hole told my job and my BCBS I don't want to get better and will

never get better. I then got a letter from work saying they were stopping all

my sick pay and locking me out of work pending some kangaroo court they were

planning on. They even denied me unemployment pay.

My wife left me and I ended up going to the EEOC and pressing charges against my

Job and the Union I was a member in for discrimination against this sick. They

took my case and sued them I won. It was just about this time I found out I was

not depressed but have low testosterone.

My wife come back but we will never be the same as we were before I got sick.

Later some 23 yrs we found out way I was in a bad auto accident and had a head

injury that damaged my pituitary.

I can't tell you how lucky he is to have a good women that stands by her man.

Co-Moderator

Phil

> >

> > >Wow reto great post you are the man.

> > >

> > >Co-Moderator

> > >Phil

> >

> > Thanks. I just felt it was important to get her as

> much

> > good info at

> > the start as possible. It took a couple days to find

> the

> > time. I

> > admire wive's who care and work like this for

> their

> > guys. We should

> > all be so lucky. (I am.)

> >

> > ------------ --------- --------- ------

> >

July 23, 2008

Yep this is about what I did she left thinking this would make her point. I have

the locks changed and would not let her back and seen a lawyer. We were just

about divorced when she had her lawyer ask my lawyer what she needed to do for

us to get back together. I have to grown married girls with Grand Kids at the

time. So I told her to go into therapy and we would see how this went. All is

good now just not the same as it was it's dam hard to forget the things that

were said and done. But still all is good.

Co-Moderator

Phil

> > >

> > > >Wow reto great post you are the man.

> > > >

> > > >Co-Moderator

> > > >Phil

> > >

> > > Thanks. I just felt it was important to get her

> as

> > much

> > > good info at

> > > the start as possible. It took a couple days to

> find

> > the

> > > time. I

> > > admire wive's who care and work like this for

> > their

> > > guys. We should

> > > all be so lucky. (I am.)

> > >

> > > ------------ --------- --------- ------

> > >

July 23, 2008

I just wish one of you was my husband, he will not read any of this

and thinks I am crazy for looking into all of it. He would not go and

get a sperm count because he thinks it was a waste of money. So we

may never have kids. When I talked to the doc about putting him on

HCG as well, the doc thought I was crazy too! It;s great that you all

have such open minds!!!

> > > >

> > > > >Wow reto great post you are the man.

> > > > >

> > > > >Co-Moderator

> > > > >Phil

> > > >

> > > > Thanks. I just felt it was important to get her

> > as

> > > much

> > > > good info at

> > > > the start as possible. It took a couple days to

> > find

> > > the

> > > > time. I

> > > > admire wive's who care and work like this for

> > > their

> > > > guys. We should

> > > > all be so lucky. (I am.)

> > > >

> > > > ------------ --------- --------- ------

> > > >

July 23, 2008

I bet he will wake up fast if you told him to get with the program or your out

of there. Any man with them problems that acts like this is only thinking about

his self. And it's all over the news men with low testosterone don't live as

long as men with good levels.

http://men.webmd.com/news/20070605/low-testosterone-may-up-male-mortality?ecd=wn\

l_men_072407

http://www.vitacost.com/newsletter/newsletter.cfm?nl=387 & csrc=EM-FYH20080718:mai\

n

Co-Moderator

Phil

> From: idhides <hides13@...>

> Subject: Re: Please help me gather some information for my

husband...

>

> Date: Wednesday, July 23, 2008, 6:26 PM

> I just wish one of you was my husband, he will not read any

> of this

> and thinks I am crazy for looking into all of it. He would

> not go and

> get a sperm count because he thinks it was a waste of

> money. So we

> may never have kids. When I talked to the doc about putting

> him on

> HCG as well, the doc thought I was crazy too! It;s great

> that you all

> have such open minds!!!

>

> > > > >

> > > > > >Wow reto great post you are the

> man.

> > > > > >

> > > > > >Co-Moderator

> > > > > >Phil

> > > > >

> > > > > Thanks. I just felt it was important to

> get her

> > > as

> > > > much

> > > > > good info at

> > > > > the start as possible. It took a couple

> days to

> > > find

> > > > the

> > > > > time. I

> > > > > admire wive's who care and work

> like this for

> > > > their

> > > > > guys. We should

> > > > > all be so lucky. (I am.)

> > > > >

> > > > > ------------ --------- --------- ------

> > > > >

July 23, 2008

On Wed, 23 Jul 2008 22:26:04 -0000, you wrote:

>

>I just wish one of you was my husband, he will not read any of this

>and thinks I am crazy for looking into all of it. He would not go and

>get a sperm count because he thinks it was a waste of money. So we

>may never have kids. When I talked to the doc about putting him on

>HCG as well, the doc thought I was crazy too! It;s great that you all

>have such open minds!!!

One of the problems I've found with low T or E2 levels that are

significantly off is that it takes away your drive to do things. I

was quite happy to be a couch potato when my T was low. My wife

thought I was depressed and I said hell no, I'm just content to lay

here and do nothing. It was maddening for her, but really I had no

choice. All the will power in the world could not overcome the low T.

Fortunately (?) for me my T got low enough long enough I started

cracking bones - 8 ribs over four incident. Shots brought me around

quickly and then this group helped me realize when E2 was sending me

back to that place.

You need to be patient with him. It's the illness not him. That's

probably the hardest part. So much of this seems like it's just will

power or laziness. But it's not. It's biological inability And once he

gets a glimpse of being 100% he'll never want to go back. But you have

to get that glimpse.

For me I got well and my wife and I still had issues. I'd been " lazy "

for a few years and she naturally couldn't let go of those memories

and impressions overnight. She harbored a lot of resentment for having

to carry the load for both of us for too long. And when I was well I

few felt that resentment unfair and had my own issues around the

" unfairness " of it all. It took some work. But it was well worth it

and easier when well. Now her principle issue is she's too attractive

to this guy in the house with the hormone levels of a teenager chasing

her around all the time.

July 23, 2008

On Wed, 23 Jul 2008 15:55:03 -0700 (PDT), you wrote:

>I bet he will wake up fast if you told him to get with the program or your out

of there.

I don't believe that's true. It might be for someone healthy. But he

needs her support right now in my book. The challenge is for him to

get to 100% so he wants to stay there and knows what it's like.

You might get a copy of SHippen's book and let him look it over at his

pace. (I wouldn't force it on him - saying " see here, he says . . . "

Just say you've read it and it's interesting and leave it around, -

maybe in the bathroom. ;-> Most of us will read anything at hand

there.

http://www.amazon.com/Testosterone-Syndrome-Critical-Sexuality-Reversing-Menopau\

se/dp/087131858X/ref=sr_1_1?ie=UTF8 & s=books & qid=1216861803 & sr=8-1

July 23, 2008

Very good post retro. Another thing to remember is to start it is kind of up and

down until you get dialed in. I have been on this road for about 8 months now. I

have a lot of it dialed in but not everything. My Dr. and I are going to be

looking at my E2 again soon and we are still working on thyroid and adrenals. I

have two or three pretty good days that I feel like getting up and doing things

and then I go down for a few days. It will come together.