My Alex is nearly 12 months out from treatment and is now at the point where he feels he is not moving forward. I think he is depressed - he complains of foggy thinking, can't see the future, and sleeps to make the day pass. Except for 1 month part time nearly 6 months ago, he has not worked since March 2010 as he cannot concentrate and suffers terribly from fatigue and pain in his tongue after a full day of doing anything. He is also still PEG dependent. Alex is many things but he has never shirked paid work (around the house a different story ...). He is definitely scared to go back, believing he would not cope.

So here are my questions. For those of you who have taken anti-depressants, which one did you take? How long did it take to kick in? How long were you on it for? What side effects did you experience? And what and how many did you try before you got one that suited you?

Thanks for your help

Hi, klo
Before we get to the depression part .... the foggy thinking may have to do with the cisplatin; as I understand it there are ways of compensating for it. Does your hospital/cancer center offer any seminars on this?

Is your dear Alex seeing a neurologist/pain specialist for the pain management. One of my riding buddies specializes in this, and her arsenal includes conventional drugs, acupunture, and even lavendar pillows!

Re: the fatigue - has he had the thyroid test yet?

Ok, now the depression. My husband (the survivor) managed without anti-depressants, but I (the caregiver) only just got off the St. John's Wort I was taking to manage life in general. Of course, Alex should discuss with a doctor whatever he takes, but in general anti-depressants will flatten your emotions, and reduce your libido. My little happy herb takes a couple of weeks to kick in; it can be dangerous - issues with diabetes - and anyone thinking of it should clear it with a doctor (I did).

One of the hardest things with anti-depressants is that people are resistant to them when they should not be - "it's bad to use a crutch." Well, its not bad to use a crutch if you need one, but the term is now a negative one. Maybe think of it as an ankle wrap - helps to support you while you heal.

Best wishes to you and Alex!

Karen,

There are some questions to be answered before I would say getting him on an antidepressant. There are several things that may be causing his symptoms and adding another drug into the mix may not.be the solution , I know it wasn't for me.

If Alex is on an opiate pain medication, he will show those symptoms. If you read the side effects of those drugs and understand how they work it could explain what he's experiencing.

Opiates depress the central nervous system, slowing the cardiovascular system, which causes the fatigue feeling, they also stimulate the brain causing insomnia and irregular sleep patterns which also cause fatigue and that foggy effect. One of the side effects is depression or depressed like symptoms.

Thyroid, adrenals and testosterone levels should be checked as both radiation damage and post tramatic stress can throw these off causing similar symptoms. Opiates also constrain testosterone levels in the body.

Finally if those are not the issue talk to a therapist as opposed to just getting Alex on an antidepressant. Contrary to popular belief these aren't miracle drugs and are most effective when used in conjunction with counseling. Cancer is heavy and there is no shame in reaching out for help, I have and I swear by it.

What I find helpful is talking with someone as well as communicating with others that can relate to where I've been and the issues I continue to deal with post treatment.

Hope that helps, keep your chin up

Eric.

Im sorry to read about Alex's problems. Cancer is a terrible disease that never seems to go away. We all fear having a recurrence. Going thru cancer treatments can be so traumatic. Just turning into another person who has limitations can be a hard pill to swallow! I know I have some days where I am deeply troubled by my new life and I miss my old self terribly. I have found that helping others thru their struggles makes me feel worthwhile and needed. Everyone needs a reason to get up in the morning. This may sound crazy but how about a pet? I love my cats and they are great therapy.

Im not one who took anti depressants but know that it can be a challenge to get one that works properly. Most will take several weeks to build up before a person can notice a difference. Many times the dosage needs to be tweaked to get it right. Often one medicine wont work but a different one will. So it can take a few months before the patient gets the right medicine at the right dosage. I would suggest that a therapist would help him too. Sometimes being able to talk things out with a stranger is what makes a big difference.

Hope things turn around for Alex soon.

Hi,
Just having been diagnosed as "subclinical hypothyroid" I want to tell you some of those symptoms could have been mine, except I was cold all the time as well. Being a thinner person I have been cold before but it was getting ridiculuous when the temp climbed to 90.
Extreme lethargy was how I would describe my mood, and I either wanted to sleep or just sit. I had to make myself get up and do things. Foggy thinking, yes, that would have been me too.

Anyway if his has not been tested it is worth a shot. It was my free T4 that was so low, so much controversy about the TSH measurement, but my TSH was noticeably higher than it had been prior to TX. I get retested in two weeks, but I can tell you I certainly feel different than what I did.
Anne

Karen, all of the above thoughts are good ones. Certainly low thyroid function could be a contributing factor. And Anne, I relate to your low temperature woes. I live in Los Angeles, and was wearing sweaters in the summer following my RT. I'm still chilly 2 years out!

Therapy and anti-depressants are a good combination. But if he's not ready for the former please don't rule out the latter. I suffered through major depression many years ago, long before my cancer, and Prozac just about saved my life. Now of course there are better drugs, things like Celexa, Cymbalta, Lexipro... a bunch of others, maybe even better than those.

I wouldn't hesitate to ask about getting on one of these. They do take time to kick in, maybe a couple of weeks. But once you get Alex's thyroid tested (if not the other things that Eric mentions) you might think about it.

Please keep us posted.

Hi Everyone,

I have been away and unable to respond so was extremely gratified to get online this morning and find such practical questions and solutions.

Alex is on no regular pain medication and left the opiates behind 6 months ago except for the occasional one when a round of golf (with a buggy) gives him a hard time. The only regular drugs he is on are a proton pump inhibitor for gastric reflux (Somac) and an anti-nauseant (Maxalon). We think the mucositis has extended all the way through his gastro-intestinal tract thanks to his chemo drugs and there is some issue with his gastric emptying cycle. I am sure this will return to manageable without drugs one day, it is just taking its own sweet time.

Maria, thanks for your point about cisplatin - I too think this has caused his foggy thinking and am looking for ways to "detangle" his synapses. Anti-depressants can do this.

Anne, Eric, and David, thanks for the reminder re thyroid. Had a blue with the radiation oncologist over this in February. He told me that thyroid levels would be done 9-12 months out and I wanted them done 6 months on. Here we are 12 months out and TSH is not done so have undertaken it myself with the primary care physician. As we didn't have baseline levels done, it is hard to know what Alex's normal is, but thyroxine is on the list to try when we get results back (due in the next couple of weeks).

Eric, yes, testosterone is low, and Alex is on baby doses of anabolic steroid injections once a fortnight. Unfortunately, the brand we were using went out of production worldwide for a few months and we had to switch brands (with different dosing) which did not agree with Alex so much. The first brand is back and we are going with it next fortnight as it definitely improved his mood and appetite, whereas the 2nd brand caused irritability and pimples.

Therapy is not an option - in Alex's mind all things ending with ology are lumped in the same category as astrology. I even struggled to get him to accept speech pathology as a rational, science based practice. Margaret the speech pathologist is his best friend now as she is the only one that listens to him and treats him like an intelligent human being unlike both ROs. Two days after a modified barium swallow that showed Alex had real swallowing issues, ROs, who have been struck out of the will, made Alex feel like a failure by suggesting that there was no functional reason for him to be not eating AND made fun of the fact he had another barium swallow at my insistance 3 months after radiation which REALLY made my blood boil.

Christine, yes a pet has saved Alex's life in my opinion and maybe there should be a thread dedicated to this. He has a Siamese (called a seal point Burmese nowadays). Besides being great company for him when he was so sick and unable to leave the house, it was a responsibility that gave him something to do when she needed feeding or letting out. This cat is like a dog and cracks the neighbours up as she walks with him to the rubbish bins up the driveway and back again every day. Unfortunately, she developed a taste for the pump feeds and if we had a leak in the middle of the night, we would have to clean it up immediately before she did it for us. She got quite fat, and I am not sure it would have been very good for her. Their relationship has changed quite markedly over the last 12 months as Alex has become very attached to her.

Thanks for the names David - I was trying to short cut the trial and error part of taking anti-depressants and was sort of hoping that someone would come back with "oh yes, I took xxx and my thinking processes improved" but in hindsight that was a little over optimistic and unrealistic. Anti-depressants are way out of my league although I know there are different mechanisms of action and they target different chemical reactions in the brain. My ignorance means that I cannot work out rationally which type would be most likely to work on cognitive function.

Can't remember who mentioned St Johns Wort - yes I considered this but it interacts with so many things that I thought we had better work with the drugs that are on the doctors prescription software so that computer will say NO if we pick one that interacts with any of his other drugs (Somac, Maxalon, or steroids).

Thanks again everyone, if anyone wants to suggest any more names I am still all ears.

Karen

PS to everyone, you all just ooze compassion and empathy as well as practical advice. Thank you so much

Hi Karen,
Welcome back and it is great to see you got wonderful advice to your question.
As you know I was on amitriptyline (Elavil, Endep) for a short time and it was not for depression but neuropathic pain. I was glad when the �trial� was over and I could ween myself off Endep.
�The functioning of antidepressants is different in neuropathic pain from that observed in depression.. Antidepressants will relieve neuropathic pain in non-depressed persons.�
Can elaborate when we talk but for others who may be interested I suffered night-time hallucinations while taking it�..Spiders!!!
Sorry to see that Alex is still having so many issues and I hope it can get sorted soon.
Cheers
Gabriele

Karen,

I'm going to write a short novel here, please bare with me.


In my opinion you've answered the question that is the key to Alex's issues. Low Testosterone and my thoughts would suggest elevated Estrogen (estradiol) in his system as well. I would like to convey how "important" testosterone is to the male system. It effects EVERYTHING in the male system. I'm going to give an excerpt from some "light" reading I've done on the matter:

"Common symptoms also include depression, mental fogginess/fuzziness, difficulty concentrating, anxiety, loss of muscle, increased weight gain, decreased facial hair and a general feeling of not caring about anything. When you are low on testosterone, you often just don't care about anything - you just "exist". Pleasure and desire can be greatly decreased greatly affecting your career and your relationships."

Sound familiar?

"Normal" range of testosterone in the male body is between 260-800 ng/dL however understand that 260 is a VERY low reading and even this low will affect how any man functions. My readings my first test was 70 ng/dL...I was a mess. My idiot GP put me on 3x the normal dosage of androderm to get me back to "normal" and that caused massive issues. Ever read an Incredible Hulk comic or seen the movies? That's when I understood and fully grasped how delicate and important those levels were for me or any man really.

When you start testosterone "replacement" therapy, your body will stop producing the hormone naturally so it's EXTREMELY important to be consistent with Low T therapy and have a dosage that keeps Alex at a consistent 500 ng/dL level in his body. This will keep his moods stable. We've all heard the expression for women when they get their moodswings as "hormonal"...well it's true for men too we just don't like to admit it or understand it.

Personally as I've shared I can test REALLLLLYYYY low on T levels however I discontinued the replacement therapy as it was difficult to maintain even levels so my moods were all over the place. I found that through diet, exercise and some other tricks I can keep myself consistant. I'd like to share some thoughts and those tips here.

EXERCISE: Even if Alex is on testosterone replacement, exercise will help his moods. Testosterone serves several purposes in the body, one of the most important is muscle building and if he's building or using muscles he's using that testosterone as opposed to having excessive free testosterone in his body which will cause swings on the really high side or rages in some people (me!). Exercise will also help on the self image, I may be disfigured but from the neck down I look phenomenal (if I do say so myself and I do!) and that helps my confidence, gives me the swagger to do what I do.

DIET: I'm almost completely on a liquid diet and I do just fine with it. I only eat solids when I'm "highly" motivated (mj reference) so anymore that's about never. What I've found is that through juicing, supplements and Ensure I can give my body everything it needs to run at a high pace. If you know anything about my lifestyle I run hard. I work long hours (average over 80 per week) and exercise hard so my body gets the fuel it needs to keep going. Diet will also effect testosterone levels and therefore your moods. I balance my protien intake (.55g/lb of body weight) as excessive protien in your system will lower testosterone levels and I distribute them throughout the day to get my body into protien synthesis (converting protien to muscle). 3 meals out of 5-6 has to have 30g of protien to do that. The more muscle the more T. I use a whey protien powder for most of my protien intake as it's easy and mixes well with Ensure.

Fats, if you've ever heard about the "Greek Physique" (greek god statues, etc...) they actually attribute that to Olive Oil. Fact is the more good fat you have in your system the more T you will produce. Olive Oil has 14g of fat per "tablespoon" and 140 calories, it is a phenomenal supplement to Ensure. Cocunut Milk and Peanut butter you can use as well, I use all three throughout my day. Most of us on liquid based diets lack good fat so we will lack T as well if not addressed.

Supplements: Horny Goat Weed, Ginseng (I use Korean) will up T production and help sex drive! Yohimbe you can use as well..it has amazing benefits but has interactions with MAOI's and has other effects you have to be careful with. It works well though as it increases blood flow to the male and female sex organs. I use all three but I'm very careful with the Yohimbe and only break it out on "special" occasions

SEX and sexual organs: There is a reason why testicles sound a lot like testosterone...they are important! Not only do you have to make sure they see regular duty but you also have to make sure they are in an environment to thrive! Unless Alex is exercising he needs to keep the boys hanging...boxers baby. Keeping those guys cool and free will help testosterone and normal sexual function.

Sex is very important to any guy. He needs to get excited, best to do so in the morning and that will promote a good outlook all day. The reason...testosterone! Does it for women too actually. When a man's excited he will transmit T through both saliva and semen to his partner giving them the added bonus too. Endorphans aren't the only cause of well being after sex testosterone is a magic thing. Even if you are too worn out for it, there is always other means and as adults we need to understand there is nothing wrong with masturbation or getting sexually aroused. As with anything though there has to be balance and boundaries.

Anyway what I found for myself through these tips is I've been able to get my 70ng/dL testosterone reading to a healthy 450+ level natually, consistantly and that has evened out my moods, given me a fantastic outlook with the added benefits of looking and feeling amazing.

Sorry for the novel, hope it helps.

Live life, be well

Eric

Very thorough Eric! Awesome advice!

Karen,

About a year after my husband's diagnosis and initial surgery, I could feel myself slipping into a depressive state. I'm sure that the events surrounding OC were a catalyst, but this was not unfamiliar territory for me as I had experienced episodes like this ever since I was a teen. This one was the deepest though and I sought out the help from my Primary Doctor. She prescribed Lexapro 10mg. I was told it could take 2 to 3 weeks before I would feel the effects kick in. By week three, I had no improvement and maybe I was a little worse. My doc changed me to Celexa (citalopram) 20mg. Within days I was feeling better. That in conjunction with cognitive therapy helped me tremendously.

I have chosen to stay on it as I have not experienced any of the recurrent lethargy, lack of motivation, and sadness that seemed to sneak up on me over the last 35+ years. By nature, I am an optimistic person and filled with energy. Family members could not believe I suffered from depression because I learned how to mask it and pretend it wasn't there. Forcing myself to be positive during those sad periods was an exhausting and challenging task.

My doctor said I could wean myself off the drug if I choose but she also said that there is no harm to stay on it especially since I feel so much better. I have decided to stick with this as it works for me. I don't consider antidepressants a crutch.

Titration is critical with antidepressants. I was counseled in the beginning that it may take weeks to months to get the dosage right. it is important to make your doctor aware of any change in behavior or worsening conditions. (I sound like a commercial!) Also, finding the one that works best is key.

My best to you and Alex!
Anita

@Eric: I enjoyed your thorough explanation of low T. Very informative.
-A

Great information Eric, thanks.

You may remember that I posted about the anabolic steroids back in Jan/Feb as a means to regain muscle mass and possibly improve appetite and mood. Alex lost so much weight (down to 105 pounds at 6'1") he was hospitalised. Unfortunately, this caused loss of muscle mass when the fat ran out and he found it impossible to regain any weight. The treatment was a success, but then the product went off the market and Alex slid backwards in everything - lost his job, the weight he had gained and slowly slid towards depression. Back on the steroids now though so hold out hope for improvement. By the way the RO nailed me to the wall with this approach so I would not recommend this option for the faint hearted as you may need to do a lot of research and prepare for battle as anabolic steroids have a bad reputation and doctors not dealing with convalescence forget about the good uses for steroids. We weren't really using the anabolic steroids to improve testosterone although we thought it would be a welcome effect because Alex WAS low in testosterone. I assumed his levels were approaching normal with his treatment but the doses are low and I need to relook at this (Alex has been doing this appointment by himself so I know nothing of test results etc).

Anita, your insights have rung bells for me - thank you for your clarity and candidness. This has got me thinking that maybe all his days are bad but the ones that are so bad that he can't hide it, are the ones I see. I need to do some thinking around this for a bit. Alex is adamant that counsel is not an option and he would tell me everything that he would tell a counsellor. This may not be true. Anita, in your opinion, is it possible to force someone into counselling and have it make a difference or would the person just go through the motions and get no benefit?

The good news is, that since I first posted, we realised that one of the drugs being used to boost his appetite (which I completely forgot about) is actually an antidepressant being used at half doses so the GP has just upped the dose to a full dose to see if this helps.

Alex has just rung in to tell me he had a great golf game this morning, has won 3 balls and only lost 3 (Alex is a crap golfer) and sounds very upbeat. This is the second good day this week!!!

Thanks again

Karen

Karen,

I don't believe in forcing anyone to do or try something they are adamantly opposed to. As a caregiver, it is hard to know how to respond to the "heavies"--those areas that a professional handles all the time. If you find yourself not knowing how to respond to Alex, I would admit that to him. When my husband asks me questions that I can't answer, I always suggest that he ask the surgeon, nurse, or some other professional as I am not qualified.

He asked me once while pointing to something "what did you think this lump is"? I said, "It looks like a lump. I don't know what it is. I'm an artist, a painter. I have no idea. If it doesn't go away in a week, maybe you should get it checked out by the doctor."

He appreciates this. In fact, it is reassuring to me that he shares his fears, thoughts, and questions. He trusts me to be a good listener and friend. While we are in this together, I am comfortable to "pass the buck" to the pros.

I say all of this because early on I felt the responsibility to have answers for all of Clark's questions. I don't know why I took on so much. When Alex tells you something that you can't answer, it is freeing to admit you don't know.

Please excuse me for getting a little off topic but your admission that you don't know may be a catalyst for Alex to seek help elsewhere.

Good luck!

My best to you and Alex-
Anita

Eric - you did it again!! Another absolutely awesome short novel!!! You have the skills and forthrightness to talk about the things that the rest of us are thinking about but too hesitant to bring up. Like Sex. Which reminded me of a Dr. Oz episode a few days ago where he divulged to the mostly female audience the "6 secrets that men don't tell women about". The #2 secret that men have is that they engage in a certain personal self-gratification activity every day! He used the "M" word (which I am still hesitant in using because of my early church years where everything fun was considered a sin), stating all the great benefits to health in that it lowers prostate cancer, flushes out toxins in the body and that women should not be offended by this activity. For sure - Especially when you think they may be lowering their chance of cancer!

Karen this thread has become very informative. Im sure many other members will be able to read the info Antia and Eric have written.

Depression is a huge problem for many cancer patients and even for the caregivers too. Even though Alex feels a therapist wouldnt help him, Im certain it would. You are not professionally trained to be able to handle Alex's mental struggles. So by telling you everything he would discuss with a therapist isnt going to help him. It will make things harder on you as you will want to help but arent able to do what a therapist can. Im sorry Alex leans on you so much. Caregivers have such a hard job!!!! You have to wear so many hats and when all is said and done you still need to have some time for yourself to just catch your breath.

I was happy to read about Alex and the kitty. Pets can be such a blessing and they give back so much. I love my kitties. I even feed a couple stray feral cats and have rescued their babies. Its something that helps me to feel useful. Im glad that Alex has that special bond with your cat. It probably makes him feel like he is needed which is what everyone needs.

Best wishes with your quest to help Alex!!! To me you and all caregivers are ANGELS!!!!

Hi all. Depression takes on many forms, different for everyone. My husband is a counselor and would rather not see one yet he is open to the idea. As caregiver I am seeing a counselor weekly. I cannot put all the burden on my network of friends and I can vent to her totally. That is where I sob. It helps me. My hubby and I talk a great deal but I cannot be his therapist. Uf he seems very depressed I will tell him that he would expect a client to seek help so he should as well. Good luck.

Karen - It's good to hear that Alex is feeling more positive and that the kitty has helped. Wherever help comes from, whether it's golf balls or kitties, or everyone at OCF, it really helps to get back the feeling of control in one's life that cancer so brutally takes away from us in so many ways. However, I would totally agree with the above posts re depression and counseling. Even if you were to pass on word for word to a therapist what Alex confides to you it still is no substitute for the interaction that occurs between a qualified therapist and patient. A therapist uses all his senses and his expertise and experience to base his treatment of a patient, asking the right questions and giving qualified answers. That way, your job is easier and less stressful and would give you the confidence that someone with the experience necessary was being consulted in helping Alex get better instead of just worrying and wondering about it. If Alex were to just give it a try, even if he was not in complete agreement with counseling, he might just find out something helpful. And if he still doesn't want counseling, at lease he would have given it a try.

Then, there is the question of Hope. Everyone needs hope, no matter how bad things seem. When my son was in treatment, he only posted on OCF a very few times. He said it depressed him too much to see how difficult it was for so many. But I knew he needed hope, (and I did too) so I posted daily - several times a day getting information and encouragement from others. When I saw someone else's experience and how they handled it, especially if it was similar to Paul's progress, I would tell him about all the positive parts of it, encouraging him to realize his own experience could certainly turn out just as well. (And it did!!) When something sad appeared, I would cut that part out and only printed the positive parts to lay by his bed for him to read (he slept most of the time). Yeah, I know that was sneaky, but it worked. If Alex asks, "What do you think this lump is?" You could reply as so many others have said here, "Sometimes a lump is just a lump" and get it checked out by the doctor. I saw my son go thru the worst kind of stress and suffering and pain that only another survivor could begin to understand. Karen, your Alex deserves the very best of care and options available to him. My hopes are with you and Alex for a continued successful recovery.

Alex has read this thread and has demanded a retraction and a clarification:

1. He is NOT a crap golfer - all the other guys he plays with lose just as many balls as he does which makes him "par for the course" (blech, I can't believe I just repeated Alex's really lame joke).

2. The cat's name is LPC although she responds with the same indifference to "elp" "be quiet I'm on the phone" and "you are NOT going out again, I just let you back IN". She is the queen rather than the princess so kitty doesn't quite fit.

Did he make a single comment about the fabulous advice we have received? Nah! I wait in hope for that day (sigh).

Karen
PS the retraction was the slander around the golfing expertise

I have never understood the golf thing... Really - small white balls? Men in plaid pants? Water you can't swim in? And sand that gets into your snazzy golf shoes? No thanks... Keep your balls give me sand on a body of water you can at least swim in ( surfing would be better! ) and no plaid... It should be banned in pant form all together!

not a sport I mind being bad at!

Thanks for the retraction, Karen. Understood: Alex is NOT a crap golfer, and he has three balls. Glad we cleared that up. Oh, and LPC is a cat, not a kitty. Cheryl, I understand your thoughts on Golf. I have similar feelings about football - bunches of grown men piling on top of each other over an odd shape ball?!! They can't decide which end of the field the ball goes - and patting each other on the butt? At least golf is a lot safer and the balls are smaller.

Karen, I had a good laugh about your retraction. Sorry for referring to LPC as the kitty. Alex, way to go on being such a wonderful golfer!!!! Im sure Karen is very proud of your accomplishments

Golf...as a contact sport guy I'll never get into it although I can appreciate the skill involved in playing. Football on the other hand is just as much strategy as it is physical, in my opinion its very much like war.

To me there are only two seasons in the year, football season and not football season. To keep myself occupied during the off season I really have to get into mma or boxing as nothing else fills the void.


Anyway I'm glad Alex is feeling good.

Eric

Golf, Football, I'm for whatever helps one to heal from the war on cancer, so good for you, Alex!!
Eric, - of course you are right about the strategy of football being very much like war. I don't know much about the game, except for watching some college football, before retiring from the Univ of TN where Peyton Manning was a Quarterback in the football program, and seeing what a brilliant strategist and all round good guy he was and still is! It does take strategy, and courage and strength to fight the war on cancer, too - all qualities I see over and over in our survivors and caregivers. And for those who may look at others' interest in Football (or whatever other sport) and call them "Fanatics" it may be well to remember that the definition of a Fanatic is just someone who is awfully interested in something that you're not.

Hi Karen,

It looks like this thread has a taken a turn but I still want to answer your initial question:) You did get great advice from great people already though.

I am a huge advocate of therapy and medication if needed. I took Lexapro. It took about 4-6 weeks to really kick in and was the only one I ever tried. I think I was lucky in that respect. It was also easy to ween off of which I think is huge because I hate that process.

Everyone is different and I feel men may shy away from actually going to see a therapist more than women (sorry for the comment men, I know it doesn't apply to all) but it was HUGE for me. Finding the right person can be as hard as the right medication so you can't give up. The first therapist I saw was horrible for me. The second was awesome and I cried the entire first hour!! Man did I feel good!! It's just nice to talk to someone about how your feeling, what you're thinking etc. I don't know what makes it so different from talking to family but it is. My theraoist was also able to give me great advice of how to put things in perspective and that's ok and good to be sad and cry. We have to feel those scary feelings.

I think most people are scared to die or at least how they are going to die. When you have cancer you think you know how your life will end you just don't when. That is scary....

Hope to hear more good stories about Alex's golf!! And hope to hear he starts feeling better soon.

I've said it before, but it so nice when a thread deviates slightly towards the lighter side of life and I really get a giggle.

However, Suzanne, thanks for bringing us back on track and this might be a good time to update. Like magic, Alex is heading back towards his old self. The drug he is taking is Avanza(mirtazapine)which is a tetracyclic antidepressant if that means anything to anyone. I am still trying to get the time to research the whole depression thing and so far have not really got far enough into it to feel like I know what is going on. It's on the list though.

Also on the list is a full blood work up with TSH and testosterone levels included which might also give us some pointers. I think that is to be done this week or next. Alex has the paperwork, just needs to get around to it.

A counsellor is still not an option - especially now Alex feels so good, I have no chance of getting him anywhere near an "ologist" anything. At the moment, I am not so concerned though.

Karen

I agree....humor is 100% needed!!

I can't say I blame him for being tired of doctors...I can relate. And, if he's going good then no need to rock the boat. I know caregivers certainly go to therapy also. Lord knows you need help dealing with us patients!!

So happy to check in and see some good news:)