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!