Saturday, March 26, 2016

Gynecomestia Part II: For Better or Worse Decision Made: Nothing Ventured Nothing Gained

Rather than add to the increasingly complex array of supplements and medications I take on a daily basis, my layman's inclination was to undergo radiation therapy. In the absence of compelling evidence to do so, however, I have decided to accept Dr. Myers' recommendation.
The following recent e-mail exchange provides additional perspective:
Patient
Assuming they are not equal, which of the two treatment options:  (1) radiation or (2) the combined medications of Arimidex and Caberloline iwould be more effective in
:--.Reducing breast size and sensitivity
--Arresting further development
Dr. Myers
"2 is safer and nearly as effective"
Patient
My decision has been far more difficult than I imagined. Rather than agonize any further, I intend to abide by your knowledge, judgment and expertize. If you would initiate a prescription  for Cabergloline and Arimidex I will get started ASAP.
For the record...I am concerned about two precautions listed for Cabergloline,  namely use with alcohol and use with blood pressure medication. As you may recall I typically consume one or two beers  most evenings, and I take Losartan on a daily basis.
 Dr. Myers
"JUST TO BE VERY CAUTIOUS. START WITH ONE CABERGOLINE A WEEK. AFTER ONE MONTH GO TO MONDAY THURSDAY FOR ONE MONTH. THEN MONDAY WEDNESDAY FRIDAY."

As indicated in the title of this entry: "Decision Made..."  Stay tuned.

Monday, March 14, 2016

Gynecomestia: A Productive Dialog With Dr. "Snuffy" Myers on a Troubling Hormone Lite Side Effect

An unedited e-mail exchange between Dr. Myers and yours truly appears below:

Patient
Following our highly productive regularly scheduled meeting last October, a concern has evolved to the point that I would appreciate your professional guidance on an appropriate course of action. My breasts have enlarged to the point that their size and shape must now be apparent to others depending to some extent on my attire on any given day. For perspective think in terms of a one-eighth to one quarter cup of gelatinous material underlying each nipple overlaid by a relatively hardened area the size and shape of two fifty cent coins stacked one on top of the other. Breast sensitivity is also a problem. On a scale of one to ten with ten being the most painful think in terms of level  three point five when I turn over in bed.
My questions are as follows:
(1) What are my treatment options?
(2) Which of these options would you recommend?
(3) Is timing a consideration? Too early? Not soon enough?
(4) In my particular case is no treatment my best choice?
(5) If we choose to take no action at this juncture what can we expect in terms of further development? I have been on Hormone Lite for roughly two and a half years. Is my breast size and sensitivity likely to double in another two and a half years?
I suspect I have over-used the Patient Portal in the not-too-distant past. You may have noticed I have sharply curtailed my use of this valuable resource over the past several months. Please be assured I intend to continue to  limit my use  as we proceed
Thanks again for your conscientious professional care.
 
Dr. Myers
THERE ARE FOUR OPTIONS:
1. DO NOTHING AND LIVE WITH THE CHANGE IN YOUR BODY
2. START CABERGLOLINE AND ARIMIDEX THREE TIMES A WEEK. THESE DRUGS WOULD BLOCK PROLACTIN AND ESTROGEN, THE TWO HORMONES THAT STIMULATE BREAST GLAND DEVELOPMENT. ONCE THE SYMPTOMS SUBSIDE, WE WOULD TAKE THE NUMBER OF PILLS TO FIND THE LOWEST DOSE THAT WOULD CONTROL THE PROBLEM.
3. RADIATION TO THE BREAST. THIS DOES CAUSE RADIATION DAMAGE TO THE SKIN. THERE IS A THEORETICAL RISK OF BREAST CANCER, BUT I THINK THAT RISK IS VERY LOW AT YOUR  AGE.
4. REDUCTION MAMOPLASTY.
I RECOMMEND OPTION TWO.
 
Patient
I very much appreciate your prompt and thorough response. The ability to access you directly as these issues arise is an absolute blessing. I expect to get back to you very soon with a request for two prescriptions.