Subcutaneous Administration of Testosterone

[dunemedic]

Joey, Thank you for the advice but he said in his email that he already blocked my email address from a response. Sounds like he has made up his mind and did not want to discuss it.

 

[Mocha]

There it is again -- the Dr.'s ego.

I've met a few of these doctors who refuse to entertain 2-3 questions. Their word is gospel, or so they'd like to believe.

Over the last few days, I've learnt more on this forum than I could have from any doctor (at least in my region). I'd say stick around this forum and keep looking for doctors. I remember reading recently (I believe it was in Built to Survive) that you'll have to go through multiple doctors to arrive at the right door.

 

[dunemedic]

Mocha, thanks for the encouragement. But as I said it was hard enough to find this guy. Now I am not sure the refills I have left at the pharmacy will be honored. I can't see my labs and I have no desire to go this alone. I am getting seriously depressed as I don't know where to go from here. This will make the 3rd doctor I have seen. There are a few clinics that specialize in TRT but they are 1200.00 for the first visit and 150 to 200 per month for the meds.
I guess I can order my stuff without a script through underground labs but we all know the dangers with that.
Depressed in VA

 

[indydaddy]

First do some damage control. Explain to your doctor that you were not questioning his knowledge or ability, you were just curious about something you had read. As a retired physician, I can tell you it gets old quickly when certain patients constantly question everything you prescribe for them. They want to play doctor, while the real doctor acts like a puppet to do what they want. The patient absolutely has the right to ask questions but not to dictate treatment. Too many patients these days read stuff on the internet (which may be totally wrong) and then demand that particular treatment. Your doctor went to school for 12+ years post-high school in order to get his license to be a doctor. He has every right to dismiss you as a patient but typically must give you 30 days to find a new doctor. You may have just caught him when he was in a bad mood. It sounds like he is progressive, compared to most since he will Rx HCG and Arimidex with the T. The difference between multiple SQ injections versus 1 IM injection per week is not going to make that much difference. I took weekly IM injections for over 25 years and only switched to the SQ due to excessive scar tissue. I really have not noticed any difference in the way the injections make me feel or how effective they are.

Most patients have NO idea how much crap doctors deal with these days from insurance companies to patients that know everything. They too reach a limit and are human. Patients used to respect their doctors. Now patients want to dictate their treatment "because I read on the Internet". Not saying this is the case with you, but before I retired I dismissed a few patients because they felt like they had a medical degree, so I thought it best that they prescribe their own treatment since they knew more than I did.

 

[dunemedic]

Indydaddy, thank you for your input. I simply asked him to consider it and sent him a study to read. I thought his reaction was totally out of proportion to my question. But he has cut off all contact with me and I can't even contact him to discuss the misunderstanding.
Believe me I know I am a surgical first assistant and have worked in the OR for 20+ years.
Yes, I might have caught him at a bad moment but he will not talk to me.
Yes, he did say that per Virginia law he would follow me for 30 days to be available for emergencies. But, he said since there isn't such a thing as a testosterone emergency his email response would be the last time we spoke. Let me be clear I did not demand anything I just simply asked him to think about it.
Now I am fubar'd.

 

[indydaddy]

Having worked in the OR for 20+ years, then you know some doctors can be a**holes. Give him a couple of days to cool down, then send him a letter via snail mail marked "personal and confidential" and profusely apologize (even if you feel you have no reason to apologize). Tell him how much you value his knowledge and expertise on TRT and how badly you want him to be your doctor. Say you will never again question his wisdom or suggest how he should treat you.

Apologize and kiss a**. Say anything you can think of to get him to take you back as a patient.

If all you did was ask him to read a study then he way over reacted. But it sounds like you need his services.

Good luck,

Indydaddy

 

[a_crossfitter]

Empower makes good medications.

Are you still in the fat at 5/8"?

Yes, I tell my patients to just push it straight in.

If I bend over a bit I am able to pinch enough fat to stay within the fat layer with a 5/8" needle at a 45deg angle. If I stand straight I can barely pinch my skin (fat included).

I will go to a local pharmacy and try and get the shortest possible needle.

Does the fat tissue gets displaced by the injected oil volume... will it be an issue to inject oil close to the 'surface skin'?

I'm not sore anymore from the previous shot. Next shot is tonight.

 

[a_crossfitter]

If I bend over a bit I am able to pinch enough fat to stay within the fat layer with a 5/8" needle at a 45deg angle. If I stand straight I can barely pinch my skin (fat included).

I will go to a local pharmacy and try and get the shortest possible needle.

Does the fat tissue gets displaced by the injected oil volume... will it be an issue to inject oil close to the 'surface skin'?

I'm not sore anymore from the previous shot. Next shot is tonight.

Update: I wasn't able to find a shorter needle so used the same size as before (5/8" 25g). I injected Monday night near my love handle, where I have more fat and at a 45deg angle, with no pain or swelling at all to this day.

 

[Dr. John Crisler]

Some guys go all the way down to a 29ga. needle.

 

[Nelson Vergel]

I use 27 gauge 1/2 inch. I hate subcutaneous injections since they really have a higher chance for injection site reactions. I inject at 90 degrees into the muscle on shoulders and legs. Pretty painless and testosterone flows fast enough with that gauge.

 

[Dr. John Crisler]

I use 27 gauge 1/2 inch. I hate subcutaneous injections since they really have a higher chance for injection site reactions. I inject at 90 degrees into the muscle on shoulders and legs. Pretty painless and testosterone flows fast enough with that gauge.

I can't advise my patients to inject into the delts, etc, of course.

 

[Nathan]

I can't advise my patients to inject into the delts, etc, of course.

Is this because of the higher probability of hitting blood vessels, nerves, etc and would be more prone to operator error?

When injecting into your naval, how might you know that you are going more into muscle vs fat, which I assume is where the higher probability of negative reactions occur? I'm curious because I got a lot of reactions the first few times and then on my last injection I tried the pinching technique and for the first time I did not get a bruise, swelling or nodule.

 

[Dr. John Crisler]

Use a short needle that won't reach the muscle.

 

[DeMegaMan619]

Use a short needle that won't reach the muscle.

Doc, I was prescribed 200 mg/week test, and 500 units/3 times a week hcg. I'm a fan of subq. How would you advise administering these meds on a weekly basis. Which syringe/needle size would recommend as well?

 

[bruin]

check out the site from BD
http://www.bd.com/us/diabetes/page.aspx?cat=7002&id=7407
I use a 31g which is the 8mm, is shorter than the 12.7mm

Also a newer 6mm, very short, had a sample it was great! have places an order.

Duane

 

[Nelson Vergel]

31 gauge is too thin. It may break. Go for 27 gauge 1/2 inch.

Easy Touch Insulin Syringes 27 Gauge 1cc 1/2 in - 100 ea

 

[bruin]

just that thought made my balls ascend automatically.............uggh, ok

 

[a_crossfitter]

I just ordered those!

 

[hamletshead]

I've been doing SC injections in a 4" radius around my belly button with a 1/2" insulin needle (30 gauge) Mon/Wed/Fri since June, and have noticed no negative effects whatsoever.

I'm still dosing the same total amount (200 mg test cyp per week) that I was Jan-May, but SC is way less of a pain -- literally -- than IM, and it's far easier to inject in the stomach than it is to reach around and try and inject in the glutes while remaining relaxed. The 30 gauge needle requires only marginally more force to depress the plunger than a 26 gauge needle, and the 1/2" vs. 1" needle makes a gigantic difference: i.e., no pain at all. If you backload the insulin needle, the tip slides right into your stomach like a hot knife through butter.

As far as test results, my first labs (8 weeks out) had TT of roughly 650, FT 38, and my recent labs (10 months after starting TRT) have TT over 1200 and FT over 50 [per MD over the phone; I'll post labs after I see him next week]. So SC is clearly not cratering my test levels.

 

[dunemedic]

Thank you for the Post Hamlet. I have been considering SQ injections and thanks for the data. How have you felt on the SQ? Do you inject EOD or only Mon-wed-fri? I am on the same dose 200mg of test cyp every week but the problem is I am running out of steam by Thursday. My new Doc did offer me option of switching to SQ but I wanted to change only 1 variable at a time.
Thanks again.