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Wednesday, May 30, 2012

If a Tree Falls

I have opened my heart once again, and to this I say “thank you” to everyone who loves me. I was morel hunting this morning—one of my private passions I don’t need to talk about—and suddenly it hit me how wrong I have been approaching the last few months. My biggest fault is to clench my fists after breaking new emotional ground when in fact these are extremes, intimately combined and yet irreconcilably unrelated.

I have been steeling myself because I had a dogged determination to make it to the finish line of the fall-winter-spring season of my orchestra. Unless I have forgotten something, I have played every single rehearsal or concert required of me since last year’s Cabrillo Music Festival thru the entire main season of my home orchestra in Grand Rapids. That’s a whole year. I have cells of a craniopharyngioma floating in my brain and yet I did my job the same as everyone else, tumor or not. Yay, Ale!

The first few times I passed this test, there were parades. Ticker-tapes! Then, after a while, it got old. I’m jumping through the same hoops. The crowd thins out and I have to find the strength to do this on my own. With dedicated fans watching the same heroic act getting lamer, I get bored too. There is nothing innately fantastic about watching an anemic person get hormone replacement therapy so he can do normal things. Ale washes the dishes and the crowd goes wild! No, it’s not really that good. And yet it is.

People in my same position, diagnosed the very same month as me in 2009, have now notched as many as seven brain surgeries. I had two quick surgeries, one after the other, and since them I have been fine. This is luck, or destiny, or whatever you want to make of it. I get to go morel hunting as recently as this morning, slipping on my long boots, happily stumbling up and down steep slopes of trillium. It is gorgeous, God-given beauty, smelling the apple blossoms and wild ferns multiplying in the deep woods. Not a voice is heard for miles and miles, not a car, just the distant call of birds and the comic chatter of squirrels. I need to be here, so deep in the woods, so close to nothing in particular. I don’t need to be alone, but I need to feel close to the natural order of things for some reason.

I found only one morel today, an old one. I suspected the short morel season was already over and this confirmed it. As I unfolded my knife and cut the mushroom from the ground, I wondered if there were anything of significance farther down, any reason to dig hundreds or thousands of feet beneath that point. Then I looked up and saw only the sky, the clouds, and the glare of the sun that made me look away. Maybe there wasn’t anything up there either. Maybe it was just me kneeling on the damp earth, parting the wet, dead leaves with my bare hands and wiping them on my pants because I didn’t want to get my sweatshirt dirty because it was the one washed the day before. Maybe that was it. The solitude around me thickened like the moisture on the back of my neck. If a tree fell in the forest that day, I would have heard it.

Friday, May 4, 2012

Endocrinologist Visit

The endocrinologist made the decision to increase my testosterone replacement therapy. We are still going to use the same gel as before, but now the dosage will be doubled. It is strange how it worked so well at first, then steadily tapered off in effectiveness over the past two years. All hormones are critical in their own way, and being without them has given me a real appreciation for what they mean to our normal lives.

I thought I was at the maximum already with the AndroGel and I feared I would need to be transitioned to injections. But I guess—in the words of a Ghostbuster—there is more sliming to be done.

I would love nothing more than a normal amount of energy going forward. I'm so tired of being tired, and I hope this will finally do the trick. There are some big projects on my plate all summer, and lots of work ahead. I can't wait to tackle all of them once I have my levels back in the normal range.

Tuesday, May 1, 2012

Scoring Low Again

I have an endocrinology appointment on Thursday but I already know my test results. Last week I popped into a lab for my regular blood work, and since I created an online account with the hospital I can view all the results as soon as they come in. My basic metabolic panel was in the normal range, also the Free T4 test, but once again I flunked testosterone. For almost a year now this number has been low, often way too low.

Testosterone is the primary male hormone, and without it I have no energy, no natural drive or zeal. You cannot "will" yourself to do things (even mental things) when you are depleted of this hormone. The past few weeks have been very taxing, so maybe this explains why a test at this juncture measured so small. But I don't care about the reason, really. I just need to have a certain amount in my system at all times, like a normal man my age, in reserve, so I can tap into it when a concert requires more energy or when I want to stay up all night composing.

Oh, this is so frustrating. I know what some alternatives are, because I read about them last fall, the last time I failed this test. Daily shots in my stomach are one solution. Not crazy about that possibility, but maybe my endocrinologist will instead have me increase the dosage of the gel I smear on for now, or change brands.

It might be more difficult with me because this particular hormone is replaced completely. Some of my other hormones are like supplements; what I take "tops up" what my body doesn't make in sufficient quantities anymore. But with testosterone the artificial replacement starts from zero, because that's where my number would go in about a week without access to the treatment.

What's that song again? "What a man, what a man, what a man ..."

(Shrugs.) Oh well, I'll keep trying.