Am I being paranoid?

Posted by scottbeammeup @scottbeammeup, 14 hours ago

Yesterday I had my nine month post radiation PSA, testosterone, blood tests and bone density tests. I was set to meet next Friday with my doctor to review the results.

Yesterday afternoon, someone from the doctor's office called and told me that my appointment was being moved to a nurse practitioner instead of the doctor and that they want to repeat the testosterone test on Monday but said they "didn't know" when I asked why (it's a full T test: total, free, estradiol, etc.).

This immediately made me think the results of one or more of these tests are going to be bad. The doctor knows I'm very emotional and I'm thinking that, rather than having to deal with giving me the bad news and watching me fall apart, he's going to have his NP do it instead.

My friends say this is a ridiculous conclusion to jump to and that I'm doing what I'm known for--always jumping to the worst possible conclusion.

What do others think? Why would a doctor want to repeat a test that was done on Friday again only three days later?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Yes. Parnoid! It’s only testosterone!

It could be the sample got contaminated.

That test really has no useful information to decide whether your prostate cancer is reoccurring. If your PSA started rising then they would probably want to put you on ADT, which would cut your testosterone down. It wouldn’t matter what your testosterone level was, they would want to reduce it.

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@scottbeammeup
I have never understood why so many people worry about things. Its not going to change anything.
I've had my testosterone rechecked and it was normal. Whatever happens “it is what it is” and worry, stress, anxiety, and negativity, is only going to alter your test results as it is one of many reasons why your levels change. Why do you choose to think negatively and assume your results are going to be bad. Maybe your doctor is just being cautious and wants to make sure the results are accurate since testosterone levels do fluctuate. and you worrying about it seems to only be causing you to be more miserable. You can choose negativity which is worse on your body or positivity which is more beneficial.
Take care,
Jake

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@scottbeammeup, what crazy twists and turns our minds can spin for us when we're worried. Getting a call from your doctor's office probably started the worry train on its route to run-away train. Whenever the doctor's office number comes up on my phone, an alarm bell goes off. Kind of a white coat syndrome effect.

You got the call and were told that your scheduled appointment needs to be moved up and you'll be seen by the nurse practitioner. No one really explained why. Ready. Set. Go. And off to paranoia land.

Can I paint a different scenario for you?

Doc sees something out of whack. Not sure why and wants the test re-done to rule out lab error or other typical anonomalies that can effect results. The doctor is a conscientious doctor and wants this done as soon as possible and therefore tells his admin staff to call you and book you with the NP because she is available sooner.

No one. I repeat. No one at the doctor's office is thinking about emotions at this point. They are looking at numbers and schedules. In their mind, they are getting you the best care as efficiently as possible. It likely didn't even occur to anyone that this "simple" administrative communication could unleash a dominoe effect of emotions and you a puddle of worry.

What do you think? Might my tale be more plausible than a tall tale?

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I think @colleenyoung has a great point. You also have to consider that doctors are in high demand, especially in the cancer arena, so if the task is something their staff can handle and free them up to see a patient who is more in need of a doctor then they are going to do that.

Pre-op, I saw and talked to my urologist regularly, since then it's been the PA more than anyone. I don't take offense at it because I'm thinking that it probably worked that way for me too - someone was seeing the PA/NP while I got the doctors time because I needed it more.

My PCP has me with his PA 95% of the time for yearly checkups, I haven't seen a doctor there in probably a decade. I suspect that, in the future, the PA will be the main PCP while doctors move up the ladder even more.

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No, I wouldn't slap a negative label on you like "paranoid."

During my first 12–18 months after diagnosis, I worried about every new/unexpected ache or pain, or slight shift in my bloodwork results (even inside normal ranges). My family doctor told me that's a normal side-effect of going through a health trauma like mine, and that I'd probably get over it naturally, but that if it was still happening after a few years it might be cause for concern.

You've been through a psychological as well as a physical trauma, and it's important to recognise that your emotional reactions are probably still miscalibrated right now, so they aren't a reliable guide to actual risks. That's not to say there isn't any risk (I'm not qualified to say that), just that you're very naturally vulnerable to what the CBT people call "emotional reasoning," a feedback loop where you feel a little scared, then you think something's wrong because you feel a little scared, then you feel more scared, then you think something must be *really* wrong because you feel more scared, etc etc.

So treat yourself with kindness and understanding. Step aside, look at how you're feeling, and tell yourself "That fear is another side-effect of my treatment, and it's ok. It doesn't mean anything, and while I don't enjoy it, I can coexist with it peacefully until it fades out."

Good luck. Be patient with yourself as you keep healing, physically and emotionally.

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@scottbeammeup
Hay do not put yourself down. We all have different levels of worry and anxiety. What one person can deal with another will not. It is one reason MCC was developed.

Just be optimistic about why retest. If you are seeing a NP ( in my case they are called PA) it means the MD doesn't need to see you. So look at the optimistic side of that. A test may need to be done again if an error occured, etc.

When I was told the results of my MRI was I had a 70% chance of it being cancer and thus had biopsies. I chose to say I am going to be in the 30% and not have cancer. I stayed as optimistic as I could. Have you considered asking your medical advisors for some anti anxiety depression type medicine.

I take a Escitilpram (spell) for anxiety/depression. Not a very high dose but was told most like would have to take rest of life. It does help me but again we are all different and what is good for me may not be for you and why your medical providers should recommend medical treatments and medications.

Can I asked if you have an exercise you like doing? How about a hobby? If you have either they can be a real help in lowering anxiety and stress. This (exercise and hobbies) is something every one of my doctors at Mayo stress to me to find and continue doing. Doing hobbies or exercises you like helps you both physically and mentally.

I assume since you had testostrone test you had hormone treatments. They maybe wanting to keep that in a certain (I did not have hormone treatments) level and want to make sure test was accurate. Hormone is something they want to keep down to starve any cancer cells. Per my urologist testostrone is not a indicator of cancer just how much is in your body. Testosdrone (per urologist and R/Os. PAs,) feeds cancer cells thus the treatments to lower the amount in body.

I do wish you good luck and a note to keep your chin up. Do something you like to do and let us know how you are doing.

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I would agree with North and JC - we are all different and we all have right to feel whatever we feel. Nobody chooses their reaction or feelings !?! We all have different genetic that determines our neurological pathways as well as hormonal levels and also levels of serotonin and dopamine. Our peripheral and autonomous nervous systems also have big influence, as well as our "lizard brain" (cerebellum) which we inherited from our "lizard" ancestors lol. We also have different experiences in life that further shape our mind and our behavior so it is really unfair for anybody to say "I do not understand". One does not maybe understand (although I can understand both ways somehow), but one either says comforting or helpful words or otherwise keeps thoughts to themselves. It is not constructive to make anxious person feel guilty for feeling anxious. It can only cause more feeling of inferiority although it is questionable if it is inferior trait particularly looking through a prism of natural selection. We better do react and have "hunch" because what do you think ... "whom will tiger eat first ? " 😉
Scott- you have normal human reaction and try to watch some comedy movies or sit/com or do anything that will take your mind off that nurse. Play with puppy or cat or feed birds in your garden, take nice walk, call a friend and I am sending you virtual hug . All will be well - you will see. Whatever is result it can be fixed this or that way , so many ways to deal with any result. And I also think that perhaps they mixed something in a lab - happens to my results all the time.

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PS:
BTW, doctors should care about emotional welling of their patients - especially since USA fairs sooooo bad in mental heath and suicide rate among other wealthy nations. ESPECIALLY doctors in oncology field should pay attention and refer patients for help if they need it.

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