dopetalk
Core Topics => Health Issues and Medical => Medical => Topic started by: Griffin on September 02, 2016, 01:32:10 AM
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So every now and then when IMing my weekly testosterone shot into my thigh after I pull out a little bit of the clear liquid comes out of the injection hole, what am I doing wrong? When it first started happening I figured it was because it was so thick and I was pulling it out to soon and not giving it enough time to get out of the syringe and the last little bit came out when I was pulling the needle out and then came out when it was completely out. I have started leaving the syringe in for a few seconds after I am done injecting which helped a bit but it's still happening every now and then.
Am I not getting it all the way into the muscle? I did a test to see how much I was losing by dripping water on the napkin I used to clean it up with to see how much would make the same amount of wet spot if that makes sense and its quite minimal like a few drops at most but its still very annoying because 1ml is 200mg and I want all I can get.
I have made sure to push the needle all the way down as far as I can where the end of the syringe is on my skin, the needle is an inch and I don't have much fat on my thigh and inject where the muscle is biggest so I should be in the muscle when injecting because when pushing down the syringe pushes into my skin so going deeper than an inch theoretically. What can I do to prevent loss, I am usually not getting a full drop of blood and not very much pain or soreness, it seems more sore on the days when a bit leaks out though if that is any correlation.
I usually wait a minute or two until the hole is healed to rub the medicine in because I am paranoid that if I rub it in to soon it will leak out of the injection site of the muscle and be lost forever. I guess I don't fully understand IMing and can use any tips you guys have. When I spread the skin apart with my fingers it seems to be virtually painless but I usually go slow because I am a shaky handed wuss, could that be part of the problem? like going to slow that the needle pushes the muscle and doesn't penetrate so that when I inject I lose it and then when I remove the needle the bit closes to the top seeps out?
Like I said any and all tips and info about the subject are greatly appreciated. The test has helped but I am still battling having zero motivation to do anything, and not being able to lose weight but at least I can see my muscles in my arm thats a first since getting on methadone I am pretty sure they are the biggest they have ever been which is cool just wish I could drop the weight and get my self confidence back. A lot of the other symptoms I was dealing with like low energy have dissipated though which is nice as well. I recommend all MMT people to get their levels tested if they are dealing with any of the symptoms of low T because I turned 26 last week and had the levels of an 80 year old man.
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I use 1 1/2" for most of my IM shots. I don't like thighs personally. I had a lot of post injection pain there from the oils breaking down over time in such a highly active area. Google how to give yourself glute shots because it is very easy. When I was injecting regularly I preferred to use ventrogluteal injections. Delts are another nice and easy location, and your 1" needles would be perfect there. I actually think that a 1" tip is a little bit short for a quad injection, but I could be wrong. Again, I would ask Candy for some advice. She is a wealth of knowledge, and I'm sure she wouldn't mind an email. If you're too shy, then you can just google how to do a deltoid injection.
I would give that a shot to see if you have the same problem. Purely from memory I think that if it pools outside it means you aren't getting deep enough into the muscle. Ideally you want to be well into the muscle, and most people who are slender have 1/2" to 3/4" or more of just skin and subcutaneous fat. If you're a bigger guy, and in different areas that could be even larger. Try out some bigger tips. They look scary, but your muscles are deep. You aren't going to bottom out or hit anything fragile.
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Thanks z, that's good to know, I am always sketched out that I am going to go to deep so that is good to know. I tried to do the glute injections at first but I can't really bend that way and ontop of my tremors it's really hard to give myself a shot there maybe the deltoids, I may ask for a longer syringe and see if that makes the difference cause I'd rather do it in my thigh but like you said I may not be going deep enough.
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When you pull the needle out after injecting,immediately begin rubbing the area and continue for a good 2-3 min. The top of my wrist is what I use for rubbing the flute because the motion is ergonomic. I have been using steroids for 13 years now and this is the way I do every shot....rub in immediately and for 2-3-5 min.
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When you pull the needle out after injecting,immediately begin rubbing the area and continue for a good 2-3 min. The top of my wrist is what I use for rubbing the flute because the motion is ergonomic. I have been using steroids for 13 years now and this is the way I do every shot....rub in immediately and for 2-3-5 min.
WTF? I don't know if I want to know what you mean.
The nurse (?) who gave me my first shot and showed me how to do it was very helpful and although she said she prefers to use the 1.5 inch and how to orient the pioint. I don't want to try and explain it becaue I wouldnt want to mistakennly give you bad instruction. There is some danger in a gluteal injection, she warned me. If you hit a particular nerve (peroneal/sciatic) you can cause permenant injury called "drop foot" so do take the time to aks a health care professional to instruct you.
The worst thing about IM is the risk of deep abcesses so using sterile equipment and rcedure is extremely important , unless you want to end up in surgery. Alhough the chances of infection may be very small each time you inject, consider that over the years those long odds can catch up with you. This is knowledge I learned the hard way and I got the scars to prove it.
When injecting IM the purpose is to get into a muscle with large blood flow that will flush the drugs/meds into your system and avoid anything collecting in fat or outer layes of flesh.
Familiarize yourself with good inection sites by using your joints as reference points. For instance, midway between your knee and outer hip joint on the side of your leg is my favorite because it is a much leaner area than your butt and you avoid major nerve bundles there.
Also, unlike IV you want to stick the needle in quickly and firmly, once sure of your spot. I'd compare it to throwing a dart, firm, with purpose but carefully. It hurts much less to be quick and sure with your motion.
Another thing, the testosterone is fairly thick, more like baby oil than water. My pharmacy gave me larger bore (19g) points for pulling it ut of th bottle and 22g for injecting, intergangable on a 3cc syringe. When you go to fill the syringe, pull about a cc of air into it first, then inject that air into the ampule (assuming it is sealed) which will compensate for the vacuum created by trying to draw up the testosterone.
Again, if what you believe is correct and you will need this treatment for the rest of your life it is absolutely worth getting professional instruction next time you visit your doctor. It is in their best interests that you do this correctly so dont be shy about asking.
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Each time I go in I have the nurse do it, so I know that I am doing it in the right spot and showing her where my injection sites are, last time she said I need to be closer to the middle(left and right) on top of the leg and further away from the side because I was doing it closer to where the side of my thigh not the top but she said it was a decent area. Thanks for the info any tips and help are appreciated, like I said I hate losing any even the smallest amounts, I guess that is the druggie in me talking.
I was incorrect earlier it is a 1.5 inch needle the inch one was the one they originally gave me for doing it in my glute but switched me because I wasn't able to do those because of the tremors and bending. I must say that what you said about the flute rubbing was odd, and I don't think I want to know what you mean hah. I guess I should just stop over thinking it and rub it right away I just figured there was still a little injection hole in the muscle and if I rubbed immediately without giving it a second to heal I'd push the test out of the whole into the fat and waste it.
DC that is my biggest worry is hitting a nerve especially an inch and a half in it just feels so weird to me, but the little picture I looked at showed that most of the nerves were closer to the inside of the leg, anyone know if there are more nerves or areas that should be avoided a picture of all the nerves would be great, are they the same for everyone, and is it just the big nerves that need to be worried about. Is there anything I need to worry about being 1.5 inches in? Like I said I go all the way in until my skin is touching the syringe because I want to be in the muscle.
As far as being sterile I try to be as sterile as possible I always wash my hands then germ-x then use the alcohol swab where I inject, my needles are supposed to be one injection each but I am going to have to reuse one this time because I have a blood test and did less the last 2 weeks before because I don't want my dose to be lowered. I am going to try to do it faster because I usually go really slow so hopefully that helps and also making sure I give it enough time to get out of the syringe completely.
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I meant to say glute but my phone put in FLUTE,lol.
And you are right,a larger pin tip for pulling it out of the bottle. Luer lock system.
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So if the shot doesn't get into the muscle is 100% wasted? Every month when I pick up my 4 weeks worth I let the nurse do that weeks shot for me, and the way she did it was weird she grabbed my fat, and didn't go in very deep and injected it and I don't think she got any into the muscle and got it all into the fat, not its sore and a little swollen it's not warm or anything so I don't think an abscess is forming but it was less then 12 hours ago so idk if thats enough time to tell for a miss. I am mainly wondering if she just waited the entire $30 shot by not going in deep at all and pinching my fat so my muscle is even further away to get to. If so that definitely pisses me off because I am having some insane money issues.
USPS just lost one of my packages so I am out $800 from selling a paintball gun because the person hasn't got it and until usps finds it I am out the money. I put $350 insurance on it but it will probably take forever to get, and it just all around sucks because I need the money for rent, and I can't get off probation until I come up with $1150 and each month it takes is an added $50 on to that. Plus I am so behind on bills right now it hurts. Just about everything that could go wrong has, they just told me it'd cost $850 to fix my exhaust and my rotor is fucked so on top of needing new brakes I need to replace a rotor as well.
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What she did is called subcutaneous. Literally under the skin. I don't think it's wasted, but I think that it changes the asorption rate. My understanding of IM oils and Esther's is that they are slow to break down there. This gives you the week long effect from one injection.
Maybe she got mixed up? Maybe it's the same? I honestly don't know
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I have been on MMT for many years and have been on TRT, as well, for nearly 3/4 of that length of time (roughly, 5 years of doing TRT and over 7 on MMT) - I assume that you are injecting the 200mg Pfizer/Perrigo/Paddock-branded single-use 1ml testosterone cypionate ampoules ("depo-test", "testocyp" among other names), the ones that come in their little tiny boxes with a fold-out pamphlet that actually unfolds to be a massive poster-sized piece of pharmaceutical instruction artwork, right?
Firstly, I should say, that it is GREAT that you are going to a doctor for this - keep in mind - you are lucky that your insurance covers this (if it does, if it doesn't it's cheaper to get it illicitly from a quality UGL supplier than it is to get it legitimately, as fucked as that is) and make sure to get your bloods done regularly - I highly recommend getting the records from your bloods and posting them to a secondary place, like one of the many online fitness boards (I prefer ironmag, /r/steroids, /r/steroidsourcetalk and assorted, similarly themed subreddits on Reddit) as you will find a LOT of really knowledgable users there who tend to know just as much, if not more, than many of the doctors including endocrinologists I have personally been in the "care" of. Nowadays, you'll find that many doctors are jumping on the TRT bandwagon, pumping out scripts for testosterone without a proper PCT/anti-estrogeneric drug alongside it as stuff like test, HCG, HGH, etc. are all schedule 3 at most and don't even register on the radar of the DEA.
Now, that being said, I thoroughly read through what you've written and the posts of other people here too. I wish Opiophile was still around so I could reference my lengthy post I had written there about 5 years back...it actually wound up getting sent to the flame forum and I got mercilessly bashed by tons of people for inferring there was a connection between long-term opiate use (particularly methadone) and testosterone issues (as well as general hormonal issues for both sexes) -- guess that a few years of time and the personal, anecdotal experiences of many others, as well as the increase in the number of doctors open-minded enough to actually prescribe testosterone and recommend TRT for anyone under age 35 (when I first started, my blood levels were at the lowest concentration my endo had ever seen in someone my age, who told me literally "I am amazed you are able to get an erection") - I mention this because it's likely, especially if you first started, that you are still adjusting to having a stable blood plasma concentration of free testosterone.
I recommend, if you are able to do so or wish to do so, looking into procuring either some testosterone-ester-based blends (sustanon in particular, or it's many genericized versions is particularly designed for long-term use with a good mix of fast-acting esters as well as longer-lasting ones). Cypionate is my personal favorite, followed by enanthate - for me, propionate and isocaproate, phenylpropionate, etc. tend to leave me with a bit of post-injection-pain. When I first began, I started off with using both Androgel (before realizing what a massive waste it was both in relation to it's low bioavailability, high cost, and low dose) as well as doing 2x injections of test, 1x 200 mg cypionate and 1 X 250mg enanthate, rotating.
IT IS IMPERATIVE that you purchase a different set of luer-lok detachable needles for your "drawing" up of the solution. I'll reiterate that since I'm nearly *Certain* that you are using pharm grade gear, the problem isn't necessarily that what you are using is 'thick', by any means. Compared to something like IV heroin, cocaine, etc. - even IV black tar heroin, sure it will feel thicker, but depending on the carrier oils (the cypionate made by Pfizer/Perrigo (it's all the same shit, literally) contain MORE than a ml of solution FYI). Not only does it need to contain the main constituent of the testosterone, but it also contains benzyl alcohol & benzyl benzoate (you'll commonly see this referenced in bodybuilding forums as BA & BB, respectively) - an antibiotic/preservative, carrier oils (I believe, am pretty certain, in this case it's USP grade sesame oil/grape seed oils (more commonly GSO) - and this adds a good 15-20 or so units if you are able to get everything out of the ampoules.
As for getting proper needles, unless you are incredibly overweight, there is NO WAY you aren't hitting your muscle with a 1.5" needle. I personally use a 1" needle. My favorite, and seemingly the most popular amongst fellow T users are the BD Luer-Lok 3ml(cc), 23g, 1" single-use latex free syringes. I buy these online (I just recently signed up here but I was on Opiophile for a decade, so idk the rules here - if it's kosher, I'll post the link to the place that I use, it's not illegal or anything - and they have all that you need). I buy a box of these BD's for about $19-21 for 100, and then get a pack of 100 individually-wrapped luer lok *not slip-tip* BD 19G (fucking horse pins!) needles.
For the technique itself: Unscrew the pre-attached 23g needle, then pull back on the plunger to measure an intake of a tiny bit over the line of 1ml. Attach the larger bore needle, use an alcohol wipe (if you wish, honestly, if you're using the amps after you've just popped the top of it off, it's fine), and stab that motherfucker in there, turn it UPSIDE DOWN while simultaneously smoothly, not too forcefully, injecting the air in the barrel into the ampoule - since it was filled/capped at increased atmospheric pressure, this will begin to automatically draw up the contents of the amp into your syringe, so I find that slowly pulling the needle tip out, closer to the rubber of the top seal as it gets to be close to filled up, will help you get all of it out. You can angle it if you want, match the placement of the needle tip's bore opening to the tiny remainder left in the amp.
Once you've drawn it all up, put your syringe right-side up, flick the side of the barrel to get rid of any of the air bubbles-unscrew the 19g "draw-up" needle and throw it away-and put on the 23 gauge, and as needed, move the plunger closer to the top, but make sure to leave a small amount of space as you would with an IV shot. This way, you're not going to have any of the testosterone solution in the actual needle itself that might leak out when you first inject it, which can not only irritate the injection site and may be what you are witnessing. Also, leaving a bit of space leaves you the option of not having to draw back on the plunger to determine if you are not in the muscle (which, given that you are injecting into your thighs, as I myself do, you'd KNOW if you were not in the muscle, trust me). As a general rule, the higher the concentration of the solution, the greater likelihood you will have some pain resulting from the injection which can range from a weak-ish feeling "dead leg" to feeling like someone whacked you with a baseball bat, with a huge muscle knot in your thigh for a few days (typically this happens because of the high dosages creating an incompletely solubilized solution, so a phenomenon known as "crashed" testosterone, which can be sometimes fixed and sometimes happens--even with the stuff you are using - which can usually be fixed by running the amp under hot water (depending on how hot, maybe a good idea to put in an unattached 19g needle tip into the rubber top to allow pressure to escape - this is usually unecessary though) and this is due to the testosterone that's "crashed" recrystallizing in your muscle, causing some pretty gnarly pain).
I highly recommend not only googling or looking for a YouTube video on a technique called the "Z-tracking technique" for IM injection, as it sounds exactly like what your nurse was doing - but also making sure to rotate spots between your thighs. Sit down while doing it, take your pants off, let your legs sit naturally on the ground. DO NOT clench or flex on your thigh muscles while injecting, this is a bad idea. Merely make note of spots that would be good for injection - which can be double checked by looking over an anatomy chart -make sure to avoid any spots with the possibility of hitting any arteries or spots with lots of nerve endings. The general rule of thumb, when working with your thigh, is to take your hand, place it at the top of your kneecap sideways, with your fingers pointing to the side of you, so your left hand pointed this way --> (your fingers being the >) above your right kneecap, and at the same time, take your right hand, and place it with your thumb beginning directly at the intersection line of the top of your thigh with your mons pubis area/groin so your right hand would be pointed like this (<--) -- the area in-between these two boundaries, from above your lower hand and below your upper hand, is a good area to go in - and it's also better to use the muscle tone on the outer side of your thigh - not necessarily sideways, but once you flex you will know what I mean.
Remember, when doing an IM injection, the most important rules are, RELAX - don't flex up your leg, TAKE YOUR TIME (on the injection itself) - once you have satisfactorily checked that you aren't aspirating any blood, you should go as slow as you wish to go. I go slow as fuck, and never have any problems. As for the actual penetration with the needle though - you want to make sure to use the Z-track method, and use your hands (or free hand) to maneuver any loose skin/adipose fat on top of the muscle (I am in great shape and have no problem hitting with a 1" needle, I am sure you would likely be able to do the same but I can't say without seeing you or knowing you), 1.5 is overkill for most places except the glutes, which is also not the best spot since it's hard to do by oneself and it's also easy to hit your sciatic nerve which hurts like a motherfucker. Best advice though - make sure to basically STAB that motherfucker straight down, in one fluid, smooth, quick motion, into your skin at as close to a 90ยบ angle as possible - if you are experiencing any runny fluid after removing the needle (despite waiting) the only reason I can think of is that you are using a spot that has built up scar tissue (which you should be able to feel and tell upon initial penetration of the needle), in which case I would suggest finding a new spot. Even so, it's not really wasting it, it's just not as effective.
Alright, that was way way too long. Look up some videos on YouTube, and if you have any questions feel free to ask me, I'm glad to help.
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@Griffin, if you want to minimize the leakage of testosterone, I would recommend just leaving the needle in for a few seconds after injection and you shouldn't see much leakage at all from the injection site. If you are using the thigh or the vastus lateralis muscle, you want to lift the muscle, which it sounds like what the nurse was doing. I don't see where you mentioned she gave the injection, but for this area, you want to do this.
Always inject at a 90 degree angle.
Here is a you tube video on how to do an IM injection into the Vastus Lateralis muscle.
https://www.youtube.com/watch?v=O7ZxHodcWAU (https://www.youtube.com/watch?v=O7ZxHodcWAU)
Here is a link to some guidelines from BD that are helpful:
https://www.bd.com/hypodermic/pdf/Intramuscular_Injection_Guidelines.pdf (https://www.bd.com/hypodermic/pdf/Intramuscular_Injection_Guidelines.pdf)
Anywhere else you give the injection, you can use the Z-track method which helps to minimize leakage of the testosterone into the subcutaneous tissue.
For anyone interested in that method here are a few links.
http://nursingcrib.com/nursing-notes-reviewer/fundamentals-of-nursing/z-track-method/ (http://nursingcrib.com/nursing-notes-reviewer/fundamentals-of-nursing/z-track-method/)
https://www.youtube.com/watch?v=IPp28ZGgobw (https://www.youtube.com/watch?v=IPp28ZGgobw)
The Z-track method can also help to decrease the amount of pain after your injection.
You can also use what is called the air-lock technique, which dieselbaby described below. Draw up your testosterone into the syringe and once drawn up, then draw up about 0.1ml to 0.3ml of air into the syringe. The last thing you administer would be the air.
To minimize pain:
~There is some thought that applying pressure to the area before injection can help.
~Make sure you are relaxed.
~Z-track method helps to decrease pain.
~Using the proper size needle: length: 1.5 inches is best, gauge: 21 to 23 gauge needle
~Inject at a 90 degree angle
~Warm up the testosterone in your hands by gently rolling the vial back and forth between your palms. Also makes it easier to draw up, especially when you don't have a larger gauge needle to draw up the medication. (18 or 19 gauge)
Hope this helps.
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Do you recommend IM or subcutaneous mini-amount (20 cc's or something small) (regular dose amount though) for street drugs?
Or will the practice lead to abscesses?
Should people ever bother to try to use Meth or H. IM or subcut ?
I suspect that it's a bad idea - am I right?
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Hi @candy, I have a question.
I've been on TRT for about a month now, and everything seems fine, but my freakin ankles are twice as big around as normal. Also at times my hands have looked pretty swollen.
I'm in the desert where it's 100F most days, so I drinks LOTS of water on the daily. I assume what I'm seeing in my feet and hands is water retention? I read that can be a side-effect of TRT, do you have any advice or suggestions? It's not something I should be super worried about, right?
Thanks!
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@chipper do not muscle or skin pop crystal! The crystal will cause an abscess almost garunteed. If for some reason you decide to use a micron filter and look for a way to clean the product of cut. I think I read of a way somewhere to clean it up but I don't recal. I know heroin isn't as bad but still run it through a micron filter,
@Esoteric Anhydride did a write up of the correct procedure to do a clean up of h using an a/b extraction. If that is the right term for the process.?
If I'm wrong I'm sure someone will tell me. Plus remember you are trying to stay away from the spikes chipper! (No judgement bro!) I just want to encourage.
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I appreciate the concern but it wasn't for me - i have a friend that has very limited IV options.
I think that it's a bad idea, too.
I'm staying away from injecting, for real. You needn't worry for me but it's very nice that you should do so.
OK, I've derailed this already.
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@Esoteric Anhydride, it may be aggravated by heat related edema.
Check your salt intake, if abnormally high then reduce.
Peripheral Edema is a known side effect of TRT so you could have both issues going on. Sorry for not being Candy but I thought it might help.
A Diuretic may be worth a try, as is leg elevation, hand massages, compression stockings and walking bouts may all help.
I think that you are too young for the other reasons for it and shouldn't worry, especially if you try one or more of the actions I just posted.
I hope candy will drop in soon.
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You might want to get all of your levels checked chops.
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You might want to get all of your levels checked chops.
Ya def need to do that again -- that Sust tho!!
It seems to be cooling off here, only 85 today so maybe I'll stop drinking so much water, two weeks ago it was 110+. I know it can cause cardiac problems but I have doubts it's that serious. It's actually better today, my ankles look basically normal, seems to peak maybe 5 days after I do my dose (weekly atm).
I'm on my feet up and down all day long, so it's not anything about a lack of activity.
I think it might be related to estrogen, if anyone who knows it could explain this mechanism, I'd be obliged.
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I only have a basic understanding, but basically some people partially convert some androgens into estrogen. Here's a wiki link that explains it in depth: https://en.wikipedia.org/wiki/Aromatase It's totally resolvable with aromatase inhibitors like arimidex, or the bodybuilding way would be to take a round of nolva or chlomid. AFAIK the only way to find out for sure is with a blood test, so it makes sense to raise the concern with your doctor.
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Swelling of the ankles is a side effect and one that should be reported to your doctor. This is seen as a serious side effect and from what I know, sometimes switching to the cream can reduce the swelling.
Are you using the testosterone cypionate? This type of testosterone replacement is known to cause this side effect, but all testosterone can cause edema (swelling). I would contact your doctor as soon as you can and let them know. Are you having any difficulty breathing? When you are lying down do you notice any shortness of breath?
It also can be estrogen related as you mentioned. I would still contact your doctor and have your levels checked.
Maybe doing the injection bi-weekly might help? My son is on testosterone replacement and he is getting the injection every 3 weeks.
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Swelling of the ankles is a side effect and one that should be reported to your doctor. This is seen as a serious side effect and from what I know, sometimes switching to the cream can reduce the swelling.
Are you using the testosterone cypionate?
I'm using sustanon 300, which is a blend and I believe it does contain cypionate. Maybe switching out to something else will help.
<snip> I would contact your doctor as soon as you can and let them know. Are you having any difficulty breathing? When you are lying down do you notice any shortness of breath?
It also can be estrogen related as you mentioned. I would still contact your doctor and have your levels checked.
Ya, I need a doc. We just moved and I haven't gotten around to medical yet, which I really need to do.
Maybe doing the injection bi-weekly might help? My son is on testosterone replacement and he is getting the injection every 3 weeks.
You mean bi-monthly? I have considered that, it just works so damned well I don't want it to stop! lol
It seems like the problem peaks maybe 5 days after the shot, so by 7 days things look normal again and I say fuck it and do another one.
I know, I need tested. But I had fucking Gynecomastia from the low-T effects of MMT (been off MD over a month now!!) and although it had gone away before, it was coming back (I can still see signs of it), and I HAD to do something, NFW was I going through that bullshit again. My horrible sweats are gone, I have ++energy and mood during the day, my junk works again, the TRT has been a *gxdsend*
I hear the warnings about heart problems, I will get checked out but I'm not very concerned about my cardio system at this point. I was pretty sedentary for quite awhile but lately been very active; swimming every day, sometimes twice a day. Walking around constantly, and I'm not feeling any heart problems at all. Only time my heart fucks with me is when I'm tapering benzos and/or kicking dope.
I gotta read up on Aromatase - thanks @Z - after 5 years of methadone trying to make me female maybe I still have an imbalance or something..
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Too much testosterone can lead to gyno too man. Please keep a few letrozoles on hand just in case. It should only be like $20 for a strip of them.
And if it's water retention related or estrogen related, an AI will help with that too. Although you may not want to use letrozole on a daily basis... it's a really strong one. It's good to have if you feel gyno is starting because it can (not always) stop it if you take it soon enough and crash your estrogen levels.
Also, I think she may have been suggesting bi-weekly to keep your levels more steady. 100 mg 2x a week as opposed to 200 mg 1x a week for example. Although with a sustanon blend, it's probably not as needed as straight enanthate or cypionate.
Lastly, I don't think switching the esters would make any difference, would it? I mean for your symptoms. Im not a doctor but the only reason I can think of the cream helping is that it will generally be a lower, more steady dose... splitting up your dose should have that same effect to an extent... less peaks and valleys and all. I mean, at the end of the day, it's all testosterone... I think.
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Life has kept me away from this board but I wanted to add something to this thread..
Yesterday I got a call from my endocrinologist's office changine the date of my appointment. That was fine because he is so busy I have to schedule them months ahead of time.
While on the phine with her I mentioned that I had recently read that men taking testosterone can start producing extra estrogen which an lead to symptoms like gynocomastia (Man Boobs) and I asked her if I would have to take an estrogen blocker. I didn't ask FOR anything or make any complaint, just asked about what I had read.
Less than a hour later they called me back and told me they were dropping me as a patient (I think) because they thought I was asking to use the T like bodybuilders do (aka "stacking"). I had done nothing at all that the doctor hadn't told me to do, even switching to injectable in Colombia because gel was hard to get there. Then when I told him how much better I thought it worked he agreed to switch me to take-home injectables.
I patiently tried to explain that this must be some misunderstanding or breakdown in communication because I have follwed his instructions all along. They said they would talk it over and according to the on-line clinic site my appointment is still scheduled. I plan to be there and clear things up but that I even have to worry about being jerked around like this REALLY pisses me the fuck of. You;d think they would appreciate a pateint who is concerned about his health and asks questions not just want to be rid of him.
Part of the problemtoo is that I am currently in Minnesota and here they ahve a thing callled "Minnesota Nice" which is another term for "Passive Aggressive." They sugar coat everything and will never actually say anything that they think you won't like or could seem confrontational. I, on the other hand amd a big city East Coast guy and I will tell you point blank when I disagree with you and although I have no animosity in saying it they always seem to freak out that anyone dare speak bluntly and honestly to them.
In a similar vein a female freind of mine back in MA was also just dropped by her doctor. Apparently there is a trend in "concierge medicine" which is essentially rich people paying their doctors a monthly [retainer] so they don't have to wait for appointments, get house calls, get more than 10 minutes face time with the doctor, etc. They essentailly pay to "jump the line" of us plebes. Consequently, the doctors can then reduce their patient listss and make as much or more money, leaving many long term but not rich patinets at the mercy of their insurance company.
I so tired of the USA and the placing of "maximizing profit" above all else I'm out of here as soon as I can afford it, which will be either inheritance or Social Security or I get accredited to teach English to professionals in some country in Latin America, where I can buy whatever drugs I need OTC, do coke w/o fear of being arrested and be the big handsome gringo that gets the hot Latinas.