hi.

jessica.

this is an update on the situation. i'll try to be terse. i presume you have the story available in previous faxes to jog your memory.

1) my emergency supply of cyproterone, as provided to me by an empathetic pharmacist, runs out at the end of september. i have re-halved to 100 mg/day out of necessity rather than free will and, while i'm certainly feeling it, i'm suffering through it stoically with the hope for better days. i don't know how long i can last. regardless, i will be back in a point of crisis at the end of the month unless something is done, if i make it that long.

2) as i am billed until mid-october, a new rx for 100 mg is not enough, even if i can suffer through the reduced dosage for that long. if medication is the only solution, i need it upped in order to merely pay for the reduction. but, i really want to go back to the 200.

3) i have called every urologist in town that i can find, and it does not appear as though i will find a urologist willing to perform this procedure (which can be done in 15 minutes and doesn't require a hospital visit) on short notice. i have been told by two local urologists that they will not perform the procedure at all (three, if you include the one from a few years)

4) given that fact, i am going to start contacting endocrinologists today.

5) as there is no bus service, it is not clear how i would access surgeons outside of windsor. this is again pointing to medication as the only real alternative.

6) i believe that dr. ===== faxed an rx for generic estradiol to university mall. this medication is pharmacologically indistinguishable from a placebo due to an inability for the estrogen to make it through digestion. it has essentially 0% bioavailability, unless taken sublingually. i have recently been able to find pharmacologically useful estrace by calling around. i will need to provide that information to the office as it is available, tomorrow or the next day.

7) while i don't really need to see dr. ====== exactly, i would appreciate some clarification regarding any evolving views on the matter, including (i) views on overprescribing the cyproterone and (ii) suggestions regarding how to get to an endocrinologist and/or willing urologist on short notice.