Hormonal Visit

 My endocrinologist visit is coming up and most importantly we review my blood lab results and primarily for me, she monitors my hormonal levels. 

In many ways, my estrogen and or estradiol blood levels are my life. Years ago when I started hormone replacement therapy, I was careful to seek out a physician to help me. I did not want to follow down the path of unmonitored hormone programs I had seen other transgender women undertake. The excesses of foreign purchased estradiol are easy to see and even easier to come by on line. Plus, since I was older (in my early sixties) I very much wanted a professional to evaluate me to see if I was healthy enough to begin HRT. When I was, I was elated. I couldn't wait to begin the new hormones and experience the changes which would follow. 

Each time I write a post on HRT, I warn everyone to seek medical advice and the results you will experience will vary widely due to many factors. Variables include your age, your dosage and even how you administer the medications.  Age of course effects the hormones already in your body. At the age of sixty (plus) my male hormone testosterone would naturally be in decline. Allowing the estradiol an easier path to begin it's changes. Dosage for me, similar to many others, started at a minimum level to see how my body tolerated the changes. I even went through a period of time early into my HRT when my endocrinologist stopped me from taking my hormones all together for another health scare I went through. Finally there are several ways to administer your hormones. I started my process on pills which were advised against by my first "Endo." Then I went to patches which I am on now. The other popular way to take hormonal doses is through injections which I have heard is the most effective way to do it. Since I have never been a fan of taking injections, I stayed with my patches which have allowed me to experience the changes I so desired.

Since my "changes" were slowed with my initial minimum hormonal dosages, I still showed amazing progress. To me, in no time at all, I experienced magical changes including breast growth, softer skin and increased hair on my head which was exactly opposite of the hair disappearing from my body. Except my beard of course. In record time I went from appearing as a macho male all the way to being a very androgynous person. Even though my outward appearance was feminized, it turned out my inner feelings changed too. As I went through my initial hot flashes, at the same time my inner thermostat became broken and I was cold all the time. I found out quickly how cis women were not making things up and their emotions were real. My lifetime of not being able to cry as a man changed rapidly the first time my emotions overcame me and I cried before a summer thunderstorm. 

Through it all, I have labored under the possibility I could have problems and have to stop my hormone replacement therapy, Since I have the benefit of having two Veterans Administration nurse practitioners reviewing my blood work before it gets to my endo, I don't anticipate any problems with my HRT continuing the way it has been. Even still, I have my share of anxiety over any potential results.  

Endocrinologist

 I love my "Endo" Doc. She is so nice and because of her I have been able to experience all the feminine changes I have been able to go through over the years. 

Of course it didn't hurt that before my visit (actually the night before) I washed my hair again and just let it go into it's natural wonderful waviness. You can see a bit of it in one of my profile pictures.

This picture was taken at only one of three times Liz and I have been out in the last year. As you can see in the picture, it was last summer. 

It doesn't hurt either I give my Endo the credit for my transgender transformations such as even less body hair (excluding my face of course) and increasing distribution of body fat to my hip areas. 

Now I wish my upcoming dental appointment could be as painless. Ha!!!

The Needle or the Patch

 Coming up on the nineteenth, I have my appointment with my endocrinologist. As I have written before, I am considering asking her about the possibility of changing my Estradiol delivery method from patches to injections. As with any other change, injections bring with them a whole other possibility of side effects. As a matter of fact, Michelle sent in this comment on the subject:

" You may want to check out this article:

https://transcare.ucsf.edu/article/information-estrogen-hormone-therapy
The highlight paragraph is one that you mentioned:

Many trans women are interested in estrogen through injection. Estrogen injections tend to cause very high and fluctuating estrogen levels which can cause mood swings, weight gain, hot flashes, anxiety or migraines. Additionally, little is known about the effects of these high levels over the long term. If injections are used, it should be at a low dose and with an understanding that there may be uncomfortable side effects, and that switching off of injections to other forms may cause mood swings or hot flashes. Some trans women have encountered difficulties obtaining a consistent supply of injected estrogen due to ongoing problems with the supplier. Realistically, there is no evidence that injections lead to more rapid or a greater degree of feminization. In my practice, I generally avoid prescribing injections unless under very specific circumstances."   

Thanks for the insight. Plus, as a matter of fact I did check out the article. So far, I have been lucky in being able to have a stable supply of patches through the VA and I have never had the problem of the patches not sticking. 

After talking the whole process over with my therapist this morning, the only benefit would be the possibility of quicker feminine development. So as it stands, I will probably just stay with the program I am on.

As soon as my partner Liz and I become fully vaccinated, I will be able to benefit from public feedback again. Which means so much. 

Vanity?

 On occasion I am incredibly surprised about how much more vane I am as my transgender woman self than I ever was as a guy. Of course it is easy to point out all the gender differences there are in fashion possibilities, even though even that seems to be in flux these days. 

With me, from the earliest days of viewing my cross dressed self in the mirror, I dedicated myself to improving my "look" as much as possible. In fact, anytime I had the chance, I was practicing. It sure beat the time I had to spend in my boring boy clothes and crew cut haircuts. I couldn't wait for the day I could purchase my own wig and better yet, grow my own hair out.

Of course, as the years advanced I grew "into" my feminine vanity and it became part of my existence. I guess more than a few feminists could say the whole process is part of societies' method of subjugating women as a whole to unfair standards of beauty.

Since to a large part, I got such a late start to living a full time existence as a trans woman, I still feel the newness of the whole process.

In many ways, my bodily changes due to hormone replacement therapy have helped increase my vanity to new heights. For example, after I pulled my leggings on this morning, I noticed my thighs were increasing in size due to the redistribution of fat in my body. By now, I know you are thinking wow how mundane is that but it gets worse. With all the problems in the world, I notices one of my thighs seems to be bigger than the other. Of course I have heard of the relatively common occurrence of women's breasts being different sizes, which is a problem I don't have. 

I wonder now, as I approach another appointment with my endo doc in the middle of this month, I am going to discuss with her the possibility of me moving my Estradiol transmission method from patches to injections. The injections I have heard are the most effective way of achieving the best femininizing results. Realistically, I am not expecting much more in my breast development but would like to see more in my hips.

Even though I have not decided which direction I will take (depending on what she says) I am leaning towards the injections.  

I guess vanity will probably get the best of me again.   

Gift Package

Well. after a year's wait to get my Estradiol meds increased, my new patches came in approximately five days through the mail. There are several different methods of taking the meds.

You can take them by swallowing pills, taking shots or by applying stick on patches.  My endocrinologist prefers the patch method due to possible blood clot issues. I know from talking to other transgender women, the other methods are preferred too. For many different reasons. Plus, I have to take the good and the bad in the Veterans Administration medical system.  Obviously, the good is that it is free. The bad is that normally you are restricted in what the VA provides as far as hormone replacement therapy goes. An example is progesterone.

Progesterone as an additional hormone has never been mentioned to me. In the past, I have had some trans friends who took progesterone. One developed the annoying habit of lactating under her shirt while she was still dressing like a guy at work.

Believe me, I am not complaining. I understand my endocrinologist has always erred on the side of caution with me. I know, as well as she does, the threat of possible blood clots is always possible.

In fact, I had to go through several vascular and heart tests to even get approved for this increase.

I start the new patches on Tuesday and I am interested to see how it affects me. After all it's a 25%  increase.

We will see if it's enough to induce hot flashes again.

Success

Finally my endocrinologist got in touch with me yesterday.  Approximately a week and half ago I did my blood labs to check my hormone levels.

My testosterone levels came back half of what the normal prescribed amount, so that is good if you are a transgender woman. Which of course I am. No real surprise because at my age, my testosterone would be decreasing anyway.

More importantly my estrogen amount was also low enough to be able to increase my dosage of estradiol (estrogen).

Since I passed all my blood clot, heart, lung and colon tests with flying colors, I was approved for an increase in my hormone patches from 1.5 milligrams to 2.0. Now all I am left with wondering how long it will take me to get my new patches.

What I hope will happen is a decrease in my overall body hair again and maybe an increase in my hips. The process started then stopped.

Of course due to my age and VA supervision, I have to be monitored again in about six months. By "monitored" I mean I have to have my blood tests done again to check my estrogen level. Sometimes I am fairly certain I set a record for the number of blood tests taken at the Dayton, Ohio VA.

I am not complaining though. I have been trying to get my Estradiol increased for the past year or so. With the increase, I still will only be at the level of several of the other trans women I know. I also know my endocrinologist is acting out of caution. Again due to my age.

Which I appreciate.

No Games

As promised,  this is part two of my previous post called no games.

It took awhile, but my endocrinologist requested blood tests came back on my levels of testosterone and estrogen.

It turns out my testosterone was very low and my levels of estrogen were as to be expected too. Also, the blood tests detected a slightly elevated of potassium. So, to counteract it, she (my Doc) is decreasing slightly my dosage of Spiro. I used to eat a banana a day, thinking it was good for me, until I found it wasn't and contributed to severe pain in my legs.

If you are not familiar, Spironolactone is used to lower testosterone and lowers blood pressure as a side result, among other things. (Or, vice versa.)

At any rate, one of the side effects of taking Spiro is it makes you lightheaded and/or dizzy, both of which I have been experiencing more of lately.

Initially, I was upset at the diagnosis, fearing my testosterone would increase and would not be counter balanced by a higher dosage of Estradiol .

Then I came back to my senses (what's left of them) and realized I was going against one of my basic principles...my health comes first.

This is definitely not a game! Plus, I have another blood test scheduled in May and another appointment in four months, so nothing is permanent.

No Choice...No Game

Yesterday's mammogram and today's call from my endocrinologist have proven to me again how my transgender journey came from having no choice and is definitely no game.  I have always been humored in a negative way by those who think any of us had a choice to go down this road.

Even though I chose the newer 3-D method of mammogram (thanks Michelle), the procedure was no walk in the park. For those of you who don't know, a "3-D gram" provides a better look at denser breast tissue, normally associated with transgender patients.

The technician was different in how she phrased the question most civilians want to know, when she innocently asked if I had completed my Mtf transition or still was expecting work to "move things around." I had a notion to say it was none of her business until I thought ahead and realized this person was going to cause me some potential discomfort. So I just replied I thought I was close to being done. Our local Transgender community was recently shocked by a trans woman who passed on (in her 40's) from complications when she went through breast augmentation, facial feminization and gender realignment surgery in the same procedure.

As we were finishing up and walking down the hall to leave, she was pleasantly telling me her about her love for upscale purses and then never carrying them.

So hopefully I will be done with mammograms, which I call a rite of passage, until next year.

The game part of this post will be coming up in my next Cyrsti's Condo offering, as this one is getting a little long. Stay tuned.

Mammogram

Well, I finally got off my rear and scheduled my mammogram appointment for Monday. It's actually in an easier hospital to get to for me and I don't have to navigate the congested maze of hospitals located around the downtown medical center. Plus I won't have to walk as far.

Yesterday, I also left a message with my endocrinologist asking her if she ever received my blood test labs which measure the estradiol (synthetic estrogen) and testosterone levels in my body. I have not heard back yet from her. One way or another it's not earth shattering because I am not trying to do anything very dramatic. Also, going through my Doc is the safest way to go.

Changing subjects here, the very crowded Democratic primary seems to keep adding people many of us have never heard of. Certain groups through are attempting to sort through all the political BS to give us a deeper look into the candidates. In fact, Democratic candidates will be facing off on LGBTQ issues in a forum this fall. It's a long read, but you can go here to check it out. It helped me to at least put ideas with names for a change.

The event is scheduled for October 10th, which coincides with the "National Coming Out Day."

The Sugar Daddy and the Endocrinologist

My trip to the endocrinologist was certainly uneventful, until I met my sugar daddy afterwards. My Doc was OK with my request to increase my estrodial and perhaps decrease my testosterone. As we talked, I said I was satisfied where I was with my feminization process but then again feel like I hit a wall. So, her (the Doc's) answer was maybe my testosterone was creeping up again and let's get it checked. So, off I went to get the proper blood labs done.

I knew my day was going too good when the 75 mile trip up to the medical center was very easy for a change, I found a parking spot and the wait was minimal. By this time, it was past noon and I hoped the wait at the blood labs would be minimal too...wrong, the room was packed, standing room only almost for a seat. I settled in to lose an hour of my life I would never get back.

As I sat there, a short time later, an older gentleman, well dressed with a straw hat sat down across the room. I didn't give him much thought except you don't see many guys at the VA who bother to dress up at all.

Approximately fifteen minutes later, he got up to go to the restroom and lost his seat. He then ended up sitting across from me. He was busily talking to a couple of other guys about the March Madness basketball games and was leaving me alone, for awhile. Then he said "Mam" what branch of the service did I serve in? I told him the Army and the chat was on. I found out he served in the Army in the mid 60's in Panama, was 75, retired but still flipped houses for a living.

By that time, he had decided to quit talking to the other guys and turn his attention to me and all the time used the proper pronouns so I felt secure in the conversation.  I had to be careful though not to out myself.

If I mentioned at all I was drafted, that would do it. Of course women weren't drafted into the service. On the fly I needed to make up a story about how I got into the military, or slightly twist the facts. Or shut up. I chose the latter but on the way home came up with a more palatable way of explaining what I did in the military.

To start with, some of you Cyrsti's Condo regulars know, I was assigned to the American Forces Radio and Television Service (AFRTS). So, I actually worked for the Air Force for one year and the Army for two years. So, I could say I was almost a contract worker for the military. At least it may work in a pinch when I get into an in depth conversation with someone who I don't want to automatically out myself with.

I must be getting dramatically better with my over all transgender presentation though. This makes the second time in a row men have called me by the right pronouns and wanted to talk while I was waiting to give blood. Years ago, I was called a "fagg--t" in the same room.

Times do change, and if my blood comes back the right way, maybe I can change it a little bit faster.

Transgender Veteran News

This is the latest episode of my life with the Veteran's Administration.
Keep in mind I have found out that even though the VA has a overall policy, that does not mean it applies to where you may live. For those of you who follow Cyrsti's Condo on a semi regular basis, you know basically where I live which doesn't mean much except for this post.
If you need geographical info about Ohio just email me and I will help as much as I can.
Today was very successful for me. You other transgender vets may have other stories which vary but this is what I learned the hard way.
1.- It was easy for me to get the approval for HRT from my VA center BUT:
2.- My center had no one who was qualified to prescribe. Important: Your primary VA Doc may approve the outside scripts to be filled by the VA pharmacy but chances are he is not really qualified to prescribe (Endocrinologist). The drugs themselves are not the potential major cost to you. The outside Doc is.
3.- Following advice from the center I went to an outside qualified doc thinking the VA would pick up the tab.
4.-The VA didn't and I took my case to a person called a "Patient Advocate".
5.-Here's what she told me today. According to the VA Transgender Directive my center has to provide me HRT or foot the bill for an outside provider. BEFORE you go.
6.-Here's a fun fact. Since my center does not have a qualified provider, the bigger center about 75 miles away does. Last year it accepted four local transgender vets into it's program and then stopped and said no more. Even if it went against the National Directive.
7.-According the "Advocate" my center has to pay for my outside doc and will if it's pre-approved.
8.-I found that person today and made sure he accepts VA compensation. (Important).
9.-It's in the Advocate's hands. She sets up the pre approval and then I set the appointment.
10.-All sounds good doesn't it but I know "it ain't over till it's over"!

As I said, if you are a transgender veteran, your experiences with the VA could be as different as night and day to mine.
As I also said if you are thinking about embarking down this path, feel free to email me for ideas!