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. 

Just My Imagination

A couple of days ago, my endocrinologist called me back with the results of my recent laboratory visit to have the vampires check my blood. 

To my surprise she told me my estradiol level had risen from the last time she prescribed me new patches from a low of "40" to "80" currently. 

Since I am very poor in asking relevant questions such as what should my levels be, I went to Google and received this answer:

"For transgender women, the Endocrine Society guidelines define the target range of estradiol as 100–200 pg/mL (367–734 pmol/L)¹; as many providers in our practice do not titrate therapy when estradiol levels are above 90 pg/mL (330 pmol/L), the range of 90–200 pg/mL (330–734 pmol/L) was used to define effective"

So, I guess because of those levels, she prescribed me adding one more patch I add to my body twice a week. I am prescribed (by the VA) Alora 1 mg patches. Each of the patches contains 3.1 mg of estradiol which is released over a 3 to 4 day period. I am fortunate I guess in that I haven't had any problems with the patches staying on. Because the next step would be me giving myself injections. I definitely have a problem with needles. 

Actually all these facts and figures are a way for me to understand the advanced gender transition I am going through. If the last time I received permission to increase my dosage is any indication, I can expect more changes again.

Of course the first time I added the extra patch, I imagined I felt an added fullness in my breasts and hip area. Realistically I know changes do occur over a period of time and not the first days. 

Plus I do know the risks of Hormone Replacement Therapy at my age. So does my Endo Doc I guess since wants to check my blood hormone levels in a month.

In the meantime, I will have to try to keep my imagination in check.  

Finally, statistics are showing nearly one in ten transgender individuals are using "underground" or un regulated hormones to aid their transition. Please be careful!

Burger King in the Gender Business?

Perhaps you have heard (from the far right) fast food giant Burger King is offering a new vegetarian Whopper sandwich.

According to right wing zealots, when men eat the new sandwich they can grow boobs, decrease the size of their genitals and become homosexuals.

So, there you go, I have an inexpensive way to cut back on my Estradiol and Spiro! :)

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.

More Blood Tests

Yesterday marked yet another trip North to Dayton, Ohio to visit my Veterans Administration therapist. Everything went well as my overall mental health has been positive since almost all of my major tests have come back positive. More precisely, my three heart exams and one lung exam. I still have the most difficult test of all coming up, a colonoscopy early next week.  As  Connie would say...a real pain in the rear :).

My blood test yesterday was extremely important in that it checked my body's hormone levels. My endocrinologist wanted the results to see if it will be safe to increase my estradiol. I am very excited to find out the results. Estradiol by the way, is a form of estrogen.

My warning always is, DO NOT attempt to self medicate with estradiol or any other HRT medications. Doing so can be extremely dangerous to your health.

My Transgender Reality

First of all, I would like to thank Charlotte for her comment to a Cyrsti's Condo post from last May. The comment was why don't I just kill myself. The quick answer is I tried that once and happily I failed.

My reality these days revolves basically around my family. And, to a lesser extent the public's perception of me  Examples include a forthcoming trip Wednesday to my grand-daughter's graduation.  Then yesterday we went to a new deli we haven't been to before. Not much happened except one of the younger guys couldn't quite seemed to keep his eyes off of me. I can never tell if he was fascinated by me, or managed to figure out I was transgender.

As I have been told a couple times in my life, it isn't all about me. So, I try to keep that in mind too.

It's interesting too, since Liz has lost nearly 120 pounds, her reality has changed also. She has explained to me she still is a heavy over weight person in her mind and it is hard to shake.  I am sure in the dark recesses of my mind, I will always be fearful of presenting as a guy in a dress.

Digging deeper, my latest paranoia revolves around an unanswered phone call I received from my endocrinologist. Now I am worried she is going to want to play around with my estradiol (estrogen)dosage.  My reality is I have grown so used to the changes in my body, I don't want to go back. She, My Doc, has already decreased my "Spriro"  which was prescribed to decrease my testosterone. She cut my dosage due to my potassium being too high.

One way or another, I will follow her advice.

Regardless of Charlotte's advice, I don't want to kill myself.

It's my reality!

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."