T Update

Oct. 5th, 2015 03:39 pm
aidenonymous: (gender)
I was off T a grand total of about ten weeks before I saw a super-competent trans activist NP and went back on ultra-low dose gel teamed up with raloxifene, an E blocker, on 21 September.  It's only been a couple weeks, and I haven't noticed any changes or side-effects, not even the mania I got every time I started or re-started T, possibly because my other meds have changed up a bit, too.

Okay, that's not quite true; there was the one day when I forgot my T but remembered the E blocker, and I had what I think might have been a minor hot flash.  I was out in the cold wearing a hoody and windbreaker, and suddenly I had to unzip the windbreaker and wished I could unzip the pullover hoody.  By the time I got home fifteen minutes later I felt fine, but that's my best guess at what happened.  I will definitely try to be more careful about remembering my T now that it's an every day thing again.  Once I get stable with it I'm going to investigate other delivery methods so I can maybe be lazy with memory again.

I'm finding it hard to get back into the routine of being on gel again.  I apply it in the morning but have been showering around dinnertime/when I get home from work so I can sleep without clothes without exposing my partner to it.  My hair has been derp-tastic at work because of this, but I just can't talk myself into showering twice a day.  I've been having really bad dysphoria since I made my last medical transition update post and can't shower unless I turn the lights off and play really loud, complicated/engaging music.  Showering is definitely the low point of my day.

Speaking of medical transition updates, there will be no more top surgery updates.  Dear posterity, I apologize, but I just can't.

Overmorrow

Jun. 30th, 2015 07:01 pm
aidenonymous: (gender)
This post is embarrassingly doubly backdated.  This first part is from last Monday, 6/22.

yesterday )

I started writing this yesterday, 6/29, but had friends over to distract me from my worrying so didn't finish until today.

thoughts )
aidenonymous: (gender)
I failed to actually post this last week when I should have, but here it is anyway.

boring )

Beep boop

Jun. 2nd, 2015 06:47 pm
aidenonymous: (gender)
And I meant to post this one yesterday but fell asleep before finishing it. . .

things )
aidenonymous: (gender)
I had my second consult with Dr. Fischer today and wanted to post something quick, even though I've got a couple drafts of actual content floating around that I should finish.  The good news is that I'm still borderline for peri, but now a slightly better candidate than I was last year, so we are going ahead with the surgery!  I was scared because my chest is kinda inflamed right now due to the whole cycles not stopping thing.  Dr. Fischer was very confident about it, which helped put me at ease.  She said there was really no benefit to building a bunch of chest muscle now, although I'll still try to get to the gym some time soon.  My pecs are already well-defined enough that she didn't think I'd have any problems with nipple position, which is kind of hard to control with peri.

I got all the pre-op instructions and clarified some details.  After I explained my history of a bleeding disorder, they're not going to force me to stop T but did recommend I discontinue it for the week before surgery.  Normally they'd recommend stopping for two weeks before and at least a week after, and going to a half dose four weeks before (ha, joke's on them, I'm on the lowest metered dose and couldn't halve it if I tried).  They were happy I warned them that my medical clearance would have that on it before they saw a red flag like that.

The bad news is that they billed my insurance for the out-of-network rate even though we went through a ton of trouble to get it counted as in-network because my insurance company is tiny and doesn't have anyone who does FTM top surgery in their network.  So they quoted me three times what they should have for my contribution, which is about $1000 more than I can actually pay right now/  I have until mid-June to pay it, so that's enough time to save up some more if necessary, but I'm still hoping I'll be able to convince my insurance company to cough up the rest given the paperwork we painstakingly completed.  My partner's still out of work but will probably have a job by July, so I'm hoping I'll have secondary insurance to help with whatever's left over.

I hung out with three friends from college afterwards.  Two did not know about my transition, and one of them figured it out and was cool about it.  But those two obviously weren't people I'm especially close to, so the stakes were low.  I have a big meeting with my thesis advisor tomorrow about my qualifying exam and the status of my work (which was going really well until a few weeks ago when things kinda fell apart), so I should go to sleep.  I mostly wanted to squee about how this is actually happening!
aidenonymous: (gender)
I booked my top surgery today.  I was pretty calm when I called, but I got the ol' stomach full of butterflies afterwards.  (Actually, I'd never felt the sensation that term describes before today, nor do I entirely recall the emotion associated with it.)  They're letting me reserve July 7 and are going to try to get my insurance to front the money so I don't have to.  It's nice that even if I do have to pay up front they're not going to make me wait to get in the queue just because of that.  Last Friday when I called, they said I wouldn't need another consult, but today they wanted to schedule one just to be safe, since I'm not going to go through with top surgery if they no longer recommend me for peri.  Realistically, I think I'd do it even if I knew I'd need a revision, but I kinda just want to hear that the recommendation hasn't changed.  So I have another consult on April 20.  It'll be a good excuse to visit friends near Baltimore anyway.  They started giving me all this info about when to show up on the day of surgery (8AM) and when to get surgical clearance from my primary care doctor (June 16-19), but then I reminded them they could give me that info in April in person.

I have a lot of other stuff I want to write about, but I'm a little short on time and should sleep instead.  I swear I'm going to catch up on this thing soon.  I'm finally finding video games less compelling and can see a world beyond this obsession just around the bend.
aidenonymous: (gender)
That's me alright.
I made a decision today. )

I also picked up my inhaler from the pharmacy today.  My endo sent the script electronically because albuterol isn't a controlled substance, and I didn't see until today that I'm supposed to use it four times a day.  My previous inhalers were either for emergency use only or twice a day, so either this is a different concentration or my asthma is way worse than it was before.  Also, I used it and didn't feel immediate relief.  I'm still coughing up mucus all damn day and apparently making a wheezing sound when I do it.  I'm going to try to make an appointment with my GP just in case my endo was wrong about the congestion, since that's a problem I'm more familiar with.  I guess I have trouble believing that the feeling of not having enough air in my lungs is caused by constricted airways rather than fluid build-up just because that's happened more to me over the past four years.

I chickened out on picking up my prescription for T.  I have about a month's worth of 1% gel left in the pump, plus over a month's worth in packets.  When I got to the pharmacy, I asked if I had refills on the 1% pump and they said yes and started filling the prescription.  My insurance apparently thinks one box with two pumps is a 60 day supply (when it's actually a 120 day supply), so they won't let me fill the prescription for the higher dose until late August, after I move.  I should be excited about starting the higher dose, but I'm actually really nervous.  I feel like I have a good thing going here and don't want to fuck it up by increasing the dose.  I can fill one and then have the other mailed to me in NYC but haven't yet decided which to fill first.  I've had enough difficult decisions for one day so will deal with this one tomorrow.

Oh, also, I told my Ph.D. advisor-to-be that I'm transferring and he's happy for me!  He didn't even ask me to terminate my contract.  I feel badly about spending his start-up-money when he's not getting a Ph.D. student out of it, but he didn't take up my offer, and I could really use the cash right now.  He had some advice about who I should work with, and I'm glad that it was advice I was already taking.  He actually wanted me to get started with someone there right away, so that's what I'm going to try to do!  I was actually drafting an e-mail for faculty at the new place before I heard back from my advisor, so that's a good sign that I'm not totally incompetent, right?  Okay, actually going to sleep now.
aidenonymous: (gender)
I had an endo appointment today.  I finally spoke up about this cyclic mood swings nonsense.  I'm ashamed that I can't just rely on stoicism to get through it, and I wish there were another way to solve the problem because I otherwise like the pace of changes on my current dose.  My endo thinks switching to shots with an equivalent dose won't make a difference.  She said that with compounded cream, the minimum dose necessary to stop periods is twice what I'm currently getting from gel.  She wanted to just have me double my current dose of 12.5 mg, which is what she prescribed when we met for the first time, but I talked her into switching me to AndroGel 1.62%, whose smallest metered dose is 20.25 mg, a tad lower.  The fact that I can negotiate my prescriptions with my endo is really cool, BTW.  She questioned my info about the effective dose being different for the new concentration, so we simultaneously looked it up on our phones.  It was pretty funny.

In any case, I hope this is worth it.  My insurance covers any AndroGel, so at least it'll be worth it in terms of cost.  I don't feel like I really need any more changes, but I'm not willing to add female hormones to my body if they come with a risk of breast growth.  I can deal with more masculinization (wouldn't complain about it in most regards), just don't want to get changes fast enough that I feel dissociated from my body.  I wonder if I should have advocated more strongly for shots, because then I'd have more of an ability to fine tune my dose instead of taking whatever Abbvie offers me.  Gel is pretty fantastically easy though, and this is still lower than what my endo calls a "low dose" for trans guys, so maybe I'm making a big deal out of nothing.  I think I have enough AndroGel 1% to last until I move, so I'm going to wait a bit to start on the new stuff, at least until I figure out what I'm doing about top surgery.  I think my endo would be okay switching me to shots if I called and asked, but then I'd have to learn how to do it on my own when things are pretty crazy anyway.

This appointment had some other notable moments.  My blood pressure was totally normal.  It was a relief because at Dr. Johnson's office, my blood pressure was actually high.  The only other time I've ever had high blood pressure was when I was having an asthma attack in a hospital.  So now I know for sure that the culprit was indeed car sickness and I am not in earnest developing high blood pressure.

My endo was really concerned about my lungs though.  It was an early morning appointment, and I had a productive cough from when I woke up until a couple hours after the appointment.  It's been like that for over a week.  I told her I thought it was from binding too much at PTHC, since I've otherwise been cutting down substantially by working from home whenever possible and obviously not being very social outside the house otherwise.  She took a listen and kept coming back to the lower part of my right lung.  She asked if I was binding and tried putting the stethoscope under my binder in the back because it sounded "muffled."  I wasn't even binding very hard, just wearing a sportster.  Anyway, after asking me to breathe ten different ways, she concluded that my chest is not truly congested, but she can hear my asthma.  It wasn't really on my mind because I use my inhaler once or twice a year just for emergencies, usually triggered by cigarette smoke.  She expressed approval over the news that I'm in the process of making top surgery happen but didn't tell me I absolutely needed to do it, something that would have been preferable because it would take the decision out of my hands.

To lighten the mood, I'll end with the fact that my endo said my voice was definitely deeper than it was the last time we met (in February?).  [livejournal.com profile] alifjiim also said my voice was deeper than he expected when he visited last week.  (I have a couple half-written posts about PTHC and meeting super-cool internet people a couple weeks ago, swear I'll finish those up sometime soon.)  I also met a few people at PTHC who said my voice was deeper than they would have thought given my low dose.  I don't remember if [livejournal.com profile] theirearlystuff said anything about it though.  Did I ever mention that my father is a contra-alto?  My voice might be the deepest of all living males in my family, and it's a bit lower than my cis male partner's voice.  I'm pretty satisfied with that.  (-:
aidenonymous: (gender)
Some interesting facts have come to light that definitely influence my top surgery plans.

The plan I'll be getting through school after I transfer won't be announced until 30 June.  Though the current version covers 90% the costs in-network and 60% the costs out-of-network, I don't know their process for designating in/out-of-network providers and the plan is subject to change in the next school year.  Essentially, until the benefits are announced, I can't count on any coverage for top surgery.  That mysterious plan will take effect 21 August.

The plan I currently have through school covers 100% of the costs of top surgery with a surgeon of my choice but ends on 9 August.  I thought this meant I really had to schedule surgery before 21 July or thenabouts.  Since I'd otherwise be uninsured from 9 August until 21 August and possibly still be at a higher risk of complications, I inquired about continuing coverage with my current plan so I won't be uninsured for the two weeks in between.  I just found out I can continue coverage until 9 September with the same benefits for $384.  So, I'll definitely be doing that because being uninsured for any amount of time is beyond my risk tolerance.  As a bonus, it would buy me a little more time to decide.  I could potentially schedule surgery as late as 15 August without having to take time off from my new job.

My partner's insurance begins 1 October, and it won't cost him a cent for me to be enrolled.  Since it looks like neither his plan nor the one I'll be getting through school in the fall prohibits secondary insurance, I can be doubly insured through him.  He finally heard back from HR, and they said his plan is administrated (administered?) in California even though it's the plan for out of state employees.  That means the transition-related treatment exclusion they had is now forbidden, so top surgery would be covered to the same level as any other medically necessary surgery.  The current version of his plan would cover 100% of in-network costs and 70% of out-of-network costs, but the details may change in the new plan that won't be announced until 1 September, and I still don't know how the in/out-of-network designation is made.

So, it looks like I have some more options.  My hard deadline for guaranteed 100% coverage is now a month later than I thought, and I'll be able to decide after the plan for my new school is announced.  Woohoo!  I owe the universe some serious gratitude right now.
aidenonymous: (genderqueer)
I kinda fell off the internet again.  I was really burnt out and barely made it to Spring Break.  I restarted T the week before break because I was a nervous wreck.  By then, I'd been having negative effects from stopping for about two weeks, and I couldn't cope anymore.  I'm going to make a T update kind of post about the whole thing, but the short version was that it was not pretty.  I basically got to the same point I was at when I started, unable to function without it.  I'll admit though, the first ten days or so were a valuable and hardly excruciating experience (that I have no plans to repeat any time soon).

I slept through most of the break and basically got nothing done but felt somewhat refreshed at the end.  I'm pretty much abandoning the project I've been working on for the past six months, which puts me at risk of not being able to take my comprehensive exam at the end of the summer, but I don't feel like I have much of an option.  Right before break, I made an appointment to talk to the head of the grad program and explained the problem.  It's not that I don't have time for research.  It's that I have only a few hours each day of peak mental productivity, and I can hardly get anything done like that, at lest not on something so abstract.  At our meeting, he told me that my advisor had just contacted him asking if I was alright, and he'd told her to go easy on me.  It's not what I want, but it may be what I need.  I don't know if this is awkward or expected given how I came out to him, but we have not said a word about it IRL and barely a reference has been made in e-mails.  Related: I need to write a coming out letter to my advisor and have been putting it off for almost two weeks. . . another thing I need but don't want, apparently.

words about my chest )

Anyway, I don't want to go into this unless I'm confident I won't regret it, even if my regular doctor, endo, and therapist are falling over themselves to write me a letter.  I don't know what I'm going to say to the surgeon when we meet, but I have six weeks to figure it out.  Maybe the surgeon will turn out to be a really good salesperson and totally win me over.  In the meantime, I should do that work I was doing before it occurred to me that I'd think better after getting this out.  I'm hoping I'll have enough spoons to catch up with folks here a bit this weekend.

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aidenonymous

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