Deal with unrelated medical issues first?

[Kali]

As I continue with therapy and support group meetings I'm thinking that before I make any decisions regarding HRT or any medical procedures, I would best be served by dealing with a few unrelated medical issues first.

I need two knee replacements; I've been putting it off as I try to lose weight, but I think it just has to be done before I start any other changes.

Lose that weight; become more aggressive about weight loss. I can't do anything about my height, but it easily masks weight gain. I really should lose 80 lbs

Weight loss will improve blood pressure issues. On the plus side, I had a recent cardiac evaluation and other than getting yelled at for not taking blood pressure meds and taking pseudophed at the same time, my heart is in good shape. If I lose the weight, any issues there should pretty much go away.

I feel like it's sort of a catch 22 situation; there are a lot of changes I need to make before I can make a lot of changes. My wife's only input is that I need to do what makes me happy and keeps me healthy.

So for those of you who started at a later age; did you deal with fixing existing medical problems before embarking on the next step in your journey?

[AveryS]

Health is important above all, however your mental health is part of it. I should really lose 80 lbs or more myself, but I've started HRT. Mentally it was the best thing for me to do.
As for other health issues - You can likely get the knees fixed any time, but you always have additional complications with HRT -- for instance, you do need to stop HRT temporarily if you're going under general anesthesia as it can cause difficulties.
For blood pressure - great news :P Sprionolactone is a diuretic... so you're still getting your blood pressure meds and anti-androgren at once :)

The bottom line - if you're comfortable living as you are until you get the larger issues (knees especially) resolved, then do that. If you're at the end of your rope, and need to do something, HRT does wonders for the mind.
*hugs*

[LeaP]

Each of the things you mention can be considered separately.

Knee surgery can be as soon as you can schedule it. Done. Out of the way. After recovery, your ability to exercise will be enhanced, which will help with weight loss. If you need knee surgery now, hormones have little to do with the decision and, as pointed out already, you will have to stop for a period anyway.

Weight loss can be pursued on or off HRT. While it's true that some have more trouble taking down weight on hormones, I think this gets WAY too much attention. For every one who has that problem there are 10 who do not. Your metabolism may decrease. You will burn fewer calories as your muscle mass decreases. The question is whether you will do what it takes to reduce regardless.

You cannot count on blood pressure or other issues going away with weight loss. You can always reduce meds as you lose weight anyway. This has little to do with the decision to start HRT unless your issues rise to a level of serious risk. Lots of people take blood pressure medications while on hormones. I do. I've lost 100 pounds - about 40 since starting hormones and about 70 since starting blood pressure meds and I still have to take them.

[kimdl93]

I can speak to the matter of HRT butweight loss will be important for your long-term regardless of what you choose

[Angela Campbell]

I started losing weight a year before I started HRT and lost over 100 lbs. It had many benefits, it lowered my cholesterol, it stabilized my blood sugar, it made me fit into much cuter clothes and it made me feel better. I wish I had started electrolysis then too. If you are planning to start HRT for transition I recommend starting laser - electrolysis immediately if not sooner.

I can tell you losing weight is different on hormones...for me I am hungry all the time now, but I can still diet.

[LeaP]

...I wish I had started electrolysis then too. ... I recommend starting laser - electrolysis immediately if not sooner...

Lord, do I wish I had listened more to THIS advice. Having started (finally) - start yesterday.

[Marleena]

Kali, yes I was already on blood pressure and cholesterol meds. A full set of blood panels came back good so it was safe to start HRT. If you're prone to weight gain try to lose it ahead of time. My appetite has increased and I've gained some unwanted weight.*sigh*.

[I Am Paula]

I started hrt, then went on a diet. So far so good, but I have a lot of determination. Can't say that it's easier or harder, but I miss chocolate!

[Angela Campbell]

Celeste....no no no no no............chocolate makes boobs grow!

[Marleena]

Chocolate...that's why I'm gaining weight! Not doing much for the boobs though..

[Leah Lynn]

My endocrinologist talked to my cardiologist and I am happily on hrt. On one blood pressure med and taking Spiro; so far, so good. Estrogen is always good. I lost 50 pounds and would like to lose another 20 to 30, but I'll worry about it ... sometime. Get the knees done and go for it, girl.

Hugs,

Leah

[Kali]

Well, my orthopod asked me to wait until at least next month before we redo all the xrays and such on my knees (I saw him yesterday for cortisone injections). His practice is reorganizing due to the AHCA and he also suggested that I wait on everything (I'm out to my medical providers) until I see what changes get made in my insurance.

I had completely forgotten that the medical care insurance changes could be an issue :(

[Ariamythe]

Lord, do I wish I had listened more to THIS advice. Having started (finally) - start yesterday.
I couldn't ignore this advice. Everyone in my group therapy told it to me, several times. Got my first laser treatment last week. :)

On the topic of the OP: only you can decide how important starting HRT is now for you vs. later. But surgery can be stressful on a body, and HRT can be stressful on a body. If it were myself, I would probably get a surgery I knew I needed out of the way first, if I were able.

[Sarah V]

Ms. Kali, I think you have a well thought out and sensible approach to how you would like to transition. Weight gain to becoming over-weight does no good for anything, esp. as we age. So, getting your weight down will certainly help your heart, take pressure off your (bad) knee joints, and make you a healthier person for the for the Total Knree Replacement(s?), and any possible feminizing surgery that may be in your future.

I am a bit in the same boat, as you are, as I am now taking care of a lot of medical "sustain", "repair" & "modernization" work I have put off for way too long now. I am retiring from my primary job late next year and it is my intent to do a lot more with Sarah in retirement, so I really want to be the best physically I can be so I can enjoy the next 20 or so good years Sarah and I hope to have together!!

I have recently made a very serious commitment to losing weight and have lost over 14lbs, with a goal to loose about 10 - 12 more. And I can tell you ---- I feel a ton better already!! When you start to think about and analyze it, take a look of all the bad stuff that is in our American diet. No wonder why we have so many medical problems as we start to hit middle age and beyond. I am by far from being a health and fitness nut/zelot, and I never thought I would be saying it, but a recent (easily correctable) digestive health problem has really made me study my diet and is forcing me to make a lot of eating & eating style improvements.