HRT frustrated

[Rachael Leigh]

So I had it all planned and was set to meet for my first appointment and begin the HRT process.
My appointment was at a doctor about 25 miles from my house. Well wouldn’t you know it tomorrow they are expecting to have ice on the roads. Well in the North maybe not an issue but in Texas you dont want
to drive somewhere that is on many freeways and such so I made the decision to reschedule my appointment. Ugg, so I call and the next one I could get as a new patient won’t be till Feb 20th.
Needless to say a very frustrating day for me. I’m just venting a bit so thanks for listening
Rachael

[Pat]

Oh gosh. :( So sorry to hear it, Rachael. You have my total sympathy. I know when you've girded up to make the journey a delay getting started is very frustrating. But it's a long-haul therapy so a month's delay will be lost over the course of years of treatment.

[Sarah Doepner]

I hate driving on slick roads with people who are foolishly brave, terribly frightened or totally ignorant. You are all too likely to run (literally) into all three types. So Yes, pick your battles and live to fight another day.

[LeannS]

Rachael
It is best for you to redo your appointment.
You might be great at driving on icy roads but the people that you encounter might not be.
Just be on the safe side. and just think before you know it the 20th will be here.
and if your like me where did the time go??

Leann
ps I love a nice snow covered road just to see the stupid ones in the ditch

[2BArianwen]

Feb 20th sounds like the perfect date to start! Best wishes

Rian x

[grace7777]

Rachael,

Sorry to hear about the bad weather affecting your doctor's appointment.

I feel you made the right decision to reschedule and be safe. Driving on icy roads with other drivers who are not used to these conditions can be very dangerous.

I remember how excited I was when I scheduled my medical appointment to schedule HRT, so I do understand your frustration.

Take Care,
Grace

[Aunt Kelly]

It was the right call, Rachel. The HRT path is a long one, and before you get very far, I'm betting that this delay of a few weeks will seem tiny in the rear view mirror.

[pamela7]

as long as you do start, soon enough the wait fades into not even memory

[Heidi Stevens]

So sorry you have to wait, but you’ll be fine. In my case I was not pressing anyone to get HRT, it was presented to me as an option. So I guess I was not as anxious as most are, longing for relief and wanting to proceed with life.
I too have a beautiful snowy morning, less than an inch of snow, but drivers who are not familiar driving on it, spinning out on our roads. Stay home and save your health and your car any damage.

286979

[Krisi]

As a northerner ("Yankee") transplanted to the south, I am frustrated with people's horror when it snows an inch or so. Schools are closed, businesses are closed and the TV stations suspend regular programing to report on "treacherous" road conditions. Fortunately, being retired, I don't have to go anywhere and I don't lose any income from missing work.

You have to make a judgement call, not only on your ability to drive, but on everyone else's ability also. And the place (doctor's office) you plan to go to may be closed anyway.

[Rachael Leigh]

This is why I love this place all you ladies are so positive and while it appears the road conditions this morning did not turn
out as predicted I now just have to wait it out. I know what a big step this is so maybe it gives me more time to really
understand what this change will mean for me. I did not expect to be here going in this direction a year ago so a few more
weeks will be nothing. I need to slow down and continue to work on being me.
If I recall years ago when one wanted to transition you had to live one year as the gender of your choice before you could
even start hormones so I guess my 6 more weeks is nothing
Thanks ladies

[Laura912]

This may be too late but if the roads are reasonable now, can they still see you? Would imagine they had other cancellations.

[Jeri Ann]

As a northerner ("Yankee") transplanted to the south, I am frustrated with people's horror when it snows an inch or so. Schools are closed, businesses are closed and the TV stations suspend regular programing to report on "treacherous" road conditions. Fortunately, being retired, I don't have to go anywhere and I don't lose any income from missing work.

You have to make a judgement call, not only on your ability to drive, but on everyone else's ability also. And the place (doctor's office) you plan to go to may be closed anyway.

I have lived in SE Texas since Truman was president. I have never witnessed any "horror" as a result of frozen precipitation. I have, on many occasions, witnessed arrogance from people who come here from a place where the weather is different. It's simple, when roads ice over, close them. If that seems odd, it's called common sense. It is not cost effective for public entities around here to invest in equipment and resources to make them safe. So, to take care of people, close everything. It is no big deal. It will only last a day or two.

Rachael's decision was a good one. I had to go to Walmart this morning. When I came out ice encapsulated my car. While sleet was bouncing off my car into my face, I was jerking on the car door trying to get it open without breaking a nail. I live several hundred miles south of Rachael.

Now, that being said, I confess that I did experience tremendous angst as I witnessed over 60 inches of rain fall in four days during Hurricane Harvey and come within 1/2 " of coming into my house. Facing south, out of my front door, the next land mass was Cancun, Mexico. I was one of the lucky ones. In the town I was looking toward, every one of the over ten thousand homes were flooded. Many got plucked off their roof in the middle of the night by a helicopter. Talk about horror, even for someone who might have been transplanted from a place where the weather is different.

[Rachael Leigh]

Good news the Dr office called today to let me know of a cancellation.
So I now have an appointment for next Wednesday the 24th. Now let’s hope the weather holds
up this time.
Let the next step in the journey begin

[2BArianwen]

Wonderful news!! Rian x

[Heidi Stevens]

Alright! Looks like the forecast thru next week is good for our part of the country. Stay calm and get ready for a wonderful ride.

[Jeri Ann]

Good news the Dr office called today to let me know of a cancellation.
So I now have an appointment for next Wednesday the 24th. Now let’s hope the weather holds
up this time.
Let the next step in the journey begin

Wednesdays are injection days for me. Listen, how 'bout I just drive up there and take you to the doctor? It is only a four hour drive. Just sayin'. Kind of a tranny transport. Lol

[Rachael Leigh]

Jeri I would love that, we could do lunch after but I actually have to be at work by 2:30.
Your awesome to offer my friend

[Heidi Stevens]

So you had great weather for the appointment today..... how did it go?

[Jeri Ann]

Well? Give us the scoop.

[Rachael Leigh]

All went well they put me on two meds, spiro and estrogen gel
The office folks and doctor were all great treating me very warmly and nice
I’ve decided since I’m heading out on vacation that I’m will start taking them when I get back from my trip
Thanks ladies for all your support
Rachael

[Pattie]

Go for it Gal I am not sorry I did. It completes your all around perspective of being close to a real Lady, yes I said Lady as I feel I am.

[grace7777]

Rachael,

Happy to hear that things went well for you at the doctor. Is there a reason you went for the gel over injections, pills, or patches?

Take Care,
Grace

[Rachael Leigh]

As far as the gel the doctor said the cream was not covered on my prescription plan.
He said the gel is also better on the liver. He said I may go to oral later

[Pat]

I started out on the gel and was very satisfied with it. I only switched to patches because the insurance company refused to cover the cost of the gel. In terms of protecting your liver, gel or patches should be about the same. It's the oral meds that put a strain on the liver, as I understand it.

[Krisi]

It is a real shame when our health care is determined by an insurance company, not our doctors.

[StaceyJane]

Congratulations on starting HRT. I'm glad you didn't let the weather be an excuse to delay.

[Lizzy Straite]

Another congrats on getting started. Just wait till it kicks in........wow! I felt like a whole new person

[pamela7]

In terms of protecting your liver, gel or patches should be about the same. It's the oral meds that put a strain on the liver, as I understand it.

Hi Pat, I feel we must be very careful here to be clear on these factors, as medical professionals' opinions are key. My doctor has said that the female hormones do not create such strain, it is the anti-androgens that cause the biggest problems. This is why he is administering to me, and to others, quarterly decapeptyl (triptoerlin) that instead signals the pituitary to stop asking the testes to produce testosterone. It is considered a harmless approach so far. So, do you have any sources that state that estradiol causes liver strain?

[Pat]

I'm not saying that estradiol causes liver strain. I'm saying that the delivery mechanism does. Transdermal delivery methods and injections involve the liver much less than oral medications (usually meaning premarin) do. My endo specifically chooses transdermal methods for older patients because she says it reduces strain on the liver. The literature on administration of estradiol says basically the same thing. I did a quick google about it and found this: http://www.virginiahopkinstestkits.com/estrogenpillorpatch.html which is kind of interesting.

[Laura912]

From the medical corner...here is how the conventional wisdom of oral estrogen being more strain on the liver got started. If one looks at the metabolism of estrogen taken otally, there will be two passes through the liver to convert the molecules to their final form. Estrogen absorbed directly into the bloodstream only requires one pass. So when the non- orals first came out, marketing sold them as less stressful on the liver which is sort of true but a healthy liver can handle any of the forms. If ones liver function is so compromised that oral estrogen is a worry, then there are a lot more serious things to worry about. My wife has been on oral estrogen for over 25 years without sequlae.

And with all due respect to Pat, the physicians in the reference are quotting anecdotal experience and are prescribing “natural hormones” which sounds great but are not supported by good randomized clinical trials.

[HelenR2]

I put mine under my tongue and leave them there to 'melt'.

[LeaP]

Laura, what final form? As I understand it, most prescribed endogenous estrogens are - or contain - estradiol in a form that is already biologically active on estrogen receptors without a pass through the liver.

The liver metabolizes estradiol into: estrone (and back again to estradiol), estradiol and estrone sulfate, and various oxides (oxy..., hydroxy..., methoxy..., etc.) that are mostly eliminated. Estrone is a far weaker estrogen than estradiol. The sulfates do not act on estrogen receptors. There are other metabolites released into circulation that have little or nothing to do with desired HRT effects.

One impact of passage through the hepatic portal is that far more of the estradiol taken up by the digestive tract will be eliminated compared to estradiol in general circulation, as a full 75% of the blood flow through the liver is via the hepatic portal vein. Thus much estradiol is eliminated before ever so much as seeing an estrogen receptor of interest.

[Laura912]

Lea, you are correct. I just stayed away from all the “chicken wire” names for simplicity. What methyl does with ethyl is entirely their business. :heehee:

[Pat]

And with all due respect to Pat, the physicians in the reference are quotting anecdotal experience and are prescribing “natural hormones” which sounds great but are not supported by good randomized clinical trials.

Pat does not feel disrespected. I can hide behind the fact I said "quick google" not that it was my personal knowledge. ;) However, here's a better google: https://www.ncbi.nlm.nih.gov/pubmed/22011208 -- which, though admittedly is just a survey of literature comes from a more credible source.

[Laura912]

Much better Pat. And there are some additional articles in the right sidebar of your reference. It is too bad there is not a national registry for treatment protocols where data could be pooled along with lab work. This was done with many chemotherapy regimens enabling quick results.

[Rachael Leigh]

Not that anyone was really all that interested, but just thought I would update everyone here.
I’ve made my final decision that I will not go on hormones. I realized that there for me was no point in doing this if I was
not going to be commited to a life of being fulltime. Not saying that would be the only reason for HRT but to me it made the
most logical sense. I want to thank all you ladies who have gone through this process for advice and wish you well on your
journey. My heart is with anyone here who has gender identity issues.
I know I’m still trans but HRT is just not something I need for my survival
Blessings to you all Rachael

[docrobbysherry]

How did u decide that, Rachael?

[Kaitlyn Michele]

gotta read all the threads Doc!!!!! get with the program!!! :heehee:

[2BArianwen]

Hi Rachael. I'm so glad you were able to come to a decision and support you completely. I hope that it brings positive results to you and those around you. Take care. Rian x

[grace7777]

Hi Rachael,

HRT does carry health risks, and I would have not started hormones if I did not plan to go full time. So I definitely understand your decision. I have been on hormones for 16 months, and full time for 9 months.

I wish you the best in the future.

Take Care,
Grace