There’s a change on the horizon

(Yesterday I published an article that I had started writing in June, and I just realized I had never finished writing it. I’m not sure how I let that slip by me, but the title had nothing to do with the article as it was written. I’m including some of the info that should have been in that article in this one. I’m sorry if I confused anyone. – JMH)

As I’ve fought with my weight the last few months there have been a few other things going on with me. Some of the things aren’t so great, and some of them aren’t bad, but there are definitely some new things for me to get used to as we get ready to turn the calendar from July to August.

The first change came in response to some blood work my endocrinologist ordered back in May. He was checking my estradiol levels, partly because we need to monitor those but also partly because my body started getting feminized late last year but the changes had completely stopped earlier this year. Among the blood tests he ordered was a hemoglobin A1C test, and when it came back it showed that I was just over the minimum number that shows a person has diabetes. Isn’t that just bloody wonderful, I thought, wondering just what that would mean for me.

It turns out that if I can get my weight down that could take care of my status as a diabetic. When I was a teenager my weight stayed around 150 pounds but when I hit 30-ish my metabolism changed and I started putting on weight and not being able to get rid of it. As I approached the holidays last year I was worried about going over 200 pounds, a number I’ve long wanted to avoid like the plague, and I did okay during the holidays, but when I started the first full week of 2017 the scale read 201 pounds even. No problem, I thought, I can get below 200 pounds easily. Except it wasn’t so easy, and I’ve see-sawed on both sides of 205 pounds all year. Since I bought my scale back in September I can step on the scale daily to see how I’m doing, and I often find I’m doing well at the end of the week only to over do the nomming over the weekend. I don’t know how I’m eating differently over the weekend but one of these days I need to get back below 200 pounds and stay there. I’d really like to get down to the mid 180’s one day and stay there, but for now, I just want to get back below 200 for a month. Especially since getting my weight down will help lose my Diabetic status.

I saw my primary care physician recently and he let my endocrinologist handle the diabetes treatment since I was seeing him a week after seeing him, but he did refer me to a diabetes instruction nurse and a nutritionist that works in my PCP’s building. When I saw my endocrinologist a few days ago he said he didn’t see any need for treating my diabetes with medications or surgery, which is really good news to me.

But my primary care doctor and I did talk about something that’s not exactly great news. My left foot has been swollen for a few years now, and last year my right foot started swelling as well. To add insult to injury my legs have gotten swollen as well this year, which doesn’t help me look very good in a skirt. After spending the better part of 50+ years in pants or jeans I prefer to wear a dress or a skirt when I can.

We haven’t been able to figure out why my legs are swelling and we’ve done ultrasounds that didn’t turn anything up. I’ll be making an appointment to see a cardiologist to see if they can figure out something.

HRT Liquid estradiolAs I wrote back in May my estradiol levels haven’t gone up all that much and my endocrinologist said he wanted to change my estradiol patches to injectable estradiol. Sure enough, when I saw him on Thursday he made the change.

That’s some good news, except for the fact that I’ve never given myself a shot, or anyone else for that matter, and I’m not a big fan of needles. Luckily the needles are really thin and really short so hopefully that will help, except the estradiol is really thick so it will take some time to get it from the bottle into the syringe and from the syringe into my leg. But I don’t have to worry about my clothes possibly rubbing the patches off, something that happens way more often than I like.

Hopefully, this will get more estradiol into my bloodstream and my body will change a little more quickly. My breasts have started developing a bit (I’m hoping to finally reach a B cup by Labor Day) but my hips and bum are still way too flat. The next blood test will be run four weeks and four days after I start using the injectable estradiol, so since I’ll give myself the first injection this morning I can get blood drawn for the test on 31 August.

Also, when I saw my endocrinologist earlier he mentioned the possibility of a surgery before the big gender affirmation surgery (also known as sex reassignment surgery). It turns out that a male-to-female transgender patient can get an orchiectomy, more commonly known as castration surgery. As a guy I would have said, “Oh hell no!” but it’s a great idea now. Not only will it make it easier to tuck my “boy parts” out of the way but it will also get rid of my quarterly Lupron injection. And when I checked with my insurance company earlier this year I was told that even a radical (double) orchiectomy is covered by my insurance. Of course with all the drama in DC, I’ll have to make sure it’s still covered when it’s time to go under the knife.

My endocrinologist said the surgeon insists on patients being on hormone therapy for at least a year, and I’ve been on hormone therapy since early September of last year so my doctor gave me the surgeon’s name so I’ll be giving him a call this week to set up an appointment with him.

But wait, there’s more

Something else changed this past week, and it’s a change that I really didn’t think was on the horizon. I’ve smoked daily for the past few years, rolling my own cigarettes to save some money and avoid the extra chemicals. I had quit several years back to support a friend who needed to quit for surgery, but I ended up smoking again before long because it hadn’t been my choice to quit. I quit again a few years ago, but that time economics forced the decision.

I’d developed a bit of a smoker’s cough over the past year but it wasn’t too bad. But coming back from volunteering at the Boston Pride JP Block Party last month I found myself coughing more. By the time I got home I had decided I would quit smoking when my current stock of cigarette supplies I would quit smoking instead of buying more supplies. It’s now been three days since I’ve had a cigarette and so far it’s been so good. True, there have been times that I have flat out WANTED a cigarette, mostly because it was when I got up in the morning, had just enjoyed a nice dinner, or the Dodgers game wasn’t going so well and they hadn’t started their comeback yet. My PCP had prescribed Chantix for me, and I have a cinnamon stick that I can use as a stand-in for a cigarette, but I figure it would be better in the long run if I didn’t reach for a fake cigarette and I leave the spice alone.

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