Category: Medical

Surgery cancelled

Read online today that Spire have contracted out their beds to the NHS to help deal with the covid-19 crisis so I guess that’s my chest surgery cancelled. I think I would have preferred to hear it directly from them rather than a press release but I suppose they’ll be in touch eventually.

I understand that it’s an elective procedure and not an emergency but that really doesn’t make it feel any better. All the arrangements such as accommodation will have to be cancelled but I want to wait until I’ve received official confirmation of the cancellation before I start messing about with them.

I’m a bit numb at the moment to be honest, all I can think about is another summer having to wear a binder.

Surgical consultation

Just had my surgical consultation for top surgery with Mr Peter Kneeshaw at Spire Hull. In the middle of nowhere, the hospital is a lot smaller than I expected but seems quite well equipped.

We arrived in plenty of time and I’d just got a drink when I was called in early. Mr Kneeshaw was very friendly and professional. He checked my referral and we discussed what surgery I was hoping to have. He examined me and took photos then explained the procedure (bilateral inframmamory fold with free nipple grafts known as a double incision or DI). He went through all the potential complications and gave me the opportunity to ask questions. He booked me in for the first available slot on April 28th 2020.

The operation will require a two day stay in hospital and I will be discharged with drains which will be removed at a post-op appointment ten days later. My plan is to stay in Hull for the whole period rather than risk travelling with the drains in. I was concerned about my weight but he said that he’d operate on me tomorrow if he could and that he wasn’t concerned about it. I explained that I was trying to lose weight and he said that was fine but I didn’t need to go mad!

Due to my age and family history of breast cancer he wanted me to have a mammogram to make sure everything was OK. He said this was precautionary as he hadn’t felt anything during the examination. I had the mammogram straight away. It wasn’t physically painful but made me incredibly dysphoric and uncomfortable in my own skin (this lasted for several days and I found it really difficult to get over). Mr Kneeshaw rang me a couple of hours later that evening to let me know that everything was OK with the scan which was very reassuring. Mr Kneeshaw said that the cost would be included with the procedure but the technician mentioned that I would be charged approx. £180 for it.

Surgery referral

Went to see Dr Myskow in Edinburgh today. With one thing and another it’s been a year since I’ve seen her but she was satisfied with my blood test results. She’s happy to refer me to Mr Kneeshaw for top surgery in time for my consultation with him in December. We talked about getting a Gender Recognition Certificate and she’s agreed to complete any of the paperwork required.

New Year, same me

A fortnight into the New Year and I’ve hit a bit of a slump. Maybe it’s just post-holiday blues but I’m struggling with my mood.

My eating habits are terrible and I just can’t seem to get my head back in the game. I’ve put weight on and not only can I feel it at work it has made me super aware and self conscious about my body – ramping up the dysphoria to pretty much unbearable. I feel so tired all the time and despite a thousand good intentions I haven’t been to the gym since Christmas. I need an injection of positivity but I haven’t found it yet. 2019 was meant to be my year but so far it doesn’t seem all that different from any of the last few.

I’m wallowing in a sense of hopelessness which seems to be turning into a vicious circle. I feel tired so I can’t be bothered trying to eat properly and exercise which is making me feel even more tired. My goal of having top surgery early next year was supposed to be the incentive to commit to losing weight and developing my physique but that has been derailed by financial pressures. A new boiler and water pump at £2,500 wiped out everything I’d saved so far for the surgery. The house almost certainly requires more maintenance this year to sort out the plastering and floorboards and having done 180,000 miles the car is likely on borrowed time so the ability to pay for surgery feels even more remote. Why bother losing weight and risk accentuating my chest if I can’t then get the surgery?

I can’t see how things are going to get any better at the moment.

Giving Blood

My latest round of blood tests revealed elevated haemoglobin levels which is a potential side effect of the hormone treatment.  I need it re-testing in the next few weeks but in the mean time to reduce my levels I decided to give blood.  This was more difficult than I imagined it to be.  I registered on the website but couldn’t find any appointments within 20 miles for three months.  I rang them to see if there were any drop in sessions and they managed to squeeze me in at my local centre.  The process itself was quite straightforward and took about an hour (most of which was hanging around).

They have an Android app which records when you donated, when you can next donate and lets you book your next appointment.  It also told me my blood type (B positive!) and I got a text saying that my blood has been sent to Manchester Royal Infirmary.  I thought that was a cute thing to do because it makes you feel part of something important and useful.

GIC screening appointment

I had my screening appointment for the Leeds gender clinic this morning.  It was a telephone chat with one of the outreach workers and was a lot more in depth than I’d anticipated.  It consisted of a review of my transition progress and my medical history as well as a chat about the care pathway through the clinic and anticipated waiting times.

He seemed satisfied with the steps I’d taken so far. The current waiting times to first appointment is approx. 18 months with approx. 8-10 months between appointments.  I’m so grateful to be able to initiate hormone therapy through a private clinic because it seems to be a minimum of 3 years through the NHS at the moment.

1st hormone review

Had my telephone appointment today with Dr Myskow to review my hormone levels.  She mentioned straight away that my voice seemed much lower and was pleased that I’d got a new job.  She was satisfied with the blood test results.   Although I thought they seemed a little low, she explained that it was better to have levels at the lower end of the range.  This ensures that the peak levels aren’t excessive which would result in the testosterone being converted to oestrogen causing all sorts of havoc.  She advised that my injection intervals should be 14 weeks going forward and asked for a full set of bloods prior to the next injection which she will review at the end of November.

T day +153 (22 weeks)

I’ve had a couple more injections since April and I thought I would explore the changes I’ve experienced as a result of the hormone therapy in preparation for my review appointment with Dr Myskow tomorrow.

Mental

  • Happy – I’m definitely happier, whether or not this is actually the hormones or just the fact that I’m moving forward with the transition, is unknown.  I’m considering reducing my anti-depressant dose but I want to ensure my hormone levels are stable before tinkering.
  • Irritable – everything annoys me especially rude people (which appear to be multiplying in numbers every day)
  • Spatial awareness – clumsy is now my middle name, I’m banging into things and dropping stuff quite a lot.  I’m hoping this will subside once I’m further along in the puberty process.
  • Confidence – in some respects I feel more confident especially in new situations which I expect is due to feeling more comfortable within myself.  However, I’ve taken a bit of a step backwards facing people from my previous life.  I seemed to be actively avoiding engaging with people who aren’t aware of my transition and when forced to confront them I feel embarrassed and ill at ease.

Physical

  • Voice – my voice has definitely dropped and according to the voice pitch analyzer app is firmly within the male range from the androgynous range that it started in.
  • Hair – I am increasingly furry on my torso and particularly on my legs and bum!  My moustache is improving and the sideburns are drifting towards filling into my beard.  I suspect I’ve got a long way to go before my beard is bushy but the signs are encouraging.
  • Bottom growth – things are definitely getting bigger down there and a lot more sensitive.
  • Libido – this has generally increased but waxes and wanes which is quite weird.
  • Hot flushes – during the hot weather this was particularly unpleasant but generally manageable.
  • Tiredness – I feel quite tired a lot.  I’ve no idea whether this is specifically hormone related but I could sleep for England at the moment.
  • Increased appetite – this is becoming a bit of an issue.  I’m just ravenous all the time which is really impacting on my weight loss efforts.
  • Fat distribution – things seem to be shifting round a bit and heading towards a beer gut which is getting me down a bit at the moment.  I think I’ve got some movement of fat from my hips as my trousers seem to be hanging differently.
  • General growth – my feet seem to have started to grow a little so I’m desperately trying to wear all my favourite pairs of trainers while they still fit.  I feel like I’m also growing taller which seems rather ridiculous so perhaps it’s just improved posture as a result of increased confidence.
  • Acne – I’ve got some acne on my chest and back which is pretty sore and uncomfortable but fortunately, despite the skin feeling more oily, I’ve had nothing on my face with the exception of the odd pimple.
  • Menstruation – this seems to have calmed down and fingers crossed if my levels stay stable I shouldn’t have to endure this again.

 

 

Blood test

What a load of drama that was! I needed a blood test before my second 12 week injection to check my testosterone levels.  The blood needs to be taken same day before the injection to give trough levels.  My injection was booked for 10.40am so I arrived at Chorley hospital at 9am – plenty of time in my mind.  Unfortunately, when I arrived and pulled a ticket mine said 83 and they were just doing 47.  Two hours I waited before being called – I had to cancel my appointment at the doctors and there was a bit of panic when the receptionist said there were no other appointments.  I explained that I had to have the injection that day so she offered me the chance to sit and wait for a free slot.  Dr Patel gave me the injection, moving the needle once to change injection site which meant that it hurt considerably less than last time.

Emailed the medical secretary to ask her to email the results over when they came in and she sent them last week – 12.5 nmol which is not bad but probably a little bit low so Dr Myskow may consider increasing the frequency of my injections to raise the levels slightly.

2nd Injection

I got my 2nd injection today (6 weeks – part of the loading phase) and boy did it hurt!  Frustratingly not while he was doing it otherwise I’d have said something but within 5 minutes the pain was quite incredible.  I genuinely thought I was going to be sick and it was awful driving home.  I think next time I’m going to ask him to do it more slowly to see if that helps any.