OK, reader, I have a lot of good news to share. Are you ready for all this positivity and progress and victory? If not, this probably is not the post for you, and you should keep scrolling through dank memes and cat videos and reposts of clever tweets.
I saw a doctor I’ve seen once before at Family Care Health Center in St Louis today. I went in there with like a 10-item agenda. I was prepared to have to argue with the new doc about my treatment and to fight with her about what is and isn’t true, but she is an amazing listener, and even better, she actually did the research she was saying she would do after our last session in November. I did my research, too, so we both came prepared to meet minds and make informed decisions. I think she is a resident instead of a full MD, but I will follow her to whatever practice she goes to after this one because of this awesomeness. So the good news here is that I lucked into having a curious, listening, collaborative, and informed doctor, finally, after so many ignorant, authoritative, self-important ones.
We’re just getting started with the good news here though.
1) She upped the dose of my depression medication, so I don’t have to pay out of pocket to see a psychiatrist for that! Huzzah!
2) She gave me the OK to start estrogen injections NEXT MONTH! This is so great, as I’ve been seeking a doctor since 2017 to give me the clear and to monitor me while I start it. It’s double great because the sublingual estrogen I’ve been taking is part of the reason I had my gall bladder removed, and sublingual E can lead to liver damage, so this is not just a move toward healthy HRT–it’s a way to stop my current HRT from further damaging my organs. Technically she gave me the ok to start them today (!), but I said we should wait a month to do smarter science because of item 3.
3) She gave me the OK to up my progesterone IMMEDIATELY. She read some stuff recently that says progesterone functions as a testosterone blocker (!) which is like SUCH A BONUS to its already awesome effects of filling out my breasts and acting as a mood stabilizer and interacting with estrogen to keep me from getting all sorts of other health problems.
4) Based on the last round of labs I did in November, I WAS RIGHT in suspecting that my testosterone had climbed back up out of the female range. I’m at 91 ng/dl Tnow, which is 41 ng/dl too high to be considered in the female range. I WAS RIGHT THIS WHOLE TIME THAT MY HORMONES WERE MESSED EVEN THOUGH MY LAST DOC SAID THEY WERE IN A GOOD SPOT. Now we know precisely how messed they were, and which kind of mess, and my inner sense of “something is off here” has been validated.
5) She referred me to a local dermatologist to get a cyst I’ve have on my face since 2013 removed!
6) She wrote me the letter I’ve needed for my passport IN LIKE FIVE MINUTES DURING THE APPOINTMENT. She also commented that the language in it was offensive to her, and that this entire process seemed unnecessarily discriminatory for me to have to go through, and that it didn’t make sense since like obvi I’m a woman obvi I’ve been transitioning for five years now, and she even understood that transition is a process and that standards of completion are different for everybody (some folks want surgery and some don’t, some folks want HRT and some don’t, etc), so why are the feds asking for this letter anyway whatever here give me a few minutes. Basically my doctor is a bamf and an ally and hopefully I’ve finished this passport process because I’m mailing out the letter tomorrow morning.
7) She’s giving me access to the clinic’s psychology services so I can see a therapist and psychiatrist through them, which will be covered by their local insurance program, so I won’t have to pay for therapy, and said they are happy to refer me somewhere else if they can’t meet my needs there! So, that whole process of finding a county mental health clinic with sliding scale fees and trans-accepting providers I was trying and failing to do after I left the psych hospital is moot now. Someone from the clinic is contacting me tomorrow to set up an intake appointment for ASAP.
8) She said she is interested in the science I am reading about HRT things she hasn’t heard of, and asked me to bring her what I’ve been reading so she can integrate it into her practice and so we can both make informed decisions regarding my care through her. Was mostly referring to why we want progesterone levels to be in the luteal phase range, and evidence for why sublingual E messes with the liver and gall bladder. THIS IS HUGE. She trusts me enough to do my own research. She doesn’t think I’m crazy, incompetent, ignorant, or deceptive, like so many of my prior providers have. I’m valid. She sees me. She listens. She trusts. We are collaborating. I love it.
9) She renewed my scrip for the anti anxiety medication I have been taking that helps me sleep and helps me leave the house! She even upped the dose, and gave me license to drop it back to the current dose if I don’t tolerate it well. Again with the trust. Feels so good.
10) She told me there is current research saying the proton-pulse inhibitor I’ve been taking since surgery to help with my digestion (Zantac) can be difficult to stop if I take it for a few months (I plan to take it all year until my guts even out from surgery) because it can produce acid bounceback after stopping it, so we switched to Ranitidine, which either isn’t a PPI and/or doesn’t have a documented history of producing bounceback after cessation. BONUS.
11) I went in there with a laundry list of stuff I needed to discuss and we covered all of it. In short, I’m getting what I’ve known I needed regarding my progesterone, my estrogen, my testosterone, my whole HRT regimen, the hormone imbalance and the accompanying dysphoria that I’ve been carrying since I stopped spiro over a year ago and have been unable to meaningfully address through no fault of my own. I’m getting the followup care I was supposed to be getting after my stay in the psychiatric hospital but couldn’t because I’ve been homeless and moving around too much after surgery to access facilities due to residency requirements I couldn’t establish. I’m getting my meds renewed and adjusted. I have access to therapy again. I’m taking care of issues I’ve been carrying for years. I’m finally finishing (fingers crossed) my passport application. This session addressed SO MUCH. It was so necessary. I left it feeling like a huge burden had left my body.
TLDR: I just had the best doc’s appointment ever and I’m looking forward to another with this person next month. But mostly I’m stoked to have forward motion again regarding my healing. It’s possible. Healing is still possible. Even in St Louis.
Wish me all the luck!