Going off Hormones

[Melissa Forever]

Hey All,

Only 14 more days will my surgery at Yeson! So excited!!!

I have just gone off hormones as requested, but I was curious if anyone can tell me why that is done? Also, does anyone know if Finesteride should be stopped as well?

Thanks,
Melissa

[iKate]

Ask Jessie about the finasteride. I don't think that is an issue. She told me the female hormone pills and/or injections but everything else is ok.

Estrogen increases the risk of blood clots which is important in surgery.

[Melissa Forever]

Thanks iKate. I have already emailed Jesse, just waiting for a reply.

[anjaq]

Yes. I think the main issue is increased risk of blood clots and also the strain on the liver that hormone pills and antiandrogens cause. In that sense , Finasteride may be an issue or not - better ask.

I asked my endocrinologist about this whole issue before I went to Yeson and she said that since I am on transdermal hormones only and not hormone pills or injections and also not on antiandrogens, I should be fine to continue to the day before surgery. Actually she said, stopping would rather cause my body to get into stress and be less good in healing, so I followed her advice even though it was contrary to Yesons directions. I believe the "stop all hormones" instructions are just still coming from a time where most people had pills - or are just to make sure that really everyone with pills stops them. What is important though is to look at the other medication one is taking - especially aspirin like substances, painkillers, blood pressure medication...

[iKate]

There are charts from US hospitals indicating which medicines are safe for surgery and  which ones are not and how long to stop them. Most can be stopped on the day of or day before. Birth control and hormones are listed as stopping well in advance. But in my opinion to prevent any possible problems I would follow the surgeon's instructions.

Honestly if you can I would talk to your GP/endo before you leave as well. I have a pre op consultation with mine to make sure all my ducks are in a row.

[mmmmm]

There is absolutely no need for stopping estrogen and antiandrogen administration for this kind of surgery, or FFS (SRS is a very different story, there are much more risks involved). The possible risks, for someone who is overall healthy and has coagulation factors in normal ranges, are so small, that it doesn't make any sense. IF anesthesiologist is capable enough to follow what is happening, knows how to read possible complication signs, and use prevention just in case if needed, there is no need to stopping HRT before surgery, other than it being surgeons demand to avoid any possible complications and related consequences like financial compensation and legal costs, while the only real cost here is patients well-being and hormonal disrupt for no good reason. You don't have to stop with HRT, but be aware that surgeon have every right to not perform you surgery if you didn't follow his/her instructions.

[Eva]

Well Im on IM EV injections, spiro, progesterone, and dutasteride....

Dr Habens anesthesiologist just asked me to stop the spiro and P a week before surgery...

Dr Spiegels staff said stop everything 3 weeks before FFS... Well I didn't, just the spiro and P and I did take a bit smaller E shot and timed it so Id be about 5 days after the shot for surgery.... Obviously I survived

Just my opinion and what I did

[anjaq]

I would not say this is nonsense to stop hormones, just would say that I asked my endocrinologist and trusted her judgement over the general overcauteous advice of surgeons. I also dont see how P would affect anything. I dont see a big point in Spiro, Androcur, Finasteride and all those chemicals anyways - they affect so many things in the body that I would really be cauteous there (my personal belief is that none of them are needed if hormone therapy is made to work properly, having regained a lot of hair and stopped hair loss just by using P and P-gel in the right way,...).

So I would do what a doctir you trust says and tell him if you are ok with stopping or worried. If no other doctor wants to say anything, go with the instructions of the surgeon. My endocrinologist even gave it to me in writing that I should not stop transdermal estradiol before surgeries.

Regarding FFS, I think it is a massive surgery and well comparable to GRS - I would apply the same caution there. Nowadays FFS is often longer than GRS...

[Eva]

Sure I'll consider dropping the anti androgens after I have SRS

[Eva]

I didn't say there wasn't an increased risk either, Im no doc but my understanding is IM EV doesn't increase clotting risk and actually lowers it... All of my pre op labs were perfect BTW so I was comfortable staying on E for a 6-7 hour FFS.... For the VFS like I said it wasn't even an issue...

[iKate]

Well I take spiro for high blood pressure so I kinda need it.

Also, aspirin is a blood thinner, so it's no good to take before surgery.

[anjaq]

I think estradiol injections are probably as "harmless" as transdermal estradiol when it comes to clot risk. Except maybe if you go on extreme dosages like we had in the 1990ies - My guess is that the surgeons are just keeping to ages old recommendations based on the use of Ethinylestradiol , Premarin and oral estradiol . They just want to play safe. But maybe they make it worse because a body suddenly going into menopause, severe PMS or even reversing hormonal sex for a while, if testosterone comes up again is certainly also not in the greatest shape for a surgery.
But thats my opinion.
By the way - Dr Kim does a blood test, they test for antibiotic allergy, haemoglobin, blood clotting, HIV - but not for hormones.

[FTMax]

My doctor gave me a 4 page packet of medications and supplements that I am not allowed to take before surgery next week. Some of them are on there because they increase the risk of bleeding. Some, clotting. For a lot of the supplements, she said she's seen some people retain excess fluid and the common denominator was the supplements.

[iKate]

How did your surgery go? Hope all went well!

[Melissa Forever]

Hey iKate,

The surgery was a success with no complications. The pain is almost gone from yesterday and I feel back to normal.

The only crummy thing is that my cold that I was 90% over when I left to fly on Monday came back a bit and made me super stuffed up. Today I am starting to get a lot of phelgm buildup, which is great in the sense that the cold is going away, but absolutely scary when your only choice is to cough or not be able to breathe at all. I have coughed once so far and I am super worried that it is going to screw up my results. I guess in the end there is nothing I can do now, so not worth worrying about...

Melissa

[anjaq]

Congrats on your surgery success (y)

Well - take that Cough syrup they give you and maybe take additional medication that make the phlegm softer and more liquid, then its not making you cough so hard and you can cough it out semi-silently. They showed you how to do that, right?

Besides that. I coughed a few times and even said a few words on the day after surgery when I was half asleep. Jessie told me later that this happens to many or even most, but it should be avoided as much as possible - but its not the end of the world if it happens... the occasional soft cough... Just really avoid seriously getting a coughing spell or any loud noises...

I even mysteriously managed to not sneeze for almost the whole 4 weeks of no-speak period.