blood work and HRT

[michelle82]

HI all

Looking for some advice. I was supposed to have an appointment for a physical at my local trans clinic today and I'm guessing blood work ordered, in preparation for my first HRT appointment coming up in mid march.  However they canceled my physical due to some conflicts and they aren't able to reschedule it before my HRT appointment. The secretary said i can still come in for the HRT appointment and that it shouldn't matter. But i feel like the physician is not going to prescribe me anything unless they have some baseline bloodwork on hand. I really don't want to have everything pushed out further because of it. Should I be pro-active and see if my old primary doctor can order me all the tests I would need in preparation of this appointment??

thanks!!

[Brenda E]

At my first endo appointment, I was prescribed HRT.  Blood work was done that day, but the doc didn't have the results in hand until a few days later.

Chances are, even if there was a problem, a few days of entry-level HRT won't cause any harm whatsoever.  I don't see any reason why you wouldn't walk out of the office with a prescription in hand unless your physical revealed issues that needed addressing (e.g. blood pressure issues etc.)

Worst case scenario, ask for the prescription to be written and held at the office pending your blood work.  If everything checks out fine, you'll get a call and can swing by and pick it up.

[ImagineKate]

Well I was prescribed first visit but even if you have blood pressure issues they can prescribe spiro which is a blood pressure drug.

[michelle82]

Thanks ladies thats reassuring!!

[MelissaAnn]

I was prescribed my HRT on the first visit to my endo! She ordered blood work and ask that I have the blood drawn before I start HRT... You really shouldn't have a problem getting HRT!

Melissa Ann

[JoanneB]

They may either do a blood draw there or send you off for one. Worse case I see is if you are sent off for the lab work they may hod off a scrip untill they get the lab results.

Also, from many in support group, more often then not you get put on spiro for a month or more, then add E

[ImagineKate]

With me they used an in house lab. After I go see the nurse practitioner I go and do the blood draw. They even call me by my preferred name.

This is good as it helps avoid billing issues and a separate co-pay.

Lab work comes back pretty fast, usually in a day or two. However, the big backlog is in getting an appointment if your doctor is busy.

[jeni]

After my first appointment, I needed a blood test (for Factor V Leiden, a hereditary clotting problem I fortunately don't have, not for any other reason). I still had my spironolactone prescription sent to my pharmacy that evening and my estradiol prescription sent a week later after they had the results from the blood test. No extra appointments or anything. If all they need to know is the results of the test, they don't need to see you again for any (real) reason.

(Even the week wait was, I think, because someone just filed the results of the test rather than doing anything with them until I called to ask...)

[michelle82]

Thanks everyone for the reassurance i was worried that i would have to wait another 3 months for another appointment!! I did call the office and offered to have my old PCP order blood work if needed and they were going to pass that information along to the HRT provider. The secretary also tried to assure me there wouldn't be any issues if i don't have my physical before my HRT appt.

[Virginia]

Even if you just go to a local minor emergency clinic for the bloodwork, you are playing with your life if your HRT regimen includes the typical spiro dosages and you don't have a baseline.  Spironalactone is a  potassium-sparing diuretic and the heart just stops when the levels get too high. Potassium injection is how they kill people who are sentenced to death.

My GP has all his high blood pressure patients who are on Spiro come in for blood work every 3 months. I have an amazingly healthy lifestyle and have been on the same HRT regimen with no problems for 5 years; he still insists I come in every 6 months just to keep an eye on my potassium level.

[ImagineKate]

If you have your old medical records from your GP and recent blood tests that helps immensely. When I first went I downloaded everything and gave it to them. Patient portals are pretty awesome but I wish there was a uniform standard for exchanging medical records electronically.  I had to give them PDFs of my chart and labs and they entered it manually. The only one that matters is the most recent.

Important tests would be stuff like triglycerides, CMP and CBC which are a battery of tests of various serum levels. Sex hormone levels for a "baseline" are overrated because they may start you off on a small dose anyway to make sure you have no negative reaction.

[katrinaw]

You should be fine Michelle, but it would not do any harm to grab a fresh set, or take any from within a couple of months...

I'm lucky here is Aussie, I did not have to do any up front, about a month after small dosages a baseline blood test, then another blood test after 6 months... But  a conversation around health and well being was had on day 1.

L Katy

[michelle82]

I had my first consult today.  Unfortunately my assumption was correct. I have a followup appointment scheduled for 3 weeks out and have blood work that needs to be completed before hand. At my followup i will be starting Spiro and Estrogen injections.

I'm a little disappointed that I left today with no prescription, but it's exciting to be one more step closer. The waiting game is so freaking painful!!

[Tori]

It is almost over!

The do not sound like gatekeepers. They are just being thorough. This wait will feel like nothing in a month or two, but for now, it is like they delayed Christmas!

We will be here when you need us.

[jeni]

Bummer you have to wait, but it sounds pretty standard.

I must say I don't understand the rationale, though. It's likely the blood work simply says "go" or "no go" on a standard regimen. For the majority of cases, they just verify that their plan is ok and then start it. That shouldn't need a follow-up. If something unusual happens, then you follow up. It sounds to me like an excuse to book another appointment, coupled with some old fashioned gatekeeper philosophy. (Even if they're not actively gatekeeping.)

But... Tori's right. It's 3 weeks out of the next forever, so you'll get there before you know it. And after all, the best part of Christmas is the anticipation, right?

[ImagineKate]

Bummer you have to wait, but it sounds pretty standard.

I must say I don't understand the rationale, though. It's likely the blood work simply says "go" or "no go" on a standard regimen. For the majority of cases, they just verify that their plan is ok and then start it. That shouldn't need a follow-up. If something unusual happens, then you follow up. It sounds to me like an excuse to book another appointment, coupled with some old fashioned gatekeeper philosophy. (Even if they're not actively gatekeeping.)

But... Tori's right. It's 3 weeks out of the next forever, so you'll get there before you know it. And after all, the best part of Christmas is the anticipation, right?

yeah, it almost seems like they're holding back to make sure the patient is "sure sure" because once you start, changes happen.

[jeni]

yeah, it almost seems like they're holding back to make sure the patient is "sure sure" because once you start, changes happen.

I know. I took that first pill and my hair grew 8 inches, my chest inflated like a pair of malfunctioning airbags, and I was suddenly watching Beaches and sobbing. It's a good thing I was "sure sure."

[ImagineKate]

I know. I took that first pill and my hair grew 8 inches, my chest inflated like a pair of malfunctioning airbags, and I was suddenly watching Beaches and sobbing. It's a good thing I was "sure sure."

LOL!

[michelle82]

I know. I took that first pill and my hair grew 8 inches, my chest inflated like a pair of malfunctioning airbags, and I was suddenly watching Beaches and sobbing. It's a good thing I was "sure sure."

Omg now i'm really SURE SURE!! Sign me up!!

[michelle82]

I had my bloodwork drawn this morning. I might call the clinic and see if they can write me my spiro script ahead of the next appointment. Im thinking ill use the next appointment to start the E injections so the nurses can show me how to inject. Wish me
Luck!!