An update on me...

[Michelle_P]

Here are my creatinine and GFR numbers along with other goodies:

Standard range
CREAT<=1.11 mg/dL
GFR NONAFR AMER >=60 mL/min (Calculated value)

8/31/13   0.94   >60
10/8/14   0.93   >60
11/14/15   0.92   >60
6/9/16   0.85   >60
6/30/16   0.91   >60
7/20/16   0.99   >60
9/9/16   0.88   >60
12/4/16   1.01   >60
2/5/17   0.97   58
7/3/17   0.97   58

Minerals related to kidney function look good, typical values for being on Spiro
K
3.5 - 5.3 mEq/L
8/31/13   4.4
10/8/14   4.3
11/14/15   4.1
6/9/16   4.6
6/30/16   5.1
7/20/16   4.4
9/9/16   4.9
12/4/16   4.6
2/5/17   4.4
7/3/17   4.9

Sodium
NA
135 - 145 mEq/L
8/24/12   144
8/31/13   142
10/8/14   144
6/9/16   140
6/30/16   132
7/20/16   137
9/9/16   133
12/4/16   141
2/5/17   140
7/3/17   139

Estradiol is behaving...
E2
6/9/16   <50
9/9/16   <50
12/4/16   <50
2/5/17   115
7/3/17   112


TESTOSTERONE, ULTRASENSITIVE, LC MS/MS
Standard range: <=75 ng/dL
6/9/16   661
7/20/16   251
9/9/16   7
12/4/16   6
2/5/17   7
7/3/17   <5

My little monster is slowly growing:
PROLACTIN
3 - 30 ng/mL
6/9/16   30
6/13/16   34
7/20/16   40
8/17/16   37
9/9/16   40
12/4/16   41
2/5/17   42
7/3/17   43
It's probably mostly inert macroprolactin, which reads as prolactin in this test.  I'm not leaking.

[Dena]

Think I may have found it and if so, there isn't a problem.
https://pdfs.semanticscholar.org/9739/37fbdbc7da53682641195ff076b9c01b4d27.pdf

[Michelle_P]

I'm so aorry to hear that, Michelle. If youre not spilling protein and your bun and Creatinine are relatively constant, I would think you could probably test different with a diet change. Cut way down on your animal based protein intake, up your volume of clean fluid and test again next month. Wouldn't be aurprised if you fall back into the reference range. Gotta do something so try and be proactive here. Just another one of those walls you get to kick down. Not being glib, just trying to offer helpful suggestions.

Yeah.  I've been running my protein intake at around 22% of my total calories.  I should probably drop that to about 16%, mostly plant, and raise fats to 34%, again plant based.  Carbs stay at 50% of total calories.  That's more inline with the 'kidney diets' out there.  I'll dial that in and see how it goes.

I use tracking software to measure pretty much every bite.

As we say here in our house when another thing piles on top of an already tough situation...

"Why the hell not?" in other words "of course something else is going to happen to complicate the situation"

One more obstacle in your way that I am sure you will work but sometimes I just want to scream "Enough!"...

I hope this turns out to be just a minor hitch for you.

I'll get past it one way or another.  Even if it means buying a nice extended vacation for myself and a friend in Thailand. The folks at Kaiser mean well, I'm sure, but they get so damn conservative.  I mean, look at the wimpy estradiol levels they want me at.  "Well above most women your age.  Don't want to push it."  Really?  Most women my age are growing mustaches and fretting about it, loss of bone mass, and fatigue.  Nope, Do Not Want.

My last set of blood tests gave a Glomerular Filtration Rate of 58 or 59 and they noted that the number was below 60. My doctor's response to this was that virtually no one above the age 50 are 60 or above on that metric. He said that 56 to 59 is normal for his patients and not to be worried about. He was more concerned about rate of change; for me and it appears for you it is stable. By the way, my doctor has given approval for gcs with my gfr at 59 - Good luck. Anne

Yup.  I'm 63.  Kidneys are lousy at regenerating nephrons, and I expect GFR to drop with age.  I'm just trying to be nice to them and get the best mileage I can from the original parts.  The aftermarket ones don't fit inside me...

I pulled up my last three tests and checked them out.

May 2016
GFR 94
BUN 9

October 2016
GFR 91
BUN 9

April 2017
GFR 81
BUN 13

What can we conclude from this? Dena was a bad girl before the April test and wasn't drinking enough water causing the levels to go up. It's not difficult to do in this climate as it draws the water out of you.

Yeah.  I thought it might be dehydration the first test that failed, so I drank plenty of fluids for this one.  Darn.  I'll try playing with protein intake.

One neat thing I learned is that estradiol has a protective effect on the kidney nephrons.  A comparison study between postmenopausal women on HRT and those without showed slower degradation with age courtesy of HRT.  Another study showed HRT causing a slight rise in GFR over time. That would be neat.

Think I may have found it and if so, there isn't a problem.
https://pdfs.semanticscholar.org/9739/37fbdbc7da53682641195ff076b9c01b4d27.pdf

Now THAT is neat.  Estradiol suppressing bone loss and kidney secretion of phosphates.  That puts the cherry on top of estradiol levels and bone loss, and reduces the worries over managing phosphorus intake with chronic kidney disease.

I knew estradiol would me my miracle drug.

[jentay1367]

Unfortunately, kidneys run best on less sodium and are prone to being unhappy with high potassium. So with Spiro you'll crave the salt and your potassium doesn't clear. You need to eat completely clean....fresh cooked veggies, beans and fish. You're going to need to drop meat, potatos, prepared dinners, canned anything.......blah blah blah. And as far as drinking tons of waterbefore a test....I think you need to do it on a regualar basis. Stay hydrated to ridiculous levels. It takes your blodd some time to clear a lot of these substances and no quick fix priora test will get it done. Were all behind you, Hon! If anyone can make this fly their way...it's you.

And as an aside...at some point go to an independent lab and check your progress. Don't take THEIR  test again till you know you'll pass.

[Michelle_P]

Successfully got my head examined!  The fMRI went OK, nobody said "boo" over the GFR, I got pumped full of gadolinium tracers and contrast dye, and much data was collected.

The slices with the pituitary region are off to Radiology so with any luck this will be my last MRI session for the year.

Breakfast at the "Sunrise Bistro" as a treat for getting my head examined!

I don't have much else on my calendar this week. I'll try to find something to keep myself occupied and out of trouble. [emoji6]


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[Michelle_P]

There's always little something to do. Today was Just Another Day In The Life...

Up early, started cold brew coffee for iced coffee when it gets hot, got cleaned up, weekly weight (135.2 lbs)and dressed (OK, skinny jeans, snug but cool t shirt, Toms white canvas loafers, etc), breakfast of cheerios, almond beverage, half sourdough muffin with butter.

I did my face, and headed to Whole Foods for produce and a couple specialty items.  Stopped for a coffee frappucino on the way home (walking), and cooled down. Made it home , put away the groceries and bag, and headed off to meet friends for lunch.

Lunch was a big salad with grilled chicken, and an assortment pack of friends. Two bi-gender, one post-op MtF, one pre-op MtF [emoji1383], one gender-fluid, one ciswoman.  We had a fun time as always.

After lunch I headed to a mall, looking for buttons and to get the ears repierced. I had to take out the new earrings for that MRI, and in the time I spent in the machine, the holes sealed up!  They aren't kidding about not removing the posts for several weeks.

Now, I'm going to an electronics place for a few parts, then a fabric shop to find some buttons. [emoji6] Then back to home for iced coffee, salad, veggies, and a main dish. Still trying to decide that. 

So, that's a typical Real Life Experience day for this trans-retiree. Boring, routine, and I can't stop smiling.



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[Steph Eigen]

Spent any time on the radio recently?

[josie76]

Michelle, what sort of electronics place do you have around there? All the shacks have closed here so Im always needing to order online when I run out of stuff.

[Michelle_P]

Josie, I have a Fry's Electronics about five miles from me.  It's a huge place that sells everything from TVs and appliances to computers, networking gear, and on to electronics parts, test instruments, soldering and rework stations, materials to fab PC boards, etc. Need a 40 pin DIP socket?  Aisle 14.  7408 chips?  Aisle 12...

It's pretty crazy.

Steph, unfortunately my condo is having exterior work done on it, continuing til September if they get back on schedule. The building is surrounded by metal scaffolding.  I can't 'hear' anything but bad LED lighting here with an antenna I pop up inside.  I can't get out on the balcony because it isn't there right now.  Long way down...

[Michelle_P]

I spent last Saturday wandering through the transmitters and receivers of KPH, the last of the Maritime Service Morse Code stations, currently run by volunteers.  Pictures of the station sites and whatnot are over on my Facebook page, viewable by the public.  Here is the big 12 MHz KPH transmitter doing the 10 AM Saturday broadcast.

Sunday was church and getting together with friends, and a quiet evening at home.  I need that every once in a while.

Today was E-Day.  My electrolyst is back from vacation, I had 3 weeks worth of awakening follicles plus the ones we hadn't gotten to yet, so both two hour sessions concentrated on my face.  Two hours on the upper lip, and two hours on the lower lip, chin, and the neck below the chin.  I look a bit bee-stung now.

After all that electrolysis, I had to go to an LGBTQ meeting.  I was a bit cranky, I'm afraid.  Being talked over and interrupted when trying to cover what I had been working on didn't help.  Made me crankier, in fact.  I made it through to the end of the meeting, and then our chairperson and I went out for coffee and pie.  Damn fine apple pie...

More meetings tomorrow.  Hoo hah...

[Laurie]

A day in your life Michelle is always a busy one.  You better make room in it for me when my travels take me that way.

Hugs,
     Laurie

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[Michelle_P]

A day in your life Michelle is always a busy one.  You better make room in it for me when my travels take me that way.

Hugs,
     Laurie

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Just give me 72 hours notice and I'll pencil you in, unless I'm doing GCS or FFS that day. Priorities...

Speaking of which, I now have a date to meet with a surgeon for GCS planning.  Specifically, next Wednesday!  [emoji79][emoji312]  This is the initial interview to see if I am worthy of being put on the schedule.  [emoji78]

Meanwhile, I am ramping up for a big campaign to educate my Unitarian Universalist brethren about pronouns.

"No, She/Her/Hers" are NOT my 'preferred pronouns,'  they are my CORRECT pronouns!"

Subtlety, thy name is Michelle...  [emoji946][emoji1008]



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[SadieBlake]

Subtle as a brickbat.

[Michelle_P]

Welp, got through my meetings and therapy session for the week.  Sort of a boring session again, no real issues beyond my having trouble sleeping (alone).  Yeah, I know the odds of fixing THAT.

I spent Thursday afternoon and evening at my (ex)mother-in-law / accepting older friend / nice older gal I help out and have dinner with.  English is lousy at affinity relationships.  The old sliding door that is the main entrance for the house broke one of the brass wheels that it rolls on, making the door unusable for an elderly woman.  The wheel actually wore through.

I found on disassembly that whoever had hung the door had gotten... creative... with how they assembled the wheels and track.  I had to remove the bottom of the sliding door from the glass and the rest of the frame, and use a spreader on the aluminum channel to pull the old roller and install the new one.  And me with no upper body strength left.  Ow.  I got it done, though. 

Never try to out-stubborn me.

Today I did a bit of grocery shopping, had lunch with friends, and got my 10,000 steps in.  This evening I'm making a berry clafoutis two ways, for an event tomorrow.  One is the traditional route in a big pan, and the other is an attempt at doing individual servings in miniature cupcake forms.  I'm having trouble getting a clean release from the ones baked in the miniature cupcake paper forms.  The traditional clafoutis will probably be cut into individual pieces and popped into the paper forms for serving.  I may try making a version in a nonstick 24 piece baking pan and see how well that comes out, in the morning.  I'm about baked out right now.

I've got two events tomorrow.  First is a brunch of sorts that is an AIDS Walk-related fundraiser.  It includes entertainment, some local drag artists and dancers.  Shortly after that is a private social event with our transwomen's group at a high end consignment shop.  They get the clafoutis.

Sunday I've got the UU church and coffee klatch that I am working cleanup on, and Monday is another electrolysis day, up to two hours on genital clearing and a couple hours on the face.  Monday night is a dinner with friends at a local Japanese restaurant, new place for me, and a meetup for local trans folks.  Tuesday I may be at my mother-in-laws again, followed by a group therapy session, and Wednesday I have my initial appointment with a GCS surgeon.  I'm sure I'll figure out something to do on Thursday...

[Laurie]

Welp, got through my meetings and therapy session for the week.  Sort of a boring session again, no real issues beyond my having trouble sleeping (alone).  Yeah, I know the odds of fixing THAT.

I spent Thursday afternoon and evening at my (ex)mother-in-law / accepting older friend / nice older gal I help out and have dinner with.  English is lousy at affinity relationships.  The old sliding door that is the main entrance for the house broke one of the brass wheels that it rolls on, making the door unusable for an elderly woman.  The wheel actually wore through.

I found on disassembly that whoever had hung the door had gotten... creative... with how they assembled the wheels and track.  I had to remove the bottom of the sliding door from the glass and the rest of the frame, and use a spreader on the aluminum channel to pull the old roller and install the new one.  And me with no upper body strength left.  Ow.  I got it done, though. 

Never try to out-stubborn me.

Today I did a bit of grocery shopping, had lunch with friends, and got my 10,000 steps in.  This evening I'm making a berry clafoutis two ways, for an event tomorrow.  One is the traditional route in a big pan, and the other is an attempt at doing individual servings in miniature cupcake forms.  I'm having trouble getting a clean release from the ones baked in the miniature cupcake paper forms.  The traditional clafoutis will probably be cut into individual pieces and popped into the paper forms for serving.  I may try making a version in a nonstick 24 piece baking pan and see how well that comes out, in the morning.  I'm about baked out right now.

I've got two events tomorrow.  First is a brunch of sorts that is an AIDS Walk-related fundraiser.  It includes entertainment, some local drag artists and dancers.  Shortly after that is a private social event with our transwomen's group at a high end consignment shop.  They get the clafoutis.

Sunday I've got the UU church and coffee klatch that I am working cleanup on, and Monday is another electrolysis day, up to two hours on genital clearing and a couple hours on the face.  Monday night is a dinner with friends at a local Japanese restaurant, new place for me, and a meetup for local trans folks.  Tuesday I may be at my mother-in-laws again, followed by a group therapy session, and Wednesday I have my initial appointment with a GCS surgeon.  I'm sure I'll figure out something to do on Thursday...

Hi Michelle,

  I see you are still as busy as ever. I admire you for it but don't see how you are able to do so much.  From myself I just made it home and as soon as I stop buzzing I'm going to get some sleep.

Hugs,
   Laurie

[Michelle_P]

I'm getting ready to meet my GCS surgeon.  There's an exam involved, so when I meet him I'll be dressed in a lovely hospital wrap and nothing else.  Brrrr...

This is the Big Gatekeeper event.  Kaiser has assigned me to this doc, and now he gets to decide if I am worthy of his skills and attention.   Yeah, I'm nervous.

More later...

[SadieBlake]

Awesome Michelle! Wishing you a great appointment.

[Michelle_P]

I'm in the waiting area at Kaiser SF Medical Center just calming down.

I had my initial meeting with Doctors Thomas and Selim to discuss my gender confirmation surgery. This is the medical procedure that brings my body in line with my gender identity.

The visit includes a discussion of the procedure, and an exam by the surgeons of the surgical site. They did ask when I would like the procedure done, and I indicated that any time or opening would be fine.

Doctor Thomas asked a variety of questions both on general health and on my prep work.  No issues were found during the exam.

And, they had an opening on the surgical schedule that I can have.

My GCS will be done on October 20, 2017.

[emoji4]


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[SadieBlake]

Oh my god, Michelle I am so very glad for you. I've sent more than a couple thoughts your way in the last few weeks, knowing you were spending some time on whether you could do this at all and whether the full monty or a more limited version.

I can't promise anything at all but if there's a way for me to be in SF to give you some support, you know I will.

Congratulations

[LizK]

My GCS will be done on October 20, 2017.

[emoji4]

That is fantastic news, absolutely brilliant congratulation 

Liz