It's been a bit since I posted in this thread, so I thought I'd bring everyone up to speed on my progress.
After about two months on Spiro and a month and a half on Divigel...
.
.
.
...it isn't working.
That is, not yet.
I did my one-month labs a couple weeks ago and finally tracked my endo down to discuss them with him. Testosterone came in at 670, estrogen at 48.
He expected T below 200 and E above 60. His first take on the results was laboratory error!
Well, probably not.
As I've mentioned elsewhere, I'm one of those people blessed (or cursed) with being an ultra-rapid metabolizer of medications. I simply need much higher dosages than a typical human being for any med to take effect. Psych meds, pain killers, you name it. My dentist always grouses about how much novocaine he has to give me.
What can you say? By definition, there have to be some people on the tail end of the bell curve.
So I remind him of that, and I also point out that I'm not feeling any of Spiro's classic side effects - no extra peeing, no cravings for sodium, no hypostasis, nuthin'. We conclude that the current dosage just isn't working.
Not exactly one of those things you'd have to go to Doctor School to figure out, but at the same time, it's not as though we'd have known things weren't working until we had all the evidence in one place.
Rationally speaking, it makes a lot more sense to take a good, sensible first shot in the dark at the right level, measure results, then adjust, but emotionally speaking, I'm left feeling sad and frustrated. Two months! I mean, I know It's A Lifetime Process, and We're All In It For The Long Haul, and there's no getting around that, but gee whiz! Let's get this show on the road, folks! I guess I can't call it two months wasted because it's two months gathering the data needed to make a better decision (darn, I hate being a scientist sometimes) but I wanted everything to have begun working perfectly from the start!
Aargh!
Darn endocrinologist
Darn transition
Darn being transgender and all the complicated needs and feelings that go along with it
.
.
.
But it is what it is.
So what to do, what to do, what to do?
First off, we're doubling my Spiro. I think I was at a typical maintenance dosage, but now we're going to head toward the top end of normal. That may be a start, but I remain skeptical. I usually need higher than the top end of normal, so I don't doubt that it'll be another round of trial, test, and adjust, and maybe we'll even conclude that Spiro isn't the right med or that we need an adjunct. Meanwhile, more time will pass. Sigh.
Second, we're switching to injectable E in the hopes that it will give us more flexibility to raise the dosage as we continue to test and adjust. I'll have to learn how to give myself shots, but that's kinda cool - I really do love needles. Don't ask.
Finally, I have to remember who I am and what I'm doing. Being myself is the objective, transition is the strategy, and all this footling around with hormones and endos and dosages are just tactics. Yes, I've got to get the tactics right to make progress, but I can't focus only on chemical transition. There are a lot of other aspects of transition to work on, many more challenges to face, much more fun to be had. A fascinating path to follow.
And I am the Battle Goddess.
Let's go.
