okay, this might need to be moved over to health at this rate.
I got my bloods.
Also the gp wants me to go for an ECG to check there's no damage to my heart because of my blood pressure (oh wonderful) but doesn't want me to take betablockers yet. Say what? So.. she's worried about damage to my heart, but is all "yeah just wait and see"?
I'm uneasy about that.
I mean I HAVE betablockers here, I could self medicate if I get too worried but it seems wierd.
She's talking about referring me to an endo if the ecg is okay to confirm what's causing the hypertension. Lady we already KNOW what's causing the hypertension, it's called estrogen dominance coupled with high colesterol!
All known side effects of pcos!
BAH. the one time they don't shrug and go "yeah it's the pcos"
the ONE time.
Anyway, the ecg is a walk in thing so I think i'll wander over to the hospital tomorrow morning nice and early to try to beat the rush. I'll probably still wait hours though. I'll take a book. It's gonna be annoying.
She agreed to do a glucose test and the other bloods my specialist wants (his letter hasn't come through yet apparently) but that won't be till June 3rd because they have only one nurse for two doctor surgeries because their management is idiotic and thinks that understaffing is fiiiine.
*sigh*
Fasting glucose sucks, it's at 11:40 so i'm gonna be so hangry but then. Grrr.
Anyway, the blood results:
these were taken on CD 12, generally speaking they like to take bloods on cd 14ish because it's supposed to be "mid cycle" or they do it on cd 2-5 so they catch the very start.
This is cd 12 so close to the standard mid point.
T levels are LOW - 0.8 nmol/l
if it's under 1 they don't bother doing SHBG which annoys me because my T is often LOW but my SHBG doesn't seem to work so it's a high percentage of FREE t.
I've asked them to redo it with that SHBG regardless of how low the dang number is just to be sure because I know from experience that low t doesn't mean much, the important part is how much of that is free and how much is bound. - Notes say "normal no action" but for someone with PCOS and a lot of the androgenising side effects like hiristuism this is LOW t.
progesterone is LOW - <1 nmol/l which means it's so low they didn't even get a decent reading on it. This makes perfect sense, low Progesterone is a characteristic of pcos and estrogen dominance. - the notes say "routine dr appointment"
oestriadiol - 471 pmol/l - I think for cd 12 that's fairly excessive but i'm not actually sure. But it suggests to me anyway that i'm right about the estrogen dominance. - the notes say "routine dr appointment" which means it's not normal.
FSH is 3.8 (normal no action) however it's LOW for the point in the cycle it was taken.
LH is 11.5 (no action) but this shows what I mean about their system being dumb and not taking interactions into account. See, LH shouldn't be higher than FSH, that's not how it works. They should be 1:1 approximately, but my LH is 3x higher than my FSH, a classic PCOS sign that one. That's normal for me, but it's certainly not "clinically normal" What it means is I produce a lot of folicles, but I don't then ovulate properly so they sit, they die, become cysts. Hence "polycystic ovarian syndrome". These numbers look pretty normal for me
Prolactin - 269 mu/l which is apparently normal. (range is 102 - 496 mu/l)
TSH (thyroid) is 1.13 which again, normal. Because my thyroid is always normal and i'm sick of them testing it when I say I have hot flushes because it's not my damn thyroid! gragh.
So I have to send these over to my specialist, see what he says.
there's a few they didn't bother doing which is annoying so I have to get those done.
And I probably need the whole lot redone on cd 2 to get a better overview but who knows when that'll be as this cycle is probably a dud and might just not happen.
anyway, I was looking at the treatments for PCOS and aside from Met they also have two other drugs but both of them are anti androgens which is like.. totally NOT something I want in me. I LIKE my testosterone.
there's a real assumption from doctors treating me that I want to remove my excess body hair (er no, no I do not.) and want to feminise more and I find it pretty annoying and presumptuous honestly. I mean even if I wasn't trans, what if I was just okay with looking how I look? It's pretty rude to suggest to a person they need to change to fit some narrow standard you know?
All my life the fact I grow facial hair has NEVER been a problem, I mean damn, you just shave it off. It's not hard.
yet there's always this assumption I must look in the mirror and be mortified by it and really? even before I realised my gender identity it more amused me than anything else.
I used to joke with my cis male friends that I could grow a better beard than they could.
We used to joke that I was a Dwarf/hobbit cross breed because I had a beard AND hairy toes lol.
I fully embrace my Dwobbit-ness.
I LIKE that I have a fairly square jaw and body hair, that's what i look like, it's me and it's aspects of my appearance that have never caused me any distress. (boobs, they're the thing I hate)
Anti androgens just.. eugh no. Get off.
i'm not sure I want to come out to my specialist because i'm not sure how he'll take it because well, he's old and he's very much a "cis women treatment" sorta doctor. I'm not entirely sure ANY of these endo/gynos really understand trans care for transguys.
I'm thinking my best option right now is to go along with stuff up to a point, agree to the non feminising treatments that'll bring my hormones into check, get myself healthier and then hopefully, by then the GIC will have given me an appointment and I can switch care over to them for the last little bits. I just really want to avoid anti androgens, I have precious little T as it is! leave it alone!
But it is concerning because honestly gyno care for transmen is TERRIBLE. I mean it's really really poor. Even someone like me who's so detatched from their biology that I can just talk about it candidly and feel no dysphoria (I mean genuinely to me, talking about my ovaries is much like talking about my heart or my liver. it's just a body part, in fact if anything due to years of having to go through tests and such for it i'm super extra ultra detached from all of it to a point it's just routine.) and WILL seek out gyno care, it's still rubbish.
"womens" medicine in general is rubbish (ahhh institutionalised sexism, gotta love it huh?) but it gains an extra level of terrible when you don't present as female and don't fit into the little pink box all doctors seem to think all XX folk wanna be shoved into.
I'm concerned that if I come out fully i'll encounter the same situation I got with my regular GP. A sudden denial of treatment or this wierdness and questioning me at every turn. This bizarre attitude that being trans someone automatically makes me not have this biochemical disorder and health problems relating to my reproductive organs. I mean it's wierd. I WISH that just saying "i'm a man" would magically disappear my ovaries and womb but that's not how it works! I still have these things and they're not healthy.
It's concerning to me how many more hurdles are put in the way of someone who doesn't fit in the pink box. It's almost like they want us sick.
and that's unsettling.
Ultimately though, I don't think it's a conspiracy so much as just flat out ignorance and twisted thinking. This attitude that somehow I won't want to talk about my body and getting well because of the dysphoria. Sorry but ultimately, my health is waaaaay more important than me being uncomfortable talking about vaginas.
And ultimately? Dysphoria doesn't effect everyone the same way. I mean im FINE with talking about my biology and biochemistry. Some people maybe aren't, but that doesn't mean we should face a situation where we don't feel we can talk about them at ALL or seek help for them.
I still need gyno care and depressingly, I get the distinct impression that in order to continue to access it unhindered, I need to continue to pretend to be a girl.
Which sucks, but if wearing a dress gets me the damn meds I need, well so be it I guess.
I'll wear a sodding dress.
But i'm not taking anti androgens and they can kiss my ass if they expect me to agree to that. -_-
extra t is NOT the problem. Excess E IS
Can I have anti estrogen instead? lol. That'd be awesome.
Anyway, no closer to treatment. It's still kinda "we're gonna wait, do more tests, muck about and sit on our hands" which is frustrating but there's not a lot I can do.
I'll get this ECG tomorrow, see how much MORE stuffed up my heart is (I already had an ecg about 5 years back and they said I had bicuspid regurgitation but it was "mild", let's see if it's gotten worse thanks to being taken off the beta blockers shall we?)
and i'll send these blood results on to my specialist and see what he says.
But eugh.. the sooner I get the damn metformin at least, the better.
I'm not sleeping thanks to the hot flushes and such, which means i'm constantly absolutely exhausted. I'm tired of feeling sick all the time.
I was thinking about what my ultimate long term goal is and at this point, i'm thinking top surgery is a definite (I mean I HATE these things so much. I put a bra on because my sports bras needed a wash and it was devastating. I LOATHE how it looks and I just feel so uncomfortable going out like this. I really am not happy about it. I need more sports bras) but it's whether they can control my pcos effectively alongside hrt. I know there are a lot of transguys out there with pcos so i'm hoping it's gonna be fine and there's no problem with doing it. If anything I sorta hope it HELPS because it'd remove the biggest more difficult symptoms to manage, the nightmare pms, the cysts (by removing the ovaries) and the erratic periods.
I genuinely feel like that's the most natural state for my body to be in.