Better HRT results following SRS?

[Caith]

I was disappointed with my psychiatrist/M.D. this afternoon.  She asked if delivering the second letter by the end of next week was okay.  Umm, I was kinda hoping she could have already composed it, and started reviewing it with my psychotherapist/Ph.D. over the telephone.   Unfortunately, she also didn't have the release form I snail-mailed to her two weeks ago.   Well, I get an EKG next week, and that's a lot later than I'd expect, as well.  Why is it when it's something the patient wants, it takes forever.  But when it's something a doctor wants, it happens "stat"?  Sheesh. 

So, I had my EKG on Wednesday, and I told them what to expect before they started recording it.  I have an inverted T-segment, and have been this way for twenty-plus years with no heart problems, ever.  The good news is, I'm down 20 pounds since last November.  The bad news is, I have to take a nuclear medicine / cardiac stress test next week.  At least it will still be valid when I need a colonoscopy in a few years, and I won't have to go through this all over again.

I'm extremely disappointed in my psychiatrist/MD/shrink this week.  I left her three separate voice mail messages and she hasn't responded to any of them.  She also hasn't provided my second referral letter as she committed to me, last Thursday during our session.  So I e-mailed my therapist and asked her to line up one of her regular associates to write my second letter.  Fortunately, we discussed this during therapy yesterday, and we were both kind of expecting this to become a necessity.  Still, it doesn't lessen the fact that I'm very, very disappointed and definitely won't be visiting this psychiatrist again in the future.

[JessicaR]

I'm curious about this, too...

  I've read allot of anecdotal evidence of increased feminization after GRS (or orchie) but nothing solid... I'm just going to think out loud here...

  I've been on HRT for about 5.5 years.. It's my understanding that antiandrogens initially stop your body from absorbing T but the effect is later amplified as the testes atrophy; after awhile they stop producing T.... right? Does anyone know more about this? My guess is that if the testes are made non-functional by HRT then there really shouldn't be any differences after GRS.

  Then again, if E acts as a T suppressor then maybe, after GRS, there might be more bioavailable E after GRS because there's a certain amount that would have been used to suppress the T.

  Heh.... where's a biochemist when you need one? 

[Caith]

The issue with anti-androgens is they don't necessarily suppress the adrenal glands' production of testosterone, nor do they halt the aromatization mechanism that converts T (however little of it still exists) into the more powerful di-hydro-testosterone (DHT), responsible for male pattern baldness, prostate enlargement, and a host of other ugly effects.  This is why so many people on HRT take 5AR-inhibiting drugs like Proscar or Propecia (finasteride) or Avodart (dutasteride) in addition to their anti-androgens.

I'm hoping after my testicles are gone, things will get better.  I'm not actually expecting it, but I'm hoping.  It very much appears to be an individual thing, related to individual metabolism and biochemistry.

[Caith]

I'm extremely disappointed in my psychiatrist/MD/shrink this week.  I left her three separate voice mail messages and she hasn't responded to any of them.  She also hasn't provided my second referral letter as she committed to me, last Thursday during our session.  So I e-mailed my therapist and asked her to line up one of her regular associates to write my second letter.  Fortunately, we discussed this during therapy yesterday, and we were both kind of expecting this to become a necessity.  Still, it doesn't lessen the fact that I'm very, very disappointed and definitely won't be visiting this psychiatrist again in the future.

So, I just received a phone call from my psychiatrist at 10:30 this morning, apologizing. Unfortunately, she tried blaming it all on her secretary and their phone system. I know she's personally techno-phobic, so the blame lies squarely on her for not checking her voice mail messages daily and responding to them in a timely manner. The end result is, she's expecting to prepare the letter and fax it to my therapist for review today.

Seeing as I have a cardiac stress test scheduled for Wednesday, if I receive the letter Tuesday, I should be able to overnight the whole damned package of two letters, an EKG, and a cardiac stress test review to Dr. Reed before the end of this week. Of course, that's only if they review the stress test results in a timely manner, and at this point I'm seriously not expecting that.

[Caith]

I had my cardiac stress test this morning, and my dilly-dallying shrink called while I was being tested to say my letter was finally available for pick-up today.  After grabbing a quick bite to eat and visiting my GP's office to pick up blood test results, I went by the shrink's office.  The letter was actually waiting for me at the receptionist's desk.  It's only three business days and five calendar days later than originally promised.  I won't be going back to this shrink for ANYTHING in the future.  Now, I just need to get everything down to Dr. Reed with a bank check for half his surgery fee, and I should be able to schedule a date for my orchiectomy.

[Tamaki]

Yay, it sounds like it's finally coming together for you! Here's hoping that Dr. Reed isn't too busy.

[Caith]

Thanks, Hannah!!   He was certainly busy when I called just before 3:00 pm Wednesday afternoon.  His office manager Anne answered the phone and told me they were about to begin a surgery.  I called to confirm everything I was sending to them today, to be absolutely certain I wasn't missing anything they required.  We spent no more than five minutes talking, but she told me exactly what I needed to know.  My Fed Ex Envelope with both referral letters, a cashier's check, and blood test results should arrive in their Miami office Thursday morning, at which time Anne should call me back to schedule a date for orchiectomy.

I'm just hoping there's still a slot available during the first two weeks in April.  Orchiectomy requires an hour (or less) for the procedure, but scheduling it really depends on how many SRS/GCS surgeries he has scheduled the same day, especially if they include other cosmetic procedures.  Also, I have to be there for a consult the day before and stick around for two to three days afterward for follow-up visits.

* Caith crosses fingers (and legs!)

[Caith]

Finally, Dr. Reed's office has received everything they need.        I e-mailed them Sunday to insure they weren't experiencing any delays due to my psychiatrist not responding to their calls.  Dr. Reed responded Monday afternoon to say the cardiologist's office had never sent the EKG and stress test results.  I jumped on the cardiologist's office and they faxed those to Dr. Reed, but they neglected to include the necessary statement explicitly clearing me for surgery.  I called the cardiologist's office back Tuesday morning, and that statement was finally provided.  So now, I'm just waiting for Dr. Reed to return to his office this weekend.  The last week of every month, he's out either lecturing, speaking, or learning something new.  Surprisingly, he's probably fewer than 200 miles away from me, right now.

Have I mentioned how stressful it's been, just trying to get everything they need delivered to them?  If I hadn't kept my eye on everything, it would be at least one or two more weeks before we actually scheduled surgery.

[Caith]

Wednesday, June 8th.    They could have seen me April 18, but the other person who lives here has a scheduling problem with that week.  I can't describe her as wife, spouse, or SO because she hasn't been any of those things to me in many, many years.   To sum things up: I'm extremely disappointed, pissed off, and a jumble of other emotions at this moment.  I really don't want to buy or consume more cyproterone/Androcur.  At least I have enough left, that I can still take it every other day until then.

[Tamaki]

I'm so sorry that you couldn't make April work. At least you have a date now! That is so awesome for you. Of course I wish it was me but my time will come.

[Caith]

Thanks, Hannah.  It's terrible to receive such a let-down, early on a Monday morning is even worse.  It required most of the day before I finally got over it.  At least it's a solidly confirmed date, now.  Nothing short of death is going to change that, now.