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Community Conversation => Transsexual talk => Male to female transsexual talk (MTF) => Topic started by: michelle82 on February 24, 2015, 06:17:56 AM

Title: blood work and HRT
Post by: michelle82 on February 24, 2015, 06:17:56 AM
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!!
Title: Re: blood work and HRT
Post by: Brenda E on February 24, 2015, 07:39:30 AM
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.
Title: Re: blood work and HRT
Post by: ImagineKate on February 24, 2015, 07:50:02 AM
Well I was prescribed first visit but even if you have blood pressure issues they can prescribe spiro which is a blood pressure drug.
Title: Re: blood work and HRT
Post by: michelle82 on February 24, 2015, 08:23:55 AM
Thanks ladies thats reassuring!!
Title: Re: blood work and HRT
Post by: MelissaAnn on February 24, 2015, 08:55:33 AM
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
Title: Re: blood work and HRT
Post by: JoanneB on February 24, 2015, 09:28:06 AM
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
Title: Re: blood work and HRT
Post by: ImagineKate on February 24, 2015, 12:02:08 PM
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.
Title: Re: blood work and HRT
Post by: jeni on February 24, 2015, 02:14:15 PM
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...)
Title: Re: blood work and HRT
Post by: michelle82 on February 24, 2015, 02:26:06 PM
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.
Title: Re: blood work and HRT
Post by: Virginia on February 24, 2015, 03:37:18 PM
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.

Title: Re: blood work and HRT
Post by: ImagineKate on February 24, 2015, 04:24:42 PM
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.
Title: Re: blood work and HRT
Post by: katrinaw on February 24, 2015, 04:52:46 PM
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
Title: Re: blood work and HRT
Post by: michelle82 on March 11, 2015, 12:03:31 AM
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!!
Title: Re: blood work and HRT
Post by: Tori on March 11, 2015, 12:53:35 AM
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.
Title: Re: blood work and HRT
Post by: jeni on March 11, 2015, 08:58:50 AM
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?
Title: Re: blood work and HRT
Post by: ImagineKate on March 11, 2015, 09:46:39 AM
Quote from: jeni on March 11, 2015, 08:58:50 AM
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.
Title: Re: blood work and HRT
Post by: jeni on March 11, 2015, 09:57:17 AM
Quote from: ImagineKate on March 11, 2015, 09:46:39 AM
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."
Title: Re: blood work and HRT
Post by: ImagineKate on March 11, 2015, 10:02:09 AM
Quote from: jeni on March 11, 2015, 09:57:17 AM
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!
Title: Re: blood work and HRT
Post by: michelle82 on March 11, 2015, 10:17:11 AM

Quote from: jeni on March 11, 2015, 09:57:17 AM
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!!
Title: Re: blood work and HRT
Post by: michelle82 on March 17, 2015, 06:52:25 AM
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!!
Title: Re: blood work and HRT
Post by: Mariah on March 17, 2015, 07:11:38 AM
My previous primary care doctor ordered the blood work ahead of time so when I saw the Endo for the first time he perscribed HRT that day. Due to my meidcal history though he only started me on Estrogen at first until the Nephrologist cleared Spiro. He was concerned he couldn't get up to what tends to be the lower end of the stand dose for MtF's. As a result of their not communicating well at first Spiro wasn't added tell around Halloween. Turns out the fears were unfounded and we had nothing to worry about plus the fact I didn't need to get up to the dose he thought I would need in the end. Good Luck
Mariah
Title: Re: blood work and HRT
Post by: michelle82 on March 18, 2015, 06:12:34 PM
Woo-hoo I called the office and spoke with my doctor. He read my lab work over the phone and wrote me a script for Spiro!!! I just got back from pharmacy with my medication in hand!! I feel so happy right now!!!!!
Title: Re: blood work and HRT
Post by: Mariah on March 18, 2015, 06:20:13 PM
Congrats Michelle your well on your way.  :)
Quote from: michelle82 on March 18, 2015, 06:12:34 PM
Woo-hoo I called the office and spoke with my doctor. He read my lab work over the phone and wrote me a script for Spiro!!! I just got back from pharmacy with my medication in hand!! I feel so happy right now!!!!!
Title: Re: blood work and HRT
Post by: michelle82 on March 18, 2015, 06:22:53 PM
Quote from: Mariah2014 on March 18, 2015, 06:20:13 PM
Congrats Michelle your well on your way.  :)
Thx Mariah!!