What should a GOOD Endo do for you at your visits and yearly appointments?
ie: blood work, physical, check for breast lumps, feel testicles OR WHAT EVER?
Curious, because I just went for my year visit and we just sat and talked? Is this normal?
What should a great transgender Endo really do?
:)
My GP prescribes my hormones (he does it for a lot of trans women). I have a once-a-year physical when I go to him for a prescription renewal. As part of that, he reads my hormone levels, and a whole lot of other stuff, and talks to me about whatever he might be concerned about.
Mine take a sample of my blood and use their own on-site lab to measure the levels of about twenty enzymes, hormones, glycoproteins, blood cell counts and whatever. A few days later they send me a report with the levels, and they adjust my medication if necessary.
They talk with me about my experiences, my emotions, whether I have observed breast growth, whether I sleep well, how I feel about my transition and so on.
I ask whether changes in my medication are possible, like using a different combination of estradiol gel and tablets, and whether we can add bioidentical progesterone or some testosterone for my libido or an estrogen cream after my SRS.
They give me a prescription for my medication lasting until my next visit (first every 6 weeks, then every three months, now twice a year).
They have never done any examination of my breasts or testicles, and I do not think it would be their job. They did however advise early in my HRT that I should have my breasts checked regularly.
I should probably add that they have many trans patients and they seem to know their (and my) business.
I see my endo every six months, three months, six months, etc. He'll check my bloods (I get the test a week before) and talk to me about the results and levels; takes my BP and weight; checks breast development every second visit; implants my estrogen crystal every second visit; writes up scripts for other HRT. I wouldn't say it's overly detailed but is thorough, takes about 15 minutes.
Now a days. Has a chat puts another implant in, every six months.
I go see a nurse practitioner and GP. I go every 3 months because I'm diabetic and need regular care.
They don't do hormone levels often. They do check blood pressure every time as well as CMP and CBC which are a standard battery of tests. They also check my blood glucose management via A1C every 3 months and also liver and kidney function. She lets me ask anything I want, and last time I asked for a blood glucose meter to better manage my diabetes. It has helped a lot.
Anyway this may not apply to you but this is how they deal with me.
Lab work, a quick of things in regards to my body and we talk. Then sends the scripts electronically to the pharmacy. Hugs
Mariah
For the first year, I had follow-ups every three months. She did a breast exam, talked about how the HRT was working for me, and then did full bloodwork (CBC, liver function test, testosterone and prolactin levels are what I recall). After that we went to every six months, similar appointment.
Now that I'm 3 years post-op, it's a yearly checkup where she still runs all the bloodwork and does the breast exam but otherwise just chats with me for a couple minutes and runs away (she's very busy). I'm thinking of switching to a GP to do the monitoring soon, at this point.
Oh, and by "breast exam" I mean the typical checking for lumps/cancer, not judging development or whatnot. She and my GP both figure since I have "young" dense breast tissue, it can't hurt to have an expert palpating them a couple times a year, so they both do it (he does at my physical). She never wanted to see my testicles or did anything to specifically judge my body, which I appreciate.
My endo is well known in the L.A. area among the transgender community - he's very old school with years of experience and he doesn't seem to put much value on the results of blood tests to check hormone levels. Aside from the initial blood test that he required when I started seeing him there hasn't been one since.
He wants to see me every 3 months. We discuss anything that I want to talk about since I saw him last, and then he does a cursory examination - he checks my weight, my blood pressure, check my eyes, looks in my ears, and listens to me breathe with a stethoscope. I tell him which prescriptions I need and he writes them, and then I schedule the next appointment 3 months from then. Lather, rinse, repeat :laugh:
I don't mind going to see him every 3 months because in my previous life I was never sick so I never went - and then out of the blue I had a stroke. I learned a very hard lesson about avoiding doctor visits and about not taking care of yourself.
I go to my endo every 6 months. We will sit in his office for a moment and just talk about my changes or concerns I may have. He checks my weight, feels my lymph nodes, feels around my belly and my back. He checks my throat and has me swallow (I do have a thyroid disease and a goiter) He also squeeze around my legs and ankles too to make sure there is no swelling. He takes my blood and all that good stuff. Very simple though a bit expensive but he's very good at what he does.
For my checkups (six months apart), I get treated to the "deluxe" examination, including tits being felt up (with added non-medical comments like "oh yes those are great!" - my endo truly gets worked up at the sight of a nice pair of transgender tits), my balls fondled, and a finger stuffed up my backside to check my prostate. Plus the usual bloodwork and physical exam. I come out of his office feeling violated.
Either he's a very thorough doctor or a disgusting pervert. (But either way, I'll keep going because he's damn good at feminizing me!)
My Endo has in essence become my GP. I also see a GP/Internist. I am considering seeing a MTF OB/GYN as my GP.
MTF-friendly