Susan's Place Transgender Resources

Community Conversation => Transsexual talk => Post operative life => Topic started by: HappyMoni on January 22, 2018, 09:36:27 PM

Title: Level of info needed by unfamiliar med personnel
Post by: HappyMoni on January 22, 2018, 09:36:27 PM
I have been sick with a bad cough, lost voice, and my own snot factory outlet for 4 or 5 days, so I visited the doctor/urgent care place. The tech took vitals, goes through the usual questions and asks about surgeries. I didn't see the need to say anything about gender history so I asked what kind of surgeries. He says anything related to the current issue. So I said, "No surgeries." The PA or whatever her title comes in and asks again. I asked what surgeries again and she says, "Oh, all of them." Being the obedient critter that I am, I blurt out my history on face and gender surgery among the others I've had. Now I am sitting here debating how much info I am obligated to tell. I am not ashamed but I also don't feel like everyone needs to know this personal aspect of my life unless it is directly related. Opinions?
Moni
Title: Re: Level of info needed by unfamiliar med personnel
Post by: Dani on January 22, 2018, 09:45:09 PM
They were just being through in the medical history.

Every time you go to an unfamiliar urgent care facility you will get asked the same questions. This is one of many reasons to find a primary care doctor you can confide in and feel comfortable telling them everything.
Title: Re: Level of info needed by unfamiliar med personnel
Post by: HappyMoni on January 22, 2018, 09:48:56 PM
Quote from: Dani on January 22, 2018, 09:45:09 PM
They were just being through in the medical history.

Every time you go to an unfamiliar urgent care facility you will get asked the same questions. This is one of many reasons to find a primary care doctor you can confide in and feel comfortable telling them everything.
I don't object to the question, it's more that I need to decide my answer. Hard to get into PCP sometimes. Thanks though Dani!
Title: Re: Level of info needed by unfamiliar med personnel
Post by: Dena on January 22, 2018, 10:22:24 PM
Possibly one way to evade the issues would be to answer "nothing in the last (year or what ever time period). I have been under a general 7 times and I am pretty sure that none of them would affect my current health. Depending on the doctor I am seeing, some might need to know about certain surgeries because they are something they deal with. An example would be my eye surgeries if I were dealing with an eye issue.

What I am confused about is Obama care was supposed to link all our medical records online so any doctor could access them anytime. How come each time you see a doctor you still need to provide a full medical history?
Title: Re: Level of info needed by unfamiliar med personnel
Post by: SonadoraXVX on January 23, 2018, 07:20:27 AM
SRS and FFS mentioning to a PA(Physician Assistant) or an urgent care M.D? No, unless you have problems with your nostrils(maybe FFS related) or problems with your genitals(SRS related), but only to a very specialized provider, maybe your FFS/SRS surgeon, who has the highest specialized training. Most ordinary run of the mill PA/MD/DO, have no idea about gender issues or surgeries, just precursory MCE(medical continuation education) readings. Maybe a ER MD/DO has seen tg SRS/FFS issues, but in big city USA(i.e. NYC/LA/Chicago/SF), but even they are clueless, they just treat run of the mill human ailments, unspecialized srs/ffs ailments.

I'm imagining, they will see you as a unicorn andmake  you feel like a unicorn, not so, they just happen to not be educated on it and much less experienced in it. Maybe they did a precursory read on the MCE(medical continuation education)credits(The MD's and RN's, much less the medical assistants or certified nursing assistants(inhouse training/I would say nil)), but that is about it, to stay on top of current medical trends.

YMMV
Title: Re: Level of info needed by unfamiliar med personnel
Post by: ainsley on January 23, 2018, 07:41:00 AM
Good question!  I usually do not divulge any gender surgeries to unfamiliar medical people (i.e., not my care system where my records are readily accessible) unless they are pertinent to the visit.  I am not ashamed of them, it just ends up being such a laborious task to list them, explain them, and quite frankly, that is not why I am there.  I understand obtaining a comprehensive medical history to provide holistic care, and if I find that it is pertinent, then I will share.  Otherwise it just muddies the waters, so to speak to tell them ALL of my surgeries.

And, Dena, I do not know about obamacare, but I get my care through the university of missouri (primarily) and when I go to different clinics/departments they make me fill out the form which asks me my medical history EVEN THOUGH IT IS ALL IN THEIR SYSTEM!!  soooooo frustrating.  So, I have started putting on the medical history sheet, which asks me what prescriptions I am taking and what my surgeries and hospitalizations are to see electronic record in MUHealthe.  :)  To me, it is just lazy medicine to not do a little bit of research for patients you have scheduled appointments with.....you know....like....read their records????  gah!
Title: Re: Level of info needed by unfamiliar med personnel
Post by: EllenJ2003 on January 24, 2018, 08:27:10 PM
Up until 2 or 3 years ago, the only doctors who knew about my past TS medical history, were my GP (who I've been seeing since 2004 - she prescribes my HRT), my Allergist/Asthma specialist (I wasn't sure if the fact I was doing HRT, had any effect on my asthma [which I was diagnosed with back in the summer of 2003 - a mega attack almost put me in the hospital at that time]), and the Neurologist/Headache Specialist, who deals with my Cluster Headaches (yes I get those rare and extreme headaches - I've been getting them since 1999, and I was formally diagnosed for them in 2005 [if you think migraines are painful, Cluster Headaches are even worse in that regard; migraine sufferers who get Cluster Headaches will vouch for that]), due to the fact that there is possible evidence that an abnormality in the hypothalamus is the cause for Cluster Headaches (sound familiar? there is a similar theory for us being the way we are), and I thought that information might be relevant for treating my Cluster Headaches (when I told my Neurologist that info., she told me that shouldn't have felt obligated to tell her [ditto for my asthma doctor], after all there was nothing wrong with me having SRS, I was just doing what I needed to do, for my own well being).  That was it for me with regards to informing doctors about my HRT, transition related (I had an Orchie in 2001), and SRS related healthcare.  I did not consider it typically relevant, to my general healthcare.  I've never told other healthcare professionals that information - IMO they have less of a need to know, than my doctors do.

Now as I mentioned earlier, the situation I just mentioned, changed 2 or 3 years ago.   Why?  Well, once I reached an age, where I would be considered post-menopausal it became problematic for my GP, to keep on giving me HRT, without explaining why, so she put transition, and SRS related medical information in my medical records, to explain why I was getting HRT.  I was not very happy about that (I argued with my GP about it), but it became a case of having that information in my medical records, or else not being prescribed HRT anymore.  It can be a hassle to find a doctor willing to prescribe HRT (I remember the problems a post-op friend of mine had with finding a doctor to prescribe her HRT, after her GP retired), so I begrudgingly put up with it.   Despite that, as a rule, I still don't generally disclose transition, some other other surgeries I've had (I had a rhinoplasty, and trachea shave, when I had SRS), and SRS health related information to medical professionals.

Consider the above comments as food for thought.  Also, if the healthcare provider you use, is like mine, information about your HRT, transition, and SRS may already be on record with them, so it may be unnecessary for you to disclose it to healthcare providers, since they already have the capability to access it (which is a lot less awkward IMO, than having to tell them - besides, there's a chance they might not even read the information).

Just My Thoughts On The Issue,
Ellen

HRT Since Sept. 1999
Orchiectomy July 2001
SRS on Nov. 25, 2003 by Suporn 
Title: Re: Level of info needed by unfamiliar med personnel
Post by: rmaddy on January 24, 2018, 09:06:30 PM
You don't really need me to post to guess my opinion, but I'd say disclose it all.  It may be that your surgical experience is irrelevant, but it's not entirely clear to me that you have anything to lose by being completely open.  I wouldn't take Vitamin C from someone who reacted with hostility toward me based on my gender identity.  Personally, I list all my surgeries. 

Besides, if I'm not mistaken, your GCS was fairly recent...to me that would automatically make it medically pertinent.  Look up the PERC criteria for pulmonary embolism (blood clot in the lung)--a condition often missed because it is a "great imitator", i.e. it may look like pneumonia or other more benign respiratory conditions at presentation.  Age over 60, recent surgery, exogenous estrogen--all of these are known risks.

That's not to say that a cold isn't more likely, but a good practitioner may be making associations that seem irrelevant to you at the time.  I have no idea if this was a good practitioner or not (and if so, what they were doing in urgent care), but I would have asked the same question.  I wouldn't have been taken aback at all if you said, "Why do you ask?"