so my endo is about an hour and ten minutes away
but he's the only one that accepts my insurance
how many times do I have to see him?
I know theres the initial visit and then the blood tests
and the follow ups
how many times would I probably have to drive up there within a year ?
Hes so far

It'll probably be once every two months for a little while until your at a stable dose.

I see my GP ever month to month and a half, but she's been fairly liberal with scheduling since I have a good insurance plan.

I second what Kelly said, once every 2-3 months when you first start the hormones then after you get your dose down and good two-3 times a year after that to make sure everything is still good.

Explain the difficulty and expense to the endo and ask if a three month recheck is o.k. rather than every two months.  Also ask if she (or he) can do a prescription for both Estrogen and Spironolactone in the first visit (or later by phone) instead of having to come back after blood work. 

If you have a Walmart, Sams Club, or other big box store nearby find out if the endo will prescribe the generic estrogen and spiro they carry as a $10 prscription for a 90 day supply.  It's an inexpensive way to do HRT, but the endo has to agree and actually prescribe the generic.

Good luck and hope everything goes well, and I'm keeping my fingers crossed for you (cyber-style)  .

K

Well lets see here. All the tests and directions are readily available on the internet for the savy person to become dam near an expert and then take that info to ANY doctor and ask him to do the tests and take care of you. Simply put there is no need for an endo if someone is smart.

Of course when I went through transition I did my homework and hell I never went to a therapist either. I didn't need to pay someone to tell me what I already knew.

That's my 2 cents. Choose as ya wish.

Katie

Ill def second that any GP can issue hormones.


You don't necessarily need an Endo.

Quote from: Katie on August 09, 2013, 03:25:08 PM
Well lets see here. All the tests and directions are readily available on the internet for the savy person to become dam near an expert and then take that info to ANY doctor and ask him to do the tests and take care of you. Simply put there is no need for an endo if someone is smart.

Of course when I went through transition I did my homework and hell I never went to a therapist either. I didn't need to pay someone to tell me what I already knew.

That's my 2 cents. Choose as ya wish.

Katie

I'll add another voice to that. In 5 years, I have never seen an Endo but put together a regime with my "Trans Friendly " GP based on information readily available on the internet. We do complete blood tests once a year which have always been fine and since I have absolutely no health issues otherwise, I really see no very good reason to do things differently especially as most Endos know no more about HRT than anyone who takes a serious interest in this subject and educates themselves.
However, if I did have other health issues, I would no doubt have taken more precautions.
My 2 centimes worth!
Donna

thanks everyone
unfortunately theres no lgbt friendly gps in my area

Yeah it's really down to which country you are in and individual GP's. My GP after tentatively agreeing to do blood tests (no prescribing of hormones, just bloodwork) has now a few months down the line, come out and said that she is flat out uncomfortable treating a transgender patient and does not want to be responsible for treatment given she has no training in this area. Which unfortunately means, no more blood work and no further assistance from her.

Yes the doctor has no training and hence the reason I pointed out that the smart person can get off the internet data that was written by doctors and take that info to any doctor and that will train them. This is not rocket science here.

Another not so well known tidbit here. A doctor does not want to give you a script for hormones..... a simple response to him that you have the hormones and will take them yourself will usually get the job done. See in most places when a doctor finds out you are going to do it they are then compelled to care for you because letting you do it on your own is medically neglegent vs. him taking care of you.

Ohhhh the experience of the post op girls is so special.

Quote from: Ravenna on August 09, 2013, 01:43:39 PM
so my endo is about an hour and ten minutes away
but he's the only one that accepts my insurance
how many times do I have to see him?
I know theres the initial visit and then the blood tests
and the follow ups
how many times would I probably have to drive up there within a year ?
Hes so far

I understand your concern.  I would suspect the endo would like to see you quarterly the first year.  Let him know that you travel quite a distance to see him.

You have some good suggestions in this topic.  That Katie - she's a smart one 

It is very well worthwhile using the endo until you are stable. I had unusual reactions to progynova that were life threatening, an inexperienced medic would not have coped with the situation. My endo has 400 trans patients and she had only seen my response a few times.

So I suggest to use the endo's experience, make sure you are safe then get the local medic to monitor. They can always consult with the endo if they have an issue.

When I started back on HRT last November, I had to have monthly tests of the blood work up. After 2 months on the basic dose, He tested me and the T levels had dropped below 5, so he doubled the dose. I then had monthly visits  for 2 months and tests each visit. After 2 months he upped the dose again, then after another 1 month, my T level had dropped to 0.9 so he then said I could add another dose, but as I was about to travel to the UK, he said make sure about getting retested after 1 month, because of the possibility of blood clots.

He also gave me 4 months supply of my Progynova E.

Basically he reckoned that with the final doubling of my dose he believed my T levels would probably drop to under 0.2 leaving Oestrogen as the dominant hormone in my body

But I decided to stick with my existing dose for the 3 months I was overseas. Now that I am back I plan to increase it in September, but get tested again then, although I have enough prescriptions on the existing dasge to last till end November (or end September if I increase it).

Interestingly on my last visit in May before I went oversas both my Therapist and Doctor stared that they thought I well adjusted now and didn't need monthly visits , suggesting that a visit once 3 months was all that was needed.

Judith

My endo said every 3 months was the standard until the dose had been stable *and* all test results normal for at least a year, then every 6 months. (I'm thinking that now, post-GRS and over a year on the same post-op dose, I may ask whether yearly is possible.)

Like others, I had a bad reaction to starting HRT that it took an experienced endo to cope with. Quite frankly, a doctor who started me off on the "super-safe" low end of a traditional dose range and didn't know how to monitor properly could have killed me...

Quote from: Katie on August 10, 2013, 11:01:55 PM
Yes the doctor has no training and hence the reason I pointed out that the smart person can get off the internet data that was written by doctors and take that info to any doctor and that will train them. This is not rocket science here.

Another not so well known tidbit here. A doctor does not want to give you a script for hormones..... a simple response to him that you have the hormones and will take them yourself will usually get the job done. See in most places when a doctor finds out you are going to do it they are then compelled to care for you because letting you do it on your own is medically neglegent vs. him taking care of you.

Ohhhh the experience of the post op girls is so special.

I'm sure you don't mean to sound so patronising, but for your information i was happy to provide her with a copy of our national healthcare systems guidelines for Transgender care, as well as supporting documentation that my gender therapist offered to pass on to her for further reference material.
The fact of the matter is, she knows i take hormones already, she knows there is material available that she can obtain and she flat out refuses to continue any sort of dialogue on the matter and insists on a referral to a specialist - which to date she has not suggested or found a single on.

Yes i very much believe that makes her negligent and she damn well knows it.

I think we realize that there are differences in the standards and practice of health care in various nations, and those standards vary with local regulation and customs.

Personally, I think it is unconscionable for a physician to withhold proper treatment without good cause.