Mattie- you just have to search around by calling. You might get lucky and find one in your area. Even if they end up being a little far, you only have to make the trip a few times a year, so not really that big of a deal. There is actually someone on the forums that flies from the UK to see my endo for treatment I know a big part for you is cost though, so I can understand why they would need to be close.

I'm happy to have sparked your interest If you can somehow manage it I can say with nearly 100% confidence you won't regret it!

god I want pellets now... I've been on the near maximum oral estradiol for so long now and my T levels still aren't dropping below low male levels

New doctor tomorrow, maybe he'll be able to refer me to an endo that can do it in St. Louis

Quote from: Evelyn K on April 30, 2014, 12:17:07 PM
Wow you nailed it. I find the medical establishment leans toward the apathetic side to our health interest, taking a too restrictively cautious and drawn out grace period wait and see approach to see if we'll change our minds during the course of what basically amounts to ineffectual starting treatments.

I would like to disagree on that.  In the world of health care, there are agreed/accepted standards of care.  These are supposedly supported by evidence based treatments and outcomes.  To go counter to that, is to invite major trouble should something go wrong.

We, as patients are often very pushy for treatment _our_ way, and when we get it _our_ way and it goes wrong, well, it's the treating doctors fault right?  They should know best, even if we insist differently right?  You can understand the reticence of the high level of caution (AKA CYA, cover-your-A**) that treating doctors go by, given the current medico-legal climate.  On the other hand, it does mean that a lot of stuffing around happens as a result of caution.

In other words, if you find health care providers overly cautious, blame the lawyers!! j/k

Quote from: Jennygirl on April 30, 2014, 09:42:21 PM

Lower doses last longer, so they are much much cheaper. Higher doses need to be replaced more frequently, so they are vastly more expensive.

You could probably compare a low dose of pellets (2-4 pellets) to a high dose of oral HRT in terms of feminization. With that few of pellets, you could likely go about 6 months in between implantations... Meaning as low as $150 every 6 months. A more moderate dose of 4 pellets would be $300 every 6 months or roughly $50 a month.

If my Dr is willing to offer pellets as an option at comparable prices I think it'll be a no-brainer for me! I'm wondering though, what kind of oral dose would 2-4 pellets be equivalent to?

Quote from: luna nyan on May 01, 2014, 06:17:11 AM
I would like to disagree on that.  In the world of health care, there are agreed/accepted standards of care.  These are supposedly supported by evidence based treatments and outcomes.  To go counter to that, is to invite major trouble should something go wrong.

We, as patients are often very pushy for treatment _our_ way, and when we get it _our_ way and it goes wrong, well, it's the treating doctors fault right?  They should know best, even if we insist differently right?  You can understand the reticence of the high level of caution (AKA CYA, cover-your-A**) that treating doctors go by, given the current medico-legal climate.  On the other hand, it does mean that a lot of stuffing around happens as a result of caution.

In other words, if you find health care providers overly cautious, blame the lawyers!! j/k

I get it with standards of care, thing is the medical establishment hasn't reached a consensus on -our- standard of care except for whats currently out there by the W.H.O. Not every doctor is following the W.H.O transsexual guidelines.

It's true however at least in the US the lawyers will ultimately dictate how slow or fast your treatments are going to go. The physicians are nothing but a proxy.

Given such, what Jennygirl said is right on and deserves a repost and highlight!

"I think the bottom line is, don't let endos push you around. If you don't think you're getting the care you deserve, don't just "take their word for it" and let them gatekeep you. There is a lot of BS methodology leftover from the old methods (or lack thereof really), so if you feel held back it might be time to find someone else who knows more / cares more about their transgender clients."

Wherever possible, make sure you get a 2d and 3rd opinion so your transition isn't pidgeonholed to some quack who isn't up-to-date themselves (or paranoid).

Though I won't see him again until the 1st week of June, I can contact my Endo through a special Web Portal he has setup for his patients for Q&A, Med Records & Bloodwork Analysis, Refills, etc. I'm going to ask him both about the pellets and shots. Anytime I can take less pills per day I'm a happy girl. And I'm becoming more and more concerned about my liver.

Ally

Jessika- we can't discuss oral dosages because it could lead to people using the information for self medicating.

On that note, I want to thank everyone for keeping oral dosage information out of this thread, y'all are some great posters!

Also I'm relieved to see that so many people see my point. Every time I hear of someone switching to pellets, I get the warm n fuzzies because I know how much happier and better off you will be. That in turn makes me happy too

Ever since I made my 1st and only mistake my 3rd day as a member Jennygirl I've been real careful about that, and I've even stopped a few newer members later on from making the same mistake. I'm very thankful for the info on the pellets. I didn't even know they existed until reading this thread. And of course anything I can do to make my transition more comfortable and effective I'm happy to do it. I just don't know yet if my Endo offers the pellets, or the shots. I just hate having to take so many pills per day so if I'm able to cut down on that and protect my liver at the same time sounds like a win win to me.

Ally

I started with my doctor giving me shots (hated it), then added the patch (hated it), then gave myself shots (hated it more), then gel (didn't like). The combo of Estro & Spiro have been my favorite. Now, pills and gel is too overwhelming for my system. I get my bloodwork at least once a year. So far so good. 

Quote from: Beyond on May 01, 2014, 02:46:37 AM
My injectable, that I get from a compounding pharmacy, only costs me about $125 a year including supplies (syringes, alcohol pads and band-aids).

OMG could you pm the details of this pharmacy. I have an appointment coming up with my doc super soon, definitely will talk to her about it! I have hope yay !!

Jennygirl: Could I get pellets from a compounding pharmacy??

There used to be two places in the US, but due to higher restrictions the one in Chicago doesn't do them anymore. So, we are left with the place in Colorado.. It's the same place as the document I linked earlier. I'm pretty sure this is where most endocrinologists (even internationally) get their pellets from!

HOORAY! sooo excited for my appointment now. Can't wait to talk to my doc about pellets. The cool thing is my docs do prescribe pellets but they don't offer it in estrogen. I feel kind of dumb now, since I just remembered they did recommend me a compounding pharmacy for shots but I never followed up on it.

Thanks for the info! HUGS! <3

Is there any difference to a doctor who does cis pellet therapy vs trans pellet therapy? Will most endo doctors who do ciswomen accommodate transwomen as well? I found a couple of doctors here who do pellet therapy here in the Houston area. Like this guy http://www.drstlaurent.com/hormone-replacement.html

Quote from: PrincessPatience on May 02, 2014, 12:23:31 PM
Is there any difference to a doctor who does cis pellet therapy vs trans pellet therapy? Will most endo doctors who do ciswomen accommodate transwomen as well? I found a couple of doctors here who do pellet therapy here in the Houston area. Like this guy http://www.drstlaurent.com/hormone-replacement.html

If I had to guess, I would think the main difference would be that they wouldn't necessarily know the right dosage or have experience with the higher doses necessary to feminize a body. They might not be comfortable with it, but it's definitely worth a shot! I think Dr. O'Dea recommends a minimum of 3 if I remember correctly.

Dr. O'Dea mentioned at some point that he had heard other endocrinologists in LA were afraid to prescribe more than 4 at a time. I am on the max he will give, which is 12 For cis females, the amount would be 1. I'm not sure what O'Dea's post op care is like, not quite there yet... but I'm working on it

Do not post links of pharmacies to get medication, that is against ToS and I shall impose penalties.

Cindy

Quote from: Jennygirl on May 03, 2014, 03:06:03 AM
Dr. O'Dea mentioned at some point that he had heard other endocrinologists in LA were afraid to prescribe more than 4 at a time. I am on the max he will give, which is 12

Do you think there's really any benefit from a dose that high? If what you said earlier was correct, twelve pellets would be four times as potent as a high dose oral regimen. I'm not an expert, but from what I understand, your body only has so many estrogen receptors, and at a certain point you would just saturate them so that any additional estrogen just wouldn't get used. Also, wouldn't a really high dose like that significantly increase your risk of breast cancer?