Quote from: Michelle_P on December 06, 2016, 03:44:11 PM
Ah, there's always something...

I've got another quarterly check coming up, a telephone appointment with my endocrinologist on Thursday.  I just did labs for this, and the results are coming in...

Estradiol: <50 pg/mL

Oh, for goddess's sake.  Six months in and I still haven't moved the needle off the peg.  I know I'm getting SOMETHING in me, as the roller coaster ride from one biweekly patch a week ended when I got to do them properly, two biweekly a week, or one every 3.5 days.  I've got growth where I want it, and a tiny change in waist and hips.

Of course, now I think I'm missing something.  Moar E, pleeze!

I dunno.  Double patches, maybe?  I've no trouble keeping them in contact and avoiding lifting. They're expensive, though.  Or should I bite the bullet and move to injections?  Alas, I hate needles.  Nasssty pointy things, they hurts us, they does!  The HMO injection center is a 10 minute walk, but I'm sure they'd rather have me be a DIY injection hobbyist. 

Yeah, yeah.  "Go on, take it like a man!"    

Not a big deal.  Annoying at worst.  I'll hash this out with my endo on Thursday.

Hi Michelle

I am on an E implant so don't have your issues in regards to E. However I have had chronic pain for many years and at one point I was on patches for about 3 years...just before they gave me this rather expensive plumbing to take care of my pain meds.

Whilst on the patches I noted they had a lead in and lead out time when getting up to strength. I understand that within a couple of hours and they should be delivering a the right amount. If the patch is not in direct unimpeded contact with the skin then the absorption cannot happen at the correct rate.

I used to stagger my patches...day one put on a new 3 day patch on one arm and the next day place another one on the other arm, the next day remove and replace. Essentially the 24 hrs before the patch is due for replacement is when the second one goes on. This will stop the ups and downs and keep the delivery at a more even level. Its appears odd and the drug authority got all bent out of shape until they conceded that my levels of medication were not actually any higher than intended just at a more constant even level.

I hope that I explained that well enough. It took heaps of trial and error to make the patches work for me and I tried several brands at differing strengths and they all had the same lead in and lead out time. The manufacturers claim the amount should always be constant...but that is under ideal conditions.

Hugs

Liz 

Thanks, Liz.  Yeah, the 'roller coaster' ride the patch delivery has is familiar.  I had the blood draw at the 60 hour point on an 84 hour (biweekly) patch, and double-checked the thing for proper adhesion when I swapped patches out the next day.  It had definitely been in place properly.

I'll just add that this particular brand has been... problematic... for others.  In theory, if I were a post-menopausal ciswoman I should have gotten a reading of 80-110 from the vendor's puff sheet.  As a transwoman I think that would land me in the 50-80 range, not really a transition level anyway. Add in the error bands for the estradiol lab test, and I could easily be running 50-60 right now.  Doubling the patches seems like one possible reasonable solution.  We'll see what happens Thursday.

Granted it's hard for me to be objective, I grew up on a farm where we did Im injections for animals as needed and have worked in medical devices for many years.

That said, giving injections is pretty easy, before I had to do this I did my own acupuncture with good results, just copying what the therapist had done.

The key, I find is simply remembering to relax the muscles. I go I'm my quad, same spot every time and sitting to ensure muscles don't twitch. Glutes is also doable but harder to see if you're doing your own.

The patch concept was never one I wanted.

I'm with Sadie, Michelle. I'm 58, had high T when I started, after 3 months my tests revealed 15/t and 300/e. We've all watched you invest so much in this process.  If you're going to do this thing.....do it!


In for a penny, in for a pound and all that colloquial nonsense!

Ow!  Now, why oh why did I wonder what others would say?

[emoji79]

I suppose syringes and vials of The Juice are in my future. I'd better get an incredible figure out of all this.  I'll post the result Thursday evening.


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Doing your own injections is really no big deal.  I was nervous about it at first too, since I also hate needles.  But after doing it several dozen times, you get used to it.

Think of it this way.  How many people in the world need to do regular insulin injections for diabetes?  It's completely normal to self-inject your own medications.

Quote from: Michelle_P on December 06, 2016, 05:54:44 PM
Ow!  Now, why oh why did I wonder what others would say?

[emoji79]

I suppose syringes and vials of The Juice are in my future. I'd better get an incredible figure out of all this.  I'll post the result Thursday evening.


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Tanner V in 11 months, breasts are still growing and the prospect of being pretty is motivating me to get back to working out more consistently.

Quote from: SadieBlake on December 07, 2016, 04:08:36 AM
Tanner V in 11 months, breasts are still growing and the prospect of being pretty is motivating me to get back to working out more consistently.

I  was just being a little snarky, a bad habit of mine I have to watch better.

Tanner V in under a year?  Damn, girl!  Good genes and rocket fuel in a bottle!

Yeah, a shot at being pretty could be a real motivator. Wow!  Go for it!

I'll settle for not looking like someone's grandma [emoji70] for a few more years. Pesky late bloomer. I should have done this 30 years ago.  I'll know better next time...



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I didn't take that for snark, looking feminine is important to me. If I can't pass, I can at least have that.

And yes, I'm still  barely on the large side of an A cup but with a filled out shape and will be happiest if another year or so hence I could be at a B cup size.

I think I mentioned elsewhere that over the weekend I updated my LinkedIn page.  For months it had no picture, and just the initial 'M' for the first name.  I put up my avatar picture there and my full first name.  That kicked up page views 600%.  Then, last night, I put up my 'coming out' letter, "Dear friends; For many years..." as an article, public, and appearing in the streams of my 120 or so connections.

I have four younger brothers, whom I haven't heard from in many years.  One of them is connected to me on LinkedIn...

He saw the update, and was wondering who this Michelle was.  Same workplaces as his older brother had, and... submarine service?  Hey...  He messaged me asking if I had four younger brothers that he named.   

"Yup, that would be me.  Hey, you know how you get bored in retirement and look for something new to try?"

"You changed your hair."

"Yeah, that and a few other bits..."

"Give me a call at xxxxxxxxxxx"

So, we had a nice phone call.  He's very accepting of the whole thing.  (I thought he might be.  Pretty mellow person, really.)  I have some other relatives on LinkedIn, cousins and nephews.  It'll be interesting to see if this prompts a connection of some sort.

All in all, a nice result from poking the universe again.

Later...

My brother forwarded the post of the image of my old name tag to his son, my nephew, with no other clues.  So, he gets a post from Michelle P with a name tag for Mike P.     Naturally, he recognized the name tag name, and clicked through.  My phone rang while I was in the shower, so I called him back...

"Hi (nephew).  This is your Aunt Michelle calling."    (I'm having way too much fun with this.)

We talked for about 30 minutes.  It turns out he's totally accepting.  One off his wives (plural) sisters has a spouse transitioning MtF who has surgery scheduled in San Francisco this summer.  He's been totally supportive of her, defending her to the snarky and rather pushy mother-in-law.  Pretty neat!  I may get together with some of the extended family when they are here.

My old family is more accepting than I knew.

Quote from: Michelle_P on December 07, 2016, 11:04:55 AM
I
"Yup, that would be me.  Hey, you know how you get bored in retirement and look for something new to try?"

"You changed your hair."

"Yeah, that and a few other bits..."

I had to laugh when I read this part...yep you have changed your hair....do you reckon he will miss the other changes...like the smiling happy woman in front of him 

Liz

Michelle, I am happy your family is accepting.

Quote from: Rachel Lynn on December 07, 2016, 05:46:09 PM
Michelle, I am happy your family is accepting.

Yeah, it's pretty neat.  These are folks I haven't see in years.  Some of that was on their side, of course, but wife-departing didn't much care for them either.  Not college grads, engaged in (horrors) menial jobs; chef, sewage treatment plant operator, etc.   

I'll probably see them more often now.

My older daughter is flying in for a visit tomorrow.  My current plans are for dinner with her after my endocrinologist phone appointment.  My younger daughter, the one very attached to wife-departing, misses me, and was talking about getting together with me for a movie night, where we watch and mock an old film, RiffTrax style.  That's a change in attitude for her.  She brought it up immediately after she heard about the dinner plans with her sister.

So, yeah, family life is improving.

I've got a different issue rearing it's head now.  My 2000 Miata is starting to flake out a bit, and I don't have my shop space to work on it any more.  To be honest, I'm sort of losing interest in the manly art of wrenching on vehicles.  My therapist pointed out the risks of a breakdown while being me.  That nice man that stops to help might decide the lug nuts are not the best place to apply a tire iron once he gets closer and hears my voice.      I may have to go shopping for a more appropriate vehicle.     There's an expense coming up that wasn't in the budget.

Step right up!  It's the Real Life Experience!  Hoo boy...

The other option is a auto club membership. So far I have had to used it once when the intake manifold water jacket burst open due to a manufacturing defect. Otherwise, I change my own tires.

Quote from: Dena on December 07, 2016, 09:47:26 PM
The other option is a auto club membership. So far I have had to used it once when the intake manifold water jacket burst open due to a manufacturing defect. Otherwise, I change my own tires.

I have that.  Alas, there's still a big risk in being a woman (trans) on the side of the highway waiting for the auto club truck.  There have even been cases where the driver was the danger, although to be fair, the tow driver is more often the one assaulted in our urban areas.

I'll have to see how the finances shake out.  Long term, a more practical vehicle is the right thing to get.

OK, I had my phone meeting with the endocrinologist.  She wants to take it slow, because of my age and a personal risk related to clotting.  My specific issues make injections something to avoid.  A reason to avoid nassty pointy things other than my being chicken...

So, with that, we're going to try doubling up on patches for a few months. Then, we'll test again and see what happens.

My wallet says "Ouch", as these things are about US $10 each patch, or $40 a week now (until I hit my Max Out Of Pocket in 2017). Estradiol valerate IM would be much cheaper.  Oh, well.  There's always going off the formulary and trying sublingual estradiol (not in the Kaiser formulary).  I'd have to pay for that, too, but it would be much cheaper.

It will be interesting to see if I can sense any change from this.

In pill form, estradiol should cost $40 for a 6 month transition dosage. The pain is holding the pill in your mouth long enough for it to do it's thing however it's giving me achy breasts at half the transition dosage so it's doing something. About 4 more months tillI see my new levels.

Quote from: Michelle_P on December 08, 2016, 11:39:48 PM
OK, I had my phone meeting with the endocrinologist.  She wants to take it slow, because of my age and a personal risk related to clotting.  My specific issues make injections something to avoid.  A reason to avoid nassty pointy things other than my being chicken...

So, with that, we're going to try doubling up on patches for a few months. Then, we'll test again and see what happens.

My wallet says "Ouch", as these things are about US $10 each patch, or $40 a week now (until I hit my Max Out Of Pocket in 2017). Estradiol valerate IM would be much cheaper.  Oh, well.  There's always going off the formulary and trying sublingual estradiol (not in the Kaiser formulary).  I'd have to pay for that, too, but it would be much cheaper.

It will be interesting to see if I can sense any change from this.

Well at least you have something to try, In the end I used sports tape to ensure my medication patches stayed on my skin, I would not put on a new patch until I was able to clean the area thoroughly. It must make contact with the skin to be effective. When they get itchy try not to rub the patch as I know depending on brand that some patches when rubbed can increase the amount being delivered...it will say in the fine print brochure you get with them. Other than staggering them by 4- 12hrs(depending how long their time to get to full capacity is)  so you don't have both run out at the same time...probably less critical than say with narcotics.

Hope you start to see an improvement

Hugs
Liz

Thanks, Liz!

I was having a pretty good response before, so it will be interesting to see what happens now.

I started last night, with my cleaning and tape drill, a couple hours before bedtime.  I don't know if it is related, but I slept straight through the night and got nine hours of solid sleep. I can't remember the last time that happened. I usually am waking up multiple times at night and get maybe seven hours of sleep at most.

I sure hope it happens again.


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WOW that is so great...my sleep has improved out of site since being on HRT...maybe it was the added dose...lets hope so

Liz