Thanks, Allie.

That could be an indication that you are a fast metabolizer. It doesn't apply to everything. My statins have kept my cholesterol exactly on target for years.

The way it was explained to me is that it is a genetic thing. Some people's metabolism will process certain types of drugs faster than others. It has to do with the molecular structure of the drug. So even within a class of drugs, like painkillers or statins, one formulation might work where another does not.

This could also be true of estradiol. For me pills didn't work so we went with patches. Those didn't work so we are trying injections. Each is a slightly different formulation.

I hope you find the one that works for you.

Quote from: LoriDee on July 13, 2024, 11:53:28 PMThanks, Allie.

That could be an indication that you are a fast metabolizer. It doesn't apply to everything. My statins have kept my cholesterol exactly on target for years.

The way it was explained to me is that it is a genetic thing. Some people's metabolism will process certain types of drugs faster than others. It has to do with the molecular structure of the drug. So even within a class of drugs, like painkillers or statins, one formulation might work where another does not.

This could also be true of estradiol. For me pills didn't work so we went with patches. Those didn't work so we are trying injections. Each is a slightly different formulation.

I hope you find the one that works for you.

Makes sense. We will see what Endo thinks on Tuesday! 🤞

BTW, I took statins from my cholesterol for years as well... that was one of the major advantages of weight loss. Was able to ditch that and my numbers have maintained good all on their own.  So one fewer pill to take! Hizzah!

Quote from: imallie on July 13, 2024, 09:25:41 PMIt was 99 in January, 66 in May, and 51 today.

Allie,

Since I am 70 and have a family history of strokes, the level you have is what my endo wants to see. Last test was 62. He always reminds me that level or lower is what most 70-year-old women have.

Ellen

Quote from: EllenW on July 14, 2024, 10:52:14 AMAllie,

Since I am 70 and have a family history of strokes, the level you have is what my endo wants to see. Last test was 62. He always reminds me that level or lower is what most 70-year-old women have.

Ellen

Interesting Ellen. I'm 58, and my end has told me we're aiming for more like 150-200, I thought. But I honestly could be wrong. I know when I was at 99 she thought it was good progress but we weren't there yet.

So I will be interested to hear what she says and her strategies on Tuesday.

The key to remember about this is where you are in transition. If you are post-op and post-menopause age, then yes less than 100 is appropriate. But as I pointed out to my doctor, I am not post-menopause. I am a 66-year-old trying to get through puberty, so 150 - 250 is appropriate.

Results are given in picograms per milliliter (pg/mL). Normal levels for estradiol are:

30 to 400 pg/mL for premenopausal women
0 to 30 pg/mL for postmenopausal women
10 to 50 pg/mL for men

University of Rochester Medical Center

Quote from: LoriDee on July 14, 2024, 03:17:56 PMThe key to remember about this is where you are in transition. If you are post-op and post-menopause age, then yes less than 100 is appropriate. But as I pointed out to my doctor, I am not post-menopause. I am a 66-year-old trying to get through puberty, so 150 - 250 is appropriate.

Results are given in picograms per milliliter (pg/mL). Normal levels for estradiol are:

30 to 400 pg/mL for premenopausal women
0 to 30 pg/mL for postmenopausal women
10 to 50 pg/mL for men

University of Rochester Medical Center

As mentioned, I do believe the 150-200 was what my endo had previously mentioned as my target. But we'll see what she says. That's Tuesday's agenda.

Tomorrow is my "beauty lesson" at Sephora so that is top of the agenda for now.

I told my wife I know she has a busy day at work tomorrow, but to please make a few minutes available to laugh at the clown photos I send her around lunch time. 

Regardless, should be an experience and I always look forward to new experiences!

QuoteI told my wife I know she has a busy day at work tomorrow, but to please make a few minutes available to laugh at the clown photos I send her around lunch time.

I think makeup is best applied with a trowel when one is young. When we're old, as you and I are, Allie, less is best, but I think you already know this. Here's hoping the makeup artist knows this too.

Quote from: Oldandcreaky on July 15, 2024, 02:27:07 AMI think makeup is best applied with a trowel when one is young. When we're old, as you and I are, Allie, less is best, but I think you already know this. Here's hoping the makeup artist knows this too.

100%. But it should be an interesting experience. Plus, as a language geek, I've always wondered what the etymology of the idiom "lipstick on a pig" really was? Perhaps this morning since I am the perfect volunteer for that experiment... I will find out... 🐷🤡😂

Ok, so things I learned in my Sephora makeup session...

I am a fair-light complexion with warm undertones. (People have long said that about me, but I've never really believed them)

Apparently I have perfect cheekbones.

My face is quite symmetrical, with my eyes being perfectly spaced on my face (fun fact - if you tell someone that information, they will then stare intently into a mirror and obsess over it until it gets weird. Better NOT to tell someone that.)

I learned I have quite a talent for makeup application, as the makeup artist (Kelci ... spelled, just like that..) told me that no one has ever picked up all the techniques as quickly as I have.  Techniques which I possible will, but 100% will not, EVER do again in my life.

Oh and I learned that I look pretty good with the totality of all this stuff on my face... which means my only choice is to never again wash my face for the rest of my life, or concede that right now is the best I will ever look and it's all down hill going forward. I choose the latter.


But again, I will likely keep trying the lip stuff on a daily basis.  So a worthwhile way to spend an hour and $175 ($75 for the session, $50-60 for the makeup and a $30 tip).

Very nice!

With warm undertones, you will look better with gold jewelry than with silver. I am more "porcelain" skin tone, so silver looks better on me. It's always fun to experiment with this stuff.

My standards are so low that if I brush my hair, people tell me I look great.

Today, as it turned out, was a pretty momentous day. NOT because of the makeover thing. Although I do think that lit the fuse. No, because I had an epiphany. And one that was a long-time coming.

I am going to violate one of my own rules here in writing about it this evening. You see, I explained it to my wife this evening, and although it's crystal clear in my mind, I'm not sure I've yet found the way to properly articulate it. I would always tell people that if you can't properly articulate your argument, then it's not REALLY clear in your head. I stand by that. But I also believe in "fake it til you make it" so we'll see how this goes...

I know many MANY times in the past I've written about going out and having people treat me as the woman I am, and having my wife tell me that it's quite obvious that I'm seen by everyone as a woman... and yet I don't believe it. I would claim that "people are just being nice to me."

What I have realized is that, in those moments, there was someone who was having trouble seeing me as a woman -- me. My doubt prohibited me from believing that others could see me that way. It was the same reason why if 100 people said something nice about me and one person said something somewhat insulting... it wasn't that the latter hurt, it was that I BELIEVED the latter and dismissed the former.

Well lately I've started to feel really good about myself. And all I see is myself in the mirror. And you know what, when we go out, every single time I've been in public, if it has been someone did not know me as a male, I've been treated 100% as a female. No looks, no glances, nothing.

Now here's the epiphany. It is 100% impossible to know what someone else is thinking unless they tell you. Can't be done. So in all those instances, there are two possibilities: 1) as most people in my life are telling me, I'm being treated like a woman because I'm seen as a woman, or 2) people see me as a trans person, and are humoring me.

Believing 1) validates my world-view and makes me feel good about myself. Believing 2) gives into the old doubts, and self-hatred and makes me feel bad about myself.

And since, as mentioned, without asking these people there is no way to know which is actually true? Why on earth would I choose to believe 2)? Because from this day forward, I'm a 1) girl, all the way.

As I've started feeling better about myself I am giving myself permission to push back when people say negative things to me. Not because they bother me, because words really don't, but because I'm simply tired of acknowledging criticism through silence. That was the old me. Not this girl.

-------------

I put this into action tonight with... hmmmm... somewhat mixed results. But no, only 'mixed' because I feel guilty for some reason. I'm glad I did what I did. 

Driving home from Sephora today I was talking to the youngest of my older sisters. I talk to her multiple times a week. She is supportive, but... she says things that are often ignorant and/or mean in ways I think she doesn't understand. So I give her a pass. Always.

Well she asked for a pic and I sent her one, and she said it looked nice... but then was asking questions about the makeup artist. I told her a funny story: The makeup artist was shocked that I'd never worn makeup in my "entire life"...so I had to explain to her that my "entire life" was like three weeks, and that I was trans. To this girl, in her 20s, it was like me saying I was Presbyterian...I mean, so ho hum.  But it explained things.

But when I told my sister that she didn't know, her response was "Really? No way!" As in... how is that even possible.

At the time, I laughed and said nothing.

Later, I updated my FB profile pic and people have been posting all these nice comments about how beautiful I look and other ridiculous (but appreciated!) exaggerations. Still, my sister saw these and texted me to laugh about someone said "beautiful smile, and amazing teeth"

I was like...well, I do have a really nice smile, and my teeth are nice so... not sure what's funny?

She said she didn't mean to offend.

I said I wasn't offended.. and if I WERE going to be offended, it would have been when she said "Really?" earlier.

And that set things off.

I told her words don't hurt me, and I was mostly teasing her (that was the old me, deflecting) and she said she's "still learning and trying to do better"... which I told her I love and appreciate.  And then I spent a while trying to make HER feel better.

But in the end, I think... I hope... I at least got my point across. As I said to her:

"When I used to feel bad about myself, when someone said something a bit cruel, I took it because I believed it. But now that I feel good about myself I'm simply not going to take it any more because I don't deserve it. Sorry you got caught in the shrapnel, I'm still learning how to aim this thing."

 

I'm glad that you have had that epiphany. It is healthy.

When I was going to school to get certified in hypnotherapy, our instructor warned us that we always have two choices: 1. Feel good about something, or 2. Feel bad about something. Both take exactly the same amount of effort, so why choose option 2?

Since then, I have modified my worldview to incorporate this. It takes the same amount of effort to be optimistic/happy as it does to be pessimistic/unhappy. I always choose positive and happy. It isn't always easy, but it is a choice I try to live by.

The "old boys" (well they both served in 2nd WW) that I started work with said " you die if you worry, you die if you don't so why worry" . Works for me, I get sharp with folk that miss gender me now but that is very rare apart from the phone. Clues in the name you numpty!!

Had a good visit with Endo this morning. She was baffled by the dropping estradiol numbers. She confirmed she'd like me to be in the 150-200 range, and expected me to be there by now. So she's moving me a twice weekly patch system (same dosage)to see if that will kick things up. Sounds like a plan.

I asked her about the letter I need to get my gender marker changed by Social Security... she was unfamiliar with it (I would have thought she'd have done them before)... but she said that she'd do anything I need, just send it. Luckily I have seen plenty of form letters, so I can just send a long a "mad libs" style of the letter... except I'll give her all the non-wacky answers to use..

We also talked surgeries.

When I broached the subject she cut me off and said "you do not need any facial surgery! You look amazing!" Which... was really nice to hear. I told her I agreed with her. Well, with the last part anyway. I'm skipping that and going right to the bottom, such as it is.

We both agree that we need to give hormones more time to work on my chest, especially since the levels are still low. I'm on board (no pun intended) with that.

But as for bottom surgery, she did say that she believed that the state required TWO letters from mental health professionals. I thought the way I read it, a letter from my therapist and one from her would suffice. But she said she writes a letter of support.. but she believes a second therapist is needed.

I really have no idea how that is accomplished. Seems foolish. I will ask my therapist, but I think I want to confirm that first.

Love,
Allie

Here are some sample letters and an explanation of what is needed in the letter.

Surgery Letters

Each state has its own rules, as do each insurance company. For bottom surgery, it is usually two letters. One must be from a mental health professional and the other can be from any clinician that has treated you as a patient (Primary Care, Endo, etc,).

Allie,

My insurance company and the surgeon I selected required both letters to be from mental health professionals. I was lucky that my therapist had a partner that wrote the "2nd opinion letter" for her on a regular basis. So, it was just one tele-health session to get my second letter.

Ellen

Quote from: EllenW on July 16, 2024, 09:55:13 AMAllie,

My insurance company and the surgeon I selected required both letters to be from mental health professionals. I was lucky that my therapist had a partner that wrote the "2nd opinion letter" for her on a regular basis. So, it was just one tele-health session to get my second letter.

Ellen

Yeah Endo seemed to think that was the state rules here.  I will ask my therapist what she thinks. Wonder if it's possible to use either my sister or niece, therapists both, but also both have different last names.

Hey Allie- Not all states have requirements. My plan required one letter. My surgeons wanted two. The surgeons made it clear that they'd been burned so many times by insurance companies changing the rules it was simpler to require a second letter. My nurse-liaison made it clear she lost that fight.

I can tell you where I got both my therapy letters, DM me if you want a name.

makes perfect sense, right? its health care.

~Jenn

Whew. Today was an exhausting day.

The least egocentric part is that my middle sister texted us from the ER. She apparently had an episode of amnesia (we don't know the details yet) and while the doctors were trying to get to the bottom of that they found that she'd suffered a TIA (a mini-stroke) and had another vascular issue. Neither were symptomatic so in some ways the amnesia was "helpful" but the two things together are terrifying and she was also the age my mom was when she had her stroke... so.. you know, I'm sure she's freaking out. We're letting her rest but beyond texting hopefully we can talk to her tomorrow.

Ok, the more egocentric part.

After that little kerfuffle with my youngest sister yesterday, we ended up speaking today for over an hour. I guess it was good. Cleared the air, somewhat. She asked me to tell her things, and I did... and it was "making her feel bad"... which, you know, is a bit ridiculous as ... well, I shouldn't have to explain that.  But even so, I was trying to make HER feel better, but still not telling her the things she has said were ok. Just that I understand she didn't mean anything by them, but that doesn't make them great and going forward I'm going to tell her when it happens.

She asked about her family and their reaction to me. Her sons are the only two nephews and nieces on my side of the family (out of nine) that didn't contact me when I came out. The rest did, all within like 48 hours. Some with emails, some with long texts, others with just brief, "I love you" texts. But all something. But not her sons. She said it shouldn't bother me because "it's just their way" and they are supportive.

I said every time I'm in her house Fox News is on, and you start connecting dots. She said that wasn't fair and that she walks out of the room when her husband is watching and "there's no trans stuff on there, just politics."

Old me might have let that go. I simply told her to watch for 10 minutes at any point of any day and see if she still feels that way.

Regardless I told her that I don't have a problem with the boys, but she asked how I felt at the time, and I told her. It went on like that.  I think overall... it opened her eyes some.  We will see.

Then, as if that wasn't enough... I spoke to my oldest sister for ANOTHER hour. While I speak to that first sister multiple times a week, I probably speak to my oldest sister monthly? Our text chain is active daily so we're always in touch..we just don't talk, but with my other sister in the hospital we started to chat... and we talked about me.. and she had some concerns (mostly she was afraid she would misgender at times, as she knows she does it when talking about me to my other sisters -- and I told her I know that's going to happen and just do your best but don't worry about it. Just keep trying). She's good. I'm having lunch with one of her sons on Thursday. It was just so much phone time for me when my migraine was in full bloom... after already being out at an Endo appointment.

And then the cherry on top of this day?

We got a bathroom renovation quote from our builder who did our home renovation 10 years ago. We love him. He does amazing work. He's a bit pricey, maybe. We spent like $100k for our kithen/family room/dining room open concept thing which is like 1,200 sq feet... plus a whole bunch of other stuff. It was worth every penny.

So... imagine our surprise when the quote for two bathrooms ... came in at $150k. Yeah... that's right.

But here's the thing. We had a kitchen cabinet drawer that was broken. He came over and took it, and said he would fix it for us. So we already know we aren't going with him (but haven't told him yet). Well today he called and said he had the drawer and came over... and it ended up being really complicated to fix and I felt TERRIBLE watching him sweat in this heat trying to fix it. He's the owner of this company so it's not normally the stuff he does.. so it was awfully nice of him.

And the whole time I was like "Oh yeah, we're just waiting for our real estate agent to get back from vacation to look over the quotes and give us her feedback and we'll let you know."

She gave her feedback last night. It was three words. "Who charges that?" 

I am SO looking forward to the peace and tranquillity of 60-90 minutes of electrolysis tomorrow morning, I cannot begin to tell you...

Love,
Allie