I had two appointments with my VA doctors today.

I specifically asked my Gynecologist about the VA's policy on allowing us to stockpile medications. She said that the VA does not allow it.

For opioid pain medications, the amount you can legally have on hand is limited by federal law, even if you have a prescription.

I asked if it was possible to have a one-time supplemental shipment of a six-month supply while continuing to receive my 90-day refills. That is not allowed.

However, prescribers are allowed to fill all prescriptions for the purpose of a vacation. For example, if you were going on vacation to tour the country for a month, they can refill a one-month supply for that vacation. When I asked if they would do that for a six-month vacation, the answer was no, that is not a vacation but a temporary change of residence.

My next question was, if I travel to Thailand for surgery and the laws changed while I was gone so that my re-entry to the US became delayed, will the VA Pharmacy ship my meds to me internationally. Again, no.

She agreed that it is important for us to make sure that our prescription labels do not say "FOR GENDER TRANSITION". Instead, they should read: "FOR HORMONE REPLACEMENT". That way, if Gender Affirming Care is defunded as promised, your medications can continue uninterrupted.

I also asked about getting surgery recommendation letters. If government policy changes to disavow "gender ideology" then it would be important to get those letters now while we can. She disagreed with me. She said there is "ZERO CHANCE" of that happening. First, because (as we all know) the VA is extremely slow to change policies. Second, she said no law, regulation, or policy can prevent her from writing a letter. We will talk about it again later when it is closer to the time that I need to have one to send to a surgeon.

Before I moved to the UK my doctor and I discussed the fact that I might face significant delays in getting my HRT prescriptions there. I  suggested that  we "double" my dosage on paper, and she said  "Great idea!" and wrote a one year prescription. So that gave me a two year supply. She added a note saying I'd be paying out of pocket so I wouldn't get any friction from the insurance company. I ended up going through TSA with a giant bottle of estradiol tablets, no issue at all...which surprised the heck out of me.

Hugs, Devlyn

Quote from: Devlyn on December 09, 2024, 03:12:14 PMI ended up going through TSA with a giant bottle of estradiol tablets, no issue at all...which surprised the heck out of me.

My fear is trying to get past them with a suitcase full of syringes. 

Here's what that looked like. 

Quote from: Devlyn on December 09, 2024, 03:17:02 PMHere's what that looked like. 

Holy Moly! That's huge.

I have never seen a Rx bottle that big. A 2-year supply is what 700 or so tablets?

I don't want to give my dosage,  but between the old prescription and the new one there were over 1,500 pills in that bottle.

Quote from: Devlyn on December 09, 2024, 03:30:29 PMI don't want to give my dosage,  but between the old prescription and the new one there were over 1,500 pills in that bottle.

D's Portable Pharmacy. 

That's good to know that you got through without issues. I would not expect them to mess with prescriptions that are clearly labeled.

My concern is that the TSA, Immigration & Customs, and Border Security will be run by Kristi Noem.
< epic facepalm >

Apparently I have refilled my estrogen as much as I can already. Lol. On my health vet it says active refill in process, but the little side note pretty much said I have made too many refills in a short amount of time, that they will refill the last requests when it finally gets past their specific time in between refills.

And as for my prescriptions saying for gender affirming care, my Dr said there's no need to change anything yet we are monitoring the situation closely and if and when the time comes we can change the reason for your prescriptions then, to say for hormone replacement therapy.

Quote from: Robbyv213 on December 09, 2024, 05:18:43 PMAnd as for my prescriptions saying for gender affirming care, my Dr said there's no need to change anything yet we are monitoring the situation closely and if and when the time comes we can change the reason for your prescriptions then, to say for hormone replacement therapy.

That sounds like typical government double-speak. Why not do it now? What are they waiting for?

I think I know the answer. In my case, they did not change the labels until after my Endocrinologist gave me a letter to change the gender marker on my IDs. It is just a VA Form Letter that says I was her patient and that I have completed appropriate clinical treatment for the transition from male to female. After that, the labels were changed without me asking.

Perhaps there is some secret rule that you must be on hormones or other treatment for X amount of time to qualify for the letter, then since you have "completed appropriate clinical treatment" they can update your records. Then the prescription labels will need to match the records. Since you are just getting started, it might be too early. At least they know that it is a concern of yours.

At the dosage I was given, my vial of EV will last 20 weeks, but the VA has been allowing me to refill monthly, so I have been.  Same with the Spiro they prescribed, it would last 2 months, but I am refilling monthly also.

I checked the TSA website about traveling with medications.

There is no limit to how much you can take with you onboard or in checked baggage. Liquid medications will need extra screening, so they should be declared at the security checkpoint. It goes smoother if everything is in the original bottles and properly labeled, but there is no requirement.

Source - TSA

Quote from: Avign0n254 on December 10, 2024, 09:01:40 AMAt the dosage I was given, my vial of EV will last 20 weeks, but the VA has been allowing me to refill monthly, so I have been.  Same with the Spiro they prescribed, it would last 2 months, but I am refilling monthly also.

I did the same for both my Spiro and ev, now my health vet says refills in progress and have been pending approval for a few weeks now. I have 0 refills left but I had been having them refill them every few weeks to once a month at the minimum before I even started taking the medication.

My next appointment is set for early March. 3 months.

Hi Everyone

Quote from: Lori Dee on December 09, 2024, 02:53:44 PMI also asked about getting surgery recommendation letters. If government policy changes to disavow "gender ideology" then it would be important to get those letters now while we can. She disagreed with me. She said there is "ZERO CHANCE" of that happening. First, because (as we all know) the VA is extremely slow to change policies. Second, she said no law, regulation, or policy can prevent her from writing a letter. We will talk about it again later when it is closer to the time that I need to have one to send to a surgeon.

What I have highlighted in Red is absolutely and categorically TRUE.  First Amendment comes into play here.

Best Wishes Always
Sarah B
Global Moderator

Hi Everyone

Quote from: Sarah B on December 10, 2024, 03:19:03 PM[What I have highlighted in Red is absolutely and categorically TRUE.  First Amendment comes into play here.

This is the reasoning behind why first amendment applies in the case of writing the surgery letter and supports what I said in my previous post on this issue:

Phil Zimmermann developed Pretty Good Privacy (PGP) in 1991 to enable secure digital communication. Its export from the U.S. faced scrutiny under laws treating strong encryption as a munition, potentially exposing Zimmermann to legal action.  He printed out the source code into a book and sent it free onto the world.

While his case never reached trial, broader encryption related legal issues emerged, particularly regarding the First Amendment.  Key rulings from federal appeals courts affirmed that cryptographic software source code is protected as free speech:

• Bernstein v. U.S. Department of State (Ninth Circuit, 1999): Ruled that encryption code is a form of expression protected by the First Amendment.
• Junger v. Daley (Sixth Circuit, 2000): Reinforced this principle, supporting the right to publish encryption-related materials.

These decisions, though not directly involving PGP, set a precedent for safeguarding encryption software as speech, shaping the legal landscape for cryptography and enabling its broader use.

Gotta love the First Amendment

Best Wishes Always
Sarah B
Global Moderator

Quote from: Devlyn on December 09, 2024, 03:30:29 PMI don't want to give my dosage,  but between the old prescription and the new one there were over 1,500 pills in that bottle.

Holy moly. 

Chrissy

I get refills every 90 days.  It is not cheaper than three 30 day supplies but it is nice to have them on hand and not have to bother with getting them every month.

A longer term prescription should be able to be dispensed into shorter term lots by the pharmacy.  That is, if your MD writes you a 90 day prescription you can choose to have it initially filled as a 30 day supply if you want.  Then get the remaining later.

But a 30 day prescription, even with refills allowed, those cannot be bulked up.  That is, you can only get 30 days at a time.

That is what a pharmacist told me and that may not apply in your country or area.

Chrissy

Quote from: Lori Dee on December 09, 2024, 02:53:44 PMShe agreed that it is important for us to make sure that our prescription labels do not say "FOR GENDER TRANSITION". Instead, they should read: "FOR HORMONE REPLACEMENT". That way, if Gender Affirming Care is defunded as promised, your medications can continue uninterrupted.

I spoke with my Doctor yesterday baout this, and I was assured that my records all State Hormone Deficiency

I spoke to my doctor as well, specifically asking how Executive Orders will affect VA policies regarding how my medications are prescribed. I expressed concern that the push to only recognize sex at birth and the defunding of gender-affirming care could jeopardize my ability to receive medications from the VA (a Federal Agency within the Executive Branch).

She assured me that until I receive care elsewhere, this VA clinic is my primary healthcare provider. As such, since I am already on medications, those medications will not stop.

I think it might become more difficult for people just getting started under future policies. However, trans people have found supportive medical providers for decades. We can continue to do so into the future.