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ceri(This is a reworked version of what I posted to my original LiveJournal. A few of you will be seeing it twice.)
I'm back home from my initial appointment at Capitol Hill Medical. Wow did that go well. I liked the place and the practice—much higher standard of courtesy among patients and staff than I've become accustomed to, for starters, and the guy who examined me was just fantastic. And he knows two friends with porphyria, which let me save a lot of explaining.
The punch line is that I am as sick as I think, but not in quite all the ways I'd guessed. First off, my blood pressure has gone ghastly high. High enough that he said it was genuinely surprising to him that I haven't had a stroke. I've got a prescription for medication to start tomorrow. He also feels very sure I've developed diabetes, though he won't know for sure until the blood work comes back; I find out about that tomorrow. Beyond that, he said that they've found a strong correlation between too-low testosterone levels and some of my major symptoms of recent years, including the worse-than-usual weight gain and mood loss. Again, test results pending (and I've got a follow-up visit for a week from Friday).
The hormone stuff in particular is going to be a pain. He was upfront about it, saying, "We have a problem here." They are quite willing to work with me on the medical aspects of transition, but he explained that getting my testosterone up for the duration of getting out of this particular crisis (he thinks my 2004 collapse was an environmentally triggered failure in T production) isn't incompatible with reducing it again later once I'm no longer critically obese and depressed and deficient in energy. I buy that. It just means delay at a time when delay is not really what I want to hear...but I am not surprised, to tell the truth.
It also turns out that what I thought would be a case of dermitits is in fact almost certainly venous stasis and some associated edema, so I also need to check out vascular consultants and expect to spend time with some sort of compression system.
I am, um, overwhelmed, a bit. I mean, I knew I have problems. But there's something about seeing them so directly laid out and approached as matters both needing treatment and susceptible to it. It will indeed be the years of work I had guessed to get things under control. Please pardon me if I have some whiny moments along the way.
I'm back home from my initial appointment at Capitol Hill Medical. Wow did that go well. I liked the place and the practice—much higher standard of courtesy among patients and staff than I've become accustomed to, for starters, and the guy who examined me was just fantastic. And he knows two friends with porphyria, which let me save a lot of explaining.
The punch line is that I am as sick as I think, but not in quite all the ways I'd guessed. First off, my blood pressure has gone ghastly high. High enough that he said it was genuinely surprising to him that I haven't had a stroke. I've got a prescription for medication to start tomorrow. He also feels very sure I've developed diabetes, though he won't know for sure until the blood work comes back; I find out about that tomorrow. Beyond that, he said that they've found a strong correlation between too-low testosterone levels and some of my major symptoms of recent years, including the worse-than-usual weight gain and mood loss. Again, test results pending (and I've got a follow-up visit for a week from Friday).
The hormone stuff in particular is going to be a pain. He was upfront about it, saying, "We have a problem here." They are quite willing to work with me on the medical aspects of transition, but he explained that getting my testosterone up for the duration of getting out of this particular crisis (he thinks my 2004 collapse was an environmentally triggered failure in T production) isn't incompatible with reducing it again later once I'm no longer critically obese and depressed and deficient in energy. I buy that. It just means delay at a time when delay is not really what I want to hear...but I am not surprised, to tell the truth.
It also turns out that what I thought would be a case of dermitits is in fact almost certainly venous stasis and some associated edema, so I also need to check out vascular consultants and expect to spend time with some sort of compression system.
I am, um, overwhelmed, a bit. I mean, I knew I have problems. But there's something about seeing them so directly laid out and approached as matters both needing treatment and susceptible to it. It will indeed be the years of work I had guessed to get things under control. Please pardon me if I have some whiny moments along the way.
no subject
Date: 2009-06-25 05:56 am (UTC)For what it's worth, venous stasis is, I think, what I had for years following my car accident, and never knew or realised the potential side effects. Those side effects are what I'm dealing with at the moment, and I can give details if you want to know (I refrain out of consideration for the delicate sensibilities of your readers and your good self, not because I'm unwilling) - but I'll say up front that the complications are very easy to prevent if only you know, which I didn't, and if they go unprevented they suck.
Feeling a bit overwhelmed is inevitable, I think. I'm glad everything is susceptible to treatment, though, and I hope things continue to improve.
no subject
Date: 2009-06-25 11:50 am (UTC)Re: I asked the witch doctor, er, nurse practitioner
Date: 2009-06-25 11:10 am (UTC)i can imagine that all this is overwhelming, even if it's good to KNOW.
the hormone bit sucks especially. *sigh*. but yeah, general health has to come first.
i have high BP and pre-diabetes, and have dealt with it for about two years; i don't post much about it now that i have things mostly under control. if you want to talk about that, we can, though.
oh, also, i was gonna ask how often you weigh yourself if you don't mind saying.
Re: I asked the witch doctor, er, nurse practitioner
Date: 2009-06-25 11:56 am (UTC)I'd love to hear some about your experience and best practices, in an unhurried sort of way.
I look at the scale each day mostly because I'm trying to get a sense of how my feeling of relative bloat or lack thereof matches up with actual weight, but I've gone from daily recording to weekly.
no subject
Date: 2009-06-26 05:26 pm (UTC)I'm reminded of my own medical circumstances back in 1999, when I went to the Doctor's because I was critically overweight and because I was desperately out of shape, and needed to do something about both for my own peace of mind... and came out of the Doctor's having discovered I was in stage four congestive heart failure. The laundry list of conditions seemed insurmountable and overwhelming.
Ten years later, I'm a couple hundred pounds down, my heart is in excellent shape, I have had surgical procedures that vastly improved my sense of self and my overall quality of life, and I'm doing really well. It didn't seem like I would get here (I'm already a year older than I thought I'd ever become, actually) but I did, and it started by my learning what was wrong and getting good doctors to help me fix it.
It may seem overwhelming, but just being able to quantify what needs to be done between now and your overall goal is an immeasurable step, and it sounds like you're getting the medical support you need in the process.
As for the hypertension -- I know it's scary (man, do I know), but the drugs? Work.
I think this is all an excellent sign for your long term health and happiness, and if there's anything I can do along the way, I'm more than happy.
no subject
Date: 2009-06-26 05:36 pm (UTC)