Ceri B.

I forgot to mention. The other thing about my nurse practitioner is that he's a fellow Firesign Theater fan.

He was preparing to give me the hepatitis vaccinations and started yawning a lot. He explained that he's developed an allergy to sulfa. I said, "Oh, I thought it was just such a long exposition." He stopped dead in his tracks, turned around, and said, "Now that's just classic", and we spent some time agreeing on the merits of Firesign Theater.

Those of you not familiar with these guys may listen to some of their best material in this three-part playlist. Firesign Theater's specialty is audio humor of a thoroughly anarchic sort; they are to American culture more or less what Monty Python was to British.  

So here's the scorecard from Capitol Hill Medical:

#1. Yes, I'm diabetic, and need to start on medication. Fasting glucose was very high, and hemoglobin A1c was even higher.

#2. Triglycerides are very high, HDL very low, LDL particle size and distribution very bad. I'm actually already doing what he recommended I start (as far as exercise and fish oil supplements go), so we'll see what else I should be doing.

#3. Thyroid level is good - which I was concerned about - but testosterone level is 202, with a normal range of 241 to 827. That means supplementing it at least long enough to help with the weight and depression problems. Bah. Pfeah. Feck.

#4. I need to get vaccinated for hepatitis A and B.

#5. Vitamin D level is way low - 21.4, with a normal range of 32 to 100. Prescription-strength vitamin D for eight weeks, then over-the-counter dosages.

And now the weather...

This time I'm planning with last week's upsets in mind, and expecting some more in this coming week's appointments.

# Prepare notes and questions for counselor and doctor sessions. Go feeling prepared.
# Choose places to eat after Wednesday and Friday appointments. Enjoy two meals out.
# Shop for some shorts in preparation for time with compression devices. Allow myself one clothing indulgence.
# Check out vascular specialists; go to Friday appointment with a reaction and preference.
# Get clothes ready for donation to Goodwill donated.
# Read three books purely for pleasure, with no thought of work relevance.
# Do 5 hours' free writing, with no topicality constraints at all.
# Fight down the urge to do anything about Project N this week, except maybe finishing the research reading in progress. Respect the stress, dammit.
# Take 5 pictures I want to share.

And that should do it for this week.

(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 feeling a little scatter-brained, just from having so many things I actually want to think about in my head all at once. Time to try a little goal-setting, I think.

# Call the doctor's office to schedule an initial appointment.
# Ditto with the dentist.
# Do 30 hours of research for Project N.
# Do 5 hours of actual writing for Project N.
# Get my old clothes definitively sorted, with a tally of what's to be donated, and get at least half of that to Goodwill.
# Do 5 hours' free writing on hopeful concepts, as per recent musings about good-news writing.
# Get players in my Soul Leverage pbem/pbp game the info they need to make characters.
# Take 5 photos I want to share.
# Get out for one purely fun outing.
# Make both of the new-to-me crock pot recipes I've got the ingredients for.

That'll do.

My regular readers know that I write "wow" a lot. The world often surprises and boggles me, and I like to note the fact. But it does leave me at a bit short when I want to really, really say "wow". Wow. WOW, even. Seattle Counseling Service impressed me a lot.

The woman who did my interview has a classic casual style, but completely professional manner. Parts of my experience with systemic illness were unfamiliar to her, but she had a frame of reference that anchored her well enough to provide incisive questions that helped me make important distinctions. She's the first person I actually said a lot of these things out loud to, rather than writing them out as previously. They sounded strange to me, some of them, but...right. Knowing myself, I imagine I'll have bouts of self-doubt for a long time to come, but I feel a lot more firmly set in the rightness of my wishes after having laid them out for someone else.

As for the help they can offer me..."all of it" seems a pretty fair description. I have here on my desk a referral to a physicians' practice that takes Medicaid and works with SCS on a regular basis, so they're prepared to deal with the medical side if and when. I've got a push to go follow up on the dentist lead I already have. And SCS will do the paperwork so that I can get disabled people's bus passes again. Within their own practice, they're set to help with the grief, depression, and anger I've got built up, as well as with sorting through my gender identity better, working out a plan of action, and then putting it into practice. Medicaid in my flavor entitles me to 33 hours a year of counseling, so I'll have biweekly appointments, with a scheduling call this week or next to set them up.

One last thing: she volunteered the suggestion, when we got to that question, that the obviously right answer to "Gender?" for all their internal paperwork is "Female." Whatever I can or can't do and choose to do or not about it, as far as they're concerned, I start off as female, and only the expression of it changes. I could get used to this.

I got out and socialized yesterday afternoon, and wow did it do me good. I got to catch up visiting with people I haven't seen in (in most cases) five years or more. We talked shop (catching up on shared industry gossip is always fun), and personal news, and random bits of commentary, and tag-team snarking at the video game play, and the whole deal.

Now, I went without any feminine presentation at all. Clean-shaven and with new clothes, yes, but really thoroughly in guy mode. Even so, in addition to several delighted comments from old friends about me looking a lot happier, I got two separate comments about how I'm looking younger. That's a very pleasing sort of thought to take with me to the intake interview on Tuesday.

This post may come out sounding worse than I intend it to, so let me be clear at the outset: I'm not in trouble over this, and I'm not delivering a cry for help. I'm on track for good stuff, and just want to write down the not-so-good part of the process to get it off my chest.

Social time on Saturday! Really, really looking forward to it, too. I have a lot of friends I haven't seen in anywhere from three to six years, or have seen only very briefly, like when they drop off borrowed books and videos. It's so great to feel like being around other people in a group larger than two, and to feel that I can handle the trip across town safely, too.

Am I nervous? Am I fretful? Am I wading through torrents of psychosomatic distractions? You might very well think that; I couldn't possibly comment. Except I am. Drat. Well, in that case, yes to all three. I'm out to a few of the folks who'll be there; I don't expect it to be a topic of conversation, but there's always that to think about it on top of my usual worries about health issues.

I'll be really glad when I'm actually there having a good time. I may not be much use between now and then.

Today I did one of those scary: I've gotten in touch with local counseling services. It turns out that one of the first friends I came out to knows someone who works at Seattle Counseling Service. She got his contact info and described my situation, and he sounded keen to help. So I called him today...only to find him out of the office. Left a message, but haven't heard back, so I'll try again in the morning.

I've been dragging my heels on getting started with medical and other help because of the sheer dead weight that is my case history. But it dawned on me, as my friend quoted her friend's responses, that while there will be hurdles to overcome in any case, these folks start off with big advantages when it comes to understanding where I am and what might help. I'm feeling my usual trepidations, but also a lot of optimism right now.

Saturday I'm going to a party, assuming no health crisis or anything like that. First one I've been to in, hmm, must be about six years now, since I hadn't been to one for a while before descending into my long slump. I am such a bundle of nerves about it, on two different vectors.

There's my health concerns. For those of you I've only met recently, I've got a trashed immune system, and respond with sort of mega-allergic complications to all kinds of common environmental things—orris root (the base of most perfumes), dry cleaning chemicals, soil molds, you name it. So being out in a crowd means a day or more of prep work with extra immune-boosting supplements and stuff, and planning a day or more recovery time afterward, and also being prepared for an acute episode while out. Fortunately the hostess has known me for a good long while now, and is used to dealing with medical weirdos besides me. So the circumstances are about as good as they reasonably can be, with understanding hostess and people I'll be happy to visit with, many of whom also have experiencing dealing either specifically with my complications or with others like them.

It's still stressful, the waiting and wondering.

And now there's the trans matter on top of that. I'm out to a few folks who'll be there, but not to most, and I feel in such a horribly awkward limbo. Never mind passing, I couldn't even be a competent cross-dresser now. Nothing to wear, no experience wearing it, no clue about doing almost anything in my presentation. Right now trans is in my heart and not much of anywhere else. I feel like a fake going and coming, knowing I'm not what I seem, unable to seem what I am. I'm very grateful for all the friends, new and old, willing to believe me. The day when it won't have to be taken on faith seems so far off.