Monday, February 23, 2015

2-23-2015 Entry: Starting Estrogen and My Trip to the ER

Okay, so I know the title of this post probably sounds a tad bit alarming, but the events of the last few days have been rather…out of the ordinary for me. First I want to begin by reporting that after many months of anticipation I was finally prescribed Estrogen and have officially begun my MtF transition. I went to see the Doctor last Thursday afternoon, at which time we both agreed that it was time for me to begin my trip down estrogen lane. I excitedly ran to the on-site pharmacy and eagerly handed them my prescription documents. They cheerfully gave me buzzer and said it would take around thirty minutes to fill the Rx.
I happily took my buzzer and found a seat in the waiting room where a book on my phone (it’s about non-violent communication).I sat there for quite some time, forced to overhear the phone conversation of some random lady who doesn’t understand it’s rude to have loud phone calls in public waiting rooms, but I digress. After they had closed the doors and attended to all the other people ahead of me in the queue, they called me to desk to regretfully inform me that they could only process the refill on my T-blocker and that I’d have to return the next day to get the estrogen patches.
I wish I could say that I’d taken this minor setback in stride, but that wouldn’t be true. Instead I allowed it to set off every one of my childlike defense mechanisms and careen me into a depression spiral. It was almost as if all the anxiety I’d had up to that point was suddenly spending the night at my apartment with me. My poor wife had to deal with my rotten demeanor knowing full well that there wasn’t much she could do to help me. In the end, the only thing that was going to make me feel any better was to get the Rx I’d been waiting so long for, and even that had no guarantees. In fact, even after I had the prescription in hand the next day and had applied the patch to my leg (important detail for later, btw) my defense mechanism were still in high gear.
It wasn’t until I finally consciously looked at the emotions I was feeling and tried to deliberately soothe them (like one would soothe an upset child) that I was actually able to calm down again and remember that everything was okay. You see, the funny thing about defense mechanisms is that their main purpose is to alert you (the consciousness that inhabits your physical form, not just your physical form) that you might be in danger. The danger might be physical, or it might just be emotional danger, like the danger of disappointment or emotional pain. Once you can consciously look at the emotional alarm bells going off and acknowledge that your choices are being made despite the potentials for emotional pain you allow yourself to turn those bells off. If you can lovingly thank your defensive emotions for doing their job of warning you of potential risks, you can begin to soothe them, thereby consciously turning the warning bells off. Once I did this, my distress and my rotten mood dissipated.
So, the hormones! Oh my good lord, the hormones! So, although I find it positively impossible to actually describe the sensations I felt upon putting on my estrogen patch, I want to make an attempt. The sensations began immediately. Even my wife, who helped me put the first patch on, felt the effects right away when her finger barely contacted the patch.
What were the sensations? Well, they were indescribable, but they were everywhere in my body. From head to toe I felt a wave of the most peculiar sensation I’ve ever experience. It was almost akin to what I understand a hot flash to feel like. It was like a warmth passed into my blood and through my body, making me feel… different… and strange. I know what I’m describing is frustratingly vague and ambiguous but it’s truly an experience you can only understand once you’ve had it firsthand (kind of like sex).
After the initial estrogen “buzz” as one might call it, things seemed to mellow out a bit. The next morning I didn’t really feel much different, except for a slight irritation around the patch (something I was warned about beforehand). That day my wife and I met with some friends at a dog park and later went to lunch. Everything was going relatively fine until Sunday afternoon came along.
The irritation around the patch had seemed to increase while I slept Saturday night because by time I got up on Sunday morning parts of my leg were feeling somewhat sore. At first I thought that the ache might have been a result from all the walking we did the day before at the rather large dog park (I don’t regularly go for hour long walks on nature trails, so sore muscles weren’t out of the question) but as the day progressed and my discomfort increased I started to feel worried that something was wrong. Upon inspecting my right leg (the leg I had the patch on) I found that it had begun to swell in addition to aching. Upon reflecting on my visit with the doctor I recalled her saying something about leg swelling, so I looked over my instructions from her again. There, plain as day, were direct instructions from her to remove the estrogen patch and seek immediate medical attention were I to experience any swelling/aching in my legs in order to rule out a blood clot.
As you might guess reading those instructions was disheartening to say the least. My leg was definitely swollen and the longer the day went on the more it started to throb. At first I decided I would give it some time before I became too alarmed. The patch was on my right leg and my right leg was swelling, so perhaps it would eventually abate. Once the swelling and pain had continued for a few hours, despite raising my leg above my heart and icing parts of it, I decided I couldn’t risk it any longer. I removed my estrogen patch and regretfully informed my concerned wife that I would have to go to the ER since my doctor’s clinic was closed.
After gathering some items in preparation for what might be a long night in the ER (our last overnight stay in the ER a few years ago had been so poorly anticipated that we probably overcompensated for this one) we left towards the hospital. I drove, despite the discomfort in my leg, and made it to the hospital within about 15 minutes. Upon entering the hospital and going through triage, during which I had to painfully explain I’d just begun HRT no less than 3 times to 3 different people, I was rushed into a room and was immediately greeted by a doctor and nurse. (not sure if they weren’t busy or they were highly concerned about my condition but there was no waiting).
I explained I had begun HRT and that my leg was swollen and aching. I explained that I’d been instructed to come in right away under those conditions to rule out blood clots. The Doctor checked my leg, agreeing that it was swollen, and ordered a handful of blood tests and an ultrasound. They took my blood and after waiting about an hour I went in for my very first ultrasound experience. The gel was warm, surprisingly, and there were a lot of strange sounds and awkward moments as the ultra-sound tech had to check my pelvic areas in addition to my leg, but the experience went rather smoothly.
After returning to my room (and wife) we waited about 20 minutes for the results of the ultra-sound and blood tests to come back. The doctor came in and told me that the blood tests and ultrasound had shown no evidence of any blood clotting and assured me that she’d never had an early ultrasound give a false negative. She said I could safely resume my HRT and that I could put my patch back on. She told me that if the swelling didn’t go down within 72 hours from seeing her that I would have to come back again but that I was otherwise okay to go home.
We getherd our things and tiredly made our way home (well after our typical bedtime) where I put on a new patch, this time on the left side of my abdomen. Given the late night ER trip both my wife and I called in sick at work.
It is now Monday night and while I’m happy to say that the swelling has gone down since yesterday, my leg is still a bit achy and puffy. Upon looking around the internet I found a few people who mentioned the estrogen causing them to retain water and to swell up in places. I’m hopeful that that’s what happened to my leg and that my problems with estrogen will be at an end.
I can say that there were many moments during my experience yesterday that I became extremely fearful that the worst was ahead of me. If estrogen gave me a blood clot right away (within 48 hours) then it wasn’t unreasonable that I’d have to permanently give up my plan to medically transition, and if that were to happen, I wouldn’t know what to do. Nothing about my preparation for HRT had included what I’d do if I just medically couldn’t transition because of heart problems. Because of this, I was forced to stare at the ceiling of my ER room and try to envision what I would do under those circumstances.
Would I continue to present as Emma, knowing that I could never look physically female? I’d come to the point of thinking about this transition as my alternative to suicide, so if I couldn’t actually do it at no fault of my own, could I still think of it that way? Was I going to commit suicide if I HAD to not transition for the sake of my own health? That almost seemed counterintuitive. Why avoid the potentials of death by heart attack or stroke only to resort to suicide? Could I just go back to be Robert instead of Emma? Any time I’d considered that idea before I’d been sickened at the thought of “going back into the closet” but would this be different? Would my friends and family understand if I suddenly abandoned this new personality I’d dawned to remain the same old guy they’d always known? Could I handle doing that, or would it eat me alive as it had been before coming out?
I honestly can’t say that I came to any sort of conclusion about that. Luckily I didn’t have to, but only time will tell if my body can actually handle the transition process. 72 hours into estrogen and I feel somewhat sickly. It’s almost like I have a cold coming on. It’s like that exhausted feeling you get when you’ve slept too much lately, you know the one when you’ve slept like 36 hours in the last 72 hours, yet you still just want to go to bed? Also, damn my boobs hurt! My nipples are very unhappy with me right now and my whole chest area is just tender. My whole body is just kind of achy and unhappy with me. I’m hoping this is just the initial recoil of my cells from the introduction of female hormones and that, with time, the discomfort will fade. I remember that I felt somewhat similar the first week on T-blocker and eventually I stopped feeling so strange, so I’m going to remain hopeful for the time being.
Well, that’s all I can stand to share right now. I’m alive and changing physically, despite my body’s protestations.

-Emma

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