Yesterday at long last I got to speak with my urologist, not the locum I got landed with four months ago. A good part of the discussion related to my bladder stones, which while of interest to me, are probably not to any of you.
The rest of the discussion was much more interesting. About six months ago, while desperately trying to secure an appointment, I put together a list of issues I wanted addressed, which included besides the stones a query as to why my PSA score had suddenly dropped from years of fairly steady values near 4 to near zero in the most recent two tests, and a query as to whether there were any health issues involved in the fact that my T levels were apparently also near zero and my penis and testicles were very severely atrophied, to the extent that the former has become an 'innie' rather than an 'outie' and the latter are now small. soft and even difficult to find. Since I was concerned that this might result in his prescribing T supplementation, I added that because I had TG issues I was quite happy with the situation provided that it did not raise any serious health issues.
I passed the list to the nurse practitioner who is our PHP with a request that it be passed on to the urologist. My DW who was there with me at the time and had seen the list said that she, the NP, was shocked out of her mind, that I shouldn't have included anything about TG issues (which she (my DW) did not at that time want to know about) and that she doubted that the NP would pass it on. However I think it is now clear that she did. Additionally I gave him an updated version yesterday, so I think that my gender issues must now be firmly in my medical record.
While gender issues were not directly mentioned by either of us in yesterday's discussion. he did say (all that follows is somewhat paraphrased) that in a case like mine he would not recommend T supplementation, and that with such low T levels its effect would be unpredictable and possibly adverse; that if the changes to my body did not worry me then there wasn't a problem, and the low T was only a problem if it caused me depression or other problems, which I told him it doesn't. I told him I was taking an estrogenic herb as HRT, he asked what, and I said Pueraria Mirifica. He didn't ask me the spelling or anything but made a note - I don't know whether it was something he already knew about or he was just being polite. He said that if it worked for me then he was fine with it, but I did wonder whether he was concerned that I would ask for a hormone prescription and was relieved that I didn't. He also said something to the effect that not nearly enough was known about the action of hormones or herbs in the kind of situation we were discussing but that it was at least very possible that the PM had caused the PSA drop, which merely signified that there was no longer any irritation to which the prostate was reacting. He did say that my recent ultrasound examination did show that my prostate was still enlarged and that this could be dealt with along with the stones, but if I didn't want that he would be fine with my decision. I said that in view of the size of the stone I had passed a few months ago, I didn't think there could be much obstruction, and he agreed with my decision to leave the prostate alone, at least for now. The reason I didn't try to ask whether he would prescribe E2 was that my DW was very concerned that I might actually do so, and she tends to see that as the road to full transition.
The rest of the discussion was much more interesting. About six months ago, while desperately trying to secure an appointment, I put together a list of issues I wanted addressed, which included besides the stones a query as to why my PSA score had suddenly dropped from years of fairly steady values near 4 to near zero in the most recent two tests, and a query as to whether there were any health issues involved in the fact that my T levels were apparently also near zero and my penis and testicles were very severely atrophied, to the extent that the former has become an 'innie' rather than an 'outie' and the latter are now small. soft and even difficult to find. Since I was concerned that this might result in his prescribing T supplementation, I added that because I had TG issues I was quite happy with the situation provided that it did not raise any serious health issues.
I passed the list to the nurse practitioner who is our PHP with a request that it be passed on to the urologist. My DW who was there with me at the time and had seen the list said that she, the NP, was shocked out of her mind, that I shouldn't have included anything about TG issues (which she (my DW) did not at that time want to know about) and that she doubted that the NP would pass it on. However I think it is now clear that she did. Additionally I gave him an updated version yesterday, so I think that my gender issues must now be firmly in my medical record.
While gender issues were not directly mentioned by either of us in yesterday's discussion. he did say (all that follows is somewhat paraphrased) that in a case like mine he would not recommend T supplementation, and that with such low T levels its effect would be unpredictable and possibly adverse; that if the changes to my body did not worry me then there wasn't a problem, and the low T was only a problem if it caused me depression or other problems, which I told him it doesn't. I told him I was taking an estrogenic herb as HRT, he asked what, and I said Pueraria Mirifica. He didn't ask me the spelling or anything but made a note - I don't know whether it was something he already knew about or he was just being polite. He said that if it worked for me then he was fine with it, but I did wonder whether he was concerned that I would ask for a hormone prescription and was relieved that I didn't. He also said something to the effect that not nearly enough was known about the action of hormones or herbs in the kind of situation we were discussing but that it was at least very possible that the PM had caused the PSA drop, which merely signified that there was no longer any irritation to which the prostate was reacting. He did say that my recent ultrasound examination did show that my prostate was still enlarged and that this could be dealt with along with the stones, but if I didn't want that he would be fine with my decision. I said that in view of the size of the stone I had passed a few months ago, I didn't think there could be much obstruction, and he agreed with my decision to leave the prostate alone, at least for now. The reason I didn't try to ask whether he would prescribe E2 was that my DW was very concerned that I might actually do so, and she tends to see that as the road to full transition.