[jannet.duff]

Here is my thoughts. Spiro should be used to "assist " Estrogen in driving down your Testosterone production. At 2mg estrogen not only does it not drive down T production, it will have very little feminization effect. You will find your self hormone starved. At 200mg your going to drive your Testosterone down to below even normal female levels, and have very little estrogen to make up for it. Oh, there will be some breast growth, but your going to start to feel over tired and have very achy muscles.

I'm confused as to why 4 months between bloodwork. At this early stage your blood needs to be monitored closely and changes made at least every few months. ( mine is every 6-8 weeks btw )

Presently, I take 150mg one day, 100mg the next. My gender Dr wanted me to go up to 200 but I put my foot down. I take the equivalent of 4mg in estrodot patch. My T is high female level and E low/mid female level.
I am seeing my Dr tomorrow, with luck I expect my estrogen will be increased again, and I'll drop my Spiro to 100mg daily. And have a blood test in 4 to 6 weeks.

I think your correct, your seeing a moron.

[GamerGurl]

Ughhhh why me! ｡ﾟ･（>﹏<）･ﾟ｡

Seriously, nothing ever goes right.


Well as it turns out, the last blood work I had done was for checking my iron levels. Last time I had my testosterone checked was..... uhh....hmm..... many many months ago?


The red flag on my insurance was not for the sudden jump in dose, but the actual level of the dose itself. My insurance only wants to cover 100 mg daily unless they get my endo on the phone for an explanation. In order for them to cover it at all, the doctor had to say I am being prescribed it for high blood pressure, and my insurance has all these specific rules about how much they will cover dependent on the actual condition it is treating.

Tbh I would switch to another endo, but my current is the only one in the area.

[Dianna1395]

I just got out of my appointment with my endo and he QUADRUPLED my Spironolactone to 200mg!!! yay!

Spironolactone's primary use is a heart medication for high blood pressure.
I would be worried about the impact of suddenly increasing the the dose by 4X.
An increase that large caused the red flag by the insurance company. It is a check and balance.
I have the same question as Jannet about the increase in estrogen and the lack of blood work by your endo. Either that or we do not have all of the information.

Dee,
Insurance is just one of those leeches we have to deal with. Since it's mandatory that we buy insurance, but not mandatory we receive care...?
I've made the arguments elsewhere. We're owned property of Das Boot, and it gets tiring, especially when so many others are intent on BEING owned. It's like I'm living a BDSM fantasy, everyone wants to be collared...

Our body, our choice. If it's good enough for abortion, which arguably involves another human (especially now they're trying to push post-birth abortions), then it damn well ought to cover whether we want tits or not (being crass to drive the point home.) For that matter, "steroids" (anabolics) are considered Schedule 3 drugs, marijuana is ridiculously over-penalized (was actually a drive by a corporation to eliminate hemp, a competitor for their patented product), and even the "hard" drugs should fall into this categorization - WE own ourselves, so WE get to choose what goes in - F-ck Monsanto (and Bayer, they merged - GMOs and PEsticide #1s, what could possibly go wrong...?), F-CK "Big Brother," and F-CK the Police State that's been developed in the various wars (Poverty, Drugs, Terror, all actually wars on the people's rights and self-ownership/agency).

GamerGuy is dealing with this stupidity. Up here in MA, a junkie can get pain meds from a doctor, but a person with a bad back, or torn meniscus, cannot get actual pain meds.... Possibly from that same doctor. So injured people have to go to the black market. And may get busted. Because they "will ruin their life!" So the pigs lock them up, make them felons, and ruin their lives...
This is insane, and while the politics is outside of this board - we need to oppose government regulation of US at every chance.
The flip side is, people will act foolishly and rashly, and get hurt. But we cannot regulate that out of the human genome, so let's not even try. It's Darwin's law, and we need to respect natural laws.

Gamer, as for dosing, a transition dose is up to 200 mg/day Spiro, and up to 4 mg/day is normal for E, but it can go higher (but not above 8mg/day as the risk of DVT gets too high, and the blood can clot inside the veins too easily - not only DVT, but risk of stroke, heart failure, lung damage via blood clots; E causes the liver to increase clotting factors, it's part of why many mammals consume the placenta after birth - stops mommy from bleeding to death. Also, Aspirin does NOT help offset the clotting, as I understand. Aspirin thins the blood, but this isn't enough to offset the issue of too much E in the blood.)
I'd suggest you go looking, even though this is the only one in the area - once you have some basics done (you have), you should be able to look online for an endo who will work with you remotely. Skype for 5 minutes (gives a face, so they can see skin color, eye dilation, imply blood flow and general health), and they just need to read the labs and make adjustments as appropriate.
I don't know if you can move, depends on if you have a WFH type job, or can consult somewhere else. If so, look for something in the Massachusetts area (GD is covered here, lots of programs and protections). Even if you're only in the area for a few days a month, you could tie it to appointments and/or support group meetings. :-)

Something to think about. Also since most of it can be done over the phone, a more remote endo might work perfectly well. Maybe that's adequate?

Sorry for the hijack above, but we're inundated with messages to bow and scrape all the time, so someone needs to point it out - and on or off topic, repetition is essential, everywhere, all the time. I know where this leads - "follow the rules and you'll be successful" is the message, but it works out to, "follow the rules and be a stepping stone for others." Don't submit, FIGHT for your rights - or they'll be taken away, piece by piece.
If the endo is an idiot, replace them, ASAP, by any means necessary. No other option, I'm afraid.

-Dianna

[jannet.duff]

When i read this stuff, it makes me glad that I llve in Canada ... I can go to my OHIP Dr anytime I want and ask for bloodwork, it's also free. My meds are covered via my work heath plan. If I'm unemployed I can apply to have my meds covered by OHIP.

I feel for some of you.

[The First Aria]

There are some really messed up insurance companies, but also quite a few good ones. So far, I have been happy with mine.

Many insurance companies go by AMA's Standards of Care. When a red flag is raised, it not just to save them money, but also to make sure the procedure's, meds are necessary, non frivolous and mostly not from a quack.

Wouldn't it look weird, if Joe Blow all of a sudden without a track record of being Trans-Gendered or need goes from just needing an aspirin to estrogen, Spiro, Fin, bottom surgery and implants? A company would wonder if someone has stolen Joe Blow's identity, to wondering if some heinous doctor is just plain experimenting and doing dangerous wasteful procedures.

To save money?? Yes.... To make sure there is NO fraud? Of course. Maybe Gamer is being protected from a quack by his insurance? Something to think about!

[julieTG]

Point well made iaboy
Julie

[jannet.duff]

Oh, I have no doubt his insurance company is doing the right thing. To up his Spiro from 50 to 200 without knowing what the T levels are is insane. That's ignoring the fact that the correct way to do it is to ramp up slow. ( Slow as in not 6 months apart )

[Dianna1395]

There are some really messed up insurance companies, but also quite a few good ones. So far, I have been happy with mine.

Many insurance companies go by AMA's Standards of Care. When a red flag is raised, it not just to save them money, but also to make sure the procedure's, meds are necessary, non frivolous and mostly not from a quack.

Wouldn't it look weird, if Joe Blow all of a sudden without a track record of being Trans-Gendered or need goes from just needing an aspirin to estrogen, Spiro, Fin, bottom surgery and implants? A company would wonder if someone has stolen Joe Blow's identity, to wondering if some heinous doctor is just plain experimenting and doing dangerous wasteful procedures.

To save money?? Yes.... To make sure there is NO fraud? Of course. Maybe Gamer is being protected from a quack by his insurance? Something to think about!

Iaboy,
While what you say has some merit, part of the issue is that we're labelled at birth, and that is where the problems start...

I had a whole long thing I was thinking I'd post in a new thread with a linkback, but here it doesn't belong.
The problem is in fact caused by "their" solution. I'd have no cares if it was voluntary, as it used to be, and I was being protected as you suggest. But I am forced to pay for insurance, and then forced to pay out of pocket for the care I receive, up to $10K. That's about $22K I lose every year, off the top, for NOTHING. And I'm hardly unique. For F's sake, that's more than I was looking at just a few years back for catastrophic coverage, and the difference isn't my age or risk levels! Nor a "family" coverage!
If I MUST pay, and they CAN deny, then I'm being extorted. THAT is the rub.

As for checking the meds, confirming it's for the right person, questioning the sudden jump? Not a problem. I'd expect that if it were non-mandatory insurance checking with the doctor, too. Double-checking is a big help, often. Not a concern.

It's the duplicitous theft, and the welcoming, subservient attitudes I see, which offend my sensibilities (I.E., piss me off.)
I had to deal with that all my life, I know the condescending attitudes, and I know the intents and drives behind it. It's NOT our benefit, it's always their profit. It was true with my parents, it was true with my grandparents, it will be truer as this country grows. I want us to evolve away from herd mentalities. I see this (NBE) as part of that drive for freedom and self-realization, and I see the storm clouds coming, too. We can face the storm or we can hide, but there's a storm on each side, and we're getting caught in the middle. It's a pincer movement, an encircling, militarily speaking, and we're in the losing circle.

Here's another (older, 1958) analysis, if anyone is interested...
Brave New World Revisited, Aldous Huxley
Problems are not going away, and "they" are fighting a war of attrition against "us."

Gamer's issues stem from this acceptance of mediocrity, I think. Herd mentality, everyone to be watched and controlled, and categorized and "farmed" for productivity and for money. It's all from the same place.

But I'll shut up and stop derailing the thread, I'm too invested in this, I guess.

-Dianna

[GamerGurl]

Believe me, I have plenty of hatred towards big government and it's bedmate Big Pharma. I don't consider myself one of the sheep, but Im swimming against the current here. All I can really do in my current financial situation is use little exploits to get my insurance to to it's job.

[GamerGurl]

Yesterday I got on the phone with my Endocrinologist's secretary, and requested an increase on my estrogen from 2mg up to 4mg. Today I am waiting for his response.

Is 4mg sufficient for proper feminization?

PS: I take my estradiol sublingually.