Tuesday, 21 October 2008

Lebanese Bread

Yesterday, I replaced much of my oral hormonal medication with an implanted pellet. It resembled in size and shape an air-rifle pellet, but was delivered in a rather more clinical fashion. The area was surgically sterilised, then an incision was made with a scalpel, which was then deepened and the pellet implanted several centimetres deep in the gluteus maximus, the largest muscle in the body.

The pellet will deliver 100mcg of 17B Oestrodiol into my bloodstream every day for the next 3-6 months. The delivered dose is variable with individual metabolism, and so we just have to see what happens. I'm assuming that it's the equivalent of 2-4mg of oral oestrodiol valerate, and have dialled back my oral dose to the more conservative value - 8mg instead of 12mg. I'll be titrating it down in future until the effects become less than optimal, then titrating upwards again as needed. I'll be guided by the serum oestrodiol levels, but really, the somatic effects are the best metric. Response is just too individually variable to do otherwise, and my medical team has now got more confidence in my own perceptions than dosages based on conjecture.

If need be, a second pellet can be implanted.

The greatest pain was to the hip-pocket nerve, $116 for the medication, then the ~$100 cost for the procedure. Apart from the initial sting of the anaesthetic, I didn't feel a thing, despite the doc requiring some effort to get the pellet in deep enough. I didn't even require a stitch, the incision had stopped bleeding while the doc and nurse were disposing of the medical waste.

Three and a half years on, we're still in uncharted territory, operating by trial and error, always being conservative with any change. My transition continues, but I think puberty is almost halfway finished now. It will be complete by age 55 at the latest.

But meanwhile, having a dressing that must stay dry and on for a week - that's lebanese bread. A PITA.


Nica said...

Hip pocket nerve...hmmmm...better look that one up in the old anatomy text...it's got to be here somewhere...ah, yes...here it is...the Kaching Plexus...funny, we never learned about that one in class...

RadarGrrl said...

I suggest a Naan, or at least maybe a dark rye.

justme said...

Huh. Any idea what the brand name is of the implanted pellet? I wonder if it's available in the US yet. I've been discussing transdermal patches with my doctor (supposed to reduce the risk of thromboembolism vs. oral for those of us over 40) but she's been discouraging me because of the inconvenience and cost her other patients have complained about (apparently she doesn't think thromboembolism is a significant risk for me, but I'd rather not chance it if I don't have to).

As for the cost of the implant--that's about what the same dose of the patch would cost for six months anyway, and I pay about that much for a testosterone or estrogen level blood test.