Friday, 27 June 2014

Some positive progress

It is hard to believe that back in May when I restarted my blogging, I was so excited at the prospect of everything that was happening with regards my future GRS (gender reassignment surgery). My intention was to create a realistic journal of everything that happened from 2nd opinion to the surgery and beyond. I wanted to give an honest account of every single part of the process so that anyone going through this in the future could be ready for what was going to happen. Knowledge is absolutely vital with this surgical aspect of our journey, and the more you know the better your outcome can be.

Sadly, it all fell to pieces as soon as it started. It all looked good in the middle of May, I was told my referrals had been written, and a few days later had my first perineal LASER session. It was all positive and just a matter of time before I was getting my 2nd opinion and pre-op appointment at Brighton. Sadly, I had been told less than the truth regarding any letters and the last six weeks have been quite testing indeed. With some very aggressive tactics on the phone, I actually managed to get my 2nd opinion with less then twenty-four hours notice! Since then it has been a waiting game for the final referral letter for my surgery. I had also tried to engage in dialogue with the Laurel's about my issues but with no success.

Today I can report that things are finally back on track. I was contacted by a lady at the Laurel's yesterday and told that my letter had been posted. I asked for confirmation about what it contained and this must have been anticipated because she had the letter on her screen in front of her.

I was still a little wary, and today the letter dropped on my doorstep alongside another from the Laurel's. The first was indeed the referral for surgery and I carefully read it, half expecting delaying tactics within the letter. Actually the letter checked out fine, acknowledged mistakes had been made and the only proviso was that my surgery can't happen before August 2014 due to the fact I will not have completed twelve months on hormones until that date. Realistically, I can't have surgery until mid October due to my perineal hair removal and there are waiting times anyway that will probably put it to sometime mid November or even a little later. One other point within the letter was that it described me as having "severe" gender dysphoria. I have been back through all the letters I have received and this is the first time it is mentioned as severe. I agree that it is so, and I wonder whether this is another tick-box to qualify for surgery?

The second letter was from the clinic manager, and it was quite apologetic about what has happened. It has even offered the opportunity for dialogue, I have contacted the clinic and should be having a face to face meeting next week with regards this.

I am now hoping that it is a much smoother ride towards surgery. I will of course be on tenterhooks until I get my pre-op date and to be honest, I wont be truly relieved until I wake up after the surgery. I hope however, that I can get back to more positive writing and sharing every part of this journey.

Thursday, 19 June 2014

Weighty issues

This is not about those important decisions in life but actually about trying to lose weight and succeed. I have always struggle with my weight and for much of my life, been obese. That is my body mass index (BMI) has been above 30. I was always a portly fellow as a man and although I lost some weight a few years ago after coming out, I have still been a plump lass.

Since before I left school, I have had this problem. It has been a twofold issue, lack of activity and a love of food, and the wrong foods too. I did little about this until sometime back in the late nineties. I remember standing on the scales and the dial went to 20 and a half stones (130 KG!)! There was no further for the dial to go and I decided then that this was time to deal with this. I embarked on a strict calorie controlled diet and actually slimmed down to 13 stone and 3 pounds (83KG). Christmas came by and that was the stop of that.

I managed for quite some time to keep the weight off and through the 2000's I kept it to around the 14 stone (89KG) mark. Slowly though it went back on and it was only in 2010, when coming out and dealing with my gender issues, I went back and started to lose weight again. I got back to that 13 stone target again and although I was going to go further, I became very ill whilst on holiday and lost a serious amount of weight in a short space of time. I became more ill because of this and was ordered to gain weight. I also became anemic (low blood iron) and this compounded the problem because anemia makes you very lethargic.

That was nearly four years ago and again, over the years the weight has slowly increased. Last year was the worst, because losing my job also lost my routine and I was using any excuse to eat, and always the wrong foods. I have always been a chocolate and crisp junkie (crisps being my biggest weakness!) and this was my downfall. I was also comfort eating and any bad event of disappointment would be rewarded with a bar of chocolate and a big bag of crisps. I think the only reason I did not get back to the 20+ stone mark was the fact that over the last 4 years, I have been a keen runner. This has kept a great deal of the weight at bay but was never going to be enough on it's own/

I started this year on 17 stone (108 KG) and decided that I would have another go at slimming down. It was slow going and I was still prone to moments of weakness. I did manage to lose a whole stone by April but then there was my birthday, Easter and a friend visiting for a week. It was a marathon of eating!

In May this year my GRS (gender reassignment surgery) started to become more of a reality and whilst thinking about that, it occurred to me that there was a possibility that the surgeon might refuse to operate on me if my weight was too high. I worked this one out for myself, with my medical knowledge from the past and then confirmed it when talking to others.

The thought of another delay in my surgery spurred me on to start taking this seriously. There was absolutely no way that I was going to get to Brighton and be told to go away and lose x-amount of kilograms. After discussion with Mandy, my partner who also needed to lose weight for her own health issues, we looked very closely at what we were eating and what we could change.

There was a large element of calorie counting. There is no fad diet here, it's a simple energy consumed versus energy expended. We closely examined every meal and I looked at what we could remove here and there to reduce our intake. After looking at everything we were surprised at what we needed to change. 

Bread is one of the staples we have significantly reduced. The calorific value of bread is phenomenal and because we make our own, I could calculate exactly what was in it. Every day we would have toast in the morning and a sandwich at lunchtime. This equated to four slices of bread each a day and was nearly 40% of our intake! This doesn't even factor in the jam on top of the toast or the filling for the sandwich. We soon changed to muesli or porridge for breakfast and had to rethink our lunch. A couple of days a week we still have our sandwich but for the rest we will have soup with a small amount of bread or beans/spaghetti on very thin toast. This has the added bonus of a hot meal in the middle of the day.

Our evening meals also needed a good look at. Potatoes were removed very soon in as they are almost as bad as bread for calories. Instead we cook a lot of rice and pasta meals in our slow cooker. The amount of rice and pasta is also reduced and bulked up instead with lots of vegetables  - onion, tinned carrots and leftover vegetables from other meals. Baked beans also make a good lower calorie filler with pasta. The addition of the extra vegetables adds to our intake of at least 5 portions of fruit and vegetables. Portion sizes were also rethought and I now weigh in everything into the slow cooker so that we end up with exactly what we require at the end with an extra 200 grams of water for evaporation. We also eat liver a couple of times a week because it is cheap, low in calories and very high in iron. This is coupled with large amounts of steamed vegetables which make for a hearty meal without the sting of the calories.

We have also started taking a multivitamin and mineral every day. I am not too keen on popping pills for nutrition, but given that I have had anemia in the past, it seemed sensible. We also looked at our protein intake and supplement this with a small amount of nuts with our breakfast. We are also eating a great deal of fruit but this can be expensive. Tinned fruit has similar nutrition to fresh so we try to have some of each.

Mandy has lost a stone this year and I have lost over 3. Mandy has to lose it much more gently and because of her disabilities, she is unable to exercise. This is why my loss has been much greater. Every morning I get our of bed first thing and go for a long run. I run up the river Tone up the Creech St. Michael and then back down the canal to home. It's a total of eight miles! That's pretty extreme but bizarrely I find it incredibly enjoyable. I have some good music on the MP3 and I lose myself in my thoughts for just over an hour and a quarter. In short I have got my BMI down to 27.6 which is well within the target for surgery. With all the delays I am having with getting my referral letters written, there is a good chance I might now get to my ideal weight just prior to surgery.

I am staggered in how this weight loss has changed my appearance. My face shape has changed even more now than before hormones and suddenly I am not even recognising in the mirror. This has blown away every trace of masculinity in my appearance. My posture is much improved and I can see myself in shop windows walking, and it looks much better. Even with pushing the wheelchair (which makes for terrible posture) I look really presentable. If there was one thing I would advise any trans woman to do to improve their presentation, it would be weight loss.

This all takes some incredible motivation and mine was my GRS. That's a pretty massive thing and not everyone has this in their life and it's trying to find something that can help you get to the goal of an ideal weight.              

Thursday, 12 June 2014

Dealing with electrolysis

Electrolysis (often shortened to electro), is a word that makes many trans-women shudder. Recent years have seen LASER hair treatments overtake electro in popularity, but it's effectiveness is not proven and if you want complete facial hair removal, electro is often necessary at some stage.

I started this process just under two years ago at a beauty salon in Taunton called Beautyworx. This small salon is owned by a lovely lady called Nicola and over the last two years, we have got to know each other very well!

The costs of electro should not be underestimated and most trans-women have to fund this themselves. Because of this cost, I can only afford an hour a fortnight. If I had the cash I would probably have a much longer session and weekly too. One of the problems with electro (and this applies to LASER too) is it only properly treats hairs during the start of their growing cycle. The growth cycle of hair is a massive subject but in basic terms, a hair starts to grow, emerges from the skin and then slowly ends it cycle. As it ends this cycle, the root of the hair is pushed away from the cells that needs treating This then means that if you then treat a dying hair, the needle then doesn't reach the right area because the end of the hair has moved away from where it should be.

In an ideal world, you would intensively treat the whole face to completely clear it and then work on all new growth. However, this is a massive initial cost and not possible in my situation. So in the two years I have been going, we have worked on the upper lip and area around my jaw and lower lip. This is often the most painful area and there have been many tears in that time. The pain is quite intense and has to be experienced to be believed. Dealing with that pain is quite a skill and is something you learn to do over time. There are of course analgesics, and I often take a couple of paracetamol before walking to the salon. Some go further and use topical anesthetic creams but I have not felt this need. 

In addition to the drug method of pain control, I have found that distraction helps. Talking is probably the best and Nicola and myself chat away for virtually the entire hour. You become very close to the person performing this treatment and intimate is a good way to describe it. I have talked to Nicola about a great many personal issues and vice versa. I respect her confidentiality and would never repeat any of what she has told me, and I feel quite privileged to have been trusted with parts of her life. This offloading between us helps pass the time and get through that pain.

Over time the pain has become better, you really do harden off to it. I recently exchanged thoughts with someone else who has had electro and wondered whether this prepares us for the pain of GRS (gender reassignment surgery) better than those who have not experienced it. It is certainly something that would be worth some studying at some point.

Today's electro was the first in four weeks. I had to cancel my last session due to having to go to Bristol for my 2nd opinion. What I have been doing between session is epilating any hair that was not removed so that only growing hairs were left for the next treatment. So when I cancelled my session a fortnight ago, I immediately grabbed the epilator and removed the whole lot. Now, epliators should be used with extreme caution on the facial area especially with male facial hair. The root bulbs are much bigger than a hair that has never seen testosterone and if you aren't careful, you can tear pieces of skin off. I am very steady with the epilator, just catching the edges of the hair growth and never plowing straight in. It's extremely painful the first few times, but eventually the hair things and comes out much easier. The end result is that my next session sees only new hairs and they are perfect for treatment. My upper lip was cleared in under 15 minutes today, a record and we worked on probably the biggest amount of chin hairs to date.

My plan for the future is to epilate my whole face prior to electro. However I still have one more LASER session left and it needs the hair in place to work. Once I have had this session, I will start the process of clearing my whole face myself with the aim of stopping a few days prior to my electro. This then means we can treat hairs over a larger area which can make it less painful and more effective. Nicola has said if I do this, I may even be able to stop shaving quite soon. However, this remains to be seen!

Tuesday, 10 June 2014

Turning a corner?

It's been a tough few weeks, all of the problems could have been avoided and very little I could actually do to avoid said problems. I don't want to be doom and gloom too much more and think that I may actually be pulling out of my situation and moving on.

I could write a whole heap about what has been going on, blame the guilty and offload all this rubbish but feel it would get me nowhere apart from wear and tear on this keyboard. Instead I will write a little about the last few days. This does include some of my situation but perhaps a more positive slant on it all.

The middle of last week was very empty. I was waiting for phone calls that never happened and this led to a very glum feeling. I wouldn't describe it as depressed, as I do not think I have ever experience that personally but I was getting very down. Eventually on Thursday, I managed to have a worthwhile conversation with the Laurel's, my gender clinic. If you haven't worked it out, this has been the source of the problems. 

Although this phone call didn't completely reassure me, I decided that I had to try to move on and take as much as I could from it. I had an appointment at the clinic on Monday and could deal with my problems face to face with someone. The weekend was upon us and it was time to enjoy myself again, something that has been impossible for the last few weeks. Saturday was an uneventful day but Sunday saw me going to a coffee evening with some other trans people. 

This was very important for me, as I had found out the month before. To listen to others and their issues, suddenly I felt less alone in all this. It didn't trivialise my problems, they were as bad to me as others problems were to them. Just knowing we are all going through the mill, or have been through it, helps a little. It wasn't just talking about these issues, there was also some laughter and general chat.

I was up at the crack of dawn for my daily run, which now consists of running to Creech-st-Michael via the river Tone and then back down the Taunton and Bridgwater canal - a total of eight miles! This has been the saving of me lately, that hour and twenty minutes gives me an opportunity to work through my problems in my head as well as the therapeutic benefits of being out in the country first thing in the morning. I've seen several herons lately as well as Monday, a fox just a few metres ahead of me.

Once I got back, I prepared myself for my trip to the clinic. I also had my facial LASER this morning which meant no serious makeup - nothing on the areas to be treated. I have often gone completely bare to LASER but today, because I was going into the dragon's den that was the Laurel's, I needed some war paint on! Lip colour, eyeshadow, waterproof mascara and penciled eyebrows were the order of the day. 

We got to the Exeter Nuffield and after a wait, were called in by Lynne. I wrote about my perineal LASER a few weeks ago, here, and this probably reflects well my relationship with Lynne. After we had finished, she asked what we were doing for the day and I said it was the Laurel's next. Lynne is very good at getting you to talk and we both ended up telling her what had been happening. Lynne is one of those who I will remember for a long time after I finish transitioning and shows just how many people we do encounter that help us on our way and treat us with kindness. I also sent regards from several people from the coffee evening, and she remember them all!

We left, buoyed up a little from this and drove into the city. We managed to find a parking space right outside the clinic but with over an hour to go, we decided on a coffee first. I don't know why I wrote coffee, for once I had tea and Mandy had hot chocolate! We also sat in front of the cathedral for a short time before psyching ourselves up and making our way to the clinic.

My appointment was with Lynda, my psychotherapist, and she called us in. I knew this was not going to be a pleasant meeting and to start off, Mandy decided to have her say in how I have been treated. It is sad that Lynda has to endure this because I feel she has worked harder than anyone to get me moving. But she was the first person in the firing line, and she had to bear the brunt. I then proceeded to give her a copy of my complaint I had made to the clinic manager (this had been handed in when we entered). We thrashed this whole episode out for the next forty minutes. There were tears from me (remember the waterproof mascara?) and I sensed that Lynda was quite upset as well. I called a stop to it all in the end, we were going around in circles and Lynda had assured me she will do all she could to hasten getting my final referral letter out of the clinic as soon as my 2nd opinion had arrived (which it hadn't).

We then talked about other things and my preparation for my GRS (gender reassignment surgery). All I had really done was think about things and get my perineal LASER started. As we closed everything down, she gave me some assurances about what she would try to do to get things moving as well as saying she would email me once the letter was on it's way.

We went back out to the waiting area and Lynda went to photocopy a couple of pieces of information for me whilst I made our next appointment. She came back out with my 2nd opinion in her hand. I gave a great cheer and the whole waiting area could sense the relief in me.

We headed back home, and sure enough, my copy of the 2nd opinion was waiting for me. It was a lovely letter to read and perhaps one of the best reports I have ever read about myself.

Things seem more positive, I feel much happier in myself and I just hope that that final letter gets written promptly. Once that is done, I am out of the hands of the Laurel's in into the arms of the Nuffield group, and they don't f... mess around!

Wednesday, 4 June 2014

Getting out of date!

I'm trying to be more positive than my last but the powers that be are not helping me much. Phone calls that were supposed to have happened, have not and I am starting to become very frustrated with "the system".

Rather than go on about it, I am trying to help myself with my writing. I realise that a lot of stuff on here is out of date and decided to start by completely rewriting the "About me" page. It was originally written in 2010 and adapted for here in 2013. I started editing it, then deleted it and completely rewrote it. Whilst it is only a brief synopsis of my life, it does lay out the basics and I hope to write much more about my past journey that was documented on my old website.

Click the link above (next to home) or click here to read my about me page. Stay tuned for more soon!

Sunday, 1 June 2014

The backside of May

I think the title says it all, I am quite glad to see the end of May. It has been a very difficult month for me and I would hope there aren't any more like this during my transitioning. Bear in mind I am comparing this to future pain with regards GRS (gender reassignment surgery). Physical pain I have always been able to cope with, emotional pain is very much harder.

The difficulties started in February. This was when I had the surprise of being put forward for GRS well ahead of what I was expecting. Sadly, the gender clinic, The Laurels, had made a mistake and I still didn't meet the criteria with regards adequate time on hormones. I was written to when this mistake was realised and told of this with the plan to start the process in May.

However, I had trust issues with the doctor there, he had made a serious mistake with my treatment in July 2013 and now another one. This led me to worry about whether he would remember to start the process at the correct time. My psychotherapist at the Laurel's tried to assure me she would work to get this started and I took a small level of comfort from this. 

May came along and I started to find the waiting game very hard going. I made some efforts to try to ease my worries by trying to engage with others in the community. Exeter Pride was early in the month and this was a good distraction. This led to me going to a trans coffee evening the following night and it was suggested that I wait until the middle of May before contacting the Laurel's to find out what was happening.

The rest of this issue has to be kept under wraps because it is the source of an investigation at this moment. I am hoping to have it resolved by Tuesday and will write about it accordingly. However I can say there are two major issues, and it could be considered medical negligence on the clinics part. I have made an offer as to what I want to placate me but if it is not met, I am considering legal action.

This has made the last fortnight particularly hard and I must thank Mandy, my partner, for being there with all the tears I have shed. It has been a daily grind to get through all this and I am only now starting to see and end to the pain. I am awaiting a phone call from the Laurel's and hoping that that will be the end of it all and I am moving on to Brighton for my GRS.

Even amongst all this, there were positives this month. I have completely accepted my female identity, with all trace of the man in me gone. This was an overnight realisation and took me very much by surprise. I am still not sure what triggered this but suspect it's a combination of hormones and everything I have achieved in my transition finally clicking into place in my head. This new found acceptance is probably what got me through May.

There was also the 2nd opinion. This was rushed through by the Laurel's as a way of trying to accommodate me with what they had done. With less then 24 hours notice, I was driving up to Bristol and then talking to Dr. Hodgson. In his words, this was the final hoop to jump through and this was a good feeling.

June has started and in a few days, I hope to have the final letter written and be able to look at things in a much more positive light.