Friday, 27 February 2015

More ups and downs

It's been another of those weeks, a big low point at the beginning and then a massive high at the end. My emotions have been so up and down for the last few months and it is well worth another write about to try to make some sense of it all.

I have a feeling that a lot of this is down to hormones. In this respect, my body has had the equivalent of being dragged through a hedge backwards, and then put through a shredder for good measures. It started back in October actually when my bloods revealed an estradiol level that was far too high. I had to reduce my dose, which then triggered the start of testosterone production.

In December, I stopped taking oestrogen (E) completely in readiness for my GRS and this then saw a full blown testosterone (T) surge. This probably explained why there was no gentle ramp up of the T, it was full blown within a few days of stopping E. Those 6 weeks were phenomenally difficult and to be honest I was clinging on by my fingernails by the end of it. Of course the GRS brought about a removal of those T producing factories and within a day, I could feel peace and quiet internally. There was also the euphoria of being post-op and this was a very powerful and emotional time.

Then there was a three week period of having no hormones whatsoever. This was initially not too bad and I was riding on that wave of euphoria. It didn't last forever though, and halfway through the second week, I found I was struggling. It was a blessed relief to restart my hormones. I then discovered that very few make it through those three weeks and some even restart as soon as they get home from hospital. I have even read more than one story where they took their hormones in hospital!

I am over three weeks of being back on my hormones and it does not feel right. I have a test in a couple of weeks which may or may not indicate the correct levels, but I am not feeling the effects I had before surgery. The most obvious should be tender breasts and they were untouchable prior to stopping E, now I can beat them with my fists. The hot flushes thankfully have stopped, but only just.

So it's entirely possible my E levels have been all over the place for several months. Of course, we can look at another factor that is likely to be contributing to this and that is of course the GRS itself. I was warned by many that it could be difficult afterwards, but nothing has prepared me for this. Overall, the euphoria is still there and when I am up, I am really up. I am super emotional and this can then lead to severe crashes which shoves the euphoria to one side. There are times when I can't stop crying and negative moments will leap into my mind and get stuck in there. It then needs a positive happening to bounce me back up again.

There is of course the physical aspect of the surgery itself, and this takes a fair toll on the body and mind too. I have ruled out the anaesthetic, I got that out of my system very quickly by drinking a phenomenal amount of fluids whilst in hospital. There is the small matter of pain and although that has not been a major issue with me, it is still there even now. Further on from the surgery is that fact that mobility is a little more limited, it is harder to get out of chairs and off the bed as well as other things. Everything simply takes more thought and effort. Dilation, I can rule out because I have no issues with that and I even use it as coping mechanism. There was also the element of isolation when back home from hospital, I could have used more visitors and even a couple more trips out but our remote location made this difficult. Most of these physical issues have lessened but now I have a sensitivity in the clitoral area that although is not too bad, it constantly there with very little relief.

This brings us to the week in hand, and this is fairly typical in how my moods have been swinging. Tuesday saw us with an appointment for my partner at the hospital with the optician because she is having some serious issues with her sight. This was very difficult to attend as I still can't lift her wheelchair in and out of the car (another issue that is distressing me). We managed to enlist the help of a friend though and after battling our way through traffic, arrived at the correct reception. We waited 20 minutes only to be told that the optician had phoned in sick an hour earlier. They could actually have rung us at home and cancelled so we didn't make the trip in, never mind make us sit there for those 20 minutes.

There was an issue making another appointment and the receptionist I was dealing with was very nasty in her talking to me. I found this very difficult to take and became even more upset when 5 or more staff then decided to cluster around me, almost as if I was going to become aggressive. I expressed my discomfort at this and on reflection felt it was a kind of misgendering, would they have crowded a cisgender woman to the same degree? In the end the ward sister came and took over, and she was actually quite a kind person. By the end of it, we were out at the front desk of the hospital with me in tears in front of everyone around. I did complain when I got back home, and a few hours after the receptionist in question rang me to apologise. I was not happy about this as I do not feel I was ready to speak to her.

Once I am on a low, it will hang around until something happens to kick me out of it. Very little I can do seems to bring me out of it and I and up with anhedonia (I experience little pleasure in usually pleasurable activities). After last years depression and anxiety, I developed some coping strategies and one of them is to go out and have a coffee. At the moment, this I have to do on my own, but I take a book and go and read whilst enjoying the bustle around me. The next morning I decided to do just this and when I ordered my coffee, the person on the till decided to call me sir. I was not ready for this at all, I objected in probably not the best way and his excuse was pretty pathetic - he calls everyone sir. This then ruined one of my coping mechanisms and it was all I could do to drink that coffee, get my shopping done and then get home - I was crying in the car most of the way. I get home to a message saying that someone was ringing about my complaint within 20 minutes. I was not ready for it at all and when the phone did go, it was very tough. I decided to tell them in the end everything, who I was, what my surgery had been and how rough things were with my hormones. I wanted them to understand that virtually everyone visits a hospital with something going on and staff should be more understanding of that. This helped a little but the day ended still very low. I even tried talking it out on a self help group on Facebook, but it didn't really get anywhere. I felt my problems were quite trivial compared to others.

The improvement came the following day. Nicola who owns the salon where I have my electrolysis had rung me the week before to ask how I was. I made an appointment for this week and decided that I could have something nice with the money I was saving from not having my electrolysis. A hot stone full body massage was booked and this was Thursday's treat. To be honest though, I was still in a trough and was not too fussed about it all. This soon changed when I walked into the salon. Everyone was there, asking me about everything and how it had gone. I was then given a bunch of flowers and all of a sudden the world seemed a much better place. The massage almost seemed irrelevant although it was very nice!

Today saw me deal with the issue at the coffee shop. Once upon a time I would have written a complaint to the head office, but I decided instead to have a gentle word with the manager. Given most there know me by name, I was going to use this and I felt much happier that I had dealt with it quietly. I walked through town to visit my new voluntary workplace and encountered a bunch of window cleaners. They had a good snigger, but I didn't care but I was on an up and nothing was going to stop me.

So this is how it seems to be at the moment, peaks and troughs and all of them quite extreme. The hope in it all is that the troughs, whilst extremely low are generally short lived and the peaks seems to outweigh them. Generally it is just lows, they are nothing like the black dog of last year and it usually just ends with massive spells of crying. I have been told by some that this is actually very normal and can take some time to level out. I am hoping that settling the hormones down might help but until I have that blood test, there is little I can do except to try cope when it is bad. I think it's important to understand that this is part of GRS and anyone proceeding down this path needs to be ready for it. I knew about this, and it has totally taken me by surprise. It still wouldn't have stopped me though!

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