testosterone

My energy seems to be fluctuating alot today. When I run out, it is like running out of gas. I just can...not...go...on. I have noticed that I am sleeping MUCH better. Now, I just wake up for my 4am call of nature and then it is right back to sleep. This is a DRAMATIC improvement over my chronic insomnia.

My second injection was today. I took the plunge, so to speak, and self-injected. My doctor's medical assistant walked me through everything. I had a hard time getting the plastic cover off of one of the needles and accidently poked myself. No biggie since it was my own blood and there was no medicine in the syringe. The MA then gave me a good tip about removing the cover safely. So here are the steps I take in order to self-inject:

1. Unwrap the syringe and place it to the side
2. Unwrap my needle that I use to draw with. I use two needles so that the needle that I inject with will stay sharp, making it easier to pass through the skin with little to no pain
3. Unscrew the needle from the syringe and set it aside (plastic cap should still be in place)
4. Take the drawing needle and screw it onto the syringe
5. Take an alcohol wipe and thoroughly clean the top of the vial
6. Take the syringe and draw about 1cc of air
7. Plunge syringe into center of vial and inject air into the existing air pocket. This creates positive pressure which helps the testosterone drip into the syringe
8. Pull back on the plunger to the correct dose
9. Flip vial upside down and watch that magic elixir fill the syringe
10. Pull out of vial once the syringe is filled with the correct amount
11. Slowly push the plunger until a tiny drop comes out of the needle. This makes sure you have no air in the dose
12. Clean the injection site with an alcohol wipe
13. Grab quad muscle HARD. This lessens the chance of that pain often associated with injections. This WORKS
14. Slide needle in at least 1"
15. It was suggested that I slightly draw back on the plunger to make sure I didn't hit a vein. No blood means I am good to go
16. Push that plunger in and feel the rush of another dose of testosterone!

Injecting myself had an almost zen-like quality to it. The message I am receiving is that I am in charge of my own body. It says that I am truly committed to the pasth I have chosen. I am surprised I did not feel more trepidation about it. I used to be the kid that would wait and have to be held down when it was time for a booster. But this time? It felt so natural. Of course, my motivation is much higher than it was as a child.

Oddly enough, my biggest concern wasn't about "sticking myself in the leg." It was making sure that I had the preparation down.

My dose is still 100mg/ml every 14 days

I was tired from the time I woke up this morning. After work, I went home and took a nap and was STILL tired upon awakening. This isn't your normal everyday didn't get enough sleep tired. This is every cell in my body is tired. Usually, I feel awake and refreshed after a nap. But not this time. It should be noted that I ate 3 times today AND downed a protein shake so I seriously doubt it was a blood sugar thing. I have to wonder if perhaps I am low on T already. I get my second shot on Monday.-

I felt buzzed for most of the day. Not that "hey man, don't bogart the bong" buzz but very energetic. In fact, I was sort of climbing the walls, or making those around me want to climb them. The guys have talked about this effect when they started T. I didn't pay much attention to them about this. I thought "ooh energy would be nice but I bet they are exaggerating." They aren't. I just kept thinking, "I gotta work out. I must work out." Feeling so much energy and not being able to channel it effectively is quite frustrating. Unfortunately, work took priority and I had a previous engagement in Federal Way which kept me from being able to blow off some steam.

I blow off steam by getting in shape. I bought a membership to the gym by my work and I am there 3-4 times a week. Couple that with biking or hiking and I am in better shape than I have ever been in my life. I have noticed so much progress in my overall strength since starting to work out that it keeps me highly motivated to keep it up. This is a good thing because one of the less desirable side effects of testosterone therapy is increased weight (probably due to increased appetite). Now, if I am going to weigh heavier, I'd rather it be muscle instead of fat. I want to be in optimal health for my surgery. Heck, I want to be in optimal health for life. I feel so much better and while my body image has improved dramatically since making the decision to transition, it is going through the roof with this new commitment to take care of it.

One of the more interesting "side effects" of taking testosterone relates to my libido. And one of the first physical changes that I've noticed was clitoral growth (which comes in very handy for a metoidioplasty). What this means is that not only is my libido turbo-charged, but my genitalia is uber-sensitive. This can make for a dangerous combination, when you get right down to it. Genetic men have it easy in a sense because once they are done with the human tangle, that's it. But for me, I am the energizer bunny. I can keep going and going and going. Now, most of the time, I think this is a pretty wonderful thing. However, thinking about what I want to do with the Love of My Life while taking someone's coffee order can be...distracting.

So now the game becomes one of self control. I suppose this is what every teenage boy goes through on his way to becoming a man. And, after all, I AM effectively that teenage boy coming of age in a 44 year old body. My advantage is that I have enough experience in social settings that I pretty much know what is appropriate. I'm certainly not perfect in acting appropriately but when I don't act as expected in social situations, I'm making a conscious choice.

Now, there are a number of things that go into my increased sex drive. I don't believe this is ALL testosterone-fueled (though that certainly does help matters along). One thing that my decision to transition has shown me is that I really am my own man. I am now strong enough to stand on my own which gives me so much more to share with the love of my life. I also think being comfortable in my own skin is a pretty powerful aphrodisiac in and of itself.

For the first time since my endo ablation, I was spotting. Normally, this would be no big deal but I am talking close to 4 years with absolutely nothing even resembling such an occurrence. I was also a bit crampy. I'm attributing this to the war being raised between the estrogen and testosterone. Since I know what the outcome is going to be, I'm not too concerned.

It should be noted that I am under active care with a physcian and I told her about these new symptoms. Because I have direct family history with ovarian cancer (my mom had it but survived), my doc has a very low threshold for anything like this that is going on. Because I have lived under constant fear of getting cancer since my mom was diagnosed, I happily agreed to an ultrasound to make sure everything is in proper working order.

My doctor is so concerned about the mental health of her FTM patients and it is kind of cute. As I mentioned earlier, she and her staff are fantastic as far as respect and knowledge goes. But it was almost like she regretted me having to go through a pap smear during my physical. And she kept re-assuring me that I would be in control of the ultrasound because she only likes to refer patients to healthcare providers who are also respectful of trans health needs.

Now, I'd like to be rid of my female parts and that will happen in due time. For now, though, I consider it vitally important to take care of all aspects of my health so I am pretty matter of fact about such medical issues. This female genitalia is still a part of my body and I cannot afford to simply ignore it.

To say that I was excited would have been an understatement. Breanna says that I was grinning from ear to ear. My physical transition begins NOW. I recently found a good doctor thanks to my friend who highly recommended her. I loved my old doc but she had to retire after some health issues of her own. My new doc (hey there Dr. Gromko!) has many trans clients and is extremely knowledgeable about the health issues of trans patients. She and her staff are incredibly respectful and know how to put us at ease in what is often an anxiety-laden environment.

Now, in most cases, care providers tend to follow what is called the Harry Benjamin Standards of Care (SoC). These SoC help care providers discern how to provide optimal treatment for clients with GID. Usually, the process can take over a year to be able to start physical transition. A letter from a qualified gender specialist is required by many doctors before they will prescribe hormone replacements because many of the changes associated with hormone therapy are permanent. For instance, I could lose my hair and stopping T won't make it grow back (please gods, no hair loss *sniff*). My voice will stay in a lower register because T will thicken my vocal cords. There are other changes I will not go into here but recommend Hudson's FTMGuide for more information. I had received my letter from my therapist several weeks earlier and was just awaiting my doctor's appointment to get started.

That morning, I felt like a kid at Christmas staring at all the presents under the tree and knowing it was too early to wake the parents. downtown Seattle until it was time to pick up Breanna and head to the doctor (Breanna wanted to be there since this is a life-changing event). The medical assistant came in and did all the medical assistant stuff and then we awaited the doctor. She came in and asked me what I thought the testosterone would do for me and I told her it would help masculinize my body. She then listed the changes and had me sign a consent form stating that I realized and accepted that some of the changes caused by hormone therapy are permanent. Then, she had her medical assistant call the prescription in to the pharmacy and said that he would give me my first injection once I go to pick it up. YAY! It is HAPPENING! OMG!

Luckily, the pharmacy is just a few blocks away so off we headed. We got to the counter and explained that my doctor's office just called in a prescription for me. Since only minutes had passed, it took them awhile to find it. Not only that, but, as usual, it was extremely busy so I was afraid I had another 30 minutes' wait in front of me and Breanna's time for this was coming to an end (she took time off from work to be with me). The gal at the counter asked for my insurance card and as I was getting it out of my billfold, I heard a familiar voice say that insurance probably won't cover it but she'll check anyway. Standing in front of me was none other than the best friend of one of the guys in my support group! What a treat to see a friendly face as I start a whole new chapter in my transition. She then took the card and prescription from the first gal and went off the do her pharmacy tech magic. No more than 10 minutes later, back she comes with my magic vial and the pharmacist to go over the details. She also informed me that my insurance was VERY good and I only had to pay $17 for the testosterone and syringes, which, at my current dose, will see me through several months.

Off we go BACK to the doctor's office. We waited a few minutes for them to clear a room. I had a few butterflies thinking WOW! This is showing some serious commitment to the path I am on. Then the butterflies dispersed and I was ready. The medical assistant went thru all the steps of correctly filling the syringe with my dose and then called "the expert" in because he needed to learn how to teach people to shoot up in the thigh as well. In walks the woman who is an utter master with the needle who gives me more tips for a successful injection (squeeze quad hard, then fast in and fast out!). She asked if I was ready and as soon as I said yes, she was in and out in a flash. WOW! My first shot of T was now coursing thru my system.

My dose is 100mg/ml every 2 weeks. This will probably change over time but it is a good starting point.