Unexpected HRT Side-effect #11

Fire drill: addendum #1

Did I say two days? I meant five days.

It is a known quantity that our customer database contains both structural flaws and a significant amount of bad data. We have another IT team working continuously on addressing these issues.

However, for a variety of reasons, it’s my team that tends to discover these problems. That’s exactly what happened this week; and it added another couple of days to the firefighting efforts.

I cannot express enough the tremendous frustration that comes with running into an obstacle of this nature. The are plenty of other industries in which a past decision can come back to haunt you; but the abstract nature of software development lends itself particularly well to ensuring these landmines are unnoticed until, of course, someone inevitably steps on one.

Absence

Apologies for not being particularly present of late; I’ve been dealing with some frustrating health issues.

As I noted previously, I was gifted a cold by a coworker in early December. The following week I contracted another respiratory virus. This was was rather more severe:

First, it induced acute bronchitis; the net effect of which is that I ended up in the ER with an oxygen saturation level of 85%. The blood tests, EKG, and chest X-ray all came back clear; so I was discharged with antibiotics and a course of steroids.

The day after, the virus began to affect me neurologically. My long-term memory, short-term memory, and focus all started to wane. I developed a sensation of weakness in my arms, palpitations, insomnia, severe anxiety, and an impending sense of doom.

The palpitations, anxiety, and sense of doom thankfully receded. Unfortunately, I also lost the ability to regulate my temperature and my blood pressure when changing position.

It looked like I was over the worst of it, until I spontaneously developed neuropathy in my lower limbs. That earned me another trip to the ER, where they ruled out - in their words - “Anything super-deadly”. (I also got my first ever IV catheter, which I found kind of annoying; and a lumbar puncture, which was pretty interesting!)

The neuropathic symptoms have also receded somewhat; but the weakness in my left arm has grown worse, and now there’s a tremor in my second and third fingers. I’m currently waiting on additional neurological tests to determine the cause (’waiting’ being the operative word; after all, heaven forbid I have an MRI without my health insurer getting to sign off on it first)!

I know where a lot of people’s minds are going to go given the timing, and I don’t blame them; but: it wasn’t COVID. Two antigen tests, three PCR tests, and a nucleocapsid antibody test all indicate that this was a routine respiratory virus that just got completely out of control.

Two fun sidebars though:

First: between the tests from last year’s check-up, and the tests from the ER, I discovered that my lymphocyte numbers are routinely low. As measures go, it’s not a one-to-one predictor of immune health; but it does suggest that there’s something not quite right with my immune system, and that this might explain why even minor illnesses cause me significant secondary issues.

Second: I’ve written at length about how COVID tests set off my PTSD. (It’s not a rational reaction; but one borne of my younger self confusing their invasive and required nature with past violations of my bodily autonomy.)

The second go-around at the ER, the nurse performing the test was extremely thorough and as a result, I experienced arguably the most discomfort of any test to date. However, I was able to manage the situation well; in large part, I now recognize, because that selfsame nurse had a warm and sympathetic bedside manner.

That leads me to think that it’s less the physical discomfort of these acts that I find triggering; and more that they are being performed without care or consideration for my person. I’m still trying to make sense of the ramifications of this insight; but it’s beginning to seem like the core of the problem is that I’ve been dehumanized in the past, and this is what I’m so afraid of happening again.

For as long as I can remember, I've been in the habit of carrying around all manner of spare tools and supplies for whatever minor emergencies life might throw in my direction.

Since downsizing from a backpack to a messenger bag, I've had to give greater consideration to the volume and weight of such items; but this has only served to gamify my choices!

(Heck: I've modified my current bag multiple times, to better organize the contents; and now I'm planning to construct a new bag from scratch, to hold everything exactly the way I want.)

The following are always in my bag:

Hedgehog best friend;

Keys (on a retractable winder);

Wallet and checkbook;

A6 notebook(s), pencil, ultra-fine marker;

Hairbrush, hair ties;

Netbook and charger;

Folder of miscellaneous papers;

Spare N95 masks and hand sanitizer;

Tissues, spare pad¹.

There are two optional item sets that I include unless traveling light - a personal care bag:

Nail clippers, nail file, tweezers;

Hand lotion, lip balm;

Travel toothbrush, flushable wipes;

Medications;

Basic first-aid supplies (i.e. Band-Aids, pain relief).

...And what could broadly be termed a 'repair kit':

Multi-tool², bit driver, additional bits;

Needles, thread, safety pins;

Universal charging cable³;

Emergency rain poncho⁴.

¹ I'm a great believer in the idea that trans girls should carry a spare pad, in solidarity. However, this also proved personally helpful during my lengthy period (no pun intended) of post-reassignment healing.

² Once used to fix the latch on an ornery stuffing machine at a Build-A-Bear.

³ Each year I attend a convention with my friend; and one of the major highlights is a puzzle-solving activity - the research for which can quickly drain a phone battery.

⁴ Prompted by a situation in which I had to cross a small distance through driving rain, and did not have an umbrella with me.

@ people who carry bags everywhere what do you put in them what is there to bring other than chapstick, keys, phone and maybe a tampon why are you packing a suitcase to be outside for 5 hours

My spouse and I just had the most wonderfully absurd exchange regarding a hypothetical scenario in which the titular protagonist of the 1968 musical Oliver! was portrayed by the (inexplicably and uncommented-upon) fully-grown actor, Henry Cavill.

This lead to the following delightful mental image:

Me

And the photoshoot results are in!

It's not often I do something like this - I'm still very self-conscious about my appearance - but it's nice once in a while to see how far I've come.

Signs I was obviously trans and I’m a f***ing idiot for not realizing it sooner #1

This is something I beat myself up a lot about: I knew, at age twelve, that I was different. At twenty-two, I was actively trying to bust out of the gender box. For a variety of reasons however, I kept it sealed for another fifteen years; an act for which I am deeply remorseful.

Hopefully I can diffuse my regrets - if even only a little - by noting, tongue-in-cheek, all the obvious signposts that I blew past on my way to the city of Obviously Not-Cisville.

To that end:

Somewhere around 2008-ish, I spent a lot of time in a particularly dark corner of the Internet; a site that has been aptly described as the “Mos Eisley Cantina of the online world”. A place that, paradoxically, was filled with the most socially malfeasant individuals, yet accepted all.

There was a board that had originally been dedicated to the subject of cross-dressing; but for obvious reasons was now home to a thriving transgender community. Equally understandably, a major topic of conversation was achieving certain transition goals - e.g. modifying one’s physical appearance - without professional medical guidance.

(Bluntly - DIY’ing hormones. I’m no going to judge anyone that goes this route; although there are legitimate safety concerns to be aware of.)

Anyhow, this is all a long-winded way of explaining why, when sorting through some backup files recently, I stumbled across three guides I had presciently saved from those days. In order: “Cute Boy Aesthetics; “How To Achieve ‘Trap-Mode’ Aesthetics”; and “How To Girl”.

But me? Pshhh! Totally not trans! 🙄

Sandwich

I have friends that are LGBT and (for reasons that are fairly obvious) refuse to eat at Chick-fil-A. However, they have family that continue to do so; and there's been an ongoing conversation on how said friends might convince said family to desist.

During that discussion, the subject of alternatives came up; and how the competing Popeye's chain serves a superior fried chicken sandwich. I wouldn't know - I've never eaten at Popeye's - but there's one in the area and I was exhorted to try it out.

That's exactly what I did - and what I can say is:

I'm not a huge fan of drive-through, but at least my voice training must be working because I got a "Will that be all, ma'am?"... That made my day!

It was a pretty good sandwich! Definitely a viable alternative to Chick-fil-A's; and also doesn't come tinged with the baggage of homophobia.

Would definitely go again!

I grew up in the UK. As a teenager, I inadvertently lacerated my index finger; an injury that necessitated emergency medical intervention, followed by surgery to repair the two tendons I had severed.

The total cost to myself and my family: £0.

A few years later, I was employed; and I am lead to understand that around 11 - 12% of my income was taxed in the form of National Insurance (which pays for the NHS; plus a number of other significant social services).

...

I then moved to the US; where I contracted a series of common respiratory infections that, unfortunately, would routinely lead to such complications as bronchitis, pneumonia, and (on one memorable occasion), pleurisy.

My first major introduction to the exorbitant cost of American-style, privately-funded healthcare came when, during one of these instances, I needed a chest x-ray; for which I paid $400 out of my own pocket (equivalent, at the time, to a month's rent).

There was a later instance in which a family member was experiencing breathing difficulties, and was directed to the ER. The medical professionals involved ordered virtually every test in their arsenal (as they were not privy to, nor concerned, with the costs involved). Our private health insurer refused to pay for these, citing the need to investigate a possible preexisting condition.

That one event cost us $15,000.

...

At my company, a mid-level employee is paid a salary of $60,000. They then have the option to purchase a mid-range private health insurance plan with coverage of all family members. This costs $600 a month; 12% of their income.

So far, there is relative parity with the NHS.

However: the plan also includes a $3,750 deductible; and a $7,500 out-of-pocket maximum. That is to say: until you reach the first threshold, the insurer pays little to nothing; and it is only when you reach the second threshold that they will pay for the entirety of your care.

(And this does not account for out-of-network care; i.e. conducted by medical providers that do not have a contract with the health insurer specifying payment rates. The out-of-network thresholds are tracked separately; and both are on the order of tens of thousands of dollars.)

So really, in the event that you actually need to exercise your health insurance, you are potentially paying up to 24.5% of your income on healthcare.

But wait, there's more!

The aforementioned $600 per month isn't the full insurance premium; merely the part the employee pays. The employer also pays a portion - another $1,600 per month.

(This is, of course, part of the employee's overall compensation package; but most Americans don't think of it as such, as the expense circumvents their paycheck. Just one of the many ways by which the true cost of private health insurance is kept opaque.)

So really, our hypothetical mid-level employee receives $79,200 per year in compensation; of which a minimum of 33% goes to healthcare (and as much as 42% if you actually need to exercise said healthcare).

(Now to be fair: a family health plan would cover our employee's partner; so their contribution of income would be 0%. Assuming that they earn a similar salary however, you are still looking at an average cost of between 16.5% and 21% for each partner.)

...

The American healthcare system is a travesty; one where health insurers and (other various middlemen) demand an enormous portion of American income, while interfering with (and frequently preventing) access to care.

The simple reality is that private industry will, in any given context, prioritize profit; and that in certain sectors of service, this will place the needs of industry in direct conflict with those in need of said service.

Put another way: to make a dollar of profit in the healthcare industry, you must take it from someone that has paid for and needs healthcare; and then you must choose to deny said healthcare, and keep it for yourself. It is the vampiric exploitation of a group of people particularly unequipped to fight back.

The people of the UK should seek to defend, tooth and nail, any and every attempt to not only privatize the NHS in general, but especially at the hands of the same US health insurers that have so successfully raised costs and lowered health outcomes.

The NHS will last as long as there are folk left to fight for it” – Aneurin Bevan

I’m no fan of Keir Starmer or Rishi Sunak. Sunak is completely out of touch with ordinary people and Starmer will promise just about anything to get himself into power and then break those promise when it suits him.  However when it comes to the future of the NHS I feel it will be safer under a Labour government than one run by free market, neo-liberal Tories.

From a purely selfish perspective  - something the Conservative Party excels at - the NHS saves all of us a small fortune. When your child needs medical care it is free at the point of use; when your parents need medical care it is free at the point of use; and when YOU need medical care it is free at the point of use.

Of course we pay for this through taxes and national insurance contributions but the clue is in the phrase “national insurance”. Medical treatment in Britain, is, at the moment, paid for through collective funding. It is a system based on community, social responsibility, and the old fashioned concept of caring for your neighbour. . Aneurin  Bevan, the "Father of the NHS” said:

“No society can legitimately call itself civilized if a sick person is denied medical aid because of lack of means."

It is a sad fact that Conservative Party members, many of them rich individuals who can afford private medical treatment, have been undermining the NHS because of their unwavering adherence to the ideological belief that all things run by private enterprise are good while all public sector institutions are bad. . The Tory’s will, of course deny this, claiming the NHS is save in their hands and that they have no plans to privatise it.

 Lets look at the facts.

Despite Prime Minister David Cameron promising there would be no cuts to the NHS this was the headline in the Daily Mirror when the Conservatives took over from Labour in 2012.

“David Cameron cuts NHS spending by £500million.” (06/11/12)

Two years later and we have this headline from the Guardian:

“David Cameron accused of hypocrisy over £1.4bn ‘raid’ on NHS funding." (06/07/2012)

By 2014 NHS staff were on strike because of the Tory government refused to give them a 1% pay rise. Rows over poor pay and under-funding continue to this day.

While Jeremy Hunt was Health Secretary patient experience and staff moral took a dramatic turn for the worse. Despite presenting himself as a “champion of patient safety”, targets were missed, waiting times increased, and the very fabric of some hospitals began to crumble, leading to Hunt being labelled “the man who ruined the NHS”. (Open Democracy: 08/07/22)

In 2016 The Independent ran this headline:

“Jeremy Hunt co-authored book calling for NHS to be replaced with private insurance.” (10/02/2016)

Is it any wonder the NHS has been seriously under-funded and run down when the man in charge was an advocate of private medical health insurance? Millionaires like Cameron (£40m) Hunt (£15m) and Sunak (£651m) can afford to pay for expensive medical care but the rest of us are not so fortunate.

This brings me back to the purely selfish reason we should vote for the party most likely to protect the NHS. Below are some AVERAGE costs for private medical procedures and treatments in the USA provided by Statistica 2021

Heart valve replacement…….$170,000     £133,390

Heart bypass………………….......$123,000     £96,518

Cornea (per eye) ……………......$17,000       £13,339

IVF treatments ………………......$15,400      £12,084

Hysterectomy ………………….....$5200          £4,080

In addition, Americans have to pay for their stay in hospital. This fee is on top of medical treatment costs. According to Debt.org (30/11/23) the price for the average stay in hospital of 4.6 days is $13,262. (£10,406)

Whatever your political leanings, the protection and restoration of the NHS should take precedent over all other electoral considerations because we will ALL need medical treatment at some stage in our lives be that as a child or as an adult.

We know the Tory mantra "private sector good public sector bad” just doesn’t live up to reality: we only have to look at our polluted waterways to realise this. Whether Keir Starmer would be any better at protecting the NHS from profit motivated private companies is a moot point.

With headlines like:

“Can Wes Streeting’s private sector plans save the NHS?” (Guardian: 14/04/24)

and

“Labour’s Wes Streeting just used the SUN to talk up NHS privatisation” (Canary: 08/04/24)

we cannot rely on the Labour Party leadership to protect the NHS from the profiteering private sector, not least because Wes Streeting has been paid £175,000 from donors linked to private health firms. (National: 14/04/24) There is no such thing as a free lunch so one doesn’t have to wonder to hard what these “donors” might want in return for their money!

Even so, I feel there are those within the Labour Party who would work very hard to stop the leadership of the party from running down the NHS to the point of collapse, as is the Tory plan, so with great reservation I will be voting Labour in the coming elections.

Save Our NHS

Housewife

I wish I was a housewife.

Perhaps I have overly romantic notions about such a thing; but I greatly enjoy cooking and cleaning and other domestic pursuits. It brings me such great joy, ensuring each day that my wife comes back to a house that is just a little nicer than the one she left.

Similarly, I greatly enjoyed the time I was able to spend with my daughter during her infancy; and took delight in being her tour guide to the world. Keeping home and raising my child seems pretty neat!

Instead I threw myself strongly into being a financial provider; and now I see that the same energy can exist in the role of homemaker - merely expressed through many small acts of love, rather than the singular act of acquiring income.

I try (with limited success) not to be overly regretful of my life choices. At least in this instance however, I do not blame myself; as I ended up a software developer and not a homemaker because of the godawful capitalist system we toil under and not because my perceived gender at the time drove the choice.

All the same: I wish I was a housewife.

Another Test

It came to my attention this afternoon that a colleague had left the office on Friday, feeling unwell; and come Saturday had tested positive for COVID. This individual is someone that works two offices down for mine and is often in close proximity.

This meant, of course, that it would be wise of me to go get tested again. The last time I was tested, it triggered a lengthy flashback.

(As always, I stress: my response to these kinds of medical scenarios is a result of my PTSD, and not an indictment of medicine. Get tested, get vaccinated, protect yourselves and others!)

Anyhow: I wasn't super thrilled about this turn of events, and let my boss know that I was heading out and most likely would not be back for the day. He did very kindly point out that we had some test kits in-office (allegedly; nobody seemed to know where); to which I countered that the last thing my coworkers needed to see was me in tears.

Fast forward: the system for registering an appointment at the test site worked well this time; and apart from a small hiccup (they had moved a mile down the road to a new location), everything was pretty much the same. The technician asked me to sit in the car and came back with a swab and sample vial.

Now, here's where things differed slightly: when my spouse was initially tested (all the way back at the start of the pandemic), the swap took the form of an elongated Q-Tip. Having this pushed all the way to the back of the sinuses was unpleasant; but I understand the discomfort subsided quickly as soon as the test was completed.

When I was tested for the first time, the swap had clearly been updated with comfort in mind: there was a thin, flexible plastic stem with a small, soft, sponge on the tip. It wasn't inserted fully into the sinus, and frankly, there was no pain or discomfort to speak of.

This is what I was expecting to see again; so imagine my unpleasant surprise when the technician withdrew from its sterile wrapping what I can only describe as a fiercely-bristled pipe cleaner.

The technician proceeded to tell me to hold my breath for five seconds, which was also a new and highly discouraging change in procedure.

I warned her that I might be somewhat unresponsive after the test was administered and not to take that personally; and she understood. Then came the part where I tilted my head back, closed my eyes, and felt this monstrosity enter my left nostril. The technician counted to five while sawing this thing back and forth along every side of my sinus cavity.

To be clear: I am no stranger to unpleasant sensations (which I will note shortly). This, however, was absolutely misery-inducing. I broke down crying the moment the technician turned away from me.

Six hours later, and my sinuses still hurt. They itch, constantly; and my nose has been running all evening. I cannot possibly fathom which person thought it was a good idea to take what was already an invasive, annoying test - and make it infinitely worse.