A long overdue update

It has been way too long since I have written a post here. I have spent the past 8-9 months fighting with my body in one way or another. Some of it related to my transition and some related to having arthritis in my knees. Last September I injured my left knee running for a bus as I was headed to work. Recovering from the knee injury in addition to recovering from top surgery would have been enough for me to be getting on with, but I also had to switch to a different formulation of my hormone therapy. In the US I was on 150mg of testosterone cypionate injected once a week. Not knowing how long it would take me to get trans care in the Swedish medical system, I brought almost a year’s supply of T with me when I moved. Once in the system I found out that testosterone cypionate is not available here. The only T available here is something called Nebido, which is a long release injection designed to last 12 weeks. Whether it was a language failing in understanding time schedules on my part or a failing in setting the time schedule on the part of the endocrinologist, I ended up on the wrong shot schedule when I switched. Even though Nebido is supposed to be a 12 week cycle, there is a ramp up time, so your second shot is actually supposed to come 6 weeks after the first. Because I was already on T, I guess the endo didn’t think I would need the extra ramp up time and scheduled my second shot for 12 weeks. In an unfortunate happenstance of timing, I ended up hitting a low in my T levels at about the same time I was hitting a depressive cycle from the top surgery anesthesia. I had been warned about the depression that could come after surgery so I didn’t know that part of the problem was that my T levels were too low.  A month after surgery I had my next injection. I started feeling better but still hadn’t put it together that it was my T levels causing problems. It wasn’t until 2 months later in the beginning of February that I started to realize something was really wrong when I began to experience severe depression that couldn’t be explained by life events. On the outside life was great. I was healing well from surgery and I had a wonderful freedom from a constant source of suffering for the first time since puberty. I had an awesome marriage to a beautiful woman. I had a good job where I was well liked and respected. But internally I was struggling to find a reason to keep going. It was maddening. I had felt this kind of depression before when I would have a particularly difficult monthly cycle so it finally dawned on me that my hormone levels were off. I tried to stick to the 12 week schedule but finally broke down and took my T shot early in hopes that it would relieve some of the depression. I was right and the shot did help, so I scheduled an appointment with the endocrinologist. The first endo I saw had moved to a different hospital so I ended up seeing a different doctor. She was the one who explained that I was supposed to have ramped up on the Nebido, even already being on T. She tested my T levels at 8 weeks and found that they were already getting low so she reset my shot schedule to every 8 weeks instead of every 12. I have been doing better, but I still feel like my levels are getting lower earlier than they should be. I have decided not to try to have the schedule changed until after my hysterectomy though. The hysto will alter my hormone levels anyway, so it will be easier to get things adjusted once that is done. I don’t yet have a date for the surgery, but I have completed the pre-op appointments and am just waiting for the surgery department to set the date. They are doing this one using a robot assist and the robot is typically scheduled for more urgent cases in the summer months. The doctors expect that I will be given a surgery date sometime early fall. Hopefully in September.

Through all of this I have also been dealing with arthritis as well as a knee injury. I went through a few months of physical therapy designed to help strengthen the injured knee and to help with the arthritis. I have been on an exercise routine with a stationary bike that is helping and a couple of weeks ago I started back on my weight lifting routine for upper body workouts. I am feeling stronger with less pain and have even lost 3kg  (6.5 lbs) in the last month.

It has been a long haul dealing with the physical pain of recovery while going through repeated cycles of soul crushing depression, but things are finally calming down now that I am on a better T cycle and have a consistent exercise routine. Life is finally starting to get back to something resembling normal, so I hope to be writing on a more regular basis. Feeling more like myself again should help.

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