Happy Saturday! I apologize for the delay. I had promised you a new blog a couple of weeks ago. However, life sometimes gets in the way and we have to re-prioritize. I really do have every intention of being more proactive with this blog as I come up with more content to share other than just my personal life experiences. So, I truly appreciate those of you who hang in there with me because you actually care enough and have enough interest in what I have to say. Much love to you! 💖
I had recently posted photos and status messages from the hospital on social media; some of you may remember the pic of the hospital gown. And many of you reached out with concern to make sure that I was okay. While comforting, this made me realize that I need to do a better job of thinking through my posts before I actually put them out there. I apologize for sending some of you into a panic as that was the furthest from any real intention. If I may, I'd like to share - full disclosure - what has transpired with my health over the past few years so that you will have a clear understanding of why you see a growing number of posts with me at the doctor.
As many or most of you know that I, being transgender, have/had been on female estrogen (hormones, a/k/a HRT) since I began my transition in the early 90's. That equates to almost thirty years. What some or many of you may not know is that HRT does not come without its inherent risks. These risks include, but are not limited to blood clots, heart attack, and stroke. This is one of the reasons I have always urged trans girls and women to seek professional medical guidance when pursuing any type of HRT regimen as we must be monitored for potential contraindications. Before I continue, it's necessary for me to backtrack for a minute and touch on one other thing.
After moving from Nashville, Tennessee to Rapid City, South Dakota during the winter of 1997, I developed a blip with my heart. At first, and for many years, it simply felt as though it would randomly "skip a beat." Doctors assumed it was simply a low-grade panic attack brought on by stress and anxiety even though it would often happen during some of my most relaxed and/or happiest of moments. I thought nothing else of it because it never really worsened into anything more and it only happened once every month or two.
Around 2015, I began experiencing more of a flutter that would last more than just a second or two; it seemed to last for several seconds, and then progressed to minutes, and eventually up to 10-15 minutes in duration. It was more of a rapid heartbeat that wouldn't slow down. I went to a few doctors to try to find out what was happening. Because they could never catch it while it was happening, they couldn't diagnose it. I was even given a heart monitor to wear for a time, which I was to use to record the events when they would occur. But they didn't occur while I was wearing it.
One afternoon in February of 2017, I was relaxing on the couch while watching a movie I had rented from Redbox. I began experiencing one of these episodes and immediately began to time my heart rate. Twenty minutes in, I was at 129 beats per minute. By thirty minutes, I began to panic because I didn't think it was going to stop. So, I drove myself to the emergency room at Sharp Grossmont Hospital where I finally received a definite diagnosis: Atrial Fibrillation. It's important to note that there is more than one type of A-Fib. And while mine is not as severe or as life-threatening as others, it can still be dangerous. During A-Fib, or my particular kind, the heart receives electrical impulses that get stuck and bounce around causing the top chamber to beat faster and out-of-sync with the bottom chamber. As this is happening, the blood is swirling inside the heart instead of pumping efficiently, which can cause other health risks, including an ideal circumstance for the potential formation of blood clots, which could subsequently cause a stroke.
For the next two-and-a-half years, I dealt with the occasional A-Fib. During this time, I also developed slight hypertension (slightly high blood pressure), although it, too was intermittent. Until these diagnoses, I had been very active. I was cycling long distances on a regular basis. I was in the gym 4-5 days per week for 3-4 hours each day. I was excited to be a regular participant in the Team Training classes at Chuze Fitness. I was in great shape and I was feeling pretty amazing. But in one afternoon, it all changed. I suddenly became afraid to get my heart rate up because I was afraid that it could trigger a medical emergency. I stopped working out and began stress eating... a lot. I didn't even realize how much weight I was gaining until I had to replace my wardrobe. This also triggered anxiety and depression, which only served to exacerbate the A-Fib.
After "moving" to Nashville in August of 2017, I found myself in yet another situation that was not conducive to a healthy lifestyle. I continued to eat crap food and did nothing to care for myself. The only exercise I fit into my life was all of the walking and stair climbing I did during my time as Manager at the AMC Theater in Madison. In fact, my situation in Nashville was so toxic that I had no choice but to leave. I was actually forced, but that's another story for another time. After returning to San Diego in March of 2018, I managed to snap out of my funk and stop my spiral before it got any worse. I began to eat healthier and take better care of my body. I still hadn't joined a gym. But I was walking and stretching more and trying to be more active. And then...
July 21, 2019.
7:00am.
My roommates and I were on our way to do a six-mile walk from Mission Beach to Pacific Beach and back, as was the norm for us every other Sunday. I experienced another A-Fib episode while driving. But this one was different. It felt different. Stronger. And I was short of breath this time where I had never been before. After a CAT scan and six hours in the emergency room at Sharp Grossmont, I was told that I had multiple bilateral pulmonary embolisms. In layman's terms, I had multiple blood clots in both of my lungs. Apparently, I "may" have had DVTs (deep vein thromboses) in at least one leg that my body had broken down enough to allow them to break loose and travel through my heart and into my lungs. As the morbidity rate for this type of thing is very high, they put me on Xarelto (a potent blood thinner) and admitted me overnight. I was also ordered to stop taking estrogen as they suspected that it was the cause for the blood clots.
Folks, I count my blessings every single day; I am extremely lucky to be sitting here, typing this blog entry right now. I have been medically monitored since July to make sure that I am tolerating the Xarelto okay. I recently found out that, due to my intermittent hypertension, I may have a slight thickening of my heart in some areas. This is normal as we age, but apparently isn't normal for someone my age. So, because of the hypertension and the A-Fib, instead of taking me off the Xarelto and putting me back on a low dose of estrogen, my cardiologist has instructed me to stay on the Xarelto indefinitely. She wants me to see a pulmonary specialist and an endocrinologist in regard to my ongoing transgender medical treatment to get their opinions as to what my best course of action would be and what would be most advisable under my current circumstances.
Additionally, I was told that I am pre-diabetic and that I need to cut way back on my carbohydrate intake (some carbs convert to sugar in the body). As well, my uric acid is higher than it should be, which can lead not only to gout, but also other cardiovascular issues. Sooo... I have to avoid even more foods that could raise uric acid levels in addition to cutting carbs.
And as if THAT isn't enough...
I take a potassium-sparing diuretic called Spironolactone (a generic form of Aldactone) to help lower blood pressure and to block testosterone. But I have to be very careful of my potassium intake with this medication because I can build up too much, which can have serious health implications. As well, this medicine has been shown to raise uric acid levels. 😳 But I refuse to stop taking it because, without estrogen, it's my only defense against testosterone unless I move forward with an orchiectomy (removal of the testes).
So, as you can see, I am up against quite a challenge. However, I refuse to let all of this hold me back. I have been told by my doctors that there is no reason I shouldn't exercise to my comfort level. I have a stress test and sleep apnea test scheduled for March 30th that should answer a few more questions, as well. And I have been talking about changing my diet for months. Now that I don't have a choice, this could ultimately be a good thing. Side note... I think this is probably one of the hardest pills to swallow in all of this - I don't have a choice. My body seems to be turning on me and I have very little control over it. I am having to make these changes, but they are not on my terms. But I guess it's better than the alternatives, right?
Oh... and the photo of the hospital gown...? I was having a few things removed from my skin (back and shoulders) for biopsy. I had to wear the gown because they anticipated that I would bleed a little bit. Fortunately, it wasn't that bad. We thought the blood thinners might cause more bleeding. But it was surprisingly better than expected. 👍
There you have it; almost everything you probably didn't need to know about my medical situation but was told anyway so you wouldn't worry too much when you see the occasional hospital post from me. I will always keep you updated if it's important, so don't worry.
xo,
Tricia
I had recently posted photos and status messages from the hospital on social media; some of you may remember the pic of the hospital gown. And many of you reached out with concern to make sure that I was okay. While comforting, this made me realize that I need to do a better job of thinking through my posts before I actually put them out there. I apologize for sending some of you into a panic as that was the furthest from any real intention. If I may, I'd like to share - full disclosure - what has transpired with my health over the past few years so that you will have a clear understanding of why you see a growing number of posts with me at the doctor.
As many or most of you know that I, being transgender, have/had been on female estrogen (hormones, a/k/a HRT) since I began my transition in the early 90's. That equates to almost thirty years. What some or many of you may not know is that HRT does not come without its inherent risks. These risks include, but are not limited to blood clots, heart attack, and stroke. This is one of the reasons I have always urged trans girls and women to seek professional medical guidance when pursuing any type of HRT regimen as we must be monitored for potential contraindications. Before I continue, it's necessary for me to backtrack for a minute and touch on one other thing.
After moving from Nashville, Tennessee to Rapid City, South Dakota during the winter of 1997, I developed a blip with my heart. At first, and for many years, it simply felt as though it would randomly "skip a beat." Doctors assumed it was simply a low-grade panic attack brought on by stress and anxiety even though it would often happen during some of my most relaxed and/or happiest of moments. I thought nothing else of it because it never really worsened into anything more and it only happened once every month or two.
Around 2015, I began experiencing more of a flutter that would last more than just a second or two; it seemed to last for several seconds, and then progressed to minutes, and eventually up to 10-15 minutes in duration. It was more of a rapid heartbeat that wouldn't slow down. I went to a few doctors to try to find out what was happening. Because they could never catch it while it was happening, they couldn't diagnose it. I was even given a heart monitor to wear for a time, which I was to use to record the events when they would occur. But they didn't occur while I was wearing it.
One afternoon in February of 2017, I was relaxing on the couch while watching a movie I had rented from Redbox. I began experiencing one of these episodes and immediately began to time my heart rate. Twenty minutes in, I was at 129 beats per minute. By thirty minutes, I began to panic because I didn't think it was going to stop. So, I drove myself to the emergency room at Sharp Grossmont Hospital where I finally received a definite diagnosis: Atrial Fibrillation. It's important to note that there is more than one type of A-Fib. And while mine is not as severe or as life-threatening as others, it can still be dangerous. During A-Fib, or my particular kind, the heart receives electrical impulses that get stuck and bounce around causing the top chamber to beat faster and out-of-sync with the bottom chamber. As this is happening, the blood is swirling inside the heart instead of pumping efficiently, which can cause other health risks, including an ideal circumstance for the potential formation of blood clots, which could subsequently cause a stroke.
For the next two-and-a-half years, I dealt with the occasional A-Fib. During this time, I also developed slight hypertension (slightly high blood pressure), although it, too was intermittent. Until these diagnoses, I had been very active. I was cycling long distances on a regular basis. I was in the gym 4-5 days per week for 3-4 hours each day. I was excited to be a regular participant in the Team Training classes at Chuze Fitness. I was in great shape and I was feeling pretty amazing. But in one afternoon, it all changed. I suddenly became afraid to get my heart rate up because I was afraid that it could trigger a medical emergency. I stopped working out and began stress eating... a lot. I didn't even realize how much weight I was gaining until I had to replace my wardrobe. This also triggered anxiety and depression, which only served to exacerbate the A-Fib.
After "moving" to Nashville in August of 2017, I found myself in yet another situation that was not conducive to a healthy lifestyle. I continued to eat crap food and did nothing to care for myself. The only exercise I fit into my life was all of the walking and stair climbing I did during my time as Manager at the AMC Theater in Madison. In fact, my situation in Nashville was so toxic that I had no choice but to leave. I was actually forced, but that's another story for another time. After returning to San Diego in March of 2018, I managed to snap out of my funk and stop my spiral before it got any worse. I began to eat healthier and take better care of my body. I still hadn't joined a gym. But I was walking and stretching more and trying to be more active. And then...
July 21, 2019.
7:00am.
My roommates and I were on our way to do a six-mile walk from Mission Beach to Pacific Beach and back, as was the norm for us every other Sunday. I experienced another A-Fib episode while driving. But this one was different. It felt different. Stronger. And I was short of breath this time where I had never been before. After a CAT scan and six hours in the emergency room at Sharp Grossmont, I was told that I had multiple bilateral pulmonary embolisms. In layman's terms, I had multiple blood clots in both of my lungs. Apparently, I "may" have had DVTs (deep vein thromboses) in at least one leg that my body had broken down enough to allow them to break loose and travel through my heart and into my lungs. As the morbidity rate for this type of thing is very high, they put me on Xarelto (a potent blood thinner) and admitted me overnight. I was also ordered to stop taking estrogen as they suspected that it was the cause for the blood clots.
Folks, I count my blessings every single day; I am extremely lucky to be sitting here, typing this blog entry right now. I have been medically monitored since July to make sure that I am tolerating the Xarelto okay. I recently found out that, due to my intermittent hypertension, I may have a slight thickening of my heart in some areas. This is normal as we age, but apparently isn't normal for someone my age. So, because of the hypertension and the A-Fib, instead of taking me off the Xarelto and putting me back on a low dose of estrogen, my cardiologist has instructed me to stay on the Xarelto indefinitely. She wants me to see a pulmonary specialist and an endocrinologist in regard to my ongoing transgender medical treatment to get their opinions as to what my best course of action would be and what would be most advisable under my current circumstances.
Additionally, I was told that I am pre-diabetic and that I need to cut way back on my carbohydrate intake (some carbs convert to sugar in the body). As well, my uric acid is higher than it should be, which can lead not only to gout, but also other cardiovascular issues. Sooo... I have to avoid even more foods that could raise uric acid levels in addition to cutting carbs.
And as if THAT isn't enough...
I take a potassium-sparing diuretic called Spironolactone (a generic form of Aldactone) to help lower blood pressure and to block testosterone. But I have to be very careful of my potassium intake with this medication because I can build up too much, which can have serious health implications. As well, this medicine has been shown to raise uric acid levels. 😳 But I refuse to stop taking it because, without estrogen, it's my only defense against testosterone unless I move forward with an orchiectomy (removal of the testes).
So, as you can see, I am up against quite a challenge. However, I refuse to let all of this hold me back. I have been told by my doctors that there is no reason I shouldn't exercise to my comfort level. I have a stress test and sleep apnea test scheduled for March 30th that should answer a few more questions, as well. And I have been talking about changing my diet for months. Now that I don't have a choice, this could ultimately be a good thing. Side note... I think this is probably one of the hardest pills to swallow in all of this - I don't have a choice. My body seems to be turning on me and I have very little control over it. I am having to make these changes, but they are not on my terms. But I guess it's better than the alternatives, right?
Oh... and the photo of the hospital gown...? I was having a few things removed from my skin (back and shoulders) for biopsy. I had to wear the gown because they anticipated that I would bleed a little bit. Fortunately, it wasn't that bad. We thought the blood thinners might cause more bleeding. But it was surprisingly better than expected. 👍
There you have it; almost everything you probably didn't need to know about my medical situation but was told anyway so you wouldn't worry too much when you see the occasional hospital post from me. I will always keep you updated if it's important, so don't worry.
xo,
Tricia
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