Started HRT and 1 week later had a mild stroke

[Joanne07081]

Good morning

As the title says, I started HRT the Thursday before last. I was on ***mg estradiol and ***mg finasteride per day as a starting dosage. I do have a history of heart issues and have had 3 stents. I also have a stable (not changed in 3 years) aneurysm on my ascending aorta of my heart. I am not out to my PCP, but my regimen was approved by my cardiologist. 

Fortunately, when the stroke came on I convinced my co-workers to get an ambulance and I was treated at the local hospital quickly. I sustained no damage from the stroke and was told I could return to work with no restrictions. 

When I started on HRT, I consulted with my prescribing doctor and we discussed the issues with oral estradiol. I convinced her to talk to my cardiologist and we all agreed to try oral estradiol. Since hindsight is always 20/20, I should have listened to my prescribing doctor and gone on the patch. I have reached out to her and hopefully I have not screwed things up and she will not prescribe new meds.

My main reason for writing this is to caution people about these meds. They are nothing to play around with, especially if you have pre-existing conditions. I was extremely lucky and have no side effects that I can see.  Work with a reputable health care provider who understand transgender needs and by all means, please take care of yourself. 

[Jackie C.]

Thank you. That's something we always try to drive home to people. These medications need to be monitored by a qualified doctor who knows what they're doing. They are not something to mess around with.

 

Hugs!

[Delcina B]

Thank you Joanne, I've just starting seeing my GT. We've set the 3 month mark for deciding about HRT. Hope this was just a bump in the road for you.

 

Hugs!

Delcina

[Heather Shay]

@Joanne07081 thank you. First of all I am so happy you acted quickly when you felt signs of a problem and I hope you are recovering. Second interacting and being able to get coordination between doctors to benefit the patient. I took HRT from gray market sources and developed prostate issues and luckily caused no permanent damage. I started supervised HRT almost a year ago and have never felt better.

Your warning is very gracious and kind and I hope those considering HRT will listen to your advice.

[Carolyn Marie]

Thank you for your information, Joanne.  I'm glad to know that you're going to be OK.  Are your doctors convinced that it was the Estradiol that caused the stroke?

 

Carolyn Marie

[April-Showers]

i'm sorta confused by this post. you said you have not come out to your PCP but it sounds like you are seeing other MDs. what is the problem with your PCP that you are afraid to come out to her or him? usually a PCP is the MD who knows your medical history best and that you have a good relationship with. just curious that you would have a PCP that you can't be totally open with. i'm glad you are ok and didn't suffer any serious problems. take care and i wish you well.

[Jackie C.]

To be fair, my PCP didn't know for a couple months until after I'd been taking HRT either. I didn't need a referral to see my first gender therapist and endo through UofM. I told him the next time I saw him and I updated him on my meds, but he wasn't involved in the initial... anything really.

 

Hugs!

[Joanne07081]

12 hours ago, April-Showers said:

i'm sorta confused by this post. you said you have not come out to your PCP but it sounds like you are seeing other MDs. what is the problem with your PCP that you are afraid to come out to her or him? usually a PCP is the MD who knows your medical history best and that you have a good relationship with. just curious that you would have a PCP that you can't be totally open with. i'm glad you are ok and didn't suffer any serious problems. take care and i wish you well.

I realize my post is a bit confusing, sorry about that. Things seem to be a bit out of sorts since this happened. 

To (hopefully) clear things up a bit. I signed up for Folx a few weeks ago to start low dose HRT. I have been wanting to for years but life got in the way. My physician at Folx looked over my medical history and wanted to have a consultation with my cardiologist, so I arranged for them to get together. They discussed my history and agree to start me on a low dose regimen to see how things go. I have not had the opportunity to discuss this with my PCP because their office is so booked up my next appointment with him is not until December. Now, since my stroke I have a follow up appointment with another physician in their office tomorrow, so I am coming clean at that time. 

 

My prescribing physician wants me to stop my regimen (which I did )until I consult with my cardiologist about switching to the patch instead of the pill. I was able to make an appointment with my cardiologist for next week to discuss my options. We cant say for sure that it was the pill that caused the stroke, but the possibility cant be discounted. I have a good team behind me and will be adding more after my PCP appointment tomorrow. 

 

My original plan of slowly transitioning in stealth mode over the next 2 years before I retire has been derailed. Now things will be more out in the open, which if I think about it, is probably the best way for ME to go.

 

 

 

[Joanne07081]

Just some quick updates...

I have a follow up appointment with my PCP today from my hospital stay. I will be bringing them into the fold, hopefully they will be as good to me going forward as they have been since I started seeing them 18 years ago. My wife will be going with me as well.

Which brings up my second update...

My wife and I had "the talk" yesterday afternoon. When we got back together 8 years ago, I told her all about my transition just so I could come clean from the start. I will admit that I told her I had things under control, which I thought I did at the time. She was almost as surprised by my conversation as if I had never told her at all. We spent the afternoon and evening (and even at 5am this morning) talking and getting things out in the open. She is as accepting as I thought she would be and said she is willing to go down this road to make sure I am happy with myself. She is also understandingly scared that she is losing me, so my main job will be to continue to reassure her that I am not going anywhere and will always be with her. We are not sure how much transition she is going to be comfortable with, so we promised to be open and honest about our feelings and will see where things go.

 

Thanks for listening.

Joanne

 

[Carolyn Marie]

Sounds very promising, Joanne.  I wish you and your wife the best of luck as you both travel this rocky road together.  It can work, as many of us here can attest.

 

Carolyn Marie

[Joanne07081]

17 hours ago, Carolyn Marie said:

Sounds very promising, Joanne.  I wish you and your wife the best of luck as you both travel this rocky road together.  It can work, as many of us here can attest.

 

Carolyn Marie

Well, so far, so good. My wife has been extremely understanding and calm now. I know from my previous transition that there will be bumps in the road (like my latest medical issues) but we are building a good support network for both of us. I had a follow up appointment with my PCP, saw one of the physicians assistants and told her the whole story. Instead of waiting for my next appointment in December, they wanted me back in 3 weeks. I am sure there will be more discussions at that time.

 

Thanks for listening everyone.

[Charlize]

I have heart issues well and have found topical E either the patch, cream or spray to be everything i need.  I've been fortunate and have had no major issues for years.  It is always a bit of a balancing act but i have a wonderful cardiologist.

Just be careful, breath and enjoy each day.  I try to live that way.  

Glad you and your wife are finding acceptance.

 

Hugs,

 

Charlize

[Joanne07081]

4 hours ago, Charlize said:

I have heart issues well and have found topical E either the patch, cream or spray to be everything i need.  I've been fortunate and have had no major issues for years.  It is always a bit of a balancing act but i have a wonderful cardiologist.

Just be careful, breath and enjoy each day.  I try to live that way.  

Glad you and your wife are finding acceptance.

 

Hugs,

 

Charlize

Hi Charlize

Thank you for posting, it gives me some hope that I still have options. I have a visit next Wednesday with my cardiologist and I am going to push to continue on the patch, never thought about the cream and will present her with that option. The one thing I have going for me is that I am back on Plavix and baby aspirin (as opposed to aspiring alone) so I have some extra meds to help controlling any future clots. 

After the initial shock and disappointment of my stroke, I have decided to continue forward with my transition. I have lots and lots of other things I need to be doing that do not involve hormones (restart hair removal, voice training, weight loss, etc) that I will be quite busy for quite some time. Also, it will help my wife's acceptance level if I do not push too much, too fast, especially if it involves risks to my health.

 

Joanne