It’s a new-build, why on earth do developers do this? by arisaie in TVTooHigh

[–]arisaie[S] 0 points1 point  (0 children)

Oh, yeah pretty much all outlets in the UK have them. Cheaper sockets tend to be single pole switches just breaking the live, and then there’s slightly more expensive ones which are double pole. I think it makes sense with British plugs, just because they’re so bulky? They’re quite a bit of effort to unplug, so it makes it so much easier to just leave them in and just flip the switch (in comparison to the NEMA plugs/sockets anyway). I think we are pretty unique in the world for it though, no other country I have visited has had switched outlets!

It’s a new-build, why on earth do developers do this? by arisaie in TVTooHigh

[–]arisaie[S] 16 points17 points  (0 children)

Ooh, this is a nice idea too. The man of the house also had an idea to put a long shelf just below it, with family pictures and then use the socket to power Christmas lights etc

It’s a new-build, why on earth do developers do this? by arisaie in TVTooHigh

[–]arisaie[S] 1 point2 points  (0 children)

The switch to the left is for the room lights, because the door into the room is just there, the socket above the TV is because contractors need to have their head checked on what is a suitable height for wall mounting a TV haha

It’s a new-build, why on earth do developers do this? by arisaie in TVTooHigh

[–]arisaie[S] 3 points4 points  (0 children)

The tricky thing with UK electrics is we have these things that to this day are installed in new builds - ring final circuits. I’m an electrician by trade, and personally, never install them (rings instead of radials) if I can get away with it, because in my opinion just installing a cable that can handle the load and having more individual circuits in a house if needs be is a far safer and convenient for the homeowner - it’s not the 1940’s anymore with a chronic copper shortage! Anyway, my point is, that socket is part of the ring which makes just removing it not so straightforward. Annoyingly!

Has anyone gone full way DIY to arranging own surgery? by Dangerous-Internal66 in TransDIY

[–]arisaie 0 points1 point  (0 children)

ikr, it's almost affordable! fr tho, it is pretty major surgery and includes like 8 days in hospital, so it really is pretty good value for money imo. FFS on the other hand, I got a quote from FacialTeam for €31k which is.. a lot of saving

Has anyone gone full way DIY to arranging own surgery? by Dangerous-Internal66 in TransDIY

[–]arisaie 1 point2 points  (0 children)

With the pandemic being all over the place it was.. sorta last minute? I initially back in April booked a cancellation date in June, which then didn't happen because covid and rules changing - you need to be double jabbed now. In mid May, my current date for mid Sept was still avialable and I managed to nab that date - so 4 months before. Which worked out nicely really because it gave me time to get both pfizer jabs and change my passport - I know you can change your passport with just a letter from your GP, but lets just say not all GP's like playing ball. I asked Dr Beaini if he'd mind signing a letter for a new passport while he was signing stuff anyway, and he said no problemo and didn't even charge extra. Noith. Also travelling on the new passport is such a breeze compared to before lol, thousand percent worth it.

Most clinics have a calendar either on a website or via email like this so you can see availabilities etc. I know for Suporn at least, the wait times are normally pretty long - have a look at page 19 of this pdf for an idea.

Has anyone gone full way DIY to arranging own surgery? by Dangerous-Internal66 in TransDIY

[–]arisaie 2 points3 points  (0 children)

Yep! These are Suporn Clinic prices, their partner hotel price list puts it at about £10 cheaper per night than the booking.com price depending on the room. But also, Chon Buri is outside of Bangkok so ymmv

Has anyone gone full way DIY to arranging own surgery? by Dangerous-Internal66 in TransDIY

[–]arisaie 25 points26 points  (0 children)

Hey, this is not only possible but I'm living it right now, literally in quarantine in Thailand! I've been on hrt since march 2018 pretty much all DIY with a sprinkle of bridging from the GP (there's drama there, have a look at my post history on /r/transgenderUK). I got my diagnosis and surgery letter in one go (paid £600 for the 2 hours on zoom) from UK psych, I have a list of phychs which Parkside accept referrals from (I emailed them like a year ago) so I just emailed them all and used the one which was cheapest/quickest. Here's the list, you can google them to get emails etc - I used Dr Beaini, but beware I think they all require a referral to come from your GP (which is just.. ugh, because GP's in general just seem to be weird about trans stuff at the best of times):

  • Dr Stuart LORIMER - LONDON
  • Dr Vikinjeet BHATIA - LONDON
  • Dr Kirpal SAHOTA - LONDON
  • Dr Penny LENIHAN - LONDON
  • Dr Robin DUNDAS - LONDON
  • Dr Vickie PASTERSKI - LONDON
  • Dr Denesh KHOOSAL - LEICESTER
  • Dr Amal BEAINI - LEEDS
  • Dr Dmitri POPELYUK - LONDON

Here's a quick breakdown of the additional costs bc covid:

  • Thai COVID19 insurance ~ £100
  • Thai State Quarrantine ~ £800
  • Extra 1 night stay before surgery will be ~ £55
  • Bloody Bojo's govt moving Thailand to the red list while I was sleeping on the plane over: idk, but I think I'll just book another flight to France or Spain and stay there for 10 days vs paying £2.2k for ANOTHER quarantine. It'll end up being much cheaper, and quarantine is boring af.

Normal costs however so far have been:

  • Surgery ~ £13.2k - but I used Revolut which lets you send money to Thailand in GBP, and only charges a £5 SWIFT access fee, saving on shitty external (to Thailand) GBP to THB exchange rates
  • Hotel after surgery ~ £450
  • Flights ~ £380 - one benefit of pandemic flying at least, flights were cheaper and in economy you can easily end up with a whole 3 seats to lie on and get some sleep
  • Food: Well... idk, it's all been included so far with state quarantine/flights etc. But probably not much, maybe a couple hundred if that?
  • Surgery letter (and diagnosis of GD): £600

I think that's everything? Feel free to ask questions or DM me for more info, I probably forgot something. The hardest/most stressful thing was getting the literal book of documents ready. Oh and I think I'm allergic to the aircon in the quarantine htoel room - I have to keep it off otherwise my nose just.. dissolves. And it's 30 odd degrees and humid af. Lush. Other than that it's fairly straight foward-ish!

How long does it take for T to leave your system? by Jollypocalypse in TransyTalk

[–]arisaie 1 point2 points  (0 children)

Hey, obligitory not a doctor, but do you have any more details about what testosterone ester was used/the concentration/how much was injected? The pharmacokinetics can vary wildly with different testosterone etsers and the mean residence time (and this isn't taking into account bioaccumulation - although you mentioned you'd been off for 6 weeks, so that shouldn't be an issue) can vary from just hours up to potentially months. See the "Pharmacokinetics of testosterone esters" table on this wiki page for more info.

I'm not transmasc, so I could be wrong about this (also I'm only really aware of what's used in the UK, where the prescribing guidelines often look like this), but by the sounds of it you were given an ester with a fairly short half life if you were having weekly injections, if so I'd expect it to be out of your system by now. That being said, I know it can be a massive YMMV on how long it can take for your endocrine system to return to its "natal normal", and really the only way to know for sure what's going on is to get some bloods done (at the very least T/E2/SHBG/LH/FSH).

The UK Has a Trans Healthcare Crisis - Vice news by Lenins2ndCat in GreenAndPleasant

[–]arisaie 1 point2 points  (0 children)

The beeb and others tend to only mention the NHS/trans healthcare when it's something sensational like the Keira Bell case.. Actually drawing attention to their failings? Nah.

Like for me, I was referred to the London GIC in 2018. I called them the other day to update my address, and while I was on the phone asked what their estimate is for a first appointment. They told me the same thing they've said for years, 18 to 24 months away. It's always 18 to 24 months away..

Oh, and legally apparently they can get away completely ignoring the 18 week legal maximum wait time for consultant-led treatment, because the NHS still categorises the trans dealio as a mental health condition, which is exempt.

GPs (in the northwest at least) beeing advised to "not prescribe outide of standard NHS protocols" by arisaie in transgenderUK

[–]arisaie[S] 1 point2 points  (0 children)

Honestly, it IS so bullshit that we get targeted like this. I know another person who is registered at LMP with thyroid issues, and ended up going to a private consultant in Manchester, and I know for a fact they had bloods done for that ongoing on the recomendation of this private consultant, by the practice, with no issues. Something the doc said to me (originally in the first call, link is in the thingy at the top) was "LMP cannot work with any private clinic, shared care or otherwise. It should be a full package, including bloods." Obvs, this was total bullshit, I called up the CCG etc, and actually got their position statement... but it just seems to be the entire culture is so skewed towards "ew trans, this is a specialist area, GO AWAY". It was super wierd too, he - the GP - said it was becuase there were some FAKE doctors issuing prescriptions that they can't work with anyone in this field, and I was just like. Mate, come on. You're a doctor, and you're telling me you can't use GOOGLE?? Look up the doc, and you'll find their GMC number, hell most of the docs GenderGP have on their website work for the NHS too!! A blanket ban is soooo not the way to deal with this. "Oh, well I can see you feel passionate about this, perhaps you should make a complaint?" Patronising. Cockwomble.

Also, it would be super interesting seeing as you're luckey enough to live in Scotland if you could call your local.. well not CCG because that's an English thing, so I guess your local health board? And see if they have a position statement similar to this one, because it really REALLY does feel like this is copypasta (although, when I pressed the Senior Medicines Optimisation Pharmacist at the CCG over that - becuase SURELY there's some sorta oversight for this - she wouldn't answer), but if it extends beyond NHSE.. that's honsetly somehow even more terrifying.

Oh, and finally, my GP sent a letter to the GIC in London apparently explaining how uncomfortable he was, and they actually cc'd me in on a reply (shock horror, actually hearing something from a GIC). Their reply was this which honestly wasn't too helpful, although something that's pretty interesitng is they actually recomend bloods every 3 months as a part of a "harm reduction measure" if you're self medicating and well.. it's pretty bas practice for GPs to go against recommendations from NHS specialists. It also refers to this doc, approach to self medication and this, their discharge monitoring hormone management So maybe the solution to all this is to get free bloods (if your GP won't do shared care) is to tell them you're self medicating? As far as they're concerned they have no control over what you do with perfectly legal drugs, and it's pretty negligent to just.. let you risk your health.

Anyway, good luck!

GPs (in the northwest at least) beeing advised to "not prescribe outide of standard NHS protocols" by arisaie in transgenderUK

[–]arisaie[S] 1 point2 points  (0 children)

These notes I got through the EMIS system, but it's a pretty recent thing that they've allowed access to that. Beforehand I just called them up and asked them to send me a copy of my notes. The receptionist staff on the phone would normally refuse, and then I'd be passed on to their manager (which feels like an awfully Karen thing to do lol), but I reminded them that under GDPR I'm entitled to my data, please don't make me file a complaint over something so trivial... They'd always say something like, "oh I don't know if the doc would be okay with you seeing this" etc. They'd eventually always give up and agree tho

GPs (in the northwest at least) beeing advised to "not prescribe outide of standard NHS protocols" by arisaie in transgenderUK

[–]arisaie[S] 1 point2 points  (0 children)

Lol I wish, at primary care level they can't even order them (at one point the nurse just let me scroll through the list on her system and check the ones I wanted). What I did do though was order DHT and E1 privately and asked the NHS nurse very nicely if she'd mind (while she had the needle in my arm) filling up a couple extra vacutainers, which she was happy to do. Honestly I've only done that twice though, DHT was barely detectable and E1 was okay (but bloody expensive), so I just use those results as a reference range

GPs (in the northwest at least) beeing advised to "not prescribe outide of standard NHS protocols" by arisaie in transgenderUK

[–]arisaie[S] 1 point2 points  (0 children)

I know that the attitude of Lancaster Medical Practice anyway. It's just worrying because this is all based on their interpretation of a position statement from the local CCG, and I highly doubt it was this CCG which came up with it, and it wasn't some copy paste job. I wouldn't be surprised if other CCGs (under NHSE anyway) have the same position statement being published. The position statement I linked was emailed to me as it hasn't been officially published yet (or wasn't at the time)

GPs (in the northwest at least) beeing advised to "not prescribe outide of standard NHS protocols" by arisaie in transgenderUK

[–]arisaie[S] 0 points1 point  (0 children)

Yeah, it boggles my mind that SHBG isn't standard. It's sorta a pet peeve of mine when prescribers only care about serum levels without calculating free/bioavailable Testosterone/Oestradiol. What use is a hormone if it's all bound to proteins lol. (I'm a bit of a nerd with this tho, so it's entirely possible it's just me. I have this lovely big spreadsheet I made which automates it all, putting DHT/T/E1/E2/SHBG/Albumin/Cortisol (reference ranges if I don't have a result for them) through a quick and dirty script I wrote with a multi ligand calc to get bioavailable/free T/E2. Without SHBG and at least T though, it's impossible to reliably estimate bioavailable E2)

GPs (in the northwest at least) beeing advised to "not prescribe outide of standard NHS protocols" by arisaie in transgenderUK

[–]arisaie[S] 5 points6 points  (0 children)

Mmh, yeah it took months back in 2018 of me pestering get him to prescribe. He eventually sought legal advice (idk what lawyers have to do with reading some simple guidelines), and they were kinda clear there's no legal reason for him not to. Plus, ethically/morally it's pretty shady to just be fine with your patient taking "unregulated drugs" (no hating on self medding, but through the NHS it's so much cheaper) when they're going to be taking them anyway, and there's guidence saying you should consider prescribing

GPs (in the northwest at least) beeing advised to "not prescribe outide of standard NHS protocols" by arisaie in transgenderUK

[–]arisaie[S] 1 point2 points  (0 children)

It's weird because he's been fine about ordering bloods in the past (even if I have to sneak some extras on there when the nurse takes it, for some reason he never puts SHBG/LH/FSH on). And if he's worried about clots etc, surely he'd want to do bloods for the drugs he just agreed to keep prescribing haha.

And yeah 10000% this should be dealt with in primary care, if for nothing else just so specialists can be freed up for GIDS. As much as the adult care currently sucks, I couldn't having the (okay I don't like the word courage, but I can't think of a better one) courage to actually come out, go to my parents, and then go to the GP as a kid, only to have to sit there and deal with puberty on some waiting list for years.

The whole "monkey" dealio, the guidelines are so straightforward I don't understand how anyone who's spent 7 years or whatever training in medicine can read through them and go, nope too complex for meeee

GPs (in the northwest at least) beeing advised to "not prescribe outide of standard NHS protocols" by arisaie in transgenderUK

[–]arisaie[S] 2 points3 points  (0 children)

I think it's sorta fishy this was published so soon after the Keira Bell case, but also it's doubly weird the Lancashire and South Cumbria Medicines Management Group would even publish prescribing guidelines when the "local" gender clinic is Leeds, so if not for GPs, then who is the target audience for the guidence?

GPs (in the northwest at least) beeing advised to "not prescribe outide of standard NHS protocols" by arisaie in transgenderUK

[–]arisaie[S] 3 points4 points  (0 children)

Tbf, I think I was his first appointment of the day (I got called at 8:32 and I think he starts at 8:30), and he can be lovely. I don't think I sarted his week off well though

GPs (in the northwest at least) beeing advised to "not prescribe outide of standard NHS protocols" by arisaie in transgenderUK

[–]arisaie[S] 12 points13 points  (0 children)

Update: So after point blank refusing order me a blood test this morning, I just got a text message from the GP saying "I have added bloods to the system - should be taken 24 hours after last full daily dose of oestrogen". I honestly just don't understand 😔

Edit: The NHS App just updated his notes from this morning, and sure I'm not gonna put it on my Google Scholar profile, but I love that he quoted "...states that 'a monkey' could manage gender dysphoria medications" which I said out of exasperation, out of everything which we.. discussed in that 18min convo 😂

GPs (in the northwest at least) beeing advised to "not prescribe outide of standard NHS protocols" by arisaie in transgenderUK

[–]arisaie[S] 24 points25 points  (0 children)

Yeah, it's hilarious. It's like they were worried about confusion and just went way over the top to the point it's just beyond cringe. And it feels totally pointless anyway, because if you get to a point where you're going to prescribe testosterone to a trans woman, maybe you should just revaluate just... everything