Posted March 26, 2023, 4:36 p.m. by Civilian Yavia Crockett (Nurse - Sacred Heart Hospital) (Jennifer Ward)
Posted by Civilian Jezem (Upstanding Citizen) in Sacred Heart Hospital - Uterus, Oh Uterus (Go Away) (Tag Medical, Open)
Posted by Civilian Yavia Crockett (Nurse - Sacred Heart Hospital) in Sacred Heart Hospital - Uterus, Oh Uterus (Go Away) (Tag Medical, Open)
Posted by Civilian Jezem (Upstanding Citizen) in Sacred Heart Hospital - Uterus, Oh Uterus (Go Away) (Tag Medical, Open)
Posted by… suppressed (20) by the Post Ghost! 👻
Jezem strolled through the hospital entry with the energy of a dying star. Outside the colony went through its morning motions, with people enjoying breakfast or making their way to work or school. Soft blues and pale pinks spread across the artificial sky of the dome. Preferable to the murky orange and mud browns of the actual sunrise beyond. If Jezem had his way he’d be in bed until noon, but if he had allowed the indulgence then he would be stuck at the hospital until evening. No, better to get this slog of a day over as soon as possible.
He checked himself in at the in-patient kiosk and took the dispensed PaDD and stylus pen. There was hardly anyone in the waiting room at this hour, so he picked the chair that caught the morning sunlight from the skylights above. Aside from his initial health assessment done shortly after his arrival to the colony, this would be Jezem’s first formal health exam. Though he could have begun this process then, there was too much to go over when all he wanted was to return home to his beloved and rest.
Which was the downside to putting off tiresome tasks. Eventually, you had to get it done.
Jezem pursed his lips as he read through the requested information. How much should he reveal? Potentially a lot. Instinct and experience told him to reveal as little as possible. It was his brain that won out. The more honest he is here, the better gender affirming care he’ll receive in return. His past doctors did their jobs, but none could or were inclined to provide the full extent of care he could have received from the Federation. Which was now available to him in all its glory.
Mind made up, he filled out the health history with as much information possible (without a single hint towards criminal activities). AFAB. First took heavy pheromone suppressors at 20. Began basic hormone therapy at 23. Received gender affirming surgery at 27. A pitiful amount of care for a pheromone-producing Orion. The therapy worked but only barely. Orion hormones were far and beyond more complex than say a humans. That wasn’t even including the delicate balance of his pheromone suppressants and their effects upon him. And his past ship doctors lacked the skills or means to address those problems. Sure they could make sure he didn’t overdose but that was the extent of it.
Federation doctors could though and that. . . that made this worth it.
After Jezem had returned the paperwork the door opened and a nurse wearing dark grey with lavender trim scrubs walked through. Deltan with bright blue eyes. “Jezem?” she asked, “this way please.” She led the Orion down a hall way of exam rooms and to a door half way on the right. “I’m Yavia, your nurse for today. You’ll be seeing Dr Ilves today. Just have a seat on the biobed and we’ll get some basic readings to start.” She reached over and flipped the controls for the biobed and pulled out a tricorder. “General check up today or do you have a specific concern?” The doctor had the forms Jezem filled out and was currently reviewing them.
He followed after the nurse and settled onto the edge of the exam table. Clean medical exam rooms, professional staff. . . Jezem could get used to this. “The second one. I need a hormone panel. I’m taking a hormone therapy as well, but it’s not working as well as it used to. Potentially a change in my pheromone suppressants too. They’re giving me headaches and I’ve started menstruating again. I will bleed for a day or two and it hurts. And my skin is dry.” That last one was particularly notable. Orion skin produced natural oils that contained mild pheromones and helped keep their skin supple and protected. Dry skin was a precursor to more serious symptoms.
The biobed reported an increase in blood pressure, an increase in body temperature, a decrease in liver enzymes, a decrease in thyroid enzymes, and swelling in the uterus. The tricorder detected clogged pores in the skin all over his body.
Yavia nodded, “Alright then let me go ahead and get a blood draw so we can the lab do a complete work up.” Yavia pulled out a phlebotomy hypo but didn’t take any blood until Jezem agreed. “On a scale from 1 being nothing and 10 the worst you have ever felt how bad is the menstrual pain?”
Jezem agreed to the blood draw and promptly answered the question, “A seven.”
Dr Ilves knocked on the door and then came in. “Hello, I’m Dr Ilves.” He was short for a Vulcan and his age unclear. “It’s nice to meet you Jezem,” and he offered his hand.
The orion coolly regarded the offered hand before hesitantly taking it, “Sure.”
“Jezem has come in to have a hormone panel done. He said his current treatment isn’t working as well and reports some complications. Headaches, returning and painful menstruation, and dry skin,” Yavia reported.
Ilves looked at the readings from the biobed. “Alright, we will begin by going over your medical history. I know it will seem tedious, but I would like a full picture of everything you have gone through rather than throwing darts in the dark.” He pulled out a stool and sat down. “You began heavy pheromone suppressors at 20. How did you react to that? Any side effects or lack of? How well did they work, anything at all you can remember from then.”
He thought back to then. First days of freedom. An allowance from Naanni to buy whatever he wanted. New clothes, new jewellery. . . his first pheromone suppressors from a small clinic. The doctor didn’t believe he should get them but money changed his tune. “Great at first. They stopped me from producing pheromones. I didn’t have any problems for. . . a year? Then I started getting the occasional dizzy spell and headaches and. . .I recall my menstruation cycle was irregular. Heavy then light and more frequent.
”. . . my. . . doctor said the dosage was too high. So I tried a lower one but that dose was too low and I’d produce pheromones. So I waited until the symptoms passed then upped the dosage. I rotated between doses until I could go longer on the high dosage. Then when I started the hormone therapy and I stopped menstruating I stayed with the high dosage. I don’t think I’ve had any problems until recently. Headaches, menstruating again. . .”
Ilves jotted down everything Jezem told him. “At that year mark did anything else significant change? Did you move, change doctors or medication supplier, or begin taking other medications or recreational drugs?” He paused here, “A lot of patients don’t want to admit to that, but those things can affect how prescription medication works. It is important to know. We aren’t here to judge.”
“No recreational drugs,” The drug trade was an ugly business and Jezem wouldn’t touch any product no matter how ‘harmless’ it seemed. “I was always moving around. I was an interstellar trader. My medication supplier remained the same for five years, that was my first doctor and the one that told me the dosage was too high. The only other thing I started was hormone therapy when I was twenty three.”
“When did this change with problems begin this time? Any significant or minor changes to other things you can think of?”
“Started a month ago. . . I don’t know I moved here not too long before that. I havn’t really changed anything otherwise.” Same suppressants, same hormone therapy. Nothing’s changed much since. Not even after his surgery.
Ilves nodded, there was a lot on Oed that could cause health problems but nothing that would affect hormone production. That they knew of anyway. “Alright, let’s move on to the hormone therapy. Forgive me, but my Orion physiology is a bit rusty. So 3 years on the suppressant and then you started the therapy. Were you still adjusting dosages while you started. Tell me about those first months and then problems and successes you had leading up to your surgery.”
“Yes. I. . .I was on the lower dose of suppressants when I started the hormone therapy. When I stopped menstruating after starting the hormone therapy, that was like. . .after three months? I never had to switch to the lower dose since. So I’ve kept that up. Hormone therapy went really well. I stopped menstruating, my voice changed, I was finally able to gain more muscle mass. That happened over the course of the first year. My doctor said I could keep doing the therapy as I was.” Gods he remembered the days before the hormone therapy, of working out until he collapsed but he could never get over the plateau he’d hit. No matter how hard the tried he couldn’t look like the other orion men. Then hormone therapy and all that changed. Though still smaller than the average orion male he lost his hips, his waist thickened and he could finally claim the muscles he’d wanted ever since he was a young teen.
“Aside from unrelated injuries and sickenss things went very well. The only drawbacks I can remember were that I had to watch my blood pressure and fluid intake. Though that was just during the first year. After that I seemed to balance out.” He took the pills and that was that. Though now that he was thinking about it, “Wait, I recall. . . Yes it was before the surgery. I found a new doctor for that procedure and he told me I had to stop my pheromone suppressants. I wasn’t going to do that, so I switched to the lower dose briefly as a compromise. I recall. . . my pheromones smelled different but I didn’t think much of it at the time. The doctor lectured me but surgery went fine so I don’t know what his deal was.”
“When performing the surgery, the male/female hormone production is set off balance, even though you were on the therapy. It can cause severe side effects and even autoimmune issues. That was why the doctor was concerned. It seems it turned out fine, you were very lucky,” Ilves explained. “Everything with your hormone replacement went well then. You’ve stayed on the same dosage since? You never had to increase it? What about the pheromone suppressants. Are you still on female suppressants or on male or both?
“Ah,” That would explain that. Did the doctor explain that? Maybe. Honestly, the days leading up to his surgery were a haze. The anticipation and excitement of finally having having his ideal body made everything else meaningless. “Same dosage. Never had a reason to change it.” A pause, “The female suppressants.” He made female hormones not male hormones. Why was the doctor asking that?
Ilves nodded rhoughtfully, a thought forming slowly. “Tell me about your surgery. It wasn’t complete but was it cosmetic, functional? How many surgeries did you have in all? Any post surgical complications or infections?”
Jezem hummed, swinging his legs a bit. This was so tedious but he’ll answer every question. “Both. Just two. Top surgery first, then bottom surgery a few days later. The surgeon said it wasn’t necessary to remove the uterus since it and the ovaries are apart of the whole pheromone thing.” Jezem new the basics of the biology involved but nothing really beyond that. “The top surgery went perfectly, no issues there. There was some infection following the bottom surgery,” Jezem paused, “Took a couple days before the ‘plumbing’ figured itself out” That’s how the doctor put it, Jezem still thought it was lame but it got the point across, “And in that time there was a small infection. Also, they talked about potential hormone concerns but I can’t remember.” He was supposed to do a follow-up with the surgeon but then they left the sector for. . . business reasons.
Ilves made a note. “Alright, if you would lay back on the biobed. If you prefer I can incline the head, I’m going to run some full body scans. It will take a few minutes for it to complete.”
“Whatever you say, doc,” Jezem leaned back, not minding laying completely flat. His thoughts drifted and he had to actively stop himself from fidgeting. Gods, waiting is so boring. That ceiling is boring. What should he make for dinner tonight? Stop shaking your foot. That vulcan doctor is weird. Vulcans are weird. The nurse is nice. What is Thyr doing right now? Hopefully staying out of trouble. . . The bed beeped and Jezem glanced over at the the professionals, “So what’s wrong with me?”
Yavia, the Delan nurse came back in with a soft knock. She had the results of the blood work and handed them to Ilves.
The metabolic panel came back with mixed results. His blood work was fine but his pheromone production was nearly completely stunted. The impacted pheromone production caused a hormonal imbalance and the swelling in his uterus that will progress to the ovaries. The swelling and hormone shift was likely what brought his menstruation cycle back, and painfully so. His surgery went well despite ignoring his doctor’s orders.
Jezem’s body showed signs of successful transitioning, with an estimated four to five months left of hormone therapy before completion. That said, his current regimen is no longer effective due to the hormonal balance. The results suggest that his body is trying to produce male hormones but cannot because of the suppressants. Continuing his pheromone suppressants will eventually cause more severe issues.
Ilves nodded. “Well that would explain your current issues. What I am sure you will consider ‘good’ news is you have only 4 to 5 monts of hormone therapy left before your body will completely take over the process. Now for the complaints you came in with. The pheromone suppressants have totally stunted the production. That is bad. Your body needs those pheromones for normal function. Suppressants should only lower them to a manageable level. This stunted production has led to a hormone imbalance that caused swelling in your uterus. This is what brought back the painful menstruation. If we don’t stop it, it will travel to your ovaries and that could be life threatening.”
“Then we have your hormone therapy. That is another part of your problem. With only 5 months at most left, your body is now producing male pheromones. The suppressant works partially on that, but not effectively. The other problem is the female suppressants are fighting your body. Your body is trying to produce the male hormones on it’s own but can’t because the medication is treating your body as female. If we don’t stop the female suppressants your body will start attacking itself and we’ll be dealing with an autoimmune issue.”
The doctor sure said a lot of things. Jezem blinked, slowly processing the explanation and how it applied to him. “Wait, I’m making male pheromones?!” He could do that? The hormone therapy could do that? Did any of his past doctors ever mentioned that? It was possible though Jezem was pretty sure he’d have remembered. He certainly recalled his first doctor going down the list of physical changes most of which had come to pass. He’d long consigned himself to a life trapped on pheromone suppressants to smother the female hormones that served only as a painful reminder of his birth gender.
Yavia gave him a smile and nodded, “That’s the end goal of hormone therapies. That when it’s done, your body functions as that gender on independently. So your body all ready had the male glands as well as the female ones. Everyone does. So the hormone therapy lowers and eventually stops the female glands and helps the male glands to produce more and become dominant.”
Of course. Maybe Jezem should have spent more time learning biology. Oh well, that’s what doctors are for isn’t it?
“So I can stop the suppressants?” He said, surprisingly excited for someone just told their body will start attacking itself. “And no more female pheromones? Just male ones?” And only, what, half a year before his hormone therapy is complete? Wait, crap, those other issues sounded pretty bad. Jezem’s enthusiasm cooled somewhat, “So I stop the suppressants and my uterus calms down and my body will become normal again?”
Ilves was cautious. “You can stop the female suppressants. You will have to, and we will have to let your new natural production take over. Then we will determine how much suppressant and which types you need. As long as you still have intact female organs there is the possibility you will have this issue happen again, and will need things adjusted. But once the suppressant is out of your system and you have balanced out you should feel much better and we can go from there.”
“I’d rather just stop the suppressants all together.” He only took them because he couldn’t stand the thought of smelling like a woman. If he began to smell like a man then that was more than okay. Perfect even. Though. . . intact female organs. Jezem pouted. He kept the damn uterus because his surgeon doctor said there was no need to remove it. Jezem didn’t mind because it’s not like he or anyone else could see it. Once he stopped menstruating he’d forgotten about it. “If I stop the suppressants would my uterus be an issue?” Maybe it was better to get it removed along with the ovaries.
“Stopping the suppressants will allow your hormones to balance out the way they want and then the painful menstruation will stop and disappear. You may have another cycle or two while things balance out but the pain should not be as bad and then your cycle will disappear. Unless something happens to disrupt your body’s rhythms. You could even have it removed after your hormone therapy is finished if you want.”
“Huh,” Jezem wasn’t sure how to feel about that. Maybe he should go through with ridding himself of it. “I’ll get back to you on that,” Jezem said. It wasn’t like he needed it anymore. Once his hormones balance out and he produces male hormones. . . it would be the last reminder of his birth gender. “Anything else I should know?”
“No that is all. Nurse Yavia will get you something to help with the cramping. Also something for nausea. That can happen sometimes as your hormones balance out. I am also writing you a refill for your hormone therapy. No more suppressants. If you have any new symptoms or feel worse come back right away.”
Well, that was easy. Jezem nodded, telling himself that he’ll really follow all of his doctor’s instructions this time. “I’ll do that.” Overall this was a rather painless experience. Short, professional and not a single side-comment. Gods. . . just what kind of doctors was he dealing with these past few years? If this was the kind of treatment he could have been getting this whole time then he really screwed up. “Don’t people usually get yearly physical exams? I should get that scheduled.”
Yavia nodded giving him a smile, “Yes yearly physicals are routine. Dr Ilves can do that now or you can come back at another time. With your hormone treatment we will actually want to see you at least every month until the treatment ends. Make any adjustments to the treatment that might be needed. I can help you get all of that scheduled.”
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