A few weeks ago I shared the symptoms I was having that make me worry I was having a heart/circulatory reaction to the estrogen I was taking (which is one of many risk factors in taking estrogen), but luckily it turned out to be a false alarm.
I had my follow-up doctor’s appointment today, and since I started taking my HRT again the other week, I’ve been doing a bit more thinking and analysis of my earlier scare so I could have a good, meaningful conversation with my doctor.
We reviewed my recent HRT history, test results from my previous visit with the LNP, family history of heart disease (very little of it, luckily) and this led to a discussion around my exercise habits (I run and bike). In short, there are no current physical indicators that indicate my previous chest discomfort and pain were anything other than the chest infection I had.
During this conversation, I put forth my own diagnostic theory: that I was having a panic attack.
I mention DON’T PANIC because transitioning is insanely complicated, and there are all sorts of things in transition can cause someone to panic. As previously related, I had a phase in life where I was regularly experiencing panic attacks, and a contributing factor was my gender dysphoria.
In discussing this with my doctor, the evidence for a panic attack reaction seemed to line up:
- The chest tightness increased right after I took my pills.
- It flared at night when I was lying in bed thinking about my HRT and transition.
- The symptoms were transitory (no pun intended) and at times completely vanished when I was otherwise occupied with other things.
- I ran an almost 15 mile training run while on estrogen with no chest discomfort.
- I have a previous history of panic attacks under high stress with almost the exact same symptoms.
- Transition is really, really stressful.
Both my doctor and I are about 99% certain that it was panic + chest infection, but to cover that 1% concern, that’s why I’ll be seeing the cardiologist.
The more I’ve thought about it, I think I’ve been able to put my finger on the causal chain of the panic attack, and now that I think I know what those links are, I’m able to address them. Here’s what I think happened:
- Start taking estrogen.
- Feel happy about taking estrogen.
- Begin to notice some positive emotional and physical changes.
- Start to think that having breasts and moving on to a full transition might be the thing to do.
- Mild panic.
- Remember that my wife told me she would divorce me if I grew boobs.
- Real panic.
- Start to feel really good about taking estrogen and think even more about a full transition and what that would mean for my relationship with my wife.
Every time I swallowed a pill, I thought about taking estrogen and what the follow-on effects to my life might be. And I freaked out.
Turns out the HRT pause I took was the right thing to do, but I did it for the wrong reason! I needed it as a mental break, not a physical break, in order to organize my thoughts more and evaluate the “why” of why I was taking HRT in the first place.
Now that I’m more clear on that, step 4 above is now merely scary instead of panic-inducing. Step 6 above fills me with sadness and trepidation, but the future has not yet happened and I continue to hear mixed messages from her about me and my transition, so I’m not freaking out about it any more. With regards to step 8, I’m moving into the Acceptance stage of self-grief around this and seeing a life for myself with or without my wife, with my preference to be with, for sure!
Transition is self-directed, which means I am in control of it: the good, the bad and the ugly.
DON’T PANIC, indeed.
No matter what’s going on in my life, no matter the relationships I have, transition will change just about everything for me in little or big ways. Attempting to firewall off the good from the bad and the ugly triggered the panic response.
On my to-do list is dig out my copy of When Things Fall Apart, by Pema Chodron out of storage and re-read it. It was very helpful to me the last time I went through something like this, and I highly recommend it to others who are having a hard time in life.
Now that I’m trying to embrace all parts of it, I’m still scared of parts of it, but I’m not panicking.