The shortage of NHS General Practitioners – How this compromises the health of those who have complex medical histories.

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Having a complex medical history makes a visit to the doctor incredibly difficult. The constant explaining is exhausting, and it gets in the way of addressing the actual problem itself. This is a dangerous state of affairs which puts people at risk. The answer to this is to have a regular General Practitioner who you see every time and who knows your medical history well.

However, becoming registered and managing to book an appointment with a regular GP, appears to be so much harder than it once was. I remember growing up with a family GP, who both of my parents saw and then who I saw in turn. I wonder, does this even happen anymore? Recently, on moving to Eastbourne, I have registered with a new medical surgery. Since doing so, I have been having so many issues in booking an appointment and in managing to see the same GP. After posting about my frustrations on my twitter account, it seems I am not alone. Understaffing at surgeries, lack of available GP’s and the inability to see the same GP consistently, seem to be common issues.

I dread seeing a GP. Being transgender, I’m often faced with the problem of the “Trans broken arm syndrome”. This is where whatever symptom you present with, the doctor somehow magically links it to your being trans. I have lost count of how many times I have sat in a GP’s office, with a complaint which has nothing to do with my gender transition, and they then spend the entirety of my allotted ten-minute appointment time asking questions about why I am taking testosterone. They sit there, glued to their screen, brow furrowed, clearly not hearing a word I am saying. I then must explain I was assigned female at birth, I am transgender, I have undergone gender transition, blah blah blah. You would think that being medical professionals, they would be exempt from problematic responses but no. I have had more than a handful of GP’s make comments such as, “You really can’t tell,” or, “Which way are you going?” and most recently, “Oh, so originally you were a female”. By the time this humiliating exchange is over, so is my appointment. I either don’t get an accurate diagnosis or I am so demoralised I simply can’t sit there any longer.

Additionally, my mental health issues mean that I require regular monitoring from a GP. I am currently in the middle of a serious flare up of depression and anxiety, this means I often need medication reviews and fit notes for claiming benefits. My mental health history is complex and every time I see a new doctor, I must explain all of this first. Inevitably, this gets tangled up with my gender transition medical history. I again then find myself using up my ten minutes explaining my history, rather than my current presenting issue. Whilst both of these factors can, of course, impact my mental and physical health, a GP who doesn’t know me is often too quick to just assign my presenting issue to one of them, without looking deeper into the issue. These reasons are why it is so important for me to be able to see the same doctor every time, I can then get all of this over with the first time I see a new GP. From then on, appointments can be kept to the point of why I am there, and I can feel like a patient rather than a medical fascination.

I was lucky in Devon that my local GP surgery wasn’t too busy. I could get an appointment fairly easily and could see the same GP each time. This means that I managed to avoid the above issues and had great support from my regular GP. This has not been the same for my medical surgery in Eastbourne. I rarely manage to see the GP I am assigned, seeing random doctors each time I visit. This means I am back to facing the same issues again and it has been very stressful and frustrating. For the last six months, I have been seriously mentally and physically unwell. I know my mental health challenges inside out, I knew that the way my moods have been presenting are unlike any mental health flare up I have had before. I have said this every time I have visited a GP. However, I do not feel any of the GP’s I saw actually heard me. Instead, they focused on my gender transition or attributed my symptoms to my mental health issues. My anti-depressants have been increased at most visits, despite my stressing that the increases haven’t helped and that I feel that something else is going on.

A couple of months ago, on discussing a strange symptom of numbness and pins and needles in my hand, I had a breakthrough with one of the GP’s I saw. He diagnosed carpal tunnel syndrome and explained that it could be a symptom of an underlying cause. He referred me to another GP at the surgery for treatment and for blood tests. This felt like amazing progress. However, the specialist GP I was booked to see went off sick. The receptionist rang me to cancel the appointment and to tell me that there was nobody else who could do it. My name would be put on a list and I would be contacted. Unfortunately, this is when issues at my medical surgery became even worse. The problems then escalated from not being able to see the same GP, to not being able to see a GP at all.

Due to severe staff sickness issues, all bookings ahead of time were cancelled. Instead, to see a doctor, you are asked to telephone in the morning at 8am or in the afternoon at 2pm, to be seen that day. This is not as easy as it sounds. In fact, it is remarkably like the yearly race to the post to get Glastonbury Festival tickets. You constantly hit refresh and by the time you get through all the tickets have gone. I’ve even tried using two phones. I’ve spent many a morning sat with my mobile in one hand and my landline in the other. Both speakers echoing the words, “Sorry, all our receptionists are busy, please hold and we will answer as soon as we can.” This is frustrating for anyone of course, but when you are a person who relies on regular GP interaction to stay well, it is an absolute nightmare.

Over the last two months since then, I have had to fight to see a GP, to have the blood request initiated and to then have the blood test itself. Having had the test, now there was the unnecessarily complicated procedure of obtaining the results. I became so frustrated with the constant failure to get an appointment that I gave up. I am so exhausted and low all the time, waking up at 7.30 and hitting redial until finally my call is answered forty minutes later to be told, “Sorry all appointments are gone,” was just making me feel worse. I decided that things must be okay with the results. If there was anything which needed to be addressed surely, I would get a call, or my notes would say something to alert a receptionist when I called?

On a more recent and desperate visit to the medical surgery, I asked the receptionist if it was instead possible to print out my blood test results. The receptionist looked on her computer notes and said, “You need to see a doctor”. I tell you it was all I could do not to fall on the floor in a fit of hysteria! Gathering myself together I felt relief, on the request from an actual GP to see me, I expected this would by-pass the staffing issues and I’d be prioritised for an appointment. Shockingly no, the receptionist apologised and said I needed to just keep trying at 8am and 2pm.

Finally, after a couple more weeks of trying, I managed to see a GP last Friday. It was another one I hadn’t seen before. Luckily, I did not find myself having to explain my entire medical history, likely because my medical issue was at last clear. The GP informed me that I have hypothyroidism, an underactive thyroid. Alongside this, I also have low vitamin D and high cholesterol which are apparently side effects of Hypothyroidism. An underactive thyroid causes a myriad of symptoms, two of which are extreme fatigue and depression. This could very well explain why my low mood has been so bad for the last six months and why I’ve felt so utterly exhausted.

This is the reason why it is vital that those of us with complex medical issues assert ourselves. It is all too easy in a ten-minute snapshot, especially with an unfamiliar GP whose focus is on our past rather than the present, to miss an important health concern. I am aware that the NHS is under a ton of strain and there is a general lack of NHS GP’s.  However, there must be a solution to this in the meantime. GP’s do most certainly need more training around healthcare for transgender individuals . I also think this is the same for patients who have mental health diagnosis, as the same problem exists of seeing the condition rather than the patient. It may also help to develop new guidelines for people with conditions that require constant monitoring, to be prioritised and to have an allocated doctor so that there is consistency in diagnosis and treatment. In the meantime, those of us with unusual or complex medical histories, need to be persistent with our GP surgeries. We must make sure we strongly advocate for ourselves to be seen and heard so that we can get the treatment we need to stay well.

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The late bloomer. “It’s never too late to be who you might have been.”

InspirationalQuotes3.pngOne of the hardest things for me in recovery from addiction and mental health challenges, and in going through gender transition, is the deep grief felt at the wasted time.

I began my recovery from alcoholism at the age of 37.  Finally, with the help of Alcoholics Anonymous, I saw clearly how drinking had not served me well at all. I drank since the age of 13, this had stopped me pursuing a career, building a life, making proper relationships and even growing up.  It felt like I had slept my life away. In suddenly seeing how wonderful life could be, I wished so much that I hadn’t waited so long to get sober. If I had addressed it earlier my mental health issues wouldn’t have got as bad as they did. I would have realised I was transgender a lot earlier and I would have had many more years to enjoy this beautiful planet and to make something of my life.

Waking up at the age of 37 has made me a late bloomer in every aspect of my life. It is only now, in being sober, that I am able to return to study and make a career for myself. It’s only now, having learnt to identify and sit with the various emotions I feel rather than drinking on them, that I can develop healthy platonic and romantic relationships. Because I have also gone through gender transition, this adds additional new aspects to my life that most folk deal with when they are young.  I have had to rebuild my identity, discover who I am as a man, get to know my new body and discover my sexuality. I am 44 years old now and only just starting out in life. I am a pubescent boy in a man’s body!

With so much being still so new, there is so much I yet need to learn and whilst I am not old by any means, neither am I young. There is so much joy in this newfound life but also so much sadness at wishing this life could have started years ago. Of course, I realise that had things been different, then I wouldn’t be the person I am today. I have skills and qualities, only gained precisely because of the path my life has taken, but still, the grief needs to be acknowledged. It is both valid and understandable. Accepting the loss of time means that I can transform it into a determination to make the most of the time I have now.

Being such a late bloomer may well mean that I can’t do a lot of the things I wish I could. However, I can find other ways to fulfil those dreams, simply by adapting them. For example, I’ve recently accepted that I must shelve my plans to be a therapist. I have too much healing of my own to do first. The motivation underlying that career choice lay in my passion to help people, to make a difference to the world and to people lives.  Instead of giving up that dream, I can search for new ways to fulfil it. Moving instead into writing as a career, using my psychology studies and my personal experiences, mean that I still get to follow my passion and in fact may even make more of a difference by following this new path.

“It’s never too late to be who you might have been”.  It may just mean you need to adapt the way you go about achieving it.

 

Spare a thought for transgender people on National Coming Out Day

I find myself torn between pride and concern on National Coming Out Day. On the one hand, I love that our society has evolved to the point that we now celebrate people coming out, on the other hand I wish it just wasn’t a big deal.  I look forward to the day where it doesn’t matter what our sexual orientation is and we won’t need to define ourselves into narrow, static boxes of gay, straight, bi, pan etc. We simply fall in love with someone and their gender is not an issue. I can dream.

The other reason I find national coming out day troublesome, is because of the part of the LGBTQ community that so often gets forgotten when talking about these things. Our beautiful trans community. For the majority of trans folk, our coming out is far from celebrated in society. When we come out we face being cut off from our families, sacked or discriminated against in the work place, harassed on the streets and all too often being the victim of violence and murder.

Those that are newly discovering themselves to be transgender, have no choice but to come out. In early days, before cross sex hormones change a trans persons appearance, we suffer the humiliating dysphoria inducing event of being incorrectly gendered many times a day. The only way to counteract this is to ask people to use the correct pronouns for us. Of course, as soon as a trans person who is not yet being read correctly does this, they automatically out themselves as being trans and place themselves at risk.

There is the additional issue that once fully transitioned (in whatever way that means to each particular trans person), we can often, as in my case although I choose not to, blend in to society and not have to disclose our trans history. Those that do this, then in turn feel pressured on National Coming Out Day to make themselves visible and feel as though they are letting the community down if they don’t or can’t do so. The fact that not disclosing is described as “going stealth” highlights how much shame is involved in not disclosing a trans identity.

I am a very proud man with a trans history who on most days is more than happy to shout it from the roof tops and face the inevitable backlash that still so often happens. However, there are so many trans people that have no control over their being outed or feel unsafe to do so. These people are no less proud, they just do not have the same freedoms and choices as the rest of the LGBT community does in being visible LGBT people. Therefore I ask you please, to spare a thought for trans folk on National Coming Out Day

“Speak your truth, even if your voice shakes”

c3bac0c0998fdd737acaaa254a9a6aadAs always after a documentary on TV regarding trans people, even when done sensitively as in the case of Horizon’s “being transgender” last night, I always spend the next day reading numerous misinformed and bigoted comments across my social media. I could stay quiet, I could just blend into the background, but I wont. I am blessed to live in a country where, although far from perfect, I have access to medical treatment, allowing me to transition which has without doubt saved my life.

I would not have access to this had it not been for brave trans folk who came before me and fought, in even worse circumstances than we have now, for our treatment and safety. I feel drawn to pay this forward, which is why I share as honestly and openly as I do. The payoff, in the amount of love and support I have received and in the messages from people I have helped or who feel better informed from my sharing, make this all so very worthwhile.

So to all the haters and bigots out there, throw at me what you will, leave your hateful comments on my videos after all, your doing so helps in our fight for equality and understanding as you help to highlight just how much opposition we face on a daily basis, in simply trying to live our lives comfortable in our own skin as is the right of any human being.

In the words of Frank Turner, “I won’t sit down, and I wont shut up”

 

 

 

 

Remembering the whole picture

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Last week, the date of the 9th March, marked 5 years since I officially changed my name by deed poll to Finlay. I had entirely forgotten the anniversary until Facebook reminded me by posting an old picture of my very proud boyish looking face celebrating the event. Being prompted to remember brought with it a flood of memories and a huge smile. I need that, with all that has occurred lately in having a setback in my surgical journey, it was wonderful to be reminded of just how far I have come. I haven’t gone backwards at all, not in terms of the whole picture at least.

The picture of me that flashed up on my Facebook news feed, with such a knowing grin, proudly clutching my signed deed poll, symbolises far more than just an official change of name. It even symbolises more than the official start to my living my life as a man. It represents the birth of Finn but far more it represents the birth of my whole being.

Just a year prior to changing my name, I entered the rooms of Alcoholic Anonymous and started my journey of recovery after a lifetime of abuse of drugs and alcohol. I truly see myself as being born the day I put the drink and drugs down. My video diaries and writing may well be heavily focused on my being transgender and undergoing gender transition but in all actuality, I see my journey as about being sober and in being so, being finally able to find the truth of who I am. By this I mean that the discovery of my being transgender was a consequence of getting sober and the start of my gender transition was the result of finding the courage to face myself and make the changes I needed to make, thanks to the fellowship of AA.  In this way, my being transgender is a small part of a much bigger journey rather than being the journey itself.

It is for this reason that this picture symbolises far more than just the change of name. The grin I am wearing symbolises the relief in finally getting to the bottom of a lifetime of depression, anxiety, self-loathing and self-destruction. It symbolises an awakening, to myself and to life and an excitement in finally being able to live, rather than to simply survive. It symbolises hope and opportunity, possibility and adventure. It symbolises an eagerness to commit to the journey of continuing to peel off the layers to reveal the truth of who I am

It has been so wonderful to be reminded of this and the way I felt when that picture was taken and even more wonderful to be reminded that I still feel the exact same way, even with all the bumps in the road. Most importantly it has reminded me that my life is far more than just about my gender transition. It can be incredibly hard not to get lost in that one part when things are not going to plan. This has been and continues to be an incredible journey of exploration, discovery and self-development of which being trans is, in the grand scheme of things at least, just one small part of a much greater whole.

 

 

 

#JusJoJan Daily Prompt – Jan 8th – ‘Mongrel’

This post takes part in Linda’s Just Jot It Jan

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The word Mongrel immediately brings to mind the song by Baha Men, ‘who let the dogs out’, especially the line, “come back you flea infested mongrel”. That’s the association with the word ‘mongrel’ I suppose isn’t it? As something impure, unclean, tainted or ‘less than’. I can remember as a child having discussion about a dog and being told it was a mongrel. I remember feeling that to me, a mongrel sounded far better than a pure breed. A mongrel felt ‘on my level’, authentic, relatable.

Looking at the dictionary definition, mongrel is defined as “a dog of no definable type or breed”,any animal resulting from the crossing of different breeds or types” or “a person of mixed descent” [offensive term]

Why does crossing breeds or having no definable breed have such negative connotations? Is this just my perception of the word mongrel or is its negativity a common assumption? Maybe my perceptions of the word speak more about myself and my moral standpoint than the word itself.

I am a person who does not like to follow the herd, although that’s not always been entirely true. As a child I felt pushed away from the herd as I didn’t fit, therefore I was  angry and resentful of the herd, I so desperately wanted to fit but I simply could not, no matter how hard I tried. Maybe this is where my initial sense of relation with the word mongrel comes from; I could empathise with the dogs labelled as such. In growing up, I have learnt to embrace living outside the herd and now to me, having no definable type and being a cross of different types is something I embrace.

My gender is male and my body has been changed to reflect that, but my biology will always show the female history, I will be forever a mix; I cannot ever be a pure breed. The closest I can get to being a “definable type” is in being transgender but I don’t relate to that ‘type’. I use it for ease in explaining my situation but I choose to define myself differently, I am a man with a trans history. Transition is the state of moving from one thing to something else and as such, gender wise I have never moved, I have always been male. Physically I have moved my body has changed from looking female to now, approaching my final surgery, looking completely male. Once this surgery is complete I will, for want of a better word, be “post transition” .Therefore to me, I am a man with a trans history.

However you look at it I am a mix, a crossing of types. I am a man but on digging below the surface you will see that I have no truly definable type, I am a mongrel through and through. Writing this makes me smile; I have always related and felt love for mongrels, now I understand why. Who wants to follow the herd anyway? What is so special about being of one definable type? I actually think that’s very limiting and to be frank, rather dull!

Here’s’ to all the mongrels out there, WOOF!

 

Keeping it real on Motivational Monday

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I am feeling good today but last week was a weird week, one of those where finding motivation is an effort, where objectively viewing doubt is a challenge and taking care of oneself is a marathon. I’m not sharing to concern anyone but to keep it real. I post a lot about recovery and about how to overcome difficulty and in doing so l think it’s important to show how l myself am still having to apply these things on a daily basis and how at times it’s not easy to do so.

When we struggle we feel we are the only ones and that no one understands. We tell ourselves that although others may be able to overcome their difficulties, we cannot because we are different in some way, we don’t have what that person has.

I’m telling you that we do, you do, we all do. No one is more special than another, there is no unique quality in recovery that one person possesses that another doesn’t.

We each have the ability to overcome whatever stands in the way of our inner peace and happiness. It may be slow, we may sometimes feel we take a backward step, but the power to overcome is in us all.

It simply requires a leap of faith, self honesty and willingness and most importantly an appreciation of progress not perfection.

One day at a time, there is nothing we cannot overcome

Keep on keeping on folks