HRT - Part 2. Clinic appointment
23 - Dec 2021
Like so much of life that isn’t planned I’ve gone into automatic story mode for Part 2. If you read it and like reading my account in ‘story mode’ you can leave me a comment and let me know. It’s arranged in chapters if you want to skip straight to the actual appointment.
Making my way there
The fast train to King’s Cross St Pancras gets me to London in under 50 minutes. I take the Northern Line and get off at Moorgate. Travelling wearing a mask is not easy when you are permanently perspiring. I feel the sweat on my upper lip soaking into my mask. I whip it off as soon as I am at street level. The air feels deliciously cool.
There are three exits from the tube station. I’ve no idea if I’ve taken the right one but I am early; I have plenty of time to find my way to the clinic. I walk over to a map. It may help. It may not. My sense of direction is - well - non-existent.
I glance at my phone for what must be the fifth time and try to commit the address to memory. Not an easy task, even though I only have to remember 65 London Wall. I randomly turn right and head towards the nearest junction. I am relieved when I see it is named London Wall. I look up and down the road. I have a 50/50 choice of which direction to take. I have time to turn around if I’m headed the wrong way.
The thing about navigating building numbers in London Streets is that they are not easily visible, unlike shop signs, which are. I do have some additional information to help me find the clinic. The entrance is between Little Farm and Chilango restaurant and ‘Look Around’ function on my phone is an invaluable resource.
You may be wondering why I don’t use my phone to give me directions. Trust me, I’ve tried that. It doesn’t help.
I almost stop and pop my head into Specsavers to ask what number their building is, but decide against it. I keep walking.
Just as I’m considering turning around, I spy Chilango. On the side of the building next to the restaurant, a huge sign is sticking out with a very large number 65 on it. You can’t miss it. I have arrived.
No. 65 is an impressive building and the clinic is on the 1st Floor. It is not hard to find and as I push the door open I am greeted with surprise by the clinic manager. I am early. Very early. An hour early in fact. She suggests I get a coffee and apologises for not being able to offer me one.
The clinic is unfussy, uncluttered and roomy. And there’s no coffee machine. I don’t really mind. I don’t fancy sitting in here for an hour wearing a mask. There is a nod to Christmas with a small gold tinsel tree on the ‘coffee’ table. The clinic manager is quietly playing Christmas songs on YouTube on her computer. It makes me smile. I say my goodbyes; I’ll be back in a short while.
It’s not hard to find somewhere to sit and have a coffee in this part of London. I go into the nearest shop and order a double espresso and an apricot croissant. The shop is deserted, except for two men wearing dayglo orange work wear, who perch on stools, and talk loudly while looking out onto the street, perhaps keeping an eye out for their supervisor who might call them back to work at any moment.
I head over to a small table around the corner and settle down to enjoy my treat.
Appointment - information gathering
I arrive back at the clinic with 10 minutes to spare. The manager is chatty. She’s there by herself and I can imagine it must be fairly boring at times. I politely chat back. She asks me where I’ve traveled from and what I’m up to for Christmas.
Bang on time, the doctor appears. She welcomes me and we go into her room. It dawns on me that the appointment is for 60 minutes. This will be an in-depth appointment like I’ve never had before.
We talk through my medical history and try to get a good understanding of the timeline of my symptoms. It’s complicated by the pandemic. We’ve all ‘lost’ time. To remember specific points in the last 2 years is not as easy as you think. I can remember just before lockdown as we had been on holiday to New York. After we got back home, Covid was spreading rapidly throughout the world and the word pandemic first entered our vocabulary.
We try to establish when I may have entered peri-menopause. My case is not so straightforward. I had an endometrial ablation in 2008 and have not had a period since then. I have no way of knowing what my natural cycle would have been. It doesn’t throw the doctor off course. We will look at the symptoms I have now and deal with them.
I talk and talk. She listens and gives me the space to fully describe how I am feeling. I’m not sure how this would have worked on-line. Something as important as this, I feel, must be face to face.
She answers my questions and explains in detail different aspects, dispelling any ambiguities around what I have asked. I am glad I have done my research prior to the consultation. I understand the role the different hormones play. I am aware that you can take hormones though a transdermal patch or gel. I’ve come prepared to leave with HRT. I know the long-term health benefits and protection I will get from osteoporosis and heart disease. I allow myself to feel a little proud that I prepared beforehand and can process what she is telling me.
It is harder to talk about the darker side of how the menopause has been making me feel. It’s not all about hot flushes and a ‘scrambled egg’ brain. She returns to this before she lets me go, “Who will you turn to if you feel like that again?” she asks. I can answer her. I have a plan.
My HRT Prescription
In just after an hour I leave with a prescription for Oestrogel and Utrogestan. I can pick it up from my local pharmacist. I feel empowered. This has been tailor made for me. It takes into account what may suit me now and how I can titrate it after a few weeks if necessary. I’ve had a demonstration of how to apply the gel and have tried it for myself using a placebo in the same pump.
I know not to expect instant results. I am good at waiting. I am aware of potential short-term side effects, which include the possibility of breakthrough bleeding, something I wasn’t aware of before. I have a return appointment booked for the end of March. I can’t wait to get home and apply my first dose.
I’ll review how I feel in a week’s time. Hope to see you then …