Sterile_Technique

Probably no catheter if it was an orchi - they do those for longer surgeries (current hospital's policy is expected duration of 3+ hours - dunno if that's universal) and orchies typically don't go that long, nor would they need a urethral landmark.

...I think my bladder tissue irritation hypothesis was probably not correct.

The best way I can describe what the pain feels like right now is when you need to piss like really crazy bad. (I don't actually have to piss though.)

That sounds like residual sensation from a Foley catheter - basically a straw that runs up your urethra and into your bladder. Once in place, the end of it's inflated inside your bladder so it doesn't pull back out, but that balloon puts pressure on the base of your bladder, and that's how your brain normally knows it's full of pee.

So, if the Foley was in place for a long surgery, that part of your bladder might have been super irritated - very common when people wake from surgery for them to feel like they urgently have to pee but the Foley was removed just before wake-up or still in place and actively draining their bladder (so we know the bladder is nearly empty either way).

I've never been in that type of surgery, so idk if they would have even used a Foley, but if yes, that's likely the culprit. If by 'balls destroyed' you mean complete genital conversion to include the penis, then Foley placement would make a lot of sense since that would act as a marker for the urethra's location as incisions around that area obscure anatomic landmarks with blood. The irritation and urge sensation would also make sense, since the Foley would have been handled a lot, making your bladder tissue REALLY angry at that balloon.

If they left the penis alone and only operated on the balls, then /shrug.

Good luck with your recovery, and follow your post op instructions to the letter! That's a high infection chance area, so don't take any risks!

d1

DM: Not that one, Job: I have a special d20 just for you!

"As you bend over to pick up the fork, you slip a vertebral disc. Your health is reduced to 30%, and will stay capped there for the following three days."

DnD in your 30s.

without

Oh, shit I misread that. My brain just saw 'with'.

Disregard the enteric coating bit.

shell/coating

That's usually an enteric coating - basically protects the medication from your stomach acid so that it can be absorbed in your small intestine.

For that reason, I wouldn't think an enteric coated pill would actually be absorbed rectally - it wouldn't have the acid bath to weaken the coating, and I have no idea how far they normally get into your small intestine before being fully absorbed. With those two factors in mind, my guess is you'd just poop it out eventually, miss your dose, and waste your money.

...also an enteric coated sublingual doesn't make sense - sublinguals don't have a coating, they just dissolve under your tongue.

follow up question, does it need to be jammed in all the way or just past the sphincter muscle?

Only suppositories I'm familiar with only have to be inserted just past the sphincter.

I'd run this by your pharmacist. Easy outcome is the possibility that estrogen is already available as a suppository (I've never heard it personally, but doesn't hurt to ask).

Different routes also often have different dosing. 10mg IV vs 10mg PO are going to hit different - unsure if it's a 1:1 for sublingual vs rectal.

But yeah, I'd take internet strangers' advice (including this post) with a hefty grain of salt on this one, and instead go straight to your pharmacist.

...it'd be nice if these folks who have their epiphany actually stay republican, and use their position to instigate some critically needed reform. It doesn't actually have to be the party of regressivism, hatred, and bigotry. Granted, remove those things (and the feel-good wrapping paper they use to package those things) and there's not a whole lot left to work with... but if you can find even a few gems to pick out of the sewage, that's enough to campaign on. Build something new from there. Call out your extremist peers for what they are and save your fucking party.

Added to my nursing bookmarks. I won't have time to do a deep dive on anytihng other than coursework for the next few months, but that looks like a great resource! Thank you!

Sounds like you've already had the conversation I was encouraging if your PCP said that.

Hormones are pretty wild. The more I study them the more I understand that what I do know is barely a scratch on the tip of the iceberg, so I'd caution against making an assumption one way or another without bouncing it off a doc who specializes in that stuff.

I would guess you're correct about the ranges, but my confidence in that guess is fairly low due to how insanely powerful hormones are.

I think people mostly just operate based on what they see

Oh 100%. I've been a surgical tech for about a decade, and have seen how people get tunnel-visioned. That's actually one of the reasons I want to switch to nursing, since I've caught myself kind of flying on autopilot, and then when some case deviates from the norm, I still do things like open the all the usual supplies, some of which may not be needed this time, so it's just waste. It's time to step out of my comfort zone. Anyway, nurses and docs do the same shit after their duties become routinized for too long.

It creates an extreme chilling effect sometimes, people stop meeting your eyes, or even interacting (sometimes interacting through a third party instead, like a cis family member).

That is fucked up. I don't know where you're getting care, but your team absolutely knows better. Even if you're that rare break from their routine... and in all fairness, you probably are - in that decade I've been a tech, I've only ever had like three patients I've known were trans. But like Ada mentioned, one of the best sources of info in those cases are the patients themselves. They should be treating you the same as any other patient, both medically and socially. Some curiosity is expected - your team should want to get to know you, but standoffish shit like you described is a red flag that merits correction. Don't be afraid to call that shit out in things like patient surveys if you have the energy to fight in that battle - they need some better training at bare minimum.

Not the first time you've schooled me - I love seeing your posts!

Thank you, and keep the insight coming. Nursing school doesn't cover transgender care hardly at all, so a good chunk of my education so far on that topic has come from people like you!

What are some examples of the biological implications and risk factors?

Nursing student here - probably a solid half of the disease processes we study have "male/female sex" listed as a risk factor. A good chunk of lab values have different ranges for male vs female.

That said, I have no idea if those are intrinsic to the sex, or to the hormone levels, so HRT might completely negate or flip those differences.

I'd run this by your HRT doc. They'd have the best understanding on what your transition is or isn't doing on a physiological level and which other docs would be able to provide better care if they know you're trans.

Generally it's best not to hide things from your doc, but if revealing that info is being treated as "I'm male" then that's not doing you any favors, since your physiology is not that of a male. And again pointing to the HRT doc, they'd be able to help you articulate that distinction to other docs.