Patricius kindly offered to take me to the hospital and drop me outside. We had a cup of tea and a chat before we went.

I didn’t have long to wait – my consultant had had a cancellation, so was able to see me before my appointment time. I guess if she gets through her list quicker, she might manage to get home early. I can’t begrudge her an early evening.

It was the same consultant as last year – I remembered her fondly because she really listened and I felt heard at a time when I was feeling especially vulnerable. I expected her to have her own ideas of how to “treat” me and derailing her would be difficult – she worked with me on my treatment.

She’d clearly read all my recent notes because she knew EVERYTHING – including the recent heart attack. Sometimes when you go into the doctors surgery it’s like they have no access to a computer and no memory, which irritates my husband no end.

I am beginning to feel that my life is now split into Before Heart Attack and After Heart Attack. I wonder whether things will ever quite feel the same again?

She recapped the need to stay on one pump of Testavan, and that lower levels of clotting agents are critical at the moment while my heart recovers.

She took me through all my notes and explained the various factors that she’s looking out for – including cholesterol and PSA (prostate specific antigen). High testosterone doesn’t cause prostate cancer, but it can accelerate its growth; high PSA values can indicate either prostate cancer or an enlarged prostate. I’m not worried about it – as I commented to the consultant, I am bloody lucky to have so much monitoring!

I like this consultant – I never felt judged by her, either when I first met her or now, she was thorough and explained everything (albeit very quickly). I know that she’ll summarise it all in a letter, so I was less worried about capturing everything on this visit.

I think things might have been different if I had wanted hormones different from those associated with the gender I was assigned at birth (she said as much on my first appointment: “I’m afraid I am not a gender specialist”). Some third-gender options are easier under the NHS than for full trans people, such is the system prejudice built into the NHS’ structure rather than its people.

Patricius picked me up after the clinic; I told him about it and explained the various things the consultant discussed with me. I am lucky to have made such a kind friend!