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Kimberly Westwood of Tampa has an innovative electrolysis program to eliminate pain using gas instead of injectables. Below is a correspondence I had with her about the technique. I hope to supplement it soon with patient experiences.
I have no connection with Nu-Woman, but I feel they offer a service worth investigating. I recommend you speak with clients who are done and happy before committing to any electrologist.
If you have been to Nu-Woman and would like to add your thoughts, please contact me.
My questions are in bold; Nu-Woman’s comments follow.
Are there any legal/medical issues, or can this be done in any state? I know some regulated states don’t allow injections in conjunction with electrolysis.
To my knowledge, there is no state (regulated or unregulated for electrologists) that permits an electrologist to provide nitrous oxide under her license/certification. I am uniquely privileged to offer nitrous oxide during electrolysis with our (Tampa Gender Identity Program) patients. Here at TGIP, anesthetics are administered under the direction and supervision of our clinic’s physician, Dr. Richard Martin. Nitrous oxide and our other anesthetics used are prescription drugs.
As a requisite for treatment, TGIP patients are assessed for any factors that would suggest against the use of gas anesthesia. These individuals have already undergone physical work-up(s) and diagnostic laboratory testing as part of our program. Non-TGIP patients (those individuals who are here for electrolysis only) are given a pre-treatment screening and physical by Dr. Martin.
In order to provide a safe environment for the patient, the treatment setting required for gas anesthesia is elaborate. The anesthesia gas is delivered from a computer-assisted anesthesia/analgesia machine. Our office is plumbed with medical gas lines and a vacuum system which safely removes the spent nitrous oxide from the building.
Do you have any patients who have also tried injections, and can make a comparison to gas?
So far I have had only one gal who has tried injections prior to coming to TGIP. She lives in Texas and had used a service in her locale. She related that the injections were painful. Apparently, for her, the effect was very localized and the electrologist would often exceed its boundaries. She also related that sometimes she did not mention she needed another shot because electrolysis would stop at this point (waiting for the doctor), and it was sometimes too painful.
But she did quite well with us, and she told me that there is no comparison between the two experiences. While we could provide injections to our patients, we don’t feel it’s the best approach.
We’ve focused on nitrous oxide, but that’s only part of what we administer. Nitrous oxide is normally used in concert with other drugs to produce the desired effect. This method is multiple-drug anesthesia. That’s what we do here.
Nitrous oxide is definitely the main component in the anesthesia. In this setting, it provides (conscious) anesthesia. I need to emphasize that while the patient is very sedate, she is conscious and awake. We even briefly converse during the session. For the typical patient, it’s more like a day dream of sorts. The patient “is there,” but not. On its own, nitrous oxide changes how we feel pain. In lighter doses, the patient INTELLECTUALLY senses pain, but it doesn’t hurt! I know that sounds contradictory.
We also use a topical anesthetic/anti-inflammatory that is compounded (custom blended) for us by a pharmaceutical firm. We’ve named it Epil-EZ. This, too, is prescription medication and is only used with our patients. Having tried/heard of Emla Cream or other OTC (over-the-counter) medications, most peoples’ first reaction is believing that a topical can’t do very much. Well, it doesn’t take long to change their minds about Epil-EZ.
Epil-EZ is about seven magnitudes more powerful than Emla, and is made in such a way that it quickly penetrates through the skin barrier. This is similar mixture to what a dermatologist may use during a extensive procedure, such as laser surgery on the face. As with surgical procedures, it is important to keep the site free from blood and inflammation. Additional drugs produce this effect. Epil-EZ contains these drugs as well. Several minutes after applying the topical to the patient, I can see the skin blanche in the area of the cream. This effect is produced by all of the minute blood vessels constricting. As a result, the electrolysis treatment area will now suffer less inflammation. Additionally, the anesthetic will last longer, since it will not be metabolized so quickly.
So Epil-EZ is quite a blessing on its own. The treatment area is deadened from pain, and I’m able to do more treatment with less after-effects.
Do you have any patients who have also tried injections, and can make a comparison to gas?
Well, there really isn’t much to feel. The patient is breathing a continuous mixture of nitrous oxide/oxygen (through a small nasal mask), and a high-potency anesthetic has deadened the area.
Pain really isn’t an issue here. I’m more focused on patient comfort – having the patient feel at ease and relaxed. Nitrous oxide provides a lot on that level. Keep in mind that regular anesthetics just deaden an area from pain. That’s all they’re supposed to do. But the gas has a very positive mood altering effect. Patients feel relaxed and generally feel that time passes quickly. They really are unbothered by the experience.
While I don’t expect patients to do this for fun, I hope the gals leave here thinking, “That wasn’t so bad!” or “This is night and day compared to that other electrolysis!”
Does this change your rate?
Yes, it does. Currently, electrolysis (on its own) is $59.00 per hour. Electrolysis with gas/multiple drug anesthesia is at the higher rate of $75.00 per hour.
The difference in professional fees involves the additional intervention and responsibility, and of course, the significant expense of providing and maintaining an anesthesia system. As far as I’ve seen, our charges are much lower than other office procedures that use nitrous oxide. The cost of nitrous oxide during a dental procedure lasting about twenty minutes may be fifty or seventy-five dollars on its own. And the methods we’re using here are much more involved.
We also have an anesthesia supplies fee of $40 per visit, or per day. The fee remains the same no matter how many hours of treatment are received that day. This cost covers medical gases, a disposable mask, and other supplies. A tube of Epil-EZ costs $60 and is enough for about twenty hours of electrolysis. With the price of pharmaceuticals and medical/surgical supplies, these charges only cover our costs.
How long do the effects last?
Nitrous oxide is extremely fast acting. The drug immediately enters the blood stream through the lungs. In five minutes, the patient is very sedate. The effects pass very quickly, too.
During breaks, the nitrous oxide is stopped and pure oxygen is briefly given instead. In a couple of minutes, the patient is quite alert. A couple minutes after that, the patient is able to get out of the treatment chair if she wants. It is considered safe to drive or leave the office unattended within ten minutes after nitrous administration. But at the end of treatment, we ask patients to wait a minimum of twenty to thirty minutes from the time the gas had been discontinued. I use this time to apply medication to protect the treated area and additionally lessen inflammation. I also go over the details of electrology after-care if she is not yet familiar with our recommended procedures.
Are there any side effects-nausea, etc.?
Nitrous oxide is probably the most extensively used anesthetic for potentially painful procedures, or when the patient needs to be extremely sedate. Under normal circumstances, it can be used repeatedly, and for a long duration.
Some individuals are prone to feeling nauseous with higher doses, or over a long duration. For this reason, we stop the anesthesia about every hour for about five minutes. After five minutes, the majority of the effects have passed and the patient is asked if she would like to continue. Outside of occasional restroom breaks or to stretch one’s legs, there is rarely any other interruption during a long session.
To date we have had only one person experience nausea. In that instance, the nitrous oxide was immediately stopped and we took about a half hour break before we continued with the session. By making an adjustment to the anesthesia afterwards, we were easily able to finish out the session. Since then she has returned for more electrolysis treatment using nitrous oxide without incident.
We also make the treatment setting as comfortable and safe as possible. For greatest accuracy, the gas mixture is continuously adjusted/monitored electronically as it is delivered. Our anesthesia system has a variety of redundant safeguards including continuous read-outs which electronically sample the gas, visual and audible alarms, along with other safety systems. The patient’s vital signs are also monitored during the session.
For patient comfort, we use a medical examination/surgical chair. The chair is very comfortable and supports the head and back well. It has special sling-type armrests that allow one’s arms to go limp. The patient is able to get very relaxed in the chair. Also, it is fully hydraulic. I’m easily able to position the patient and get the most hard to reach areas, such as under the chin. Also, we use a focused beam light to illuminate the area. Unlike the ring-light familiar to most electrology patients, the beam is very precise – there is no bright light in the patient’s eyes.
I’ve had difficulty getting client comments, since Nu-Woman is linked to a larger gender clinic upon which many depend for other transition services. For this reason, some have written privately that I might have a hard time until a few people have completed or left the program.
This is a valid point. I had similar misgivings about my gender therapist, but I wasn’t about to voice that until I’d gotten my SRS letter from her. Even though those providing services to TSs probably would not punish us for candid assessments, it’s better to be safe than sorry.
That said, I received a report from a client whose experience with Nu-Woman was “not entirely positive” due to some skin damage she fears may be permanent. She would not elaborate beyond that publicly, except to say, “My sadder-but-wiser conclusion is that this process needs serious reconsideration.”
Q: Have you tried non-nitrous electro, and how do they compare?
Yes, and there is no comparison. Nitrous electro does not put you to a level at that you do not feel any pain, but the pain does not seem to bother you. The time just flies by. There have been times that I think that 20 minutes have passed, only to find out that in actuality two hours have passed.
Q: Have you also tried injections, and can make a comparison to gas?
No, but from what I have heard about injections, I do not believe that I want to try injections.
Q: How long do the effects last?
As long as the gas is being fed to you. Recovery is within minutes of the gas being shut off, and pure being oxygen introduced.
Q: Are there any side effects-nausea, etc.?
If there has been, it has been for me, very minor. It has been a very positive experience.
Q: How would you rate the effectiveness of the treatment?
I have had 60 hours of electrolysis to date, and I have gone from having to shave once or twice a day, to having to shave once every second or third day.
Q: How would you rate the condition of your skin?
Excellent. The combination of the hormones and the electrolysis has made my skin as soft as any females.
Q: Any scarring or pitting since getting treatment?
This was a concern of mine when I first started, but there has been none.
Q: How long have you been going and for how many hours.
As I stated earlier, I have had 60 hours to date.
Q: How many more do you anticipate?
I would guess from the results to date, that I should be just about done with another 50-60 hrs, or less. It is difficult to say, since Kim goes above and beyond what one expects. I don’t know how she does so much in the time allotted.
I have been to Nu-woman both before and after Kim started using Nitrous gas. I have also been going to see an electrologist here in Key West. My first experience with Kim was after I had been going to my local electrologist for a few months. I went mainly to see if Kim was as good as she indicated and to see how my other electrologist compared. Kim was definitely faster. I was also still satisfied with my results locally except for only being able to get 1-2 hours a week. Last summer I spent living in Bradenton Fl. relatively close to Tampa so I went to see Kim weekly. At first I went for 4 hour sessions which was as much as I could handle. After she started using the gas I went for the same length of time with only finances keeping me from doing more. I found the swelling and irritation to be reduced when using the gas. Also the numbing ointment is much more effective than Emla.
After getting in the chair Kim puts a blood pressure cuff on your arm and takes your vital signs, which she does periodically during the session. She then puts a small nose mask on and starts the gas. In a very short time I am under the effects of the gas. There is very little sensation during the treatment except when she reduces the gas to bring me round for a break. After the session is over there is some soreness but it is not at all bad. The time seems to have flown by.
Last summer I was going for a 4 hour session once a week. Since Sept. I have been back in Key West so I go up about once a month for 8 - 10 hours over 2 days.
The only tips I can think of are: 1. Eat and drink lightly the morning before a session. 2. Be sure you have waited long enough before driving. 15 min. seems to do it for me.
In closing I would say that the extra cost of the nitrous is well worth it. I also feel that Kim has a higher hair kill ratio than others. I recommend her services.
- Nu-Woman Electrolysis
- Kimberly Westwood, CPE, CCE
- [kim at nu-woman dot com]
- Website: [nu-woman dot com]