Thursday, March 8, 2012

15 Days Post-Op - Home Sweet Home

"Home, where my thought’s escaping,
Home, where my music’s playing;
Home, where my love lies waiting,
Silently for me."

-- Simon and Garfunkel, Homeward Bound
Just after my last post, we went in to get the packing and catheter removed. Happy day!

The trip back in to the office was exhausting, and even the cushy couch in the waiting room was stupidly uncomfortable. We didn't actually see Dr. Bowers, but saw an assistant I'd worked with a little before, Melissa. After calling me back, she had me undress from the waist down and get in to a gynecology-type chair.

First, she drained the balloon holding the catheter in place, then counted to three and tugged it out. There was a terrible sensation for all of five seconds or so, but it quickly faded. Next, she reeled out the packing, which was apparently a very long single strip of gauze, wound back and forth. Fortunately, this made it pretty easy (if time consuming) to remove without any pain. Once both were out, I immediately felt a lot better.

Next, Melissa showed me how to dilate. I had forgotten my dilators at the room, so she showed us with one she had in the office. She applied lubricant and anti-bacterial gel, then slowly and carefully inserted it. It was strange and uncomfortable, but not exactly painful. Then she removed it and had me try. It was a little tough getting the angle right, but Melissa was patient, and after a slight struggle I managed. Normally, I'll have to keep the dilator in place for 15 minutes at a time, but this time she had me remove it right away, told me to swap lower nakedness for upper nakedness, and left the room to get Dr. Beck (my breast augmentation surgeon).

I forgot to mention in my last post, but we've actually been a little nervous and frustrated with regards to Dr. Beck, because he didn't visit at all while we were in the hospital. When he came in to the room, right away he started explaining that he'd had a personal emergency come up, something very major, and apologized profusely for not being able to see me sooner. Him bringing it up first made me feel loads better, and no harm, no foul, I suppose, since Dr. Bowers was keeping an eye on me.

Dr. Beck talked to me about maintenance and about having my stitches removed by a doc back home, then showed me some exercises to help keep the scar tissue around the implant from contracting. I'm really happy with the size, which is in the large B to small C range (just a little bigger than I was padding them to before), and they get softer and more shapely by the day. The stitches will hopefully be removed by the local doc that I'm seeing next week.

On Wednesday, the day after my follow-up, a friend who I game with online (but who I'd never met in person) offered to come visit! He and his fiancée offered to drive down from Berkeley, almost an hour away. I felt a little guilty, having them drive that far to hang out with people they'd never met, but he was very sweet and encouraging.

That morning, I managed to take a shower and wash my hair without feeling like I was going to pass out by the end, which was good progress. They arrived in the afternoon, and the four of us sat around in the hotel room chatting randomly for a couple of hours. It was surprisingly not awkward, thanks to both of them being very sociable and generally awesome people. As evening rolled around, we decided to go out to eat, and they suggested BJ's, a California-based chain with a location just 10 minutes away.

Erin has celiac disease, and can't eat wheat. Though we can usually find something for her to eat just about anywhere, we were pleasantly surprised to find out that BJ's has specific gluten-free options. The friends graciously drove, the restaurant service was good, and the food was delicious. Admittedly, I may have pushed myself a little too hard, which was compounded by our dessert taking far too long to arrive. Expending energy seems to turn my body in to a furnace right now, and by the end I was hot, sore, and exhausted. Still, it was worthwhile for me to get in some social interaction with such great people, and for Erin to relax with a couple of drinks and some yummy gluten-free pizza. It was also beneficial as a test-run for having to fly home just a few days later.

Around that time, I received a couple of Facebook messages from friends-of-friends saying that they'd read and appreciated this blog, which means a lot to me. Thanks to Google Analytics, I've always known that I have readers scattered around the world, but it was very heartening to hear such wonderful unsolicited encouragement. To anyone out there reading, please know that I keep this blog completely public on purpose, and that even if what I post seems somewhat personal, you are welcome to read and comment as long as it's not TMI for you. =)

On Saturday, we packed up and checked out of the hotel, then drove to the San Francisco airport. We'd called ahead and asked for wheelchair assistance, but I still had to walk and wheel a bag from the rental car drop-off to the luggage check. Thankfully, SFO has a cool tram system, and it wasn't that far, but I was still pretty tired by the time we got to the Delta desk.

I mentioned the wheelchair as soon as we got there, and I'm sure they could see that I was sweating and having a tough time, but for some reason they didn't offer any sort of extra assistance, or even seem empathetic at all, which made me kind of mad. They also didn't call for the wheelchair until we were done with everything, and then the lady who made the call disappeared, forcing the wheelchair assistant to search all over for her while we waited. >_<

After that, however, it was pretty smooth sailing. The wheelchair assistants and TSA people were very nice. The Delta agent at the gate let us board first, and even moved us to seats near the front of the plane, so we would be able to deplane much easier and faster. As we taxied out to the runway, I took two percocets and quickly zonked out. After sleeping most of the way to SLC, there was a wheelchair waiting for us on the jet bridge. Erin's oldest brother offered to pick us up, and even met us at the baggage claim, so I didn't have to drag the luggage any farther.

Being home has been nice, if nothing else because it's comforting and familiar. I was most excited about being able to play games on my nice computer, instead of the crappy lappy we brought. Sadly, sitting up at the keys for very long seems to put odd pressure on certain sutures, and has even caused a little extra bleeding, so I've been keeping the computer sessions short until I'm a little more secure in my healing progress.

The bruising is almost completely gone, and the swelling has gone down considerably. The sutures are healing nicely, but I'm still careful to baby them and apply Neosporin religiously. Most of the pain is going down slowly but steadily, and I'm taking about half the pain pills that I was when I first left the hospital. My breasts, on the other hand, seem to be getting a little more sore as time goes on and they realize what's been done to them. =P

For the past few days I've also been trying to get up and move around the house a little more, and my energy levels are much better than they were last week. Tomorrow, we're going to hang out with some friends and play DnD, which I'm excited about both because I've missed them, and because it's a comfortable atmosphere where I know I can relax.

Dilating is still strange, but getting less uncomfortable. Being unused to it at first made it tough to relax, and my muscles tensing up was causing a lot of the discomfort. It's also a little difficult getting the dilator under the pubic bone, since I wasn't blessed with the higher pelvis pubic arch that comes with teenage female puberty, but that's also getting easier as the tissues learn to accommodate.

For now, I have to dilate three times a day for 15 minutes at a time. After three months, I can go down to twice a day. After six months, once daily, and so on. I can picture myself getting really lazy about it in the future, but so far, I've managed to stay pretty regimented. Within the next few days I'm supposed to move up to the medium-sized dilator though, which is somewhat intimidating.

Dilators in three sizes: small, medium, and scary. Melissa actually had yet one larger size in the office, which thankfully wasn't provided to me.
Next week, I have a post-op checkup. As I mentioned a while back, my primary doctor wasn't sure if she would be comfortable checking out the healing, but I did manage to make an appointment with Dr. Luikenaar for Friday the 16th, and I'm sure she'll do just fine.

I've still had very few doubts or major concerns, which is especially unusual for me and my overly analytical mind. Really, I'm just happy to feel like my body looks normal. I wouldn't mind losing a few pounds, but I think once things heal, I may even be semi-comfortable in a swimsuit for the first time in my life, which is incredibly exciting. Most of all, I'm grateful to finally look in the mirror and be able to say with confidence that I see me looking back. =)

Tuesday, February 28, 2012

6 Days Post-Op - Back at the Hotel

"I'm taking her home with me,
All dressed in white;
She's got everything I need,
Some pills in a little cup."

 -- A Perfect Circle, The Nurse Who Loved Me
I've been out of the hospital for three days now (since Saturday)! =D

On Friday, I was able to get up and walk around a bit. I managed to make it to the door to my hospital room and back (with help of course). Moving around stretched sutures and hurt a bit, but mostly it was just exhausting. Those few steps made me feel as though I'd run a mile. Later I tried again and made it out the door and down the hall a bit before returning. Baby steps!

Erin loaned me a small mirror, and I got a better look at the new parts. The brusing is surprisingly minor. I've seen pictures of people covered in bruises from thigh to thigh, but in my case I've just got some light patchy bruises on each thigh, and some bruising and swelling on my left outer labia.

Of course, the sutures look a bit ugly at the moment, but even the nurses were complimenting them, saying that they would heal very nicely and with very little scarring. Dr. Bowers was even asking me to send her pictures once everything's healed, so she can use my results as an example on her website. =D

After a couple of days, the drain slowed down considerably, but also started to sting pretty badly. Thankfully, on Saturday morning Dr. Bowers came in to remove it. She snipped the stitch holding it in place and slid it out. I was surprised at how long it was; apparently it had been curved up and around through both outer labia.

There were one or two nurses that we really disliked, but most of them were great. Our definite favorite was a woman named Pat. She was sweet, thorough, and genuinely invested in my well-being, but never sugar-coated things, and also took the time to make sure Erin was fed and comfortable, which helped Erin to help take care of me. We made sure to give her a hug before we left. =) 

I had thought that they would take the catheter and/or packing out before I left the hospital, but it turns out that both have to stay in until my followup appointment on Tuesday. >_<

We checked out of the hospital and headed back to the hotel Saturday afternoon. Erin helped me get dressed and gathered, then went to get the car while and one of the nurses loaded me in to a wheelchair.

The nurse wheeled me down to the front door, then helped me carefully transfer to the car, and on to the donut-shaped pillow we brought. The car ride was painful, but short, and Erin was careful to avoid jerks and bumps wherever she could. Our hotel has a parking lot in the basement, with spaces very close the elevator. The room is also pretty close to the elevator, only a few doors away, so the walk to the room was manageable.

Since we got back I've basically just been lying in bed, working through the Netflix instant queue with Erin (Memento, The Producers, Howl's Moving Castle), and playing PS3, DS, and Android games (PixelJunk Shooter, God of War II, Dungeon Siege III, New Super Mario Bros., Advance Wars: Days of Ruin, Words With Friends, Hanging With Friends, yesI'magameaddictshhhh!), while Erin reads manga online. Honestly it's been a lot like being at home, except that my lappy sucks too much to play DotA 2 or SW:ToR. Thank goodness for a room with free and decent internet access. =D

Overall it's pretty easy to stay happy and entertained, though we do both get a little stir-crazy. Erin makes almost-daily trips to Safeway or CVS pharmacy to pick up food and sundry useful supplies. I honestly don't know how I'd manage without her. She's been so amazing, doling out my meds, helping me get up and down, getting/making food, keeping me company. She's been like a super-nurse, except her shift never ends, which I feel bad about. She's too sweet for her own good; sometimes I can tell she's getting a little frazzled, and I have to remind her to slow down and take care of herself for a little while.

In the hospital, the nurses were keeping me clean-ish with washcloths, but after a couple of days at the hotel I was feeling pretty disgusting and decided to try a shower. Erin managed to wash my hair, while I spent most of my energy trying to balance and just generally rinse off. Unfortunately I pushed myself a little too hard, and ended up feeling a pretty faint and dizzy by the end. Still, after sitting down and recovering for a few minutes, it felt amazing to finally be clean again.

I'm still taking percocets for pain, which seem to be helping more and more as the pain from the stitches decreases. I still get random stinging from sutures, and strange zaps as nerves slowly re-establish themselves, but I swear that most of the pain at this point is from the catheter and packing. The packing causes lots of pressure, which is constant, but gets much worse if I try to sit up for any period of time.

The catheter doesn't help in the pressure department, and though I've gotten a little more used to the always-have-to-pee feeling, I don't think my body has. If I'm off the percocets for too long, everything gets generally tense and very uncomfortable in that area. The tubing has also gotten kinked once or twice,  before I figured out how best to situate it, and each time it has taken a bit to even figure out what was causing the extra pain.

My breasts have gotten slightly softer as the skin stretches, but they still have a long way to go. The stitches (in the creases underneath) get itchy from time to time, which is a good sign, and other than some minor aching here and there, they've been relatively pain-free.

Later today, we'll be going back to Dr. Bowers' office for the follow-up, and removal of the packing and catheter. I seriously can't wait, as I think these will ease my discomfort by a lot, but I'm also pretty nervous, because it means the start of dilating.

For a while, my body will see the new configuration as semi-foreign (like a piercing), and try to close things up. Among my bag of clothes from the hospital, we discovered my very own set of dilators (smooth medical-grade dildos is honestly the best descriptor =P), which I'll have to use routinely for a few months to keep things from collapsing. I suppose it can't be much worse than this damn packing, though. >_<

Friday, February 24, 2012

2 Days Post-Op - The Waiting Game

"My vagina has two sets of lips,
But I don't get monthly blood drips;
My vagina, hardly even used."
-- NOFX, My Vagina
We got to the hospital at 10:00am on Wednesday morning and checked in with the surgery center's admissions desk. After a few minutes, they called us to a little desk to have me sign a bunch of consent and release forms.

Another few minutes went by, and a nurse called us back in to the back rooms. She had me strip down and helped me change in to a hospital gown and silly paper booties. All my clothes went in to a plastic bag, and everything else, my wedding ring, tongue ring, cellphone, and wallet, I gave to Erin.

The nurse directed us to a small room with a recliner for me, where she put an inflatable warming blanket over me and attached a couple of wristbands for identification. She worked away at the computer, and gave me a few more forms to initial and sign saying that I knew who my doctors were and what I was getting. She also wrapped compression sleeves around my lower legs, which rhythmically contract to keep the blood flowing.

She then left, and we continued waiting. One-by-one over the next half hour or so, various people from the surgical team dropped by.

The anesthesiologist was the first to introduce himself. He was a nice, slightly quirky, wiry-looking guy who spoke quickly and wore a black bandana on his head. After he left, Dr. Bowers dropped by to say "hi", and to assure us that everything was going to go great. At this point we were both pretty excited, but Erin was also obviously nervous. She teared up a couple of times, but tried to hold back and smile to keep me from worrying too much. =3

Lastly, a sweet and reassuring younger woman who said she'd be helping with the surgery came in and asked me to come with her to the operating room. Erin and I gave each other a hug and a kiss, then parted ways. I was then led down a hallway in to the OR, where I lay on a flat table under some giant movable light structures, and people bustled around me. There was a slight depression in the table's surface, and they had me adjust until my butt was right at the edge of it.

They removed my gowns, so that I had just one loosely draped over me, and put oxygen tubes in my nose. My arms were propped straight out to the sides, and the anesthesiologist started telling dorky jokes while he inserted the IV in to my left forearm. The last thing I remember was chatting with the anesthesiologist and assistant woman about it being a little awkward that everyone in the room was there for me, and then I was out.

I woke up in the recovery room around 4:30, and a nurse immediately noticed me and offered me some bits of ice, which I happily chewed. Within half an hour or so, I was fairly lucid, and they wheeled me to my room. Erin was there waiting for me, grinning from ear to ear, and she gave me a kiss.

Erin was planning to go back to the hotel to sleep, but I have the hospital room to myself, so they offered to wheel another bed in for her and she has stayed with me both nights so far. It's been so comforting to know that she's only a few feet away if I need her. On Thursday morning she went back to the hotel to shower and grab a few things, but otherwise she's been hanging out here, playing video games, and even eating hospital food with me.

The nurses are, for the most part, awesome, though there was one incident where a CNA was trying to adjust my tray and accidentally slammed it downward on to my crotch. I saw stars for a second and nearly swore, but it was an honest accident, and I did my best to keep calm while she apologized repeatedly.

My crotch has been completely bandaged over, with packing inside as well. I have a JP Drain coming out my left side which they have to empty red goo out of a few times a day, and a catheter tube going to my right. The catheter feels horrible, like I always have to pee, but I'm sort of getting used to it by now.

My breasts feel tight and tender, but don't hurt much. I really like the size, and I think I'll be really happy with them once the skin stretches and they settle. For now, they're just sort of stuck in place.

The pain in my groin area was fairly bad on the first night. The nurses gave me morphine through the IV, which helped a lot, and percocets by mouth, which didn't seem to help at all. For a while, there were rhythmic zaps of pain centralized in one spot, but I couldn't figure out what part it was originating from, because as far as my brain is concerned, the old nerve map of my genitalia is still valid, and nothing has changed. After a while it dawned on me that the zaps were almost definitely coming from my clitoris, which was exciting! Eventually I was able to get some sleep, and the pain was much better in the morning.

After spending Wednesday evening laying down, I decided to sit up and play around on the lappy on Thursday. That afternoon, Dr. Bowers stopped by. She told me that I looked like I was recovering well, and that she was really proud and happy with the way my surgery turned out. She also said that she's sure I'll like it. I hope she's right! =D

As the evening wore on, the pain from the sutures nearly went away, but it was replaced by a new aching throughout my entire lower abdomen. At first, I thought it was just from sitting in the same position for so long, so I carefully tossed and turned, trying to find a comfortable spot. After a couple of hours of this, the pain just continued to get worse, so I told my nurse, who pointed out that it was probably gas build-up. She gave me some gas-ex, but said it would take hours to take effect. Since I was nearly in tears, and it was getting late anyway, she gave me some more morphine and an ambien to knock me out. This morning, I still feel a little bloated and sore, but much much better.

At 7am today, a new nurse came in to remove my dressings! She had me lay flat, and she slowly peeled the bandages off of my vagina (that still feels weird to say). I only got a short glimpse before she replaced the bandages with a maxi-pad, but so far it looks great! My labia are very swollen but good, and the clitoral hooding is perfect. Even though I knew logically that everything was there, it's nice and extremely exciting to be able to finally see it and know that it's real.

I should be able to get up and walk around a little today, which I can't wait for. I'm sick of being stuck to this bed. If all continues to go well, I should be checking out of the hospital tomorrow morning! W00t! =)

Wednesday, February 22, 2012

T Minus 1 Day - Surgery Eve!

"Tomorrow! Tomorrow!
I love ya, tomorrow!
You're always a day away."
-- Annie (Annie), Tomorrow
Hooh! It's been a full week, as expected, which has kept my mind from wandering too much. Every once in a while a wave of realization will hit me, and I'll reel for a couple of seconds. It's finally here!

The flight from SLC to LAX was fine. After going through the body scanner, a TSA agent did give me a "thorough patdown", but she was very amiable and professional. The flight was short, but I'm already considering looking in to an upgrade for the trip back, just for slightly more comfortable seats.

Disneyland was a lot of fun, though the lines were longer than expected, and rides kept going down right when we wanted to go on them. Erin and I take a trip down there every couple of years, because it's an easy/fun road trip and we get to stop in Vegas, but I've never seen the rides go down that much.

We'd only planned to hang out with Erin's brother Chris while there, but we found out a couple of weeks ago that Erin's oldest brother, Dave, who lives in SLC, was coincidentally also going to the LA area at the same time as we were. He and his girlfriend ended up joining us at Disney, which was brilliant. Funnily, both of Erin's brothers are averse to roller coasters, so us three girls ended up going on Space Mountain without them.

The visit with the grandfolk on Sunday was good. Since we were exhausted from Disney, it was nice to just sit around chatting over dinner, and they're such good people.

I knew we'd forget to bring something from home. The something ended up being hairspray, a mouse for the laptop, and a car charger for our phones. The charger was the most problematic, since we use our phones for GPS directions. Thankfully we found a Best Buy (and grabbed a couple more video games to boot) before driving up to San Mateo.

We met with Dr. Bowers yesterday, and she talked us through the expected outcome and possible (but unlikely) complications. I thought I'd have a million questions, but I just kept looking at Erin, and neither of us could think of anything. I spent so much time over the last couple of years researching the surgery in general and Dr. Bowers in specific, I think all I really needed was to hear her reassurances. And she was amazingly reassuring.

She's obviously been at this a long time, and being trans herself, she has a unique and very comforting perspective. She said everything looked fine and that there shouldn't be any problems.

After that, we went and picked up my prescriptions (laxative, bowel prep, pain relievers, antibiotics, and antibacterial cream) and some supplies, i.e. neosporin, baby wipes, and clear liquids for me to subsist on today. We'd thought about doing something touristy for the remainder of yesterday. Instead, we relaxed in the hotel for a while, then went out to a steak joint for my last meal. It was a nice recharge that I think we both needed.

We saw Dr. Beck this morning, and he was a little less personable than Marci, but still very nice. After he took some pictures and measurements of my chest, he had us work with his assistant Jasmine on sizing and such, and she was wonderful. She knew just what to say to boost my confidence and make me feel good about what I'm doing.

Next, we had to drop by the hospital for some quick blood work. Then back to the hotel to start in on the bowel prep to clean me out. The solution came in a jug, which I filled with water to mix it. I was then supposed to drink a glass every ten minutes until gone.

The first five or six glasses went down fine, but after that, the stuff started to make me nauseous. I know it was partly psychosomatic, so I did my best to power through it, but I couldn't seem to down a full glass without feeling like I was going to throw up. It didn't help that the jug was four freaking liters, meaning about 16 small glasses over the course of several hours to get through it. Ugh.

I also wasn't allowed to eat anything today, just liquids. Remarkably, I haven't been that hungry. A light snack probably would've helped settle my stomach when drinking the bowel prep, but I made do with ginger ale or apple juice chasers.

At this point, I'm just waiting for bed time so we can wake up and head in to the hospital. We're supposed to be there at 10:00am, but the actual surgery doesn't start until around 11:30. It should last around 4-5 hours, with both docs working at the same time. I'll be in the hospital for about three days, then back to the hotel for another week before heading home.

I half-expected to have a lot of doubts and moods swings to work through over the last week, which would've been normal, but I've had surprisingly little apprehension. I'm anxious and antsy, but I think I made up my mind and overcame my qualms a long time ago.

By now I'm just excited that the wait is finally over. Of course, this is also just another beginning, but in my head, it's the beginning of the rest of my life, and I know that I'm ready for it.

Friday, February 17, 2012

T Minus 5 Days - Heading Out Californee Way

"Airplane, airplane,
Don't you go down today;
Take me away, off to a better place,
You know just where I'd like to go;
Please get me there on time,
Don't delay me from losing my mind."
 -- Plain White T's, Airplane
I mentioned in my last post that I've had way too much to do. Well, other than at work, most of that ran out a couple of weeks ago. Since then time has been dragging, and I've had way too much time to sit around and think, and make myself anxious. I couldn't wait for today to come, just so that it could be over with.

I've had various pre-admission phone appointments over the last week with Dr. Bowers' staff, Dr. Beck's staff, and the hospital staff. We've booked flights, hotels, a rental car, etc. I think we're ready, but I know I'll forget something. Hopefully it's something stupid and small, like toothpaste. ;)

I stopped most of my hormones a little over a week ago. I'm still on a little bit of estrogen, but temporarily off progesterone, and thankfully I'll never have to take spiro (testosterone-blockers) again. Yay!

After a few days off hormones, I started having mild headaches that won't go away. Normally, the only time I get headaches is when I'm about to get sick, so it's been really scaring me. Getting sick right before surgery would not be good. So far, the headaches are the extent of the physical discomfort, though.

A few days ago the mood swings hit. It really seems unfair that I had to stop hormones during one of the most emotional times of my life. In addition to minor bouts of depression and anxiety, I've been feeling really self-centered. I'm making an effort to reach out to friends to help them, but at some point I also have to accept that it's ok to be a little self-involved right now, even though that's tough for me to do.

The great support I've gotten from friends and family has helped a lot. (THANK YOU!!!) I'm never down for too long before a new heartfelt text or Facebook message rolls in to remind us how loved we are. I also got an insanely sweet 'Good Luck' card from a bunch of friends that made me tear up a couple of times while playing Dungeons and Dragons. I am so freaking lucky.

My last day in the office was on Wednesday. It's strange thinking that I won't work again for around six weeks. My boss was super cool about it, though, and helped me wrap everything up and train people to cover for me. We had a last meeting to make sure everything was settled, and she kept telling me to forget about work for a while. =)

The only real uncertainty remaining is my time off work being qualified as medical leave. I'm still pretty sure it will go through, but they don't give the official word until I'm actually hospitalized, which seems idiotic.

Tonight, we're stopping by my sister's to receive a mystery present, then to Erin's mom's, and finally to the airport to fly to LA. Honestly, I'm a little bit terrified of the TSA right now. I've heard way too many horror stories of people who got pulled aside, outed, or berated because their bodies didn't look like "normal" male or female bodies under the scanners. I can deal with answering questions and outing myself. But I can be really defensive and ornery if I feel I'm being pushed farther than I should be, and the TSA are the last people I want to be ornery with. >_<

Tomorrow, we'll be in Disneyland with Erin's awesome brother who lives in that area. In two days, we'll be hanging out with Erin's grandparents and other family from around there before driving up to the San Francisco area. The last time I saw her grandparents, I'd just started transitioning, but didn't tell them. Later I found out that Erin's mom told them, and that they were amazing about it, so I'm excited to let them see the real me.

In three days, we'll be meeting with Dr. Bowers, then hanging out in San Francisco. In four, we'll meet with Dr. Beck, and I'll spend the day stuck in the hotel drinking a bowel prep, and not eating anything. And in five days, I'll be on the operating table!

It's so surreal to think that in less than a week, my body will be significantly changed forever. It's nerve-wracking, but it's exciting! At the same time, I know that the surgery itself is just the beginning, since I'll spend the next few weeks/months healing. Still, I'm huge on life experiences, I wouldn't trade this ride for anything.

Tuesday, January 24, 2012

T Minus 29 Days - Insurance and the Many Machinations

"We didn't choose to be bureaucrats,
No that's what our mighty Ja made us;
We'd treat people like swine and make them stand in line,
Even if nobody paid us!"

-- Hermes Conrad (Futurama), The Bureaucrat Song
Only 29 days remaining! I've had way too much to do to prepare, but I suppose I should be grateful, because it's made the time go by quickly. On the electrolysis timeline, I only have one session left. Things in general are also coming together really well!

The craziness kicked off in earnest when Robin with Dr. Bowers' office sent me a surgery info packet a few weeks ago, which included a checklist of various forms and such to send to them, recommendations for hotels, a list of important dates, etc.

Among the things to send, they requested HIV test results. Normally these tests can cost around $150, but the Utah Pride Center does free testing on certain days, so Erin came with me and we both got tested. Of course, both our results were negative, but it's always nice to know, and it's very cool that we have such great local programs.

I also had to send off my letters of recommendation, an information release form, medical history, an anesthesia evaluation form, my name change court order, a picture of myself, and a one-page self bio. No, I'm not making that last bit up. =P

At the start of the year, I switched to a new insurance plan with Anthem Blue Cross that covers trans surgery. I was still nervous about my chances for approval, and trying really hard not to get my hopes up, just in case. As soon as Robin had all my info, she contacted the insurance to get the pre-authorization started. It was only a few days later (last Friday) that I heard back from both the insurance rep and Robin, telling me that I'd been approved! SO EXCITING!

This is such a huge weight off my shoulders. I've said many times how terrible I felt having this huge cost looming over Erin and me (even knowing it'd be worth it). My out-of-network deductible was $3,000, which is a substantial discount from the $22,500 I'd planned on paying. After surgery, we're hoping to take a vacation or two, then start looking for houses. =D

I'm a little sad that we won't be able to thank Robin in person, since she works in Trinidad, CO. I know it's her job, but Robin has been amazing to work with, and I can't imagine coordinating all of this paperwork without her help. I can definitely see why Dr. Bowers kept her on in Colorado, even after moving her practice to San Mateo.

In addition, I've been researching plastic surgeons for the possible breast augmentation I mentioned in my last post. Oddly enough, Salt Lake City has a thriving plastic surgery industry, with a lot of good surgeons with good rates. With the power of the internet, I found a nearby surgeon who gets great reviews, and decided to schedule a consultation. Of course, one of the first things I asked the girl on the phone was if the doc had any experience with trans clients. I was surprised to hear that he very much prefers to not work with trans people, and also that the rep had no idea why. "It's just his policy." Although I wouldn't want to work with someone that doesn't want to work with "my people", it was still incredibly disappointing. =/

After that, I decided to call one Dr. Beck in California. Not only does he have a lot of experience with trans clients and enjoy working with us, he often works with Dr. Bowers, to perform aesthetic surgeries during the same session as the SRS. I had a phone consultation with him a couple of weeks ago, and I really liked his demeanor and his recommendations. At first I was wary of the prospect of healing from both SRS and a BA at the same time, but the idea of having it all done with and not having to be put under twice is quite appealing. After insurance came through, I went ahead and scheduled the BA with him.

On another front, Erin and I have both put in for medical leave from our respective work places. Mine is still in the works, though I'm pretty sure it will be approved. Erin's, well... a couple of days after she turned in all the paperwork, they said that her request was denied because "they don't recognize domestic partnerships."

When Erin explained that we're actually married, they told her that even if we're married in another state, it wouldn't count since same-sex marriages aren't recognized in Utah. *facepalm* She then, of course, had to divulge my history and explain it in detail before they decided to look at it again. Thankfully, in the end, they did approve it. It's just frustrating that we'll always be forced to come out in order to validate our marriage, and that they wanted to discriminate in the first place.

Originally, we'd planned to drive to Cali in order to save money, but between Erin not liking to drive, the possibility of hitting snowstorms on the way back, and me being unsure how I'll feel sitting in a car for that long, we decided it's smarter to take a plane. We booked our flights a couple of days ago, and we'll be leaving February 17th and coming back March 3rd!

I'm still working on hotels. We're trying to save money wherever possible, but I also think it would be a good idea to stay somewhere with a kitchen, since we'll be there for a while. Decisions, decisions.

And last but not least, I still need to find a local doc who can give me a post-op checkup a few weeks after the surgery, to monitor on healing and such. My primary care physician said she didn't feel like she'd be good for it, and I feel stupid even broaching the subject with other offices without being referred. However, there is a nearby Dr. Luikenaar who recently announced that she's looking to help trans clients, and whose specialty is gynecology. Perhaps it's meant to be? I'll give her a call soon. =)

Friday, November 4, 2011

Overdue Update, on Electrolysis, Surgery, Insurance, and Boobs

"The boob fairy never came for me
No the boob fairy never came for me
Look, I wasn't wanting melons, just a cute curvaceous "B"
But the boob fairy never came for me."

-- Deirdre Flint, The Boob Fairy
I know this is where I'm supposed to make some excuse about why I haven't been updating for the last three months, but I've got nothing. Well, I've got a few things, but they're empty excuses that don't really matter in the long run. It's probably best if we all just move on and pretend that nothing happened. =P

Electrolysis continues. I've now logged just over 8 hours on my face, and 15 down below (and spent about $1,200 on it). I saw my physician for a checkup back in August and finally asked for lidocane/prilocane numbing cream, which she was happy to prescribe. In general, the numbing helps a ton, especially on my upper lip, but there are certain areas I'm not so sure about.

The cream only numbs the top layers of skin, and in a few spots this has the strange effect of removing most of the pain, but not the itching. With the top layers numb, scratching does absolutely nothing, and I end up wanting to crawl out of my skin by the time she's done. At least without the cream, the pain from each successive zap helps relieve some of the itching from the previous stabs.

It helps my mental well-being to think about the time until surgery in terms of how many electrolysis sessions I'll have in the interim. Assuming that I continue with my current schedule of two weeks between sessions, and that I stop around four weeks in advance to allow the skin to fully heal, I only have six more sessions before surgery! Contrasted with the 17 sessions I've already endured, I think I just might make it with my sanity intact.

Yep. Surgery is less than four months away (if I haven't established, I'm definitely waiting for the official date of February 22nd), and once again it's all I can think about. Honestly, damn this wait!

For the longest time I racked my brains over whether or not I even wanted surgery, then whether or not I was ready, whether we could save the money, what surgeon to go to. It seems unfair that the seemingly interminable year-long wait could only happen after these decisions were made. At this point, I check the countdown calendar on the right side of my blog constantly. I'm ready to move on now... please? =P

Still, the year since scheduling is more than two-thirds over. I just hope the days fly by faster as the date approaches, and not slower.

Saving is going well, and I'm pretty sure we have the funds secured, but I've been stressing over money a lot lately. All I can think about is what else we could be spending $20k on, like truly starting our married life together. I've recently been having dreams that insurance pays for it, and suddenly we have enough to put a down payment on a house, buy furniture, take a vacation.

Erin is amazing for taking this all in stride. I also appreciate all my friends for putting up with me repeatedly doling out the same tired excuse: "I want to, but I can't. I'm saving for surgery." If you're sick of hearing it, believe me when I say that I'm sick of saying it, too. I think the fact that I've never had to pretend to be broke for this long is affecting me, though. I'm definitely a child of the consumer age, and I miss spending money on stuff.

On that note, I'm trying really hard not to count any chickens just yet, but it's looking like I probably will be able to get insurance through work that will cover my reassignment surgery. It's insanely exciting, and hopefully I'll have more details soon. Fingers and toes crossed!

Speaking of doctors and insurance, I also saw my endocrinologist not very long ago for a yearly renewal, and to discuss my pre- and post-surgery hormone regimens. Female hormone replacement pills are known for increasing the risk of thromboembolism (traveling blood clots), so most surgeons, including mine, require patients to reduce or stop taking hormones a few weeks before surgery. My endo suggested that I wean myself off slowly, to reduce the inevitable hot flashes and moodiness. Though I'll resume estrogen and progesterone after surgery (and for the rest of my life), I'm definitely looking forward to never needing to take testosterone-blockers again. =D

She also gave me the regular blood work, to check my hormone levels, but apparently she forgot my insurance situation and coded it under "psycho-sexual disorders". My insurance will have none of that, and denied the claim, so I recently got a bill for $400 worth of blood tests. =(

I've talked to the hospital and asked them to change the coding and try again, but I'm nervous that the damage has already been done. A friend of mine recently tried to claim her SRS through the same insurance (SelectHealth), and after denying her, they also decided to start denying anything and everything else that they could claim was related, whether it actually was or not. Hopefully the re-code on my blood work will pass through, and that's the last I'll hear of it, especially since I'm planning to switch insurance ASAP.

Last, but not least, I've been doing a lot of ruminating about possibly getting a breast augmentation. It's something that's been in my head for a long time, but something that, for a few reasons, I haven't really talked about. It's odd to me that I find it fairly easy to disclose all sorts of information about my transition and body, but not so easy to talk about this one thing.

To be honest, I have some self-esteem issues around my body. I still pad my bra, and though I know that's not that strange, I guess I just want to feel like I can have more confidence in my image, without having to think about it daily.

Even though putting it that way makes perfect sense to me, I still feel guilt around the subject. I suppose I view SRS as simply necessary, but implants have been socially drilled in to my brain as being purely superficial. Well, sure, they are superficial, but we live in a superficial world, and if that's what it takes to make me feel comfortable in my own skin, then I should probably stop feeling guilty and do it.