Getting ready for Surgery

I really don’t have a clue on how to organize or what to talk about in a blog, but here goes:

My hope is that friends and family will be informed on my progress.  I hope that others that stumble on it may gain understanding of how and why I’m doing this transition.  I also hope that in some small way I can help those who are thinking about needing to transition themselves realize that while it will not be an easy journey, it also does not need to be a devastating one.   

In my first post I mentioned that I micro transitioned for years.  When I look back to where in the deepest recesses of my mind I started making major changes I really realize how far I have come.  On the left is a picture from 2002, when I used food and alcohol and activities to bring joy to my life.  But always with the gnawing issue of gender dysphoria.  Back then it was a disorder, making the stigma of having it even more important to hide it.   Now I feel more and deeper joy than ever before.  The shedding of my secret was a truly freeing event for me.  The lifting of a heavy burden.

So I will continue the story of my journey for 2015 with a few thoughts and events around getting ready for my surgeries, how I have been preparing for them, my feelings evoked by the process, and of my fears and joys tied to those feelings. 

Already the year has been eventful.  I started writing this sitting on a jet headed to Philadelphia to do my pre-opt with Dr. Leis.  Much of my energy so far this year (as it was last year) has been aimed at the surgery event. To get here required a good plan and persistence.  From the beginning I wanted to be medically safe.  So using the experience I had gained with my work with the OAC and the obesity community I started studying and pulling together my medical team.  I pulled down the WPATH Standards of Care and read through them to help me determine who I needed on that team.  

I approached my transition a bit differently than many of the other girls I know.  Once I decided to move forward, and knowing that I had to be full time for at least a year before surgery, I jumped into the process full speed ahead.  I started full time before I pulled my medical team together.  My first “recruit” on that team was Meredith Manker.  Meredith is my primary counselor.  She is great, as we focus not just on the transition, but all aspects of life.  

One thing I have noticed about the Transgender Community is that as we work our way through our transition, it becomes way too easy to make that the sole subject of our lives.  There is so much to do to get ready for surgery that it takes a lot of physical and cognitive energy to pull it together and to work through getting all the steps done.  Meredith has listened to me, let me talk through the process, and made suggestions for managing life along with my transition.  Thank you Meredith.

Finding other resources in upstate SC proved to be more difficult.  I had a hard time finding a physician willing to manage my HRT (yes I really started full time before hormones).  I finally stumbled upon some online resources that pointed me to Dr. Rhett Brown in Charlotte.  Another amazing connection.  Dr. Brown approaches transition conservatively and focuses on safety.  He got me to a place where my hormone levels were truly female. He and Meredith wrote letters for me that helped with my travel needs and by last summer that helped me establish my correct gender marker for my Passport and the SSA.  Thank you Dr. Brown.

Before I could start with the HRT Dr. Brown needed letter from a psychiatrist.  I was able to find a Dr. Smith here in Greenville as a potential member of my team.  Meredith knows him and endorsed him.  He had experience with others who were transitioning and was able to evaluate me in a single session.  And, knowing that I was in good hands with Meredith, he determined that we did not need to meet again.  His notes also fulfilled my requirements for surgery.  

My plan was falling into place.

But, some physical work also needed to be started as I knew I needed a lot of work on my voice and hair removal.  I had actually started both years ago.  For hair removal I found Judy Shelly in Columbia who was willing to work all of the areas I needed done and who was willing to work with a trans client.  I think the clearing of "Area 51" is tantamount to torture even with Lidocaine cream. The scrotum has so many wrinkles where the cream doesn't apply evenly.  Also, the Raphe (the seam between the two halves) is so sensitive that so far no amount of cream deals with the pain.   I can only do one more session before my surgery so that will be about two more hours down there and one hour on the face.  I think everything is cleared except for a bit just below the most sensitive area.  I do three hour sessions because its a 2 hour drive each way to get there.

For my voice I have been able to build on the work I did a number of years ago for singing.  I started with some apps and lessons from Kathe Perez.  I use them for my daily warm/tune up.  I also did some work with a local speech pathologist which moved me a little but not much.  I still have a ways to go.  My goal is to able to not be identified as male on the phone.

All of this lead up to my pre-op session with Dr. Leis.  I felt like I lucked out as he had a medical student observing our session who was interesting to talk to while then good Doctor worked on forms for the hospital.  Also I think he had a few more technical comments to explain to her some of his ideas and techniques.  In each of the procedures he will be doing for me he has years of experience and high volumes.   Most of the session was to insure everything was in order, that I met all the WPATH criteria, to insure I was fully aware of what the risk were of the surgeries, and to understand my pre and post-op responsibilities.  One of the best parts (and funny) was when he gave me a schedule to wean off of my hormones instead of stopping them that day.  He said this was so I didn't go all PMS on everyone.  Karen appreciates that.  He did some test to check for elasticity around my eyes, rechecked my bone structure, and took pictures of the areas that will be worked on (said my breast are about a cup size bigger than I thought).

Now I'm down to 3 weeks.  I need some blood work this week, to make sure my EKG was sent to Dr. Leis and pay the anesthesiologist.  Paid Dr. Leis last week .. Ouch .. so one other thing I will be doing (on the 16th) is verbally presenting an appeal to remove the exclusion from our medical plan for the treatment of sex change.  If it passes it will save us 50K to 60K.  Money I really need for a down payment on our retirement home (RV).

The next three weeks will also bring an amazing amount of work to get prepare for being gone for 3 full weeks.  In my role it will all be work deferral or I need to get it done before the event.  I spent 5 hours of my Saturday (yesterday) doing just that.  So the next posting will probably be as we are headed to Philly for the big event.  I am so glad Karen will be there with me.


If you made it this far you are a real trooper.  Thanks for reading.