Day 14 – return to US tomorrow

Today I am preparing for my trip back home to NYC. My recovery is proceeding well, and aside from the extreme boredom of sitting in this apartment in Belgrade for the last 10 days, it has been a very good trip.

Healing is progressing quickly, or at least, pain is decreasing quickly. Today is Sunday and since Friday, when the stent was removed, I have been much more comfortable. The catheter is still slightly uncomfortable but mostly all the pain from surgery is gone. Hair growing back on the testicles and around the whole “operation” is itchy, so I have tried to shave what I can, and I bought some baby powder as well. So far my efforts have helped a little.

I still use the bag most of the time, with the catheter, because emptying my bladder completely by unblocking the clamp involves a little twinge of pain at the end, and I have found it to be more comfortable to just keep a constant flow going.

Since the stent was removed, I have been instructed by Marko to use a syringe (no needle) to inject saline into the penis (2cc’s) which I have been doing. Overall things are looking ok. I definitely can feel that my penis, and the whole area is sensitive (erotically) speaking and I am looking forward to the stitches healing so I can explore that “feature” more extensively.

I was able to get a sort of measurement of the penis down to the base, and it seems to measure about 2.5″ so that is good. Right now about half of it is covered by fatty tissue in the mons, so I look forward to having that taken care of, and will be working on losing more weight in the coming months, too, which should help.

I haven’t taken any pain medication-even Aleve  for over 24 hours and I mostly feel just fine. The wrapping around my penis comes off tonight, and I am hoping that will improve the itching, but I can’t be sure. It will either get worse or better.

One week from tomorrow I am cleared to attempt to void through my new urethra. Assuming everything is successful, I can have the tube removed 2 days later.  I’m planning on making an appointment at Callen-Lorde to have this done. If it turns out that there is a leak or any other issue, I am supposed to wait (another week?) before having the tube removed.

Why blog?

The NYTimes has an article out about the benefit of hearing other patients’ stories in their healing process. It reminds me a lot of how wonderful it has been to share information about meta, and how important it has been for me to read other guys’ blogs.

Read the article here: When Patients Share Their Stories, Health May Improve

Day 7 update

Today is Sunday, and I had surgery last Monday, so I guess that makes this Day 7, depending on how you count. I had initially planned on updating more often, but there are a couple other guys who have blogged recently and my experience meets up with theirs, almost to the minute, so that would probably be redundant. If you’re looking for something like that, I highly recommend http://quirkycalm.wordpress.com and http://toyneboi.wordpress.com for very detailed reports. I followed them in real time as they posted, and actually they have been very helpful in the last week, so I could know what to expect each day in terms of activity, healing, etc.

Anyway, so I just have a few things to add, mostly my feelings/experiences that may not apply to you at all, but I figured are helpful to see a bracket of normal.

I came back to the apartment from the hospital on Thursday morning, and I was thrilled to do so. I was extremely bored in the hospital, and I found the nurses to be, uh, average. They did their jobs–I got every medication at the correct time and they responded extremely quickly to the call when I needed something, but they didn’t seem like they were what I could call “A students”: – some examples:

-my catheter showed pink/red urine and when I asked about it, the night nurse told me I needed to drink more. I told her I would drink everything they brought me, and I did, but they didn’t bring much. I finally asked them to fill up a bottle and drank it with great rapidity. I don’t understand why, if drinking water was so important, I wasn’t offered more of it. I had a glass that they filled only every 6-8 hours, and was about 6 oz of fluid. Obviously not enough – I’m drinking 3-4 liters now at home. Not life-threatening, but not evidence that they were really super concerned with giving me my best opportunity to heal.

– a similar experience with walking around. One morning, the daytime nurse arrived and asked how much I had gotten up the day before, and I told her once, and she said, “you have to walk more” which I was happy to do. She got me up and walked me around once that day, which was Wednesday, but no one else did, so I didn’t walk anymore! In the hospital bed, sleeping and watching TV, time passes without you really knowing what time it was, so I don’t think I should have been the person in charge of making sure I was up and walking every 6-8 hours. Anyway, the next morning I left, so whatever.

-finally, they kept leaving the door open, both at night and during the day, but more during the day. When I pushed the call button and asked for it to be closed, they did, but if you’re keeping track, I would have had to be pushing the call button a dozen times a day on top of just the regular times, to solve these small issues. It made it hard to sleep, or even rest, since listening to people talk loudly in Serbian (or even in English) is not really pleasant.  I’m sure American nurses “yell” when they talk too, but I just haven’t had the pleasure of hearing it.

So really, all of my issues with the nurses were minor, but added up were not very encouraging. I think it all could have been solved by having a friend along, but unfortunately the person who was supposed to accompany me had to drop out the week before I came. If it is possible for you to bring someone, even for the first week, I highly recommend it.

Overall on the facility: it was very clean and the TV was great, in that it had lots of English language programming, the Wi-Fi was extremely slow and didn’t work on my iPhone or iPad (probably an issue of proximity to the access point, so this will vary by room). I found the food overall not very good, but I didn’t want to eat so I didn’t care. When leaving on Friday morning I was able to do almost everything to get myself ready (put on sweat pants, button down shirt, shoes) myself, which is good since no one was helping me, and I wanted to leave so quickly that I accidentally left my wallet and passport (they were returned to me right away) –if that is any indication. Anyway, mostly I was bored out of my mind.

Marko drove me to the apartment and brought my things in for me, and explained that he would be here on Friday (the next day) to change my dressings so I could take a shower, and Miro would be here on Saturday to check on me–Miro had said that before, in the hospital, too. While I was gone the fruit he had bought me had spoiled and his mother had come and washed dishes and cleaned up a bit, which was very nice.

On Friday he called and said he would be here a little later than expected, and he would call 30 minutes from his arrival, at which time I could remove all my dressings, take a shower and he would arrive to re-pack me, as it were. He instructed me to begin antibiotics – 1 pill of one of them and half a pill of the others, every 12 hours. I did begin then and have been fairly consistent about them so far.

Then, later Friday night he called and said the team was in surgery later than they anticipated and he would be by on Saturday morning. I took off my own chest dressing at that point because it was so annoying and made it difficult to get comfortable. I hadn’t shaved nearly enough of my chest or my underarms, so it was a little on the painful side, and I used a pair of scissors to cut some of it away from the hairs.

My chest looks good, as they removed nearly 14 ounces of tissue, and was only a little bruised. One side is more painful than the other, but by today, Sunday, it actually is mostly ok, as long as I stay out of certain weird positions. When I took the packing off, there was some liquid, dark, blood that oozed a bit but nothing serious. The chest surgery was definitely more like the original top surgery than I anticipated–the new cuts are about 6 inches on both sides, and probably nearly as painful. I wouldn’t say don’t do it at the same time as lower surgery, but again, it would be great to have had someone with me to help out.

Miro had the plastic surgeon work on it, and it will be a charge of 400 Euros (not the 500 he quoted me) which I am more than happy to pay. He/they did a good job and I’m very happy with it.

So on Saturday, Marko did finally show up, around 11am or 12pm, and we took care of everything. On the phone he told me to wait for him, so I did, and he removed all the dressings on my “parts” and said that it had every little bleeding, which was a good sign, and removed the drain in the testicles by cutting a stitch, which hurt like the devil, but was over quickly. While I was getting undressed he took a call from a friend which lasted a couple minutes and dragged out the whole process longer than was really necessary.  It was kind of annoying, and unprofessional, too. He said Miro would be by on Sunday to check on me, so I am expecting him to call soon.

So after he had unwrapped me, I sat down in the large tub and used the shower head thing to wash off, using Johnsons & Johnsons baby shampoo as both shampoo and soap (I had accidentally left my regular things downstairs and I just wanted to have it over as quickly as possible. While I did this he went to the grocery for me, and got, at my request, some chicken breasts and some fresh veggies, and he also brought that yogurt drink and a loaf of bread.

[Marko had also helped me take a photograph of my new parts and everything looks pretty good. Lots of swelling and bruising in the testicles, but the penis looks good, if very sensitive. I sent the photos to my gf and she is very excited. I remember seeing the photos of other guys’ stuff right after surgery and was kind of scared/horrified. But now that it’s my own stuff I can see the change and the future a little more clearly and I feel good about it.]

I got myself dressed then, in a t-shirt, american apparel boxer briefs and 2 4×4 gauze and a larger puffy menstrual-pad like gauze–that is the only padding I have down there and it is OK so far.

After the shower I felt MUCH better. It was time for a vicodin and I cooked myself a chicken breast in onions with fresh raw tomatoes on the side, and made a coffee. At some point I shaved, which also helped me feel a lot more normal, and eventually I got ambitious and threw on some pants and shoes, stuffed my catheter and bag into my waist band -and went across the street to the grocery store “Maxi” to get a wider variety of veggies, a jar of pickles, a bottle of vinegar, and some pork (I don’t know the word for this so I just pointed to the chops I wanted, held up one finger and said “kilogram” – it worked, at a cost of about 4 euros.)

The shopping trip was fine except for waiting in line, which began to get painful, so I teetered from foot to foot until the lady checked me out – 840 Dinars or about 10 bucks and I paid via credit card – and scooted back home.

That was probably too much, and I was in some pain after that so I went to bed and at some point took another vicodin. When I crash, I crash hard. This morning, Sunday, I woke up at 6am feeling a lot better, and also my chest feels pretty good. I cooked myself breakfast, did dishes and am sitting up watching TV now.

So that is about it! If anyone has any questions, I’m happy to answer them.

Ok, so it happened

Surgery happened, finally! Everything went fine and 22 hours later, I am not in much pain. Aside from my anesthesia-related nausea, I’ve been just fine. I’ve been sleeping a lot, but when I’m awake I’m alert and able to use the computer, chat with my friends, etc.

I did throw up twice last night, and asked at one point for something for the nausea. The nurse didn’t seem like she could give me anything, but when I threw up she gave me something via IV that seemed to help.

The anesthesiologist came by the morning and said that I may have “lazy bowels” – 1 in 10,000 people apparently do. He knew about my previous nausea issues and says he gave me anti-nausea stuff meant for people going through chemo, so I assume that is pretty strong. I guess my body just doesn’t like anesthesia. Oh well.

I finally got some more stuff for anti-nausea and was able to sleep, and then eat biscuits, drink water and tea. Right at this moment I feel fine, with very little pain.

I did get up to take a walk around the room, which was easier than I expected. Aside from the getting up/down part, the walking/waddle was fine.

T-Zero. 2 hour countdown

I am currently waiting for surgery, I guess just like I have been for the last several years. In about 2 hours, I should be beginning the anesthesia – 2pm local time.

I arrived in Belgrade yesterday, a Sunday, so there weren’t many people at the airport or on the streets. The airline misplaced my bag, so I only had my backpack with me, no extra clothes and none of the supplies that I had planned to use, such as razor blades, compression stockings, etc. The lost bag put me in a mood, and combined with the extreme exhaustion, driving into town past the concrete slab buildings made me a little more depressed than I would like to admit.

I was greeted at the airport by Marko’s sister who was extremely nice. She took me to register at the police station (I have a small paper ticket) and then to the grocery store so that I could get a tooth brush and some other small things to tide me over until the luggage arrived. She seemed to assume that I had never been in a grocery store, and explained to me that there were different types of water, including sparkling and still. She showed me how to pay and explained that usually the cashiers will not bag the groceries for you.

I think at any other time I would have found this charming. I’ve travelled extensively, so I know that people think Americans are stupid, and I think I’m going to stop admitting my country of origin in the future. The attention to each minute detailed continued to the apartment – a sprawling, well-appointed three floor palace of a homestead in a run-down working class neighborhood. I was shown where the refrigerator was and how to open the door. I was shown how to use the telephone and how to open the door to the balcony. I was assured that there was no extra charge for the soda, should I care to drink it. The computer was turned on. The TV was plugged in and she apologized extensively when there was no place for a lamp in the living room to be plugged in.

By now, I was beyond tired but I tried to hide my growing annoyance with my host. When she finally left I was able to relax, and I went grocery shopping, took a nap and waited for a call. Miro finally called around 5:30pm and said he would be coming by around 7:00pm. Around 7:30 he arrived, with the anesthesiologist, and he greeted me with a bear hug. As previously reported, these guys are extremely friendly, and not in an annoying, fake way. They seem capable, they remembered minute details about my medical history without notes, and they answered all my questions. I paid him the balance of the surgery at that time.

I was given a ducolax suppository and told to use it that night, which I wasn’t excited about. I was told to bring pretty much everything to the hospital, including my passport. Later that night I heard from Marko, who arrived around 10 for a very quick check-in, and who took my 1026 Euros for the payment for the apartment. I was glad to get rid of all that cash finally.

I went to bed after enjoying some TV—“Weird Science” was on and I felt compelled to watch it, for ceremonial reasons. I did use the Ducolax and it worked within about 15 minutes, with great thunder.

This morning, I got up at 7am feeling well rested and I took a “shower” and shaved my chest hair, per instructions by Miro, since there will be a small top surgery revision done.

The taxi driver was supposed to arrive at 8, but he arrived at 7:45, so I didn’t eat any breakfast, since I ran out of time. I’m kind of sad about this, because I am starving now. I drank water until 10am, but I have a long 2 hours without food ahead of me.

When I got to the clinic, I had blood drawn, an EKG and a meeting with the cardiologist in rapid succession. He took my blood pressure and a short medical history, confirming that I was going “woman to man.” He also asked me if everyone in American had cell phones. Both answers were an emphatic “yes.”

After that, I was deposited in what I suppose is my room, which is very nice. After a while, a nurse came in and told me to shave everything, so I did that. There is no reason that I should have waited and I wish I would have done it at the apartment. The shower in the adjoining bathroom is out of order so I did everything at the sink.

I will say just one thing about shaving my genitals: It is not very fun.

About half an hour ago, the same nurse came in to give me a shot—an anti-coagulant—in my upper arm.

The internet does work, but not on my iPad or iPhone (just on my laptop). The password is 1111122222, not 5152 (you can see how I was confused). Also it is very slow—so slow that it is difficult to use Gmail, and I can’t load WordPress.com. I’m guessing that I won’t be able to skype later on, like I had planned.

So far so good, except I wish I had a cheeseburger. In previous surgeries, I have had a little bit of nervous-ness right before it began. My hysterectomy was scheduled for the early morning but when I got there I had to wait for about an hour, and during that time I started worrying about things that were impossible, like that I was pregnant and they would discover it during the surgery and not do the surgery. (I have never had sex with anyone that might result in this situation occurring, but that didn’t stop me from worrying.)

During my last surgery, I didn’t get nervous until a long walk down the hallway to the operating theater. Right before I entered the room, I met the anesthesiologist, and signed the consent forms, and at that moment had some misgivings about what I was about to do. Today, all I can think about is being hungry.

T-14: This is what stress looks like

Two weeks out and I swing between excitement, impatience and concern/second thoughts, it seems like every day I feel something new about this.

Second thoughts is not the right phrase–it’s more like fear of the unknown. I’m worried that I’m taking my body which, even though I’m not happy with it, works pretty well. I can functionally pee and have sex and, er, sit on a couch, without pain or even thinking about it. And I’m taking that body and hacking it up and hopefully in a few weeks, or months, I’ll be able to do those things again.

I need to stop reading blogs and looking through surgery photos, because they only stress me out. (At one point they were informative, but now it’s just overkill.)

I finally calmed myself down by deciding two things:

First, even if all they do is close up the hole, that will be 100% better for me and how I feel about/function in my body.

Second, I’ve lowered my expectations. I don’t personally think of my new junk as a penis, or a small penis, or even anything particularly male (other than the fact that it is attached to me, and I am particularly male).  Instead, I’m going into this with the expectation that this surgery will help externalize what I do have,  and have more fun using it.

I’m still a little worried about what I tell new partners. The irony is that the parts that I do have pose no issue for the people I sleep with. They are used to seeing guys with “girl parts” and they understand the implications–what to expect, how to operate it, etc. But after this surgery, I’m worried about opening up to new partners and showing them my “operation” and I’m worried what they are going to think. It’s like transitioning all over again!

This all has come about because of this weird, unexpected lag in between raising the money for surgery and waiting to leave for the operation. For so long I was just focused on saving the money that I didn’t have the brain power to think about all this other stuff, or at least to let it bother me too much.

Doctor’s Letter #2- Snag

So I got one doctor’s letter, which said nothing about my gender and just cleared me medically for the operation. Then, I was supposed to get a second letter from someone–anyone–in mental health services at Callen-Lorde, but no one there could see me, and they can’t just print me out a generic letter. Even though I have been a patient there for 8 years.

I’ve never needed a doctor’s letter for surgery until now, so this is perhaps poor planning on my part. Anyway, I have asked Dr. Miro’s office if it is OK if an RN writes the letter, but haven’t gotten a response. I’ll post here the outcome with this because I imagine other people might experience similar issues.

Testosterone Gel

I have barely been using it because it burns my parts. But today I tried again, with just a little (about the same size as a pencil eraser) and it burned but not enough that I had to put ice on it, like before. So I’ll keep on with that for the next couple weeks.

T-29 days

I heard from Marta this week that Dr. Miro should be able to also do a slight revision to my top surgery while I’m under for the meta. If it is “just skin” he can do it for no extra charge, but if it is more than that, it will cost 500€, the plastic surgeon’s fee.

Suffice it to say that this is a huge bargain compared to getting this revision done separately in the US. Plus it means I don’t have to go under anesthesia again.

I have heard from lots of folks that the Belgrade team is awesome, and so far they do not disappoint in the least.

T-47

I finally have all my Euros and I’m gearing up to head out. It still seems really far away.

T-86 running fast to stay in place

This week is finally over. It hasn’t been the busiest week at work I’ve ever experienced but it was enough to keep everyone on their toes. I’ll be honest, I made more mistakes than normal. I guess I’m distracted!

Money Matters

I put down $2500 US – cash- for the surgery deposit, bought plane tickets for myself and my companion to Belgrade (total for both: $1470), went to the dentist, the doctor and the walk-in radiology appointment for my chest x-ray.  Luckily my regular health insurance covered everything (including the x-ray, the HIV test, the EKG and the numerous blood tests that the Serbian doctors have asked for) aside from a $15 co-pay.

Still, my surgery bank account is down! Way down from the beginning of the week, even though I’ve been putting my earnings away all week. It’s a little hard to keep the faith that I’ll have the money by the time I leave, but I know if I keep my “nose” to the “grindstone” it’ll all work out.

Meds, Pain and Otherwise

My primary care physician has agreed to write all the prescriptions, including for vicodin. I’ve had percocet in the past and I hated it. My doctor said that pain meds start at Tylenol with codeine (which I have had and was great), then vicodin, then percocet, and finally on to the major stuff.  I’ll also be bringing some Motrin with me and am not worried in the slightest.

The one outstanding issue that I have is the DHT cream–not available in the US. I could order it from the UK for about $130 plus tax, or Marta says that if I send them another $100, Dr. Miro will send me a tube next time he is in the US (December). I’m going to do that.

 

T-90: Pictures of my junk

It’s 90 days out from surgery fun time in Serbia, and today I had the honor of shaving my pubic hair and photographing my funny bits. I need to send them to Dr. Miro so he can, I suppose, get a sense of what to expect before I arrive.

Overall the team in Belgrade is very responsive–I’m already in contact with the lead surgeon, the assistant (also an M.D.) and the anesthesiologist. This is truly remarkable–in previous surgeries, my meeting with the anesthesiologist consisted of 30 seconds before I fell into a deep sleep, immediately preceded by him asking me to place my signature and initials on a ream of paper full of fine print. Which is fine, I don’t necessarily desire a long term relationship with this person, but it’s remarkable, as a difference, nonetheless.

But today, I sent the photos and I haven’t yet gotten a response. Normally I wouldn’t worry. It is Sunday after all, and it was well into the afternoon in Serbia when I sent them. But sending photos of your junk to some internet man you’ve never met (but are hoping to) and not getting a reply is downright depressing.

Luckily I was distracted by an email from the assistant, Marta, who has provided me bank information regarding the deposit. As other people have mention, the deposit is 10% of the surgery fee (that is, €10,000) and €780 for the testicular implants (hereafter referred to as “nuticals”). I considered asking how much “brass” implants would cost, but I’m afraid that the joke wouldn’t come across and something unfortunate could happen. All in all, $2500 US will be put down as a deposit.

It turns out that the Serbian team has a US bank account (BoA, just like me) and I’ll be withdrawing the 2500 in cash from my account and depositing it in theirs and that should be that. Much easier than dealing with international wire transfers, fees, conversions to Euros, etc. Five minutes at a teller should take care of everything.

Here’s where it gets interesting: with regards to the balance, I can either wire it to their bank account and pay certain bank fees, or just bring cash (€9000) with me when I come. My roommate thinks that this is starting to sound like a Nigerian scam, and if I hadn’t actually met people who had done this before, with these doctors, I would, too. But I like this style of medicine. There is something comforting about dealing with doctors who do their jobs well and also treat it like a business. They value me as a customer and want me to tell other people so they can get more customers.  We (FTMs) are lucky that now there are enough transmen in the world that the market exists for surgeons to earn a living perfecting work on us.

The reason I ended up going with this surgeon is actually not because I’ve met him, or that I think his work is better than anyone else’s. His “after” photos are fine, sure, and so are every surgeons. Find me a surgeon who will show you the ugly complication photographs!  It was really because every single surgeon in the US and Canada was booked up for 10-12 months already. And I didn’t want to wait. Dr. Miro was able to schedule me in 90 days, and that fit better into my schedule.

So, in the end, the invisible hand of capitalism will be operating on me. In 90 days. As long as I successfully travel 5000 miles with €9000 in my wallet. Piece of cake!