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sunflorable · 6 years

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So I had top surgery

Idek if the people still do this shit anymore, because I haven't kept up with any of those like trans support blogs or anyone's transition blogs since like 2013 but I'm gonna post about my experience. I know they helped me a lot when I was younger, when I was scared about the general idea of surgery, when I was trying to find a doctor, when I had no idea what to expect. And I'm gonna be really specific about some weird aspects, like this will be like a surgery/my trip to Dallas post, because I want to detail the level of activity I had post-op, the issues I had traveling, my prescriptions, general shit about having a surgery, etc., because they were all questions I had to figure out myself and if what I have to say helps anyone, I'll feel great. And if it doesn't, whatever, I wanna talk about shit.

So I had my surgery with Dr. Peter Raphael at the American Institute for Plastic Surgery in Plano, TX (which is basically a neighborhood of Dallas or smth)

Doctor Selection: Initially, like almost every other ftm/masc nonbinary person on the east coast, I was looking into Dr. Garramone. Honestly, I had my decision made back in like 2012. He was who I wanted. And I was having a harder time looking for bottom surgeons, because absolutely nothing bottom surgery had to offer looked appealing to me (remember transbucket? from like 2007? does that still exist? there were so many bloody, scarred, immediate post-op pictures from people getting surgery in Thailand and whatnot....man, I feel like an Old Trans. I took so long with my whole process, and still am), but then I saw something, which I don't even think exists anymore, called a Centurion Procedure by a Dr. Raphael in Texas. It was supposed to make the metoidioplasty wider, longer, and more natural??? or some shit? And I was interested, wanted to keep my eye on that sort of thing. See if it went anywhere.

Fast-forward to now, and I don't even know if I want bottom surgery anymore. But, I'm still keeping an eye on Dr. Raphael's practice, as well as Dr. Garramone's. Looking through their sample pictures and everything. From what I could tell, Dr Garramone's mostly showed the same body type. Meaning probably, that's the best body type for him to operate on. I don't have that body type. I'm fat. I also liked the idea of a practice where they do different types of surgery. When I tried to explain this to friends and family, they saw it as counter-intuitive, but in my mind, a doctor that works on other procedures has experience with different people with different needs, different types of bodies, and, still keeps in mind the artistry of plastic surgery. Which, I know is kind of a taboo phrase, but top surgery is a surgery that affects how you look on the outside. The surgeons that perform it are plastic surgeons. And you want it to look good. There's a form of artistry in it, sculpting bodies. Even if it's for medically necessary reasons. (sorry for romanticizing this, I watched a lot of nip/tuck okay?)

Also, if I still wanted bottom surgery, I still wanted it from him, and it would make sense to do everything with the same provider.

and, this was the real kicker for me, Dr. Raphael doesn't use drains. I thought the whole experience would be gross and uncomfortable, and I had accepted it as necessity, but I realized I had options.

Plus, I have family in Dallas. Even though I don't know them well, if there was an issue, I could call them for help. (I also have family in south Florida, where Dr. Garramone is, but I hate them and would never call them for anything, and my mom's best friend lives down there, but they'd been out of touch for years until literally last week.)

Prep/Insurance?: Recently, what still blows my mind, is that several insurances will cover the surgery. I want to make it very clear though, that an insurance approval does not mean insurance will pay for it. What I mean by that is simple: medical billing sucks. I work in a pharmacy, so I understand prescription billing intimately, but medical billing is a whole different animal.

I was aware that I had a huge deductible (as most employer-based plans do, employee insurance really sucks basically no matter what company you work for), but my idea was this: I would end up paying out of pocket (with insurance approval) for the entire surgery, but then I would have met my deductible for the year, and I could run to other doctors (my pcp, dermatologist, maybe even a hand specialist for my wrists) for free because I would have met my out-of-pocket maximum as well as my deductible.

Then reality struck, and I saw the true evil that is medical billing. So, when you bill a prescription it works like this: There's the retail price of the prescription, then the insurance gets billed, they reimburse the pharmacy whatever they choose to reimburse, and the patient gets a copay. If the insurance decides to not reimburse the pharmacy because of deductible, or it's not a preferred drug, but still covered, the patient is charged the retail price. Nothing more. Medical billing is an entire different monster. My surgery total was $6750. To bill insurance, the surgery and the anesthesia are billed as separate claims, whereas the $ amount above is the total for both. So, rather than running it through my insurance, insurance saying “you've still got deductible,” me paying $6750, then meeting that deductible for the future, I would have had to pay for the surgery, then another couple thousand for the anesthesia. Medical billing is a bitch.

The surgery office spent a great deal of care and time explaining this to me because, coming from a pharmacy billing background, it made no sense. So I had done all the footwork to get PA letters from all these doctors, and I wasn't even going through insurance. (I was kinda mad I was out about 350$, I had to see a psychologist for part of it and she was out of network, but that being said, if anyone needs a good psychologist in Charleston,SC area I know one.)

But, I agreed to have them run it as a cosmetic surgery rather than through insurance, sent them my $500 deposit, and my appointment was made. (Their availability seemed to run about 3-4 weeks out, which was way sooner than I expected. I think I made the appointment around the beginning of april, and I opted for the last week of may because flights were cheaper then.)

In addition to helping with insurance, they sent me a nice lengthy packet with all of my prep instructions as well as what to expect on the day of, and my post-op instructions. And another packet about financing. (My credit is in the toilet because the place I used to get all my labs done for my testosterone doesn't know what an apartment number is and sent my bills to the wrong address, wouldn't let me pay them without having a bill, then sent everything to collections, so I opted for carecredit with my mom as a cosigner. If you've got 6k laying around you've managed to save, I commend you and would like to know how because my savings account usually gets up to 500-1k and then something horrible happens and it becomes zero)

What they expected of me pre-op: Not all surgeons do this, and it may sound horrible to some, but they wanted me to stop testosterone 3 weeks out. (it apparently messes with your hemoglobin levels, and they don't want you to get blood clots) I managed pretty fine off t for that long, but acne came with a vengeance and I'm sure, starting it again, it'll get worse, then (hopefully) go back to being manageable.

They also wanted me to take a vitamin C supplement, which was nbd.

And then there was the huge list of meds to avoid in the week (or two) before surgery. Basically it boiled down to any ibuprofen/aspirin/naproxen (NSAIDs, y'know), as well as a list of tricyclic antidepressants, and a bunch of brand names of things that I don't think those brands exist anymore (in the us at least).

Actifed was mentioned, as well as Contac, and a few other brands that had sinus-like words in the name. Sudafed itself was not mentioned, nor the drugs pseudoephedrine or ephedrine directly, but Actifed was pseudoephedrine and an antihistamine, Contac has pseudoephedrine in it, and my butt was too lazy to call and say “can I really not take Sudafed in the height of allergy season??” and just stopped. It was a miserable three weeks without anything to help the sinus congestion and really bad sinus headaches except Flonase and Tylenol. (and I bought this super awesome nose spray when I was in japan called nazal and I love it but I can only use it like once a week because my nose is too sensitive for it. it's also too sensitive for normal Flonase so I have to pay out the ass for the brand Flonase sensimist)

They wanted me to wash my chest with betadine every day for the week before surgery, I opted instead for hibiclens because I don't want to look like an oompa loompa, and they were fine with it. They actually, at my pre-op appointment, gave me some hibiclens and told me I'd like it better than the betadine and I was like “jokes on you, I've already been using hibiclens.”

Travel prep: I said I wanted to be oddly specific here, so yes I'm talking about my travel arrangements. I said previously I have family in Dallas, they actually live in the The Colony, which is close to Plano so it would have been really convenient to stay with them, but I don't know them well, their drug addict son lives with them, and I think their house would have been full so I opted instead to pay for accommodations. I looked at hotels--expensive, and I didn't know how I'd feel, so I wanted to make sure I would be able to bear hanging inside the place for a week without wanting to murder everyone and everything. My next choice would have been something along the lines of an Extended Stay America, but it looked kinda crappy, and it was near the airport (the airport, for reference, is about a 35$ uber ride to the surgery center--yknow, the place I'd have to visit multiple times.) So, I looked at airbnbs. I ended up finding a cute 1 bedroom condo right by the surgery center (and within half a mile of a food store!) It ended up costing, for me +2 people (they slept on an airbed and a couch) about 800$, which is about the same price as the Extended Stay America, anyway.

One of the things the surgery center requires, and honestly, it's a good decision anyway, is to have a ride to and from surgery, and to and from the 1 day post-op appointment. A ride like not a taxi. I rented a car for the day we arrived (since we'd have to go to my pre-op appointment, go food shopping for the airbnb, then kill time until checkin time), the day of surgery, and the day after. (We ended up, because of my stupidity, paying for 5 days instead of 3, because we picked it up an hour early--they charged for a full day--and had to keep it later because my post-op appointment was past the return time)

And I just have to say about rental cars. When you reserve a car online, it gives you a price. That price is always a lie. You get there and suddenly there's so many fees they didn't bother telling you about before. This is my second time renting a car, from two different companies (the time I got in a car crash doesn't count because I didn't pay) and both times it was like this. First of all, I KNEW most states require you to be 25, and if you're not 25, there's a fee. The site didn't tell me that, even though I put in that the driver was 24. So I thought texas was different. (btw, if you're under 25, it costs about twice the price per day)

And I was super frustrated with this because I'm 25. But I can't drive because I'm having surgery. But my caretaker is 24. I was so tempted to lie and say I was the driver, but I wouldn't have been the one driving the car to return it. (my mom, later, a true moral compass lmao, was like you could have pulled over like right in front of the return thing and switched spots--but you see, never having had surgery before, I didn't know how I'd feel, if i’d even be conscious enough to drive a car for like 100 yards to return it.)

Then, the rental car lady made me opt into a coverage plan. Probably because my caretaker was 24. I kept telling her my credit card had built-in coverage for it.

And then she goes “there's a $12 per day toll thing, so you don't have to pay any tolls, they just bill them to us.” and I knew there was a toll between my condo and the surgery center (a 5 minute drive lmao) and she asked what neighborhood we'd be in, and when I said Plano she immediately said I would need it. Which I figured. I didn't keep track of how many toll lanes we went through but it definitely was a lot.

Anyway, what the website told me would be about 100$ ended up being 680. Fuck rental cars.

Choosing my caretaker: Now, I could have chosen a caretaker who was 25. But I had reasons for choosing Jess to take care of me. I really only have two friends I would trust to care for me over 25, and then there's my mom. First friend is in the military and he can't take off whenever he wants, plus he's married and has pets and his husband, also in the military, is always deployed. Second friend is a CNA so she knows how to take care of people and honestly that would have been great if I'd have thought of it, but she has a baby and idk if she'd have been down to go to texas with me like that. (then again, we could have frequented all the tex-mex restaurants and gotten good use of our Spanish degrees lol) There was really a choice between two friends who live in the area and could take time off work (both of them ended up coming, but that's a different story) and I chose Jess because even though he's not the first person you'd think of when you thought “caring” A: he went to culinary school and likes to cook and B: If I was too weak to do something in a social kind of manner, like if I was too weak to order my own food or my being physically weak made me revert into a social anxiety shell, he'd be on top of it.

I ended up with two caretakers tho, which ended up being awesome, because I felt up for doing things most days so it kinda was a good vacation. Also when I slept (which was a lot) they kept each other entertained.

Now I'll get into the nitty gritty

Pre-op appointment: We went over all my meds I currently take, the nurse explained to me what would happen tomorrow, gave me a folder that had all my pre-op instructions in it (which were also in the email they sent me a month ago so I already had them read over but I have come to realize I'm more meticulous about reading shit than a lot of people) Then they had me disrobe and put on a bathrobe type thing (it was cozy, I wish they'd let me keep it) and took photos of my chest as it was.

Then the doctor came in, felt around on them to see what he had to work on (he made jokes about it, he was like “man! you've got a lot to take off here! this is ridiculous!”) He was really chill, I got the feeling they were a tad overbearing with the gender-affirming language, but I know a lot of trans guys would be emotional that someone's looking at and touching their chest, and it could be comforting to have your gender affirmed while someone's looking at the very thing that makes your gender feel...well...not affirmed. He talked about taking out some of my back boob (for lack of a better word? like if you feel right behind where your arm lays there's that flab?) and told me he might not be able to get all of it, but we both agreed I could lose the rest.

He asked if I had any special nipple requests, I probably looked at him like wtf because I didn't know what that meant. (He went on to explain, in a non-hipaa-violating way, that he once had a tattoo artist patient who wanted to tattoo them on himself, which i'd actually heard of people doing. I want nipples with sensations, so not for me.) They gave me my scripts, to be filled before surgery, and I was on my way.

Prescriptions: Now, I'm gonna talk a lot about these because it's my area of expertise. Plus, younger me who didn’t have any insurance or anything worried about what they'd give me,how much it would cost, and present-day me worried about taking opioids (not being addicted, of course people aren't usually that susceptible to being addicted from an acute supply of pain meds) but just because the strongest thing I'd ever taken before that is 800mg ibuprofen or 1g Tylenol.

they wrote me for hydrocodone/acetaminophen (Norco) 10/325, which is the highest strength, which gave me pause. That much? (The directions were also one to two) like there was no way I, who'd never taken an opioid before, would need to take two of the highest strength Norco at once. (I was mostly right, there were only two occasions where I actually took two of them.) What they wrote for was a 3 day supply, it's eight days after my surgery and I still have slightly less than half left (I'm still sort of taking it, mostly just at night, because I wake up in the morning in a lot of pain.)

Then there was diazepam, which I was like cool, for anxiety the night before. But it's also indicated as a muscle relaxer, and, something you don't typically think about (because you're so focused on all the fat on your chest, and nothing else) is that they have to cut through muscle. So, there's lot of that. I found myself taking the diazepam a lot more than the Norco after the first couple days. They gave me a 3 day supply of this too, day 8 I've got like 4 tabs left.

(pharmacy math, btw, assumes you're taking the max dose the max amount of times/day. so like my Norco was written 1-2 tabs every 4-6 hours, they're assuming I'm taking 2 tablets every 4 hours to calculate a days’ supply, even tho you might only take 1 tablet every 6 hours or even less.)

Then they gave me an antibiotic to ward off infection. Nothing fun to really mention about that.

and last, and I got a little scared when I saw this one, they wrote me for Zofran ODT (orally-disintegrating). which, without insurance, is fuckin expensive. I'll talk about prices in a second, but I just wanted to say, this. shit. works. I only took 2 of the 8 tablets they gave me, but you can be sure af I'm gonna keep these around till they expire because I put that shit in my mouth and the nausea was gone. Just. like. that.

prices on the drugs:

it's really important, to me at least, to mention it. I have insurance, so it wasn't bad for me. I paid about 30$ total for everything.

but something I do want to mention, and this applies to anything, is that your prescription coverage is what pays for your drugs, no matter what kind of procedure you have or if the procedure was covered. I can't tell you how many patients I get in the pharmacy that hand me their dental card because they got scripts from the dentist. Or people who say “it's cosmetic surgery, so they won't pay for the drugs.” Prescription coverage doesn't care what you're using the drugs for (in most cases.) If it's a legit prescription written by a legit doctor, and the drug is on your prescription formulary, they pay for it. They don't care that the procedure isn't covered by your medical insurance. They don't care that the procedure was done by a dentist.

Now, all the meds, minus the Zofran, are cheap. My insurance decided it didn't wanna pay for the diazepam, but it was only 5$ so wtf ever. the antibiotic they gave me is on the $4 list at Walmart, even without insurance.

If you are worried about the cost of medications, for instance, if I didn't have coverage, the Zofran odt would probably have been close to 100$. for eight tablets. There are always options. Goodrx, singlecare, and other discount card are options. Several retail pharmacies have lists of medications that are discounted, such as Walmart's $4 list, Publix (not an option in Texas but hey if you're going to Dr. Garramone or anyone else in plastic surgery capital usa there's publixes everywhere in south florida) has several antibiotics for free, and I'm sure many other chain pharmacies have promotions as well. You can look them up online, or even ask the doctors, because most pharmacies advertise these to the doctors, drop off brochures every now and then, etc. or, don't forget, the doctor can always change the medication. For anything (except for the hydrocodone, because of pharmacy laws, and the diazepam depending on the state probably) the pharmacy can call the doctor and ask for a medication change. If they wrote you Zofran odt, the pharmacy can always call and ask for normal tablets (they're a little cheaper), or even something even more cheaper like promethazine. For the antibiotic, if they'd written you something expensive like doxycycline, they could always ask for a cheaper one like cephalexin or amoxicillin, etc, basically what I'm saying is there's usually always an option for cheaper medications if you're worried about the price.

The fun part--the surgery:

We had to be there at 6 am, my friends hated me for that. I got there just as the nurse was unlocking the doors, which meant I would have been the first one in for surgery, but I had a mishap. They make you pee in a cup to test if you're pregnant, and I know, being ftm, especially if you're not into dick or not okay with your body enough to do that, or have vaginal sex at all, it's kinda...well...eh. But, I woke up and peed like 20 minutes ago (I mentioned my condo was RIGHT THERE, right?) and I hadn't been allowed to drink anything. So I kinda spent like 20 minutes having an emotional breakdown in the bathroom because I couldn't pee and what if they didn't let me have surgery because I couldn't pee????? Even tho, if I had been pregnant, I hadn't had sex in like 5 months so i'd be well into the second trimester and i'm pretty sure I wouldn't be stupid enough to not realize something was up with my body after that long. They came and knocked on the door like twice (I think they thought I was maybe having a nervous breakdown??? That's probably something that happens) and finally, I came out and I was like “it's not gonnna happen.” and instead of scolding me like I was afraid, she was like “okay let's get you hooked up to the iv and then maybe you'll be able to in a bit.”

She had me disrobe and put on a hospital gown, which I failed spectacularly at putting on right and my friends had to help me. There were snap buttons to close the sleeves and my little mind just didn't understand them.

In my pre-op paperwork it said to wear comfy socks, so I had some on, but then they were like “take those off and put our socks on” so I'm not sure what the point of that was. But, I got these thick socks with doggie paws on the bottom to keep and you can be sure I'll be wearing them around the house constantly. And then I sat for a while, I heard them in talking with another patient in another little curtained room. My friends sat on chairs wrapped in a blanket and made jokes as I continued to internally stress about not being able to pee and holding everything up like an asshole. Then they put the iv in (nurse: “are you squeamish or anything about having an iv?” me: “well blood doesn't bother me and stuff but I've never had an IV.” she was shook. Didn't bother getting into the “ I grew up poor, no access to health care till a couple years ago.” thing. but then she went slow and explained everything she was doing, which was nice.)

She let it drip into me for a while, while my friend didn't know the solution was called “lactated ringers” and we had a good laugh over that and looked at some articles and shit. There was a heater under the bed, so I was cozy and warm and the nurse had the nerve to say to me if I didn't like it they could turn it off--absolutely not, she didn't realize who she was talking to.

Then I realized I could try again to pee, and went to get up, trying to be independent and all, and she came to get me like as soon as I had the thought. idk if telepathy is a part of modern medicine or what but it felt like it. So I peed (yay) and then I didn't bother/couldn't reattach the hospital robe in the back so I just walked out and she was like omg and held it to cover my butt, meanwhile I'm like who's back here??? they can see it

but then I laid back down. the doctor came in and marked me up exactly like you'd see on an episode of nip/tuck (I continuously thought of nip/tuck, if you can't tell, but I don't think either of my friends there have watched it so all my references were just for my private enjoyment) The marker tickled like it took a lot to stay still.

Then I laid back down, and the anesthesiologist came in. He had called me last night, and talked like super quiet with the phone mic right against his lips and I could hardly hear anything he said. I almost had a panic attack because he called at like 7 and I thought he said no food after 9pm, and we were just walking in to see solo so wouldn't be out until after 9:30. all my paperwork said midnight. So I went with that but had really plain food (aka my first in & out experience and it was horrendous, but maybe I'll make another post about that). He had asked about heartburn and acid reflux because I'd put Pepcid ac on my meds list, and he told me to go out and buy omeprazole and take it the night before, and they'd give me another dose in the morning.

After solo and then the in & out nightmare, I just wanted to go home. so no omeprazole. besides, a bottle of store brand omeprazole is like 8$ and i'd only take 1 capsule? I don't even get heartburn that much. anyway, when he came in, he was kinda miffed at me for not taking the omeprazole, probably should have just lied. he had said he'd give me a dose in the morning, so I figured that would be sufficient. He asked me if my parents had any history of interactions with anesthesia, and I had to tell him I didn't know, to which, again, I met surprise about my lack of health care. I was like “well I don't know my father and I don't know if my mom ever had surgery, but I'm assuming if there was an issue someone in my family would have said something when I told them I was on my way to having surgery.” He stuck something in my iv, and at the time, I assumed it was the dose of omeprazole he said he'd give me, and maybe it was included in there, but they wheeled me out immediately after that and I was out.

It was maybe about 7:30 when I was taken back. I woke up around 10, and the nurse asked me how my pain was 1-10. I said 2. Then they gave me some water, called my ride who were almost there anyway, and then I was like “okay now it's like a 6″ so it intensified that quickly. She gave me a tablet of my hydrocodone, and I think I went back to sleep for a few? or maybe they talked to me asked me questions, and then Jess and Bria’ showed up, took me home, and I think I went straight back to sleep. I don't think I ate anything yet.

I woke up starving some time in the afternoon and we had pizza and hoo boy, as soon as that pepperoni went into my mouth it was heartburn city. Nobody really tells you that, or at least nobody properly prepped me (except for the anesthesiologist on a hard to understand phone call the night before surgery and I refused to listen in my hubris) for the intense two days of heartburn if I ate anything so much as slightly spicy (all the snacks we bought for the house were spicy. because that's what we like. go figure.)

I think they watched some hokey pokey magica, I woke up and they were in the middle of one of the madoka magica movies and I watched whatever was going on there and then the other one, so I guess they did that while I slept.

Day 1 post-op: I think this was the day I had to take a Zofran. my mouth was really dry, and it took a long time dissolving, and it tasted like berries and just....that bitter pill taste. but I was instantly not nauseous. (The second time I took one, my mouth was not dry and it dissolved at a much more tolerable speed.) I went to my appointment, where they checked everything out, changed all the dressings, and instructed me on what to do (or what to have my caretaker do, he should have come back with me probably, but instead I just relayed it all to him later)

SO they did something I thought was strange, but rather efficient. So they ran maxipads in a taped train along the incision line, to catch any drainage, and then wrapped me up in ace bandage.

I'd like to take a moment here to just say, when nurses wrap you with ace bandage, or tape a wound, they're trained professionals. They've been doing it for years (or however long they've been on the job.) When you go home and have your friend do it, it's not gonna be as good. When you try to do it yourself when you feel a little better, if you're as dexterous as a fucking ox like me it's fucking worse. Do not be afraid to ask people to redo it throughout the day if something doesn't feel right.

anyway, I was to change those daily, and keep compression stockings on for the rest of the week, (I could take them off while I was out and about, and to clean them, but have them on whenever I was napping or sleeping. and especially flying home. they're to prevent blood clots.)

She said I was walking really fast for someone 1 day after surgery, and looking really well. She said most people come in there like *mimed a zombie* and we talked about how the shirt I had on used to not fit, I had to have it open to wear it before.

She said I could do stuff but to take it easy.

We went to the aquarium.

It was indoors (so temperature-controlled, when it was 100 outside), there would be plenty of benches throughout to rest on, I had it thought out. The aquarium was awesome. I kept my pills in the glove box in the car in case I needed any, and did pretty well. Went home, took a nap, ate some food.

Day 2 post-op: This was the day we had to return the car. This was also, if I remember right, the last time I had no problems sleeping propped up and on my back (i'm used to sleeping on my side curled in a ball)--the following days I kept slumping down and sort of turning. So we returned the car, then sat in the building and hailed an uber. We had decided we were gonna go to the Perot museum, we saw the building across the aquarium and thought it looked cool. The uber guy ended up being an asshole, and he called me and started yelling at me because he couldn't find us, when he's the one working as a driver around the airport. and I just couldn't emotionally take it so I handed the phone to my friend and let him deal with it. Eventually we cancelled it and reported him and got someone else who was really nice.

But then we got to the museum and my debit card wouldn't work. and we had bought tickets to see a 3D movie at the museum, and it was starting like instantly, so I had to sit through that before I could call the bank and the whole time I was freaking out and trying not to cry and I just got so overwhelmingly emotional.

Then I got the bank sorted out. They flagged a transaction of me buying jewels on KHUX as suspicious. They know how often I do that. they see transactions from google play-square enix all the damn time. (which is shameful but another thing entirely) I felt better after that, but then I kept getting pains under my right armpit. This was the day I ended up having to take two pain pills.

The day ended up being really taxing for me. Afterwards, since, we were in texas after all, we went to a steak place for dinner and it was amazing. Friend date 10/10.

Also I caught an alola exeggutor in pokémon go.

The next few days we just hung around the house. no car, nobody wanted to spend money on an uber (though we did spend some on uber eats, when the fuck we gonna get that here???? I miss it so much) and that was when it became harder and harder to sleep propped up.

My last appointment: I actually went the day before, because my appointment was originally at 9:30 am and my plane left at 11, and I was scared. so I rescheduled to the day before in the afternoon. They took off all my bandages, it was the first time seeing my nipples (which honestly, just looked like a red swollen mess but it was super awesome) and instructed me on how to care for them in the coming weeks. They gave me these little pads that go over them, stuck with Vaseline, and then gauze goes over that, and I compress it. At this point they suggested I get a compression vest because ace bandage fucking sucks and I'll have to compress the next 6 weeks. After another week, the tape on the sutures should come off, and then I'm to put silicone scar gel on the incisions to help with healing, which they sold to me for like 20$ a roll. I bought one, and when I return to work I was gonna see if we can order it from our vendor since we use the same vendor as them, so long as they don't restrict us from ordering the tape it should be fine. They asked if I needed any refills on anything, since I wouldn't be able to pick up any hard copies (required for the Norco, possibly for the valium idk what texas law is), I declined the pain meds, since I had so much left, but took a refill on the valium.

Then the doctor came in, showed me the pre-op pictures and took a look at everything, said I was healing well, told me if I'm ever in Dallas to stop by (lol maybe i'll go back for pho, I had some kickass pho)

Then home: I was nervous I wouldn't be able to lift my arms to do the airport security thing, or hold them out to my sides for a metal detector sweep. I was really nervous about what TSA would say, mainly because the TSA people at my home airport in Savannah are never nice to me. But, the TSA people in the Dallas airport were fine, and as it turned out, come yesterday, I could actually wear a t-shirt. which meant I could lift my arms for a short second for the security thing. Of course, she made me get in the position, and then she goes “are you SURE you don't have anything in your pockets??” so I had to check again (idk why, I had linen pants on and you could literally see the pockets through the pants but whatever, she ddidn't ask anyone else, just me) and put my arms up again, and at that point they were hurting. I couldn't lift my suitcase in or out of the taxi, luckily I could roll it right onto the scale for it to be checked, and then I couldn't get it off luggage carousel or into or out of my car.

and it's a good thing I took the refill on the valium, and I probably should have taken the refill on the Norco. after having them mess around with everything, and remove my nipples from their comfy tight shell, things are starting to hurt more. But if it becomes unmanageable I'm sure my pcp would write me something, so I'm not worried.

The other thing, because I haven't heard of anyone else doing this or talking about it. body masculinization lipo procedures: They seem to be growing in popularity. Dr. Garramone has that mansculpture thing? I think it's called??? Dr. Raphael has one too. I didn't know what kind of body you'd need for it to work well. I didn't know much about it at all other than it was some lipo. So, in my consult I had asked about it, and I figured I'd share what I learned. The nurse said my body type made me an excellent candidate for the procedure, as I “unfortunately have a very feminine shape,” the way dr/ Garramone's website talks about it, they do it the same time as top surgery (sorry to compare so much to him, he's really the only other doctor I know so much about and I feel like a lot of other people will have the same knowledge base), but the way AI4PS does it is they said ideally I'd lose some weight (which, apparently is common after top surgery woo), and they do revisions in 1 year, (revisions which are free!) so I could just pay for that procedure while they did revisions. (also, in case it wasn't apparent by the way this procedure sounds, it's gonna be 100% cosmetic and not necessary in any way, so insurance wouldn't even think about covering it)

#dr raphael #top surgery #ftm #ai4ps #fc's transition tag #dude I wrote a novel #it took me three hours to write this post #why did I feel it was necessary

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