November 20, 2007

My Day in San Francisco (Alternate Title: “The Toothbrush”): Part II

Posted in schedule, surgery, transgender at 4:30 pm by Michael

(If you haven’t read Part I, scroll down, read that first. Otherwise, you ruin the whole story.  – Ed.)

In reading the packet I got in the mail about a month ago from Dr. O, one instruction, besides the normal when to eat, when not to eat surgical instructions stood out.

“No Chinese food for three days before surgery.”

This instruction puzzled me and Anh. Must be the MSG. Nah, maybe it’s the fried food. Noodles? Can’t be the noodles, its just flour and water. What about Vietnamese food? Hmm…

Dr. O cleared this up right away. Turns out that a little varmint called “Black Tree Mushroom” can be a strong anti-coagulant – causing uncontrolled bleeding if you eat it before surgery. Using the Internet for fun and profit, I searched trying to find this – nothing on wikipedia, and search engines didn’t come up with much… I did find one restaurant in SF  that served said evil bleeding-causing mushroom, but nothing much else except for the list of Chinese exporters that would bring it in.

Dr. O says that the mushroom is a common ingredient in Chinese food, one that’s often undisclosed. So, just say no to Chinese food if you are about to have surgery!

(When I have some time, I’ll blog his whole story about this – it was almost worth the price of surgery (and the pain) just to hear this detective story. I was impressed!)

Anyway, after the fungus bashing, we started to get into the good stuff…

(dramatic pause)

The Facial Surgery

NOTE: Surgical details follow, interspersed with attempts at humor. If you are squeamish, step away from the blog….

Step 1: The Death of Adam

The Adam’s apple gets it first. This will be one of the few visible scars. I thought this would be on my neck somewhere, but instead, it will be just inside of my chin. Dr. O says he gets a better surgical view from there, and the scar pulls less and is less noticeable. Interestingly, this location also comes with a convenient “explanation” if anyone asks. turns out that some salivary cysts are removed from the same location. So, if anyone asks: “Yeah, that salivary gland cyst was a real pain. I just had it removed!”

Step 2: The Creeping Hairline

Second visible scar. This one goes from just above each ear over the top of my head, forming a new hairline. The scalp hair is pulled forward, remaking the line to be down a bit. Here’s the sucky thing: doing this will cause nerve damage to the top of my head. Best case, couple months of top-of-the-head non-feeling. Worst case, this lasts basically forever. Dr. O suggests having hair transplants into the scar line if it’s super noticeable.

Step 3: Not by the Hair of My Chinny Chin Chin

I thought the chin resculpting would potentially come with a little scar too, but not on the outside. The scar for this will be below my lower lip, inside my mouth. Again with the potential nerve damage: challenge here is losing sensation on the lower lip. Two problems: saying “P” and “B” (damn you Peanut Butter!), and lack of heat sensation, causing potential mouth scalding. Note to self: Ice Americano is your coffee drink of choice.

Step 4: Jaws

No risk of nerve damage here, but just a ton of super-fun swelling potential. Here, the lower mandible gets reshaped and redecorated with some lovely titanium plates, screws and wire. Non-metallic, of course, to eliminate any pesky TSA or MRI problems.

Also, I need to do cool jaw-opening exercises to avoid the appearance of Mr. Howell-like closed jaw talking. I’m not a blue blood, so it wouldn’t really work for me. These exercises involve prying my jaw open with my thumbs. Repeatedly.

The scars here are inside the mouth. Orajel, here I come!

Step 5: The Furrow of My Brow

The details here are yucky, and I tuned out a bit. Suffice it to say, my brow gets “shaved”, which means no more brow ridge. Yea! Which means more grinding, wires, titanium, etc. Ugh. Good news though – this goes through the same incision as the forehead deal, so no additional nerve loss possible!

Ah, one thing though. The brow ends up a little “high”, and then settles. So, if you see me in December, and I look really surprised, I’m probably not.

Step 6: Monkey Boy No Longer

When I was a youth, my ears were a bit, um, big for my head. (NO JOKES ABOUT MY HEAD BEING TOO BIG NOW – HILLEL – THAT MEANS YOU) “Monkey” – not my favorite epithet. So, for all you school yard bullies, I’ve finally gotten my revenge! I’ve gone ahead, changed my gender, and will now get my ears pulled back! What are you going to tease me about now, huh? Not so tough, are you!

Step 7:  Long in the Lip?

As previously discussed, one of the steps is to reduce the length of the upper lip. Normal female range is 20-22mm, mine is more like 28-30mm.

“That’s a big lip”, Dr. O says.

This work causes the third visible scar, right below the nostrils (but tucked in.)

This brings us to our last act:

Step 8: Nose – or – “Damn, that’s a lot of steps!”

Samwich is super cute. Have I mentioned this? I think I have. In the last couple of months, he learned to “Give Kisses”. Initially this meant that he would open his mouth as wide as possible, and latch on to either your chin, cheek or nose, and suck. Much slobbery goodness ensued.

Last month, his m.o. suddenly changed – when I wasn’t expecting it, he decided to go for my nose, grab my mouth at the same time, and blow. Now, even at seven months, he’s got quite the set of lungs. This caused some sort of quasi-CPR positive pressure action to happen, and he actually was able to blow down quite a bit. OUCH SAMWICH! That HURT!

If he does that next week, please scrape me off the ceiling gently.

In any case, I’m leaving the nose selection work to the good Doctor. This will cause more bone action, and the post surgical insertion of “packing” on the inside, as well as a hard “cast” on the outside. I will be a mouth breather for at least two weeks.

He carefully explained that one problem I will have is that excess saliva will build up for the first couple of days. In which case, I should use the thoughtfully provided suction tube (like at the dentist’s office). However, he cautioned against trying to “help” the tube device by closing your mouth when inserting it.

“If you do that, a partial pressure vacuum will be created, and the packing in your nose will go up into your sinuses and back into your throat. We’ll have to take that out.”

Good tip. No frigging way I’m closing my mouth.

Part III will come a bit later tonight. In Part III you will hear about the stunning conclusion where the mystery of the toothbrush is finally revealed.

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