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.

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

Posted in schedule, surgery, transgender at 6:13 am by Michael

I didn’t end up going back to sleep yesterday after getting up at 2am. Our flight was at 6, so it didn’t really work timewise.

Anh and I sleepily got to the aiport (The Samwich was still comfortably sleeping at home, his cousin watched him for the day). Luckily, the wings of Alaska were on time, and we went to go through security.

The airport, that early in the morning, is always a fantastic place for people watching, especially at the holiday time. I love the teens wearing PJs and bunny slippers, holding onto their pillows. I love the tired people, completely on autopilot. On that autopilot point, our flight was to leave from gate “D” at lovely SeaTac International Airport. (As an aside of an aside… I need to know how the town, excuse me, “city” of SeaTac came to be named. Is there any more self-annihilating way to name yourself than a CamelCapped merged name of the two cities you are between? It would be like renaming our middle son PeriDaniel. Odd.) We get to security, and as feared, there’s a big line. No problem, we are plenty early. Then, I down the concourse, and not fifty feet away, they have opened a whole new security screening area. There are zero people in line. People are just walking right through. We walk over, thinking that this must be the ultra special employee line. Nope, it’s a regular line. It’s a new line, but a regular line. Not fifty feet away, people are slogging through a half-hour cattle dance, too sleepy to notice. Through in two minutes, on to the gate, onto the plane and we take our seats.

We are sitting in row 7, and again, on the people watching point, I love watching people as they get on the plane. About five minutes before its time to push, one of Anh’s old co-workers gets on (I knew her), and is coming down the aisle… I say hi, she says hi, at this point Anh is already asleep. She says “What are you guys doing down in San Francisco?”. I think “Ok, is this really a good time to get into this? Do I really want to hold up the line for this?”. Quickly I say “We are just down for the day!” (Which is TRUE!) She says “Me too, down for a mediation, see ya later.”

Plane pushes back w/o any further ado, and we are on our way.

We arrive just around 8:30, and my appointment isn’t till 11, so we were thinking breakfast – San Francisco is a great place to eat. On the way down, in a moment of lucidness, Anh says “What about Dim Sum?” Sounds great! We called her brother who lives in SFO to get the name of the place that he always goes: “Yank Sing”  (Another aside: Mobile data cards – priceless – way better than having to deal with WiFi hotspots – and cheaper too if you travel much. I use Verizon, and have had a fantastic experience.) We look up the address, and take the Bart into the city.

When we get to our destination however, tragedy, it doesn’t open till 11… (Yes, was stupid to not look in advance for the hours, but what Dim Sum place isn’t open for breakfast?)

As backup, and Anh *always* has backup, we walked down to the ferry terminal to get some breakfast. I’d highly recommend it – lots of little vendors with local fresh stuff –bread, pastry, roasted meat, produce — awesome. (We had a sticky bun, a chicken hum bao, and a Saigon roasted pork sandwich – all good). For the two days that I can eat food when we are there next week, I’m sure it will be great.

Anyway, time is getting tight, and we grab a cab to get to the doctor’s office. The cabbie has a white panama hat and a ponytail. Loved it. We give him the directions, and he says “Davis Medical Center – you two work there?” We say no.

As we get closer he says again “You two work there?” Again, we say no, but this time he adds:

“I died there, and they brought me back. Total flatline. Those people are ok in my book.”

“Wow… Well, every day is a day to the good then, huh?”

What else do you say?

We arrive, and go to the office. Tatiana is there behind the desk, and she says: “Hi, how are you both? Where’s the baby?” Everyone loves the Samwich.

She brings us to one of the rooms, and Dr. O comes in. Time to talk about surgery…

First we talk about my, um, “augmentation”. At this point, I’ve already confirmed with Mira the type, location, and size (as previously reported in this space), but the Dr. goes through it all again, measuring, prodding, and making sure that all will be ok. He then started to discuss the various complications that could arise – nerve damage, capsular contraction, and rupture.

He tell us that of the roughly ~1500 implants he’s done, that he’s only had two ruptures. The first was a woman who while skiing, hit a tree, flat on one breast. POP!

The second was the victim of an overly vigorous hug from her dad. That must have been some hug!

We then got a thorough description of the dressings, the drains, and the schedule for taking everything on and off…

The comical part was when he described how to guard against capsular contraction. Basically, the implants need to be massaged – up, down, left, right – once an hour. Watching him demo this was just… well – it was something I won’t soon forget.

At that point he says: “Well, all of this will be easy, compared to Thursday…”

Which I’ll cover a bit later… the Samwich just woke up, he’s on my lap, and while I love his contributions… he’s a little young to be blogging.

I leave you with this picture.

A toothbrush

A clue… yes, I’m supposed to use this.

More in a bit.

November 19, 2007

Off to SFO for the Day

Posted in friends, schedule, transgender at 2:46 am by Michael

Today we go down to visit Dr. O for the final pre-op consultation. Its 1:59 am, we have a 6am flight, and surprise! I can’t sleep.

I’ll do my best to be coherent.

A week from now at this time, we’ll be in SFO, three hours away from being at the hospital for surgery #1. I keep on wanting to write: “A week left of Michael”. I think it, I write it, I delete it. Doesn’t sound right, doesn’t look right. I can’t write it.

I can’t write it because it’s not how I feel. I can’t write it because I don’t want to let go.

Why not? I don’t think of Michael and Megan as two people. I’m just me. The name is a label, the name is a pointer, the name isn’t a definition. When I wrote that my friends and family had an infinite hall pass to call me Michael for as long as they wanted, I really meant it. However, I’ve gotten a ton of feedback/pushback from folks about that.

The nut of the feedback is that I’m “Becoming Megan” (I think that’s even in the blog title somewhere). They don’t get how calling me Michael after November 26 will make sense.

In thinking about this, maybe this is really about me not wanting to let go, or just being scared beyond belief. Maybe this isn’t about making them feel comfortable, it’s about me being comfortable. I say that I’m the same person – and I really want to be the same person – and maybe saying “Call me whatever” is a way to attempt to reinforce that. Maybe the name is important to me, but its not the Megan name, it’s the Michael name.

Not maybe. Really.

I’m just me. I’ve got to get over the name thing. In a week, people will call me Megan. I picked it! How lame is not wanting people to call you by…

(Ok, the baby just woke up (2:16 am). There’s very little in life that’s more satisfying than rubbing your kid’s head and having them fall back asleep. Daniel was born with a full head of hair (this was the first part of him I ever saw – his crazy black hair), and it’s so soft, so comforting… I love him. Now he’s asleep again…)

… the name that you chose for yourself? This name that fits in the gender that I’ll be 24/7/365/∞.

I’ve got to be confident in the fact that I am the same person inside, wrapper changes and all. I’ve got to get over the fact that by others calling me Megan, they aren’t saying “Ok, you are different” – but they are just being consistent with the choice that I have made.

Part II – The Best Advice

Anh said: “If you aren’t ashamed, don’t act like you are ashamed.”

By far, the best advice that I’ve had…

Part III – This Weekend

We love to throw big parties. We had better love to, because we do it often. Saturday we had a baby shower for Anh’s sister and brother-in-law. Their baby, who we have nicknamed “Pickle” (goes with Samwich!), is due early next year. I’m so happy for both of them.

Anyway… this weekend, I was “fulltime at home”, even with the big party. There were about thirty people at our house for the party, about half who I’d never met before.

I felt totally normal.

Over the past few months, its been a process to get to here – where it wasn’t a production to tell everyone in advance “Hi, I’m transgendered, and I’ll be dressing in women’s clothes for today.”

When I chickened out, and didn’t tell people, and didn’t dress the way I felt, I generally felt crappy. I felt like I was hiding. See Part II – The Best Advice.

Anyway, at the party, I didn’t feel like anything other than the host (hostess?) with a house full of thirty people. I felt like me…

Anh’s sister after the party said to me (and I almost lost it) “I’m glad you wore comfortable clothes.” Me too. They were comfortable.

November 15, 2007

Day of Lasts

Posted in schedule, transgender at 5:54 pm by Michael

Today was my last electrolysis, my last therapy appointment, and over the past few days, I’ve seen people for the last time before my surgery.


The last electrolysis — well, not too many regrets on that. Over the last few weeks, I’ve looked like C. Everett Koop most of the time, as I’ve had to not shave to make it possible to get rid of the remaining white hairs (of which there are many).

As for seeing people for the last time – that’s just hard. Harder than I thought. December 7 isn’t that far away – reentry into society!

Many people have asked me “Are you sure?”…. I had this thought this afternoon:

 I thought I’d be scared that I was doing the wrong thing. However, knowing that I’m doing the right thing is even scarier. 

Yes, I’m sure.

Off to shave.

November 13, 2007

The Plan

Posted in schedule at 11:10 pm by Michael

Here’s the schedule for the next few weeks.


Monday, November 19: Pre-Op appointment with Dr. Ousterhout in San Francisco.

Have an early morning flight down to SFO with an appointment with Dr. O to talk about all the pre-op stuff. Here’s where I get to hear about all the risks, and go over for a final time what he’s going to do. This is also when I need to pay him (in full).

Sunday, November 25: Fly to San Francisco

Monday, November 26: Surgery #1

Have to be at the hospital at 5:45am for the first surgery (outpatient)… Breast Implants. Ok, I know everyone is going to ask: Saline, Under the Muscle, Through the Nipple, Oval, C cup is the goal. (I still want to be able to run!). Time in surgery: 3-4 hours. 

Thursday, November 29: Surgery #2

Ok, if that wasn’t enough fun, its time for the “Full Meal Deal”. No fries included. Again, 5:45am at the hospital. Here’s the plan:

Hairline: While eight months of hormones and Finasteride have slowed my hair loss, and even regrown some hair, my hairline is still too high. The hairline is moved “down”. How much – not huge, but noticeable.

Brow: This is the one I’m kind of spooked out about. Here, the take my brow, and “shave’ it to make it flatter. Men have a brow ridge, women, not so much. Mine’s not huge, but its there. Here’s the spooky part – the amount of bone that he takes out *may* mean that he “punches through” into my sinuses. In this case, a titanium plate will be used to cover the holes, so I don’t get an extra two nostrils.

Nose: Smaller, narrower – basically a standard nose job, bony work included. Again, I’m sure we’ll talk about the goals here the 19th, but right now, I don’t have details.

Upper Lip: Turns out that female top lips are “shorter” than for men. So, here, he “shortens” it. I will end up with a little scar right below my new nose.

Chin: Implant of some type – will be narrower, but more protruding. Again, more detail on the 19th.

Jawline: Near the joints on the back of my jaw, he’ll shave from the bottom, making it narrower.

Adam’s Apple: In the words of Dr. O: “We’ll take care of that”. Basically, it gets “shaved” and reduced so it’s not as noticeable. Little scar right below.

Ears: Pinned back. My ears stick out a bit… not for long!

Total time in surgery will be about 12 hours… long day.

Because of the jaw work, my diet will go from liquid to soft over the next weeks. Hard foods (which happen to be parts of my staple diet) like granola, trail mix and beef jerky are out for months. The other downside of this is running. According to Dr. O’s assistant, Mira, running isn’t prohibited after the first month, but “You probably won’t want to run for three months or so. Other patients have tried, but felt like their Jaw was going to fall off.”

Huh. I’d like to avoid any jaw-falling-off feelings. Three months it is.

Saturday, December 1: Leave Hospital

After all of the fun of the 29th, I’ll be in the hospital for two days.

Tuesday, December 4: Office Visit #1

From what I understand, here’s where most of the mummy-like bandages get removed. However, the nose bandage stays on for a few more days. I get the first real glimpse of my post FFS face.

Two words: “Train Wreck”.

Friday, December 7: Office Visit #2

Rest of the bandages, sutures, duct tape and bailing wire gets removed. After the appointment, we fly home to Seattle. Lots of things about this will be interesting. First of all, I’ve seen lots of pictures of folks going through this and what they looked like on this day. I don’t think I’ll look much like my license picture at this point – both because of the surgical changes, plus the fact that there’s likely considerable swelling and bruising still.

I’m also very curious as how I’m going to get “read” at this point. Male? Female? Sir? Miss? Who knows… I’ve never been read as anything but male to date, so this should be an experience.

Previous page