November 25, 2007

Almost There

Posted in schedule, surgery, transgender at 4:17 am by Michael

Surprise, I can’t sleep again.

Tomorrow at this time we’ll be in San Francisco getting ready to go to the hospital. I say that apropos of nothing, other than wow… its close!

Last night Anh, Peri and I went to El Gaucho for dinner. We had a sitter for the Samwich, and John wanted to stay home and decorate the Christmas tree and watch TV. Not a night to get into a power struggle with a seven year-old. El Gaucho is definitely one of our favorite places – it’s where our wedding reception was, and the combo of food and service is hard to beat. Who would have known that a windowless room could have so much charm?

While we were sitting waiting at the bus stop, Peri says to me “Aren’t you nervous that they are going to cut into you? Isn’t that icky?” Uh, yeah… very nervous!

Dinner was great, crab and shrimp, Caesar salad tableside (plenty of mustard – I’m convinced that’s the key), steak and ribs. Yes, we ate too much, but it was grand. At one point, the wine captain (who’s a woman) comes over to pour for us and asks “Are you celebrating a special occasion?”

I look at Anh.

Anh looks at Me.

I say: “Well, yes. It’s a little uncommon. Are you sure you want to know?”

This was not fair of me to say. Any human with a pulse, and an ounce of inquisition is going to want to know with that kind of buildup.

“Sure! Tell me.”

“Well, I’m transgendered, and tonight is my last real dinner before I have a bunch of surgery next week. This is a special restaurant to us, and we thought it would be great to eat here tonight.”

“Wow! That’s great, congratulations!”

There was more… but I’ll leave that out.

The server leaves, and I say to Peri: “Anh gave me the best advice ever. ‘If you aren’t ashamed, don’t act like you are ashamed’ And, I’m not ashamed!”

Peri: “Cool!”

Dessert was fun, dessert wine was fun too (and they bought us dessert, for no reason, which was very nice.)… cab home, pay the sitter, bedtime. Till 2am… can’t sleep, which brings us to here.

One story from last week that I forgot to mention – glasses. Dr O. strenuously insists that post the nose cast coming off, no glasses (or sunglasses) should be worn for a month. Now, I’m kind of blind. I wear contacts all the time, glasses when those aren’t in, so this should be a challenge.

Now, as you can imagine, Dr. O has a “good” solution for this.  First, take a piece of half inch tape, and wrap it around the bridge of your glasses, leaving about a two inch tail, sticky side in, going up (to your forehead). Carefully stick said tape to your forehead, so your glasses hang, without touching your nose.

This is an awesome engineering solution to this problem. I commend the thought, the effort and the inventiveness of the solution. We’ll see how desperate I become.

I’m bringing 4 sets of contacts.

Twelve hours left in Seattle. Still have to pack.

Earlier, (because I’m still a geek at heart) I was thinking about two of my favorite Yoda quotes, which are apropos for this situation (not sure this is what Lucas had in mind). These may be so common that they are trite, but hey, my blog, my trite quotes.

“Do, or do not, there is no try.”

And

Luke: “I don’t believe it!”
Yoda: “That is why you fail.”

I’m in “Do Mode”, and I do, in fact, believe.

Today should be a busy posting day….

November 20, 2007

My Day in San Francisco – Part III – In Which the Mystery of the Toothbrush is Revealed

Posted in friends, Identification, surgery, transgender at 10:08 pm by Michael

(If you haven’t read the first two parts, scroll down and read below… otherwise this whole toothbrush matter will seem odd. – Ed.)

As a parting thought, Dr. O explained various reasons why I should call the office, or call the nurse.

“If your PCA [patient controlled analgesia – narcotics on demand] isn’t enough… call the nurse.”

“If you feel nauseated, call the nurse. We have stuff to help that.”

“If you get the stuff, and you still feel nauseated, call the nurse. We have other stuff to help that.”

“If you vomit blood, remember that a little blood in your stomach, mixed with acid, makes what looks like a lot of blood. Don’t worry, but call the nurse.”

Etc. Basically, if something is wacky… call the nurse.

Dr. O says bye, and hands us off to Mira. The process with the Doctor took about an hour. It was a long time to talk about all the stuff that would go wrong, but hey, that’s the essence of informed consent. I do feel informed. (and I still consent!)

Off to Mira’s office, where the first thing that she does is call admitting, and hand the phone to me. I notice for the first time that Mira is referring to me as “She” and “Her”, both to Anh, and also to the admitting nurse. This just strikes me as cognitively dissonant for a second, as I’m dressed like a guy, everyone still calls me Michael, but I’m “She”. I look down on my chart, and here we go, for the first time, under gender, the “F” checky box is checked.

The admitting lady, very nice, confirms the surgery dates, goes through medical history – basically does all the hospital things that everyone has done if they have gone to the ER.

Mira then comes back in, and she’s got a big stack of pink papers. Turns out that these are all consent forms – one for each of the procedures I’ve listed previously. Each is a page, double sided, describing the activity, then listing risks. Each one is signed, dated and countersigned, and on to the next. I’ve signed fewer papers buying a house!

We go through final details of pickup./dropoff times, going again through when I need to stop eating and drinking. As a fine point on the fact that I will from liquid, to soft (e.g. oatmeal), to partially soft over the two weeks that I’m there, she says:

“Enjoy Thanksgiving. If you eat too much, its ok. You will loose it, trust me. Have an extra dessert! Have an extra serving!”

 And then, she opens her drawer and takes out the toothbrush, and sets in on the table.

A toothbrush

Anh says “Who’s that for? A gift for Samwich?”

“No, its for Michael.”

Jointly: “Huh?”

“Well, remember the discussion about the jaw opening being restricted? Well, this might be the only toothbrush you can fit in.”

Anh: “Neat, it’s a piglet one! Do you have another one for Samwich?”

Anh Rocks.

With all that out of the way, I gave Mira the check (paid in full), and she said to me as we were leaving:

“So, when should we all start calling you Megan?”

“How about Monday?”

Epilogue

We ended up walking back to the Bart station to catch the train for our flight. Our flight home was delayed an hour, but we got back in time to have dinner with the Samwich. On the way home, Anh and I watched video on my laptop of the Samwich crawling, and babbling, and playing with Peri and John (Peri dragging Samwich around the house on a blanket, singing “Samwich train, Samwich train, all aboard the Samwich train!” over a soundtrack of him just all-out belly laughing is just one of those things in life that you don’t forget). I think we both got a little misty… This is our life. It’s a good one.

I was thinking about Thanksgiving tonight as I was driving home. This Thanksgiving will certainly be different than last, and it will be different than the next, but I hope in ways that are more superficial than substantial. I feel incredibly fortunate to have an amazing wife, a great family, and friends who have just been superhuman in their caring and support. I was a happy person before this all started, I’m a happy person now (if not a tad bit stressed), and I hope to be happy and even more complete person in the future.

I think that’s all you could ever ask for.

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.

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