#i have to schedule a drs appointment for a top surgery referral

[spark1edog]

art show prep szn and i’m finding myself in the oh god oh fuck i need to take out every art supply i’ve ever owned and do nothing but make art for this 👁️👅👁️ but. i have to also do other things

[transmanwillgraham]

Long post ahead.

Okay folks, tomorrow begins my last business week of having chromosomally mandated breasts. I wanted to talk about my top surgery journey, as it has been so far.

I've been wanting this for longer than I've been aware of my trans identity. It has likely come from a place of gender dysphoria that, at the time, I could not articulate. By exploring my wants, needs, and feelings about my body, I've been able to build a better relationship with it. I remember asking my mom if I was supposed to be a born a boy in high school. With the thought that my body seemed wrong somehow, that I was wrong somehow. For years, I felt like a floating head, just existing adrift like errant litter.

I've avoided feeling how important this is to me simply because of how big it is. It's an event that the rest of my life will feel the ripples of. I am ready for and terrified of it.

It took a long time to overcome a mental block in pursuing top surgery. I wanted it but was not ready for it, had not felt like I was in a safe landing place to accomplish it. I attended my first appointment with the University of Kansas Health Systems Gender Clinic to discuss surgery. The process began in December 2022 with telehealth visits. From Dr. G and her staff, I was referred to Dr. A for one of two letters.

If you have it, insurance must approve the procedure to cover it. That includes letters from both a psychiatrist (Dr. A) and from a licensed clinical therapist (my therapist, N), attesting to your readiness to undergo surgery. These letters are deeply personal, built from in depth conversations about your identity. They validate your experiences, and outline your plan(s) for care after surgery. Once obtained, I had to send them in to the Gender Clinic, where they helped collect the paperwork I needed.

I attended two telehealth appointments with Dr. G and her nurse in December 2022, the appointment with Dr. A in April 2023, and an appointment with N in May 2023 to get my letters and referrals sorted. After providing the Gender Clinic with both letters, my consultation was scheduled.

I received the call to schedule in July or August of 2023 and my consultation was set for February 20th, 2024. Admittedly, I was devastated at first. Then, I worked through my feelings and accepted that it would still happen even if it was a hot minute. I decided to focus on myself and my social circle, building new relationships and rehashing old ones. I genuinely truly felt alive for the first time in a long time after getting my letters, and I did my best to live alongside my anxiety.

On October 13th, 2023 my surgeon's office called with a sudden opening for a consult on Halloween. It was a glorious rug pull. A panicked delight. I drove out and talked with Dr. P about the process and some expectations. We took photos of my chest from a few different angles (titty mugshots) and sent them to insurance alongside my letters. I was euphoric at the same time as on edge. How soon would my procedure be? How quickly would Dr. P's office get back to me? How far out would the surgery be scheduled from my consultation?

Time passed. I felt many complex things all at the same time. A mouthful of all of the Skittles but in my head. I am eternally grateful for all of my friends for their patience, as well as the space they've allowed me to feel through this. I have been fraught and all over the place, it feels.

When I found out my surgery was approved by my insurance, I was not contacted by Dr. P's office. My anxiety was faster. I checked my insurance account and found that insurance approved sometime after November 1st. I called Dr. P's office and left a message for his nurse, asking after the scheduling process. A few days after that, she called and we scheduled the surgery for January 12th, 2024. More than a month before my consultation had originally been set. What I had thought would take a year if not longer to accomplish had been drastically accelerated.

At some point after my consultation on Halloween, I began to internally feel like Sandy Cheeks trying to beat hibernation. So many small moving parts to this whole thing have had to be organized. From designating responsibilities to my friends, collecting supplies for post-op recovery, and learning as much as I could, plans have fallen into place. Any gaps that arise will be adapted to. (I'm working on unclenching about it still.)

I started going back to therapy regularly to help with the mental load. N says she's noticed I'm more settled in myself and I can feel it. In the way that you know exactly what you need to in dreams- that strange euthymic understanding- I also know that I am ready for this change. I am ready for the discomfort, the vulnerability of it. Just the thought of being more me than before is cathartic. I'm excited for all of the nitty gritty that I know is part of this.

I can't wait to feel how my shoulders unburden. I can't wait to feel sun and air on my skin in lovely weather. I can't wait to be unrestrained, whole, and one with my body.

I can't wait to be at home in myself.

[salty-inc]

you got top surgery!! congrats! and uh... what is the process of getting it if you dont mind me asking

Here’s the steps I took. I am 18 and live in Colorado. These may be different for you depending on how old you are, where you live, and other factors:

1. First I asked my normal doctor who gives me flu shots and stuff to give me a referral to the TRUE center at Children’s hospital in Denver Colorado. I requested a referral specifically to Dr. Reardon because I heard he’s super great and easy to talk to.

2. I went there and explained why I wanted top surgery but am not on HRT. I explained where I was and wasn’t dysphoric about. I had to meet with a few therapists.

3. I got a special gender therapist from the TRUE center. We meet a few times then she wrote me a letter for top surgery and gave me a list of sergions.

4. I looked around at the list of sergions she gave me, narrowed them down to who would take my insurance, then started looking at their websites and portfolios. Since I didn’t know what type of surgery I would get, I just looked for neat scars, consistent nipple sizing and placement.

5. I found the sergion that I liked the most and gave him a call. We scheduled a consultation. This is where we meet, he sees what he has to work with, does a few measurements then tells me what surgery I was going to have. (I got periareolar)

6. After that appointment we had to work with insurance to see if they would cover this. They did. Then we scheduled a surgery date. For a little peace of mind, I asked him to send me portfolio images of periareolar surgeries he has done on people my weight and size so I would know what type of look to expect.

7. We drove to Denver on the 8th. I had to get a corona test because they can’t operate on corona people. The tests don’t actually hurt that bad. They just feel kinda weird. Then on the 9th we went to the hospital at the arrival time and got my surgery.

8. We drove home and now I’m chillin in bed like the nasty lil slug I am

[babysealfi-blog]

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[queerforscience]

Top Surgery Consult

I meant to write something about this a while ago buttt I didn’t, I mostly wanted to give some feedback on my surgeon for other people’s information and help people know what to expect for these appointments. Let me know if anyone wants to know anything else!

I had inverted T top surgery on 6/20/18 with Dr. Hema Thakar in Portland, Oregon. I am nonbinary and am not/have never been on T.

Consult

I honestly didn’t really know what to expect during my consult. I got this appointment through a referral from my PCP so I didn’t really know anything about the surgeon or anything. At this appointment a nurse took vitals and gave me an open front gown to change into before I met Dr. Thakar. 

She looked at my chest and took some measurements, then talked through the options for different procedures (after letting me put a shirt and binder back on so I wasn’t so uncomfortable), which in my case was double incision or inverted T because my chest was Not small enough for keyhole :p. During this part she talked about some of the pros and cons of those procedures and showed me pictures of her results from these. She did mention that she worked with a lot of nonbinary people! She said that a lot of her nonbinary patients tend to like the inverted T procedure. The two drawbacks to that procedure she mentioned was that it does leave a little bit of breast tissue so it doesn’t get you quite as flat as Di, but cis dudes aren’t entirely flat either, especially ones built like me, and that if I were to go on T the leftover tissue might shrink and make the skin in my chest be loose. 

(The weight thing something else I was worried about from what I’ve heard about other’s experiences, I know some pepole have been told they need to lose weight but my weight was never mentioned other than in relation to having a bit of tissue left looking natural and I’m definitely a bigger guy.)

We also discussed that I needed a therapist’s letter for insurance coverage and when I mentioned that I didn’t currently have a therapist it turned out that she even had a social worker that worked with her office that could help me find a therapist to write one. I did talk to the social worker who gave me some names of local therapists that would do “top surgery assessments” so I could get a letter without it taking too long. I did end up deciding to get a letter from my former therapist when I went back to school though because I thought it would be better to talk to someone I had an established therapy relationship with and everything. Her office also helped me work out scheduling so that worked out so I could use that letter and get top surgery while I was home for the summer.

Both from my experience and what other people have said online it sounds like Dr. Thakar’s office is really good at working with insurance to get people’s top surgery approved. The main impression I got from this visit was that Dr. Thakar definitely had good experience working with trans patients and had a really great bedside manner.

I was also going to write about my pre op in this post but this is already really long so I’m going to make that another post.

[damiantransitions]

So I'm bringing this blog back because I think I actually do want to document my process and hopefully it will help someone but it will at least be something for me to look back on. I'm going to try to summarize what has happened so far (and this post is going to focus on the external process and moving through the system to get top surgery and so forth--I'll make another post with context on more personal stuff later). Nov 2017--I told my primary care provider (Dr. Novak at Kaiser Oakland) via a video appointment (video because I was at school in Massachusetts and also because it was free) that I wanted top surgery and asked how I would make that happen and he essentially said "well that's easy. I just have to write a referral and send it to the Multi-Specialty Transitions Clinic and they'll get in contact with you." He did that as we spoke and I got a call from MST that evening to schedule an initial consult. Jan 2018--I had the consult which was essentially meeting with a social worker (Dr. Gillian Goldstein) and she asked me a few questions to get a sense of why I wanted top surgery and basically to make sure I met WPATH standards, which is what Kaiser follows. She cleared me to meet with a surgeon and I scheduled that. My parents and I also signed up for the top surgery class that Kaiser offers and went to that and heard from a nurse, a surgeon, and a patient. The nurse also showed us how to find out our share of cost, which I looked up the next day and found out that insurance covers everything so all I would need to pay would be a $50 copay, which is amazing. Mar 2018--I went to my next appointment and met with two new social workers (Dr. Goldstein was on maternity leave) who wanted to know about my situation with my parents (more on that in another post) and then with the surgeon herself. I had decided on Dr. Tong because she was the only surgeon available to see me in the week I was home for spring break, but I had also met her and one of her patients at the class and she seemed both warm and competent and her patient spoke very highly of her. She was very considerate of what I wanted, asking me about options I hadn't even thought about (do you want your chest to keep a little bit of tissue or do you want it completely stretched flat like a little boy's) and we agreed that double incision made the most sense for me. It was clear from the amount of options she gave me that she was very skilled and able to work with a lot of precision to give her patients the outcome they wanted. I wanted to have surgery in the coming summer, but she didn't have any openings until October, by which time I would be back at school in MA, so we scheduled the surgery for June 12, 2019 and she gave me the phone number of her OR scheduler and told me to call to be put on the waitlist so I would have a chance at getting it done this summer. Now it's early July 2018 and it's clear that I won't be able to have surgery this summer. Part of that is my fault; I found out in June that they're more likely to move you up the waitlist if you call regularly, and I'd only done that once. When I found that out, I did start calling once a week, and they did give me an option in August, but August would be too late for me because I wouldn't have enough time to recover at home before going back to MA. So it looks like I have to wait almost a year, which though I definitely would have preferred it sooner, seems doable.

[parachim]

I had top surgery yesterday whoo!!  Summary of the entire experience below

I had started T Feb 13 of the previous year.  My insurance doesn’t require me to be on T for the surgery but it probably made it easier to convince all the medical staff along the way.

Early November - In a panic about will I have health insurance after 2018 because of trump fuckery I started researching drs who did the surgery in the area.  Turns out there are 3 in total in Pittsburgh.  I went with Dr. Grunwaldt because her office got back to me first.

Mid November - Meet with a regular general practitioner in the area that had trans patient experience.  I probably didn’t absolutely need to do this but it updated my records within the UPMC system and got me a referral to a therapist.

Meet with the therapist.  Lots and lots of life history questions.  This doesn’t bother me but if you’re seeking this sort of thing be prepared to get into the nitty gritty details of your life.  She’s says she’ll give me the letter after the first session.  There’s some scheduling issues about getting it when I originally planned but I got it in December and was also able to use the letter to get my new insurance to cover my T script for $50 well spent.

End of November - Meet with the surgeon for the first time.  Asks me some basic medical history and looks at the surgical site.  Takes some pictures and describes the basics of the process.  Says she has no problem doing it she just needs the letter.  Also bonus points here since she had no issue with me being nonbinary and was good about pronouns.

December - Surgeon’s office asks for a letter from my previous doctor from Boston to back up some of my records.  I was worried about getting this but shout out to Dr. Vetters from Sidney Borum getting it done in 24 hrs.

January - Call the surgeons office to tell them that my new insurance has kicked in.  They submit the paperwork to have insurance cover the procedure.  Insurance approves it no issue at all.  (Though, this is a UPMC doctor in a UPMC hospital petitioning to UPMC insurance so this is probably as straightforward as it gets).

Got my appt scheduled for Feb 21 originally and then it was moved to Feb 28 because of scheduling issues.

February - I have a pre-opt appointment on the 13th.  They look me over again and confirm some medical history.  They give me the scripts to fill ahead of time for the day of the surgery.  Surgeon is concerned about some of the mild acne on my chest so I end up using an online UPMC dermatologist to get some antibiotics and some washes to clear it up.

Day of the Surgery - Arrive at UPMC Children’s on time (I no longer count as a pediatric patient but the surgeon is specialized in this and does older patents at the hospital.)  Check in at the same day surgery counter.  Confirm my identity and everyone I’m with also has to show their ID and get a sticker.  They also have to confirm they haven’t been out of the country in 3 weeks.

I get called back and they check blood pressure, pulse, height and weight,  Have me take off my clothes and use some special cleaning wipes all over my body.  I get to put on a gown, some awful disposable underwear, and some grippy socks.  I get a bag for my clothes that I eventually hand off to my mom.

I’m taken to another room and I meet with the surgeon.  She marks up up with the surgical marker to prepare everything.

I then meet with someone from the anesthesia team who has me sign a consent form.  Then I see someone from the pain team that gives me the option to have a nerve block injected into my chest after anesthesia.  I don’t know if this is something offered everywhere but it seemed to help.  I meet with a nurse who had me fill in some medical info and also choose someone as my person if something goes wrong and sign off on those forms.  Me and my family wait around for a while because the surgery before me was delayed.  We probably wait for about 45 minutes before I’m taken back by myself into the initial anesthesia room.

New person takes me back to that room and puts in my IV and takes my blood pressure again.  The anesthesiologist comes in and hooks up my IV to The Good Stuff and I’m out of it pretty fast.

About 4 hours later I’m wheeled into a recovery area where my family is and I wake up.  There’s a screen with movies you can pick on it and I pick The Incredibles but I’m too spaced out/sleepy  to really watch but since I already knew the plot of the movie it was a good way for me to gauge how much time had passed.  They gave me some apply juice as you had to have so much fluid before leaving.  My parents went and filled my scripts for a second time ?? so now I have double of everything (and that’s why there’s an opiod epidemic...).  

After I started feeling more awake I got up and moved to a chair.  I felt nauseated after that and barfed about a mouthful of apple juice.  They reattached my IV to a bolus and I felt a lot better after that.  Got dressed in my regular clothes and they went over how to deal with the drains.

Someone came by with a wheelchair when I was good to go and wheeled me over to the car.  Went home and I’ve been pretty good since then.  Pain is very mild and my appetite is normal.  I have to go back in a week when they’ll take the dressings off and drains out so I can see everything better.

[lawrencedienerthings]

As coronavirus became reality in Colorado, I dealt with a different diagnosis — breast cancer

#twowomen🤖 🙆 💬 👹 🎀 💺

Colorado News

On March 5, I went for a mammogram.  The clinic was crowded that day and women in pink gowns sat in the hallway and more sat in another room.  Two women and I chatted, used the Keurig machine, and mused on this new virus but couldn’t remember its name. No one was wearing a mask.

The following morning I received a call to come back in on March 9 for a mammogram. The receptionist was wearing a mask and she had a bottle of Purell sitting near me.  I wasn’t sure what to do; should I use it before or after I signed my name on the electronic pad?

After the procedure, I was led to a special waiting room where I sat calmly and read a well-thumbed magazine about wild animal refuges.   I was called into another room where a radiologist told me I needed a breast biopsy.  Calcifications, she said. She was not wearing a mask.  We scheduled it for St. Patrick’s Day.

Later that day, I picked up student essays from the junior high where I teach to take home and grade, and would have gone to my writer’s group but it was canceled. A sleep apnea test I’d scheduled for that week was also canceled.  So were a party and an author lecture.

Sunday, March 15, I, my husband, John, and his siblings went to a Mexican restaurant.  I ordered the Corona Margarita which had a bottle of Corona beer upended into the glass.  We laughed. Our waiter said that it was possible they would have to close soon.  This didn’t make sense.  It wouldn’t happen.  Two days later, it did.  

MORE: See all of our Write On, Colorado entries and learn how to submit your own here.

When we were walking to our cars after dinner, my brother-in-law received a call saying his elective back surgery was postponed indefinitely.  He was clearly upset.  

When I went for the biopsies, everyone had masks.  The magazines were gone.  Two days later, my cell phone rang but there were three dropped calls before I was able to clearly hear I had breast cancer and set an appointment the following Monday with my oncologist.  I walked into the kitchen and casually mentioned that I had cancer.

On March 22, my husband and I went for a long ride in the foothills above Fort Collins.  We were going to take this one step at a time, we said.   Once back in town, we stopped at Dairy Queen.  John went in and tried not to stand close to anyone.  The server was not wearing a mask.  I enjoyed my cone immensely.

On Monday, we bravely walked into UCHealth Cancer Care.  The receptionists were wearing masks.  We met the doctor and she had on a serious doctor mask, which she said kept her from touching her face, nothing more.  Then we got down to the diagnosis:  breast cancer in the right breast which called for (at least) a lateral mastectomy and chemo and maybe radiation.

After almost three hours of this, we left with a fistful of appointment sheets and referrals and a white notebook filled with such information as, “So, you have cancer!  Now what?”  I was overwhelmed and not much else mattered for several days. The next evening, I was supposed to host my book club, but it had long been canceled.  I thought I sure would rather be having book club than cancer.

I went in for an MRI, CT scan, blood tests and genetic screening.  With each visit, I saw more healthcare workers with masks.  My appointment to find out the results was changed to a virtual one.  At last, I could see what Dr. Datko looked like. Neither of us could look the other in the eye. Welcome to a new reality.

I was slated for a mastectomy and possible reconstruction but it was unclear if the surgery would even happen or where it would be done.  The mastectomy might be good to go but the reconstruction part might be elective which meant postponement.  It was out of the hands of the surgeons.  The hospital board had to approve it. 

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Surprisingly, both procedures were approved and scheduled for April 9, at the surgery center on the premises.  I met with the masked surgeon and then an unmasked plastic surgeon.  He said the masks were useless.

At this point, I had stopped watching the news and was trying to be positive and mindful.  COVID-19 stayed far away from my awareness. It had to be that way.

The day of the surgery, the streets were empty.  The parking lot, likewise.  We walked into the building, the lobby deserted, and the information booth unoccupied.  Once at the surgery center, we had to ring a bell.  I stood behind a Plexiglas partition where forms were pushed to me through a tiny slot.  

The waiting room had gaps between all the seats. When it was time for me, my husband was not allowed even to wait in the waiting room. He was sent home. That was hard. I cried.

The surgery and reconstruction went well and everyone was masked.  The pathology report was good but I was told I needed 12 weeks of chemo just to be sure.  Once the worry was over and I went home to heal before starting chemo, I began to let in the virus news.  

My friends brought over dinners but left them on the front porch.  I was gifted four home-made masks.  I talked in person with my neighbor while outside, 10 feet apart, wearing masks.  Only now am I feeling the brunt of social distancing and safer-at-home.  Going to a grocery store is a distant memory.  Everyone else has already developed coping skills to get by but I haven’t as yet.

Cancer in the time of COVID-19 sucks.

Darlene Mueller Morse is a writer and editorial consultant who lives in Fort Collins.

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[j0nsonco]

I live in the dmv and I have kaiser Permanente and I just recently scheduled my first appointment with the behavioral health department. If you’re transitioning through Kaiser, you can either directly schedule an appointment with their behavioral health department or email your main health care team and if you specify it’s sir transgender services, then they will assign you a case manager (which you will be assigned to either way) that you will speak to first. I called her and she did a quick 5 minute assessment and gave me Dr. Bernard Mungin’s name to schedule an appointment. I do not know if this will be the case for minors, but my case manager stated that in one to two sessions (video sessions are available as well) he would most likely write me a referral for hormones and I would be free to schedule an appointment with the endocrinologist. With Kaiser as well, you do not need to be on hormones to apply for top surgery (and I’m assuming it is the same for mtf chest surgeries) and it is the same process as with hormones. I was able to get in contact with my case manager and setup an appointment with the behavioral clinic in a week, so it was a speedy process. My appointment is scheduled for April 6th (Monday) so I will update next then. Kaiser’s care team as been really polite and respectful so far, and I hope this post is able to give some more information about Kaiser’s east coast transgender services since I could not find much information prior.

-Damien

[nbtopsurgery]

Part 1: The Gender Clinic

So, in brief: I started identifying as non-binary round about 2010. I began to socially transition at that time – came out to friends and family and started using they/them pronouns but was unsure if I wanted to pursue any medical transition. I had been experiencing dysphoria about my chest since before I came out as non-binary, but between 2010-14, it became compellingly distressing enough for me to eventually refer myself to the Sandyford gender clinic in Glasgow in early 2014. As the Sandyford clinic takes self-referrals, I didn’t discuss anything with my GP beforehand.

A leisurely thirteen months later I had my first appointment at the gender clinic in early 2015, with a psychiatrist who no longer works at the clinic. A small aside: many, many non-binary people fly under the radar at gender clinics because they can present themselves as a binary trans man or woman. Gender clinics’ historic hostility to non-binary identities means that people are understandably unwilling to come out and possibly jeopardize their treatment, but it does also mean that doctors severely underestimate the numbers of non-binary people among their patients. However, I do not want to take testosterone and am really not at all masculine, as well as being a terrible liar. So, I felt I really had no choice but to go in and present as an openly non-binary person, who has dysphoria and wants to get top surgery. Going in, I didn’t think my chances were very good at all, but it seemed important to at least try, as it would be difficult for me to fund it privately.

Confirming my worst fears, this first appointment was a total, crushing disaster. The psychiatrist I saw appeared totally non-plussed by non-binary identity, and not at all open to learning about it. Among other uninformed and dispiriting statements during the course of the appointment, she said that I seemed like a ‘regular girl’, implied I wanted surgery for the androgynous fashion opportunities and told me point blank that I would not get top surgery on the NHS. I hadn’t exactly expected it to go well, but I wasn’t quite prepared for such outright dismissal and misgendering. She said that I could have a second appointment in 6 months, but her entire manner suggested that it was just a formality.

Approximately 6 months later, then, I had my second appointment, this time with a different doctor. I was originally scheduled to see the first one again, but something happened that meant I ended up seeing Dr Ewan instead. This turned out to be a fantastically good thing, and if I could go back I would have specifically requested not to see original doctor again after that horrible first appointment. The difference between the two doctors was astounding; while Dr Ewan still seemed to be fairly new to treating openly non-binary people, he was willing to listen to what I had to say, and learn from it. He even apologized for asking searching personal questions, which is unusual from a gender doctor. He confirmed that the issue of treatment for non-binary people was the hot-button topic of the day for gender clinics, and seemed interested in what I was saying about experiencing gender dysphoria without wishing to ‘fully transition’. He said that he would have to discuss my case with the other doctors, but I left the appointment with the impression that he would advocate for me.

I made a point of reassuring him that my expectations of top surgery were ‘reasonable’. I.e. I knew that having surgery wouldn’t suddenly mean that everyone would gender me correctly, but that I believed it would make me feel a lot happier and more congruent with my body regardless. I also tried to show just how long I had been thinking about this (about 4 years active consideration at this point).

A couple of months later, I got a letter from the clinic saying that I had been referred for surgery. Hooray! By this point we’re at about October 2015. For several months, I waited to hear something, and didn’t. By February 2016, I was worried, and attended the monthly drop-in service to see if I could chase up what was happening. I saw a different doctor again at the drop-in service, and explained what had happened. She promised to look into it and get in touch within the month. Nothing happened again.

At the start of April, I called the secretary of the gender clinic, to see if I could find out what was happening. The person on the phone told me that my surgery hadn’t been approved by the funding board, and seemed surprised that no-one had told me. I was also surprised that no-one had told me. They said that I would need to take hormones before having surgery, contradicting what the clinic head had said in a Q&A I had attended, and what Dr Ewan himself had recommended. The guidelines for top surgery had only recently been updated to be inclusive of non-binary people, and I assume that she had not read or been informed of the updated guidelines.

I make an appointment to see Dr Ewan again at the earliest possible convenience, which was in August. In the meantime, I talked to James at the Scottish Transgender Alliance, who was doing excellent work advocating for non-binary access to surgery. August rolled around, and I asked Dr Ewan what had happened. He was very apologetic for not informing me about the funding refusal, and said that he would bring my case again to the funders. Around October 2016, a year after my initial referral, I received a letter from Dr Ewan saying that the funding for my surgery had been approved. Hooray.

[armyhealth9-blog]

This might be why your hands are always cold

© Provided by TIME Inc. To say my body doesn't do well in the cold is an understatement. When the temperature drops, my fingers freeze, and often turn deep red, followed by white. On especially exciting days, they'll look a little blue. "Cold hands, warm heart," my mom used to tell me.

Growing up in sunny Southern California, this rarely happened—mostly just on ski trips or when I’d spend too long in the ocean. (Yes, I realize how obnoxious that sentence is.) But when I moved to New York for college five years ago, my blue hands became a winter mainstay. I’d never lived in a cold climate, so I assumed this happened to everyone in frigid weather.

Turns out I assumed wrong. On a trip to Chicago to visit extended family this past Thanksgiving, I went for a walk and returned to my aunt's house with my signature blue fingers. “Oh, you must have Raynaud’s," my aunt said. I must have what?

Naturally, I headed back to New York with a lot of questions, so I called up Melisa Lai Becker, MD, site chief of emergency medicine at Cambridge Health Alliance in Everett, Massachusetts. Dr. Lai Becker described my experience as "the classic vignette that would open a textbook chapter on Raynaud's disease." (By the way, it's pronounced ray-NOHZ.) So if you're concerned you might also have Raynaud's, here's some info and advice from Dr. Lai Becker to help you (and me) out.

RELATED: Why Your Hands and Feet Are Always Cold and What to Do About It

Raynaud's symptoms

“The average person can go into chilly weather and get by without gloves, their fingers would just get a bit cold,” says Dr. Lai Becker. But someone who has Raynaud’s has a much more extreme reaction. “If you touch their hands, you can tell the difference," she explains. "Even in a moderately cold environment, they have white, ice-cold hands.” In addition to getting cold, if you have Raynaud’s, your hands might turn white, then blue, and red when you start warming up again. But not everyone with Raynaud’s exhibits all three colors, or in that exact order. You might also experience these symptoms in other extremities including your ears, nose, lips, and even nipples (cringe!).

If you notice any of these symptoms, even simply getting cold and painful fingers, Dr. Lai-Becker recommends you see your doctor and possibly get a referral to a rheumatologist. A doctor will help you determine whether you have primary Raynaud's (the most common type), or secondary, meaning it's brought on by another condition.

RELATED: 10 Things Your Hands Can Reveal About Your Health

Raynaud's disease causes

For primary Raynaud's, genetics likely play a role. According to the Mayo Clinic, about one-third of people with primary Raynaud’s (the most common type) have an immediate relative with the disorder. Although anyone can develop the disease, Raynaud’s is “overwhelmingly more common with women and generally first discovered in adolescence,” explains Dr. Lai Becker.

But for cases of secondary Raynaud’s (also called Raynaud’s phenomenon), the National Heart, Lung, and Blood Institute says there’s usually an underlying cause such as nerve damage, injuries to hands and feet, exposure to certain chemicals, repetitive stress (like typing or playing the piano), medicines that affect blood pressure, or nicotine. Secondary Raynaud’s is less common, and doesn’t usually appear in adults until after age 40. However, since it tends to be a more serious condition, it’s important to see your doctor if you notice symptoms of the disease later in life.

RELATED: 11 Products You Need to Stay Warm in Your Ridiculously Cold Office

Why does Raynaud's make my hands turn blue?

Why the heck do you turn into a blueberry when it’s cold? “No one’s been able to say for sure what causes it,” says Dr. Lai Becker. “But we know one thing: Cold can trigger the closing up of blood vessels.” If you have Raynaud’s, the arteries to your fingers and toes go into vasospasm—which means your blood vessels narrow and limit blood supply to affected areas, explains Dr. Lai Becker. Chilly temperatures generally trigger this phenomenon, whether that’s in the form of cold air or icy water. However, according to Dr. Lai Becker, doctors have also found an attack can be caused by emotional stress or hormonal changes.

RELATED: 9 Gifts for Your Friend Who’s Always Cold

Is Raynaud's dangerous?

For the most part, Raynaud’s isn’t a huge concern, says Dr. Lai Becker, but it does increase your risk for frostbite. “Another thing that could happen is spasms,” she explains. “You have these tiny little blood vessels in your fingertips, and if they start to spasm, that makes it difficult for blood to get to your extremities.” This could result in sores or dead tissue. It’s also possible that blood circulation to your fingers and toes could stop entirely, leaving deformities. But don't freak out—these conditions are extremely rare. But if for some reason they do occur, it’s important to seek treatment from your doctor immediately.

RELATED: 10 Winter Health Myths, Busted

Raynaud's disease treatment

There are plenty of treatment options available, depending on the cause and severity of your Raynaud’s. “If it happens to be the primary problem, it’s not that big of a deal,” says Dr. Lai Becker. “It’s very manageable and there’s certainly medications you can take.” You can try anything from medications that widen blood vessels to nerve surgery to Botox injections. But for the most part, Raynaud’s is manageable without extreme treatment. “The best way to cope with it is to avoid a trigger, which is generally a change to cold weather,” says Dr. Lai Becker. “Plus, getting yourself a really good pair of gloves is essential!”

Since I don’t have plans to move back to sunny California in the near future, here are the next two things on my to-do list: schedule an appointment with my doctor and invest in a hefty pair of mittens. Who’s with me?

To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter

Source: http://www.msn.com/en-us/health/healthyliving/this-might-be-why-your-hands-are-always-cold/ar-BBPsmDF?srcref=rss

[legitryanf]

Hello, Im sorry if this is prying but you're 16 and already have had top surgery? :O how did you manage also how did it feel, how do you feel post op? what was your experience?

Haha hi, you’re not prying at all! I’m happy to answer any questions. I’ve been trying to get surgery for a while, it all just takes time. I live in Portland, OR which is very supportive and has a lot of resources for trans people. I started out by going to a gender therapist and getting my letter to start testosterone, and after I was on testosterone for a year or so I started the process to get top surgery, which was basically I had to have a letter from my therapist and also a referral from a doctor which I also got from the same doctor I go to for my hormones (endocrinologist). I actually had to get a letter from my primary care doctor and my endo. Then I set up a pre op/consult with my surgeon (Doctor Berli at OHSU, who specializes in gender reassignment surgeries) (HIGHLY RECOMMEND DR BERLI AND OHSU AMAZING SURGEON AND AMAZING PATIENT CARE) and scheduled my surgery and post op appointments from there. I was very excited but very nervous going into surgery as I had never had surgery or been under anesthesia. I had to take a shower the night before with special antibacterial soap and sleep on clean sheets with clean clothes. I got to the hospital around 8:00, put on a gown after wiping myself down with special cloths, got an IV with a sedative and was taken into the OR where they put special stockings on my legs for blood circulation and was told to breathe in the gas and was out before I knew it. I woke up in recovery with a bunch of blankets on me cause I had apparently gotten really cold in the OR. I was in recovery for about an hour as I woke up and was given pudding and water, and then was rolled into a different room where I got dressed and was taught (aka my mom was taught) (side note make sure you have a good caretaker, makes all the difference) how to empty my drains and all about my meds. I’m not gonna lie this shit hurts. I didn’t think I would need to take my pain meds but I ended up taking them for about 5 days, every 6 hours. Sleeping on your back sucks and you wake up super sore. You can’t shower so you feel pretty greasy but dry shampoo and a wet washcloth helped me out with that. I’ve been walking around hunched over because it feels like your chest is pulling when you try to stand up straight. Also, I’m not sure if this is the case for everyone but I got super lightheaded very often, so make sure you rest A LOT and lay down whenever you can, so don’t push yourself and drink lots of water. You have to wear a tight post op vest for about a week after (I’m 6 days post op and still wearing mine). At my post op (5 days post surgery) they pulled out the drains which didn’t hurt it just felt tight and uncomfortable and I got insanely lightheaded when they pulled out my right one and had to lay down with a wet washcloth on my forehead for a couple minutes. The surgeon came in and showed my how to dress my nipples which I will have to do everyday for a couple weeks. I can’t really move my arms much so I need a lot of help. Everyone’s experience is different and so is everyone’s pain tolerance and heal time. Me personally I’m still pretty sore and it feels weird to stand up straight. Most important thing to remember: EVERYTHING TAKES TIME. I didn’t just get these letters and appointments within days, it took months, even years for some stuff. But as long as you’re patient and try to deal with the binder the best you can you’ll be okay. Recovery is rough and there’s a lot to it but I promise you it’s so worth it. Having a flat chest is insane, I’m happier than I’ve ever been (: if you have any other questions feel free to shoot me an ask/message if you want it to be private. Sorry this was super long I hope you got all the info you wanted!

[vacantclassic-blog]

Courtesy

Dr. Richard Curtis, a practitioner at his own clinic in London, was my original clinician.

He was a transman himself and his practice was brought into question sometime before I attended, legal issues pertaining to the prescription of testosterone to underage or ill screened patients. I didn’t care for that. I was old enough and ready, and this was the quickest route to the medication I needed to stop the clock over my head - or at least, slow it down so that I got to live some of my years as a man.

It was also the quickest route to emptying my bank account. Appointments, scheduled to last 30 minutes but only taking half that at most, sometimes less than ten minutes, cost £230 a pop. Adding in my travel, a round-trip taking me approximately three hours each way for fifteen minutes of his time, cost me over £300 a time. In the beginning, I used large sums of my wages to afford to see him.

I wasn’t fond of him. He was dismissive of me, doubtful of my transition. He puled into question my clothes, my hair and even my name choice as ‘feminine’. It annoyed me and I often left his office feeling even more dysphoric than when I went in. I wouldn’t admit it though. This man was the key to hormones. I didn’t want to rock that boat so I sucked it up.

Even when I wanted to switch from gel to the shot, he questioned me and pulled into doubt the information I’d garnered to weigh up my options and reach the decision. He didn’t agree with the age of the internet, in fact he hated it, and revelled in any chance to show how unreliable it was.

The last time I went to see him was when I wanted to be put forward for top surgery. I’d been on T for over two years, nearer to three, and had come into some money I could use to pay for the treatment. 

He was more than happy to recommend me to one of his partners who performed the operation. I don’t remember the surgeon’s name, but a few weeks later and I was paying another extortionate amount of money to be seen in the fanciest, private hospital in London I could imagine. 

The surgeon was friendly and detailed, examining me and taking photos which he later showed  back to me in front of my mum. That really upset me, as at this point my relationship with my chest was deteriorating rapidly. Seeing it made me incredibly depressed. Especially in front of my mum.

We discussed the options and I asked to have some time. When I came out to pay the fee to the receptionist, she immediately asked when I would like to be booked in. Next week, perhaps? I declined, to her utter surprise, and said I would like time to think before I splashed out nearly seven grand in fees. How unusual that I would like time to make sure I was comfortable with this?

That’s when I decided to wait, and contacted my doctors for a referral to the Charing Cross GIC. This was also a disaster, of course, as my doctor had no idea and because I was going for chest surgery, instead opted to refer me to the local breast clinic. And thus, the most haunting, embarrassing experience to date occurred. The kind that wakes you in a cold sweat in the early hours of the day, when all the things you don’t like to think about come back for you. 

[transition-of-lanabean]

As always, I’m in full agreement with my shirt, and encourage anybody/everybody to follow suit to their bed. Sleep is wonderful, and I rarely get enough of it!

 I do hope you all have had a nice couple last days, it’s been stressful at work so I really didn’t feel like posting anything yesterday. Not going to go into too much detail, lets just say that the co worker which as been stressing me out for a long while has upped it to a whole new level. I had to have a talk with my boss to let her know what I think about the bad co worker.

 After work today, my sister and I took a trip to Costco and picked up a few things. We chatted about a few fun things, like makeup and clothes, so that was a nice way to end the day. We also grabbed a not-so-healthy bite there. Worth it.

 Transition wise there’s lots of general things to report. I’m of course slowly continuing to change. Boobs are coming along and I can feel things fill out more and more every day, and are as usual a little bit sore, but mostly when they’re touched. Only a couple times have they done their own thing and gotten angry for no good reason. They haven’t been itchy much lately though which is unusual for that to go on this long. I’m continuing to generally feel good, skin is also getting better and better.

 The laser sessions continue to show, and I have seen quite a difference the last week or so. That’s a bit odd to see change so close to my next session (Tuesday), but I’ll take it. Looking forward to the next session as always. Too bad with each session comes one step closer to getting a laser shot at my nether region. Ah well, it’s progress.

 Monday is my next HRT visit, so I had my blood drawn on Wednesday for that. Greatly looking forward to those results. My estrogen levels jumped up to over 215 last time, more than 50 points up from before that. Still on 6mg/day Estradiol, with no blockers whatsoever. Plus I have a few GRS related questions.

 Speaking of GRS, I’m making some progress with getting GRS scheduled too. There are a number of surgeons I’ve contacted, and heard back from a couple. Any/all will almost be guaranteed to be at the maximum my deductible is ($6850.00 I think?), so it’s all about who I’m wanting to go with and how long I’ll be okay holding off for. The deductible likely won’t be that high though as if I plan on having the surgery late in the year, other things will count towards that first.

 Dr. Toby Meltzer is off the table as he is not covered by my insurance, so it’ll cost me 10k or more to go see him. He was my #1 choice in Scottsdale, AZ and wasn’t booked out too terribly far.

  I have contacted several others, but the one that is honestly at the top of my go to list has to be, like so many trans people, Dr. Marci Bowers in California. Her wait list is the longest (~3 years), but they have a cancellation list, plus it’s only $1,000 to guarantee a spot.

 Now for the good and bad, mostly obvious.

+The extra time will of course make it so I can mostly save up all the money so I don’t have to get a loan.

+Plenty of time to see a second therapist for a second required therapist referral letter for surgery.

+She is one of the best GRS surgeons in the country, hands down, Hence the ~3 year wait.

+I’ll be able to casually get my weight further down and not have to rush by losing the ~35-40 lbs quickly required to see her.

-3 years is 3 years.

-Her cancellation list means I’ll likely get in a lot sooner, which is good and bad. I probably won’t have the money myself before the time, so some sort of loan is highly likely.

 There you have it. I’ll update more as the time comes, and of course let y’all know how my appointments on Monday (HRT doctor) and Tuesday (laser) go.

 I hope you have all had a great week!

 - Lana

[heleftnowwhat]

I haven’t written in a while. I have had some repeat doggy clients so I wanted to wait for a new one to write about.

OMG, I just had a my tiniest guest today. Diego is a 10 week old, 3lb Beagle/Chihuahua mix. This was his first visit and he did very well. I assumed that he would play for an hour and sleep for an hour and I was correct. I took him out every 60-90 mins to go potty, which he did. All and all, a great first visit. I believe that he will be coming back, YAY!!

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 Like I said, I have had some repeat clients….here they are…

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Also, A friend and I went back to PA for a weekend in Sept. We joined my sister’s team, to walk and to raise money and awareness of Melanoma. It was fun and very successful. I am excited to say that my sister has had her 12th and final treatment and all looks good now. She is so strong. This is her story…..

My Melanoma Madness Family history: none Number of full skin checks I had through my life: zero Melanoma type: Acral Lentiginous (subungual) the most common in Asian, Hispanic and African American races. Of which I am not. This type of melanoma makes up less than 5% of all melanomas. Melanoma is the deadliest form of skin cancer. Timeline: Years and years ago I got a mole on the cuticle line of my left big toe. It was fine. Appeared normal. I thought it odd to get a mole on my toe, but I was not concerned. Fast forward to sometime in late 2017-ish I notice I have what I think is a blood blister. It’s near or on or around the “mole”. So I google blood blister on toe. Because who googles toe cancer??? I go several months until having it looked at.

May 2018: I’m in my 3 month diabetes check appointment with my Doc and at the end of appointment, I ask him to look at my toe. He glances at it and tells me it’s ugly and I should cover it for a week and if it doesn’t improve I should go see a podiatrist. Ok!!! Sounds easy. So I do what he tells me and it seems to start to dry up so I don’t go to the podiatrist.

September 17th 2018: Ok, I give!!! Made an appointment with the podiatrist because it seemed to get worse again. I go in, sit down and show him my “blood blister”. Instantly he tells me it is a wart. Oh! I ask if warts oozed and bled. He shook his head and told me no and that he wanted to biopsy it to see what kind of wart it was so he knew what type of antibiotic he may need to prescribe. OUCH. That kind of hurt. But ok! The results will be in in 7-10 days. Thanks doc. So, because I’m impatient, I go buy a wart freezing kit and try to freeze the little bitch off. HOLY CRAP. OUCH IS AN UNDERSTATEMENT. And it obviously wasn’t even worth the pain. Tic tock…. tic tock September 28th (10 business days later): I call the office to ask about results. I am told there are none. Sometimes these things could take up to a month they say. Of course, I argued that and said that the doctor told me 7 to 10 business days. They shrug and say they hope it’ll be in next week. HOPE?????? Mind you, I struggle with anxiety and unknown things are huge a trigger for me. Ok. Sigh.

October 5th 2018: Ring ring. Hi, this is Stephanie Heart. Calling to see if results are in. Nope. What the hell????? Ok. This is science. Deep breaths. October 17th 2018: Cell phone rings. I’m in middle of something and can’t answer my phone. Voice mail says: “ hello this message is for Dr. B…, this is so-and-so from the pathology lab in Maryland and I need to speak with you directly about one of your patient’s biopsies” UMMMMM….. what the hell? Now I’m freaked out. So of course I call back and leave a message. No response. Text— no response. Call doctors office and leave urgent message with answering service. Call doctors office again first thing in morning and start pushing. Hard. Turns out the initial abnormal results were in a couple weeks ago and lab was doing further testing. WHICH NOONE INFORMED ME OF. The lab certainly broke some rules by accidentally calling me directly. They say they will have doctor call me. 15 min later he does. Tells me same story. Says he is trying to get in touch with pathology lab and will get the results for me and I can pick them up in office tomorrow. Ok. Fine. Instantly google cancer on toe, because why else would a lab be trying to reach the doc?

October 18th (my cancerversary, I guess) I arrive at the office and go to desk and say I’m here to see the doctor about my results. They tell me he gave us this for you and hand me a sealed envelope. Um. Alright. I leave office and am in lobby. Remember, I’m impatient. So I open envelope while alone in the lobby. And all I see is MALIGNANT MELANOMA and I am alone. Frozen. Oh. Also a note with a referral to a dermatologist. That bastard let me read that alone. Ok. Now it’s a search and destroy mission. I immediately call this dermatologist and fax over results while I am on the phone. While scheduling the appointment with the receptionist, she asked me to hold on and out of nowhere this doctor gets on the phone. He tells me that he would gladly see me, however, he would be telling me immediately to get to a surgeon at Fox Chase Cancer Center and gave me the name. He told me that this was a deep tumor and it would have to be removed. Holy shit. This is serious. Like WAY serious. My fingers instantly started dialing the number to the doctor he referred me to. They were amazing on the phone while I cried and they got me set up for an appointment with the chief of surgery in less than a week. Begin massive anxiety attacks. Google. Bing. Explorer. Knowledge is power.

October 25th, 2018 Appointment with surgeon. The guy who saved my life. Tells me that the depth on the report puts me at a stage 2. Which means they remove it and then do a sentinel lymph node biopsy to check the nearest lymph node to see if it spread. But only 20% chance it would have. And then he tells me that to remove it, they have to amputate the top half of my big toe. Wait. WHAT??? Alligator tears begin flowing. Sends me on my way to schedule surgery.

November 2, 2018 Surgery day. Maybe after today I won’t have cancer anymore. Ativan on board I head to the hospital with my army. Long day of waiting and tests. Blood work. They do the injection for sentinel lymph node biopsy. Waiting and scans. Then it’s time to head back. I don’t remember any of it. Wake up. Foot is wrapped and I have a nerve block. They said they were sure they got clean margins. So as long as lymph node comes back clean, I would be cancer free! Remember only 20% chance of the lymph node being malignant. They send me home same day with healing instructions and tell me results will be in in 7-10 days. I’ve heard this before. Anxiety is in high overdrive. My family and friends took amazing care of me. But in the midst of this I told the boyfriend to take a hike. Zero empathy and he couldnt understand my fuss. It was only a toe. Not even a whole toe. It wasn’t like it was a boob or a lung. I’m sorry…. you’re out of my circle now. Piss off.

1 week later: Still no results. Tic tock. All I can think of is just getting back to work and I did. I work from home so was able to do some work and elevate.

About 12 days post op: Guess who is in the 20%???? Of course I am. Worst news I could have gotten. I now have stage 3 melanoma. Stage 3. Are you kidding me? You have to be. Now what? Time to have a PET scan of my entire body to see if it has spread anywhere. This would place me at stage 4. Thank goodness, it had not spread. I remain stage 3, but now I have to face a year of immunotherapy treatment with CT scans, skin checks, MRIs, ultrasounds and a slew of other tests every 3 months or so.

November 28 First meeting with medical oncologist. He details the plan of action to do everything we can to make sure the beast stays away. Melanoma is really sneaky and can just show up anytime anywhere. Sigh. A lifetime of anxiety. There is no cure. We set up the treatment plan.

December 5,2018 Treatment day. Lab work first to see if my body can handle it. Meet with oncologist again. Then head to the infusion room. Walk in and there are a ton of cancer patients in their chairs hooked up to IVs. Not gonna lie. It was scary and I couldn’t believe I was there. They begin the infusion after mixing the medicine. They have to wait for doc approval for this as they bill my insurance company $115,000 a month for this drug. Yes, the comma is in the right place. Infusion begins. And ends just as fast. Only about 30 min. And they send me home. Almost instantly, my entire body is hot and so itchy. A normal side effect. Any type of “itis” is. I’ll take that over chemo though. The itch continued for 2 months. My first 2 treatments.

Wash rinse repeat. I just completed my 6th of 12 treatments. I’ve had some scans and skin checks in between. So far…. I am FREE of cancer. We call this NED. No evidence of disease. And we celebrate this.

A few things I have learned: Not all melanoma comes from the sun, but most does. Mine didn’t. I am now susceptible to any and all skin cancers as well as having an increased risk of developing other types. I must be diligent with protecting myself from the sun. When in doubt, get it checked. Schedule yearly dermatology appointments. ADVOCATE for yourself for fast treatment and diagnosis. You are never too busy to take care of your health. In times of crisis you really learn who your true circle of people are. Mine is huge and I am truly blessed.

I am so thankful for the care I have received and continue to receive from everyone at Fox Chase Cancer Center. They literally have saved my life.

I still struggle with anxiety and depression and some pain and swelling. But I’m managing it by staying informed and positive and laughing at things. That’s how I deal. Gotta laugh. My side effects haven’t been horrible from treatment. I hope that my story can help at least one person to get help if needed. Early detection is KEY to surviving melanoma.

I am a melanoma warrior. A survivor. And I plan on keeping it that way.

GET CHECKED PEOPLE!!!

Doggy Guest #30 Diego and more I haven't written in a while. I have had some repeat doggy clients so I wanted to wait for a new one to write about.

[miawintersgf]

How to Find the Best Plastic Surgeon

Cosmetic surgery is among the simplest methods for correcting any bodily imperfection or improving the looks. Though expensive, plastic surgery permits you to attain any appearance -- you may become the epitome of how"ideal" if you would like to.

 Reaching your desired outcome from plastic surgery chiefly is based upon the plastic surgeon that you operate with. If you're trying to find a plastic surgeon Santa Barbara or even any place on earth, employ these tips so you are going to wind up hiring the very best.

     Simply utilize a plastic surgeon who's board certified.

 In contrast to popular belief, state health boards are not sufficient to ensure that a plastic surgeon is commendable; he or she must also be qualified with the American Board of Cosmetic Dentistry since it provides education, certification, and coaching to get plastic surgeons. Dealing with a plastic surgeon Who's board certified can Provide you the following advantages:

     You're going to be at ease knowing that you have entrusted your own body (and cash ) to your trained and skilled plastic surgeon.

     You will not wind up working with a physician who is only proficient in general operation or other medical care. Simply speaking, you are going to save yourself from receiving disappointing results which may result in more prices.

     The process you will experience is dependent upon what you need or aims. If you do not like the way your nose appears, a nose lift may be the solution you're searching for. As soon as you've already decided what process to get, start looking for a plastic surgeon who's board certified and has adequate knowledge in that process. You can request the next questions to gauge a plastic surgeon's experience:

       Have you been trained using the process I am thinking about? How?

       Just how long are you doing this process?

       The number of customers have you had for this particular process?

         Contemplating referrals is an simple approach to simplify the procedure, but only as your friend was delighted with the outcomes of the process does not signify you ought to employ his plastic surgeon straight away. As a means of ensuring that you Employ a plastic surgeon that shares a similar aesthetic feeling as you can, think about the following:

           Consider the before and after pictures of this plastic surgeon's customers. If you presently have a listing of alternatives, compare the outcomes for the processes you desire. Which one of the surgeons delivered outcomes that agree with your tastes? If you are intending to get facial processes, start looking for customers having exactly the exact same facial structure, demographics, and worries as you. For breast surgeries, start looking for customers who possess exactly the exact same breast form and chest.

           Assess whether the plastic surgeon reveals consistency with her or his services. The plastic surgeon customers should reveal similar outcomes, particularly for comparable processes. Is this the way you imagine yourself following the process?

             Obtaining your very first plastic surgery can be exceedingly nerve-wracking. This is why choosing a plastic surgeon that makes you feel comfy ought to be at the top of your listing. It all will come off easier after you operate with a plastic surgeon and employees that make you feel protected and secured. Do not forget to inquire about these questions before Selecting a plastic surgeon:

               Can I enjoy the plastic surgeon's character?

               Can I expect that the plastic surgeon's recommendations and services?

               Can I really feel comfortable requesting the plastic surgeon questions regarding my process?

                Together with the wisdom of the plastic surgeon, then the working facility may make or break the success of the process. If the centers are unsanitary or are not equipped with the essential equipment and tools, you might not obtain the outcomes that you desire. Worse, the process might even set your own life in danger. Steer clear from this management by performing the following:

                  Inquire in the surgeon in the place where they execute their operations and discover out its degree of certification.

                  Request for the credentials of this anesthetist, also.

                    Make the most of the appointment to understand important facts concerning the process and what will you expect as a customer. Communication is vital to the achievement of almost any plastic surgery, so ensure the plastic surgeon understands what you would like. Be Ready for the appointment by drafting a few queries, for example:

                      Just how long does the operation last? Are there any foods or beverages to prevent as a prep for the operation?

                      Just how much does the operation price?

                    Just Pick the Ideal

                    Cosmetic surgery has become the topic of several controversies for the decades. But if you've decided to undergo a process for your advantage, by all means, proceed! Just be certain you simply entrust your own body to the ideal plastic surgeon. You do not wish to cover a hefty amount of money and end up being frustrated with the outcome ?

SCHEDULE A CONSULTATION

Interested in know about the best plastic surgeon in Santa Barbara?  Whether you are thinking about having cosmetic surgery, a non-surgical procedure or have had prior surgery and are seeking additional touch-ups, it is critical to work with a skilled plastic surgeon that specializes in facial procedures. Dr. Robert Sheffield is a board-certified facial plastic surgeon at SB Aesthetics offering services to those in Santa Barbara, Santa Maria, San Luis Obispo, Oxnard and Ventura, CA, and the surrounding communities.  Dr. Sheffield offers patients a customized treatment plan and is available to answer your questions. To schedule a consultation, call 805.318.3280 today.

SB Aesthetics

https://sbaesthetics.com 2320 BATH ST #203 SANTA BARBARA, CA 93105 P: (805) 318-3280 E: info@sbaesthetics.com