#mtx surgery

[androgyny2018]

So my insurer has pulled a new stunt. Since FFS consists of multiple procedures, they want each procedure done in a separate surgery. I was going to go ahead and do it all at once and sort it out afterwards, but the surgeon's office couldn't schedule a long enough block for "cosmetic" surgery with any nearby hospitals.

So I'm having partial FFS (covered by insurance) in about 2 weeks. My bottom surgery revision is already scheduled 3 months after that and that surgeon requires 3 months between any previous surgery and the revision. The FFS surgeon requires only 6 weeks between procedures, so it's likely that I'll schedule something 6ish weeks after my revision to do the rest of the FFS. Hopefully my insurer will have realized by then that doing all the remaining procedures at once saves money, stress on my body, and most especially healing time.

Also, while my lawyer was helping with the appeal for the revision, they asked me to resubmit the referral to my insurer. Upon receiving their response, my insurer gave preauthorization. Go figure. I can only assume that my having pulled out a lawyer in the past has influenced their revised decision.

That's all for now. Updates maybe in 2-3 weeks (cause I'm clearly so good at doing things when I say I will).

[genderkoolaid]

hi!! ik youve posted about wanting/having both a penis and a vagina simultaneously, and it’s something that ive been kind curious about, but im not sure exactly how it would work. as someone who currently has a vagina, if i were to undergo bottom surgery to get a penis while still having a vagina, where would they both go? thank for the blog btw, both it and you are very cool!!

thank you!! the term for this is "salmacian" btw :)

there's a few ways it could go. if you get metoidioplasty without vaginectomy, nothing really changes other than your bottom growth becoming more prominent and possible getting testicles.

if you get phalloplasty, you can either have it placed over your bottom growth (called burying) or not (unburied), in which case your penis would be slightly higher on your pelvis than your natal phallus would be. r/phallo has a lot of photographs of people post-op which should give you some idea of where phallo dicks are placed. In all cases, the vagina really isn't touched so it stays where it is.

Tbh for FTM/FTX people, salmacian surgery is kind of easier, since penis-creating bottom surgery has never involved the use of vaginal tissue. Vagina-creating bottom surgery on the other hand traditionally uses the penis to create the neovagina, which is why there's a lot of FTM/FTX people who end up salmacian without realizing its a Thing while MTF/MTX salmacians really have to be aware that penile-preserving vaginoplasty exists in the first place.

[genderqueerdykes]

hi!

what do you think about old words like FtM and MtF? (and I guess FtX, MtX, ItX, ItF, ItM)

it would be cool if young trans people share their thoughts too!

are they still comfortable for someone?

idk I just realized it's less dysphoric than AGAB form.

AGAB sounds like it's forever with you, meanwhile XtX sounds like escaping/transitioning from "not you" to "you"

of course it also sounds like if person "was" female (FtM) or male (MtF), which it not true

I personally just found out recently I'm okay with ?tX lol

hello, thanks for asking!

FTM and MTF aren't very old terms, they are still widely used and in fact the primary subreddit for trans men, transmascs and other masc aligned trans folk is r/FTM. i noticed you said it sounds like the person "was" female if FTM or "was" male as MTF, which is not what the terms mean, and also, some trans people do identify as having been female before transitioning to male or male before transitioning to male. if you read the interviews contained within To Survive on This Shore you will read the stories of a lot of trans people who did in fact love their lives as the other gender before they transitioned. while a lot of people do not like that rhetoric, some do, and it's not fair to try to erase their experiences for the sake of 'inclusive language'. people can define these terms or not use them as they please

FTM and MTF are not offensive, bad, or outdated terms in any way shape or form.

keep in mind that this line of thinking is a fundamental misunderstanding of what FTM and MTF actually mean. the the "F" in FTM refers to that person's biological sex marker- as in, you are changing your biological sex in some way to go from what was assigned/viewed as F to M. the opposite is true for MTF.

FTM is not a term that's just for trans men and MTF is not just for trans women. these terms refer to the changing of your biological sex, so an FTM person could be anything from a trans man to an FTM identifying transsexual butch lesbian. MTF people can be trans women or drag queens who take hormones and get surgeries. it can be a wide range of things, and while i can see it being uncomfortable for some, in others, they are loved and appreciated terms with a lot of history and are inclusive. i am not AFAB in the sense that i have a 100% "biologically female body" and I still identify with the term FTM because I find the X/I terms clunky. i have been using FTM for a decade now, i'm not going to trash it just because of a misinterpretation of what it means

also AGAB just literally refers to the gender you were assigned at birth. it's not really "permanent" it's a snap decision that was made when you were underdeveloped as a newborn baby. biological sex can be altered freely at will. to be brutally honest with you anon, i actually really detest the logic that the XtY labels are "escaping" something "to become your true self" for every trans person- i really would not apply this logic to anyone but yourself. this sounds very much like a you thing and not something that suits the entire trans community and this could be very offensive to some trans folk. many FTM butches are still women. many FTM drag queens are still men. p

i am very glad to hear you are okay with that term! I personally find the ?/X terms clunky so i don't use them for myself. i am FtMtF or FtMF. i'm glad it you found what works for you. I'm not a fan of implying FTM and MTF are bad or outdated, and i think it's exhausting to try to cycle them out of the common vernacular or do a big reach and assume it means something that it doesn't. it's a term that people can use if they want to, but trans men are under no obligation to use FTM and trans women are under no obligation to use MTF. they're terms you can use if they find they suit you, and folks who are made happy by them deserve to get to keep terms that weren't offensive to begin with

hope this makes sense, take care

[bearphase]

Sorry for the millionth vanishing act

Working on Sims stuff again, though! Anyway, rant/vent under the cut.

This month has been hard. I need (just a fairly minor non-urgent thing, not dying, dw) surgery, it was scheduled for the nineteenth, and I suddenly had it canceled and have had to find a new surgeon in network. Basically, I'm on humira and methotrexate for psoriatic arthritis, and my rheumatologist advised I go off only humira for surgery and continue mtx, but my surgeon wanted me off mtx, too, and two whole weeks in advance. So, I did that and developed a massive patch of psoriasis (I have psoriatic arthritis, after all) right where they needed to operate, which they can't operate on (unless it's an emergency, I'd assume.) So, they ask me to talk to my rheum about "alternate plans". Rheum says to stay on methotrexate, like she originally said, so I don't get a psoriasis flare right before surgery. Surgeon's office says no. It ended up as a massive back-and-forth of "you need no psoriasis AND no psoriasis meds" vs "that would be a literal miracle, why the fuck do you think I'm on the meds?" (except... politely.) Until the nurse (I haven't gotten to speak to the surgeon at all) said she'd discuss with the surgeon and... ghosted me entirely! No more replies. I scheduled the surgery months in advance and planned to be unable to do much for a couple weeks, too, which makes this even more annoying. My consultation with the other surgeon isn't until June, either.

[androphagy]

i appreciate and agree with that post where you talk about how "transfemininity is not a separate form of womanhood" but why do you have to refer to cis women as "anatomically female" ? because trans women aren't "anatomically male" thats just upholding the sex binary in a way that contributes to us (trans women) being seen as something separate or deluded

oh i meant as in "has a vagina" but in my reading and research it's a term i see used instead of AFAB, as AFAB doesn't cover internal intersex characteristics and CAFAB is specifically in relation to intersex gender assignment (with coercive being the first letter.) so i suppose i could use CAFAB/AFAB, but then that also groups together what can be very different situations person-to-person with gender assignment at birth and "corrective" assignment at a later date. anatomically female in the case of my writing just means a uterus, ovaries, vagina, and the "usual" external anatomy (though that varies as well with born superficial anatomical differences such as a lack of a labia minora, for example.) trans men and transmascs are also anatomically female until/if they have surgery to create a penis, testicles, etc. believe me, i would do away with male/female altogether if i could, but unfortunately for the culture and history i'm writing in relation to there's not another sex-based dichotomy in which i can use.

it's a situation i wish didn't have to have a delineation at all, but there are genital differences that are important to make distinctions on when speaking on certain transgender issues -- especially relating to SRS and other forms of gender affirming care. i'm still anatomically female as i'm not intersex and haven't had SRS yet (though hoping to change that next year!) though i have modified sex characteristics such as a large clitoris and flat chest due to my recent bilateral mastectomy. the same is for trans women and transfems when they develop breasts, fat deposits, and if genital atrophy occurs (along with many other changes estrogen can induce! there are a few different hormones and anti-androgens which can impact different things, so it varies.)

that's all i meant by anatomically female :) i hope i didn't come across as mansplain-y, transgender hormone therapy, history, and culture is something i'm very interested in, both MTF and FTM; unfortunately i'm less versed in FTX and MTX, as i'm in a certain "field" right now, but i do intend to learn more about nonbinary affirmative surgery and care.

i know the comparison is very overdone, but it truly is a metamorphosis akin to a caterpillar to butterfly. the human body's "base state" being able to be changed and modified so thoroughly to match what an individual really wants, instead of what they're born with, is amazing. the first phalloplasty was actually done in 1936, but it wouldn't be until 1946 that the first trans man would have one done, and that took 13 procedures over 4 years! if you're interested, i can see if i can crack a few of these papers/books and i can provide some readings.

i'm sorry that this got so long; with everything, there are going to be pros and cons with the language you use, and there's always going to be issues with the terminology, especially when it's a delicate subject with such a massive range of experiences. thank you for your message and for weighing in!! i will look more into alternative terms, though i really want to avoid using terminology like "penis-havers" or listing out all of the individual anatomical parts.

[virovac]

I am not well.. My condition is getting worse and my health is unstable... Next week I will travel to Egypt to undergo surgery. I was injured in the war when our house was bombed... The missile fragments scattered and flew and hit my leg and hand, but until now the doctors have not removed them from my body because they are internal and stable and not superficial. I pray to God to heal me. Please help me and send me 25€ today. There is only 550€ left of the cost of the operation. God willing, before I travel, I will have collected the cost of the operation.

DM me if want to be removed  @z-moves @togekissangel468 @jezabatlovesbats @m0nsterwife @terminarch4 @yarch0 @endy-boi @huevobuevo @nomadic-star @thunder-jack @artymajig @foxpunk @vicesario @addictwiththeart @dracudyke @2deadkat @bukesstuff @4gentm0thman @randommmmie @mtx-lol @hgf-the-fairy @imasadidiot @donsofwaste @spicyc3darw00d @mixingmetaphorsoup @mazm-imagines, @muslimintp-1999-girl @7yrannic @fifthnormani / @wouldntyou-liketoknow @bbluberrys @tardytotheparty1114 @angelicdevil @these-veins-are-borrowed @hungry-joe @king-bombinopples @notedchampagne @breezydays-cloudyaus @ringosnoop @itsonlyonceinalifetime @a-regular-octopus @psychicisopod @yellowstriipes @fruityfruit-salad

Please, friends,

remained less than 700 euros only to reach 5 thousand euros.

Please donate and contribute, do not stop our support,

we are close to the goal of 5000 euros

thanks to God first, then thanks to your donations,

you approached the goal of 5000 euros, where you reached 4317 euros.

4317euros 👉5000euros

Our life, even the smallest donation makes a difference.

Will it help us achieve our goal?

And in my help with treatment abroad to perform surgery, save my life, please 🙏

✅️Vetted by @gazavetters, my number verified on the list is ( #370 )✅️

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[normalbirb]

Anyone interested in top surgery, but like scared of surgeries: the surgery itself is the easy part. Like you don't even have to do anything. Its what comes after that's stressful. But even that will pass and after that it will be all done.

[hopefultrans]

Once I medically transition I'll

Like mirrors much more

[androgyny2018]

More denials

Scheduling for FFS is set for December, vaginoplasty revision in March.

My health insurer has denied my referral to Dr Gupta. I'm working with a lawyer and we've caught a technical snag because the referral/denial were mistakenly for office visits, not for surgery. My PCP, who made the initial referral, is on vacation, so I met with a primary care doctor with my insurance who was surprisingly accepting and professional about my nonbinary goals, not something I have come to expect from most doctors.

So the proper referral should be in place and when it gets expectedly denied, lawyer stuff can proceed.

Meanwhile FFS is mostly covered (apparently some procedures to relieve my dysphoria are considered "beautification" rather than "facial feminization") and everything is in place for that. I plan to make a claim for the uncovered parts after surgery.

Whatever happens though, I will be proceeding with both surgeries, even if I have to self-pay part or all of it. My insurer has held me back for the last 6.5 years and I'm very done with it.

[genderkoolaid]

also stop assuming every nonbinary/genderqueer person has a body you'd expect from their gender assigned at birth. stop assuming every FTX person is perceived as a woman by society and/or (only) has a vagina, stop assuming every MTX person is perceived as a man and/or (only) has a penis. & stop assuming someone getting surgery means they are moving closer to cis-passing, when there are many people who medically transition and come out the other side even more visibly trans than before.

anyway. include post op trans people in your activism now

[findinghaven]

Nonbinary surgical transition

CW: Discussions of gender affirmation surgery, medical interventions, genitals, and sex

I’ve long dreamed of what it would be like to have a physical/surgical nonbinary transition. But in a world where gender affirmation surgery is hard to get in the first place and surgical interventions continue to be binary focused, it is hard to see where I fit and what is possible. The body I’ve dreamed about long before I knew I was trans had breasts, smooth skin, a penis (that in my dreams is…

[doctorfoxtor]

post ain't long it's wrong, can't study till dawn? yawn

100 days of productivity

day 44 + 45

CVS/RS

rheumatoid pleural effusions closely mimic complicated parapneumonic effusion on analysis, w/ ph <7.2, marked ↑LDH and notably glucose <30 (in fact glucose >30 almost rules out rheumatoid effusion)

in afib, digoxin will slow ventricular rate but is unlikely to cardiovert the rhythm

itraconazole in ABPA causes a 50% reduction in steroid dose and 25% reduction in anti-aspergillus IgE, and either partial or complete resolution of CXR infiltrates or improvement in PFTs/exercise tolerance

TRALI can happen as early as 15 minutes into the transfusion apparently?????

mesothelioma is an abject death sentence. The most you can do for patients beyond stage 1 is chemotherapy (limited survival benefit with platinics), radiotherapy to biopsy/thoracoscopy tracts only and surgery (lung-sparing debulking ± pleurodesis for recurrent effusions; radical surgery has shown no survival benefit)

mild tachy + broad qRs in haemodynamically stable pt s/p PCI for MI → likely to be LBBB developing; watch and wait

CNS/Ophthal/Psych

PSP looks similar to parkinson's bc it affects the opposite pathway as parkinsons (striatonigral vs nigrostriatal)

the best response you can get from deep brain stimulation for parkinsons = the best response you got from medication; DBS will NOT add a greater response compared to maximum medical therapy

without any other information, parkinson's ssx w/ dementia WITHIN 1 year of onset, it's Lewy body dementia; if it's more than 1 year, it's parkinson's w/ 2° dementia

choroidal neovascularisation with NO OTHER fundal signs: wet mac degen > diabetic retinopathy

focal dystonias are better treated with botox than with medication

SAH is unlikely to cause cranial nerve palsies other than III and maybe VI; pituitary apoplexy presents similarly with very severe headache/projectile vomiting/AMS, while affecting nerves III, IV, V-1 and VI

MS relapse: 500 mg PO or 1 g IV methylpred x5 days

there is no difference in risk of progression to Korsakoff when Wernicke is treated w/ glucose first vs w/ thiamine first

Endocrine/Repro

hyperaldosteronism: hyperplasia > adenoma

acute alcohol consumption can trigger hypoglycaemic events as the liver uses up NAD+ for each step of the alcohol detox pathway, where NAD+ is an important cofactor for the malate-oxalate shuttle used in gluconeogenesis

cinacalcet's major indication is hyperparathyroidism taht can't be corrected w/ surgery (eg, unfit pts)

Rheum/Derm/Immuno

topical steroid potency: hydrocortisone < clobetasol butyrate, betamethasone valerate low-dose < betamethasone valerate high-dose, fluticasone propionate < clobetasol propionate

onycholysis: trauma, tinea (infections), thyrotoxicosis, tetracyclines

pseudoxanthoma elasticum is assoc w/ mitral prolapse, renovascular htn, PVD, CAD, GIT bleeds and retinal vessel abnormalities

IgE values are normally distributed, so about 2.5% of the pop has raised IgE and 2.5% has reduced

s/p parathyroidectomy → acute drop in PTH → bones that are used to high levels of PTH experience a relative hypoPTHism → ↑blastic ↓clastic activity → acute bony uptake of calcium, PO4 and importantly magnesium = hungry bone syndrome (replace calcium and magnesium!)

carpal tunnel pain can radiate retrogradely to the forearm and sometimes even the arm

periarticular osteoporosis → RA

punched out erosions in juxtaarticular bone → gout

GIT

Peutz-Jeghers: small bowel hamartomas → intussusception, colorectal cancer, pigmented lesions (classically perioral/mucosal, but also palms/soles)

pernicious anaemia: parietal cell Abs (common) > intrinsic factor Abs (specific)

haemochromatosis: venesection → keep ferritin <50 and transferrin sat <50%

passing stools frequently, elevated inflammatory markers, ↑faecal calprotectin, PPI but not in demographic for IBD → take a colonoscopy and biopsy, this is probably microscopic colitis (and PPIs can trigger at any age)

liver biopsy is not indicated for Gilbert's—it is sufficient to do routine CBCs/LFTs w/ bilirubin analysis

pancreolauryl (fluorescein dilaurate) is quite nonspecific and will not pinpoint the exact pancreatic disease

hep A can be precided by short diarrhoeal illness`

in an IBD (esp UC) pt who comes >10 yrs after initial symptoms with recent change in bowel habits, offer urgent colonoscopy to r/o ca colon BEFORE starting on treatment

Onc/Haem

MTX + antifolate antibiotics: makes sense not to give them together—they can cause fulminant marrow failure

leukaemia can very rarely lead to acute painful scrotal swelling

5q- syndrome = myelodysplasia, but with thrombocytosis; diff from essential thrombocythaemia by anaemia with normal reticulocyte count and leukopaenia in the former

radiotherapy is a primary modality of tx in retinal, CNS, skin, oesophageal, cervical, vaginal and prostatic tumours; it is adjuvant in all other tumours

the commonest presentations of CMV s/p txp are pneumonia or pulmonary infiltrates

Renal/Biochem

SIADH causing drugs - SIADH Causes Poor Voiding: Sedatives (barbiturates), Indomethacin (NSAIDs), Antidepressants (TCAs/SSRIs), thiazide Diuretics, 1st gen antiHistamines, Cyclophosphamide/antiConvulsants, 1st gen antiPsychotics, Vinca alkaloids

malaria: irreversible nephrosis (esp memb or FSGS) > nephritis

2° syphilis: reversible nephritis > nephrosis

even if the patient doesn't qualify for ACEis/ARBs for HTN, give them first-line anyway if concomitant renal disease

kidney size difference >1 cm is significant

for drugs that will be dialysed out on dialysis days, dose them immediately after dialysis on those days

only urge incontinence is not primarily managed with pelvic floor exercises

Pharm/Toxo

valproate ADRs - VALPROATE: Vomiting, Alopecia/Anorexia, Liver tox, Pancreatitis/PCOS, Redistributed fat (weight gain/lipodystrophy), Oedema, hyperAmmonaemia/Ataxia, Tremor/Thrombocytopaenia, Enzyme inhibitor

opioid withdrawal: methadone is the best single tx and avoids needing to give multiple drugs to cover ssx (eg, clonidine + dextromethorphan + loperamide)

aminoglycosides preferentially affect proximal tubular cells

the classic pattern of symptoms in both cotton workers and workers at factories that process nitrates is that of 'Monday disease'

toxicities for which measuring the blood levels is indicated - SLIME TiPP: Salicylates, Lithium, Iron, Methanol, Ethylene glycol, Theophylline, Paraquat, Paracetamol

amphetamine tox → hyponatraemia due to water retention, worsened by the excessive thirst; hyperkalaemia → rhabdo; hypokalaemia not seen because amphetamines tho sympathetomimetic do not have affinity for the β2 receptor like cocaine does

[shinmegamitensei2]

"topsurgery.net is a site with lots of before + after pics categorised by surgeon. I encourage everyone with other resources on srs surgeons and their results to share them here, for mtf/mtx surgeries too please"

posting this here so that ppl can reblog without being forced to see fucking medical trauma

[virovac]

Sorry for spamming this . You probably remember just last night I made sure his wife could get surgery by spreading around

DM me if don't want to be included

@z-moves @togekissangel468 @jezabatlovesbats @m0nsterwife

@bilal-salah0 @acehimbo @terminarch4

@yarch0 @endy-boi @zone0neko @huevobuevo

@nomadic-star @thunder-jack @artymajig

@foxpunk @vicesario @addictwiththeart  @autisticmudkip

@dracudyke @2deadkat @bukesstuff @4gentm0thman

@randommmmie @mtx-lol @hgf-the-fairy @imasadidiot @donsofwaste

@spicyc3darw00d @mixingmetaphorsoup @mazm-imagines, @muslimintp-1999-girl

@7yrannic @fifthnormani / @good-old-gossip @wouldntyou-liketoknow @bbluberrys

@tardytotheparty1114 @magentasky234

@angelicdevil @these-veins-are-borrowed @hungry-joe

VERY important post!

@abood-gaza51 sent me these messages a few hours ago, he is in serious danger and URGENTLY needs donations to be able to move to a safe place!!

He told me that the money would arrive faster with PayPal donations, so please donate at least a little to him. We are talking about a life, he urgently needs help. If you can't donate, share as much as you can!

he also has a gofundme campaign which is also vetted!

[mcatmemoranda]

Choriocarcinoma that occurs after normal pregnancy has worst prognosis. That would be sad to have a baby and then die from choriocarcinoma. It likes to metastasize to the lungs and brain. It’s treated with surgery and chemo (“MAC” = MTX, Actinomycin D, Cyclophosphamide).

[andisupreme]

In case this is a new thing because I’ve been kinda bad about keeping tumblr up to date since starting to use Twitter more--the chronological series of events:

I saw the local plastic surgeon hoping to get assessed for either aggressive breast reduction or MTX top surgery. It wasn’t exactly a great and gender-affirming time and in the second consultation, she said she would need a therapist note for top surgery even if I paid out of pocket.  “Okay,” I said, “then what about aggressive breast reduction? I meet the insurance requirements for reduction you said.”  “I would take you down to a C according to their usual standards. Any smaller than that and I’d still need a letter from a therapist to prove you’ve thought this through.”  “Even if I paid out of pocket?” “Yes.”

So I took the hard stance that FINE I’ll go through the therapist rigamarole to just get it done right the first time but I work an 8-5 weekday job that makes appointments really hard to set. And my back pain’s been really bad lately so I’ve been wondering if I should just give in and let her take me down to a C so I can at least be in less pain while I try to take care of gender stuff in the bg??