ts-adventure

[ts-adventure]

6/4/2019: showtime!

(Cw for medical stuff throughout.)

On Monday, June 3, me and my parents drove up to Madison and settled into a hotel. I was given very specific instructions on how to shower that night and the next morning, with a special antiseptic soap. I barely slept that night, I was so excited.

June 4, we woke up at 4:30 in the morning. Our appointment was at 6:15, and we wanted to be totally sure we would make it on time. We did--we were the very first people in that day and they had to unlock the doors for us. I was starving, but I couldn't eat or drink because anaesthesia.

Once we checked in and were called, my parents got a number to "track" me with as the surgery progressed. We went to a hospital room with an attached bathroom. I was given a gown and nonslip socks to change into. The nurse took my clothes and glasses and arranged to send them to the room I would recover in. I also had to give a urine sample for a pregnancy test. Then me and my parents sat in the room and waited. Dr. King, a few nurses, one of the anesthesiologists, and another surgeon all trickled in and out of the room, introducing themselves and making sure we were doing okay. This is about when I really started getting nervous.

They hooked me up to an IV, in the back of my hand, not my inner elbow, and had me take some meds--painkillers, anti-inflammatory, and lower blood pressure, I think. They also stuck an anti-nausea patch behind my ear. Then my parents filed out and the nurses added the first bit of anesthesia meds to my IV and wheeled my bed into the surgical room. I started zoning out pretty quick--they put an oxygen mask on me to speed it along, I think.

Then I woke up in the post-op recovery room. I felt fine, though I didn't want to move. There was a very thick, stretchy binder over my chest, pulled very tight with cotton and dressings packed underneath, and I had a catheter in. A nurse was there and he talked me through how the rest of the day would go. Then they wheeled me to a different hospital room, and my parents came in.

We hung out there all day, with me dozing off every few minutes as the anesthesia wore off. Our nurse (an incredibly friendly, funny woman) kept an eye on us, taught us how to empty the drains, all that good stuff. We ordered dinner from the hospital cafeteria once I felt up to eating. Terrible food, but not inedible. The nausea patch worked--I felt woozy and a little dizzy, but I could eat. My parents decided that my dad would stay the night with me, and my mom would spend the night at the hotel working out logistics.

We were the only overnight patients. Once everyone else cleared out, we were moved to another room with an attached bathroom. My drains were barely filling, which everyone said was a good sign--the nurses checked every few hours for full drains or firmness under the skin. Me and my dad slept super cramped, and the nurse came in at 4:00 AM on Wednesday to take out my catheter and IV. This was nowhere near as unpleasant as I was expecting--honestly, the tape that had been holding the pipes to my skin was far more painful.

My mom brought the car up, and my dad and I went to meet her at about 5 AM. My pain meds were wearing off, and the ride back to the hotel kind of sucked. They set me up first in the chair and then in bed, and I took more pain meds and started feeling better. My mom got me breakfast.

We stayed in the hotel room all morning, with me zoning in and out and falling asleep and waking up. I checked my drains and they still weren't full enough to bother emptying. My mom got us all lunch, and then we headed to our first post-op appointment at 1:45.

Dr. King looked me over, and had me lie down. He undid the binder, which was held on with velcro, and pulled out the massive hunk of cotton. He checked the drains and incisions, and felt my chest to see if there was fluid buildup--my pain meds were wearing off again, and my chest felt very bruised. He laid a soft absorbent sheet of dressing over the incision sites and wrapped me back up in the binder, not as tightly this time. Then we headed home.

Right now I'm chilling at the kitchen table before going back to my room to start resting again. They had me breathing through a tube durning surgery, and even though I don't at all remember having it in, it left me with a seriously sore throat that I'm drinking honey tea to deal with. I feel sleepy and out of it, and my chest is kind of sore, but I'm closer to functional than I really expected to be.

Second post-op appointment is next Monday, and that's when the drains will come out. Meanwhile, I'm just gonna rest.

[ts-adventure]

5/17/19: early prep

18 days till surgery!

This week, Dr. King's office mailed me a giant folder full of details on pre- and post-op care, including a big list of medications to stop taking and very specific instructions for showering the morning before surgery. Then they called me and basically walked me through/gave an overview of what was in the folder.

Props to them for keeping me in the loop! We have to go and buy a specific, super antibacterial kind of soap for the night/morning before surgery, but other than that, everything is in line with what I expected.

[ts-adventure]

Pre-op pics (4/2/19)

Seemed like a good time to do “before” pics, front-and-side. Sfw/shirt on--didn’t want to risk getting flagged. I’ll do afters in the same shirt. 

With binder:

No binder:

...notice how the binder does next to nothing, jeez. 

[ts-adventure]

1-4-2019: the re-saga-ing

Okay, let’s play catch-up, since I somehow managed to get two full months out-of-date. Starting with Jan. 4, the day of my consultation. 

Mr. Counselor pulled through in a big way, and I got the letter with time to spare. Life lesson: be cheerful, kind, and acknowledge that you’re asking for a lot, and people will pull for you. 

On the morning of Jan. 4, I got a phone call from Dr. King’s office. Picked up and heard, “hey, you haven’t sent in your insurance card and pictures of your chest, so we’re cancelling your consultation.”

Life lesson 2: the best way to go from sleepy to Fully Awake is a hearty dose of sheer panic. 

I said, “Sorry about that, I was under the impression that I didn’t have to do that since my consultation is in-person.”

The person on the other end said, “Oh, really? Whoops. You’re back on the schedule.”

I said, “Thank you,” very carefully, rather than screaming at her, and hung up. 

The consultation went well. I hadn’t expected it to be just...in a doctor’s office, with a waiting room and lots of floors, just like a normal checkup. We signed in at the desk on the correct floor and waited to be called by a nurse, who did the usual preliminary height and weight check and gave me a gown to change into before Dr. King came in. 

Dr. King is the absentminded-professor type, kind of odd, which immediately put me and my parents at ease. He examined my chest, then we all talked about what he recommended (double-incision, no surprise there) and all our questions and concerns. 

I had a giant list of questions, making sure I really understood every part of the process from pre-care to healing, as did my parents, and Dr. King was very thorough in answering all of them. One main one for me was whether he performed inverted-T surgery, since I was interested in the chance to retain nipple sensitivity. He said he wouldn’t recommend it, not because he wasn’t confident in performing it, but because retaining the nipple stalk means the chest can’t get quite as flat as most people want. That was enough for me to settle on double-incision. 

The other big question was insurance. Dr. King, the insurance specialist, and every single nurse strongly encouraged us to pay out-of-pocket--because apparently, fairly often, the total cost after insurance is higher than Dr. King’s out-of-pocket quote of $11k. 

Well, that confused all of us, so Dr. King explained. Dr. King apparently goes out of his way to file the corners off every fee--that $11k is close to the bare minimum the surgery could cost--while it’s in the best interest of the insurance company to find the absolute maximum cost for everything. You’ve seen that post of the bill charging $10 per Hall’s cough drop? The insurance bill would calculate the cost including, for example, the price of every length of gauze--whereas the hospital could absorb that cost. So 30% of the total cost the insurance company calculated could easily be more than 100% of the out-of-pocket cost Dr. King calculated. 

My parents are better with money than me, and I’m not the one paying for this, so I didn’t do much talking. They eventually concluded that, while King’s account was probably exaggerated in some areas, it might be worth it to consider paying out-of-pocket. Because we wanted time to talk about it, we didn’t schedule the surgery that day. The nurse took some pictures of my chest, and we headed out. 

A few days later, we were confident. I called the office (again, I must have dialed that number about fifteen times at this point) and scheduled the surgery, arranging to pay out-of-pocket. I referred them to my mom to pay the confirmation fee and work out the other payment details. 

Final surgery date: Tuesday, June 4. The surgery will be at 6 AM, with some wiggle room for a pre-surgery appointment that will be scheduled a day or so beforehand. We’ll stay in a hotel in Madison the night before to save us from being on the road at 5 in the morning. 

As of the day I’m writing this update (March 1, 2019), I’m getting top surgery in 95 days!

[ts-adventure]

12-11-2018: the saga continues

I called again today, with much better results. Here’s how it’s supposed to go: I called, said, “Hi, I’d like to schedule a top surgery consultation with Dr. King?” The person on the other end set a chart up for me (they needed my name, date of birth, permanent/non-campus address, phone number, primary care physician which I don’t have, and an emergency contact’s name and number). 

Then they scheduled me a consultation!!! Friday, Jan 4, at 3:15. 

Which means I need to very quickly get that referral letter from that therapist. Like, before break starts in three days quickly. 

And we’re moving! At suddenly breakneck speeds, progress is being made!

(Hey, if you’re reading this soon after I post it, send good vibes that the letter business gets worked out quickly. I could sure use it.)

[ts-adventure]

12-11-2018: the saga of Last Friday

Ok, now that I’ve calmed down a little, here is What Happened Last Friday. 

So I call the number on Dr. King’s website, and a flustered-sounding person in a very loud room picks up. I say, “Hi, I’d like to schedule a top surgery consultation with Dr. King?” They say, “Uhhh, let me transfer you, can you hold?” I say, “Yeah, thank you.”

I get put on hold, and a more professional-sounding person somewhere a lot quieter picks up. I say, “Hi, I’d like to schedule a top surgery consultation with Dr. King?” They say, “Um, this is the front desk, we can’t do that here. Let me transfer you, can you hold?” I say, “Yeah, thank you.”

I get put on hold, and another professional-sounding person picks up. I say, “Hi, I’d like to schedule a top surgery consultation with Dr. King?” They say, “Okay, do you have a chart with us? Have you figured stuff out with your insurance?” I say, “No, not yet.” They say, “Okay, you’ll need to do that first. Let me transfer you, can you hold?” I say, “Yeah, thank you.”

I hit someone’s voicemail. It tells me to leave my name and date of birth. I do, and say, “I’d like to schedule a top surgery consultation with Dr. King?”

Five minutes later someone calls me back. They say “I don’t know why you got transferred to me, I’m the one who talks to the insurance and gets approval after you’ve had the consultation. You should be talking the the schedulers. Let me transfer you, can you hold?” I say, “Yeah, thank you.”

I get put on hold, and the call drops. 

So I gave up, and tried again today, with results that will be the topic of a different post. 

[ts-adventure]

12-7-18: cursed bureaucracy

Just got off the phone with Dr. King's office. Got transferred three separate times, and wound up having to leave a message on the voicemail of the last one. Fun times were had by all! Buckle up for some phone tag.

[ts-adventure]

11-13-18: an advancement!

Dr. King's office emailed me! That's the good news. The bad news is they emailed me to TELL ME TO CALL THEM. Ugh.

So now the next step is to prep for that call. Which mainly means getting both my parents' schedules from now until God knows when, plus mine for next semester (which I won't have until I register for classes), and then coming up with a script so I don't actually dissolve from stress.

I repeat: Ugh. We're getting there. Dragging ourselves hand over hand by the fingernails, but we're getting there.

[ts-adventure]

11-10-18: *impatient noises*

I re-emailed Dr. King earlier, because I wasn’t 100% sure I’d put in my info right the first time, and I figure almost a month is long enough to make that a legitimate concern. This time I double-checked!

I hope he gets back to me soon. Yesterday I realized that it’s not a matter of how long I’m willing to wait for this, it’s a matter of how long I can survive without it. 

Hey, we got this. One day at a time. 

[ts-adventure]

10-17-2018: insurance chats

Hi! Phone anxiety stinks, but I made the call and got the info. My plan covers 70% of the surgery cost, and Dr. King is in-network! I passed that info along to my parents. The next step is to set up a consultation with Dr. King (over email, thank god), and in the meantime go back to the counseling people and get a letter that hits all the requirements we can figure out. I’ll ask Dr. King what he thinks the insurance’s requirements will be, and we’ll work from there!

[ts-adventure]

10-15-2018: introduction and catch-up

Hi there! For my first post, I’m just going to talk a bit about where I am right now and the steps I took to get there. 

I’ve wanted top surgery since I was 16 in the summer of 2015, several months after I figured out my gender. It was mostly a vague idea back then, but I got more and more serious about it as high school went on and my dysphoria got more concrete. By the time I hit senior year in 2017, I was sure that I wanted top surgery--someday. 

College stress over the past couple of years, worsening my dysphoria, has pushed that “someday” into a definite “asap.” A month or so ago, in September of 2018, I took all the scattered research I’ve done on top surgery over the years (mostly through the incomparable @transgenderteensurvivalguide) and stuck it in a very rough google doc for fine-tuning. At that time, I also located my nearest top surgeon, Dr. Clifford King in Madison, Wisconsin, and saved his website (topsurgerymidwest.com) for future reference. Then I texted my parents and let them know that I’m serious about this. They were both supportive and offered to help however they could. 

A few weeks ago, I made an appointment with a therapist based on-campus and talked to him about trans stuff, knowing at that point that Dr. King requires a letter of support from a mental health professional and the insurance (Anthem/Blue Cross Blue Shield, through my mom’s work) might too. He said he was more than willing to write me a letter whenever I have more concrete plans and requirements. 

Earlier today, I condensed my rough google doc into a nice, concrete to-do list and set of questions for my surgeon (tailored to Dr. King). It looks like I’ll need double-incision or inverted-T. We live close enough to Madison (about a 2-hour drive) that I probably won’t have to stay in a hotel in the area, but that’s something I’ll have to talk to Dr. King about. 

My next step from here is to figure out whether my insurance will cover me, and if so, what I have to do to be eligible for coverage. To do that, I’m going to start by calling Dr. King’s office, asking to talk to the billing department, and asking them if they have experience with my insurance and can give me an idea of what will be involved. Then, if necessary, I’ll call the actual insurance people. Mainly I want to find out whether they need a letter with different contents than Dr. King’s, and whether I’ll need to pretend to be a guy or if they’ll cover nonbinary folks. 

That might take a while to get around to, because phone calls are scary and I don’t like them, but I have a script written up so fingers crossed. 

I’ll get back to you when I’ve made some phone calls and have some insurance information. See y’all next time!