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And Now For Something Completely Different … – Part IV

28 Tuesday Nov 2017

Posted by ts4jc in About Me, General Christian issues, General Transsexual issues

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answered prayer, AO Fox Hospital, Bala Cynwyd, balancing tasks, bathroom bills, blood test, cardiologist, curettage, Dr. Carolyn Wolf-Gould, Dr. Sherman Leis, early MTF transition, echocardiogram, EKG, estrogen, female, full schedule, Gender Reassignment Surgery, genital hair removal, genital size, God, God's will, GRS, identity, lab technician, MTF, multi-tasking, new technique, Oneonta NY, orchiectomy, painkiller, passing out, penile skin, personal gender, pubertal blockers, rename, sitting, standing, stress test, surgical risk, surgical technique, testicles, Transgender, undescended genitalia, urinalysis, urination, vaginoplasty

Fifty-four years later, prayers are answered

Sometimes God answers prayers with a yes.  He also has a couple of different ways of saying no.  One is, “No, I love you too much to give you that.”  Another is, “No, because I have something better in store for you.”

And then there’s the one most of us heard at some point in our childhood: “You’re too young now; maybe when you’re older.”  Of course, there is no maybe with the Lord.  He knows whether it will be a yes or a no.  But after all, we are His children.  And sometimes we do need to wait until we are older.

American girls – 1960’s style

I recognized my female identity when I was seven.  It didn’t become problematic until I was around age 10 or 11.  I was at that age that I started to pray that I would wake up with a girl’s body (an interesting prayer, since I still didn’t know what a naked girl’s body looked like).  And it was soon after that time that I renamed myself.  After all, if I trusted that God grants prayer requests, I needed to be prepared with a girl’s name to tell people.

Renaming wasn’t new to me.  By that age, I had heard the story of the younger sibling of a girl in my brother’s grammar school class.  When this sibling was born, the gender assigned at birth was female.  The child was given a female name and raised as a girl.  At some point in time before the sibling started school, the sibling started to complain about severe pains in the abdominal area.

When the doctors did their examination, it was found that this child was really a male who was born with genitalia that didn’t descend out of the body: therefore the female appearance at birth.  After surgery was performed to correct the problem, the child’s first name was masculinized and was now raised as a boy.  And by the time I was ten, I heard about this event.

(As a side note, some of the so-called “bathroom bills” aimed at restricting transgender people from using the bathroom that corresponds with their personal gender identity would require this person and others like him to use the women’s bathroom in public places.  Why?  Because his initial birth certificate identified him as female and that is one of the criteria in these bills for assigning the bathroom to use.  The result: a very masculine person in all other regards breaking the law if he uses the men’s bathroom in public.)

But back to my story: although the battle over dental insurance was ongoing, things had quieted down on the GRS front.  My hair removal was proceeding on schedule and by September, virtually all the dark hairs were removed.  I was ready for my pre-surgery visit with Dr. Sherman Leis on September 13, 2017.  This was where the rubber would truly meet the road.

One of the sobering parts of the meeting is the reading of the long list of possible risks of the surgery.  Some of them were minor and some were rare.  One or two risks were so rare that Dr. Leis said that he had never seen a case or heard of a case of it occurring.  Nevertheless, it was part of the list.  I was glad that death was not on the list.  I took a breath and signed a copy of the list that indicated that I had heard and received a copy.

One of the things that impressed me was that my surgeon stays current on technique.  If I understood him in terms of the time frame, he had learned a significantly new surgical technique compared to what he was using when I had seen him for the initial consult on 11/30/16.  Previously, after the orchiectomy (removal of the testicles), the remaining genitalia was completely removed.  To complete the vaginoplasty, the penile skin is sewn back in.  The surgical scar would roughly be in the shape of the letter “O”.

With the new technique, the remaining penile skin is not completely removed.  At the top of the genital area (i.e. the part furthest from the anus), the penile skin is left attached to the rest of the body.  Anything that needs to be done can be done from that position, but not as many nerves are detached and there continues to be a flow of blood into the penile skin at all times.  This new procedure reduces risk, such as risk of necrosis, and aids in healing the surgical area.  With this procedure, the surgical scar is roughly in the shape of the letter “U”.

Of course, I had some questions.  Someone in the transgender community asked me if Dr. Leis “scraped” (technical term: curettage) to remove any stray or gray hairs.  He said that he did not do so because penile skin is very thin and delicate and curettage tends to be harmful to it.  He would remove any stray and gray hairs with a needle (the only painless form of electrology, presuming the patient is totally knocked out on general anesthesia!).  He might have described it as a form of cauterization, but my memory may be less accurate on the term.

I also wanted to know why he hadn’t asked to examine my genital area.  Other trans women I had read about who either were post-op or were in the process had been examined to make sure they had sufficient depth without resorting to additional procedures.  Dr. Leis asked me I had a normal sex life and if my genitals had developed normally (i.e. not a micro penis or inhibited by using blockers from an early age).  When I responded in the affirmative, he told me that size would not be an issue.  (This can be an issue, however, for those who start their transition these days at a young age and go on pubertal blockers and then start on estrogen to block the effect of testosterone on their body.)

During the visit, we also discovered that I had a gap in coverage during the first two days after I left the hospital.  I could have sworn I was told that I would be in the hospital for five to seven days after the surgery.  It turns out that I was told (I found it later in my notes) that I would be released after three days.  I generally have a very good memory.  The only explanation I can think of is that I read about someone else going through GRS who was going to be released after 5-7 days (or who had that experience).

In some ways it didn’t matter.  None of the people who would be taking care of me for the 11-12 days after my release from the hospital were available for those two extra days.  (In the end the first person taking care of me rearranged her schedule, at a financial cost to her, to come a day earlier, so I was only basically on my own for one day.)  I tried a number of avenues, but another person could not be found who was willing and available to help.  More on my experience in a later post.

I left Bala Cynwyd with two scrips: one for a heavy-duty painkiller that could only be filled in PA.  I held onto that rather than carry around the painkillers for three weeks.  I would fill it the day before the surgery.  The other scrip was for medical tests: blood work, urinalysis and an EKG.

At this point, I was doing my best to balance my preparations for my GRS, my teeth issues and the needs of my clients.  Looking (unsuccessfully) for someone to cover the first two days after the hospital and the pre-op tests added two more items to my plate.

Model with glasses

Knowing that I was losing Medicaid soon, I also had my first eye exam in nearly three years and got new glasses.  I was following up to find out what happened to my school tax credit (STAR program).  I needed to sign up for a Medicare supplement program.  I was searching for an oral surgeon who had appointments available before I lost my dental insurance.  And I needed to keep track of the schedule of weaning myself off of various medications and supplements prior to GRS.

I went in for the blood and urine testing on September 21 (no appointment required) and scheduled the EKG for the following day.  It was almost too late.

The testing brought me back in contact with one of my favorite people at the local hospital a quarter mile from where I live.  In the past, I have had major problems with giving blood.  The first time was in April 1981 when New York required a blood test to get a marriage license.  It was not a big deal to me.  My dad gave blood regularly at work and it was a matter of fact thing and satisfying thing for him to help others in this way.

I went into the lab that day with my fiancé, had the blood taken, had the juice and the cookie, and then went outside with my fiancé.  We were talking about the rest of our day.  The next thing I knew, I was back inside, sitting down and feeling very woozy.  Without warning, I had crumpled onto the sidewalk, leaving my fiancé perplexed as to what to do next: run inside of help and leave me there or try to drag me inside.

So I knew I had a history of passing out by the time I had a blood test a few years ago when Dr. Carolyn Wolf-Gould became my primary physician.  Now blood work was a big deal to me.  Then I met the lab technician at the hospital.  On her office door, she had a child’s drawing of a vampire.  A woman who I would guess to be in her late 40’s or early 50’s (warning: I’m not very good at estimating ages), her hair was dyed blue, green and black.  It was so different that it helped put me at ease.  When I saw her pulling out one vial after another, I joked with her, asking if she was going to leave me with any blood.  She joked back, “A little.”  Still I warned her about my past problems and she took the blood with me lying down on a gurney.

That was the last time I needed the gurney.  Maybe my metabolism is slowing down.  Maybe it’s the effect of the estrogen.  (I was quite chagrined when I learned that young males are far more likely than women to pass out after giving blood.)  Maybe this technician has gotten me so relaxed that I no longer have a problem, even when she isn’t the one taking the blood.

So it was time for blood work again.  But first, my body was telling me to give the urine sample.  It was primed and ready, locked and loaded.  I went into the privacy of the bathroom and faced a decision.  Although I didn’t have to, ever since I knew it was likely that I would transition, I have sat down to urinate.  (The only exception was when I was still wearing men’s clothes and no stalls were available at the Penn Station men’s room.)  I knew it would be much more difficult to give the urine sample sitting down.  So (presumably) one final time in my life, I peed standing up.

It is also worth mentioning that in my head and heart, I knew that GRS was the right thing for me.  But was it God’s will for me?  Even if God does not have a problem with this surgery in general, that doesn’t necessarily mean it was right for me.  With these tests coming up and the surgery less than a month away, I went to the Lord and prayed that if I had been dull of hearing and ignored the Lord telling me not to go forward with the surgery, that He would intervene and do something to stop it.  And for a while, it looked like that might be the case.

My EKG – September 2017

The UA and blood work results came back and there was nothing in them to prevent the surgery.  The EKG was another matter.  I had never had or felt any problems with my heart.  No one in my immediate family has had heart problems.  I had one uncle on my mother’s side who suffered a heart attack, but no one else among my grandparents, aunts, uncles or cousins that I knew of.  But the EKG came back with some irregular readings.  I would need an echocardiogram and a stress test before I could be cleared for surgery.

This created a new problem.  Time was growing short and we were also running into the Jewish holidays.  A stress test must be administered by a cardiologist and I didn’t have one.  And many of the doctors in my area are Jewish.  I couldn’t get the stress test done at my local hospital without first establishing a relationship with a cardiologist on staff or with residency privileges there.

Instead, I had to drive two and three quarter hours each way to the hospital upstate with which Dr. Carolyn is affiliated.  At 7 AM on a cold October 2 morning, watching the news coverage of the Las Vegas shooting, I waited to have my tests.  I drove up the afternoon before, not wanting to leave at 4 AM (or worse, oversleep and miss my appointment).  Fortunately I had some rewards points to lower the cost of the motel room.  Between the alarm and a wakeup call, I got up in plenty of time.  Instead of 165 minutes, it was a five minute drive.

I learned that I need to go back to the gym.  I was breathing heavy after the stress test, but that was in part because I couldn’t really get the hang of a treadmill. I never have.  But my recovery time was a lot faster than two men I had seen take the test before me.  I learned that I have some minor valve problems, yet nothing serious enough to prevent the surgery.  I took this as an indication that God had answered yes.  This was above and beyond the promises He makes to His people.  Even so, every good gift and every perfect gift comes from Him. (James 1:17)  But the extra tests and travel took one more day away from me as I finished up one more client’s tax return and tried to get final planning and packing done for the two weeks I would be away in Bala Cynwyd.

Finally, October 4 arrived.  It was time to do my last minute list checking and packing.  Mid-afternoon, I called Dr. Leis’s office to let them know I was just about to leave.  A short while later, I brought the last items to my car and began to drive to Bala Cynwyd for the third time.  After years of waiting, wondering and almost losing hope, surgery was T minus 17 hours and counting.  This was it.  This was really it.

For all the promises of God in him are yea, and in him Amen, unto the glory of God by us. – 2nd Corinthians 1:20

God bless,

Lois

Lois Update and Dodgers Clinch NL West

26 Friday Sep 2014

Posted by ts4jc in About Me, General Transsexual issues, Just for Fun

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Adrian Gonzalez, anesthesia, blood test, Carl Crawford, Clayton Kershaw, conventional colonoscopy, cyst, Dee Gordon, Derek Jeter, eyeball, Giants, Hanley Ramirez, hormone levels, Hyun-Jin Ryu, Juan Uribe, Justin Turner, laxative, Los Angeles Dodgers, Major League Baseball, mammogram, Matt Kemp, medical coverage, medical tests, National League West, NL Playoffs, passing out, sonogram, virtual colonoscopy, Yasiel Puig, Zack Greinke

Clayton Kershaw

Clayton Kershaw (Photo credit: Wikipedia)

As a lifelong Dodgers fan, it is happy news when they clinch the pennant.  And for the second year in a row, they have emerged atop the National League West division.  It is even happier news when they clinch it while playing against the Giants.  Clayton Kershaw, the winningest pitcher in the Major Leagues this year despite missing 5 weeks of the season with an injury, fittingly pitched and won the clincher, with an easy 9-1 drubbing.  To help his cause, he knocked in the first run with a triple and showed some dazzling fielding as well.

It is known which five teams will advance to the NL playoffs.  But there could be some reshuffling of the matchups before the season ends on Sunday.  If the Dodgers pass Washington for the best record in the league, they will play the winner of the Wild Card play-in game.  Otherwise, they will play the winner of the NL Central Division, either St. Louis or Pittsburgh.  Either way, the Dodgers will enjoy home field advantage in the first round.  Since the Dodgers have the best record on the road in the Major Leagues this year, better even than they played at home, that advantage won’t be as meaningful as it would be for some teams.

In the American League, Baltimore and the Angels have clinched their respective divisions and Detroit has clinched a spot in the playoffs.  Four teams (Kansas City, Oakland, Seattle and Cleveland) are battling for the final two spots this weekend.

I wish I could be more optimistic about the Dodgers chances in post-season play.  They played poorly against Washington and Pittsburgh this year, and while they had a winning record against St. Louis this year, the Cardinals were the team that knocked them out of the playoffs last year.  And should they play the Giants at some point, the Dodgers eked out a 10-9 record against them and with their rivalry, the Giants would be a tough opponent.

Other concerns I have about the Dodgers include their dismal record in extra-inning games, 5-12; only twice have they come from behind to win this season when trailing in the late innings; they have hit poorly with runners in scoring position, especially with the bases loaded (an anemic .206); their relief pitchers are deep in the bottom half of the league in earned run average.

But after all, the Dodgers have won over 90 games this year.  So they have been doing many things right.  In addition to Kershaw’s dominant season, Zack Greinke is another former Cy Young Award winner who is racking up victories.  The team is also hopeful that solid number three starter, Hyun-Jin Ryu, will recover from some problems with inflammation in his pitching shoulder and be able to pitch in the playoffs.

On offense, Matt Kemp has regained his power stroke in the second half of the season, Adrian Gonzalez has been steady all year, Carl Crawford and Hanley Ramirez are swinging the bat well, as are Juan Uribe and Justin Turner.  Yasiel Puig is the x-factor, as he can win the game with his hitting, base running, throwing arm, and his ability to make great catches.  But he is still somewhat prone to committing the odd gaffe on the field that can cost a ball game.  Dee Gordon leads the majors in stolen bases, and Crawford’s stolen base totals have increased significantly this year as he bounced back from injury concerns in recent seasons.

September 25, 2014 also saw Derek Jeter play his last major league game at Yankee Stadium.  In typical clutch fashion, he won the game with a walk-off single.  A testimony to how Jeter helped the Yankees be a top team throughout his career, it was the only time he played a home game with the Yankees already eliminated from advancing to post-season play.

It is not customary for Dodgers fans to heap praise on a Yankee player, but Jeter has been a rare talent with both his athletic skills and his baseball instincts.  In the 1940’s and 50’s, Brooklyn fans recognized the baseball prowess and stellar conduct of Stan Musial.  I could picture them doing the same for Jeter.

Turning the attention to me, medical visits have been a significant theme since May.  Having medical coverage for the first time in over 20 years, plus the fact that I am now at an age when health issues are more likely to pop up, I have been undergoing a series of routine medical exams, following a visit to my new doctor at the end of May.  This has included blood tests, a mammogram, a sonogram to reveal the places where the mammogram was not clear because I have dense breasts (I am now imploring them to spread out!), and a bone density test.  I also underwent two versions of a colonoscopy, the virtual one and the conventional one.  The reason was for both was that I originally opted for the virtual but was unable to complete the test.  While I would prefer to avoid anesthesia, I doubt that I will ever opt for the virtual method again, unless that method sees significant improvements.

One of the things that I realized as these tests were being done is that the doctors assumed certain things about me that were not true, and I am not talking about gender.  Rather it is because I have been blessed with such marvelous health over the years by the Lord.  So there are many things that I had not previously experienced that most people 61 years of age would have had a long time ago.

First of all, I had never taken a laxative in my life.  Usually, all I need is a little orange juice or tomato sauce and I am fine.  So I was totally unprepared for how my body reacted the first time I took it for the colonoscopy.  (Another benefit of the conventional colonoscopy is that its associated laxative regimen is not as severe.  It was more like the way I had expected it to be the first time.)

Also, I had never had anesthesia before.  (In fact, I have never needed to spend overnight in the hospital since mommy and daddy brought me home in a blue blanket.)  It is an interesting experience in the sense that you have very little experience at all.  The anesthesiologist put a shunt in me to receive the anesthesia, there were people around me doing things, and the next thing I knew, I was all alone wondering what went wrong because I was still awake.  It took the nurse checking on me and telling me that it was all over to realize that I was looking at a different wall.  I was a bit annoyed at the fact that the doctor reviewed the results with me while I was technically awake, but still deep in la-la land.  Fortunately, I have no polyps or anything to be concerned about there.  But for the rest of the day, I could see why they don’t want you to drive afterward.

The blood test was a different concern.  Historically, I have not done well with needles.  People have told me, “Oh, you’re just anxious.”  No, that wasn’t it, not initially anyway.  When I was growing up, my dad gave blood on a regular basis at work.  Every so often, we would see a flesh-colored cloth bandage on Dad’s left arm and we knew he gave blood that day.  So I grew up with the idea as commonplace and nothing to be worried about.

The first time I gave blood, I was 28 years old.  It was April 1981.  New York State still required a blood test before they would issue a marriage license.  So my fiancé and I went to a medical lab.  When it was my turn, they took the blood, and then gave me orange juice and a cookie.  Then we were on our way to the car, chatting about the next thing on the agenda.  Next thing I knew, I was back inside, feeling weak and clammy and a little nauseous.  I had passed out on the sidewalk.

Ever since, every time I have given blood (and one time when I received an injection with a long needle), I have either passed out or was very woozy and incoherent.  So when I had the blood work done this time, I made sure I gave full warning to the lab tech who drew the samples.  And yet this time, before the test, I was able to joke with her.  Maybe it was her hair dyed in three different colors, or the drawing of a vampire on the door of her room.  Or maybe I am a new person, fully comfortable in my skin, growing less and less uptight by the day.  Whatever, the reason, as she reviewed the orders for the different tests to be done and was taking vial after empty vial and placing it in her rack to receive my blood samples, I asked her in a playful voice, if she was going to leave any blood in me!  I am learning that most medical personnel respond positively to appropriate humor from a patient.  Better that than to deal with someone who is filled with anxiety.

Of course, she took the precaution of having me lie down while she drew the blood samples.  And when she was finished, she brought me some orange juice and a snack pack of graham crackers.  And I was fine.

After the first time I passed out, I had read somewhere that young adult males are the ones who are most likely to pass out as a result of giving blood.  I remember being very upset at learning that.  It was one more way my maleness had failed me.  But now, more and more, my body is becoming that of a middle-aged woman.  And it seems to suit me.

Of course it was the first time I ever had a mammogram, or a sonogram for that matter (on my breasts or anywhere else).  I have had a number of women tell me that they have needed a sonogram as a follow up to their mammogram.  I am told that the reason for having the mammogram first is that it is cheaper.  But if that many extra tests are required, I find it hard to believe it is cheaper in the long run than just doing the sonogram first and being done with it.  The mammogram is painful for most women, while the sonogram is pleasant, especially since my hospital warms the gel that they spread on your skin before doing the exam.  I have to wonder how long mammograms would be done first if most men had to have them as part of their routine physical care.

I have not received the results of the bone density test yet, but everything else came out very well.  My triglycerides were high, but they were high twenty years ago, and it could be due to the stress I felt giving blood.  The best part was that my estrogen levels came out within the normal range (if on the lower end), but my testosterone levels are below the normal range for adult women, and are nowhere near normal for an adult male.  No wonder I feel so much better!

The only medical concern I have right now is a cyst on my eyeball that is taking longer than expected to go away.  But my optometrist tells me that I have nothing to be concerned about, as it is soft, fluid filled, and hasn’t changed color.

A merry heart doeth good like a medicine: but a broken spirit drieth the bones. – Proverbs 17:22

God bless,

Lois

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  • My Sermon on 10/20/2019 October 27, 2019
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  • And Now For Something Completely Different … – Part V December 26, 2017
  • Lois Simmons: Evangelical Transgender Woman December 8, 2017
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  • And Now For Something Completely Different … – Part IV November 28, 2017
  • Tribute to Vin Scully – Part IV November 23, 2017

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