And Now For Something Completely Different … – Part VIII

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Certified Nursing Assistant, communication, Derma-Lase, discreet, Dr. Carolyn Wolf-Gould, Dr. Sherman Leis, FidelisCare, follow up visits, FTM, full kitchen, Gender Reassignment Surgery, genital hair removal, GRS, health grades, health insurance, Joy Vanderberg, laser hair removal, Lower Bucks Hospital, medical profession, MTF, nurse, office staff, pain level, plastic surgery, recommendations, recovery room, respect, safe, secluded, stem cell research, training, trans broken arm syndrome, Transgender, website

For the medical community treating or considering treating transgender patients

Evaluations (Grades and Comments):

The Philadelphia Center for Plastic & Reconstructive Surgery (www.drshermanleis.com or www.thetransgendercenter.com): (A-)

→ Dr. Sherman Leis: (A) – An excellent surgeon who stays current and cares about the transgender community.  In general, he’s a caring individual with a very good bedside manner.  He trains other surgeons.  On a couple of occasions, I didn’t grasp what he was telling me on the first go round, but I have had this problem with others in the medical profession as well.  Part of it may be due to the fact that I have had little interaction with the medical profession until I started to transition, so I don’t always know what to ask.  Part of the problem (which I also have to be aware of when I provide tax preparation services) is that there can be a disconnect between professional lingo and everyday speech.

→ Pain Level: (A+) – Dr. Leis states that he doesn’t believe in patients having pain.  Most of the time in recovery, my pain level was between 0 and 1 (with 10 being the worst) and it never got above a 2.  My biggest problems in the hospital were a cramp in my lower back and some discomfort from the IV lines.  Dr. Leis told me that I have an excellent profile as far as not having a lot of pain (don’t drink alcohol, don’t smoke, not diabetic, no hypertension, good BMI).  And people tell me I must have a high pain threshold.  Maybe so, but believe me I felt a lot of pain after my oral surgery.  I believe a lot of credit needs to be given to Dr. Leis for his technique and post-operative protocols.  For one thing, the patient resumes walking more gradually than I have heard for most GRS surgeons, and walking immediately after surgery seems to be a very painful activity for most GRS patients.  (The only downside is that I have heard that the walking provided an opportunity to meet other transgender patients.  I didn’t get that opportunity.  But I’ll sacrifice that to have less pain.)

→ In General: (A-) – Top notch, discreet office staff; nicely appointed, secluded offices in a safe neighborhood with a range of services nearby.  Traffic can be difficult at times and public transportation is a bit lacking.  The walk up to the top floor can be inconvenient and was a challenge (and can be very difficult for some patients) three days after GRS and with a Foley catheter still inserted.

→ Communications: (B-) – The staff is very efficient in sending out necessary e-mails and making phone calls to patients, other physicians and insurance companies.  There was some information lacking and a slip up or two in terms of handouts to the patient.  Some information communicated verbally was missing on handouts.  A handout on what is available in the kitchens would have been helpful.  The notice to not put things on the floor was on a counter where I didn’t (and wasn’t likely to) see it when I came in the day before surgery.

→ Amenities: (C-) – The recovery rooms for the patients and caregivers were comfortable, spacious, and attractive.  The cable TV with a plethora of channels was a plus and the shared kitchen was very good.  The other recovery room with which I shared the kitchen and bathroom was empty for most of my time there, but a shared bathroom when one is recovering from surgery with four other people present (my caregiver, another patient and their two caregivers) potentially could pose a problem.  (I came close one time.)  The person who was supposed to provide me with a relaxing experience was a big negative for me, but I didn’t mark down as much as I might have because I understand that other patients are happy with the experience.  All I can say is that with all the people I dealt with, whether in Dr. Leis’s office, the hospital or at my primary care physician’s office, this person was the only one who I felt didn’t treat me with respect.

→ Follow up Care: (A) – Thorough and accommodating.  Dr. Leis and the staff were readily available by e-mail, phone and in person during appointments.  This is very important.  Not only should your surgeon recommend follow up visits, you are likely to have questions along the way and problems of various orders of magnitude are likely to develop, especially in the first few months after GRS.

→ Websites: (A) – Informative and excellent at communicating the type of work that the center provides without hyperbole.  My caregivers who looked at Dr. Leis’s website were as impressed as I was.  It is an accurate reflection on the nature of the practice and the type of work done there.

     Lower Bucks Hospital (www.lowerbuckshosp.com): (A-) – The nurses and certified nursing assistants (CNA’s) were excellent.  They were professional, caring, knowledgeable, pleasant and patient.  I could not have been in better hands during my three days there.  The television by the bed instead of on the opposite wall is a very good idea.  Since I was not mobile during my stay, I didn’t get much use of my room, but it was spacious.  The windows were large.  The décor was typical hospital, as was the food (including the three daily meals jammed together between 8 AM and 5 PM).  The intake and release procedures were efficient and the registration staff did a good job.  The only significant negatives were that my personal belongings never made it to my room until a few minutes before my release and that the IV monitors were prone to beeping for no apparent reason.

     Joy Vanderberg (www.derma-lase.com): (A) – I could not have found a more caring and cooperative person to do my genital hair removal.  She had done my facial hair removal as well with laser.  She was cooperative and more than respectful: she was a cheerleader in my process.  And I would find it hard to believe that there is anyone more knowledgeable about hair and hair removal (especially lasers and the pros and cons about lasers versus electrolysis).  I have recommended two other transgender patients to her and they are very happy with her as well.  I hope she will advertise her services more to transgender clients.  And I wish it wasn’t such an ordeal for her to deal with the insurance company for reimbursement.  I helped her as much as I could.

Dr. Carolyn Wolf-Gould (https://physicians.bassett.org/details/568/carolyn-wolf-gould-family_medicine-oneonta): (A) – While not officially part of my surgical process, I could not have successfully made it through GRS without her.  She was the doctor that I was so fortunate to find when Obamacare became law and I had to find a doctor knowledgeable in transgender medical care who is in New York State.  She was the doctor who brought my hormone protocol into the 21^st century, taking me off of Premarin and sticking with me as we tried different estrogen delivery methods.  She was the one who told me that Governor Cuomo’s executive order for GRS coverage included Medicaid.  She was the one who eventually found Dr. Leis and recommended him to be my surgeon.  She used her connections in the industry so I wouldn’t need to start over with another surgeon and further delay surgery when a surgeon who performed GRS in NYC began accepting Medicaid.  She was there to help me when my EKG came back with some irregularities and I needed to get a sonogram and stress test a few days before surgery.  And she was there just a few days ago when I was feeling overwhelmed by blood clot issues, dilation issues and mouth issues.  She is a knowledgeable doctor and a caring individual in the unlikely location of a small upstate NY college town.  She listens, she is proactive, and she is there when I need a hug, a pat on the back or a little shove in the right direction.  A practice that features transgender medicine is being set up in my county and maybe when they get some experience under their belt, I will switch to a local doctor.  But for now, as long as I can manage the long, pleasant drives into an area similar to where I went to college at Cornell (and much of the drive covers the same route), it is worth it to me to take those 2½-3 hour drives each way to see Dr. Carolyn and some of her other staff members who I have come to know over the years, as well as some new ones I have just met.

     Insurance [Fidelis Managed Medicaid] (www.fideliscare.org): (B) – When I had to choose a Medicaid provider at the New York State Marketplace website, I asked Dr. Carolyn and her staff for a recommendation as to who they worked with best.  Their first choice did not cover my county.  Fidelis was their second choice.  They felt that their first choice did better with medication requests, but that Fidelis did better with the surgery procedure.  One of the best things about Fidelis is that they provide each patient with an actual caseworker who is also an RN.  Susan Wolfe did a good job and is a caring individual.  The drawbacks with Fidelis was that I sensed that Ms. Wolfe had a much too big caseload, there were restrictions put on her access to information about my case that somehow customer service reps could access, and that there was some negativity towards transgender patients creeping into other departments at Fidelis as well as some overly complicated bureaucratic procedures for some steps.  In three different instances, I ran into problems.  Ms. Wolfe went to bat for me each time (and was understanding and tolerant of my impatience) and each one was eventually resolved favorably.  With her help, my persistence and some outside help from Dr. Carolyn in one case and a NY State Senator’s office in another, difficult employees became ex-employees for whatever reason and troublesome policies were changed for the better.

Recommendations to Medical Personnel and Organizations providing GRS services:

These recommendations, in conjunction with the evaluations I gave earlier in this post, can be used by those who provided me with services and any others who are either currently providing similar services or are looking to do so.

To Dr. Leis in particular: you have trained other surgeons who have gone on to start their own practices.  That is commendable as you recognize that there is plenty of demand for transgender related surgeries.  My hope is that for patients who will come in the future is that you will train a surgeon to join you in your practice who has the potential to become as skilled as you, the ethics and curiosity to stay current with technique, and the heart to treat patients with the same level of care and concern as you do.  It would be a shame if the practice you have built so well does not remain and continue in the same vein after you are no longer able to perform surgery.

To surgeons in general: there is a template contained in my evaluations and recommendations on what it would take to be a top surgeon in general and a surgeon for a transgender practice in particular.  Every patient receiving any kind of medical service deserves the utmost in respect, and that includes the ability to deal tactfully at times when misunderstandings arise with patients.  But the need for respect is especially true for transgender patients.  As a group, we have been denigrated by sizable segments of our society and even been mistreated by an unconscionable segment of the medical community.  Many transgender patients report having been refused routine medical care and there are so many physicians who are prone to blame every malady we experience on the fact that we are transgender a sarcastic name was coined for it: “trans broken arm syndrome.”  http://www.pinknews.co.uk/2015/07/09/feature-the-dangers-of-trans-broken-arm-syndrome/

To the next generation of surgeons: I make a shocking recommendation.  Put yourselves out of a job!  Or rather, follow the progress of the use of adult stem cells and research in these areas and adapt your practice as bioengineered stem cells taken from the bodies of your patients can be used in many ways as a less invasive alternative to surgery.  Currently MTF bottom surgery has limitations and FTM bottom surgery is even less adequate.  Uterine transplants have a high risk of rejection (the same thing that probably killed Lili Elbe).  But we are also seeing bioengineered adult stem cells grow new knee cartilage instead of a knee replacement operation and they are also being used to grow new ears.  In time, maybe 25-50 years, it is conceivable that similar use of stem cells will be able to transform endocrine systems and genitalia for transgender and intersex patients.

Jenna Bonneau

Gender related surgical and medical offices: As the doctors lead, so the office staff should be expected to follow.  It made a world of difference that Dr. Leis has hired efficient, effective and caring office personnel.  Carole and Jenna deal with needy (and sometimes verbose!) patients, insurance bureaucracies, and schedules that occasionally get blown apart by weather or people running late (whether the doctor or the patients).  And they get the job done.  The one thing I can’t stress the importance of enough is clear communications, especially when it comes to procedures: whether it is the patient’s schedule from arrival to hospitalization to recovery to release, or what is available and permissible in the recovery rooms including kitchen and bathroom, or post-surgical schedules, techniques and procedures.  Avoid only conveying some of the important information orally when related information has been conveyed in writing.  There is a danger in overwhelming a patient with too much information.  Therefore it needs to be in a format that is easily digested.  Even those of us from my generation have become used to the sound bite culture.  I have changed my blog posts and my communications with my clients to make them easier to read as much as possible.

Amenities: I would have preferred a professional “Mom” than the person who was provided for my benefit in the middle of my recovery.  Why a Mom?  A Mom is someone who is there when you arrive and is glad to see you.  She is there to make sure you are comfortable and that everything goes well while you are visiting.  In particular, she would tell you all about the TV remote and cable stations, the beds, the closets and dressers, what’s in the bathroom and in the kitchen and that some of the food left by other patients has been there a while.  She’ll let you know about the nearest grocery stores and pharmacies and other things that you and your caregivers might need to know.  She’ll also be there as you prepare to leave to make sure you get off on your journey well.  Like a Mom making sure a child in winter has their mittens and warm clothing, she’ll make sure you have all the things you are supposed to leave with (paperwork and supplies) and when the surgeon is coming to give you your final checkup before being released.  She’s not a caregiver.  She gives the caregivers the information they need to take better care of the patient.  And she would take a lot of the burden off the office staff.

Seest thou a man diligent in his business? he shall stand before kings; he shall not stand before mean men. – Proverbs 22:29

God bless,

Lois

And Now For Something Completely Different … – Part VI

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ABD pad, aesthetician, agitated, appetite, Bala Cynwyd, bedding change, belongings, bowel movement, Bristol PA, bumpy roads, caregivers, caring, Certified Nursing Assistant, cheerful, Christian, climbing stairs, clitoris, Combine Pad, conversation, Dr. Sherman Leis, fainted, Foley catheter, food serving schedule, friends, Gender Reassignment Surgery, granny panties, GRS, hospital bedding, hospital food, hospital staff, Jenna, labia, Lower Bucks Hospital, medical discharge, non-woven sponge, nurse, positive attitude, post-surgery dressing, recovery room, SCD, Scriptures, sequential compression device, supportive, thighs, Transgender, urethra, vagina, vulva, walking, wings (knit pants), witnessing

… and a Fortnight

After nearly three months, a lot of my stay in the hospital is a blur and I don’t remember the names of most of the staff anymore.  But what I do remember was that all the nurses and CNA’s (Certified Nursing Assistants) were very caring and supportive.  All of them were good and most were excellent.  Not once did I detect any measure of negativity towards me because I was transgender.

One major change for me since I transitioned is that I have a much more positive attitude towards medical situations and personnel than I used to have.  Yes, if I am truly in pain, I will not hide that fact.  But I try to be pleasant, even cheery and I can even tell a joke or two, sometimes in the midst of pain.  Hopefully the hospital staff came away with a good feeling after interacting with me with each shift.

Every so often, I had a few moments to chat with one of the staff members.  With one we talked about dealing with psoriasis.  Another time, I shared about probably having played high school baseball against Denzel Washington.  With another, I shared about my talent to imitate popular singers (although not enough breath to do it at the time and not sure if I will still be able to do so when I get dentures).  I remember explaining to one nurse the meaning of “cisgender” and talking about transgender issues in general.  Another staff member told me about some differences in Dr. McGinn’s protocol.  And shortly before I was about to be released, I had an emotional moment with an understanding CNA who had another staff member wait while I had “a moment”: talking about what my surgery meant to me, how fortunate I had been to not have any negative public incidents in the five years since I had begun presenting as Lois to the world and how bad I felt for my transgender sisters who haven’t been so fortunate.

That’s not to say that everything went perfectly.  The machines which monitored the drip from my IV bags beeped far more often than they should have.  One staff member told me that they never worked properly.  But I never wanted to ignore that beeping for long.  So I rang the nurse’s station more often than I would have liked, probably 90% of the time for that reason.

My operation was on a Thursday.  Business must have been slow because on Friday evening around 5 PM, I got a ride to a different wing of the hospital on that floor.  So few beds were occupied that they shut down the wing I was on and consolidated the patients.  That wasn’t a problem.  The problem was when the nurse went into my closet and didn’t find my belongings there.  They never came up with me from where they had been put before surgery.  And because it was now the weekend, it was much harder to find someone to bring my bag to me.  I had some jellied candies in it that I would have loved to eat at times when I had an appetite and no food in sight.  And I had some pocket testaments that I would have loved to have offered to some of the staff.  (If the conversation went in certain directions, I was not shy letting staff know that I am a Christian.)  I was only reunited with my belongings about 15 minutes before I was discharged on Sunday.

Then there was the food: do not go to the hospital for the food.  To be honest, I didn’t have much of an appetite for a couple of weeks after the operation.  Furthermore, I don’t understand the Romans wanting to be fed while lying on a couch.  Breakfast in bed doesn’t seem to be much of a luxury for me anymore.  In summation, the food was edible (and sometimes better than that) and occasionally I was hungry.

There was also a matter of timing.  We were served at 8 AM, Noon and 5 PM.  There was also a shift change at 8 AM.  One night, I ended up horizontal instead of slanted at my usual 30º angle.  I rang for someone to put me into position to eat breakfast.  It didn’t happen until 9 AM.  And I enjoyed that breakfast (French toast with bacon, as I recall, and both were very good).  But lunch three hours later was too soon.  And there was always a long gap between dinner and next morning’s breakfast.

Somehow by around 10:30 on Sunday morning, October 8, I was reunited with all my belongings, I had calmed down from my “moment” and one of my dearest trans women friends came to take me from the hospital to the recovery room at Dr. Leis’s office.  Since she had two of her children with her, I don’t know if she wants me to identify her by name.  But since she reads my blog, she can certainly do so if she wants to and if it won’t cause a problem for her.  And she knows that when it is time for her recovery from surgery, I will be there for her.

Slowly getting to my feet for the first time since Thursday morning, I managed to navigate the distance from my bed to the wheelchair and the walk from wheelchair to front seat of her car, while being cognizant of having to carefully handle the catheter bag.  While it was nice to get out of bed and out of the hospital in general (even as wonderful as everyone was), if I had my druthers I’d rather have stayed in place until that catheter had been taken out.

Roosevelt Boulevard (US 1&13), Philadelphia

And so I made the return trip from Bristol to Bala Cynwyd during daylight hours on a gray, drizzly, cool morning.  The GPS took us a different way than Dr. Leis used, a combination of I-95, US 13 and US 1.  There were lots of places with bumpy pavement (and the occasional railroad track) and after major surgery I was much more aware of those bumps than I was on Thursday morning.

Then we got to the doctor’s office and confusion.  I thought someone on staff was meeting me.  And I thought that Dr. Leis would examine me at some point, maybe even when I arrived.  (I didn’t see him at any point while in the hospital after the operation.)

A sequential compression device on a patient’s calves, while in a hospital bed.

But when we arrived, no one was there.  I finally reached the doctor on his cell phone and he told us to just go straight to the recovery room.  He saw me that evening.  So I gingerly made my way up the stairs with my thighs feeling like they had turned to lead in three days.  During the hospital portion of recovery, Dr. Leis uses SCD’s (sequential compression device) on the calves in lieu of walking early to prevent blood clots (plus an injection of blood thinner), but they do nothing to stimulate the thighs.  Having been told that everyone manages to do it, I pressed on and made it.

The most important thing I can tell you if you are facing GRS or any other major internal surgery in the future is that every person’s body reacts differently.  They can only tell you what happens in most cases.  Your mileage may vary.

Dr. Leis had told me that it would be a few days before I would have a bowel movement.  Jenna told me that for a while I would have a feeling of pressure like I was having a bowel movement, but it wasn’t one for the first few days.  The hospital staff doctor who checked me and pronounced that I was fit to be discharged told me that I wouldn’t have a bowel movement for a few days.

Even so, I had experienced a watery discharge from my bowels the day after the operation.  It had come on my quite suddenly, too fast for the nurses to get there when I rang for them.  So I got to experience what it is like to have your hospital bedding changed when you are in the bed.  I’m sure it isn’t their favorite job, but they are quite proficient at it.  And fortunately for them, I’m more featherweight than heavyweight.

Now I am in the recovery room in Bala Cynwyd.  I wasn’t able to get anyone to stay with me for the first day (my friend who chauffeured me had to leave for a family event) and there is no one staying in the adjoining room.  Jenna is going to come at some point and make something for me to eat but she hasn’t arrived yet.  I have finally figured out which remote will change the channels and I am looking forward to watching some playoff baseball.

You know how you are warned on the passenger side mirror that things aren’t what they seem to be?  Well I had been told that something that felt like a bowel movement wasn’t really a bowel movement.  But by golly it sure felt like one.  And finally I decided I couldn’t take the chance.  It was a good thing I moved when I did.  Dragging a catheter and moving at a reduced pace and trying to avoid soiling the floor, I made it over the toilet bowl just in time.  (Of course, I was in the room furthest from the bathroom, but it was the room out of the two where the TV worked.)  I couldn’t get the outer dressing out of the way in time, but I did the best I could.  Sorry Jenna!  At least I was wise enough not to flush and clog the plumbing with the dressing.  With rubber gloves, the packing could be retrieved (and was).  I think I finally convinced Jenna that I didn’t put the dressing in the toilet on purpose.  Hopefully by now she realizes it could have been much worse.  And life went on.

I got good news early on.  I was told that my friend Carolyn (wife of college classmate, Blair) had rearranged her schedule to come a day earlier than originally planned.  Actually she did more than rearrange.  She cancelled some piano lessons (paying customers) on Monday so she could come a day earlier.  Blair stopped in when they arrived and it was great to see them both.

Foley Catheter

All of my caregivers were wonderful.  But of the three, Carolyn was the only one who had children.  So she was the most experienced caregiver at a time when I needed the most care.  And she figured out how to empty the Foley catheter bag, a strange contraption of clamps, tubes and storage compartments that seems to be illogically configured at first, second and third glance.  (I had done it when no one else was there, but very clumsily and it was difficult for me to explain it.)

Dr. Leis showed me how to change the dressings when the catheter was in, and more importantly, once the catheter was removed.  The removal caused an interesting sensation and a moment of pain when it popped out, but then it was over.  I have been told to be glad that I never needed a penile catheter.

Carolyn was there from Monday to Saturday.  In between sleep, watching television, reading, phone calls, meal prep and Carolyn’s daily walk, we had many interesting conversations.  GRS in itself is somewhat surreal, even as much as it was important for me.  But it was also surreal to be having deep conversations with her.  My mind flashed back to having similar deep conversations with Blair, sometimes to the wee hours of the morning, whether about life in general or what we were going through in terms of relationships, school or career. Those conversations were ostensibly guy to guy.  Now I am having woman to woman conversations with his wife.  I am blessed to have two such wonderful friends and conversationalists in my life.

Carolyn was my caregiver (although she excused herself) when the catheter came out.  That was when I was handed the mirror and got a glimpse of the Dr. Leis’s handiwork for the first time.  The raw tissue and stitches were still very visible, but at least from the outside, I now look female there.  That wasn’t surreal.  It was very matter of fact.  I started to change my dressings with two non-woven sponges (that look more like gauze pads to me), covered with what is known as either a combine pad or an ABD pad.  And I learned how to pull up what Dr. Leis calls “granny panties” (aka wings) over them to serve as my disposable underwear.

Most of all, I had a surge of delight when Dr. Leis (clinically, of course), described my genitalia as “your urethra”, “your clitoris”, “your vagina”, “your vulva” and “your labia”.  This was my actual skin and tissue, not some prosthetic device.

While Carolyn was there, I got a visit from an aesthetician that Dr. Leis provides for his trans women patients recovering from GRS (perhaps others as well).  She told me that she could come back on Friday.  It would be a time of pampering, I was told.  She would arrive between 1:30 and 2:30 in the afternoon.  My friend Deirdre also called me to tell me she would be coming to visit on Friday afternoon.  Gauging the traffic and when she could leave, she expected to arrive around 4 and 4:30 PM.  No conflict, right?

Of course, the aesthetician arrived at 2:30 or even a few minutes after.  And Deirdre, even after a stop at Murray’s Deli, was early.  The traffic between DC and Philly must have set a record for lightest ever on a Friday afternoon.  And my tablet is ringing with her phone call while I am covered with a skin treatment and can’t get to it.

As far as the aesthetician, all I will say is that sometimes two people just do not hit it off.  I get along with almost everyone.  After all I move comfortably in very conservative Christian circles and very liberal LGBT circles.  But she and I, after the first few minutes, just did not click.  What was supposed to be a pleasant, relaxing pampering experience turned out to be the opposite.  In fact, I was somewhat agitated and talked to Deirdre and Carolyn about it a few times after the aesthetician left.  Plus the session cut short my visiting time with Deirdre, which in retrospect I would have much preferred.  (Fortunately Deirdre and Carolyn, both having music backgrounds, had friends in common and had a lovely conversation in the next room.)

Margaret, my friend from sixth grade, followed Carolyn in the caregiver role from Saturday to Monday.  Despite my telling them not to bring food (I had enough there to feed Sherman’s army and with me off my feed, it lasted longer than expected), they both did.  But it was good and we enjoyed it.

Standard equipment for Jamee before she retired.

My friend Jamee (a former engineering co-worker of Blair and a client of mine until she retired) took the final caregiving shift.  Jamee met me for the first time a couple of years before I transitioned and she and I just hit it off immediately.  It was also great to get to know her better as one can do when sharing a room for three days.  We also had some great conversations.

Jamee also helped make a key decision for me.  Dr. Leis wanted to see me before sending me home.  But he was delayed on Wednesday.  By the time he arrived and checked me out, it was past time for us to have dinner.  While Jamee had started to load the car for me (she was a blessing in that department), we hadn’t finished.  She told me that she could stay until the following morning and suggested I stay rather than leave and get home late.  It was an excellent suggestion.  So that’s what we did.

Mid-morning on Thursday October 19, I headed for home.  Wanting to avoid stopping to go to the bathroom if possible so I wouldn’t have to do a dressing change in a public bathroom (I eventually became quite good at doing so), I made excellent time and found myself home in a little over two hours.  But by then, I really did need to use the facilities.  I took care of business and then rushed back downstairs because I had cold food in the car that needed to be refrigerated.  From the exertion, I barely got inside my apartment when I passed out.  Fortunately, I grabbed hold of a quilt nearby and slid rather than fell.

I revived, put the food away and went to sleep rather than try to bring the rest of my things upstairs.  In fact, that would take a while and was done gradually over the next week or two.  The next day, October 20, I would have my next irreversible surgery of the month: all my teeth were being pulled in preparation for dentures.  As of this writing, due to complications in my healing, I expect to be without usable teeth and on a soft food diet for about three months before I have wearable dentures.  But that is an entirely different story.

I will have one more blog post in this series, dealing with the aftermath of the operation, evaluations and recommendations.

Remember ye not the former things, neither consider the things of old. Behold, I will do a new thing; now it shall spring forth; shall ye not know it? I will even make a way in the wilderness, and rivers in the desert. – Isaiah 43:18-19

God bless,

Lois

Living Long Enough To See the Day

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Based on something I recently saw: name and location omitted to protect privacy. To know how much this moved me, understand that I am one of the least poetic people on the planet, unless it is set to music. To move me to actually write poetry is astounding. Don’t expect an anthology in this century.

They sat together, backs to the waiting room wall
Two seniors, the younger on the left
The face on the right was weathered and wrinkled
Those lines hinted at a life journey

Perhaps the first lines were etched by the harsh Korean winter
Or was it from the salty sea air on an aircraft carrier?
Back home, that face greeted many a sunny day
Disdaining sunblock and protection from the wind

Dairy farmer? Truck driver?
Hard work wrought to provide for a family
Leading to one, two, even three generations more
Never getting closer to the heart’s deepest need

The nurse enters and calls out a female name
It could be Barbara or Melissa or Linda or Sue
The weathered person rises with a husky voice,
“Can my friend come in with me?”

After all she has faced in life as “him”,
She relishes her friend’s support.
“Sure,” the nurse replies. The friend smiles,
“Just kick me out when you need to.”

The faint swell of her new breasts under androgynous clothes
She disappears into the sanctuary of privacy
One more step into emergence
From a cocoon that was close to becoming a coffin

She is not a statistic, cause or evil pervert.
She is a person, a life nearing a lifetime,
Risking her aged health and the love of family
To finally live a few precious years and die as she really is:

A Woman in mind and heart.
A day she never believed she would see is here
She is Carol, Jeanette, Elaine, Nicole
She is finally free.

 

The Lord thy God in the midst of thee is mighty;
He will save, he will rejoice over thee with joy;
He will rest in his love,
He will joy over thee with singing.
– Zephaniah 3:17

God bless,

Lois

Why Me?

Tags

acceptance, ambulance, Bible, blessings, Cartoonist, Comic strip, conjunctival cyst, counseling, difficulties, eye surgery, family, Flickr, God, help, IV tubing, ministry, MTF, needle, negative attitude, nurse, One Big Happy, ophthalmologist, paramedics, police officers, positive attitude, post-operative recovery, prayers, rejection, Rick Detorie, Ruthie, salvation, school accidents, Scriptures, sedation, Transgender, Transition, Transsexual, violence against transgenders

In December, I had the first surgery of my entire 62+ year life.  I had stitches in my knee when I was in 8^th grade and had to walk on crutches.  (If someone squirts you with a water pistol and the school driveway was just graveled, don’t chase them.  Pick a more convenient time for payback on your terms.  Hah!)  I had my wrist x-rayed because I fell on wet grass and jammed it in 7^th grade.  In 10^th grade, I sliced the skin under my right thumbnail when I was washing wax off of petri dishes and one cracked in half because the water got too cold.  (I make my school sound like a dangerous place.  But I got through three years as a hockey goalie, four years as a starter on the baseball team, one year of cross country and one year of soccer with nothing more than shin splints and a temporary loss of a toenail when a slap shot hit my big toe dead on – wearing only regular skates, not goalie skates.)

About 25 years ago, I went to the hospital in an ambulance because of stomach pains.  I ended up walking home from the hospital a few hours later when the pain subsided and never found out the cause.  And in April 2007, I had to have an encapsulated infection drained when it blew up to the size of a Mallowmar.  I nursed that thing with home remedies and triple antibiotic cream until tax season was over and I could get it treated.  But three weeks ago, I had a procedure that actually could be classified as surgery.

No, it wasn’t one of those surgeries.  Except for a little makeup, a thin pad in my bra and a little “better living through chemistry”, I am still “what you see is what you get.”  (I was on prescription hormones for less than a month for all but two of the pictures on my Flickr page that you can access from the Links page on this blog.)

What I had was a conjunctival cyst removed from my left eye.  As anyone familiar with conjunctivitis knows, that means it was on the eye ball.  It was tiny as eye ball cysts go.  In fact, my optometrist thought it was a fluid bubble on the surface of the eye ball and just needed to be “popped”.  But it was an actual cyst containing a clear substance.  The biopsy came back that it was benign.

The adventure happened on the evening after I came home from surgery.  I was awake but sedated during the operation.  So I did need to have an IV in my arm during the operation.  I was wheeled upstairs into a recovery room where they gave me a buttered roll, flavored gelatin and water.  (I hadn’t eaten solid food in about 16 hours by this point and nothing orally for about 12 hours.)  At some point, they told me that I could get dressed and that they were calling the person who would be coming to pick me up and take me home.  I had a patch and a plastic “egg” half taped over the left eye.

A swing through the drive thru of the golden arches closest to home and I had my quarter pounder with cheese, fries and a large sweet tea.  I made two phone calls after eating to make an appointment with the ophthalmologist the next day and then arrange transportation.  Then I took a four hour nap to recover from the sedation.

I woke up and was hungry again.  I had already planned on making an omelet.  Soon I had a cheese omelet, English muffin and juice in front of me.  I ate while watching the previous night’s episode of NCIS online.  But I felt something sticking me in my left arm every time I would bend it.  When the show was finished and I cried a little for McGee’s loss, I rolled up my blouse sleeve.  There was the cause: plastic tubing connected to a needle still stuck in the crook of my arm.  And beneath the tubing was a reddish-purple circle of blood.  I found the paperwork that contained what I should do if I had a post-operative problem.  The person I spoke to at the hospital said I should call an ambulance and that this was enough of an emergency to call 911.  (First and hopefully only time I have done that.)

I went down to the lobby of my building.  (There isn’t room in my tiny apartment for much more than me right now.)  Soon, I was joined by two paramedics, a two-person ambulance team and two local police officers.  So after a debate as to whether to remove it there or take me to the emergency room (I told them “Whenever in doubt, CYA.”), five of them stood around while one of them removed the apparatus, cleaned it with alcohol and then taped it with gauze.  (The building’s Christmas tree next to me added a festive touch.)

Apparently it was a hectic day at the hospital.  So instead of just one nurse taking care of me in recovery, I was handed off to another.  Each nurse thought the other nurse had removed the tube.

In the end, it was much ado about nothing.  But I was told that had nothing been done, it could have become infected or even a blood clot go into my bloodstream because of it.  My reaction could have been “Why me?  Why does stuff like this always happen to me?”

And indeed there was a time that I had that attitude about my life.  In addition to the burden of being born trans, I could point to career underachievement, lack of a successful relationship, and financial troubles.  And once you go down that road, you start to tack on every little problem or slight in life, real or imagined.

In my late twenties, I learned in career counseling how important it was to have a positive attitude.  After I was saved at age 36 and I began to understand the ramifications of that event, I knew intellectually that I had one thing in my life that I did not earn or deserve that made up for any bad breaks that kept me from rewards I thought were my due.  But old tapes have a way of replaying when you are vulnerable.  Pity parties require little planning and few guests.

One of the things that helps me through the day, besides Bible reading and prayer, is my daily dose of comic strips.  They remind me of the absurdities of life, to laugh at them and sometimes laugh at myself.  One of the strips I read daily is One Big Happy by Rick Detorie.  The star of the comic is a precocious six-year old girl named Ruthie.  She is a pip, but she is also as lovable as she is bright.

In one Sunday comic strip, Ruthie settles down to say her prayers before going to bed.  She comes to God wondering about the fact that some people talk about their misfortunes and ask, “Why Me?”  But then she starts to tell God about all the good things in her life: a nice house and yard to play in, enough food to eat and clean clothes to wear, the fun things she does with her dad and the dress-up games she plays with her mom, a brother (two years older) who can be a pain sometimes but who also plays with her and holds her hand when they watch a scary show together, her grandpa who tells her jokes and plays cards with her and her grandma who watches movies with her while they eat popsicles (grandma and grandpa live next door).

As Ruthie finishes her list, she concludes that her life is very good indeed.  And so she asks God, “Why me?”  In counting her blessings, she realizes how fortunate she is compared to many people.  In response, her attitude towards God is commendable.  She wants to know why God would choose to show her favor.

I am considerably older than Ruthie.  But I find myself in the same position now.  And ironically, much of it is connected to my transition experience.  I am liked and respected by the members of my new church (both those who know my past and those who don’t); while some Christians have rejected me, most have stayed in fellowship with me, including the pastor of my previous church (if the weather cooperates, we are having lunch today); while my brother is still struggling with the news told to him two months ago, he hasn’t rejected me, and all the cousins who I was in contact with prior to transition are very supportive; I retained most of my clients and added new ones to replace those who left; I am in very good health for my age with only one minor surgery and still no overnight stays in the hospital since my mom brought me home for the first time; and people tell me that I don’t look my age and some even think I am attractive; I have had zero bad incidents in public since I went full-time 26 months ago plus a year before that when I was somewhat androgynous (but wearing male clothes).

Yet I am well aware that this is not typical for an MTF transsexual.  For years I read about (and was deterred by) stories of transsexuals being estranged from families, thrown out of churches, losing jobs, being beaten up, being murdered.  Only a fortunate few were able to rise above.  But if they were public figures, they were also fodder for comedy routines.  Some others managed to live in stealth, constantly wondering if they would be outed.  The rest paid even higher prices to live in accord with their innate gender identity.

But now I am getting these stories from a new source.  As the number of readers of my blog slowly increases, I am hearing from some of you.  I am hearing first-hand of your struggles with family, career problems, opposition from your religious community, and friends turned away or attacked.  A few of you see me as an oasis in a dry and dusty land.

And so I am asking God, “Why me?”  Why am I being spared most or all of what these dear people are going through?  I know that some of it is circumstantial, based on geography and family structure.  But I believe it is more than that, the beginnings of God’s affirmation that He has more than a blog for me: He has a ministry.  I do not hold myself out as a trained or licensed counselor.  But I can share Scripture, be a friend and give perspective.  Occasionally there may be additional ways I can help, perhaps to talk to a third party.  The Lord is still working on me and there are areas of my life that need more discipline.  Plus at this time of my life, tax season and my clients still have a higher priority because the bills need to be paid.  But I am here and watching to see what develops.

And we know that all things work together for good to them that love God, to them who are the called according to his purpose. – Romans 8:28

God bless,

Lois