Surgery: Best Care Anywhere

best care

8 February 2019

“Best Care Anywhere”

This was the tag line for the fictional Army Medical Unit on the popular 70s-80s television show M*A*S*H. I know of a real-life contender for this moniker.

The nurse connected something to my IV tube and pushed the plunger on the syringe, the doors to the prep room were opened, and I was wheeled out and everything faded to nothing.

Not even to black.

I remembered nothing until the groggy haze of waking up in a hospital bed in a small private room. It felt like I was wearing a diaper and I lazily tried to survey my surroundings and get a grip. The past four hours felt like an instant. I glanced to my right and saw the smiling face of my wife. I couldn’t remember why I was there or what was happening. The anesthesia was doing a great job of sedating me.

11 months prior I experienced my first major surgery when I underwent facial feminization. I also experienced an awfully bad reaction to anesthesia. It had me vomiting for the first 24 hours after surgery. Not a good thing to be doing when you’ve just had your nose reconstructed and your brow bone shaved down. Going into this new surgery with that knowledge was extremely helpful. And worrisome!

All along the journey in getting to this point I made it a habit to let my new medical team know that I had had a bad experience with anesthesia, but it was my aunt that suggested requesting a scopolomine patch which is used for stopping nausea from motion sickness or anesthesia. It was a relief when I was in the prep room for surgery and one of the first things the nurse did was to place that tiny patch behind my left ear. The anesthesiologist also assured me that there were other things that they could do to reduce the chances of nausea after surgery. He was good to his word and I was very glad in my post-op state that I was just groggy and not sick to my stomach!

I think I slipped in and out of consciousness for a while. I remember my wife telling me that Dr. Gast came to her after surgery, telling her everything went perfectly. And that she was then told what my room number was and where she could wait for me.

At one point she asked if I was hungry to which I must’ve responded to the positive. We had brought tiny bags of Nilla Wafers, provided by friends Jon and Chloe (“They are the perfect snack and only 20 grams of carbs per bag! Easy to account for!”). My wife fed me while, not within my memory, I sang David Bowie tunes very quietly.

“Ch Ch Ch Ch Changes……”

I know that I slipped back into unconsciousness for a while and eventually woke to some sort of stable lucidity. I was laying in the hospital bed with an IV of fluids and antibiotics as well as insulin. I wear an insulin pumps 24/7 but it is only good if I am coherent and able to monitor it. As with my last surgery, I suspended the pump and relied on the anesthesiologist to control my blood sugar levels and make adjustments with glucose or insulin based on their incremental testing during surgery. Post surgery I was still unable to stay awake for long periods, so I was left on that insulin drip so that the nursing staff could monitor my blood glucose levels for me.

IMG_0559Panoramic view of the room from my hospital bed.

I was also catheterized, a new experience for me. But since the catheter was inserted during surgery, and afterwards I was wrapped pretty tightly, it just made it easier for everyone involved. It was odd though to not have to get out of bed to urinate even though I was hydrating regularly.

Eventually my wife left for the evening and retired to her hotel room. It was within walking distance but with the cold weather and the benefit of a complimentary shuttle service she rode back and forth to her accommodations. I quickly and easily fell asleep but was woken every hour for a blood sugar check and every six hours to take pain medication. It’s not as bad as it sounds, especially when you’re doing nothing but sleeping or lying about.

The next morning I received visits from the plastic surgery team that accompanied Dr. Gast. It is a college hospital so there were many of the staff from the OR to the nursing staff who were students. Mid-morning Dr. Gast came in and inspected the compression bandages. I was also visited by the assisting surgeon, Dr. Block, another wonderful doctor. I feel very fortunate to have had not only an extremely skilled and compassionate team but also predominantly female, something that I hadn’t realized made a difference to me until I was recovering.

Eventually Ann-Elizabeth arrived and I ordered some breakfast from the hospital food service. They have an ingenious method of using iPads given to each patient for choosing from the menu. The iPad is issued to each specific patient and contains several pieces of information such the food menu as well as ones care team.

I cannot say enough about the wonderful team that cared for me in recovery. There was Beth, Tara, Ashley, Rachel, Vivi, Pentrecia, Jasmine, Maddie, Devon and Bri, and I’m sure I’m leaving some out. I am so grateful to all the nursing staff on floor 6 as well as the room service staff that took such good care of me while I was recovering. Their dedication to care is inspiring and so very appreciated!

The day was not significant in any form except that by mid-afternoon I was cleared to connect back to my insulin pump. I do want to say that as far as pain, I did not feel anything other than mild discomfort. There really was only a dull pain in the general area of the groin. I was only on taking acetaminophen. The only other pain that I incurred was in my back from having to lay in pretty much one position. I was allowed to recline but no more than a 40 degree angle to avoid putting direct pressure on the wound. Even now as I write this on day 5 I am not allowed to sit upright.

I slept very little that night due to an extreme ache all throughout my back. The next morning was Wednesday, Day 3. We had reserved the hotel only through noon of that day. We were waiting for Dr. Gast to arrive and find out if if the bandages would come off and we would be able to go home, or if we would have to remain another day thereby requiring us to hold the hotel room for another night for Ann-Elizabeth.

I ordered breakfast from the electronic menu. Food usually arrived within 30-40 minutes. The previous day I had learned the difficulties of eating while reclined and began to choose menu items based on their ability to be cut and consumed without too much mess. My omelet arrived and I began to eat. About halfway through breakfast Dr. Gast arrived to remove the bandages.

This was it! I would be more comfortable, I would be getting the catheter removed, and most importantly I would see my transformation!

I was packed and taped quite thoroughly. Over the bandages I wore some hospital supplied white mesh boy shorts. The shorts were pulled down and sniped off and then the impressively secure tape was peeled off, followed by the not too bloody gauze pads. I lay my head back as Dr. Gast and the nurse did their work. Next the drain tube and reservoir was removed. I was told that this drain tube may stay in place until my followup 8 days later, however not much fluid was draining so it was decide that the tube would be removed. Dr. Gast announced, “This is going to feel weird,” or something to that effect. She pulled the tube from the bottom of the sutures. It wasn’t that odd or painful. She then removed the catheter. Oh boy! I’m glad that it was quick because it was also intense! Not painful. Not too unpleasant. Just intense.

After a quick cleanup she called AE over to point out the different areas. Now, my wife is an amazing woman, but she is not prone to handling even mildly graphic medical situations too strongly. She admitted later on that she almost fainted, I knew the moment that Dr. Gast called her over it was not a great idea, but my trooper of a wife came over and saw my new transformation for herself.

I scrunched forward a bit and looked down. I almost burst into tears.

The previous Monday I had been at my day job questioning my entire journey. Was I transgender? Was bottom surgery the right thing for me or was I about to make a terrible mistake?

Looking down and seeing the smoothness of my new womanhood let me know that everything I had done was right. I could not believe the elation I felt. I was complete.

Erasmus or Rotterdam said, “The summit of happiness is reached when a person is ready to be what (s)he is,”

I hadn’t realized how ready I was to be me.

But I was ready, and I was extremely happy!

~ Tiff

A NOTE: This blog chronicles my experiences and my journey. I am not an expert or medical professional. I am learning as I grow and my experiences may differ from other transgender people. Everything is correct to my best understanding.

Author: Tiffany Thomas

I am a 48 year old trans-woman living in the Midwest with my wife and two cats. I was born the year we landed on the moon, grew up in the 70s and 80s, am a type 1 diabetic of 34+ years, and have a bachelors degree in fine arts. I work as an Art Director in manufacturing. I began transitioning in 2016. I enjoy traveling, seeing new things and meeting new people. And I believe that the greatest accomplishment one can have in life is to have a positive impact on another person. This blog is an account of my journey as it happens. I make every attempt at citing correct facts. Every person's journey is different and nothing that I post here should serve as a blanket fact about anyone person or group of people. gofundme.com/bringtiff2life

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