Thoughts that came up with surgery and more

I had to have a non transition related surgery which I found out I had to have on December 13th and on December 14th the date was set for me to have surgery for December 22nd. So with that said all the happenings portrayed below happened  in a really short amount of time.

 

Last time I had to have such a surgery it was for my knee and this was after I had top surgery. To be cleared for that I got my clearance letter from my primary care Doc.

This time around things had to happen so quickly I got my clearance from the office the surgeon was affiliated with. Because I have a history of cardiac issues I always have to get a cardiac clearance meaning I have to take off my shirt. I just saw my cardiologist the week before but he only did my annual EKG and not the full workup to make sure I was ready for surgery. Though I knew what the outcome would be I still had to go through the motions with these people I don’t know just for liability purposes which I definitely understood.

My cardiologists receptionist wasn’t answering when I called so I ended up having to get another EKG. The nurse who did my EKG was kind enough not to ask me about my scars or comment on them. This was fine by me. I didn’t get asked about earlier surgeries until after she did my EKG so there was no way for her to know I had some chest surgery. We joked about me being hairy and the pads being a free hair removal option but other than that there was no other comments made about my chest.

The Doc who came to check me out asked me about earlier surgeries and I told her I had surgery for SEVERE gynecomastia, Knee surgery and urethroplasty. I did not mention me having had a TLH BSO (Full Hysto) or that I had vaginectomy. I did NOT disclose my transition history.

When asked about medications I did report being on Testosterone and when Asked why I stated for low testosterone levels. That answer seemed to suffice and justify the gynecomastia surgery. The Doc then proceeded to ask me several questions about my medical history and family all pretty standard and I answered.

I had to then see the cardiologist who’s office was a few blocks away. I went to see him and he asked me the same medical surgical questions and I gave him the same answers. He did have me take my shirt off at which point he asked me about my areola and I told him I had some severe keloiding (which was true) so the areola stretched and I planned to get a revision for it but never got around to it. All he said was OK. Due to my cardiac history though I am healthy and young there isn’t much research on the rare disease I had which affected my heart so for my sake and for the sake of his license I had to come back in a few days to get a stress test and echocardiogram. It is times like this that I am happy to now be 100% self-employed.

When I went back for the echo and stress test once again more shirts had to be taken off. The nurse who was prepping me for the stress test had me take off my shirt and she made no comments about my scars. She too made jokes about free hair removal and I joked back about it. I did my stress test which was long because my heart was fine and since I am younger than the majority of patients who get that test my heart rate had  to go higher which meant I had to stay on even longer. After the stress test was done someone else came into the room to do the echocardiogram. She didn’t comment on my scars either.

I was really happy that my chest scars weren’t a topic of discussion. Usually I only take my shirt off for my cardiologist who met me right before top surgery because I had to see him to get cleared for top surgery. My usual cardiologist never brings up my transition history or comments on my scars and outside of right after surgery when one nurse asked if my chest was still sensitive,  because she was applying the pads that hurt when you rip them off and it was near my new areola, no one else mentions it.It’s like it never happenec and that’s how i like it.

This all makes me think of how many times folks think about scars and what to say. I am realizing more and more how much of a non issue my scars are which is a great feeling.

So fast forward to the day of surgery. I got to the hospital and I know they make you take off your clothes and the nurse says “Take off everything including your underwear”. This gave my pause. I even asked. “Why does my underwear need to be off if I am having shoulder surgery?”  She responded with “That is our policy”. When I had knee surgery and top surgery I got to keep my underwear on. For hysto and meta obviously I had to take it off but with those two the surgeons knew the deal so it wasn’t a surprise. For top surgery my surgeon knew as well but she didn’t feel like I had to have my underwear off so I got to keep them on. For knee surgery they didn’t know my transition history but I still got to keep my underwear on.

so I take off my underwear and am naked under this gown. It was also cold so I was self-conscious. I am large for a post op guy of trans experience but in comparison to cis men I am smaller than average which was a very real feeling in that moment.

When I met with the anesthesiologist and the assisting Doc to my surgeon I did ask about catheterization and they said I would not be catheterized for this procedure so I felt I can go ahead without disclosing. the anesthesiologist did ask if my concern was related to my earlier urethroplasty and I told her yes because I didn’t want to risk a fistula and left it at that. They said don’t worry about it.

So surgery happened and I woke up in recovery. I vaguely remember my surgeon telling me things went well and he will see me at my post op appointment in a week. The anesthesiologist also came to check on me because I had a nerve block which means my whole left side would be numb. There was no giggling or whispering when I woke up so I assume no one knew how small I was in my pants and if they did they didn’t act any differently.

When it was time to get dressed the nurse offered to put my underwear on for me but I told her I was fine and to just close the curtain and I would let her know if I needed help. I got dressed all by myself big boy style.

After all of this I began to wonder if at any point the gown was pulled down below my waste that they could see my package. If so what did they think? What was the conversation? Was there a conversation?

I then decided not to obsess over it but it also reminded me why I was so adamant about lower surgery and it also made me think about when to disclose and if I should change my practice around disclosure to providers.

Right now I plan to keep things this way in terms of who I disclose to and when but I am surprised I didn’t have major anxiety over it. I thought it would have kicked up more shit for me but it didn’t which is very interesting  when I think about it.

I will probably post more when not one-handed and a little high on pain meds.