MTF in need of help

[Rachel]

I received a letter from Aetna today about the April 4th surgery. I am a bit confused as to what it all means. I guess there are some pretty general things referenced in the CPT codes. Dr. McGinn told me I had extra skin and fat in my crotch area that she was suing for the graph. HSe said there was a mint correction of the clitoral hood and the movement of my urethra.  The letter had the following:

CPT 14040, adjacent tissue transfer or rearrangement forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and or feet; defects 10 SQ CM or less.

CPT 53430 clitoroplasty for intersexed state

CPT 53430 arthroplasty reconstruction of female urethra

CPT 14040 adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and or feet; 10 SQ cm or less

CPT 56805 clitoroplasty for  intersexed state
CPT 53430 urethroplasty, reconstruction of female urethra


I received a post cart from Aetna stating they are in receipt of my level 2 appeal for my FFS. I will most likely need to do a level 3 appeal at which time I will contact a trans Lawyer specializing in trans appeals for surgeries. 

I feel a little overwhelmed at the moment and have some thoughts of, is it worth it. I had GCS and I am happy with the results. It is mostly the very painful scar tissue that motivates me to get this done and only because the orange dilator brings me to tears. There is a very minor issue with the hood that Dr. McGinn noticed. The urethra is high but I compensate when I pee. I am just tickled pink to be able to pee so well. The scar ring I do not care about because I probable will never be with a guy.

[Cassi]

I received a letter from Aetna today about the April 4th surgery. I am a bit confused as to what it all means. I guess there are some pretty general things referenced in the CPT codes. Dr. McGinn told me I had extra skin and fat in my crotch area that she was suing for the graph. HSe said there was a mint correction of the clitoral hood and the movement of my urethra.  The letter had the following:

CPT 14040, adjacent tissue transfer or rearrangement forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and or feet; defects 10 SQ CM or less.

CPT 53430 clitoroplasty for intersexed state

CPT 53430 arthroplasty reconstruction of female urethra

CPT 14040 adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and or feet; 10 SQ cm or less

CPT 56805 clitoroplasty for  intersexed state
CPT 53430 urethroplasty, reconstruction of female urethra


I received a post cart from Aetna stating they are in receipt of my level 2 appeal for my FFS. I will most likely need to do a level 3 appeal at which time I will contact a trans Lawyer specializing in trans appeals for surgeries. 

I feel a little overwhelmed at the moment and have some thoughts of, is it worth it. I had GCS and I am happy with the results. It is mostly the very painful scar tissue that motivates me to get this done and only because the orange dilator brings me to tears. There is a very minor issue with the hood that Dr. McGinn noticed. The urethra is high but I compensate when I pee. I am just tickled pink to be able to pee so well. The scar ring I do not care about because I probable will never be with a guy.

I'm sorry you're having problems Sis.  Scream loud enough and they'll come to their senses.

[SashaHyde]

P.S to thos not in the know okcupid has a bunch of dating option where you can put what you identify as or don't and what you are looking for in someone.

Hugz

--Sasha

[Rachel]

Sasha, thank you, I think I will try that site. I guess I should just jump in and give it a try.

I went to a meet up at the Art museum today. I could not find the group. There was a children's event where we were to meet and it was very crowded. I will join the group and next time and I will be able to text. They were having trouble finding each other from their texts.  They also do breakfast on the weekend and I think I would like to do that too. 

Cassi, thank you for your support. I was confused about CPT code 14040 with the graft. I am ok now, it just hit a raw spot. I am not symmetrical in my face. The CPT code hit me wrong. I had just been with Dr. McGinn a few days prior and I wanted her to correct my one brow that is a little lower than the other. She said she would not do it because if she overcompensated then it would be higher than the other. She also said I am the only one that notices it. I am very self conscious about my body and face.

I have a price from Dr. Spiegel to do an upper blethoplasty and may do that some time in the future.

I am very happy that I transitioned. It has come with a cost but I have a sense of calm , a feeling of absence of dysphoria or congruency. There is a feeling of loss of my family but I text my ex and we will be doing dinner next week and my daughter stops by and we watch a few episodes of White Collar on Saturdays. So I have contact and we still love each other.

I ordered some tops and pants for work, spring tops. I love to get new tops and pants.

[Rachel]

On Tuesday I had two appointments at Dr. Sataloff's office (voice surgeon). The first appointment was with two speech pathologists, one very experienced with trans and one with experience.  As I performed the exercised one person was perpendicular to me. After a while they switched. Then they had recommendations.

Sit with a straight back.
Have your head aligned with my spine (head back)
Have my jaw perpendicular to my vertical chest.
Use diaphramatic breathing. ( breath from stomach but did not fully explain. I did what my past speech pathologist told me to do).
I practiced the voiceless s to z sound, M sounds and words to place resonance in the front of my face.

Next I went to the singing coach. I thought this will be a waist of time. Thus was the most important voice training session I have ever had.

She knew I am a mechanical engineer so she spoke to me in scientific terms and explained the reason for each exercise. She made a 3 track CD for me to practice each morning on my way to work.

She did vocal exploratory tests. She said I needed to loosen my vocal folds and train my new voice. She was impressed with the pitch ability of my falsetto.  The exercises are to stretch my vocal folds. She said as I go to a higher pitch I need to use more air for the more taunt vocal folds to keep them in resonance. She said I need to use more air in general. She taught me diaphramatc breathing which is:

Stand straight with head and chin back. Put hand on tummy and hand on chin to feel what is happening. relax abdominal muscles so diaphragm expands. Next gently apply abdominal pressure to assist with air exiting throat such that less pressure is exerted from the rib cage. Increase the pressure if using a higher pitch.

We did a bunch of exercises which I will review later. The exercises really does stretch the vocal folds. I can speak clearer now.

She has me speaking with a more open mouth which causes me to speak slower. She has me focusing on my jaw, toung, lips and pallet to make sounds. She showed me a technique to move my pallet up to allow resonance into the front of my face. I will review that technique later. 

I was wrong. The voice team is really very good and the singing coach is extremely good and very worth while going to. I will go over the techniques later after I practice them a few more times. I will continue to go to them to see how my voice can improve. My pitch may be too low in the end and the doctor may need to do a glottoplasty but I will give this every effort.

[Rachel]

I took my ex out for her birthday tonight. It was an Italian family run restaurant at 2nd street on South Street in Philly. My daughter would not go because she might see someone she knew. Anyhow the dinner was excellent. When my ex and daughter were leaving my house I became really sad. I held back the tears until after they left.

I continued purging and cleaning after they left. There were tears streaming down my face. I miss them.

I cried as I put the old male clothes in bags to donate. I talked to my Dad and Mom, long since gone. I asked why they would not help me. Why they made my life a living hell. Why did I not keep doing the things I tried to do when I was younger. Why did I date my ex. Why did I marry. It is not all my Mother and Fathers fault. I dated then married my ex. I am to blame for that. The pain I felt tonight was the loss of my ex and the embarrassment of my daughter to be seen with me in public.
.

[Kendra]

Rachel that is so painful - to have your daughter skip dinner at a restaurant because she cares more about her social circle than you.  But I'll admit when I was younger I did many clueless things, I hurt others without realizing it as my priorities were backwards.  That correlates to age but isn't absolute - I know some incredible caring people here who are young, and I know careless people who are older.

I believe your daughter would have made a positive decision in the future - not just if she hopefully matures and understands, but as you are continuing to refine into the person you are while society is gradually acknowledging how much damage is caused by the obsolete yes/no concept of gender binary.  As time goes on, even if she does not change she won't see you as quite the risk to her Friends list or whatever it's called.  It's possible there will be a day when she sees you as the inspiring, incredibly strong parent who clawed your way from the worst despair and wouldn't take no for an answer.

My stepkids (age 24 and 26) knew I was having major surgery 3 weeks ago (GCS) but didn't bother to text, email, call or anything.  I have done a lot for them.  That stung, but then I remembered the times my parents had surgery and I was too busy to be bothered.  Today, I'd drop everything to go hold their hand.  Some people change, some do not. 

None of us can literally move time backwards, although HRT and being sensible with health can roll the odometer back a surprising amount.  Reminds me of song lyrics - when you look behind you there's no open doors.  Some of us do the best possible from each moment forward, as you are, but we are human and the emotions that hit you are completely understandable. 

You will feel better tomorrow, when tomorrow becomes today.

Kendra

[Cassi]

Rachel,

I'm so sorry to hear about the disappointment you experienced and as time passes I feel your daughter will draw closer to you. 

[Laurie]

Hi Rachel,

   That pain you describe is all too real for me. It hurts. It hurts to high hell. And unfortunately neither you nor I can do anything about it except to somehow learn to accept it and hope things will change. Your daughter is still a young person and her social society is important to her. It isn't right that she puts that ahead of your love for her. She has time to mature more and may easily have a change of heart. I don't believe I have that same reason to hope with mine. I hurts Hun, it truly does but you are not alone. There are those of us that know your pain. Just hang in there are hope she will someday see the light.

Hugs,
   Laurie

[Rachel]

Hi Kendra, I did not know you had GCS. I will need to check out the GCS forum. CONGRATULATIONS . I am so happy for you. Make sure you eat well and do not overdo it. I know at 3 weeks you think you are all better then you walk to far and realize you have a ways to go. If you have any questions let me know, been there done that kind of thing.

Today is a different day and I feel much better. Thank you for the post.

Hi Cassie, I hope she realizes some day I am the same person and will be happy to go out in public with me.

Laurie, I am sorry you have to deal with this too. It hurts but then I have to remember she has her life and a choice to have me in it or not. Thank you for the support and if you ever need to vent contact me.

[cynthialee]

Long time no see.

I am finally post op.

Dr. Dugi at OHSU on the 8th of this month.

Still in early healing mode. Thought I would stop by and see how you are doing...wow. The years have moved forward.

[Rachel]

Hi Cynthialee,

Yes a very long time. Congratulations on GCS. You are just 8 day out so yes you are in the early stages of healing. I am so happy for you. How have you been? 

My life has changed a lot in the past 5 years. I am divorced and just signed up for Match.com. There are a lot of guys on there. LOL. Kind of leery about dating and want to take it slow. Who knows, anything to get me out of my shell and just meet guys would be a big improvement.

[cynthialee]

I have been well. I keep busy with my life and transgender stuff doesn't come up much. But I figured I really owed it t the forums to come say howdy and let folks know I finished my surgical portion of transition. Especially seeing how it was some of the people on this site who saved my life early on in my transition. There is a historical document one could compile and I waned it to have the proper ending for any historians in the future tracking my narrative. Only took 8.5 years from when I started the process...

OMG hun, you are gorgeous! You look like an ex of mine from many years back. You could be cousins.

[Rachel]

Cynthialee, thank you so much about my avatar. I get my hair trimmed and colored next weekend. Someday I will get daring and apply more makeup and different shades.

I am very happy you are at the end of your journey. I still have a vaginal procedure April 4th for some corrective work and I will need a second vocal procedure. Anyhow, I am pretty close to the end and am starting to look for companionship. Of course there is the 30 pounds I have been trying to lose for years, LOL, and most likely will give it a good effort for the summer. I will be on the beach this summer:)

As far as documenting, I wonder what people would think of this thread? I hope it helps someone that is starting out or looking for something to help them get to sleep. I was really at the end of my rope when I finally made an account here. The people here helped me make it until I had my intake.

I hope you drop by again and do not wait so long between visits. Thank you sis for helping me when I was so desperately in need. I wish you the best and good luck healing. GCS is a major operation and in 2 weeks you may think you can resume activities but take it slow. I have a friend that is 4 weeks post op and she walked a lot last week and caused some separation. Treat your kitty well

[Laurie]

Hi Rachel,

  I just had to say something now that we finally get to see you. Your avatar is very cute Rachel. I don't know why you have hidden yourself from us for so long. You are a cute lady Rachel. Looking for someone to love... well hun I wish you all the luck in the world that you find someone Rachel. I hope you really are doing as well as it sounds like you are. You have come a long way Baby. You have been through a lot as most of us do but you have come through it now and deserve to enjoy life from here on out.
  You mentioned that you wonder what others think of your story and I can tell you that you have impressed and inspired others with it. It be a hard road you've followed and yet you  kept on. One step at a time you moved forward and overcame obstacles. I have liked being a small part it your story having come late to the party but I've seen enough to know it hasn't been easy for you. Where will you go from here once you at at what your think is the end of your journey and decide to sit back and enjoy life? Who knows? But I will wish for you to be genuinely happy with who you finally are.

  Hugs,
    Laurie

[HappyMoni]

Oh Rachel, just seeing your avatar picture cheered me up and has me smiling. You are gorgeous and oh wow that smile. I love it. Thank you for sharing. Hugs,
Moni

[Allison S]

You look so good Rachel!! I really love curls  [emoji4]

Sent from my SM-G930T using Tapatalk

[Rachel]

Lorie and my Monica, thank you about the nice comments on the avitar. I am very self conscious and have an issue with body image. Next week I get my hair trimmed and colored. Blond,  very excited. I have wanted to be blond again and now it will happen.

I am doing much better since the Thursday night. I still get sad but I am getting past it. I was really depressed then I slept really well and the headache was gone as well as the stress and feeling of pending doom.

[Rachel]

Thank you Allison, I wish I had straight hair. However, I just wash, condition and scrunch dry in the mornings and the curls just happen,

[Cassi]

Lorie and my Monica, thank you about the nice comments on the avitar. I am very self conscious and have an issue with body image. Next week I get my hair trimmed and colored. Blond,  very excited. I have wanted to be blond again and now it will happen.

I am doing much better since the Thursday night. I still get sad but I am getting past it. I was really depressed then I slept really well and the headache was gone as well as the stress and feeling of pending doom.

So happy to hear that you're feeling better.