MTF in need of help

[Rachel]

Thanks Kendra, the pain is subsiding. I found that swallowing a little water several times works. If I need to cough I just exhale ( one time and I just got through it). The headache and neck ache must have been from positioning and it is getting better. I took a pain pill codeine  (helps with coughing and pain) and Tylenol.

Kendra, did you notice breathing is different? Maybe it will subside but right now I feel breathing has some restriction. When you exercise do you notice a difference in breathing pressure? I never thought to ask about that. When I do 33 flights of steps or climb a steep hill with a 60 pound pack I use a good volume of air. I would hate to struggle to breath. I breath deep now so breathing under exercise stress is very important.

I got home and slept for 4 or 5 hours, best thing.

The hound dog has been real sweet. He senses something is different. He is a super loving dog. I am glad I have him. When I got him the research vet told me to have him on a specific food. My ex wanted him on some other food. I got a bag of his old food and put it next to the food he has now and he loves his old food. I got him a 50 pound bag of his old food.

I need to make an appointment to see Dr. Sataloff for 1.5 weeks from now. No talking. I have a feeling I will not be allowed to talk for a month. I guess after the first week it will become easier. I really need to take a pad of paper in my purse.

[Dena]

Soup and soft food is the best. Avoid anything dry as it tends to stick on the way down and make you want to cough. As for pain, everything, teeth, tongue and throat hurt after my surgery. The doctor said I had a very stiff neck and he needed to use force in order to get the correct angle for the surgery. That was another reason for soft food as my teeth had been banged around and it hurt to chew food. After a few weeks, things returned to normal and I returned to normal food.

Also try to sleep with your mouth closed. The best approach for me was to sleep on my side and use the pillow to block my mouth closed. I also sleep with a glass of water by the side of my bed just incase I wake with a dry mouth from sleeping with my mouth closed.

[Rachel]

Thank you Dena, that helps to reassure me. I still have a small head and upper neck ack. Much less than earlier but still there. My throat is sore now but better than before.

I planned on being off tomorrow and I will see about Wednesday.

How long after the operation were you allowed to walk a few miles or exercise. When exercising I try to quiet my mind and focus on breathing.

[Dena]

I was walking as soon as I was out of the hospital. There was no mouth breathing and I carried a bottle of water to deal with any urge to cough. My daily walk is about 2 miles and I didn't push it. Your regular workout probably should wait about 6 weeks putting you out to the point where the sutures have dissolved and most of the healing is done.

The warning I received is you don't want the surgical site to dry out and you risk that if you breath through your mouth. It's probably a little worst here in Arizona because the humidity reaches 8% so even the bread in your sandwich can dry out before your finished eating it.

[Kendra]

I didn't notice any difference in breathing after VFS, or any problems walking and wandering around the city within a day of surgery. 

A small notepad and pen is essential.  Cindy recommended a text to speech app, Talk to Me for iPhone (not available on Android, but similar apps are).  The app worked great.

[Rachel]

Thank you so much , Dena and Kendra.

I cut the front lawn today and stopped 3 times. I did not want my heart rate to elevate and breath hard. I can feel a bit of increased air pressure at higher rates of breathing. Perhaps this if from swelling and will go away. 29 days to go

I think it is 85 degrees and humid today but I have been drinking fluids. I plan on a walk in a few minutes.

I just loaded voice app, thanks.
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Head ach and neck ach are gone. My tongue is 95% better with one spot still sore. They definitely held it down with something.

My throat definitely is better and just feels sore when I swallow. Not bad just a little sore and getting better.

[Laurie]

Hi Rachel,

  I'm sorry. I've been in my own head lately and missed the surgery. I and glad it seems to have gone okay so fay and glad the pain has lessened. I see you're trying to over do it. Somehow that figures. Slow down girl take it easy on yourself. Give it a chance to heal well before pushing it. I am happy for you Rachel.

Hugs,
   Laurie

[Rachel]

Hi Laurie, thank you.

I think I will go to work tomorrow. I am very board and it is my social outlet. I am very much routine driven and being home is difficult. My head and neck is fine. My tongue is still a bit sore in two spots. I have a light sore throat and some mucous. Other than that all is well, other than not being able to speak.

[Rachel]

Not talking has been a new experience.

I went to work Friday. It was odd as I could not speak but it worked out fine. I used a cell phone app and it was ok (thanks Kendra and Cindy). Some people talked louder at work but most just spoke normal. I felt so much better being at work than home.

I went to an event today and it was odd. I purchased a pretzel and diet coke. I handed them $10.00 and she repeated 3 times $6.00. Then she counted the 4 dollars change several times in front of me. She spoke to me very loud. I purchased several items at the show. People were nice but they repeated themselves several times and spoke loud.

So far so good without speaking. I have an appointment with my doctor Tuesday and am very interested in how I am healing, if he was able go get the tie equal on either side and what my couple of first sounds are like( I think he will have me make a few sounds).

My tongue is still sore where they grabbed it . It is still a bit swollen and a little painful to pressure but getting better.

My throat is still a bit sore, more so on my right side than left. When I swallow there is just the slightest of pain. 5 days from the operation and I would rate it 90% pain free. I did 5 miles walking today, mostly at the event, and when I picked up the pace in the parking lot (it was raining) I felt pressure when I increased my breathing. I wonder what the % tie he used on me.  It could be in my head but if it is not that will take some getting use to. I will inquire about the % tie and when I can exercise.

So my ex texted me and invited me out for an early birthday dinner present next Saturday. I have not seen my daughter for 2 weeks and neither know I had vocal surgery. I will need to text her (them) and let her know I had vocal surgery and that I will not be able to speak. Perhaps she will postpone or not do the birthday dinner all together.

[Rachel]

I saw the vocal surgeon today. They did the scope down the throat. The web looks good and the stitches are all holding. They are covered by white tissue. My vocal fold area is still swollen. Making  two sounds and speaking a few words was at a very low tone and did not sound good. He said it sounded great at this stage

The doctor said everything was healing very nicely. He wants me to speak 10 minute an hour. He said it would help the site where the web is located. The tone is very low.

The doctor said to not do any heavy lifting or heavy exercise. He said any grunting or heavy stress on the web could still break the stitches. I see him again in 3 weeks and start voice therapy at his practice in 2 weeks.

[Rachel]

I had glottoplasty on 5/14/2018 and had my doctors visit on 5/21/2018.

The last two pics are from after my cricoidthyroid subluxation ( put cricoid cartledge behind and above the thyroid cartledge and sutured in place. ). That procedure stretches the vocal folds.  Prior to the operation my hz was 130 as measured at Dr. Sataloff's office. That is my base. After the procedure my HZ was 160 but in a 3 month timeframe is was at 170. My timbre to me sounded male from recordings.

The first three pics are one week after the glottoplasty. I have mucous on the vocal fold area and I am swollen. I believe the web is 50% or perhaps more from looking at the pics. I will ask the doctor in 3 weeks when I see him next.  I will also ask him to verify he used micro instruments. He said he would. I guess if he did not it would be a mute point (LOL).

I am supposed to speak 10 minutes an hour which I do not on the weekends as there is no one to talk to. One thing that has been great is that it has been super humid since the operation.

The doctor did a battery of tests on my throat area prior to the cricoidthyroid subluxation including an MRI with and without contrast, ultrasound,  shooting my throat with electrical charges and viewing the effect for nerve damage and recording my vocal folds vibrate while making sounds. He said my right vocal fold is a little slower than my left vocal fold. Anyhow, my right vocal fold has a little pain still associated with it still. It hurt very much for a few days after the operation.

The doctor said the most difficult part of the operation of aligning the vocal folds such that it provides symmetry and having a sharp edge where the sutures join.

https://imgur.com/a/8QfEsC0

I will post more pics as the vocal folds heal.

Aetna paid close to $70,000 ($64,000 to the hospital) for the first operation and $52,000 for the glottoplasty. This does not include the speech pathology and follow up visits or pre and post op testing.  I just wanted them to pay 80% of doctor Kim's cost and I would pay for food, air fair and hotel. Aetna refused. I considered going South Korea and paying for it all out of pocket. In the end I chose a different path. My cost is $25 for speech pathology office visits which is my co-pay. Both the Hospital and the Doctor's practice is in network.

My voice is hoarse, which I was told is to be expected. I do notice two things. One my pitch is very high (horse but high) as measured on the fine tuner. It is just an app on my cell phone. My original base pitch on my app measured 135 hz while at Dr. Sataloff's office their instruments measured 130 hz. I do not know how the fine tuner's accuracy trends as pitch goes up. Post cricoidthyroid subluxation my base was 160 hz originally. In three months 165 hz and after 6 months 170 hz base. I had thoughts of cancelling the glottoplasty wondering if I would get to 180 or 190 hrz which would have been close enough for me.

The second thing I notice when I talk the air is felt at the back (top in the pics) of the vocal folds. It projects into the nasal passage without effort, sort of odd feeling.

[Dena]

The web should be no more than 50%. Any more than that and the voice sounds unnatural. As long as you have swelling in your vocal cords, your voice is going to sound off. The cords have a rather complex vibration pattern that you can see about half way down this page and until they are free of all swelling, the voice will sound a little off. Some people take as little as 6-8 weeks and I took a whole lot longer for the voice to get where it should be.

[christinej78]

It's probably a little worst here in Arizona because the humidity reaches 8% so even the bread in your sandwich can dry out before your finished eating it.

Hi Dena,               29 May 20118

Was reading this thread and came to your post. Love the humidity (about as low as it can go) and your sandwich comment (funny). My kind of humidity; wish we had it here.

Best Always, Love,
Christine

[Rachel]

Hi Dena, thank you. I think it will take a while longer to see how the healing goes. From the vocal link provided the vocal fold animation is like in intricate dance. I am impatient.
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I just got back from Papillion to have the revision work checked out. I had some granulation treated. There is a spot in the front that I guess was a flap that healed but you can put a silver nitrate stick through it. Great if I wanted a piercing there. She treated it with silver nitrate. If it does not heal she will remove the piece.

I asked Debbie if Dr. McGinn was going to bill my insurance for the revision work. Debbie said she does not bill for that, only the Anesthesia and hospital are paid. She also said the doctor wants her patients to be happy with her work. I said I am very happy

When The PA-c was treating me she first measured my depth. She measured 4.25 inches. Then she did the speculum inspection. She said I have a lot more depth then the cotton tipped stick can measure because it curves upward. Then she asked basically how big a penis can fit, in a fumbling way. I said I have not had sex yet. I explained I did not feel comfortable with myself until after I had the revision surgery. Now I am comfortable and will be able to be with a guy.

(Doctor McGinn did a great job. I really had very little to work with and what I had not have much in the way of vascular support. The first procedure made the vaginal canal and made a vagina that was shallow. My whole glands penis was used and remained in the same location. The doctor removed about 0.5 inches of material from the shaft. The office procedure one week after the GCS close me up. My graft had survived the first week about 75%. The procedure 1.5 years after GCS made the vaginal canal deep and my hood was made robust. Material between my vagina and vaginal canal was removed and the bottom of my vagina was finished. Also, my urethra was repositioned to the correct location. I am done with my vagina, perhaps some tattooing at Papillion in the future )

So I see them in a month. I think that will be the last visit. I may get some lip injections then and perhaps some vaginal tattooing next year.

I may be coming to an end of my  surgeries. Although, India may be in my future for some lower face tightening and some fat removal from the jowls and tummy. I could go bigger on the boobs and I could get one more round of hair grafts. I think my hair look pretty good and my boobs are nice so that may be me just obsessing. Anyhow, no more procedures for a while. 

I need to see my therapist next week and go to group. I think I am ready to now focusing on guys. I am attracted to a type of guy which really gets me hot. There are other guys that are pleasing but this one type of guy really gets me going. I will need to talk to my therapist about that.

I have a transman friend at work. I need to invite him and his wife over for dinner. They are really nice to me. His wife offered to go out with me and take me to places where the type of guy I like are located. She said it would be no problem finding a guy for me and that is a bit scary. I am thinking of inviting them over next weekend for dinner.

[Rachel]

Tomorrow I will see my therapist for the first time in about a month due to the glottoplasty. I will also go to electrolysis and group. I am excited to see my friends and find out how they are doing.

I had to call UPS today. I am hoarse and low in volume. I never gave my first name but was gendered female.

When I sneeze it sounds much more soft.

I never measured my breasts after my BA but I may have grown a tad up top. I have lost about 20 pounds since I had this one top on and now it is just a bit too tight in the breast area. How can this be??

Some issues I am dealing with
So I am a little depressed my voice will never come back and I will be stuck in this state. I know give it time but it is very worrisome. Be patient.

I think my breasts are a bit too separated. I think about another BA and wider implants to reduce or eliminate the separation.

I wonder why I have not hooked up yet. Part of me wants to test drive my new equipment. Part of me is shy and part of me has given up on having a special friend. I have a bunch of insecurities, height, voice, face body and being different. How do I find someone that likes me for me and will feel comfortable being with me in public and their family?

I think about a scene in Dune when he can not see the future and wakes up from a dream and says he needs to drink the water of life. This case the water of like if taking the risk to find someone and start a new beginning, to trust another and believe I am whole when I feel less than whole. I feel those that are nice to me is because I am seen as different and they feel sorry for me.

I do not think there is anything I can do to make myself feel whole with surgeries or any amount of time the E can change me to feel whole. Maybe it is the way I see myself and I am the issue and others are treating me as anyone else.

I guess it boils down to love yourself before you can love another.

[Michelle_P]

I do not think there is anything I can do to make myself feel whole with surgeries or any amount of time the E can change me to feel whole. Maybe it is the way I see myself and I am the issue and others are treating me as anyone else.

I guess it boils down to love yourself before you can love another.

You are onto something here, Rachel.

In our lives, and in transition, we are often hurt by those we trusted, and harmed or rejected by those we engage with.  We learn to not trust, to avoid engaging, and so set ourselves apart from the universe of possibilities.

As we near the end of our medical and social transitions, we need to invite ourselves to return to a state where life is more whole, to find our way back to that world, refocusing our sense of what is wanted and what is needed.  It's not yet another surgery or a new medication that we are craving, but a return to the center of who we are and what we want in our lives.  This restoration and renewal is something that is difficult to express, but vital to our lives.

Even as we have learned to not trust, to not engage, now we must reverse this isolation, trust and engage in the spirit of possibility.  We often speak of our paths through our transitions.  This, I think, is what comes next, a path not of transition but of renewal.

We need to examine the paths before us, and choose this path of renewal, becoming open to the possibilities if we can only engage and trust the universe around us, open ourselves up a bit to find a state where life could eventually be more whole.

I apologize for not being able to express this better, but I am new to this place, this state, myself and am just now re-learning to engage and trust in the universe, and discover the possibilities for a more whole and happy life.  It's not terribly clear, but there seems to be a better state that I am moving toward.

[annaleaver]

Hi Rachel,

The two pieces of advice I can give you is:

1) Find a specialist consultant through your local GP. Even if they refuse to offer you transgender-related treatment they should be able to refer you.

2) Try not to self-medicate. Though in reality, this is easier said than done. I'd be lying if said I hadn't spent £100's on dodgy estrogen pills while I waited for my first appointment. But I also experienced severe side effects: stomach cramps, lightheadedness, uneven breast development, and almost passing out on several occasions. The worry of developing blood clots due to the lack of specialist guidance probably turned me into a hypochondriac too.

Good luck,

anastasia x

   

[Rachel]

Hi Michelle, I am so glad you have a significant other. You both look so happy and I am very happy for you
both.

I agree, I need to get out and just be myself in as many public venues as possible. Cis and trans and LRBT type events as possible. I also have a few places I want to go this summer for fun and I have a few new goals. All of which are fun, creativity and adventure related. I do need some advise in making a dipole and from what I have read you are quite the authority.

Hi Anastasialea, Thank you for your advise. I too started out doing a little self medication and I inject a little earlier than the bottle says but my doctor knows. I follow my medications pretty closely with the exception of E and that is a bit sooner than officially prescribed buy my doctor knows. My e prescription was never lowered from pre-op to post op so it is high.

I see my therapist and I have two special therapist I am enrolled with through Aetna in phone consultations. They are for high risk people. One helps me to make goals ( the get out in public events is a goal in my goal plan). The other is a therapist that accesses my depression and self harm potential and gives me a depression and self harm objective questions and scores the result. We work on the depression issues and I really think she is there to access self harm potential. As soon as possible (8 weeks more) I will end the special therapists sessions and just keep with my therapist.

One of the things that is difficult is the self harm questions. There two special therapist ask some really difficult questions, questions difficult to verbalize. I really feel horrible when I am done their special sessions. I think I may end the sessions before the committed time frame.

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I went to lunch with my ex today. When she walked into the house she made a comment about my shorts. Something to the effect that if I had an ass those shorts are so short it would be hanging out. They are 5 inch inseam shorts. I recognized the comment and then thought I am so glad I am not continuously exposed to that any more. Anyhow lunch was good and the weather was beautiful. I enjoyed myself.

Tomorrow I am in the pride parade with work and I will be working a table at Penn's Landing. That should be fun. I have to meet someone in King of Prussia at 0900 and then back to Philly to the gayborhood.

I do thermolysis 1 hour a week on Tuesdays and blend 1 hour a week on Thursdays. I really dislike not shaving an area. I use hair trimmers to maintain the required length but not have hair any longer than needed.

Voice is a bit stronger but I am still breathy and low volume.

[Rachel]

I marched with work at the Philly Pride parade and helped at a work booth at Penn's Landing the entire event.

The parade started and a guy from work waved to me on the side line. He followed the group a block then joined in the group. He asked if it was ok if he joined and I said absolutely. About half way to Penn's Landing he said to me, I was watching the parade groups form from my apartment. He said I was looking out and said to myself I need to get out there and join in. Then he said he needs to get out more and take risks and join in events. He said he needs to get out there and socialize with people.

When I saw him and watched him follow the work group from the sides lines. I though that is nice of him. When he walked with me I thought he was there giving me support.  When he disclosed he basically is lonely and isolated and needs to get out with people I was blown away.

At my last therapy session my therapist told me that divorcing and starting over is very difficult for may people and I am not alone. Transitioning and losing your family is very difficult and I am not alone. She said combining the two and it is very difficult to cope for many people. She said I need to go to as many events I can in Philly or New Hope and just mingle and be myself. 

The point of the Pride parade and after events is about community, about feeling good about my gender and sexuality while all my life I felt so incredibly bad about myself. Today I learned I am not alone and there are many people that are alone and struggling and want to be more social or find social outlets and that special person or people.

[JudiBlueEyes]

Rachel he might have admitted he was lonely but he saw you and recognized that he too needed to get out and take risks.  Sound familiar?  You're doing fine.  He's not taking anywhere near the risk we take, but good for him.  See, you can be a role model too. 

Transitioning and divorcing can be terribly difficult and I'm sorry to hear you are in this spot but from what you write, I think you're certainly making progress.  Get out and be you!
Judi