Hi everyone!
This is my first time posting, but I've been stalking this thread for so long that I feel like we're good buddies already....! *Activate super stalk and make everyone feel awkward*
Firstly, I want to thank all of you have been posting here for so long and provided such rich discussion for stalkers like me. I'm actually a very introverted social media hater (no FB, no Twitter, no nothing over here) but I wanted to create an account and post here because I feel like I've been so helped already by everyone on this site, and on this thread in particular. So, in the interest of giving back (!) I wanted to share some information and updates being now just about 22 hours post op! I'm actually non-binary, not FTM, but again, have felt really helped by you guys and most of my info about top surgery came from my FTM brothers, so it felt right to post here. No T for me. Obviously I'm still in my bandages and vest today, and will try to post a photo later. So far everything feels good, mostly like pinching at the top and sides of my chest.
I had my top surgery yesterday with Dr. Javad Sajan here in Seattle. I want to start there, as I can't say enough good things about this man. From consult to surgery I felt well taken care of, treated respectfully, and, honestly, loved. Dr. Sajan and his whole team made it clear that not only did they want to give me a surgery I could be proud of, but that they cared about me as a person and worked with me to make sure I was always comfortable and confident. For those in Seattle or Washington State who are in the process of trying to choose between Dr. Sajan and Dr. Mangabut, I would strongly recommend Dr. Sajan. It's nothing against Dr. M at all, and, in fairness, I did not do a personal consult with Dr. M, however I already knew both the doctors, as I am a psychologist who works with a lot of trans and gender variant folks, so we actually attend the same consult groups! Why I chose Dr. S over Dr. M:
1) Dr. S. does not use drains - hallelujah! I heard ENOUGH from you guys about the pain of having and removing the drains
2) Dr. S DOES do lipo around the sides, whereas for Dr. M this is a separate procedure, for which I believe you would have to pay extra
3) Dr. M does a more curved incision, whereas Dr. S does a straighter incision with a little curve (though I haven't seen mine yet!)
4) Dr. S does a lot of research and some teaching - as a part time academic myself I know how important this is to keeping your practice and skills sharp
Both doctors also take Group Health (now Kaiser Permenente) insurance, so I was able to have 80% of my surgery covered with insurance, which was fantastic! For reference for everyone: the total cost of surgery was $8500, of which I ended up paying about $2500 (had not met my deductible yet). The meds were about $90 (including 6 scripts filled at the pharmacy and a packet of Arnica that I bought directly from Dr. S) and I'm told there will be about $100 in post-surgery scar treatments. I think I will probably have a $30 co-pay at each of my post-ops as well, so all told this is probably going to wind up at about $3000. I did NOT have to have any pre-op blood work, x-rays, or other procedures. I'm being really specific here, as I know I had a lot of particular questions approaching this, and I know there are probably other stalkers out there who aren't yet in recovery but want to know what it's all about!
Dr. S has an office in Ballard and also his own surgery center, both of which are beautiful. It's a bit weird hanging out in the waiting room with a bunch of ladies waiting for their facelifts but, meh.
Consult: I went into my consult totally unprepared, as I had some questions that I thought might bar me from getting the surgery at all so I didn't do a bunch of research, not wanting to get my hopes up. That meant unfortunately that I didn't get to ask a lot of questions that I needed to, but I sent Dr. S a packet of information about my preferences as well as about 12 reference photos a few weeks later and he was so helpful and collaborative - he went over everything with me, and even reassured me that we would do my marks together pre-surgery so we could agree on nipple placement (which I was worried about). He or his staff always returned my emails and phone calls promptly and absolutely NEVER made me feel weird, out of place, or like a freak. Everyone asked my name and pronouns, and it was charted appropriately. Super win.
Preop: Got TONS of info here, and a lot of questions answered - mostly done by the nurse, but Dr. S made time to pop in and go over my pictures again with me and make me feel comfortable. He does several top surgeries a WEEK, so he really knows his stuff. They also let my partner in with me the whole time, which was great. I would recommend making sure you schedule this at least 3 weeks out, since there's stuff they want you to stop at 2 weeks (alcohol, some meds, etc)
Surgery day: I got a call from anesthesia 2 days before, and my anesthesiologist was a total delight. He reassured me about my bizarre and admittedly totally irrational fear of waking up during surgery with stats (of the 4 million cases of general anesthesia administered every year, there are 24 TOTAL documented cases of this happening. Ever. Set your minds at ease, gents!). The nurse was very kind and both eased my nerves and played up my excitement, reminding me of those excited parts too! I waited around for about 1.5 hours after check in as various folks came in and out to meet and check in on me - anesthesiologist again, nurse, then Dr. S to do my marks. I consented to have before and after photos, as well as allow the Dr. to snapchat my surgery (without my face), so he was narrating my marks as he also asked me questions and made sure we were working together. Again, I felt very comfortable and cared for. I was SO grateful to those of you who advised to bring reading/distracting materials for this waiting period before things got started - I would've been going out of my mind otherwise! I would recommend something silly and or funny to keep you lightly entertained and spirits high - I brought Hyperbole and a Half, which was bang on PERFECT! My partner and I could read together and were laugh-crying, which was exactly what I needed.
Post-surgery: I came to in the recovery room already dressed and having apparently been "awake" for almost an hour. My partner was already there, which was great, and they discharged me about 30 minutes later. Dr. S gave me his personal phone number to text whenever I needed and repeatedly encouraged me to do so - LOVE. THIS. GUY. Was pretty out of it throughout the afternoon and evening, and Dr. S called at 10pm (clearly on his drive home) just to check in on me and answer any questions I was having. Sleep was rough - even with a pillow fortress and several good neck pillows I'm still sore and it was touch getting in and out of bed during the night (drinking lots, so needed to pee lots!)
Some special things about my case that I wish I had heard more stories about:
1) I have fairly severe endometriosis (hysto here I come in August!) and take estrogen and progesterone to stop bleeding and pain. I couldn't stop my estrogen prior to surgery, as the last time I did I wound up in the hospital on and off for a week as they tried (and failed) to contain the catastrophic bleeding and pain. Dr. S was really reassuring that this would be ok, although it does increase my risk of clotting, and took extra measures to help mitigate this. I work compression massage boots during the surgery itself, and was sent home with compression stocking to wear until my post-op Tuesday (surgery was Friday, yesterday). I have also been ambulating 500 steps every hour that I'm awake, and got the go ahead from the Dr. last night to walk as much as I feel comfortable. So, if you're out there worrying about taking estrogen, this is what's been working for me - so far so good!
2) I use marijuana to treat endo pain, as well as insomnia and some other issues, and was worried about this prior to surgery. I don't smoke, but I do usually vape. I stopped this 2 weeks prior to surgery and switched to edibles (about 30-50mg per day) and so far have experienced no problems. If you also use marijuana, be very honest with your anesthesiologist, as they will need to administer more anesthesia to keep you under, and with your doctor. Unfortunately as long as it remains federally illegal (legal here in WA state) they can't do proper research on the effects, so we're all flying a bit blind - my Dr. advised me that he "couldn't say yes or no" but also that he's had other patients using edibles up to the surgery and they have all been fine, which so far is the case for me too.
3) Other meds - I tend to respond better to promethezane (phenegran) than odenstron (zofran) for nausea, so I swapped these. No problem according to my doc. I also got a Scope patch, which I think has been helpful. We had an hour long drive home and I threw up almost as soon as I stood up in the parking garage, but after that haven't been nauseous at all. I was prescribed oxy for the pain and have been taking 1-2 every 4-6 hours so far - I have a hypermetabolizing liver, so I tend to metabolize substances much faster than other folks and therefor need a bit more to stay on top of the pain. I also have a script for Tramadol (acts like a narcotic, but isn't) for my endo and the docs also cleared me to use this pre and post surgery as needed so I can avoid taking any more narcs than I need to and get back to work earlier (I can work on the Tram, definitely NOT on the oxy)
I think that's all for now! Thanks again to all of you for all your help so far, and I'll try to keep posting in the coming days and weeks as things heal and shape up!
