Susan's Place Transgender Resources

I will post updates here over the coming weeks so I can document what happens with mine over time.

I have a different approach than most MtF people have in that am very much living full-time as a older female;  yet have an androgynous presentation that causes people to stop and try to determine what I am.  My goals for surgery are to: address some physical issues relating to my HRT use, address some long-term urinary issues, bring body and mind together, and have my body match my government documents.  Oh, and to and also get on with life with my best friend and loving wife.

My challenges have been working with my HR and related insurance company to cover my GRS with a trans surgical exclusion in place. This has gone on for over a year at this point and it wasn't until just two days ago - last Friday - that we finally got the policy changes loaded into the UHC computers and got the prior authorization approved at breakneck pace in only a few hours...a mere 20 days before the procedure. Talk about nerve wracking thinking that plan "B" might be needed at any moment and I'd be forced to come up with $35-40K in cash in a week.

More to come. 

Update as of Tuesday July 5h

I have the final word on insurance. It's finally approved with full prior authorization at T-16 days.  Whew.  It was an EPIC battle to remove he exclusion and get everything past the insurance clinical review team in hours not weeks. 

Still counting down and will be sure to update the group here if anyone cares to hear my tale of adventure.

I'm still in Florida and get to go on a 12 hour drive home after a week at the beach with the family. Yeah, I laid low so I didn't get an infection or something. I can't miss this date in CA in less than two weeks now. 

Don't worry I still have to go for another Electrology clearing in DFW and work another 4 days before going on short term disability.

Tick tick tick tick. 


Sent from my iPhone using Tapatalk

Hi,

Way to go on getting your insurance coverage.  It would be good to hear more about this and how you got it covered when there was an exclusion in place.

As far as presentation...who cares.  Do what is right for you. I think it's cool.

Congrats and looking forward to more updates!

Hugs

Jen

Jen,

It was a 50/50 split between:

1-educating people about what it meant to be discriminated as a trans person and the rest tied to the fact that they are based in CA and have a plan option (HMO) available in CA only - that covers it. Of course, I don't live in CA...... So the available option didn't cover it (snap fingers) nope, wasn't moving to CA.

2-educating them on all the other side effects and long-term urological issues that I have been trying to get resolved - but couldn't because I was trans.  It helped that in addition to my normal 3 GRS referrals I also had 2 letters of medical necessity- and a written estimate. 


After convincing them that the correct thing to do was to cover it...it still took mid Oct to 7/5 for the final confirmation letter to go out. 

Never let it be said I wasn't a finish line crosser. But...it got really close.

Hope this is what you were after.

Kris

Quick update... Headed to SFO today.. Fun times... 2-3 hour delay on 2nd connection due to weather at SFO.. We are officially having fun...

Yeah, sorry about the fog. it's an SF thing. Congrats and good luck. Dr Satterwhite is pretty awesome

We arrived and had dinner with two wonderful ladies, one a Satterwhite post op and one other lady.  I was not in the best of spirits since I had been up for so long by the time we concluded the evening.  (22 hours)

Today they already moved my pre op appointment which I don't care but I'm not surprised at this point. Obviously they need to focus on current patients who have issues.  It will make for a extremely long day on prep since I won't start until 2pm today.

My op is the morning slot tomorrow.  I have no feelings at all about it.  The last week or two there has been nothing more than no feelings at all.

I'll keep people posted on how things go.

Well, today was the big day.  I am now a post-op. 

It was about a 4.5 hour surgery and I was out of recovery quickly.

I've been extremely aware and have a new sense of calm. 

He said I had ample and pliable skin and it went very well.

More to follow

Congraduations KrisAvery1969, sounds like you are doing fine and have great results, keep us up to date on your recovery.

Day one was just an easy time. I spent the entire day exhausted from countless issues of bring in a hospital. So per Satterwhite, the surgery site seems to be healing well.  I hurt getting around with packing and sutures ties digging in my skin.  He said my skin was very pliable and there was sufficient quantity to work with. Yay?

Wow, who knew good news for a 47 y/o chick.ll

Congrats Kris!!! Big milestone behind you.... Rest and keep the staff on their toes

The staff seem very very on top of their game.  As Ruby said - my the weekend will be the real test.  I'm compiling a few lists of what went right and wrong,   Satterwhite CLEARLY had had an intervention between May and now.  Wow!

Congratulations!!! 😊

Thanks everyone. 

I'm apparently doing super well and Satterwhitte told me I was doing better than 90% of his patients at this point and asked if I wanted to be discharged a day early.  Wow, knock on wood.

So....I got discharged from CPMC about 10am today and Dr. Satterwhite told me once again that I was doing amazing - better than 90% of his patients at this point.   First post operative appointment to get the packing out is Wednesday morning.

KrisAvery1969, sounds like you are having a great recovery.  Who is it getting around with the packers still inside you?  Do you still have the catacher too?

Mm, it would see that I am having an extraordinary recovery.  Perhaps all the good wishes in advance from Ruby and others. [emoji136]. 

I feel like I can't move well without risk of ripping myself to shreds.  The notion that the crotch is actually sewn to a bandage is EXTREMELY accurate.  Getting up and down, standing, and of course - sitting, is painful.  I have no feeling like the old appendage isn't there anymore...or that there is some kind of fundamental issue...  I have filled 2-3 pads since discharge and don't like the fact that I am scared to death to attempt to have a bowel movement.

I am also down to taking only one 10/325 pain pill every 4 hours. My goal is to eliminate them completely by Wednesday morning...so long as it doesn't effect my mobility.

By the way, I have ABSOLUTELY NOTHING bad to say about the nursing staff at CPMC!!  They were all extraordinary and will need to be called out for their EXCEPTIONAL care.  Satterwhite said he had sorted the issues prior to my arrival. 

Congratulations

Super happy for you! Congratulations on the fast healing!

Quote from: KrisAvery1969 on July 25, 2016, 06:09:59 PM
Mm, it would see that I am having an extraordinary recovery.  Perhaps all the good wishes in advance from Ruby and others. [emoji136]. 

Ruby is like Trans-yoda or something. You can return some well wishes to her as she just flew to buenos Aries today to get some revision work done.

Congrats on your speedy recovery, tell dr Satterwhite hi from me and thanks for the hospital staff update. I'll be there in March.

I had to have emergency surgery on 7/29 so yeah. Fun times. It's been rough but I'm going home day after tomorrow.

What happened  KrisAvery1969?  I hope you have a fast recovery.  Let us kown how you are doing.

Quote from: KrisAvery1969 on August 05, 2016, 12:15:31 AM
I had to have emergency surgery on 7/29 so yeah. Fun times. It's been rough but I'm going home day after tomorrow.

Oh no what happened? I will pray for you!

Best wishes and hopes to you Kris. We are thinking of you!

Quote from: KrisAvery1969 on August 05, 2016, 12:15:31 AM
I had to have emergency surgery on 7/29 so yeah. Fun times. It's been rough but I'm going home day after tomorrow.

Oh no! Wishing you the best. We're all thinking of you, sending you good vibes.

Quote from: TC on July 26, 2016, 06:27:42 PM
Ruby is like Trans-yoda or something. You can return some well wishes to her as she just flew to buenos Aries today to get some revision work done.

Congrats on your speedy recovery, tell dr Satterwhite hi from me and thanks for the hospital staff update. I'll be there in March.

I wish I was, but surgery can be very unpredictable :( I'm a bit scared of my upcoming revision. Kris was doing so well but healing can take a turn for the worst. I hope she let's us know if everything turned out okay :(

- Ruby

Oh Kris,

So sorry, you were doing so well.  I have been following you to girls having you turn with Satterwhite very closely as I;ll be having my turn next month !  ;D 

What went wrong girl?  Was it the trip to gym to practise soccer?  :D

Well, overall, things are still going great.

I made it home Saturday after 19 fun days in CA.  I had the bottom level of a $4M house to hang out in with an awesome view of the bay. I am still able to got 5-6 hours of car riding/shopping/doctors visits before I poop out - daily.  Yes, my life is that busy at home. I held it to 2-3 hour outings while in the Bay Area.

In many ways I have had it extremely easy. I always said if I had any luck at all...it was bad luck.  Now I am not so sure about that.

I had a bleeding hematoma in the vaginal area...it just happens sometimes.  Swelling, blood underneath, rupturing, then spurting blood. I couldn't control it with ice and pressure after hours of trying so I had to be repacked...awake..7/28 at 8 pm in the clinic - followed by emergency surgery the next day after I fasted again. 

The result was that I spent 12 - not 6 days packed and I was also packed 3 different times.  It wasn't so bad by the third time but the two surgeries tired me out a bit.

I still have scars from the bolster sutures cutting me in two.  I think this was the result of the super pliable and supple skin I have.  Lumberjack I am not.  Satterwhite said surgery is way easier and a way better result potential if you aren't working with shoe leather. ;)

I didn't mind the catheter as I didn't have to get up to pee.  LOL. Can I keep it? Just kidding.

I'm now a week behind on dilation schedule for my original date - but it's going extremely well. I guess I'm lucky again with a good cosmetic result and good depth. I think he said 5.5".

I hit the drugs in the hospital good but tapered quickly to ibuprofen after only 10 days.  I bet it would have been much quicker without the packing and 2nd surgery 8 days after the initial one.

I do have a few problem areas that are dying- but that's typical at the bottom of the vaginal opening and at the top hooding the clit.  I'm off to my local gynecologist today  - who also happens to be a reconstructive surgeon.  (Luck) so she is well versed in wound complications and treatment.

I have nothing bad to say about the care I received at B&C.  Satterwhite is charming and adorable.

I had an awesome set of nurses at CPMC and nothing bad to say there either (gasp).
Satterwhite did say they got sorted out after Ruby.

Am I glad I did it? How soon did that point happen? LOL. Yes, (the moment when I woke up) from the big surgery.  Regrets? Never..

I'm happy to keep people informed and am also glad to answer your questions. 

I'll also be returning to the Bay Area in February for a 6 month checkup.

Hugs

Kris

KrisAvery1969, glad you are home and doing fine after the problems you had.  Having a good GYN dr will be great for you, can caught any little problem you have with wound problems and treatment. Keep us updated.

Kris,

I'm glad to hear that you are home and safely recovering.

I have been following your journey with Satterwhite because I have my own surgery scheduled with him next month.  I am both excited and nervous about it.  When I read that you had to have an emergency surgery it really scared me.  My stupid response to you above was the result of my nervous fear.

I met Satterwhite in Seattle the day you flew home.  I totally agree with you, he is extremely pleasant!   

Thank you for the follow up and you luck be forever positive. 

Rachel

Glad to hear you're OK and thanks for filling us in - I'm 2 months from my interview with Satterwhite and nearly a year from surgery. Like moonrise I was a bit freaked when you said emergency surgery.

I can see how a hematoma would be a risk, do we have any idea how common these are?

The notion of losing tissue at the clitoral hood is also daunting. All's well as ends well, and if it's just part of the process of (re)constructive surgery I am sure I can deal. Happily I know I recover very fast from injuries / surgeries and my skin repairs with relatively little scar tissue.

hugs and welcome back home!

Thanks ladies.

My visit yesterday with my local (in-state) gynecologist who is also a surgeon herself - and has been for many years is obviously now complete.

She was shocked and amazed that my result is so incredibly good and healing is coming along so well at only 3 weeks post-op. She could only say 'wow' and 'amazing work' as she examined every part of my new vulva and vagina.

She did some housekeeping by cleaning up some aspects of healing such as 'cirrus fluid residue' as well as a full assessment.  Noting like a spit shine and evaluation.

She addressed a very small area of necrotic tissue at the bottom of the introitus (which is extremely common due to the thin, tightly stretched, and poorly vascularized tissue). 

The other area of clitoris hooding isn't as bad as I thought initially since there is extreme diversity in the cis-female population and I have great labia that shroud it as well.

All and all, I'm super excited and feel great about myself between the surgery and the result of healing thus far.

Also, I have no data about the hematoma occurrence rate.  I was told I was only one of 2 patients he had that had to be repacked.  I don't know how many vaginoplasty he is up to at this point.

Also, I had such little pain in the overall process and no issues waking up from anesthesia (both) times - I'm not wanting to say it is easy to do this.  I will say overall I'm very happy with what I have thus far.

Kris

Update:

I had another appointment with my local gynecologist and we had previously received permission from Satterwhite to remove the sutures based on my healing and how my bodies' chemistry was reacting to them.  I further clarified if he meant ALL or just the surface ones. He said all.  I then asked if snip only or snip and remove.. He said snip and remove.  Well ladies... I would recommend snip and remove the surface ones... If sufficiently healed of course.....

However...OMG. I must say that you probably don't want to entertain snip and remove the deep plastic like ones holding the clitoris structure together.  Based on feeling I have there - this is clearly the very last thing on planet Earth I will *EVER* undertake again.  First, they didn't all come and second, imagine putting a the head of a carrot through a French fry maker wire screen.. Again, do NOT recommend..ever...

Summary:
Sutures out of medically indicated.. Yes
Deep plastic sutures out? NEGATIVE  just pull a bit and snip.


However, on the happy side:
I'm no longer getting poked with every movement and the surface incisions are laying down great. 

I can also say I feel better sitting and walking than I have since surgery 4 weeks ago today!


New fun:
I have some tissue in the vagina bulging more now that's been there since the first surgery so I'm taking things real easy.   Both physicians are following carefully and in getting great care.

I'm still exceedingly happy with the outcome and highly recommend Satterwhite.(big surprise)


Very happy woman!

Kris

Well, the bulging continued and part of the vaginal lining is being ejected. Normal but nothing like having part of what you worked so hard for seem to rot away and die.  I have been told by both surgeons that it will slough off, smell, not hurt, and then new skin eventually form over the raw meat.  Great.  Check for the smell for sure.  So gross.  I am in a bad place.

So sorry Kris, sending best wishes.

Hey Kris,
I just caught up with your extra adventures and am glad hear you are past these difficulties. The things we do. maybe you could start a home catheter kit company for people that don't want to get out of bed ??

Well, thanks for making me laugh.


I have been having chunks of skin fall out of my 5 week old vagina in my panties and on the floor and also out my pants all day.  I hope this phase gets over quickly.  I would be out of mind had I not just had a pelvic exam just Wednesday and my gynecologist said its OK and not to worry - there is pink tissue underneath and the lining will regrow within weeks - healthy.  I'm going to hold her to it but am optimistic that she has seen and dealt with this before.

The bad news is that all this rubbery tissue makes dilating rough.  I feel like I'm working against what's left - which of course - I am.  Slow and steady.  The gross part is that what's left has to go back inside as I insert the dilator... Ewwww.

Anyway, I'm pressing on and not in any great pain so I feel blessed.  Still maintaining depth and width through all of this.

The external suture lines are laying down nicely and a lot of the associated redness is gone.  I'm very happy with the external look of the vulva and vagina - as long as I get past this string cheese/cow intestine phase.

P.S. Did I mention it stinks and rubs between my labia? :/

Still very happy female here.

Another update.

I had an amazing week of recovery and my gynecologist was floored and actually cleared me for a BATH two weeks ahead of schedule. OMG how glorious 6.5 weeks later. 

Life is good, the shedding skin has shed.  The area continues to heal and is already at the 'as good as cis' state and its been only 6 weeks today.  Wow!

Love that Doctor Satterwhite!

So happy for you (and relieved to hear this news, my consult with Satterwhite is 32 days, 8 hours, 53 minutes away).

Has dilatation through this complication been more difficult or painful?

Actually dilation through it all is not too bad - but then again I only took Percocet for 10 days and I had the second surgery 8 days into the 10. Perhaps I have a high pain threshold.

It was worse to have wet cold skin hanging between your legs and sticking in the crotch area. Thank God it is gone.

Now that the skin is gone, yes, it's sore where there is no skin inside. It will regrow and then I'll be set.

I'm so glad that you have enjoyed hearing all this.  Sometimes I wonder if anyone is interested. ;)

Tell him you know Kris from late July and he will be sure to smile. BTW, he is adorable - you will love him.

If you, or anyone else, has any questions at all, feel free to ask. I'm an open book.

Hi Kris!

I'm so glad that you are doing so well.  You really had me worried when you mentioned your emergency surgery.  Yes, we are following your adventure and wishing you well. 

Full disclosure, I'm riveted because I have surgery with Satterwhite in 11 days!  When I had my consult with him late last year there really wasn't much info here about him.  I met with him in Seattle shortly after your 2nd surgery and I agree with you, he is amazing.  He is very compassionate and I really believe he is doing this to serve our community. 

I am very nervous!  I hope I heal as well as you have!   

Hi Kris,

I am sorry I am reading your thread late. I am glad you had a very good experience and thank you for sharing your surgery details.

I am still healing.  It's down to just a bit of red at the bottom of the introitus and some redness at the left side of the inner labia. I also have general swelling that persists that is really pulling some deep sutures located at the top of the vulva.  All the skin appears to have sloughed off from the vagina.  I used prescribed swabs to insert and rotate through the vagina to pull the rest of the skin ready to come.

Now...if I can just get those damn heavy sutures to dissolve and also the sutures in the clitorial area to release - I'd be a happy girl. 

I also have some extra skin that we are watching carefully on the left side suture line that may need to be numbed and removed so I don't cut the crap out of myself if it won't lay down on its own.

Speaking of shaving, how long do most people wait before resuming laser in the area? I can't wait to finish my bald eagle. The only thing I hate worse than having to shave male junk...is female parts (with the folds).

Thanks for any advice people have. 

Another question.  How long do people usually wait to try any stimulation in the area? I'm horny but any stim makes me feel like I'm being drawn and quartered down there.  Again, 8 weeks Thursday.

Final thought: due to my 2nd surgery, my 1/2 way mark to reducing dilation frequency and moving to #2 is Wednesday.  What an ordeal. ;)

Hugs
Kris

Quote from: KrisAvery1969 on September 12, 2016, 05:29:36 AM
I am still healing.  It's down to just a bit of red at the bottom of the introitus and some redness at the left side of the inner labia. I also have general swelling that persists that is really pulling some deep sutures located at the top of the vulva.  All the skin appears to have sloughed off from the vagina.  I used prescribed swabs to insert and rotate through the vagina to pull the rest of the skin ready to come.

Now...if I can just get those damn heavy sutures to dissolve and also the sutures in the clitorial area to release - I'd be a happy girl. 

I also have some extra skin that we are watching carefully on the left side suture line that may need to be numbed and removed so I don't cut the crap out of myself if it won't lay down on its own.

Speaking of shaving, how long do most people wait before resuming laser in the area? I can't wait to finish my bald eagle. The only thing I hate worse than having to shave male junk...is female parts (with the folds).

Thanks for any advice people have. 

Another question.  How long do people usually wait to try any stimulation in the area? I'm horny but any stim makes me feel like I'm being drawn and quartered down there.  Again, 8 weeks Thursday.

Final thought: due to my 2nd surgery, my 1/2 way mark to reducing dilation frequency and moving to #2 is Wednesday.  What an ordeal. ;)

Hugs
Kris

Sounds like you are doing well :) thank you for the updates!

I think I have enough for an additional update. It's just a day or two to 10 weeks post-op.

Basically the majority of the healing is complete as well as the face that my energy level has returned to normal.

I even got a wild hair and switched to the #2 blue dilator a whopping 40 days early and still get full depth with it.  Yes, it's tighter but my skin is very elastic and there is no damage, spotting, or issues using it. For a few days I started smaller and then switched after 5 minutes. Now I just lead off with it.

I hate to admit it, but I wasn't careful enough with the #1 purple dilator and it's filled with nicks and dings in the surface like a used car. Ouch. It's blessed relief to use a nice one again. I'll be more careful.

So, to recap, I started bathing at 6 weeks ( not 8 ), started the second dilator at 9 weeks ( not 12 ) and have been healing great.

The scar lines are prominent but they appear to be starting to fade.

I have a bit of extra skin on my left side near the bottom of the suture lines that I want addressed. My lovely local gynecologist surgeon will just numb me and take out a triangle of skin and close the skin. This should resolve the issue.

Other news, I'm still moving forward with pellets of estrogen rather than shots. You would think that this is never done the way insurance is acting.  Hopefully I will be able to start in a few weeks to a month.

Also, I got into a speech pathologist who has a clinic with the university using graduate students and will get 10 voice lessons for the commanding fee of $50 total.  Wow, $5/session. Can I afford it? LOL  I'm really looking forward to that as I have a very male sounding voice and want the ability to not get constantly clocked by it... I honestly have no expectations about what I will see or do. 

This GRS thing has been quite a ride and I'm looking forward to less and less drainage. I only wear pantyliners occasionally if there seems to be more clear fluid than normal. Mostly it's a spot or two in the panties and I can handle that.....rather than mess with pads or liners.  I was wearing something 24/7 for 8 weeks so it was time to be done....

Very happy with Dr. Satterwhite and his care.  If you are on the fence and want less waiting time ... I would not hesitate for a second.  His work seems to be exceeding Dr. M.B. by a large margin in my case.

Hugs
Kris

Great news kris! And thanks for the update, I'm also an historically fast healer and having just today gotten the word in person that both of my pshrinks are ready wo write letters, I couldn't be more excited to have 8 slim days!! to my consult with Dr S -- I've been doing the math wrong, earlier this morning I was telling myself it was 2 weeks away still.

So glad to hear from you and so excited :-)