Susan's Place Transgender Resources

This thread begins where this one (https://www.susans.org/forums/index.php/topic,201947.0.html) ends.

The TL;DR version of that thread - I went back and forth about whether meta or phallo was right for me. I consulted with a few surgeons. I had a lot of issues getting surgery scheduled. By the time I was ready and able to schedule surgery, my insurance had changed significantly to where it was cheaper for me to go abroad to get what I want. After weighing all the pros and cons of the options available to me, I decided to schedule metoidioplasty with Dr. Miro in Belgrade, Serbia for early spring 2017.

I settled on meta because my only goal with this surgery is to be able to pee from the tip of my penis. Urethral complications are much lower with meta than phallo. Everything else that I want could have been achieved with either procedure. It didn't make sense to put my body through the more invasive option. If I'm wrong, I can always "upgrade" later in life. I chose Dr. Miro for this procedure because he is not a plastic surgeon. He is a urologist, and has spent a lot of his career in pediatric urology so he is used to working on the plumbing of very small packages. I like that he does everything as a single stage, and I have never read a negative patient experience from guys who went to him.

So that's where we are today. The next post here will be my correspondence with Dr. Miro so far.

I filled out the contact form on Dr. Miro's website on December 1st. I got a personal reply from Dr. Miro on December 3rd, where he answered my initial questions about cost and whether or not it would be possible to have surgery in the same time period as a friend who is scheduled for the end of March.

Cost of metoidioplasty w/ vaginectomy and scrotoplasty = 10,000 Euro
Cost of testicular implants = 960 Euro

Requirements for surgery = 2 mental health referrals (one at a PhD level), have been on HRT for 1 year

He said it was possible to have surgery in the same time period as my friend, asked for my friend's name to confirm if they would have availability, and also asked for pictures of my downstairs so that he could give me pre-op prep advice. I sent back all of my referrals, plus pics, and answered his question about my friend and scheduling.

He replied back a week later confirming receipt of my referrals and confirmed that he could do my surgery in the same time period as my friend, possibly even on the same day depending on how things work out. He also advised me to resume pumping and to use DHT, which he would supply for $110.

I did a bank transfer of $110 to his account, and we agreed to meet in New York on Sunday, December 18th. He'll give me the DHT so it doesn't have to go through the mail, I'll get any questions answered (I don't have many at this point), and I'll get contact information to follow up with his associate Dr. Marta about scheduling surgery.

I am planning to put together another list of questions for this consult like I did with my two previous ones. Most of my questions at this point are logistical in nature and not related to surgery, so if folks have specific questions they'd like me to find out for them please PM or reply here before Sunday morning.

I hope this works out for you, I'm rooting for you! I had a dialogue going with Dr. Miro about 2 years ago. He is so nice. And he personally responded to my emails. The only reason I'm not considering him is because I want phallo with a micro hookup and he doesn't do that. But for meta I've heard he is THEE BEST.

Quote from: CMD042414 on December 13, 2016, 07:16:48 PM
I hope this works out for you, I'm rooting for you! I had a dialogue going with Dr. Miro about 2 years ago. He is so nice. And he personally responded to my emails. The only reason I'm not considering him is because I want phallo with a micro hookup and he doesn't do that. But for meta I've heard he is THEE BEST.

I was thinking the other day, I'm not sure who is friendlier between him and Dr. Bluebond-Langner. They are both just absolutely delightful to speak with. You can tell they both care about giving us what we want. If you like Miro, I think she's a very similar fit personality-wise.

Quote from: FTMax on December 13, 2016, 07:28:07 PM
I was thinking the other day, I'm not sure who is friendlier between him and Dr. Bluebond-Langner. They are both just absolutely delightful to speak with. You can tell they both care about giving us what we want. If you like Miro, I think she's a very similar fit personality-wise.

Yes I am looking forward to meeting her. However I have yet to receive the email from her office. Even after calling again so that doesn't sit well with me. I've contacted Dr. Ting too. If I have a consultation there I plan on documenting it because I think that office is an unknown for most of us.

Quote from: CMD042414 on December 14, 2016, 04:09:32 PM
Yes I am looking forward to meeting her. However I have yet to receive the email from her office. Even after calling again so that doesn't sit well with me. I've contacted Dr. Ting too. If I have a consultation there I plan on documenting it because I think that office is an unknown for most of us.

I've known a few folks who had surgery at Mt. Sinai with Miro while Dr. Ting was learning how to do it. I haven't heard from anyone yet that's gone directly to him. Not sure if he's started doing them solo yet or if they're still scheduling them out. Definitely document it though!

Someone said on a FB group that they were calling NYU at least once per week to follow up about Dr. BL. I would try that if you're hoping to schedule next year. A friend of mine just got scheduled with her for mid-March after some pretty persistent calling.

Quote from: FTMax on December 14, 2016, 04:13:19 PM
I've known a few folks who had surgery at Mt. Sinai with Miro while Dr. Ting was learning how to do it. I haven't heard from anyone yet that's gone directly to him. Not sure if he's started doing them solo yet or if they're still scheduling them out. Definitely document it though!

Someone said on a FB group that they were calling NYU at least once per week to follow up about Dr. BL. I would try that if you're hoping to schedule next year. A friend of mine just got scheduled with her for mid-March after some pretty persistent calling.

I have a consult scheduled for January. Just haven't gotten the email about what they need from me.

Good to have this new thread to keep track of how you proceed, keep us updated. I am very interested in how everything goes and hope the best for you.

Thanks guys :)

Just spoke on the phone with Dr. Miro. He told me he'd meet me in the lobby of his hotel tomorrow for a quick coffee and chat about surgery and the logistics, and he'll give me my DHT. I should have all the info I'll need after tomorrow to get in touch with one of his associates to schedule.

For folks wondering how DHT works for me, I do intend to take some measurements as well as pictures of my hair since hair loss is a big concern that keeps a lot of folks from using it. Unsure if I'll take photos of my junk, but if I do they would be made available by request only and not posted elsewhere online.

There really isn't too much I need to ask about. I've followed Dr. Miro's work since before I started transitioning. I'm very familiar with the techniques he uses and what his results look like visually. Some things in particular I will be asking about:

- Whether or not I can get a mons resection done at the time of surgery, what that scarring would look like, and how much extra it would be. It would undoubtedly be cheaper to do it at the time of surgery if it's an option, but I don't think I've ever actually seen a mons resection scar. I'm curious about whether or not the scarring would be worth whatever the resection could do for me in that region since size isn't necessarily important.

- What the apartment situation is like there. There are 3 of us who want to go around the same time, one of whom has a friend coming to help out. One guy isn't sure he'll have someone to bring, and I'm not sure but leaning towards no. From what I've read on people's blogs there are a few different apartment options available, but it also sounded like if there was space you could end up with someone random filling that space. I'm going to see if there's something large enough for all 3 of us and how the fee for that is set (flat rate vs. per person).

- Whether he's ever had anyone exceed the 10-14 days he asks people to stay due to medical reasons. I am currently planning to spend 15 days there total, but was planning to come a few days in advance of surgery to do touristy crap and go hiking - my planned medical stay would only be 12 of the 15 days.

Will report back tomorrow once I'm back from NYC!

I left at 2am and traveled to NYC for a 7am meeting with Dr. Miro. After an oversleeping snafu, he hustled out of the elevator at 8:30 and wrapped me in a big hug. He apologized profusely for his lateness and said how embarrassed he was, but he was glad we were able to connect.

We made small talk about New York, weather, the holidays, and Belgrade. This was the first big difference between Dr. Miro and every other surgeon I'd consulted with. From the hug, to offering up personal details about his life, to telling me how excited he was to give me the full Belgrade experience - he shifted from being a one dimensional doctor to being a complete person. When we spoke on medical items, that same knowledge and professionalism was there, but there was a genuine warmth and even excitement that of all the places I could've gone, I was choosing to be his guest.

Small talk shifted to medical talk. He confirmed everything I'd want: metoidioplasty with urethral lengthening, vaginectomy, scrotoplasty, and testicular implants. He confirmed I'd already had a hysterectomy. I asked if we would be able to do a mons resection at the time of surgery. He said 80% of the time it was doable, 20% of the time it was not, but unfortunately he wouldn't know until I was on the table. He said we could plan for it. Surgery would be under 3 hours. He said he averages 70-80 of these per year and has done over 1000 at this point.

He gave me my DHT and a homemade pump. I'm to do both twice a day. The DHT until I run out, pumping everyday until surgery. That is also something I'll have to do after surgery once I'm a little more healed.

His entire complication rate for surgery is 7%, and the majority of that is urethral issues. The other potential issue is how well the testicular implants settle. He said both were easily fixable, and he would take no fee for fixing any complications I had.

He also said if in the future I decide to pursue phalloplasty, he would offer a significant discount if I chose to return to Belgrade and have surgery with him. This offer has no expiration date - as long as he's still doctoring, it's on the table. That is a huge relief. While I do feel that meta is going to suit my needs, it's nice to know there's a cost effective road to phallo that isn't dependent on my insurance coverage.

We shifted to talk logistics. I was the third person looking for an end of March date, and he knew I was friends with one of those people. I told him I had spoken to the second guy as well, and we would all love to come together if possible. He was excited at the prospect of this. He felt that people were always in better spirits when they had friends to recover with. He owns a large apartment that he could put all of us in at once, depending on if any of us brought travel companions. He said that would be his preference, but he wanted everyone to be comfortable so he may divide it up into two apartments.

He asked how long I'd be able to stay. I'd have 5 weeks of vacation time and was planning to stay 2 weeks with maybe some extra days for touristy things. He said if I stayed 3 weeks in Belgrade he could remove my last catheter before I fly home. This is appealing, though I know it's more expensive than just coming home at 2 weeks and pulling the last catheter myself. I will have to think about it.

As we wrapped up, he texted me the contact information for his associates that I'd need to speak with to move forward with scheduling - Dr. Marta and Dr. Korac. My marching orders were to get home, send them an email, and get myself on a schedule for DHT application and pumping.

He walked with me a few blocks toward the station. It was unseasonably warm in New York today, and I mentioned how I loved the temperature, fog, and rain. He laughed and said I would love Belgrade in the spring then. We hugged, shook hands, and he told me to give him a call or email if I had any issues getting in touch with his associates.

Per Dr. Miro's instructions, I started using DHT and pumping twice a day on 12/18 leading up to my surgery which will be at the end of March. Before starting, I took pictures of my hair and my downstairs, and measured my downstairs. Since hair loss is a deal breaker for me, I have been taking daily update pictures of my hair. I will do downstairs pics and measurements once a week on Sundays. I will not be posting any pics of my junk, though I am open to sending them to people who request them. I will be posting hair photos if there is a significant change.

I measured at 1.5" before DHT. T worked pretty well for me. I was not visible at all prior to starting T, so that 1.5" is entirely related to testosterone.

I got a single tube of DHT and a homemade pump from Dr. Miro. The pump feels a little flimsy but seems to work well. It has just been a pain trying to squeeze in a full hour of it every day. The DHT is about what I expected, but better in many ways. It's a clear gel that gets a bit slippery once you start handling it. The amount I'm putting on twice a day is very small, so I'm not worried at all about running out in the three month period that I need to use it.

My first time applying it, I didn't really experience the burning sensation that everyone talks about (DHT contains alcohol). It was more like a warming sensation. Not pleasant but not uncomfortable. The second time I applied it, it was more of a burning feeling and that was by far the worst application of it. It seems to be a little different for me each time. Sometimes it's just a gradual warming, sometimes it's a stinging feeling. It has never been unbearable, and I don't dread applying it.

During my first week, I experienced no hair loss or thinning. I don't know if it's too early for that to occur, if I just have good genes in terms of hair, or if it is due to my hair care. I wash my hair with biotin and collagen boosting shampoo, and I take a biotin supplement along with a multivitamin. But so far, no changes there.

I've also seen no changes whatsoever in terms of size, still measuring 1.5". I'll need to go back and re-read some other blogs about DHT but I felt like most folks were seeing some changes in size very early on, though I know some of them were doing a different kind of cycling in order to reduce the likelihood of hair loss.

My only complaint thus far is that it seems Dr. Miro's team does not respond to emails during the week. I emailed Dr. Marta and Dr. Korac last Sunday after my meeting with Dr. Miro. So far I have not heard back from Dr. Marta who is responsible for scheduling my surgery and taking a deposit. I did hear back from Dr. Korac today and we've exchanged a few emails. Since I get regular lab work done, there are very few tests I'll need to do before surgery. So that's nice at least!

Surgery date is set for March 21st! I have two friends going with me who are having surgery on the 22nd. Making a little list here to keep me on track of things that need to get done before surgery:

Done:

- Paid deposit for surgery date via bank transfer - 1960 Euros (1000 deposit + 960 for testicular implants)
- Made doctor's appointment for pre-op physical and testing on 1/19
- Made an Amazon Wish List for supplies
- Located passport
- Sent referrals to Dr. Marta
- Requested 3 weeks time off with an additional 2 flex weeks or remote work time

To Do In Advance:

- Email pre-op physical and lab results to Dr. Korac
- Pay remaining balance of surgery costs via wire transfer
- Purchase airfare
- Review credit card terms for foreign transaction fees
- Open new credit card if necessary
- Make a packing list
- Find a morning dog walker
- Find a urologist
- Schedule a post-op check up with my doctor
- Stop T 3 weeks in advance of surgery

Week Before Leaving:

- Do all laundry
- Pack suitcase
- Clean house completely, organize things for roommate
- Use up/get rid of non-shelf stable food
- Purchase any remaining items from Wish List
- Make sure there are 2 month's worth of dog food and treats in the house
- Contact bank and credit card companies to let them know I will be traveling
- Write out notes for morning dog walker
- Confirm all travel arrangements with Dr. Miro's staff

Based on other people's packing lists and advice, I've put together my own preliminary packing list. I've still got plenty of time to refine it. I'm hoping in posting this early, I can get some feedback from post-op folks.

The end version of this will be turned into a page on the top menu bar of my blog. It'll have each item listed and a short explanation of why I felt it was important to bring. After the trip I'll also update with how useful I found each item I brought or items I didn't bring that I wish I had. Will also take some pics and list approximate prices for anything I had to purchase.

Things to remember: I will be staying for just over 2 weeks, and 2-3 of those days will be spent in the hospital. Medical supplies are provided. There is a laundry machine in the apartment to wash clothes.

Supplies

• Thermometer
• Flushable wet wipes (2 packs of 48)
• Paper tape
• Gauze pads
• Anti-embolism thigh length stockings
• Compression belt for mons resection

Toiletries

• Toothbrush
• Toothpaste tablets
• Shampoo & conditioner bar in travel tin
• Facial cleanser lotion
• Soap in travel tin
• Deodorant
• Lip balm
• Safety razor w/ 1 pack blades & shaving cream

Medications & Supplements

• Testosterone w/ related supplies
• Any requested prescription medications
• Advil & Advil PM
• Arnica Montana tablets
• Bromelain tablets
• Cranberry softgels
• Vitamin C tablets
• Stool softener softgels

Documents

• Passport w/ holder
• Flight information & boarding passes

Entertainment & Creature Comforts

• European power adapter
• Tablet w/ keyboard case, micro SD card, and charger
• Nintendo DS w/ games and charger
• Throw blanket

Clothing

• T-shirts (7)
• White briefs (7)
• Socks (7)
• Pajama pants (2)
• Basketball shorts (2)
• Slippers (1 pair)
• Bath robe (1)
• Sweatshirt (1)

I was about to ask all these questions about bottom surgery when I saw your thread. I just read all of it. Thank you for sharing your experience. It was very informative, and it will be interesting to hear how it goes. Everything with the money and the cancelled appointments and delayed dates sounds like a nightmare.

I live in Sweden so we get the surgeries basically for free but the waiting here is even worse if you can believe it. Once I get my top surgery, in a year or so (hopefully...), it will be almost 5 years from the time I decided to transition, and 2.5 years after I started T. I'm very thankful that I don't need to pay huge amounts of money or worry about insurance but waiting for so long is really depressing.

Either way, I hope it all goes well and that you enjoy you stay in Europe in March.  ;D

Quote from: somewhat on January 04, 2017, 06:07:03 PM
I was about to ask all these questions about bottom surgery when I saw your thread. I just read all of it. Thank you for sharing your experience. It was very informative, and it will be interesting to hear how it goes. Everything with the money and the cancelled appointments and delayed dates sounds like a nightmare.

I live in Sweden so we get the surgeries basically for free but the waiting here is even worse if you can believe it. Once I get my top surgery, in a year or so (hopefully...), it will be almost 5 years from the time I decided to transition, and 2.5 years after I started T. I'm very thankful that I don't need to pay huge amounts of money or worry about insurance but waiting for so long is really depressing.

Either way, I hope it all goes well and that you enjoy you stay in Europe in March.  ;D

Thanks! I hope my updates are helpful for you! And feel free to ask anything you think I might know but might not have written about :)

Someone was asking me the other day to compare/contrast the US healthcare system for someone transitioning with the same system in the UK. I believe their wait time is a little shorter than yours, but still lots of time constraints and milestones you have to hit to get everything taken care of. That is perhaps the only benefit of our system - nothing is centralized so you're free to go at your own pace provided you have the funding (either your own or via insurance) to make it happen.

I think as long as I knew there was an end in sight and I had a timeline that didn't change, I could function fine in a national healthcare system. That has perhaps been the most maddening part of my whole process - just as I get to the end, the goal line changes somehow.

Update:

I paid the full cost of my surgery over the last week. The exchange rate between Euros and USD was really good so it was almost an even switch. I have a spreadsheet going on another computer of everything I've spent so far in dollars and euros, and I'll be adding another column for the local currency while I'm in Serbia. It feels good to have the bulk of it paid for, but sad to watch all that money disappear.

All of my supplies have been purchased with the exception of toiletries, anti-embolism stockings, and an abdominal binder. The last two were requested by Dr. Miro. Everyone is told to bring the stockings, but you only need the abdominal binder if you're having a mons resection.

The only two other major expenses I'll have are airfare and the apartment once we get there. Should be under $2000 in total. I'm not 100% sure how many days I'll stay yet. One of the other guys having surgery the day after me is planning to fly up to me and then we'll fly over together, but I'm not sure if he wanted to fly back together as well. He is waiting to hear back about his passport before we buy plane tickets, so once he hears back I guess we'll discuss it. I'd like to stay 12-14 days.

Plane tickets are purchased. All supplies have been purchased and they all fit in my suitcase. That just leaves one major expense left for surgery - the apartment. This should run me around $1000 for the duration of my stay. I've looked at my budget and I'm good to pay this in cash.

2 months and 12 days until I leave!

I've officially been on DHT for a month now and have absolutely no changes to report. I've seen no additional downstairs growth, and no hair loss. It's a little disappointing to be honest. I'm considering doing an extra application during the day to see if that will help since I've had no adverse effects to my hair so far. Stats from a study on cis men with micropenises say the most growth occurs during the first month on DHT, with lesser amounts in the second and third months. I'm not sure if they used the 2.5% or 10% DHT in the study. They stopped producing 10% in 2009 and the study is from 1993, so 10% is my guess.

I posted my updated packing list on my blog and solicited feedback from a few of the groups I'm in. I also contacted Dr. Marta about any necessary prescriptions I should bring. They apparently don't have anything as strong as Vicodin or Percocet, so if I want something that strong I'll need to get it here. I don't know how comfortable my doctor would be writing prescriptions for those, and I'm not sure I really want something that strong.

After losing a bunch of weight, the last time I took Percocet it really put me on my butt, even on a full stomach. I might see if I can get some Tylenol 800mg. Does anybody have any thoughts on this? The studies on this seem to indicate that a combination of acetaminophen and ibuprofen is the most effective non-narcotic option, and what I was planning to do. But I also don't want to be under prepared if an opioid is absolutely necessary.

Also in other news: my roommate has requested that I not hire a dog walker while I'm gone. He said he doesn't feel comfortable with having someone in the house when neither of us are there during the day. I offered to set up a camera, and he said that wasn't necessary and that he'd walk the dog a few times a day and we could work out some kind of payback after the fact, most likely in the form of food. I had budgeted $700 for dog walks for the 17 days I'll be gone, so that's a huge savings!

Quote from: FTMax on January 16, 2017, 03:04:06 PM
I've officially been on DHT for a month now and have absolutely no changes to report. I've seen no additional downstairs growth, and no hair loss. It's a little disappointing to be honest. I'm considering doing an extra application during the day to see if that will help since I've had no adverse effects to my hair so far. Stats from a study on cis men with micropenises say the most growth occurs during the first month on DHT, with lesser amounts in the second and third months. I'm not sure if they used the 2.5% or 10% DHT in the study. They stopped producing 10% in 2009 and the study is from 1993, so 10% is my guess.

I posted my updated packing list on my blog and solicited feedback from a few of the groups I'm in. I also contacted Dr. Marta about any necessary prescriptions I should bring. They apparently don't have anything as strong as Vicodin or Percocet, so if I want something that strong I'll need to get it here. I don't know how comfortable my doctor would be writing prescriptions for those, and I'm not sure I really want something that strong.

After losing a bunch of weight, the last time I took Percocet it really put me on my butt, even on a full stomach. I might see if I can get some Tylenol 800mg. Does anybody have any thoughts on this? The studies on this seem to indicate that a combination of acetaminophen and ibuprofen is the most effective non-narcotic option, and what I was planning to do. But I also don't want to be under prepared if an opioid is absolutely necessary.

Also in other news: my roommate has requested that I not hire a dog walker while I'm gone. He said he doesn't feel comfortable with having someone in the house when neither of us are there during the day. I offered to set up a camera, and he said that wasn't necessary and that he'd walk the dog a few times a day and we could work out some kind of payback after the fact, most likely in the form of food. I had budgeted $700 for dog walks for the 17 days I'll be gone, so that's a huge savings!

Hi, Max.  That is really interesting about the DHT.  Have you heard of it not helping anyone else?

That is great about your roommate!

I think that you can't take Ibuprofen and acetaminophen at the same time.  You can rotate every 4 hours.  I would strongly suggest you consider Toradol.
  https://www.drugs.com/toradol.html

I really, really loved it and it didn't make me feel "dopey".  With that said, I strongly, strongly suggest you bring an opioid.  No way regular ibuprofen or Tylenol could have handled my pain.  As an aside, I did some reading and Ibuprofen really is strongly recommended for surgeries (especially soft tissue type), over Acetaminophen.  Surgeons like acetaminophen due to blood thinning of ibuprofen, but I am just SO over the Tylenol...it did nothing for me.  stage 1 and during stage 2 I did the every 4 hours flip flop (this was after I stopped opioids and Toradol) and decided the Tylenol was useless.  Our pain comes from inflammation...that is what ibuprofen is for!  Toradol you are only supposed to take for 5 days, but I got Ursula to give me an extra 5 (hee hee).  It made a big different.  I really don't like opioids but do take them the first couple days.

I've actually heard of a few guys not seeing any changes recently, but they've all been on T much longer than I have. DHT apparently only works if you still have available androgen receptors down there. So for someone that's been on T for 5+ years, it does kind of make sense to me that they wouldn't see anything. Yet it apparently works for cis men with micropenises, who all presumably generate some amount of testosterone for themselves. Idk. Science is not my strong suit. Even if I don't get any growth from it, I think I'll be fine. I can already clear my fly while wearing underwear and jeans with very little difficulty, so I'm hoping with the little boost I'll get from the mons resection, I should have no issues.

Can I ask what you took for top surgery and how long you took it? I know that's not really a point of comparison pain wise, but it is about as close as I get to it. I used Lortab for less than 3 days for that and honestly don't feel like I needed it, didn't need them for my hysto, and took one percocet after my wisdom teeth were removed. I had a chronic fatigue/pain issue for several years and as a result it takes a significant amount of pain for me to even notice that I'm hurting.

Looking at the Toradol - it says you shouldn't use it if you have active or recent bleeding which is a concern for me due to the vaginectomy. I just asked about meds on the yahoo group specifically for folks who went to Dr. Miro so hopefully I get some responses. I just saw my doctor for the surgical clearance and lab work and she said she might want to do some vaccines before I go, so if I need anything it shouldn't be too hard to stop in and ask.

As far as the OTC options, you can combine ibuprofen/aspirin/naproxen with acetaminophen because the function within the body is different. You couldn't combine ibuprofen with aspirin or naproxen (or any combination of those) because the function within the body is the same, though you could cycle them when it is time for another dose.

Gosh, all this talk of pain meds. I can't swallow pills so this is always a problem for me. I end up just taking OTC stuff and I'm fine. I have to crush pills into a powder and knock it back. So I know what meds actually taste like. Antibiotics and opioids taster the absolute worst. I'm really hoping my ability to handle pain well continues with phallo. But I'm sure my genital area will be on fire.

Quote from: CMD042414 on January 22, 2017, 07:47:02 PM
Gosh, all this talk of pain meds. I can't swallow pills so this is always a problem for me. I end up just taking OTC stuff and I'm fine. I have to crush pills into a powder and knock it back. So I know what meds actually taste like. Antibiotics and opioids taster the absolute worst. I'm really hoping my ability to handle pain well continues with phallo. But I'm sure my genital area will be on fire.

I used to not be able to swallow pills. I think (not 100% sure) there is a liquid Tylenol w/ codeine? I could be wrong though. I made the mistake once of trying to blend up my daily vitamins in my breakfast smoothie and that was so awful I wouldn't wish crushed up pills on anyone.

Quote from: CMD042414 on January 22, 2017, 07:47:02 PM
Gosh, all this talk of pain meds. I can't swallow pills so this is always a problem for me. I end up just taking OTC stuff and I'm fine. I have to crush pills into a powder and knock it back. So I know what meds actually taste like. Antibiotics and opioids taster the absolute worst. I'm really hoping my ability to handle pain well continues with phallo. But I'm sure my genital area will be on fire.

That use to be my problem. Then I got a period and I learned to swallow pills very fast.

My friend got his plane tickets finally! We're sitting next to each other on all but the very last flight, and even then I think we're just across the aisle from each other.

I got all my lab results back from my doctor and have forwarded them along to Dr. Korac. I'm a little nervous about the bill I'll probably get in the mail for them. My doctor coded them all in such a way that they should be covered as much as possible (fatigue for the EKG, high risk sexual behavior for the HIV and hep tests, etc.), so fingers crossed for that.

I did my taxes yesterday as well, in hopes of having a refund prior to my trip. The IRS has already accepted it, so hopefully I'll have a big influx of cash within the next month. For anybody who had surgery or had a lot of medical/dental expenses over the last year or will next year - save those receipts, put together a spreadsheet, and see if it's worth it to itemize! I'm getting $3.3k back and reduced my taxable income by $21k with itemized deductions. I am happy to show you what this looks like and how to do it. Hopefully I'll have my refund back before my trip!

Looks like my doctor's method of coding worked. I got my explanation of benefits - the bill was initially $787 for all the pre-op testing needed, but insurance took care of everything and I owe nothing. Win!

I still haven't heard anything back from Dr. K about my lab results. I emailed Dr. Marta to let her know that I had sent him everything, and I haven't heard back from her either. That is so far my only complaint about this team - a lot of their responses are not very timely. But that seems to be a problem with most surgeon's offices so I can't really say it's a unique issue. Plus when they do respond it's generally with more detail than I've experienced from other teams. I think it just stresses me out more because there are significantly more miles between me and this team, so IMO everything needs to be coordinated much more efficiently.

I also checked on my tax refund, and that is officially being processed. The IRS says I should have all my money back by 2/1, which is great. I am going to set it all aside in a separate account. It is the equivalent of a full month's worth of pay for me, so it's good to know I have that much available in the event that I need to exceed my 5 weeks of paid vacation and am unable to work from home for whatever reason. I'm sending good vibes into the universe and doing all that positive visualization stuff, but I'm a planner at heart so it does my brain good to know that there's a plan C.

51 more days until surgery, 49 until I leave for Serbia!

Quote from: FTMax on January 24, 2017, 01:41:13 PM
I did my taxes yesterday as well, in hopes of having a refund prior to my trip. The IRS has already accepted it, so hopefully I'll have a big influx of cash within the next month. For anybody who had surgery or had a lot of medical/dental expenses over the last year or will next year - save those receipts, put together a spreadsheet, and see if it's worth it to itemize! I'm getting $3.3k back and reduced my taxable income by $21k with itemized deductions. I am happy to show you what this looks like and how to do it. Hopefully I'll have my refund back before my trip!

When I had top surgery I had to stay in a hotel for a week while I had drains in. Does that count as a medical expense?

Quote from: AnxietyDisord3r on February 01, 2017, 05:36:18 AM

Quote from: FTMax on January 24, 2017, 01:41:13 PM
I did my taxes yesterday as well, in hopes of having a refund prior to my trip. The IRS has already accepted it, so hopefully I'll have a big influx of cash within the next month. For anybody who had surgery or had a lot of medical/dental expenses over the last year or will next year - save those receipts, put together a spreadsheet, and see if it's worth it to itemize! I'm getting $3.3k back and reduced my taxable income by $21k with itemized deductions. I am happy to show you what this looks like and how to do it. Hopefully I'll have my refund back before my trip!

When I had top surgery I had to stay in a hotel for a week while I had drains in. Does that count as a medical expense?

Yes, you can deduct travel expenses (airfare, rental car, etc.) as well as lodging expenses that are related to medical care. The lodging expenses have a $100/day cap.

Hi folks,

I started a private FB group to document my meta experience. It'll have daily updates, pictures, and videos throughout my experience. If that is something anyone here would be interested in, send me a message.

I'll be compiling my posts from there to add to this thread and my blog, but if anyone wants to see things as they happen and see pics, that'd be the best place for it.

I haven't been active in this thread in a month. Surgery is officially under two weeks away.

I emailed Marta last week to ask if I could pay for the apartment via wire transfer instead of carrying over $1000 cash with me to Belgrade. She gave me and my friend a discount for sharing an apartment together and for paying in advance, which was nice of her. The transfer went through last Friday, so that's all taken care of. No more big expenses left! The spreadsheet I use to track all these expenses is on my other computer, so I'll post a breakdown of what everything came out to at a later date.

I need to go to the bank sometime next week and take out some cash. I'm planning to use my travel credit card for meals during the layover in Frankfurt and groceries once we're in Belgrade. Cash would be just for taxis in/around Belgrade. I can't imagine spending more than $250 on taxis in 2 weeks, but you never know. I think that's what I'm planning to take out.

I've got a little calendar as my desktop background that has all the days between now and then, and 3 things in each block that I want to accomplish that day. It's been nice for keeping me focused and not letting me jump too far ahead. I just wake up each day, look at what I need to do, and do it. It also hasn't allowed me much time to worry about all the what ifs.

A big part of each day for the last two weeks has been a daily 5 mile hike. The rule for the hike is that I can't think about anything other than the hike I'm on while I'm out there. This is about as close to meditation as I get, and I think it's been really good for my stress levels.

The big task on the schedule this week is some hardcore meal planning and prepping. I'm planning to load my freezer up with meals that I can reheat in the microwave or bagged smoothies that just need to have water added. That way when I come home, there's no need to go shopping or stand around in the kitchen cooking. This weekend I'll be visiting each of my parents for the last time before surgery. Due to some work developments (vacations approved at the last minute, employees leaving the company), I think I need to move up some tasks into this week (packing, hair cut).

Like I mentioned in the last post, I started a private Facebook group to document my experience. As of right now, that is the only place where pictures will be posted. So if you would like to see pictures and follow that experience as it happens, add me on FB via the icon under my avatar and send me a message saying you'd like to be added to the group. I'll be posting a summary of the goings on after the fact on my blog and here. But probably no pictures on my blog and definitely no pictures here.

Quote from: FTMax on March 08, 2017, 09:39:04 AM
I haven't been active in this thread in a month. Surgery is officially under two weeks away.

I emailed Marta last week to ask if I could pay for the apartment via wire transfer instead of carrying over $1000 cash with me to Belgrade. She gave me and my friend a discount for sharing an apartment together and for paying in advance, which was nice of her. The transfer went through last Friday, so that's all taken care of. No more big expenses left! The spreadsheet I use to track all these expenses is on my other computer, so I'll post a breakdown of what everything came out to at a later date.

I need to go to the bank sometime next week and take out some cash. I'm planning to use my travel credit card for meals during the layover in Frankfurt and groceries once we're in Belgrade. Cash would be just for taxis in/around Belgrade. I can't imagine spending more than $250 on taxis in 2 weeks, but you never know. I think that's what I'm planning to take out.

I've got a little calendar as my desktop background that has all the days between now and then, and 3 things in each block that I want to accomplish that day. It's been nice for keeping me focused and not letting me jump too far ahead. I just wake up each day, look at what I need to do, and do it. It also hasn't allowed me much time to worry about all the what ifs.

A big part of each day for the last two weeks has been a daily 5 mile hike. The rule for the hike is that I can't think about anything other than the hike I'm on while I'm out there. This is about as close to meditation as I get, and I think it's been really good for my stress levels.

The big task on the schedule this week is some hardcore meal planning and prepping. I'm planning to load my freezer up with meals that I can reheat in the microwave or bagged smoothies that just need to have water added. That way when I come home, there's no need to go shopping or stand around in the kitchen cooking. This weekend I'll be visiting each of my parents for the last time before surgery. Due to some work developments (vacations approved at the last minute, employees leaving the company), I think I need to move up some tasks into this week (packing, hair cut).

Like I mentioned in the last post, I started a private Facebook group to document my experience. As of right now, that is the only place where pictures will be posted. So if you would like to see pictures and follow that experience as it happens, add me on FB via the icon under my avatar and send me a message saying you'd like to be added to the group. I'll be posting a summary of the goings on after the fact on my blog and here. But probably no pictures on my blog and definitely no pictures here.

Hey man, how'd it go?

It went well! All the travel went fine, no hangups with TSA or security at any of the airports. Surgery was a little over 3 hours and they did the metoidioplasty with urethral lengthening, vaginectomy, scrotoplasty, medium sized testicular implants, and a large mons resection. I was in the hospital from Tuesday night through Saturday morning, mostly because the guy I traveled and shared an apartment with had surgery the day after me and they felt it would be more convenient to keep us on a similar schedule.

Didn't need any narcotic pain meds the entire time! I was never really in any pain, just a lot of soreness in the balls. The time back at the apartment (Saturday 3/25 - Wednesday 4/5) was pretty uneventful. Dr. Marta came by almost daily to change bandages and check on us, and her mom who lives upstairs brought us food frequently so we didn't have to cook too often.

The only slight issue, which is really a non-issue since it's very common, is some light bleeding from between my stitches. Marta said because we removed the drain from the mons resection, whatever old blood and fluid is leftover in that region will slowly migrate down and out over the next few weeks. Gauze was irritating me so I'm wearing really thin pads.

I get to try peeing for the first time this coming Tuesday and if all goes well Dr. Miro will let me pull my catheter a few days after that. If I have any leaks, they'll want me to keep the catheter and use it for another week before trying again.

It was a great experience, I'm super happy with how everything looks aesthetically. Fingers crossed that my urethra is flawless! Miro will be in the US this week so if I have any issues he'll be much easier to get ahold of than if there was a time difference. I am considering a second small surgery to join my ball sack at a later date, but I want to see how things settle and heal over the next six months before I make a decision on it. Marta said it would just be a small (under $1000) hospital fee plus whatever it costs to get over to Serbia. Still cheaper than using my insurance :P

Wow that's great to hear. I'm glad it went well. Sending good vibes that your urethra continues healing with no serious issues. Did you get to see Serbia at all? And did they do the UL through the tip? Being that you didn't need pain meds were you bored as all hell waiting for the days to go by lol? I can imagine you weren't able to actually do anything in recovery.

Yes, UL through the tip.

I didn't see much of Serbia. Just the views of our street and the short walk through a local park to a grocery store. Marta and some of the other doctors also took us and some visiting American surgeons (Nikolavsky, Zhao, Weinberg - the last two you will probably meet soon!) out to dinner, so got to eat at a nice restaurant and see a different part of town. Other than that, I stayed put. Miro said we should be walking as little as possible to let the implants encapsulate and stay relatively close to where he originally set them. My surgery comrade did not heed this advice and his have already started to migrate.

It was a little boring just hanging out in the apartment, but I watched a ton of Netflix, read some books, and caught up with people on social media. I started a FB group to document everything and that was also fairly active with pics, Q&A, etc.

Yes, I met Zhao in NY and he is really nice. Crazy smart too. I'm really glad he's my urologist. I wouldn't peg Serbia as a place to go for trans surgery. Sounds like a good option though.

 FTMax, so glad that you are having great results so far and that your UL and peeing go fine this week.  i have seen the results of having the balls sacs as you put it joined together, looks so much more natural afterwards. Continued to give us reports. Thanks

Happy for you Max, that is awesome!! <3