I have FFS surgery scheduled for late February '09 with Dr Spiegel in Boston.  I've been a member of the FFS yahoo group for much of my research which was helpful, and accumulated many tips from there for getting ready for the surgery (giving credit to the women at the FFS group for this list).   I'll post my current planning here, and if anyone has additional tips or comments on these, would love to hear them!

• Hotel reserved close to the medical center.
• Microwave and Refrigerator in the hotel room, it will be my abode for 10 days.
• Have someone with you, at least the first 3-5 days or so.  A friend is coming thank goodness.   I was so fearful of going alone.
• I ordered SinEcch, which is a laboratory prepared form of Arnica, which is a homeopathic herb remedy to help with post-surgical swelling and bruising.
  
• Have a couple of bags of frozen peas in the freezer, the shape and flexibility of the bags fits nook and crannies better to get cold too.
• Get nutrition shakes, like Ensure.
• Get medication for pain and anxiety (Valium) beforehand, at current Dr, where it's covered by my medical plan.
• Get Vitamin E to apply to wounds to reduce scarring.
  

That's all I really have on my list for preparation and to cover the 7-10 days following surgery.  Any other advice? 

Oh and if anyone has been to Dr. Spiegel before and has advice specific for working with him or his office, or the BMC I would love to hear it, either posted here, or sent via personal message.   I've met with Dr. Spiegel and his staff twice, and was impressed with their professionalism and objectivity.  I've also met a few post-surgical patients of his, and was awed by their results, which seemed very natural and feminine to me.

Thank You, *huggs*,
Melan

Not speaking about FFS itself (never had it), but books or books on tape for something to do? From what I know about it, you won't be too physically active for a while, so you might need some distractions. Or music or a dvd player with movies maybe?

Dennis

Thank you for the reply Dennis 

A good reminder for me to get a bunch of divx movies i have moved to a portable USB drive for the trip.  The first 4 seasons of "24" should keep me occupied, and brain dead for 10 days, *giggles*.

And I have a backlog of books to read and bring, good ideas!   Thank you!

*huggs*,
Melan

You really won't be feeling like watching anything for a few days. Have some food ready for your friend to make for you.. easy stuff like applesauce, pudding, mac and cheese. Plenty of juice. Pain meds, vaseline, pain meds. Did I mention pain meds?
Good luck!
FWIW, I felt that the surgery was really worth it, but it really kicked my butt. recovery might be longer than you think.
Namaste, Lunae

Thank You Lunae,

Vasoline added to list... pain meds were on there.. must get more!!! lol.  I really hate the sound of that.   Hey, my FFS doc never said anything about this being painful!  *giggles*.

I have 3 weeks to recover, before returning to work .... I hope I'm ready, yikes!   Just to make sure it's a stressful enough time, my return to work will be my first day at work "as a woman"...

*huggs*, Take Care,
Melan

Its also advisable to stop taking hormones for a while and any other tablets such as aspirin, if you take them. Leaving tablets out that may cause blood clots or thinning is safer.

I actually took some instant chemical ice packs (the type you use for sports injuries), which where really useful.

Dont forget the dark sun glasses and make up (especially good concealer), swelling goes down relatively quickly but bruising takes a lot longer.

I went back to work a month after FFS, still had some bruising around my eyes, but that was mainly from have the septorhinoplasty.

Rebecca

Quote from: Buffy on January 17, 2009, 10:38:36 PM
Its also advisable to stop taking hormones for a while and any other tablets such as aspirin, if you take them. Leaving tablets out that may cause blood clots or thinning is safer.

I actually took some instant chemical ice packs (the type you use for sports injuries), which where really useful.

Dont forget the dark sun glasses and make up (especially good concealer), swelling goes down relatively quickly but bruising takes a lot longer.

I went back to work a month after FFS, still had some bruising around my eyes, but that was mainly from have the septorhinoplasty.

Rebecca

Thank You Buffy!

The doc has me stopping hrt/aspirin two weeks prior, yikes!  Not a pleasurable idea, but it is a necessity. 

I have some of those large sunglasses that were the fashion last year  so I'll pack those as well as the chemical ice packs.   Maybe for the first bit of travel I have to make post-surgery I can pick up an Obama mask, *giggles*.

*huggs*,
Melan

1) Try to limit intake of percocet if he gives it to you, can cause bad nightmares post-FFS (did for me and many other I know).

2) PLEASE make sure you either have some with you the firt three days after or have people check in on you physically. Let the front desk know you are having major surgery and that you'd really appreciate it if the manager could check in on you once a day to make sure you are ok.

3) Give yourself a good 10 days of pain, swelling and feeling really out of it, if you are having a lot done. For long-term, remember that it takes at least 4 - 6 months to see real changes. Don't get depressed looking in the mirror after like 5 days and saying "nothing changed!"

4) Write yourself a letter beforehand to yourself. Tell yourself why you are having surgery, that you expect to get a little depressed and tell yourself some positive things to make yourself smile. Post-op depression is very, very real. Being couped up in a dark, cold hotel room can contribute to it. Try to get up after a few days and walk up and down the hall with a friend or something.

5) Stay in touch with friends and family/keep a journal of your experience. It will fly by and you'll wonder to yourself, "hey, what happened!" so try to write some stuff down and talk to people.

Those are my tips for you If you need anything at all, let me know I went through it in July!

Thank You Meghan!   Some great tips there.

I really like the point about writing the letter.  I can see the post-op depression taking a toll, and wondering why the heck I did this, needing that reminder.  Added to my pre-op to-do list!

I have a friend coming for the first 5 post op days or so, luckily enough.  Between her and a laptop, I should be able to keep human contact with friends and family while couped up for 10 days in a hotel room.

Thank You!  *huggs*,
Melan

I just want to echo what others have said about the bags of peas.  When I had surgery, they worked great, plus it costs almost nothing.  I got one large bag at the grocery store and divided it up into four ziplock bags.  That way I could have two in the freezer and two being used (one for each side) at all times.  They will get into the folds of your skin a lot better than the chemical ice packs, so they are great to have right after surgery.  Then I would go with the others, especially after your friend leaves.

Best of luck, hon.

Kristi

Quote from: Kristi on January 19, 2009, 11:18:47 AM
I just want to echo what others have said about the bags of peas.  When I had surgery, they worked great, plus it costs almost nothing.  I got one large bag at the grocery store and divided it up into four ziplock bags.  That way I could have two in the freezer and two being used (one for each side) at all times.  They will get into the folds of your skin a lot better than the chemical ice packs, so they are great to have right after surgery.  Then I would go with the others, especially after your friend leaves.

Best of luck, hon.

Kristi

Thank you Kristi for the good wishes!  Frozen peas are on the list for sure!   

*huggs*,
Melan

Quote from: Melan on January 20, 2009, 07:48:52 AM

Quote from: Kristi on January 19, 2009, 11:18:47 AM
I just want to echo what others have said about the bags of peas.  When I had surgery, they worked great, plus it costs almost nothing.  I got one large bag at the grocery store and divided it up into four ziplock bags.  That way I could have two in the freezer and two being used (one for each side) at all times.  They will get into the folds of your skin a lot better than the chemical ice packs, so they are great to have right after surgery.  Then I would go with the others, especially after your friend leaves.

Best of luck, hon.

Kristi

Thank you Kristi for the good wishes!  Frozen peas are on the list for sure!   

*huggs*,
Melan

This might be off topic but you look like you don't need FFS.

Stardust

Quote from: stardust on January 23, 2009, 02:13:46 PM

This might be off topic but you look like you don't need FFS.

Stardust

Hi Stardust,

Thank you for the comment.  But a picture doesn't really capture the nuances of the face, especially if you are like me... take 20 pictures, and you get one that comes out like you like, and is halfway flattering.   My point is I do look ok in person, and usually pass (well, still working on voice, uggh), but my height which I can't do anything about, is like a flashing neon sign, saying look at me, and it's usually on that 2nd look that people get that *knowing sparkle* in their eyes.  That in itself isn't enough to concern or worry me too much.  However, I'm a career professional, transitioning in a difficult environment, that isn't perhaps the most forgiving of industries, with a very male-dominated management (which I am part of), where, in my company of 10,000 plus employees, no trans woman has ever gone before.  Hell it's rough going for my fellow management women co-workers.   FFS is as much as an investment in my future, my career.  Not looking 100% the part of the woman that I am would handicap me in my day to day worklife, where I need to be able to get my point across, to convince people of my plan or proposal, etc.   

Oh, and frankly, if I goto hot yoga or swimming without makeup, forget about it, i look like a dude.  FFS will cure that.  I'm using savings from the last 10 years to do this, pieced together whilst living miserably in my closeted, denial, "run and hide from the world" years.   It's so gratifying that something so wonderful came from that dreary time period of my life.  So happy and excited, and FFS will be a part of building that continual happiness with my new life.

*huggs*,
Melan

Check with your doctor about any OTC meds or herbals you are taking.  Herbals ore not FDA tested and you never know how they will interact with prescribed meds.

The first four days for me was VERY painful.  All I wanted to do was avoid the pain and get past this ASAP.  You cannot take care of yourself right after surgery so having someone there with you is a necessity.  And pain meds do not help reasonable thought processing.

Cold smoothies, icy frostys, fruit juices and tapioca pudding were my staple for the first few days.  My GF cut up small pieces of meat to help with protein intake.  Protein is beneficial in the healing process. 

Sleep will come usually right after taking the meds.  The pain will wake you.  Then it's med time, nibbling then sleep.  And the cycle will repeat itself.

You'll want plenty of pillows to prop you up so you can sleep sitting up.  I bought one of those cushions with the arms on it, commonly used for bedtime TV watchers.

After the first four days the pain levels dropped off dramatically.  I was off pain meds by the end of the fifth day.  Eight days after my FFS I was on a plane to Montreal.  I didn't look all that great but I had no problems traveling.  Two weeks I was back in surgery for BA.  (NOTE: This is not something I would recommend!  Two general anesthesias in two weeks was more than the body could take.  It took months before I felt normal again.)   

A side point - My endo doctor is against stopping HRT for any surgery.  He's been at this for 30 years, has written papers on it and is often asked to speak at seminars.  I believe what he says.  My FFS doctor did not require it and I had no problems. 

In conversation with a well known FFS surgeon my endo asked him why he tells his patients to stop HRT before FFS.  He said it was a precautionary measure.  "Do you prescribe testosterone to your female patients before surgery?" he asked.  The FFS doc didn't answer.  "Do you think it's wise to put your TG patients through menopause because of this precautionary belief?"  The FFS doc walked away.  My endo says this is an antiquated belief and needs to be corrected.

You will be going through a lot of physical trauma.  Does it make any sense to add emotional trauma to that?  I'm not suggesting you disobey doctor's orders but it wouldn't hurt to ask why he feels it's necessary to stop HRT.  My understanding is blood clotting is the biggest reason but my endo says there's no evidence to prove that.  Check with your doctor.  If you are on a full course of HRT meds you could experience depression, fatigue and other negative side effects from going off the meds.  If that can be avoided it will make your recovery that much easier.

I wish you all the best and a speedy recovery.

Julie

Hi Julie,

Thank you so much for the words of advice!  The protein is noted, I hadn't made plans to make sure that was in my post-op diet, but will now.   Pillows, I'll be flying in, but perhaps I will pick up an arm-pillow, the night before on my pre-op shopping trip there.   I will survey the "pillow situation" at the hotel and make sure they are adequate, and if not, add that to my purchase list.

Comforting words about the pain dropping off after 4 days, and flying comfortably after 8, which is when I will be flying.   Thank you for that.   I won't be doing any additional surgeries for awhile, thank goodness.   

As far as stopping HRT, it is much too late for me to protest, or debate my Dr. on this point.   I've not been affected too emotionally by HRT, perhaps I'm odd that way.   I just don't want to allow any complications from not following the Dr orders to stop the HRT.    I will bring that point up with Dr Spiegel, but I will not counter him on this, as I don't want to rock anything, and do want to get through this thing without interpersonal complication.   I don't foresee stopping HRT affecting me too much.    If I regrow a beard though, I will be pissed, *giggles*. 

Thank you so much for the advice!

*huggs*,
Melan


     

   

Quote from: Julie Marie on January 23, 2009, 05:15:41 PM
You'll want plenty of pillows to prop you up so you can sleep sitting up.  I bought one of those cushions with the arms on it, commonly used for bedtime TV watchers.

Good point, Julie, I forgot about that. I know it's overdoing it, but I slept at a 45 degree angle or more for the three months after my surgery to ensure that my face didn't swell any more than necessary. It's REALLY REALLY important, like Julie said. I have always slept on my stomach and it was hard to get used to so I spent the month before FFS basically learning to sleep on my back. It worked well. Also put a lot of pillow and firm cushions all around you tight and you won't roll over in the middle of the night

Quote from: Julie Marie on January 23, 2009, 05:15:41 PM
A side point - My endo doctor is against stopping HRT for any surgery.  He's been at this for 30 years, has written papers on it and is often asked to speak at seminars.  I believe what he says.  My FFS doctor did not require it and I had no problems. 

Dr. O. also agrees that stopping hormones is not necessary. I was on them the whole time and never had any issues that I know of. If possible, I say continue them! Good point Julie!

I had surgery with Dr Spiegel July 29 last year. Exactly how you feel post op will depend on how much your having done and on how well and quickly your body tends to recover from surgery. I had surgery two days before a friend of similar age underwent a similar set of procedures and two weeks after you'd hardly guess what she'd just been through, whereas I still looked like I'd just been dragged out of a major car wreck.

Assuming you're having 'the works' and you're you experience much the same as I did, during the first three days post op expect to feel pretty damned awful, largely incapable and very uncomfortable with the swelling etc. and all you'll want to do is sleep. At this stage I would strongly recommend you have someone with you if at all possible. I really wouldn't worry too much about pain, however, in my experience and that of my friend there's very little post op pain and you'll leave hospital with enough Percocet to control any amount of pain short of a DIY amputation. As Megan has said be careful with the Percocet by day 4 both of us were experiencing really unpleasant nightmares induced by this drug and as a consequence stopped it and substituted straight paracetamol which was all we needed by then anyway.

In those first few days eating can be a problem. I'd recommend soups and purees, as I could barely open my mouth sufficiently get a spoon into it.

As far as I remember psychologically days 3-6 were the worst and I suffered quite severe post op depression with that 'what the hell have I done to myself' feeling. It'll pass however, as you start looking more human and less 'creature from the black lagoon'.

As far as things to take with you, most have be stated here, but haven't you been given a list by Kelly? If, you haven't I'd ask her for one soon.

I hope I haven't painted too black a picture, but no one should be under any illusion that this is anything other than major surgery with many hours of anaesthesia and these will temporarily take their toll. However, six months on I have absolutely no regrets, and given the rewards, I'd go through it all again in a blink of an eye.

Hi Jenny - Nice to see you "this side"...

Quote from: Jenny Jackson on January 24, 2009, 01:55:57 AM

I had surgery with Dr Spiegel July 29 last year...
...I have absolutely no regrets, and given the rewards, I'd go through it all again in a blink of an eye.

Jenny's being modest...

Before the surgery Jenny was "quite attractive" - Now, she's ABSOLUTELY GORGEOUS!!!

Quote from: Jenny Jackson on January 24, 2009, 01:55:57 AM
I had surgery with Dr Spiegel July 29 last year.

Hi Jenny, Thank you so much for the response, sharing your experience, and words of advice.  Did you stop use of HRT two weeks prior, per Kelly (and Dr. Spiegel's instructions) ?.  Kelly did send me a list.  I've found it useful, however, it has been augmented with much of the wonderful advice I've garnered in this post.

Quote from: Jenny Jackson on January 24, 2009, 01:55:57 AM

Exactly how you feel post op will depend on how much your having done and on how well and quickly your body tends to recover from surgery. I had surgery two days before a friend of similar age underwent a similar set of procedures and two weeks after you'd hardly guess what she'd just been through, whereas I still looked like I'd just been dragged out of a major car wreck.
In those first few days eating can be a problem. I'd recommend soups and purees, as I could barely open my mouth sufficiently get a spoon into it.

Yes, pretty much doing the works.  May I ask roughly how old you and your friend are?  I'm a hair shy of 40, and do *knocks on wood* tend to heal quickly, but we shall see.  I'll be trying SinEcch, having heard wonderful things about Arnica and the healing process.

Quote from: Jenny Jackson on January 24, 2009, 01:55:57 AM

I hope I haven't painted too black a picture, but no one should be under any illusion that this is anything other than major surgery with many hours of anaesthesia and these will temporarily take their toll. However, six months on I have absolutely no regrets, and given the rewards, I'd go through it all again in a blink of an eye.

I have no illusions about the invasiveness of this surgery,nor what is required to recover from it.  I have read many journals, talked to several post-operative patients in person, and left my bed wet from sweat more then once thinking about it.   The friend I have going with me, is extremely smart, caring, raised 4 kids, so she is really good with dealing with boo boo's ... my face will just be one really big boo boo for her.

Thank you all so much for the posts and words of advice.   It helps tremendously to hear things like "However, six months on I have absolutely no regrets, and given the rewards, I'd go through it all again in a blink of an eye." as Jenny wrote, and will be one of the things that goes into the letter to myself, as per Meghan's advice.

*huggs*, Thank You,
Melan

One other thing (I can't believe I forgot this): Virtual FFS.

I joined FFS Support, read countless stories, saw many before and after photos, talked to local professionals as well as former patients but nothing helped me as much as Virtual FFS.

If you aren't aware of it, it's a service that takes your present pictures and does a virtual image of what you'd look like after FFS.  Alexandra, the woman who does this, is very knowledgeable about the various procedures and produces very lifelike results.  It wasn't until I did this and saw the results that I finally had an idea what I'd look like.

Along with the pics she provides a detailed description of each procedure she did and alternatives to what she did.  I paid for three pics but she sent back six, three with chin work, three without.  I took these to my consultation along with the list of procedures and descriptions.  I had two consultations and in both, after I had decided what work I wanted done, I asked very directly, "Is this a realistic possibility?"  The doctor said confidently it was. 

Now I had something to hold him to.  There would be no, "I thought you meant..." when describing what I wanted.  I had pictures and he said he could do it.  No doctor can perform all the procedures with great results.  You have to weed out their weaknesses and the pictures help.

My GF did the same thing and sent them to several doctors, Spiegel included.  She got email responses, did phone consultations (some for a fee) and did a lot of outside homework before she decided on her doctor.

I showed her the virtual FFS pic of me recently and asked if the work turned out like the picture showed.  She said, outside of the nose (which I didn't do) it was pretty much identical.  You can see my VFFS pics here: https://www.susans.org/forums/index.php/topic,24462.0.html

It's a great tool and well worth the money.  And for me, it was what motivated me to have the work done.

Julie