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Surgery in Thailand – Part 2, Hospital

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Day before surgery – Lisa and I doing a ‘selfie’. I love this picture!

Our third day in Chonburi, Thailand started like the previous ones, get up, wash, dress and then meet the other transwomen for breakfast on the first floor of the hotel at 9 am.  Breakfast usually takes an hour as we sit and chat.  Then promptly at 10 am everyone goes back to their rooms.  Later I would find out that the clinic staff starts their rounds at 10 am and everyone needs to be in their room then.  But that would not effect me until after I came back from the hospital.  I was told to be waiting at the front lobby at noon for the clinic van for my ride to the hospital.  So we went up to our room to select and pack the few things we would need.  I brought a dress (and wore another one), my get well cards, computer and tablet to have something to do and some of my astronomy magazines to read.  Not much for a week in the hospital!  Before we knew it, they called up from the lobby – again our room clock was wrong but was close enough that we were ready and were almost out the door anyway.

I remembered the first trip in the van to the hospital and how the woman in the back seat was on her way in for the surgery and how she was feeling – nervous but excited.  I was the same, a feeling of finally, let’s do this.  As we waited in the hospital lobby, an older Thai man and his wife started to chat with us – but they didn’t know any English and of course we didn’t know any Thai.  It was interesting and a bit uncomfortable as he kept staring at me, probably figured out I was transgender.  They were polite, but I couldn’t wait to get up to our room.

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Just got into my room, night before surgery. Waiting for the 2nd bed and soft mattresses.

I had a private room with two beds and a nice view of the bay off of the ocean.  Lisa stayed in the bed next to me the entire time which was quite a comfort.  Being a nurse, she could communicate with the other nurses and the doctors to make sure everything was right, plus she was able to help and to direct my care, given her experience.  At times it sounded like yet another foreign language as they spoke to each other in medical’ese!  I was really impressed with the nursing staff and doctors and the way they treated Lisa as one of them.

Great Thai food – although due to the language difference we sometimes were surprised by what actually showed up.  But that was good too – never disappointed – although surprised.  Also some american food they prepared was, well, the best way of saying this is that is was ‘their’ interpretation of what it was supposed to be.  It was still good.

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View out our window. The bay (tide is in) on the right. This is mud during low tide!

 

I was admitted at noon the day before the operation.  After settling in, getting a special mattress top for the bed (the beds were solid as rock …), we ordered something to eat as the nurses brought all the other ‘stuff’ that I would need afterwards and went through it all with me (dilators, pads, medicines – quite a large amount of stuff).  The anesthesiologist came in and had a long talk with Lisa about what I could and could not take (I have a reaction to ibprofin).

Then a psychologist came in to interview me (making sure I really was a transsexual).  I had to draw two pictures, one of me, the other of some scene, with trees, etc.  The first picture I drew of myself, longer hair, wearing a dress and giving an astronomy talk.  The second picture I drew of a cabin in the woods, on a lake, a porch going out over the sand beach and Lisa and I in inner tubes close to shore.  He asked about each picture, getting details of why I chose what I did.  He seemed impressed by them …

And finally Dr. Suporn and the staff member that would be looking out for me came in.   Later that night, after enjoying a particularly good Thai supper – the enema nurse came in …. oh girl.  I supposed since I had already enjoyed that meal – what difference did it make ….. Trying to make it to the bathroom that final time was um ‘interesting’ and challenging to say the least.

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Right after surgery. I feel great – certainly not how I look tho… This was taken very soon after I came around after surgery.

The next day went soooo fast it’s hard to remember what happened.  I do know they came in early – like 6am or so.  First was a nurse that shaved me down there.  I don’t remember much about that, just that it happened.  Then a bit later they came in and inserted an intravenous tube in my veins.  At 9 am they came to get me.  They wheeled my bed down the hall, into the elevator and down to the operating room.  Boy, watching the ‘ceiling’ move, Lisa by my side, nurses by the other side, was a strange feeling.  Lisa was by my side all the way into the operating room suite, holding my hand tightly and smiling.  I remember holding Lisa’s hand, lots of people in blue and the anesthesiologist (she was very sweet and comforting) talking to me – and then ……. nothing (someone ‘slipped a mickey’ into the intravenous I when I wasn’t watching ….). In the states, they would always say “count backwards from 10” but here, things just went blank.

This next part is from Lisa – as I have no memories of.  Lisa got back to the room at about 9:15am and waited there for me.  I and my bed were wheeled back into our room at 3:20 in the afternoon.   Lisa says that as soon as I saw her, my face just beamed – totally glowing she says.  She said I just kept looking at her, I couldn’t keep my eyes off her! I would fall asleep for a bit, then wake up, hold Lisa’s hand and we would talk for a bit before I would fall back asleep.

My first recollection of conscientiousness was back in my room, in my bed, with Lisa giving me a kiss to wake me up!  My new bottom was fully bandaged with a stent packing inside me.  I had three tubes coming out: urethrae, drain from under the packing and a catheter with a drip bag with a side tube for a morphine drip.  Right away, the first feelings I had were of a very deep body sensation of being ‘right’.  I had a deep visceral feeling of being back to the way I used to be – even though of course, I was never physically female – but that is the feeling.  As things progressed and I was able to register feelings from down there, I was surprised and astonished that these new feelings were oddly very familiar – same way as the visceral feeling of being back to were I was.  Both of these experiences deeply affirmed who and what I am.

That evening, a staff member came and slept on the couch and watched over me the entire night.  It was so reassuring to have her there.  I would look over to Lisa sleeping on one side and the nurse sleeping on the other:  I was surrounded by care and love.  It made that night very relaxing.  I was in no pain what so ever.

On day 4 Dr. Suporn came back and removed the bandages/covering.  Then on day 6 he came back to remove the stent packing inside.  Holy cow – it was like watching a magic show where they pull a scarf out of a hat or something and it just keeps coming and coming and coming …..  There was a lot of stuff in there!  I thought “exactly how big am I” — geeesh.   Now I was allowed to getup out of bed and finally had my first shower – boy that felt good (although I was not allowed to move without a nurse present).

Day 7 was release day – they pinched off the catheter, I had to drink lots of water, then they removed it and I had to prove I could urinate before they would allow me to leave.  This was difficult, but I was finally able to do so by standing in the shower – which is good cuz I could take a shower and when I dried off, the wheelchair was there ready to take me to the waiting van and off Lisa and I went, back to the hotel.

The only ‘pain’ I experienced the entire time in the hospital was a sore butt as I had to stay in the bed for 5 days without getting up.  I remember having 3 tubes in me and having to be very careful when turning side to side.  Thank goodness all three tubes were on the left side – not a problem.  Then on day 4 they moved the catheter to the right side —– that was just not fair …..!!!!  Moving was a tad more complicated then.  I would do small exercises in bed, like lift my bottom up, move my legs and arms around, etc. just to try to prevent them from getting sore laying there.  That did seems to help.  They had the infamous morphine button by my bed too.  I only used that once the entire time, and then it was not because I was in pain, but because I started to feel something down there more and more and thinking it might turn into pain decided to head it off at the pass kind of thing…  Who knows if I really needed to do that.

The next post will cover dilation – something I’ll need to do for the rest of my life.

With Aloha,

Sifan

POISONED !

woman in fog 2Some of the following I have written about in previous posts.  Something wonderful and difficult has happened that brings a slight twist (and then maybe not) to my perspective on being a trans-woman.  Perhaps it’s a nuance, most of what I’m about to write seems like what I have always been feeling and saying.  However, there seems to be a deepening and a visceral understanding of my life as a result of this.

If you have been following my posts, you already know that I had my SRS surgery last month.  In fact I just celebrated my 1st months anniversary.  This is actually a bit scary, as months 2 and 3 are the hardest.  This is when the ‘insides’ finish healing and the nerves start reconnecting and become active.  The body views this as a wound and attempts to close it.  I have to counter that with daily maintenance (three times a day) to soften and keep it’s form.  The combination of these makes these next two months difficult and painful.

Needless to say, this means that I’m quite familiar with my ‘new’ anatomy.  I put quotes around new because it is new only that it’s one month old.  But here’s the kicker:  it’s not new, it’s been there all along ….  Now that might seem a bit strange, so let me explain.  This realization came to me when I was in the hospital, minutes after I woke up from surgery.  My immediate thoughts and feelings were “Finally, I’m back to the way I was” – even though I was never like this.  But that was the internal visceral response I had.

I have talked about the ‘body map’ a few times before.  As a refresher:  medical science has found that we carry a body map located in a part of the hypothalamus.  This map basically says what we have and where it is at any moment in time.  It also tells us what things are supposed to feel like and the feeling those parts are normally supposed to produce.  The oft used example is the person that has their arm amputated yet still feels their fingers and can tell you where their arm is located – even though it’s not there.

My experience post surgery was a huge confirmation of this body map.  That is what I meant “I’m finally back to the way I was” and that this was not something new, but was always there – it was always there in my body map!  My ‘new’ bottom did not feel different – did not seem new – was not strange – I was not missing something.  Instead I felt normal, I felt the ‘nothing’ that everyone else feels about their parts – it’s just simply is who I am.  Ask yourself, what does it feel like to have your ‘parts’?  Does it feel like anything at all or is it just the way it is – that is, just you – nothing – nothing special – just is.

That is how it is now for me.  That was NOT how it was pre-surgery for me:

That … is the big difference.

That … is the hardship a transsexual faces daily until they transition.

My previous ‘down there’ was not in my body map.  Things did not match up to what was supposed to be according to my body map.  And, it is not just the physical aspects but also the mental, emotional and hormonal aspects of the body map that were not in agreement.

Let me re-tell a couple of incidents from my youth plus another one from my previous marriage to illustrate:

As a very small boy, I knew that I was supposed to be smooth down there, I was not supposed to have ‘that’ hanging out.  Ever being the budding scientist, I have a distinct memory of trying to figure out how was I supposed to urinate if it was smooth there!  This is when I was around 5 years old.  I had no concept of sex or what a woman/girl looked like – I just knew this was not me – I was supposed to be ‘smooth’ down there.  When I was 7 years old, my sister was born.  The first time I saw her ‘down there’ – well, everything came together.  For the first time in my young life I knew what I was supposed to look like, what my young body map identified with.

The second incident occurred a few years after this.  My mother was a seamstress – not professionally, but she created clothes for our family, relatives, neighbors and friends.  Being intrigued both by the creativity but also by the mechanics and design aspects of sewing, I would watch and learn.  Finally I felt that I could create and sew something myself – from scratch – no patterns, I would make my own.  So I did.  I made a beautiful skirt that fit me perfectly.  It had a hem (I remember using this stick with a bulb on top and a movable nozzle that would squirt chalk at where you wanted the hem to be – in order to get it perfectly level all the way around), I also had belt loops, elastic around the waist plus a zipper on the side.  I was very proud of my creation.  I did all this without my mother’s knowledge as I wanted to surprise her.  When it was finished, I waited for her to come home and proudly showed off my new creation.  My mother is 100% German and very strict and conservative and was very brutal.  My pride turned to shame is less than a second.  The scolding and punishment and continued reminders of what I did drove any thoughts of me being a girl to be deeply buried.  This was the start of the ‘layers of the onion’ and more and more layers were added to deeply bury any sense of me being a woman.

In one way I consider myself fortunate.  I attended a very conservative Catholic grade school back in the 1950’s, in a very redneck conservative northern city.  I was ‘fortunate’ to witness some of my classmates as they tried to assert who they were (being different than anyone else) and witnessing the severe reaction of both the other kids but also from the teachers, nuns and priests.  I was an observant little girl inside a boy’s body who learned very quickly from others to keep my identity secret.  This sort of sealed the onion layers for good.

Later in my teen years all that was left was a rationalization that I was a boy but with all these extra capabilities – emotions, what I liked, mannerisms, ability to understand and listen to people … the list goes on.  I could not stand the playground games of the boys and would prefer the girls but I had to be careful to mix it up …  I had buried my truth so deep that I no longer knew myself and accepted my role as a boy and rationalized the rest.  It took another 40 to 50 years to unravel and peel back that onion.

Now, here’s the new part.  This revelation suddenly came to me during a talk with my ex-wife.  I don’t think I would have seen this before surgery – somehow it took being whole again to be able to see this next piece.  This is a bit hard to discuss and embarrassing for me – please bear with me as I try to find the words for this ….

During puberty my body changed drastically.  Testosterone was now cursing through me and creating a lot of changes that were upsetting.  However, I could not figure out why – again I had a deep rationalization that I was a boy.  It wasn’t the physical aspect of puberty but the mental and hormonal parts that really disturbed me.  Here it gets hard for me to put this to words – hang on:  one example, it’s a pretty well known fact that most men masturbate many times a week, some daily.  This urge was intense and of course I hated that – that part was not me – why was this happening.  I had so much shame around that but I could never understand.  Of course the Catholic church drills into us that is a sin.  And of course the other boys bragged about it.  Why was this so awful for me?  That wasn’t all – there are other incidents that I was very ashamed of as well, both growing up and throughout married life.  I carried these all my life, not understanding what drove me and carrying the guilt and shame all these years.

In my talk with my ex-wife a couple of days ago it suddenly became crystal clear and I broke down crying.  Hindsight is like that I suppose, but this required me to already have had my surgery in order to be able to put this together.

I was POISONED!!!!

Others have called this the “testosterone fog”.   If you are a male (birth sex) and a man (gender) then testosterone is the correct hormone.  But I am not.  I don’t expect men to get what I’m about to say, but I think any women would and any transsexual definitely will.  As a woman, having a high testosterone level, I would experience these hormone driven urges and their results and was mortified by them.  Disgusted and shamed as I would witness myself in those moments and then the regrets afterwards.  Again, for a male/man these are natural and congruent – no problem.  But for me – this was horrible and these feelings have haunted me my entire life.  But, I didn’t know why – the layers of that onion were so thick by now – I had long ago buried and lost my gender identity.  Only these hints were left.

It’s only now, that I’m physically, mentally, socially, hormonally and internal-chemistry-wise finally a woman that I could solve my last great quandary that has plagued and weighed on me all my life.

As a woman – I was POISONED by testosterone!

I had to go off of spiro (a testosterone blocker) a couple of weeks before the operation – this gave me a really good ‘scientific’ test of what for me was the intensity of this poison. It confirmed and validated my views and led to the realizations that I am writing about here.

Again, testosterone is absolutely appropriate for a male/man, but I am not – I’m a woman and this has tormented me so much.  At last I have come to peace with those disturbing aspects of my life that only now do I realize are part and parcel of being a transsexual woman.

I want to apologize profusely to those that I have hurt  unintentionally and hope for your forgiveness.

I now understand.

I am now free.

With much aloha,

Sifan

Transition: Mental and Physical

I just had an incredible experience: Dr. Suporn’s clinic staff make daily rounds between 10am and noon. I’m not going to mention her name because what I’m going to say applies to all of them.

This was her last time she was going to see me (as they take rotations and I’m leaving on Monday). So she took extra time to sit and talk.

This was unexpected – she thanked me for my positive attitude and optimism. I can only imagine the range of people and personal issues they have to deal with and this is what I want to share with everyone: this staff goes so far beyond just simple care, they truly are amazing. To me, this was a high complement – it’s also means that I really did touch others here – I hope I was able to make my trans-sisters more comfortable but also the staff and everyone else.

Yes, everyone has different experiences – but think about what the staff has to do (and what they have to put up with). And they do it with love and a smile!

You know – it’s sort of like my last post about being able to tolerate pain having a down side. Dr. Suporn’s surgery is (for a lot of us) almost pain free – it’s like little has happened. We get back to the hotel feeling so good and ready to party on the town, not fully taking into account the 7 hour surgery, 7 days in a hospital, etc. And then those that do, get in trouble.

I remember Dr. Suporn’s words about mentally relaxing and not worrying etc. that a lot of this has to do with the inside aspects of ourselves. And that brings up another huge issue: this is both MENTAL and PHYSICAL. You have to ‘solve’ both of these for yourself. His surgery solves the physical – if you are not mentally ready – after surgery you are now going to have to deal with the other half.

I was fortunate. I had a great therapist and worked on the mental aspects of this for more than 10 years. This surgery was the icing on the cake as they say. The night before surgery is when the final pieces of the physical aspects came into sharp focus. See “Why have Surgery” for more on that.

That was the big message the person from the clinic and I came to this morning – being prepared both mentally and physically for this.

And I really do hope that I shed cheer and happiness to those around me – to me, that is an important aspect of my life.

With much aloha,

Sifan
“Hoku Wahine” (literally: star woman, eg female astronomer)

Why have Surgery

This is something that happened the night before surgery.  I never doubted or questioned what I was doing.  I knew this must be done.  But there was a piece of the puzzle that was missing.  Now I know why.

The night before surgery, it all came to me.  I had spent so much time on the mental aspects and removing the layers of learned male behavior some of which disgusted me (the testosterone fog).  The piece that was missing was physical part.  “Why would surgery matter if you are already living as a woman?” type of question.

But the night before, my early childhood came back to me.  The memories of something wrong – it was supposed to be smooth down there, I was not supposed to have this thing sticking out.  This was long before I know anything of the sexes – I just knew it was supposed to be smooth.  In fact, I remember wondering how I could possibly urinate if it was smooth!  Then my sister was born and for the first time I figured out what ‘smooth’ was supposed to be.

Fast forward to the night before surgery and my discussion with the psychiatrist, my mind had pushed that out of the way so completely, yet the extreme dissonance remained all my life and caused just as much grief as the mental aspects.  But, just like the mental aspects, there were many layers of this physical part that also had to be removed – and that night before surgery it became clear.

After surgery I have to use a mirror when I do my ‘maintenance’ and the feeling of not only completeness but of wholeness is almost overwhelming.  It’s like being back to what I was (even though I never was this way) but that is the feeling – being correct and true and just ‘me’.  It is so wonderful, so incredibly ‘natural’ – I’m running out of words to describe this.

I’ve mentioned before about a body map, a part of the brain that sort of knows what you are, what you have, and where and what these parts are doing.  The example often given is of an amputee who not only still feels their arm but can tell you exactly where it is in relation to their body.  This body map for me is what tells me I’m female, both in the physical and the mental aspects.  The memory from my childhood shows this clearly – I didn’t know what I was supposed to have down there, only that this didn’t match what my body map had.  This is the HUGE relief I have now, when I do my dilation, etc. having to use a mirror and in contact with ‘me’.  It is what was missing, it is what inside me says is supposed to be there.  Now it is!!!!

With much aloha,

Sifan

Choosing a Surgeon

I have finally chosen the doctor and clinic for my GRS  (gender re-affirmation surgery).  I will have my surgery in mid September.

In order to qualify for GRS (some call it ‘bottom’ surgery), a transsexual person needs to have:

  • Signed letter by a therapist stating you are indeed a transsexual and that surgery is required, plus that you do not have any other psychological disorders that would prohibit or complicate this
  • Documentation showing that you have lived at least one year totally and completely in the chosen gender (this is called the RLE – real life experience)
  • Medical documentation that you are fit and can ‘live’ through a 7 hour procedure.

It has been difficult to choose a surgeon/clinic for my GRS.

Basically, from everyone I have talked to, emailed, read blogs, etc. that have personally been through GRS plus reading many different clinic web sites and information – it came down to three:  Dr. Bassard in Canada, Dr Bowers in California and Dr. Suporn in Thailand.  Anyone that had been to any of these three had raving reviews for their doctor and would go to them again.  Everything put these three at being precisely equal as well.  This made the decision all that much harder.

Dr Suporn’s method is not the standard method for GRS.  It is not the ‘inversion’ method and it results in most everything being ‘reused’.  This results in most of the same areas being sensate that a natal female has.  One of the women I talked to stated that this was a very high importance to her and Dr. Suporn came through.  She stated that other doctors would not guarantee the result would be orgasmic, however Dr. Suporn did (however she would have to pay the airfare to come back for corrective surgery – but he would guarantee it and the corrective surgery would be paid by him).

Two other factors also helped in choosing Dr. Suporn.  As my GP doctor stated:  “go with who has the most experience” and that is Dr. Suporn by a long shot.  His fees are lower as well.  I’ll be able to get both the GRS and a breast augmentation for the same price as the GRS alone here in the states (and that includes the travel expenses and the hotels).  They also keep you longer.  I will be staying in Thailand for 30 days, verses the two weeks with the others.

Dr. Bowers is herself a transsexual, having had the surgery from one of the pioneering doctors in this field and going on to study from him and eventually take over his clinic when he retired.   It was hard not to choose her.

I’ve had glowing reviews from people I know that went to Dr. Bassard’s clinic in Montreal.  My sons and grandsons live in Minnesota and I would have been able to stop over on my way back, breaking up the journey and being able to recuperate closer to the clinic.

But in the end, it was a letter from a friend that went to Dr. Suporn that finally allowed me to decide.  The different technique, the additional sensate tissues and layers, the more ‘normal’ appearance and the additional comfort that Thailand affords, all added up to make it the winning ticket!

Of course there are other things that I now have to take care of:

  • Airline tickets that cross the international date line (the flight is 21 hours, plus crossing the date line – so exactly which day do I actually land?  The tickets give the time of landing but not the date – ack)
  • Getting my passport updated, in time.  I already had turned this in only to have it returned stating that I used the wrong form and please attach a letter from my doctor, which I had and they did not return!
  • Getting a visitor visa for Thailand.  Their consulate here is on a different island, so I may have to fly over there just to get this.
  • Transferring a large amount of money overseas – governments don’t like that – smells of terrorism.  So lots of red tape plus a lot of intermediate banks that all want to charge a fee.
  • Cardiac stress tests (like why do I want to stress that?  Does not sound nice at all) and other medical tests.
  • My partner (will be my spouse a week from now) is coming with and will have to deal with all the name changing and especially passport and visa issues.

I’ll keep posting as this progresses.

With much Aloha,

Sifan