Recovering from surgery: week 1.

The first 2 days after the surgery I had to stay at the hospital. I wrote about that in my previous post. On Saturday morning they sent me home with my drains. I was really happy to go home and at that point I didn't care about having to keep the drains. Well, it sucked, but I figured it was better to go home with them then having to stay. I felt much better just wheeling out of there. The dear friend who was picking me up had decided it would be fun to push me around in a wheelchair and she was right; it was.

She dropped me off at home and stayed for a cup of tea. It was so nice to be at my place again, with proper tea and a nice sofa. And no nurses sticking things into my ears and all that. I slept really well that night, even with the drains. The next day I felt even better. This didn't last too long though. Having the drains was, well, draining. The stitches that were holding them in place really hurt. That was actually all that hurt. I quit taking the diclofenac on Monday and on Thursday I took the last paracetamol which I had felt was symbolic anyway. But the pain from the drains made it really hard to move. I was also impossible to have a proper shower and I needed help to get into and out of my binder. I still felt really dependant on other people. I was. Good thing I had lots of help.

This is something I was really surprised about, in a good way. A lot of people will tell you: if you need anything, just let me know. But when push comes to shove you just have to wait and see who actually shows up. My friends had told me I really had to ask and I had assured them I would. But I didn't need to. They offered. And they came. People sent me text messages or PM's on Facebook, asking me if I needed anything and when they could stop by. I actually had to make an effort to keep the visitors down to 2 a day and sometimes someone would just show up and I actually would have 3 people over in one day. People bought me flowers. I never get flowers. But I did now. People brought me vegetables and prepared food for me. They did my dishes. I even got help with my laundry. I couldn't believe it. I felt so blessed. I have a hard time asking for help as I've always needed to do everything on my own and have been quite a loner most of my life. This was a new experience for me and I'm very happy for it.

The rest of the time I mostly spent on the sofa with a book symbolically in my hands. I managed some reading but not much. Having to drag around the drains was exhausting. They ruled my every move. Getting up to walk to the toilet or kitchen was something I needed to prepare for mentally. As the days went by and the fluids got less and less and the drains therefore more useless and just an annoyance, I started to feel like a prisoner again. I went looking for ways to get rid of them as soon as possible. I first asked a friend who is studying to be a doctor but she told me she had never removed a drain so it didn't seem like a good idea. My GP is an idiot. He told me I should just put my drains in a bad and walk over there if I wanted him to take a look at it. Sorry but I just had a hysterectomy, I'm not even supposed to go outside the first week. He didn't understand how that could be a problem. It sounded like he was just panicking and didn't want to help me because he didn't know what to do. Like I said, he's an idiot. I figured I didn't trust him with something like this and I should be getting a different GP anyway so I decided against it in the end. I called the hospital on Monday, hoping they would be willing to get me an appointment sooner then Thursday as they had first suggested. They gave me Wednesday. What a difference a day makes. It seemed much closer now and I had something to count down to. I counted the hours.

The same friend who had picked me up had offered to give me a ride again and she actually had time that day so it was all perfect. My plastic surgeon first removed the drains without question and I felt better right away. People told me that removing the drains can feel really weird but one I didn't feel at all and the other one felt a bit like something was pulling on the inside but that was what was actually happening. It didn't feel awful or anything, just a bit strange. She took a look and told me everything was fine. She asked if she could take some pictures so she could use them for a presentation in November. People kept asking her about the volume of nipple stems so she wanted to use me as an example. About what? During the chest surgery you cut loose the nipple which has a cluster of veins and nerves (I think it's called the stem). If the stem is too long you have to cut it and do a loose nipple transplant, reattaching it elsewhere. If the stem is short enough and strong enough you can keep it in tact. The advantage of keeping the stem is possibly regaining sensation in your nipples again. They can function close to normal again if you're lucky. The downside, for a lot of transmen, is the bulk of the stem. Most transmen want to be as flat as possible because they want to be as passable as possible. But people are now wondering how much bulk we're actually talking about here. So she needs examples. She asked me to send her pictures of my chest in a couple of weeks and I told her I would also send her some end of October so people can see how it looks in the long run. Four months isn't that long but it's all the time we've got. If you want to see the whole development you can check my tumblr. I'm posting pictures almost every day.
Then she send me home again. I didn't have to make a new appointment or anything. Of course, if I felt the need I could call. I felt home feeling great. You always do when a burden has been lifted. All I had to do now was keep on my binder for another 3 weeks and then try not to run to the gym for another 2. Just a few more countdowns and I can start my life.

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Surgery part two: my stay at the hospital.

Hospitals are strange places. Nobody really likes them. It's where you go when something is wrong, usually. I don't like hospitals either. One of the things hospitals are, unfortunately, well know for is the bad food. I know I'm difficult with food in general but hospitals are a really bad place to have food allergies and not sticking to the food pyramid. I eat primal and low carb. Grain and I are not friends. I told them this and so they served me gluten free bread. Maybe it's just because they don't serve it a lot (most of the time it arrived frozen) but it tasted like cardboard. It also had the texture of cardboard. I know the anaesthesia didn't help but my stomach reacted pretty much the same way as to normal bread. Not well. I had brought some food myself but not enough and it didn't stop them from trying to feed me cardboard and milk all the time. I didn't have the energy to explain to them why I didn't want any so just repeated I was allergic or simply said no thanks. So this was no fun and really didn't help my recovery.

Don't get me wrong. The nurses were all really nice and trying to be helpful. But they also had instructions to follow, protocols and such. Just like with the people who did my surgery I felt like they had to take an empathy course or something at that hospital. I was truly amazed. They really tried to make me as comfortable as possible with the means they had.

The other thing that didn't help was the lack of sleep. Hospitals are very noisy. And with the heat we had to leave the window open to get in some cooler air. This meant we were also letting in all the lovely sounds of the train, the tram, the highway and the huge flock of blackbirds. I don't sleep well in unknown environments in general and if they are noisy I can pretty much forget about it. A nurse coming in at 1 and 6 in the morning to check my pulse and blood pressure didn't help much either. My temperature has been checked more often during my stay at the hospital then in the 10 years before that. And if the nurses weren't chatting just outside the room which was at the beginning of the hall so everyone had to pass by our room, the other trans guys would be snoring softly. If I had been able to move I would have been tossing and turning all night long. But I couldn't. The drains made it impossible to lay in any other position then coma mode; flat on your back with your arms along your sides. Both your chest and abdomen had been stitched up so you didn't want to put your arms anywhere on your body. Truly wonderful.

After a hysterectomy (removal of the uterus and ovaries) you only have to stay one night but after a mastectomy (the chest surgery) you have to stay a bit longer. It depends on the drains sticking out of your armpits. Usually it's 2 or 3 nights and then they remove the drains. Sometimes they send you home with drains though. After 2 nights of about 3 hours sleep each I was ready to go home. I felt like a prisoner, claustrophobic and helpless. I'm not good at giving up control and having people prod and poke me 6 times a day, feeding me bad food and pills while I have a bunch of tubes sticking out of me was not my idea of a good time. I was amazed at how quickly I plummeted into feelings of depression and it really scared me. I knew I had to get out of there. So on Saturday morning I managed to convince the nurse to convince my doctor to let me go home, drains and all. She called my doctor and a few hours later I was on my way home. I felt so relieved. At that point I didn't care I had to keep the drains for 5 more days until my check up. All I wanted was to go home so I could sleep. And I did. I slept 10 hours that night while I usually sleep about 6 or 7. I was so happy to be home. The worst had passed. Things were only going to get better.


For pictures of my recovery check out my tumblr.

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I had my meeting with my surgeons.

Last week I went to the Slotervaart hospital in Amsterdam for 3 meetings.

The third one was with the anesthesiologist. He turned out to be a very nice guy who clearly enjoyed his job of making people as comfortable as possible. He told me not to worry and he would take good care of me. I'm getting an PCA which means as much as patient controlled pain medication after the surgery. I'm very happy about that because being dependent on whenever the nurses can find the time to listen to you and decide you might actually be right and either need more medication or not, is not exactly ideal. I have a high pain threshold but also get used to pain medication really quickly. So that's something that could go either way. Like this I will be in full control and will get what I need.

The second meeting was with the gynecologist. He's a bit of a quirky man but he's a professional alright. He told me what he is going to do. They will put air in my belly to make room to work. Then they will make 4 tiny incisions; one for a camera so they can see what they are doing, and the other 3 for tools. There's already a larger opening they can use to pull out that annoying bit of tissue. Then all they have to do is stitch it shut at the top and they are done. He told me a whole bunch of things that can happen after the surgery that might freak me out but I don't need to worry about. He also told me a few things that could happen that would mean I should call him. But in all cases I don't need to worry because if anything goes wrong they'll just fix it, no problem. Okay doc, what ever you say. I an 100% confident that he will indeed set things right.

Now the first meeting was the one I was nervous about. It was the surgeon that will fix my chest. In broad terms there are two ways of doing this. The big surgery and the small surgery. The big one means two large incisions below the breasts. With the small one they make circular incisions around the nipples. Clearly, the big one causes bigger scars then the small one. Most transmen are really set on getting the small on. It's a big deal. It's important because else you are mutilated for life with those huge ugly scars across your chest that will remind you for ever and always what you went through and will cause the whole world to ask what the hell happened to you. People had told me I should be able to get the small one. People told me it was important for me to get the small one. Everyone wanted to small one so of course I would want the small one as well. So when my surgeon took one look at me and said: no way, I was in shock. I had counted on getting the small one. After a while I realized I felt like I had lost some sort of competition. This confused me and later got me mad. This is why it took me a while to write this update. I wanted to figure out where this feeling came from.

Among transmen, or trans people in general really, there is this silent competition to be as passable as possible. I feel very conflicted about this. The problem is that if all transsexuals just disappear after their last surgery it makes it harder for the people who live further away from the norm to find a place in society. As a transsexual you stand out for a while during your transition. It's a big deal. It's heavy. It's hard. And also, it's very visible.You can't go into a cave and come out a few years later and go: tadaaa! It doesn't work like that. You are forced to do it in plain sight. This is why transsexuals get a lot of media attention. But once you are done, you are done, and you can pretend it never happened most of the time. You can go back to your ordinary life. Sure, some will still stand out but these days people can start transition during their teens and most of them are absolutely passable once they are done and sometimes even before then.

A lot of people who are transgender but are not transsexual don't have that luxury. They don't go though an awkward phase and then come out as themselves and can fit one of the boxes on every bloody form on the planet. A lot of them are somewhere in between. They always stand out. They can't just put on a shirt to cover the scars and pretend they're one of the guys. They need our support.

The other things is that there seems to be a shame culture happening here. Even though people are now coming out as trans on television and there are shows being made about trans people and all the media attention and people shouting that transsexuals should be accepted a lot of trans people still seem to be ashamed of the fact that they are trans. It's like being ashamed of being black, or of being ginger, or of being short, or of having blue eyes. It seems to me that a lot of transsexual people feel the need to be as passable as possible because they are afraid that people will still see them as less, as inferior, of not one of them. They are afraid of not fitting in, of being cast out. They want to hide part of who they are, part of their history, in order to secure a future.

I am not ashamed of being a transsexual, just like I'm not ashamed of being ginger and short. I'm not ashamed of having Indonesian ancestry even though no one sees it. I'm also not proud of it. I didn't do anything to be any of these things. These are the cards I got dealt. That's all. There is no shame in that. There is also no pride in that. It simply is what it is. So why did I freak out when she told me I was getting the big surgery? Because people had told me I should. Well, not directly, but they did make me feel that way. Personally I don't have a problem with a few extra scars. I have plenty already and they all have a story. This would just be another story, one that I'm not ashamed of. So that's why I got mad. My peers had, unintentionally, made me feel like I should be ashamed of who I am. This makes me sad and it worries me. I am able to take a good look at who I am and how I feel about myself and get past this. But not everyone can. There are a lot of trans people who are very vulnerable and who are unable to stand up for themselves. I can imagine some people would get very depressed hearing such news, maybe even suicidal. If they really feel like they should be ashamed of who they are and that they will be rejected by society if people find out there is something seriously wrong. It's all fine and dandy that we have those tv shows now and that there are so many people coming out publicly but there is still so much work to do.

I'm getting the big surgery. I am getting two scars on my chest that tell my story. I'm okay with that. I'm still waiting for the date but it should be before my birthday in late July. The surgeon really is a nice lady and she knows what she's doing. She is one of the best in the country. She saw how shocked I was and did her best to reassure me everything would be okay and she would do her best to minimize my scarring. In the mean time I am coming up with all kinds of ideas for tattoos in combination with scarifications for my torso. So I'm not worries at all anymore. Right now I'm just curious about the final result so I can start designing.

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My uterus and I.

My uterus and I haven't been getting along for quite a while. I'm not completely sure when it started. When I was on the pill as a teenager and in my early twenties I would get my period like clockwork. Tuesday afternoon at 2pm. But when I got a girlfriend I quit taking the pill and my period disappeared. Later I learned it was probably because of my low weight and the fact that I wasn't eating enough. In my mid twenties I started eating a bit more for a while and my period came back. We have been arguing ever since. I never knew when she would wave a red flag nor if she meant it. So eventually I got a coil, hoping to settle things once and for all. Or at least for a few years. No such luck. She still pops up every now and then but never in full bloom.
Now I have started testosterone things have not calmed down at all. In addition there are sharp pains or cramps as I feel my uterus shrinking. She's not going down without a fight.

A uterus is a woman's greatest asset. It's her crown jewel. It brings forth life. But in my case, she is an adversary. She reminds me of what I am and what I am not. Of what I will never be. Every time she cramps up it feels as of she mocks me. She holds back my masculinity. Over the years she has forced me into a shape I never wanted. She has made my life miserable. If all goes well she will be out of my life for good in as little as 4 months. It will be a little bit of death, and a rebirth. I can't wait.

In the mean time, I'm not getting any jewels back. I will be permanently infertile. I will never be able to have children. Then again, I'm 35 and not in a solid relationship where children are even an option. I never even wanted kids in the first place. So this shouldn't be a big deal, right? This is simply moving forwards. A logical step. Nothing to it. Alas, that is not how it works. Having the choice to not have children is different from not having a choice anymore. I know, having been born female bodied, the choice is pretty much over anyway. But my sister is 2 years older then me and is now having her second child. I'm happy for her. We hadn't expected it to happen but it did. So of the still got a chance at her age, why shouldn't I?

But wait, I didn't want kids, right? Right. So why is this a big deal again?

I have been thinking about this and I think it has to do with mortality and the meaning of life. If you have children a bit of you lives on in them when you die. If you don't have children you have to find a different way to impact the world. That's it in a nutshell. A lot of people try to live through their children. It's not always a good idea but it happens all the time. They hope their children will do all the things they never did, for whatever reason they may have had. Their children can compensate for their mistakes. They can undo their wrongs. When you don't have kids, you have to do all of that on your own. That's pretty big. This means that making the permanent decision to not have children automatically results in making the decision to live my life for me and me alone. That I have to do everything myself. That I can not rely on someone to make up for the things I didn't do.

Feel free to accuse me of thinking too much for my own good. I won't deny it.

Another thing is the social implication. Life exists purely to sustain itself. Procreating is the most important thing there is. We have copied that in our social structures. You can see this in any society. Children provide status and security. If you do not have children you are pitied. People generally find it hard to believe that some people don't want to have children. They don't understand why someone would not want to have children. I don't feel the need to defend myself as to why I don't want them, that's up to me and me alone. Often people assume you're just saying that because you don't have the option. But if you actually can't have them, then you truly are pitied indeed. And that is the last thing I need. I don't want this status attached to me of poor transperson who had to give up children. That is not the case. But I know some people that I will meet will think that way because it is easier for them then to accept the fact that I chose to live my life for myself instead of trying to live it through someone else. This might make me not a good living creature, but it doesn't make me a bad person. I think a lot of people would be happier if they focused a bit more on what they would like to do with their lives instead of putting pressure on their kids to have better grades then the neighbor's kids. If you want that's best for your children, don't you think setting an example on how to be happy with yourself would be more valuable then comparing them to others?

Final conclusion: it's time for me and my uterus to part ways. After all, you usually regret the things you didn't do more then the things you did do.

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