Tuesday, May 6, 2014

Consultation and a Trip North

A lot of people have asked me why I chose Dr. Brassard as my GRS surgeon.  Some suggested  I spend a lot of time traveling the country, and possibly the world, interviewing surgeons to find the one I was most comfortable with.  Rather than interviewing the actual surgeons, I chose to spend my time and energy talking to their patients to get a more accurate representation of what to expect.  After all, if I decided on my surgeon based on personal interviews with them I would likely choose the doctor who gave the best presentation or made the best personal connection.

What I was looking for was someone who would do the best job for me in those few hours on the operating table and provide an excellent level of aftercare for the delicate recovery period. I was looking for the surgeon with the best track record. 

There were a few limitations to my considerations, one being I did not want to travel overseas.  There are a few great GRS surgeons in Thailand, a couple I was interested in, but the long travel and longer recovery time that those surgeons require took them out of consideration.  My family situation dictated that I stay closer to home and make the effort to be gone no more than  2 weeks.

So this limited my search to North America.  There are quite a few doctors in the United States who perform GRS and a few of them are gaining recognition as being top surgeons.  Then there is Dr. Brassard in Canada.  If proximity to home was to be a consideration, I needed to give a close look to the three doctors in the Philadelphia, Pa. area, as that is the closest location for any of the major surgeons and less than a day's drive north of Rocky Mount.

Ultimately I chose Dr. Brassard because he has an excellent reputation, is regarded as one of the very top GRS surgeons in the world and I know more people (both online and in person) who had GRS with him than all the other surgeons combined.  My therapist has sat in on one of his surgeries and gives him the highest recommendation.  Dr. Brassard has many years of experience and performs hundreds of these surgeries every year.  There is a fully staffed residence on the grounds of his hospital facility that provides the assisted recovery I feel I will need.  So many great recommendations came in for him that I had to put him on the top of my list, but my decision really came down to my intuition.  I just have a feeling that Dr Brassard is the right surgeon for me and I have learned to trust feelings and instincts.

I will say that there are a few really good surgeons in North America and any of them would have been a good choice.  Sometimes I tell people that the best surgeon in the one that gives you your surgery.  In most cases that is true, as most people I've talked to have been happy with their results. That is not universal though, as a few people I've talked to are not happy with their surgical outcome or wish they had chosen another surgeon.  I only know one trans woman who regrets having surgery at all, but she was just as unhappy before GRS as she is now.  It is no panacea.

There can be problems, sometimes big problems, with any major surgery and GRS is no exception.  In fact this is a very difficult, life changing surgery and anything can happen.  I only hope that I get through it with a minimum of complications and if complications do arise, that they can be dealt with by the medical professionals.  Hopefully I will be able to mentally deal with any complications but ultimately I am hoping for as few problems as possible.  We will just to have to wait and see.

A Trip North

I did interview one surgeon during my decision making process and have been saving my blog post about that consultation for this time.  Back in November I had been full time I had been full time for 11 months and knew that soon I would be completing the one year of Real Life Experience that is recommended by WPATH before receiving qualification letters for surgery.  My friend Facebook Rachael Kruse had been wanting me to come up to Baltimore for a visit.  She was one month post op and had a follow up appointment coming up with her GRS surgeon, Dr. Kathy Rumer, in the Philadelphia suburb of Ardmore.  So I offered to come up, visit her for a couple of days and take her to her doctor's appointment on November 8th.  Just like that I was off on another adventure, my last trip of 2013.

Once I knew the trip was on, I let Rachael know I would be able to give her a ride and also called Dr. Rumer's office to schedule a consultation for myself.  It turns out I had to fill out a lot of paperwork online, basically a complete medical history, in order to get a free consultation.  Dr. Rumer is a plastic surgeon who does the full range of transgender surgeries (FFS, BA,GRS etc.) and also does other cosmetic procedures for the general public.  I had pretty much decided on using Dr. Brassard, at least for GRS, but it does not hurt to learn all you can so I thought why not go for it.  It was free, after all, and I was already going to be right there in her office.

On November 7th I headed north on Interstate 95 and made it to Rachael's that evening.  Rachael has a big, two story house in one of the suburbs surrounding Baltimore and it was already dark when I got there.  She has a really cool, older house with a lot of bedrooms that she shares with two roommates, a married couple.  All the bedrooms except two are occupied with stuff, so I stayed on a couch in the living room during my stay.  There were Halloween decorations everywhere, which I thought were left over from Halloween but Rachael is a real Goth chick and loves that stuff, which also I thought it was really cool.

We hung out that night, talked and watched television.  Rachael loves to keep two or three chats going on on the computer or phone all the time, which in some ways reminds me of myself.  Later that night her roommates came in, said a couple of words then retired to their back room to watch their own television.  I couldn't help but fall in love with their dog, a big lovable Rottweiler named Annabelle.  All dogs seem to fall in love with me too, maybe because they can smell Buddy and Nightingale on my clothes.

The next morning we had to get up at the crack of dawn, so I set my alarm for 7:30 AM.  What we had here is 4 girls and one bathroom, with Rachael and I needing to get ready to go to Ardmore for a 10:30 am appointment and the other two needed to get ready for work.  I did have enough time to take a shower and throw on a little makeup but I didn't have time to dry or style my hair, so I threw on some clothes and rushed out the door.  The main thing was getting there on time and luckily we even made it a few minutes early.

Rachael went in the back for her appointment first as I sat in the waiting room alone.  Dr. Rumer's office is in a large, three story house in suburban Philadelphia.  The offices and examination rooms are on the first floor, the third floor has apartments where patients recover after their operations, and apparently she lives on the second floor.  What a neat building, but it did seem a little strange to have all of this in this big stone house with a tiny yard in an upscale residential neighborhood.

While reading material in the waiting room, I found out that Dr, Rumer was once an aerospace engineer who decided to go back to medical school and become a doctor.  I found the setting there to be quite impressive, if somewhat intimidating, and I was certainly impressed with her credentials.  When Rachael came out I went back and talked to the assistant a bit before Dr. Rumer came in.  I had considered getting consultations for FFS (Facial Feminization Surgery), BA (Breast Augmentation) and GRS, but I chickened out on asking her anything about facial surgery.   Her assistant asked me what I wanted to consult with the doctor about and she asked me how long I had been on hormones (at that time it was almost 18 months).

She said that hormones can really soften soften your features and that I looked great.  I was just afraid that if I asked the doctor a general question of "what would you do to feminize my face?" she would suggest things that I may not really need and that would get into my head later on.  Before I started transition there were a couple of facial procedure I wanted, and there are still a couple of things that I might want done at some point but they are not a priority right now.  I seem to be able to pass with no problems and have a man that thinks I am beautiful so I am pretty happy with things in that regard for now.  

Also, when thinking about any surgeries the only one that terrifies me is having someone cut on my face.  Maybe that comes from being awake when I had the skin cancer next to my eye cut off last year, or a fear of coming out looking worse than I did going in, I don't know.  Anyway, the only two things I consulted about were BA and GRS. 

The BA consultation involved looking at different sizes and material of breast implants, which were kept in a large box.  She explained how the silicone implants were considered safe now and there are made of something like a gummy bear material so that even if they break, they do not leak.  They certainly felt more realistic than the saline implants.  As far as sizes, she pretty much looked me over and asked what size I would want to be.  She didn't take any measurements, which I would have expected in a serious consultation.  She thought that a 500 cc implant would give me a solid D cup and I even put one into my bra to see how it felt.  To me it felt huge and felt bigger than the breast forms I used to wear, but I assume that when placed under the muscle and skin they are more proportionate.  I asked her to give me a quote on that surgery alone, one for GRS and also on the GRS combined with BA.

The GRS consultation consisted of Dr. Rumer showing me a power point presentation on her laptop computer.  She gave me an explanation of her techniques and I asked a few questions.  She asked me when I would meet WPATH qualifications for this surgery and I told her that I had been full time almost a year and that I had 2 therapists and a doctor that would write me letters whenever I needed them.  One thing that impressed me about her is that she says she will see patients for follow ups, and revisions if needed, at any time in her office.  Also everything post op would be free of charge unless you also had to go to the hospital. 

When I walked back into in the waiting room someone called my name and came over to introduce herself.  I recognized her from Facebook but could not think of her name right off hand.  Being in that strange doctor's office was still a little overwhelming but we went outside to chat for a bit and I remembered my friend.  Honestly, if Keri Abrams had not come over and introduced herself I would have thought that she was a genetic female coming to see the doctor, as this doctor sees all sorts of patients. 

It was a little crowded in the office so Keri and I went out on the porch and talked for a couple of minutes.  Rachael was in my van on the phone and it turns out that Keri's mother had made the trip and was in her car, waiting to come in and join her for her appointment.  I was thrilled to find that out and really happy to see someone else with such a supportive mother.  I think mine would go to Canada with me if she could and I believe Keri told me her mother had accompanied her to Chicago for some other surgeries she had there.  Today she came along to meet Dr. Rumer and make sure that she was going to take good care of her daughter.  That sounds like a typical Mom and a good one! 

The good news that has since followed is that Keri's Mom was impressed that day and she went up for her GRS and is now few months post op.  I saw her again recently at the beach while visiting Lisa Lesher and hope to see her again before too long, as she only lives a couple of hours north of me, in Richmond.


*******

The plan was for Rachel and I to go into the city of Philadelphia after leaving suburban Ardmore, have a cheese steak sandwich, do a little sightseeing then drive back to Baltimore.  One of the people she had been texting was Sophie Lynne, who lives very close to Dr. Rumer's office.  Sophie is another Facebook friend, Vanity Club sister and fellow Blogger.  I had been wanting to meet her for some time and it looked like this would be the opportunity.  This was a pleasant surprise so we decided to meet at noon at a nearby brew pub located within in the King of Prussia Mall.


Rachael and I at King of Prussia Mall
We had a nice lunch and a great chat while sampling some of the craft beers brewed right there at Rock Bottom.  Sophie told us that this mall has more stores than any other mall in the country, so after lunch I wanted to take a little walk around.  Actually we'd met Sophie's other side for lunch but she was going to go home and get changed to go out later that afternoon.  Rachael and I took a little stroll around part of expansive mall but she was very tired from being out so soon after surgery, so we cut the tour short and went over to Sophie's house.
 

There I got to meet the real Sophie and have another beer while Rachael rested up a bit.  Sophie has since gone full time but even though she had another name then (part of the time) I only saw her as her true self, even earlier at lunch.  Luckily, Rachael felt good enough to hang out a little longer so we were able to accompany Sophie to another local bar/restaurant to meet with Angela Gardner.  They were working on a project together for Angela's website, TG Forum, and needed to discuss a few things over, what else, more beers.  I could already see that we were never going to make it into the city for that cheesesteak and that being around these Pennsylvania people was a lot of fun.

The talk of cheese steaks led into a discussion between Sophie and Angela about who had the best of the signature Philly sandwiches.  It runs out that there was a place very close by that offered a classic Philly cheesesteak, so we decided to pick some up for dinner.  Sophie is a great tour guide and she had one more bar she wanted to show Rachael and I before dinner, so we tagged along to Mackenzie's.  This is another brew pub and of course we had a couple more of the local craft beers while checking out this great bar and restaurant.  They had good food there but not cheesesteaks, so after we left we picked a couple up from an inconspicuous little place in a strip mall and took them to Sophie's to eat. 

"Provolone wit"..authentic Philly cheesesteak from the suburbs...
Sophie was heading over to have dinner with her family so Rachael and I sat there and munched on the sandwiches.  It turns out that little restaurant had a world class cheesteak, just like Angela and Sophie had said, so I ended up eating the entire thing.  By then it was close to 9 pm and we had to drive back to Maryland, so we snapped a couple of pictures and hit the road.

It had been a great day and it was awesome to finally meet Sophie Lynne and also meet Angela Gardner.  Seeing the city of Philadelphia would have to wait until another day.  The beers of the afternoon had worn off but I got so sleepy on the 2 hour drive home, mostly from being stuffed from the cheesesteak, that Rachel had to drive the last 30 minutes or so.  She said I went to sleep in the passenger seat.

*******

The next day was Saturday and I really didn't feel like going home so I called Mama to make sure Daddy was doing alright, as we didn't have a sitter then and I hated to be away from home for so long.  She said everything was alright there I decided to stay another night and chill with Rachael in Baltimore. 

That afternoon we went over to the Maryland State Fairgrounds to the Irish Festival where I got to meet another friend I knew from Facebook, Faith Davis.  It was a pretty cool festival with music, food and a lot of interesting booths.  We had lunch there, walked around a lot and I bought a few unique gifts to kick off my Christmas shopping.  Later that afternoon we drove back to Rachael's and picked up some fresh, steamed Blue Crabs to tkae back to her house for dinner.  Steamed crabs are a real Maryland specialty but they require a lot of work to eat and are sort of messy.  Loving seafood the way I do and always jumping at the chance to sample local fare, I really enjoyed those crabs.

There was a support group meeting that night in Baltimore and we considered going but decided to relax for awhile and head into the city to meet the girl's from the group at a cool little jazz bar.  Faith Davis was there and I got to meet a few more people as well.  It was really cool being in the city at night and it's so alive on Saturday evenings.  After the group broke up we ended up briefly checking out a local club and having a night cap.  That place was packed, with everybody dancing, but we were both kind of tired from a busy couple of days so we decided to drive back and call it a night. 

Rachael had done a whole lot for someone still recovering from surgery so I have to give it to her for finding the energy to show me around while I was there.  I appreciated the experience of visiting the surgeon, and talking with Rachael about the whole GRS experience.  As usual, I managed to make a mini vacation out of it, meet some awesome people and have a great time.  Driving home on Sunday I even took the scenic route and drove by the US capital building. 

If consulting with every GRS surgeon could have turned into such a fun trip I probably would have met with them all.  In December I got my 2 of my 3 required letters clearing me for surgery then Daddy fell at Christmas.  That pretty much put any more traveling on hold for awhile, although I was able to slip away for a couple of days in January to Pennsylvania for electrolysis and had a little bit longer trip there in March. 

By that time I had already made my decision and scheduled my surgery with Dr. Brassard for June 16th.  I feel good about this decision, great even.  It won't be the end of my transition and in many ways it will be the beginning.  There will be more consultations with other doctors for other things later on, but right now I am focused on my big day coming up very soon.....