Another hurdle jumped. Was it the final one? In an unexpected twist, there might be one more.
My sex reassignment surgery (SRS) is scheduled for April 11. That’s four weeks from today. Yes, I am counting it down, just short of marking X’s on a calendar.
Though my surgeon, Dr. Sidhbh Gallagher, is with IU Health, my surgery will be performed at Eskenazi Hospital, in downtown Indy. Why Eskenazi? Because they have the best unit for this surgery.
Their burn center.
Yup, their burn center. There, they have top-notch folks, with the best experience, performing plastic surgery and providing post-surgical care. SRS qualifies as plastic surgery. I am delighted that I will be in the best of hands.
After having passed the physical for my vocal cord surgery in January, I was confident about yesterday’s physical, what they call pre-anesthesia testing. But, with SRS being a very serious surgery, I did not know if the physical would be more extensive.
It was. Barely.
We went through all of the expected things. Katora, who got things off on good foot by complimenting my purse, took my vitals. She then poked my finger, to test my blood sugar, a test not done for the previous surgery. I was curious what it would be, though I’ve never had trouble with my blood sugar. It was 107. A very good number for late morning.
As nurse Karen entered to take my history and go over the instructions for the day before my surgery, things had heated up between Katora and me. Quickly, I had found her to be fun for bantering, so I gave her the full arsenal of my wit and dorkiness.
She had trouble finding a vein in my arm, to draw blood. “You call yourself a phlebotomist?” I needled her. “You know, I can walk the few blocks to 440 University Ave, to IU Health, where Ramitha takes my blood every few months, and she’ll have the vial filled before you know it.” Karen was belly-laughing; Katora was indignant. She pretended to ignore me and headed for the back of my hand.
Ouch! To be poked there stings! Katora got the last laugh on that one.
Clearly, her work here was done. Katora exited and Karen got down to it.
Are you allergic to anything? Not that I am aware of.
Do you smoke or use tobacco products? Never.
Do you drink? Rarely; maybe a beer or two a month.
Ever use any illicit drugs? Never tried them.
Do you have ANY bad habits? No, Karen. I’m perfect.
Okay, I made up that last one.
Dr. Gallagher’s able office manager, Nicole, had already given me instructions for the surgery, but Karen went over everything. She had one new one. She gave me a bottle of an antiseptic/antimicrobial cleanser, instructing me to wash thoroughly from neck to bottom, both the night before and the morning of surgery. Infection occurs all too easily with this surgery, so all precaution is taken.
Karen was thorough and friendly. She responded to some comment I had made with a question, which led to more questions about all I had gone through leading up to this time. Her concern was genuine, and the questions were good ones. I appreciated them.
We finished up. There. That hurdle was jumped. I had thought it would be the final one. Several weeks ago, when Nicole gave me her set of instructions, I learned of another potential hurdle, and this one might be very tall. Indeed, when I learned of it, I thought, “What on earth? You want me to do what? You’re taking away my lifeline!”
One month before surgery, which was last Saturday, I was to stop taking my hormone replacement therapy (HRT). That means, from now until the surgery and for two weeks after, I will not be injecting estrogen, assisting it with progesterone, and inhibiting testosterone with spironolactone and finasteride.
That means, over the next few weeks, my estrogen level will gradually drop and my testosterone level will rise.
That means, by the time I arrive at surgery day, my testosterone and estrogen should be returned to the levels of a genetic male.
I am a bit scared of this.
After beginning HRT in September, 2013, I stopped taking it three times. Each time, about a month after stopping, when my levels returned to normal for a male, I crashed. Badly. Worse each time.
Each time I resumed HRT, about a month into it I felt better. I have read and heard enough from other trans women to know that this is a real, physical experience, and not that of the mind—psychosomatic—so dramatically are we humans affected by our sex hormone levels. (Pregnant women are not joking when they blame dramatic mood swings on their hormones being out of whack.)
Why do I have to stop HRT before surgery? First, estrogen helps blood clots form easier. The more estrogen in one’s body, the more prone one is to blood clots. Second, surgery in the mid-section makes a person more prone to blood clots.
Having me stop HRT now, to get me back to the very low estrogen level of a genetic male, is purely for my surgical and post-surgical health, even if it might work against me in other ways in the days leading up to surgery.
I had been on HRT consistently for two years. I’ve now been off of it three days. The clock is ticking toward April 11. Will I crash in the final days before surgery? Might my excitement for this huge event be enough to buoy my spirits?
I am determined not to let anything get me down. For months, and with each passing week, my anticipation has only grown, my desire to have my body match my brain has only heightened.
I am soooo ready for this.