T'was The Night Before Surgery

January 31, 2005

VGP Days to go: 1
Stress Level; Low Pre-op Day

It takes me a few days in the same hotel room with the same bed before I can sleep well, last night was no exception. I had my usual “strange bed and room” unrest for part of the night. I got up a 4:30 AM to make a bathroom stop. I got back in bed trying to catch some more zzzz’s with mixed results. Eventually, we got out of be at 7:11 AM. It’s time to get ready for my appointment at Dr. Meltzer’s office.

We arrived at Dr. Meltzer’s office at 9:20 AM, about 10 minutes earlier than my scheduled appointment time. Jen and I waited for a short time in the waiting area. Since we had some time and not much to do we took some pictures of us in the waiting area. I checked in with Robin the receptionist and she told me they were ready for my pre-op appointment. Cheryl came out and we followed her into one of the exam rooms. I sat down in the dental chair where Dr. Meltzer does the exam and waited with Jen sitting in a chair off to the side. A few moments later Janet on of Dr. Meltzer’s nurses came in, it was all hugs and hello from all of us. Janet asked Jen how she was doing; Jen told her pretty well except for the stream direction. Janet handed me the surgery consent forms to sign, I looked them over and began to initial and sign them. Janet asked me to open my mouth so she could take my temperature with a disposable strip thermometer. I don’t remember exactly what was said at the moment, what I do remember was laughing so hard that I nearly dropped the thermometer out of my mouth. Jen got a picture of this rather funny moment. There was a knock on the door; it was Dr. Meltzer with his usual happy smile. He got the tires we sent him a while ago. The topic of tires came up during one our bicycle chats in October 2004 when Jan was here for her VAG. We chatted about his new bike, his old bike, pedals, and some to the places to pedal in Scottsdale.

We chatted a bit about his uncle who was a doctor when he was still trying to figure out what he wanted to do in the world of medicine and how his uncle influenced him in the health care profession. Years ago, I would have dinner with Dr. Meltzer’s uncle since my sister in law worked for him. He was one of the last doctors I knew of that did house calls and he always had a real interest in his patients on a personal level. He was simply a truly caring individual who practiced medicine. Dr. Meltzer told me his uncle influenced him quite a bit as to what it means to be a doctor who cares about his patients. While doing technically difficult surgeries were intellectually satisfying, it was not personally satisfying in the way taking care of his TG / TS / IS patients were. I honestly believe the TG / TS / IS community is very lucky to have Dr. Meltzer as a doctor & surgeon in this specialty.

The topic of the rising urine stream problem came up and I told Dr. Meltzer that I believe it was rather unpredictable due to the many variables like swelling, the process of healing, individual anatomy, effects of dilatation, stray hairs that can get in the way and etc. He appeared to agree with my observation. Stream direction is usually corrected during labiaplasty, it’s an easy fix according to Dr. Meltzer. He asked Jen if she would like to have her stream direction adjusted while she is here, Jen thought about this for a moment and decided to wait. The topic of body position came up as one of the ways to deal with stream direction. The next topic was my lack of genital electrolysis; this was something he found I did not need during my pre-op exam in July 2004. I was still concerned. With that, we proceeded with my pre-op exam. After a few moments, he confirmed that the hair and me not having any electrolysis in that area was not a problem. As the exam continued he noticed something missing, it was Bert and Ernie. We all began to laugh with this discovery and I told him I had an orchiectomy done several years ago.

The last topic of discussion was me being not circumcise and how that would affect this procedure. Dr. Meltzer started to describe what was done differently in my case with medical specific language that made my head spin. I told him I don’t understand and he got some paper and pencil to draw what was done different. It turns out the skin fold under the gland of the head of the penis tends to neck down smaller so the dissection, incision is made length wise and the graft shape is like a leaf rather than being a simple end extension which is the case of a patient who is circumcise. I also asked him if it would be possible to make a clitoral hood during this procedure, his reply it usually does not work very well partly due to the amount of surgery done in this area and blood supply. So the best results come from the two step procedure. It is generally better than a single step procedure for overall results. I asked about this due to the experience of other patients who were not circumcised and had to deal with a hyper sensitive clitoris post op. Jen asked about pictures, his reply was no pictures are needed. Jen asked if he would like to see the results of the lipo she got done in October. He said sure and handed Jen a black robe. Jen put on the black robe so Dr. Meltzer can do an exam. Dr. Meltzer and Janet returned a few moments later to have a look. The results were really good and he did want a few pictures as a before and after comparison. We all went off the photo area for a few pictures of Jen’s lipo areas. Pictures done, we headed back to the exam room where I sat down in the exam chair again. Dr. Meltzer asked me if there were any more questions, no we were pretty much done. I did want a picture before we headed off and Jen got two pictures of me and Dr. Meltzer. He left the room and went on to his next patient. Janet returned to our room and gave me instructions for the bowel prep. Finally, we were done.

There was a Starbucks near by and we stopped there for a drink, Jen ordered a Mocha and I ordered a hot chocolate. Jen and I sat down on one of the sunny tables outside. Dr. Kay (retired surgeon friend, also T*) called to say hello and see how I was doing. I told her OK and chatted about stuff for a bit, then passed the phone onto Jen for her to say chat for a while. We enjoyed the sunny Scottsdale day for a while longer before heading over to Landis bike shop where Jen purchased a Landis cyclery water bottle and sort sleeve jersey. Then it was off to Target for a few items we forgot to get yesterday night. This was when I began the, “drink 8oz. of water every hour process.” I don’t have any problem with drinking lots of water or a clear liquid diet.
The only problem I have with this it my need to pee often and sure enough, this is exactly what happened. When I go off on bike rides that are several hours long a liquid diet is preferred and lots of drinking is a must.

Our next stop was Safeway to get Jen some food and me more stuff to drink. A young woman stopped me in the parking lot to comment on my long hair. She told me it reminded her of a Japanese female cartoon character with hair just as long as me. She asked me how long I have been growing it, I told her about 10 years. It was the first time she saw hair this long. After our Safeway shopping trip we headed back to the Holiday Inn to drop off our stuff. The cold stuff went into the fridge and the rest put away where they were needed to be.

Now we had some quite time to relax before visiting the Greenbaum hotel to say hello to familiar faces like Julie, Nancy and the rest of the nursing staff at the Greenbaum recovery (hotel) center. When we got there, it was like old time again, Julie was on duty and so was Nancy. I told them we are back and now it’s my turn so we will be spending the next several days here again.
Jen said it felt a bit strange going back there as we both have many memories from that place back in October 2004.

After that visit, we went back to our hotel room to continue the bowel prep process. Jen went out to get a coffee grinder and filter just like what we did in October. I’m in a pretty good mood overall, not very nervous at all, not fearful, not excited, not stressed. I guess having done this with Jen in October, knowing most of the personalities involved, having been thru the surgery process before, and knowing what is about to happen to me makes a significant difference in how I feel about the whole experience.

At a few minutes pass 5:00 PM, I drank the entire 10oz. bottle of Mag Citrate, It took two gulps to do this. The stuff was just as I remembered it when I tried a little from Jen’s night before surgery. It has a carbonated slightly salty, sweet lemon line flavor, similar to some sports drinks I have tried, but less drinkable and something you don’t enjoy drinking. I gave my hair a good wash and conditioning. It’s going to be several days later before I can do this again.
This is when having really long hair is a real problem.

Jen came back from her shopping trip with a coffee grinder and filter in hand. She got the same coffee grinder we got the last time. The problem will be what to do with the grinder when it’s time to leave for home. Jen made some coffee with the new grinder and coffee filter. Yes, that coffee is good. Home roasted coffee is a real treat that can get you spoiled.

8:00 PM, it’s time for the Bisacodyl suppository. With a bit of KY gel, I put in the suppository and waited. My tummy now feels like a bomb ready to go off. I lay next to Jen to rest for a while. In just about another 30 minutes, it’s time for 4 Bisacodyl tablets. All this was happening while Jen was watching 24 on TV. The 8:30 Pm commercial break came and Jen got me out of bed to take the 4 tablets. Down they went one at a time with some water. About 15 minutes passed and I made a trip to the potty. Just as I got started, my cell phone rings. I call out to Jen and ask her to answer it. The caller was Amy and Jen passed the phone to me. She was calling to see how I was doing and I told her what I was doing at that moment. “Would you like me to call you back later?” No, I can chat while I do this. So, we compared notes from her trip here in July 2004 and a few other things before I said goodbye.

It’s just after 11:00 PM and the plumbing is finally beginning to feel like it’s settling down.
I’m headed off to bed now and hope to get some degree of rest before I need to be at Greenbaum at 10:00 AM. One last shower in the morning, take my last pre-op meds and Jen will drive me over to Greenbaum. Then, the wait and real fun begins..

February 1, 2005
Surgery Day
Stress Level; Low, Calm and Resolved To Get On With The Process

I got up this morning with an amazing sense of calm. The whole pre-op process from yesterday got me a bit tired. Jen and I got up earlier this morning before sunrise and we watched the colorful sunrise together before going back to bed. I did not sleep all that well but managed to get rested enough until we finally got out of bed at just after 8:00 AM. I took my last pre-op meds this morning completing the pre-op process. One last shower before getting dressed to head over to the Greenbaum Surgery Center Where I will be for the next several days.

This will be the last time I get to listen to Loreena McKennitt for a while too.

10:00 AM, we arrived at the Greenbaum  Surgery Center and signed in with the receptionist. A few minutes later, the other receptionist called me to the desk to verify my Identification and information. I did this with my passport and Driver’s license. She noticed my long hair and we started to chat about owning long hair, it turns out she is a fan of long hair. She asked me to check my information on the ID tags, it all looked fine and this was passed on to Jen, one of the 

intake nurses. She escorted me into a room where she took my vitals and once again verify my personal information. She also commented on my longhair and asked how long I have been growing it, I told her about 11 years. I noticed they had a computer on the net, and told her where there is a picture of me. I typed in the URL and she liked the picture on that web page. I asked nurse Jen to braid my hair and get me two hair caps. She went off and got two hair campo and she braided my hair as I sat down in a chair. I learned how to deal with my hair from a previous surgery. It was the only thing we found that worked the first time and still the best solution for my hair. Nurse Jen asked what my height was, I told her 5’ 7” and she handed me a gown to change into then left the room for me to change. Everything that has happened so far is nearly identical to the first time I had surgery. Once I had changed, with a knock on the door, a different nurse took over, Dana. We finished gathering up my clothes and patient information, then she escorted me to bed# 11. I got on the bed and Dana proceeded to install an IV into my left arm. The first try did not work, it might have hit a vein valve. On the second try she tried my left hand, I don’t know what the reason was, but that failed too. All this has taken about 30 Minutes and I was on the verge of crying over what was happening. I have not had this much difficulty getting an IV installed in the past. Dana asked another nurse to get this done I don’t remember her name, but she got the IV installed on her first try. The only problem with this IV was the location, it was on my wrist and that prevented me from typing until it was removed.

Once the IV was installed, I asked the nurse to get Jen to come in. Jen has been waiting for a while and was getting worried. We greeted each other with a kiss and she sat down and held my hand as we waited for Dr. Meltzer and the anesthesiologist to visit. Dana gave me a pill, I don’t remember exactly what the name was, but it was used to lower my BP for surgery and then an injection of anti- coagulant to reduce the possibility of blood clots during surgery. In short time, Dr. Meltzer came in to chat for a little while. I told him years ago when your uncle mentioned you that performed this procedure regularly, I would have never guessed that would be one of your patients back then. He smiled and we chatted about the events to come. He had just finished surgery on his VAG patient this morning. I will be his second VAG patient for today. He went off to have lunch made by his wife before we got started. The anesthesiologist came in to see me and asked if I have had general anesthesia before, yes, I have. I told him it was done with a combination of drugs Propfol, Fentynal and Gas. I was also given some Anzemet to prevent nausea. I was certain of being intubated; it’s the norm for this type of general anesthesia. He told me these are pretty much the same meds they will use today. Knowing that I have not had a reaction to these specific meds does make me feel better. As he went off to get some meds, OR nurse Cindy came in and told me she will be my OR nurse for today. I gave Jen a hug and Kiss, told her I love you and she mirrored the same words to me. When the anesthesiologist came back, he injected a sedative into my IV line and I floated off into sleepy land as they wheeled me into the OR. The last thing I remember hearing, “Is she gone? Yes.” I don’t’ remember anything more after that.

The surgery team;

Dr. Toby Meltzer, surgeon

Dr. E? , anesthesiologist

Michael, Dr. Meltzer’s surgery assistant

Cindy, surgery nurse

??? Operating room tech

Surgery Day, Feb. 1, 2005, 12:40PM into OR, 1:00PM start of surgery ended at 4:15 PM.

I remember very little of my time in Post Anesthesia Care Unit. I had no problems with nausea, recovery time and etc. The only thing I remember during that time was a nurse calling my name and I responded. She removed my O2 mask and they began to wheel me upstairs to room 16. The ride in the bed was totally disorienting, I sort of remember going straight, turning, then into a elevator and finally into my room. Jen was waiting for me there and was worried why I was taking so long in the PACU. The wait brought back memories of what happened to Jen’s mom in December of 2004. I finally arrived to room 16 around 6:00PM. I sat up when Jen came over, gave her a big hug told her I love you and thank you. Jen and I chatted about stuff for a while before we watched a bit of TV together. I ate some Jell-O, soup, and crackers. This was the first meal I had since my liquid diet day on Jan 31 and basically dumping everything down the potty from my digestive tract as part of the prep for surgery. I asked Jen what Dr. Meltzer told her about my surgery. She told me that Prep took 20 minutes, and the procedure started at 1:00PM and took 3 hours and 15 minutes. This was less than his typical 4 hours for this procedure. 

Event at this time, my sense of relief was incredible. It felt like a huge burden has been removed from life and will not be back. I was honestly surprise at how I felt so early post-op.

My nurse for the night was Katie, she is the nursing supervisor, but was filling in for another nursing staff member that nigh.

I was tethered to my bed by an IV, vitals monitoring, urine catheter, two blood drains from my sutured together labia, calf compression stocking to reduce the possibility of DVT and a ice pack on surgical site. I also had Patient Controlled Anesthesia control button. This controls an extra dose of pain meds (meperidine) depending on my needs in addition to the timed program dosage. The pain level as not that high so I that I used the PCA much over the next 12 hours. With all this stuff hanging from me, I was not going anywhere for a while.

I did not sleep well that first night due to all that racket coming from the IV pump, DVT compression device, vitals monitoring device. I was in a state of semi sleep. I felt OK, but I was tired from the events of the day.

Karen a nursing assistant came in several times during the night to check up on me. That made getting any real sleep difficult. Jen stayed with me in our room that night to make sure I was OK. Back in October 2004, I slept in that same recliner and I can tell you, it’s not comfortable to sleep on, it’s lumpy, and hard.

Katie came in at 7:00 AM to take me off the PCA. She asked me if I wanted another hit, I told her, Na. Katie told me some patients like being on the PCA, it’s not surprising since meperidine is a narcotic similar to morphine.

Post-op Day 1, Feb. 2, 2005

This was basically a bed rest day. Charlotte was my nurse for the day. She was Jen’s nurse when we were here in October. Other than trying to get comfy in bed and dealing with all the drainage from the surgical site, dealing with ice bag, and Charlotte changing my IV meds of IV fluids, IV antibiotics and etc, it was a pretty uneventful day.

Janet from Dr. Meltzer’s office came in to do a quick exam and check on me to see how I was doing.

This is the same day I was switched to oral pain meds. I have taken perocet the last time I had surgery and worked OK for me the last time, so I chose the same med again knowing it would be OK. I tend to try not taking any meds if I can. In the case of the pain meds, I should have taken them more often today than I did. It would have made things a bit eaiser.

There was another problem that I’m concerned about, I was not circumcised, those who I have spoken to about this had a hyper sensitive clitoris, sure enough this might well be the case for me. It’s a good and bad thing. 

About 1:00 PM Dr. Meltzer and his surgical assistant Michael came by to see how I was doing. We talked a bit about my surgery. He told me that the procedure took 3 hr & 15 min, less time than usual. Everything went well and nothing out of the ordinary. My blood loss was less than 100cc during this procedure. I was a bit surprised that so little blood was lost over a bit more than three hours of surgery. When I asked Dr. Meltzer about this, he told me since I was a well trained aerobic athlete, you can easily allow the patients blood pressure to be in the 80 / 50 range. This means you bleed a lot less during surgery and the vascular system can tolerate this well. Jen had loss a similar amount of blood during this same procedure. Blood loss has an effect on overall recovery.

I was feeling icky from all the stuff that has happened over the past few days, so Jen gave me a body wipe down with some wipes similar to baby diaper wipes, that felt nice when we were done.

The nurses would come in once ever so often to take my vitals, when they do this during the night, it can get annoying.

We had dinner together in my room and Jen stayed the night again to make sure I was going to be OK. 

I called a few friends to chat and returned a few phone calls. I got some pain meds from my nurse took them and went to bed.

The level and quality of care Dr. Meltzer’s patients recieves is nothing short of special in today’s world of HMO’s and mass production health care. In some ways, many of Dr. Meltzer’s patients and staff is like an extended family. Dr. Meltzer has stopped by every day to spend time with his patients and see how they are doing. He would ride his bike on weekends and stop by Greenbaum to check on his patients to see if they were doing OK, answer any questions or deal with problems that might come up. He would change from his bike clothes and put on his scrubs to do rounds. How many doctors do you know who spends time with his patients in this way? 

:)

Scottsdale Arrival & The Day Before

January 29, 2005
VGP Days to go: 3
Stress Level; Moderate, Thinking About The Days Ahead

Got up this morning at just after 6:00 AM, washed up, got my Serotta ready, got dressed, checked my email and went out for my last bike ride until I’m recovered well enough to get back on the bike again. This morning ride was rather magical, the sun was just starting to rise as I began my ride out to Page Mill Road, thru Los Altos and back home. There were moments when the clearing fog and sun peeking thru the trees that looked and felt magical. The whole experience reminded me of the times I went pedaling in Paradise Valley in Scottsdale. The ride felt good both physically and emotionally. During most of the ride, I spent a lot of time thinking of the days to come. I usually don’t try to maintain my summer / fall level of fitness during the winter months due to burn out. This winter was an exception; I kept up my cycling schedule and tapered off at about 1.5 weeks before my surgery date. It’s the same process as peaking and preparing for a race. When I was at a competitive level of fitness, my resting pulse rate in just below 50 BPM, now my resting pulse rate is just above 50 BPM with a blood pressure of around 107/69. I basically trained for endurance, not power the way I during my race days.

When I got home, Jen was dressed and pretty much ready to go spend out day in San Francisco with Camille. I got out of my cycling stuff, took a shower, got dressed had some coffee and a bit to eat before Jen and I drove up to the Manor house. When we arrived at the Manor house Camille was still on the computer playing neo pets on the net. I got Camille some clothes while Jen packed Futurama & Sponge Bob DVDs. We were all ready to head off to the zoo at just after 10:40 AM. Jen has not been to the SF zoo for near 40 years and things were quite different since then. A trip to the children’s zoo to pet the farm animals, a ride on the zoo tram tour, and the last thing we did was watch the big cats eat. I don’t know why Camille enjoys watching the big cats eat, but it is something we do every time we go to the zoo. We headed off to West Portal have Pizza. We ordered a medium size half sausage with pesto and Hawaiian with a few drinks.

This will be the last time I spend any time with Camille for a while until I’m back from Scottsdale and recovered enough to spend time together. With a kiss and hug, we said good bye to each other.

After pizza we drove Camille home and I gave Arlene a check for the February mortgage. She asked me when I’m going to be back, I told her I’m not sure and will call when I know more. Jen and I drove over to the Lumiere to see, “Beautiful Boxer”. We found a parking space after a few tries with time to walk to Lumiere. The film was surprisingly good. Many scenes were too close to home and left me crying really hard at times as I thought about my own childhood and life experience. I have wanted to see this film since I read about it in the news a few years ago. I was surprised at the films honesty and presentation of this real life story. This film added to my emotions since we watched it so close to my surgery date. Jen liked this film too; this surprised me since Jen usually does like films like this.

On the drive home, we stopped by Safeway for dessert and coke. Jen needed to get her coke fix.
Jen continue to get her stuff packed while I munched on stuff and finished more of my packing. It’s basically done; all that is left is finishing packing my music CDs. I called Vicki to confirm our ride for tomorrow morning; I got her voice mail and left a message. I will try and call again tomorrow in the morning. Later that night, Vicki called to confirm our trip to SJC. I got mad a Jen for throwing out the box for the Go Video DVD player, it had a bunch of cables and other stuff left in it. It took me a while to get over it. What can I say, stuff happens.

Jen cut the chocolate cake into two slices and put a candle on top of each slice. AS we sat down on the dining table, Jen made a toast, “to another VAG.” We brought the two slices of chocolate cake and Jen’s glass of coke into the bedroom and finished our cake in bed watching All My Children.

I’m jus a bit tired right now from all the events of today. I’m just in a state of resolve to get there and get this done and over with. It’s time for bed.


January 30, 2005
VGP Days to go: 2
Stress Level; Moderate, Time to Leave for Scottsdale

I got out of bed just before 6:00 AM this morning and decided to write. I woke up this morning thinking about several scenes from “Beautiful Boxer” and how close they were to my own life and feelings. All this brought back memories from my own childhood growing up as a feminine child who was never able to hide how I felt. The scene of Parinya Charoenphol’s being physically beat up during her childhood brought back memories of a very similar thing that happened to me several times during my own childhood. Yes, these were emotionally painful memories from my child hood being brought back to life on the cinema screen. I wound up crying in bed as Jen cuddled up with me. There were also memories from years past when I would be in crying in bed hoping one day the reality of being physically incongruent would be gone.

There are only a few things left over for me to get done before we are off to Scottsdale, finish packing my music CDs, clean up the house a bit, check our travel paper work and go down the list one more time. At 10:30 AM, Vicki will pick us up and drop us off at SJC.

It all seems so unreal to me as we are about to head off to SJC and catch a flight to Phoenix / Scottsdale, it’s been a long road to get here.

Jen came out of our bedroom and gave me a hug and kiss as I was sitting in front of my notebook writing. The she went off to make some coffee for the two of us. I made maple oatmeal while Jen had oat o cereal with milk and sugar, we shared a banana too. With breakfast ready, we sat down to chat for a while about the events to come.

There was still time for a bit of last minute clean up and packing before Vicki is here to drive us to SJC. Everything was packed and the house cleaned at just before 10:00 AM. Jen and I began to get ready for our trip to Scottsdale. Vicki arrived right on time, we ended up with two more quick runs back to the house to get a few last minute things we nearly forgot, I nearly for got my passport (Vicki was telling me about her Kelly hell and the topic of IDs came up), Jen forgot her sunglasses. I’m sure there will be other little things we forgot, but it’s time to go and we will deal with it what ever we might be missing later. The trip to SJC was totally uneventful, Vicki dropped us off at the SWA curbside and we checked in our baggage at the SWA curbside skycap. It was time to head off to gate A6 with our boarding passes in hand. It is now 11:40 AM, Jen and I are sitting at the gate waiting to board flight 2884 to Phoneix.

I’m feeling just the usual stress for traveling and it seems still sort of unreal that we are on our way to Scottsdale for my date with Dr.Meltzer. I’m a bit surprised at the moments of emotional calm as my date draws near. I still feel emotionally unsettled at times, but they are the same feelings of being physically incongruent I have been dealing with for the past several years, the difference now, the end is in sight.

We boarded the plane on time in typical SWA fashion. Our flight appears to be on time and we should be in Phoenix before 4:00 PM. It’s pretty much the usual travel stuff with all the waiting and dealing with airports, baggage, rental cars, driving to the hotel and etc. So far it’s been pretty much a repeat of our trip to Scottsdale in October 2004.

SWA flight 2884 arrived in PHX on time at 3:30 PM Phoenix time. We got off the plane and headed to the baggage claim area and got our baggage. The next stop is Dollar rental car. I gave Jen the reservation for the car. Jen was at the service counter a while dealing with the rental car stuff, it turns out, Jen wanted to get a PT cruser again. The same car we had in Scottsdale during our visit here in October 2004. We got our rental car paper work and went out side to the shuttle bus area. The Dollar shuttle bus was just pulling up as we arrived at the pick up area. We go on with our stuff and the shuttle dropped us off at the rental car pick center. The car was ready and waiting for us. The doors were opened and all of our stuff went in the back and we headed off for the Holiday Inn Scottsdale. The same place we stayed at the last time we stayed at Scottsdale. The good thing about this Holiday Inn is the location. It is about a 15 minute walk to the Greenbaum hotel. During our trip here in October I brought my bike and spent most every day pedaling during the morning for a in paradise Valley for a few hours before I would walk over to the Greenbaum hotel to spend the day with Jen. If you ever visit Scottsdale, visit Paradise Valley, it is a really beautiful place with houses that generally fit well the environment.

We parked the PT curser in the front of the Holiday Inn and went to the front desk to check in. we asked for a room on the third floor thinking that it would be quieter, since the last time we stayed here, our room on the ground flood was noisy and kept me up for much of the night. The desk clerk obliged and gave us a room# 359. We rolled our baggage into to the elevator and found room# 359. I reminded Jen that we stayed in room# 159 the last time we were here. Jen put the door card into the lock and opened the room. The room was fine except for one thing, there was a buzz coming from some where in the room. Now, we are both pretty tired from the stress of getting ready for this trip and travel. The last thing we needed was a room with an annoying buzz. We tried to locate the buzz but were unable to find it. I was not in the best of moods either. I’m basically bottomed out with my estrogen and progesterone levels and this makes me easy to irritable, it’s what some call this PMS. I called the front desk and they put me on hold, after several minutes of waiting on the phone. I got tired of waiting, hung up and redialed the front desk. When the clerk answered, I told them the room has something buzzing would like to get this fixed. We waited for over 20 minutes with no results. I called again to ask for a different room. The clerk said, “Fine, come down to get another room card.” Jen was patient and kind enough go down to the front desk to pick up the room card. The room card was for room#356, it was just across the hall from room#359. We opened the door and rolled our baggage in to the room and parked them in the same place as the other room. Strange enough, this room buzzed too. How tiresome! Jen and I went to the bed room to lie down for a just a moment. That buzz was still there, so Jen closed the doors to lower the sound of that buzz. We got a few moments of rest and relaxation before Jen got up and went down stairs to try for another room. When Jen got back to our room, she got a room card for room# 147 on the first floor. I asked Jen if the room was buzz free and she said it was, so it was time for another move. We rolled our stuff into the elevator and arrived at room#147, parked our baggage in the same place as before. Guess what, that buzz was in the room again. This was strange and frustrating all at the same time. When things get this way, I can get short fused and the wrath of Nici comes roaring out. I went over to the front desk and told them the buzz was still with us. One of the guys at the front desk told me he would send some one over to look at it. After waiting for over 15 minutes, no one came over to check on the problem. I headed over to the front desk again and finally got one of the guys to come to the room and have a look. He followed me to our room, heard the buzz and told me he would get one of the maintenance guys to look at it. Another 15 minutes passed with nothing happening. With all this lack of service and attention, Jen and I were getting pretty darn irritated over the whole thing. We were talking of getting some form of compensation like a room upgrade for all this hassle. I went over to the front desk one more time, this time I got another guy from the front desk to have a look at the problem. When he arrived at our room, he looked around, did a bit of listening and announced that the buzz was coming from my luggage! I was more than a bit surprised. He went back to the front desk, I opened up my luggage and to my amazement, and I discovered the battery powered tooth brush was the offending object. I took the tooth brush out of the bag and turned it off. Something must have bumped that toothbrush to the on position along the way here. Jen and I had a big huge laugh with this discovery. I’m not going to hear the end of this from Jen for a long time. I asked Jen if she would like to stay in this room or go back to room#359. We discussed this for just a bit and decided room#359 was better. I sheepishly went back to the front desk and asked if we could move back to room# 359. The deck clerk obliged and gave me another set of room cards for room# 359. We moved back to room# 359 in short time and finally got settled in.

After our episode of musical rooms, it was time to get din din. SA we drove down Scottsdale road looking for a place to eat. We decided to have din din at Coco’s after getting caught in a traffic jam due to road construction. Jen had a bacon burger with beer and I had sun dried tomato chicken with a glass of Fetzer Cabernet wine. We shared a piece of pecan pie for dessert. Our next stop was Target for a few toiletries. The last stop was Trader Joes on Scottsdale road for drinks and a few snacks. We are now back in our room and taking time to relax and unwind.
Tomorrow morning is my pre-op appointment at Dr. Meltzer’s office. It is also going to be liquid diet and bowel purge day. It’s not something you want to do often, but part of the pre-op process.

On Babies, Marriage & Relationships

January 23, 2005

Zack was born this morning around 4:00 AM, The mom is our sister in law, Kellie. We went to her baby shower last Sunday and many of us were guessing when baby will arrive. They were planning to induce labor on January 26, 2005. Guess there is no need to do that procedure now that Zack has arrived. Thinking back, so much has happened during the last part of this year. Jen and I going off to Scottsdale for her date with Dr. Meltzer, the death of Jen’s mom, all the holiday celebrations, and my date with Dr. Meltzer in about a week’s time.

Reading the news today, there were more and more stories regarding transsexual individuals and marriage. I’m deeply saddened to see transfolk dragged into the whole “same sex marriage” mess. In their effort for define marriage as only between a “man & woman” they are totally ignoring every bit of scientific fact regarding the spectrum of human complexity. It is impossible to define every individual human being as clearly man or woman. Beyond those who are transgender / transsexual, there are those who are born intersex. There are about 1 in 300 births that have some degree of variation from the expected male / female norm. They also have no concept of the difference between sexual orientation, gender identity, gender expression and physical genitalia. All of which are separate aspects of an individual. Most individuals are born congruent, but many are not. They are basing their beliefs on an ideal image of them selves where there are no differences in humanity.

I’m not at all surprised by this as religion and science has never gotten along very well over the since their beginnings in time. It took the Vatican about 400 years to admit they were wrong in judging Galileo’s discoveries and writings regarding the sky, space and planets. Change is possible, but for them, it takes an amazingly long time to come to terms with reality and the natural world.

What is most disturbing with all the stuff coming from the conservative Christian’s use of fear and mis-information to get their way. It is their form of propaganda. One of the basic rules of propaganda is to tell what you want the public to believe over and over again until it becomes fact. The real facts can then be ignored since only what the public knows becomes the facts. They claim legalizing same sex marriage, homosexuality and etc will become the destruction of society as we know it and humanity will burn in hell forever with never ending human suffering, pretty scary eh... The facts are, the bible they so highly value is a re-written version of the old testament and it was originally written in a totally different source language. It has been interpreted into English by more than one individual. So much for, "The Direct Words of GOD.” As anyone who is fluent in more than one language knows, you cannot translate without some degree of interpretation. There is also the whole problem of interpreting what is written. History has proven that interpretations of these writings are a reflection based on the political climate of the time and social /moral views. The old testament was based on a set of scrolls that no one appears to have ever seen before. When you start looking at this very, very carefully, the entire basic foundation is questionable. I honestly feel they are using the bible to support their beliefs and doing all they can to get everyone to think, believe, and feel they way they do. It comes down to a power and control issue. It’s also why children get dragged into all of this mess too. The question must be asked, why are some individuals so fearful of those who are different from them be it homosexuality, trans, intersex, historic origins, deferring set of beliefs or morals, and etc. Why are they so bent on forcing their values and beliefs upon those who different than themselves. Do they feel they are so right and everything else is wrong and what they feel is wrong should be eliminated?

Have they forgotten the importance of separation of church and state as written in the US constitution? I wonder what Thomas Jefferson and Benjamin Franklin would think of our society based on what they had intended during the time when the constitution was written.

The real problem with marriage today has everything to do with the individuals involved, not "same sex marriage." What they totally ignore as a serious problem is enforcing strict roles and simply following their traditional marriage formula is no guaranteed to being in a happy and satisfying marriage.

Historically, marriage had everything to do with family property rights, passing on the family name and procreation. It totally ignores the relationship (all the other aspect of the marriage that has nothing to do with sex) between two individuals which are key to the success of any marriage. In many cultures, historically and today marriages are arranged based on family needs, and little to nothing to do with the individuals involved. Once again, it's about property, control and passing on the family name. Why is this so very important to some? If you look at the troubles in the middle east and other parts of the world. You can see how traditions, beliefs, values that are passed on have resulted in wars and hatred that has lived on for hundreds of years and in some cases, to this very day. Is this why procreation in marriage is so important, to maintain this way of life for generations today and in the future?

You cannot base a marriage on sex, procreation and family alone and expect everything to work out fine. Its love that makes a family, not strict gender roles, ceremonial passing or following a how to make a family formula. And, love is not sex. They are two very different aspects of humanity.

Relationships require respect for each other, caring for each other, allowing each other to simply be who they are and know they are loved as such, shared interest, and the tools to work out problems that are going to occur, are just a few aspects of what makes a relationship work. These factors can also be the building blocks of a society.

The answer to the "same sex marriage" problem is pretty simple. Delete the sex marker on all birth certificates and allow ever member of society to form relationships that work for them with respect from society for these relationships. Equal rights do not mean you must be a certain type of individual before you are an equal member of humanity. This is pretty basic to being free or the concept of freedom.

How All This Came To Be

January 21, 2005

Nine days before we leave for Scottsdale, Eleven days before my surgery date of February 1^st, 2005. The days appear to pass faster as my date with Dr. Toby Meltzer draws near. It’s been a long road and journey for me. Back in 2001, I had an orchiectomy done to deal with part of my need for surgery. While this step for ever changed me hormonally and allowed me to deal with the legal aspect of changing my sex designator. It was only a matter of a few months post op that the problem of being physically incongruent reappeared. Due to the cost of vaginoplasty, I was not able to afford this procedure, so I tried all I could to accept my self as is. As the years passed, I bottomed out my ability to cope with this problem and this is when depression began to set in. At one point, I felt totally hopeless and so very depressed over the whole thing.

I filed a grievance with my HMO and eventually the grievance went to the California Department of Managed Care. No matter what I presented as fact or case history, coverage was denied.

I learned that the health care system does not have your best interest as their goal, but it’s simply a matter of $$$$$ and covering their liabilities. I honestly believe they would rather see you dead and no longer a liability rather than provide proven effective treatment. My case is also a reflection of this society’s view of transsexual individuals. Our lives are disposable and not worth wasting resources on. The total lack of proper and proven effective transgender / intersex specific health care education in medical schools everywhere only adds to the problem. This problem can be traced back to the John Hopkins Medical School gender program run by John Money, Paul Mc Hugh, Jon Meyer and staff. Their faulty theories were published and became accepted fact regarding health care protocols for Trans and intersex individuals without solid scientific proof. They have based their findings on their beliefs and morals instead of using real unbiased scientific facts or worst, biasing the study data to prove their beliefs and ideas. There is a growing current body of scientific facts and research that proves their theories are wrong regarding surgical treatment of transsexual and intersex individuals and the casue of this state of birth. Paul Mc Hugh is a current member of the Bush Administration’s board of bio ethics committee. He still hangs on to his dated views against surgical treatment for transsexuals based on his morality and religious based value system all current science and studies that proves he is wrong is totally ignored by him.

There are tens of thousands of very successful post-op transsexual women living well and making quite and very significant contributions to every society world wide. These success stories are totally ignored by Paul Mc Hugh as refuses to see the reality of these successful post op transsexual women.

I believe the only way trans and intersex individual are ever going to receive proper and specific health care is when the law mandates it. Nothing else will change the ways of the established health care provider and education system. This is the legacy left for generations of transgender, transsexual and intersex individuals to deal with. They have affected countless thousands of TG/TS/IS lives world wide based on their flawed theories to this day.

Being transsexual is not a choice, but a state of birth. No one gets to chose how you are born.
We only get to chose how we deal with the results of being born this way.

One of the core issues regarding gender identity is our basic freedoms. How can we be truly free if something as basic as your core sense of identity has been chosen for you based on visual inspection of a small part of an individuals anatomy or other unit of measure. No only is your identity chosen for you, but the script for your life has been dictated for you based on these factors. If we are truly free, each individual will have the ability to chose, decide and declare who they are not based on another individual’s judgment of any kind and society will respect this declaration from any member of society. Procreation should not be the prime directive for members of any society.

Based on my experience, if you are a transwoman considering an orchiectomy as a stop gap measure, it might not be the best answer to the problem. For some, it will be a viable one, but for others, an orchiectomy might not be enough and you will need to get vaginoplasty done one way or another to be at peace with yourself.

If not for the love and generosity of my partner, my surgery date would still be a far off reality that may never happen and who know where my state of depression would have left me.

Vaginoplasty is just another stop along my journey of life, not the finally to my story by any means. I can’t say that I’m really excited about having this procedure done, what I can say is the sense of relief when the surgery part is done and over with. I still have the entire recovery and post-op care process to deal with when we are back from Scottsdale. I just want to be done and over with this medical procedure so we can get on with our lives.