Jen's Surgery Day

Jen's Surgery Day
October 12, 2005

I did not sleep that well yesterday night and spent part of the time writing my previous journal entry. I found myself waking up after listing to an Enya CD. It was 2:00 AM before I woke up and went on to bed. I got up this morning around 6:30 AM to get ready for our day ahead. Jen was not up and around until after 7:00 AM. Jen and I got ready for our appointment at Dr. Meltzer’s office. We arrived at Dr. Meltzer’s office at a just before 9:00 AM and met Debbie at the front desk. I was really surprised to see her, she looked great! After our warm greetings and short chat, she went to get the room ready for us. Jen and I sat down in the waiting room for what appeared to be a short time before Debbie told us that our room is ready. We followed Debbie into the exam room and Jen sat down on the familiar dental chair. I sat down on the chair to the right. Debbie handed us two black robes to change into. Jen and I looked at each with early morning eyes, undressed and put on our robes. Debbie returned into our room, while she took Jen’s temperature and other patient info, Debbie and I began to chat about all that’s been happening in her life since that incident with her ex. At one point during our conversation, we both got tearful and comforted each other with a big warm hug. Debbie is so thankful to have received the many gifts of love and caring that was given to her by those individuals touched by her spirit. I’m so glad to see her doing so well after all that has happened to her only a few months ago.

A short while later, Dr. Meltzer entered our exam room. He was a bit under the weather from the previous week, but still cheerful and charming as ever. After a bit of bicycle chat, he went on to do Jen’s Labiaplasty pre op exam. Jen wanted IV sedation for this procedure, make an adjustment to her urine stream. Otherwise, it was a rather routine Dr. Meltzer Labiaplasty. Now it was my turn, ug.. We chatted as the exam chair rolled back and he did an exam for Labiaplasty. I was concerned with the need for some hair zapping around the clitoral area that becomes the hooding. It turns out that there is enough clear area to get the clitoral hooding done without any hair zapping. I was surprised, relieved and feeling very lucky that was able to skip the entire genital electrolysis (hair zapping) for both surgeries. I don’t really have any problems with urine stream problems (it’s more like a downward pour) and since my clitoris is relatively flat, I don’t have a problem with rubbing on a very sensitive clitoris. In many ways, I could skip the Labiaplasty and be OK with the way things are now. Labiaplasty would be an improvement more than a required procedure. We discussed my eye catching raised scars and while it’s pretty much the same as we discussed the last time, I did consult with a skin doc on this a few weeks before our trip to Scottsdale and it looks like a series steroid injection to flatten them. This is pretty much what Dr. Meltzer told me the first time he examined them. I should do something about them some them in the near future, but I’m not looking forward to a series of really painful steroid injections. We moved on to the next schedules surgery, breast aug. This began with, “how small could you make the incision?” Dr. Meltzer is well aware of the way my body tends to heal with raised scars. While there is a difference between surgical incisions and skin trauma, I still believe what ever incision is going to heal with a raised scar. To minimize this, the smaller the incision, the smaller the raised scar. Our discussion began to take on the feel of a buyer / seller at bazaar. Seriously, there is a finite space required to do this. I did mention Dr. Gray’s tiny incision (about 0.5” under the actual nipple) Dr. Meltzer was curious about the consistency of his results from this. In the end, it came down to less the half the diameter of my areola which is less than 1” or so. The norm for a peri areola incision is 1.5” or half the areola diameter. With that out of the way, we continued to my primary concern, the loss of sensation question. I mentioned to Dr. Meltzer that when I posed this question to a number of BA patients, the reply was extremely varied. From just fine post op to totally numb over one year post-op.

What he told me was the primary factor is what happened during the implant dissection process. If the pocket is made wider, there is a greater chance of damaging the nerve that connects to the breast, areola and nipple. It is possible to alter the implant pocket dissection process by significantly reducing the width of the pocket and staying as far away as possible to the nerve area around the pocket area and areola. This also means a smaller implant which is fine with me.

Dr. Meltzer told me of a case when he was in Portland where the patient canceled her BA for exactly my same concerns. At that point, I mentioned that maybe this is a procedure I should not do for this reason, his reply, “no not really, there are ways to reduce this risk.” Hearing this was a bit comforting, regardless, in the world of surgery and most everything in life there are no 100% guarantees, just varying degrees of risk. That is when I mentioned the reason for all my worry and concern over the loss of sensitivity problem is due to me being breast orgasmic and something I really don’t want to lose. He agreed that losing this would not be a good thing. Several years ago when I first began hormone therapy, my developing boobies definitely hurt like any other girl going thru puberty. Even after a year or so after my Orchiectomy, my breast did not have the degree of sensitivity they do today. I believe in my case, it’s a time to mature development thing. Thinking back to when I first started HT, losing sensitivity due to BA would not have been that big an issue for me. It’s only in recent years and being able to share with a loving partner that this has become a serious issue for me.

As for implant size, it’s one of the focal issues that concern the majority of women who get a BA. Dr. Meltzer does implant sizing while you are on the OR table. After a look at my boobies, he notes that I don’t have a very wide chest and his estimation for implant size would be in the 300ish cc range. Not far from what I discovered after I tried on a large number of implant sizers during my long Dr. Gray consultation back in April 2005. Dr. Gray suggested implants in the 450cc range for me…errr.. I don’t think so, “your’re not the one who has to live with them.”

I honestly believe the enjoyment and sharing of sex between two individuals is not primarily for pro creation, but emotional bonding between two individuals. This topic is discussed at length in Prof. Joan Roughgarden’s book ‘Evolution's Rainbow: Diversity, Gender and Sexuality in Nature and People’. Her book counters one of Darwin’s theories that sex is primarily for pro creation. It’s well worth the read.

While there were still more BA stuff I wanted to discuss with Dr. Meltzer, the clock was rolling towards 11:00 AM and Jen’s surgery is scheduled for 12:45 PM, so, I cut my consultation short thinking that I could discuss this again with Dr. Meltzer during the next day or so during one of his post-op visits with Jen at Greenbaum.

We left Dr. Meltzer’s office and headed over to Greenbaum for Jen’s surgery date.

Jen signed in, registered and filled out the usual pre-op paper work. It was a very short time later that one of the OR nurses called Jen and she was on her way. I waited for the call to join Jen in the pre op area. 45 minutes passed and after a few inquires, they finally allowed me to join Jen in the pre-op area. For what ever reason, everything seemed to run late today. This started with our appointment with Dr. Meltzer to the events at Greenbaum.

The pre-op area looked all too familiar. Jen was in stall# 11. She had the usual IV, taken a pre-op sedative and laying on the gurney partly spaced out from the meds. We held hands and waited for her surgery to begin. As more time passed, the two of the OR nurses appeared and was ready for Jen. There was also another RN named Bill who administered and injection in Jen’s arm. The clock rolled past 1:00 PM, this was 15 minutes past Jen’s scheduled surgery time.

At 1:05 PM, Dr. Meltzer appeared, check on Jen for a few moments and Jen’s Labiaplasty is ready to begin. I took a few more pre-op area pictures as the two OR nurses rolled her gurney into the OR. It was time to head back to our hotel room, pack our stuff for the overnight stay at Greenbaum. I zapped a burrito from TJ’s for lunch along with some Cranberry juice. I had a free moment and called Michelle to chat. Michelle and I chatted about our Dr. Meltzer appointment this morning. As I told her about what happened during our appointment, she said, “Ok, let’s get to what you decided to do about your schedules BA in February?” Michelle and I have been discussing this over the past several weeks. Yes, she got a BA with Dr. Meltzer along with her VAG a few months ago. In her case, everything worked out just fine. I told her, “Yes, I’m going to do the BA with my LP in February.” Yes, I’m leaning towards that direction and I did feel a bit better about this after discussing this with Dr. Meltzer, but I got to say it is a reserved yes. There is still the fear of me doing something I’m going to seriously regret for all the long winded reasons that has appeared in my blog over the past several months. It is possible that after my BA is confirmed, fee paid and etc that come surgery day that I would cancel while I’m on pre-op gurney. I don’t what this to happen, so I need to get comfy with saying yes to getting a BA. This has been the most difficult elective surgery choice I have made in my life. Every other surgery was such a simple and easy decision for me. What a way of allowing one’s desire to cause so much grief and stress over the past several months. Michelle and I finished our phone conversation and I got off the phone, loaded everything into the car and headed over to Greenbaum.

It was early when I arrived at Greenbaum so a trip to the second floor to visit would be a nice thing to do. Into the elevator and when the elevator doors opened, all the memories of my days at Greenbaum came roaring back. Many of the nursing staff remembered me instantly. After a few quick warm greetings, I moved our stuff into the room where Jen is scheduled to stay. Once this was done, I went back down stairs to wait for Dr. Meltzer to come out to discuss how Jen’s surgery went. I arrived back at Greenbaum at just 3:00 PM estimating that Jen’s surgery would take about 2 hours after they began. After my arrival at Greenbaum, I took an elevator ride up to the second floor to visit and went over to the nurse’s station. Much to my surprise, Katie was taking a group picture of the nursing staff. Many members of the nursing staff remembered me and were quite surprised to see me. Since they were taking a group picture, I got out my camera and took a few too. After a bunch of warm greetings, I headed back down stairs to wait for Jen.

The time passed like Jell-O stuck in an hour glass. No sign of Dr. Meltzer either. I took several trips up to the second floor and back to the first floor trying to find out any news on Jen’s status.
It was not until 4:30 PM that Jen finally arrived at room 11. Jen was still pretty loopy from the meds when she arrived, but semi awake enough to chat for a bit and order dinner. Jen had chicken fajita and I had the chicken with cheese and tomato sauce. She was pretty hungry after not eating anything since our dinner with friends from the previous night. After dinner, Jen went to sleep, knackered from the stress of surgery and all the events of the day.

I took some time to relax in Jen’s room after such an eventful day. The nurses would come into Jens room once every hour or so to take her vitals. Jen had an Oximeter alarm that would go off every so often when her pulse rate got below 40 BPM. That is the lower limit set on the Oximeter. It turns out that we have a tendency to do this as it was due to our low resting pulse rate for all the cycling we do. The nurse adjusted the lower limit and the Oximeter and the problem went away.

I decided to visit a few of Dr. Meltzer’s patients while Jen was sleeping. The visits were welcomed by every patient I visited. As we shared our stories and parts of our lives, the experience was emotionally healing and bonding for us.

The nursing staff changed shifts and I got a chance to say hello a few of the night shift nurses when I was at Greenbaum in February. I was nice to see then again.

The clock was nearing 10:00 PM when I got back to our room. It was also a dilation day for me. So I asked one of the nurses for some bedding and it arrived shortly after my request. I even remember how the roll out sleeper worked. Once the sleeper was rolled out, I put the bed together, changed into my night gown and began the date with my plastic boyfriends #3, #4, and #5. It was really strange dilating in the same room where Jen stayed for her VAG almost exactly one year ago.

Once my date was done, I took a sleeping pill and went to sleep. After all the events of the day, I was tired, very tired, but the first night post op is always a noisy due to all the monitoring activity and I learned from my time at Greenbaum that taking a sleeping pill works for me as I’m a light sleeper and wake easily from all that activity.

What a way to spend our Anniversary.