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Pre-op appointment with Shannon @ Dr. Fischer's office
March 10, 2014

Okay, so. Pre-op appointment with Shannon last Thursday: got there a bit early but went to a cafe’ first cuz the office didn’t look like it was open yet and my dad & I were hungry. Apparently the cashier/waiter dude was checking me out a lot and I didn’t notice until after my dad mentioned it, haha. Awkward. He walked past me like literally 4 times and kept talking to me for no reason.

Anyway. This old lady came into the office shortly after I did right at my appointment time and she was kind of a mess because she’d just had facial surgery 2 days earlier, so Shannon had to deal with her first and that took a long time, like over half an hour. I had lots of paperwork to fill out anyway though. A bunch of stuff needed witness signatures so it’s a very good thing my dad came with me (although if I’d been by myself, probably one of the nurses could’ve signed them?). Dr. Fischer even did a draft of a letter to a Notary Public about my top surgery saying that I should be legally recognized as male. I don’t know if that will be enough to change my birth certificate or not because I was born in DC and I forget what the law is there but I think some places require at least a hysto if not also genital surgery. I filled some stuff out wrong but it was just minor stuff that doesn’t matter that much cuz it’s just going in my file with Dr. Fischer.

So eventually Shannon finished up with that old lady and took me and my dad back into the room with the couch and all the photo albums and a table. Shannon had a whole folder for me of copies of the paperwork I’d filled out, prescriptions from Dr. Fischer, and info sheets about pre-op stuff, surgery, and post-op stuff, plus info about what OTC pain meds I can’t take because of bleeding risk (NSAIDs) and for how long, and a little pamphlet thing about the drains. I’m glad the stuff is organized.

Shannon also had the new nurse (who was there to listen in) go get a sample drain to show me what it looks like and how it works (it uses suction). It’s a closed, sterile system so I don’t even have to rinse it out, just squirt the post-op fluid into the toilet. I only have to start recording the amount of fluid from day 3 to day 7 after top surgery. The drains totally look like clear plastic hand grenades.

I asked lots of questions (or I feel like I did) and she answered all of them thoroughly and patiently, which I appreciated. We talked about pain meds because I had to let Shannon know that Dilaudid made me incredibly nauseated last year which overshadowed however much it helped with post-op heart surgery pain, and that my dad & grandpa have mild allergies to Codeine. (So far, I do not have an allergy to Codeine.) Dr. Fischer wrote me a prescription for generic Vicodin (Hydrocodone), 30 of them, which seems like a lot. Vicodin’s a pretty heavy opioid, so I don’t know if I’ll like it or not since I hated Dilaudid and I was unconscious on morphine. We’ll see. Shannon said to take it if I need it for pain, and “Don’t be a hero because we have too many of those around here.” Other than that, I can take Tylenol, but no Ibuprofen or other NSAIDs til I think 2 weeks post-op :\ As for gardening, I can’t till any soil or anything else with lots of upper body movement. All I can do at the beginning of planting season this spring is plant & cover up the seeds (and I have to still wear a surgical binder for that so my chest will be more protected). I should be able to help out more with gardening toward the middle or end of growing season, once I’m better healed.

The restrictions for top surgery post-op are pretty much what they were for heart surgery last year: can’t lift anything over 15 pounds until after 4 weeks post-op; sleep on my back only; walk around; no pulling or pushing or reaching for things behind my reach; no arms over my head while still healing. A big difference though is that I can’t shower until I think after the first week (or after whenever I get the drains out), I can only do baths but my chest can’t get wet. After I get the drains out, I can shower but the water can’t spray my chest directly because it can hurt the nipples I think.

I think my dad only asked Shannon one question, and it was about what the typically general level of post-op pain is. She said it varies a lot with the person, and some guys manage without any pain meds, other guys need pain meds only sometimes, some need more. I have a pretty high pain tolerance. We’ll see.

After all that, then it was time for her to take pre-op pictures of my chest for Dr. Fischer, and then I had to try on a surgical vest. I wasn’t expecting either of those things, so it was a surprise, and I hate having my chest exposed and even more I hate having my chest touched. The photos didn’t involve touching, obviously, but unfortunately putting the surgical binders on did. Kind of a lot of touching. I don’t know why Shannon didn’t just have me put it on myself since obviously I know how to put a binder on. I would have said something but I was pretty triggered and when I get triggered I don’t usually speak, and I was already overwhelmed by the whole appointment (not in a bad way.. just lots of paperwork, lots of information, lots of feelings / processing the fact that top surgery is actually fucking happening for me). So that wasn’t fun at all. Shannon didn’t do anything wrong or inappropriate, it was all just medical stuff but unfortunately, 1) I’m autistic so I often hate being touched anywhere because of that, 2) I have PTSD so I also hate being touched because of that. I could have told her those things (they’re in my surgery letter from my transition therapist, actually), but I was triggered and wasn’t speaking much. The size small surgical vest was a little loose even with me pre-op, but the extra-small fit like a binder so that’ll probably be fine post-op. She’s gonna give both to Dr. Fischer just in case. I’m gonna have to wear the surgical binder basically 24/7, it sounds like, even to sleep, which sucks. Hopefully it won’t be tight enough to hurt my ribs like my binders do.

Anyway, so that whole thing was overwhelming. I went home and had a meltdown from being overwhelmed, exhausted and triggered. I wasn’t just triggered from her touching my chest, but 3 other people (two nurses, and my doctor) touching my chest at my cardiology appointment the day prior to that to do my heart check-up stuff. Normally nobody touches my chest except me. Ugh.

All medically necessary stuff though. Glad it’s over with.


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