Breast Augmentation Consult

I have been at four consults with different surgeons trying to get a feeling for who I wanted to go with. Last night I saw Dr. Antonio Mangubat and I decided he is the guy. Funny enough, he is the guy who did the FTM top surgery for my husband back in 2016.

The surprise I have had overall is the wide variance between surgeons and how they handle things. They are all good surgeons, but I hesitated at each of the three previous surgeons because it just didn’t feel right for whatever the reason. Now however, I will be getting 800cc implants in April and I am excited. Another great part is the fact that my insurance is going to pay for it.

Wearing an 800cc sizer to see how my new breasts will sit.

I did want to talk about my consultations a little though. The four doctors all very qualified, but very different.

Dr. Javad Sajan – a great surgeon in Seattle did my original consult back in November of 2018. He is a very personable guy, but I wasn’t happy with what his before/after pictures are for trans ladies, and he seemed to want to go with a smaller size on me, which thinking about is probably what I was seeing in those trans ladies photos… implants that for me looked too small for their frames.

Also he was a little too much into self-promoting/instagram/etc. Made me uncomfortable. Also they didn’t like taking insurance (they refuse to contract with my insurance but agree to do it as out of network, meaning it can be turned down by my insurance if he tries and charge too high a price. This does not mean he is a bad surgeon, but that combined with a lot higher prices meant he wasn’t my number one pick (but still in the running until I sat with Dr. Mangubat)

This was from my testing at Dr. Sajan in November 2018, it isn’t bad, but the 800cc at Mangubat seems better feeling to me.

Dr. Ellie Zara Ley – a fantastic surgeon who did my FFS bone work, although the office interaction/after care could use a little touch up. The reason in the end I didn’t go with her was because first, it is in Scottsdale and I don’t really care to stay another two weeks in a hotel in Arizona if I don’t have to. The extra cost of the flight down, the hotel stay, food, etc makes this not my favorite.

On top of that she explained she would decide what looked right for my body frame once I was under and do it with an expander. She is a wonderfully artistic person, but I wasn’t to keen on waking up not knowing what to expect.

I wouldn’t ever change Dr. Ley having done my FFS although it hurt a lot (April 2019).

Dr. Christiane Ueno – a fantastic Kaiser surgeon. She actually walked me through all the questions I should ask, and she was very knowledgeable. The biggest reasons I didn’t go with her was the upper limit on size, she didn’t think she could go above 600cc (which was in the lower range of what I wanted) but especially her equipment only let her go through the bottom of the breast, not through the armpit. This means very visible scars, not the highest on my list, but she is still a great surgeon.

Dr. Antonio Mangubat – The surgeon I am going with and an overall great choice. First and foremost I was experienced with his office (only Dr. Ley scored for similar reasons) and I knew his office was responsive to concerns and were there 24/7 during recovery.

Also Dr. Mangubat is the one that liked the 800cc and explained how it would help camoflauge the center of my chest and give me a proportional shape. He didn’t have any prejudgments on what I was interested in. Also, his before/after photos blew everyone else’s out of the water, and when I look at my husband’s top surgery results I see that he is a good surgeon.

The hubby went through hell, but his results were really good (this is him post FTM top surgery)

Also it helps that he is the second closest surgeon to our home, meaning I will get the surgery done and come home to my apartment to heal. He also didn’t hesitate about FMLA paperwork or taking my insurance.

Dr. Mangubat’s office is going to contact our transgender case manager Raelean today and will arrange the insurance coverage. We talked about possible dates and when I asked about April they said that shouldn’t be a problem at all. This gives my hubby a chance to work a few audits, and me a chance to get ready physically and mentally. Also it is kind of funny that it will be approximately a year after my FFS that I get my breast augmentation (same month, one year later).

I am super excited about this!

Finishing Off 2019

This last month was supposed to be mostly vacation and medical appointments. With Christmas coming and this being the first Christmas where I am not so depressed that I was numb, I knew it might be a little rough emotionally.

It was a lot worse than expected. On Christmas Eve I got a call from my sibling. They had a broken leg, had decided to run off to Vegas to marry someone and within three days of being there it was broken off. I get a call saying they are stuck there with no money, no flight and no place to stay. They literally only went to Vegas wearing pajamas (although they did get some clothing when they got there).

I spent the next three days on the phone with them, other hotels and airlines trying to arrange a way for them back. To make it worse, the sibling wasn’t behaving very rationally and was having some issues of their own. They wouldn’t just take the next flight home and had to wait a day and a half (meaning I had to pay for an extra hotel night). They yelled at me (but stopped when I hung up and I think they knew I was going to leave them if they didn’t cut that shit out), and finally they got home.

They are doing better, which relaxes me. However, I haven’t slept more than 4 hours a night until last night since this whole event. It has set off my own mental health issues, but fortunately my hubby and my therapist have been really good (more about my therapy in the future).

The end result is a lot of extra money on a credit card, mental health flare and a continual worry that my sibling is going to hurt themselves as they are currently homeless back in Bellingham. It wracks me with guilt because I can’t afford any more money, and they have been nice about it not asking, but I still end up feeling like a failure.

None of this even counts the emotional grief I am not able to process because of this for the death of my parents and my missing them.

That is ok, this is a new year, new outlook and a new girl who is establishing boundaries. So don’t pity me too much, I will be fine. I just needed to write down a very abbreviated version here.

Current News

I realize I have been extremely radio silent lately, and that mostly has to do with me working on my mental health, the holidays, and the numerous small trips I am having to make for transition. All of this has left me emotionally and mentally exhausted. I realized this and I figured I might give you all a little update on what is going on and why.

For the last year or so I have been seeing a therapist for my mental health. It started just as a couple of sessions to appease the gatekeepers in my transition, but my therapist has turned out to be really good with PTSD, which I suffer pretty heavily from. I still don’t go as often as I should, both my husband and I are overwhelmed with work and my transgender related appointments, but it has picked up. That being said I am aware we haven’t even really scratched the surface yet.

The last couple of months the therapy I think I has been building up a strong base, and it has hit me a bit harder than expected. Combine that with me coming out of my depression and the first holidays where I can feel are also the first holidays I notice my parents missing. The hardest part though is dealing with the fucked up things in my younger life.

This has meant it has been really hard to talk about myself, my transition or even day to day things in this kind of format. I don’t know if I was hiding, or just not ready, or what it was. That being said I think I am going to talk more about myself here then I initially intended. Otherwise I end up ignoring huge chunks of my life here, and I really want to just use this as a full outlet about what I am going through.

I also want to be clear that my being transgender identity has nothing to do with the trauma. It did not cause me to be transgender, rather it delayed a lot of my self examination to confirm I was transgender.

I guess this is my way of saying I am going to try and make 2020 a more interactive year for my journey with those around me. I have found for the first 46 years of my life, I had compartmentalized everything, and most people weren’t allowed to know everything… evidently I hadn’t even told my husband of 27 years most of this stuff. So I need to work on that this year.

It is funny, I have to credit Wil Wheaton a lot for my decision to be more open. To watch someone who went through things like he did, be able to talk about it and how much that talking has helped him. So if you ever read this Wil, thank you for being you!

That all being said, I have to thank my husband the most. He has been incredibly supportive even though he is undergoing his own concerns, problems, etc. My transition is incredibly hard on him time wise. He worries about me constantly, now it isn’t even just my safety going out, but all the medical appointments and recovery. He has been my hero!


Also, I will be back posting regularly, there is a lot I have to get you all caught up on ;).

Tired…

This was originally a Facebook post I posted earlier this morning, so if it isn’t cogent… I blame Facebook.

People make me tired. This is a long rant so please scroll on by if you are inclined.

I was in a line at Safeway yesterday standing behind this older looking guy (but probably not really any older than me). He is a little shorter than me and I am dressed in my blue skirt and a black top (with red under shirt). I am grumpy, but I am feeling fairly good with my look.

He stares at me, looks away, turns back and stares again but this time makes some sort of “hrummph” sound, looks away, looks back and makes a motion with his hand and mutters “what?”
Continue reading “Tired…”

Rough day (transphobia)

Yesterday was harder than normal, and represents the third day in about a week of hostile encounters. I realize this is the new normal, but I figured I would share them.

The day started with me going to Safeway to pick up some paper bowls. I was wandering the paper bowl/plate aisle when two older black guys come wandering up. As a clarification this is not the same guys who were at Safeway in my earlier post.  I knew this was going to be an issue because they had parked in front of me outside and had been talking to each other and pointing at me.

To be honest I was worried, which is something I haven’t gotten used to, as they both walked up. The smaller guy within about 3-4 feet of me. They started talking with me and started getting pushy on who I was. The biggest thing I remember was them both saying “What is up with this shit” and then hand waving at my clothes and boobs.

I sputtered for a few moments not sure what was going on and eventually figured I was going to get hurt so I went off about how they would hate losing to a girl with a bigger dick then them. By no means did I think I would win any confrontation. I am a hundred pounds lighter then I was, and a good chunk of that was muscle. My husband tends to be stronger than myself now. However, my feral childhood and parents instilled a “last great act of defiance” mode and I guess I hit it in panic.

Surprisingly both guys just stopped and watched me. They then looked at each other, nodded and walked away. I don’t by any means think I may have intimidated them, but I do think I made the cost of any more harassment not worth it to them and I will take it.

I couldn’t figure out why they approached me though, until my husband brought up he thought that they might believe I was a pro. That they were seeing if maybe I was for hire. It sort of makes sense, I know there are chasers out there and I saw my husband get propositioned a few times (and heard about it even more) before he transitioned. It makes a little more sense, and wit that knowledge I think next time I will handle it different.

Even so, that wasn’t the thing that bothered me most that day, that was still coming up.

I got to work and a couple hours later I was talking with a couple of my lady coworkers. It was confirmed by one of them that there is a large selection of women who won’t use the restroom if I am in there. I am fairly sure they are the same ones that don’t respond if I say hi, or walk away.

To be honest I am not surprised. It is fairly common that I will be sitting in a stall and a lady will come in, stop and turn around even though there are other open stalls. This happens even faster if I am standing at the sink putting makeup on, or washing my face. A large portion of women will step in, look at me directly and just turn around and leave. I have even said hi when they come in, they just stare at me and walk away without saying anything.

I know that is weird because most women who don’t run from me won’t stop talking to me in the bathroom (which also freaks out my socialized as a boy self… but I am getting past that).

I have seen it in other places such as the lunchroom where a group of women will start whispering when I come in the room. I figure it is something about me, or my clothing. It is worse though when I step into a room and a bunch of women stop talking and they all just watch me get into the fridge and get my lunch. I think the silence is worse.

None of this is new, the being accosted is something I am starting to expect outside. However, the work situation bothers me a lot. I don’t like it when people I am around are uncomfortable about me, or actively hate what I am (there are a couple that do that).

The one good thing about my coworker confirming that, is it confirmed I wasn’t crazy or misreading people. At least I know I am seeing clearly and that is important to me.

Things I forgot

You would think that I would remember my childhood all the time, the violence (not on us by parents, but surrounding us), the alcoholism, the homelessness, but evidently I forget huge chunks for years at a time and am surprised when my PTSD pops things back up.

We went to the movies to see Rambo Last Blood. Yes it is horrible, outdated and I will probably see another one if Stallone does it. It just is a tradition. However, I did have something happened that was jarring.

It was during the first half of the movie. Stallone was beating up a man, he broke the man’s collar bone and started twisting it out of his skin. It was ultraviolent but not more violent then a lot of what I watch. However, I found myself curled up into a ball in my theater seat, hiding under my leather jacket trying to catch my breath. Evidently it gave me a huge anxiety/panic attack.

That is when I remembered once when I was 10-11 or so and we were out at my dad’s friends in Granite Falls. My parents had run to the store, and a couple of the guys there were working over another man in a room very seriously. You could hear the beating in the room I was in next door, the whimpering, crying and growling/grunting from the people.

When they were done, one of them came out and asked if I could keep an eye on the man in the other room, so I got up, went in and sat on a chair while the two men who beat the person in this room left to have cigarettes.

First, let me be clear I never felt I was in danger. I never was threatened, harmed or anything up until a couple years after this when some of the same people attacked my family (they owed my dad money and thought they would be better off removing us instead of paying, but that is a different story).

Also, when my parents got back to the house my dad lost his shit on the two guys. He didn’t want me seeing that or being around that. My parents were open about everything they did. I had even saw cocaine deals happen regularly involving kilos of cocaine, but the violence on someone in front of me really upset my parents, so we didn’t go back out there for a few weeks after that.

I can’t say I remember everything clearly. I have always had a hard time remembering specific details, but I remember feeling bad for the person there. Also I know he wasn’t killed or anything (at least then) because I saw him a few months later and he acted like nothing had happened.

However, this left me in the theater panting, and panicking for a short time. It passed and I told the hubby about it. I figured it was one of many stories I have told him about my childhood. He was surprised and had never heard this story. I guess it turns out and  I was evidently wrong. I hadn’t realized how much of my life I haven’t even told him.

I am sure this came up partially because of my transition. I am having to rethink who I am, what I am and where I go. I am also seeing a therapist fairly regularly, and they are having me start to delve into things. Finally I think the thing that triggered me was Rambo wearing his green army jacket. It reminded me so much of growing up where I was surrounded by my dad’s friends and associates who all wore army gear, things like that green army jacket.

It has been a couple of days now, I can start sleeping again, but I do feel like a wuss. Nothing bad had directly happened to me. I had seen ultra violence in real life more than a few times before I went into that room. I guess maybe this means the therapy and self review is starting to unlock some of my shit I locked away. Maybe I can start working on it now.

Some good news

I got my blood test results back. I have some good news and some ok news.

Good news: my testosterone is “LESS THAN 10 ng/dL” and the range is 0-74ng/dL. So at least we know my testicles haven’t mysteriously grown back 🤣.

The test is to ensure the male hormone has dropped off thus allowing feminine hormones to work their magic. This is first time my testosterone hasn’t decided to make a comeback and I find it encouraging.

Another bit of good news is my progesterone numbers (prolactin test): 15.5 ng/mL and the range is 2.5-19 ng/mL. That is excellent news as this is the hormone that developed breast growth.

Finally I got my estrogen results via paper only (for some reason it isn’t on my electronic documents). 98 pg/mL and the standard range is 30-500.

This is an upward trend (my last result was less than 20), but not where we want it (300+ is the target score, there is another test that goes up to 700 and on that one we want 400+, not sure the difference though between the two scoring systems).

I will admit I was really disappointed by this. However Dr Fields is awesome, he said we will take this progress and up my dosage to 8mg of estradiol per day (I was taking 6 as of yesterday and only 4 when I had the horrible doctor) so I feel like we are moving.

I will go get another test in November and cross my fingers.

Anxiety

One of the things I had done during my FFS was cheek implants. I originally didn’t think I wanted them, but the doc talked me into and to be honest she was correct. I think they look great, and I am really happy.

The left cheek implant has always bothered me during the healing contest. Not heavily, but enough. It was the last to stop swelling after the initial surgery, the skin tends to tighten around it more so occasionally if I smile there is a stretching feeling, but this is all within a normal parameter.

Several weeks ago I noticed when I feel my cheek from inside my mouth, my left cheek feels more jagged on the edges then my right one. It could be a stitch, or just the way it healed. However it does give me a little anxiety about it.

A couple weeks later I was talking to my nurse, she asked for me to get pictures of the inside of my mouth and send it. I did so, got some good pictures and sent it to her. She replied it looks fine, but she would show the doctor… then I got an email asking for me to make an appointment for the doctor to see my mouth when she comes up to Portland (they are in Phoenix, but were going to be in Portland as they expand their offices).

The doc said it is fine but she would like to look. That of course makes me nervous as well but I have an appointment on September 20th.

Fast forward to a couple days ago I noticed it was spread out a little more in my mouth (still looks fine externally). Yesterday it ached and swole up a little (both sides do this occasionally,its just a natural part of healing. This morning it is a bit more puffy, I don’t think its infected but I worry.

My biggest anxiety breaks down into a few things.

I just don’t want to incur any more cost of having it removed, waiting six months and putting it back in. I am already tanking us financially and doubling or tripling the price of my cheek implants is freaking me out. This doesn’t even include the cost of flights or time off.

I am worried about what I would look like without the implant, whether its just temporarily for six months while it heals or if its permanent. Will the skin over the implant sag, will I have a more gaunt look in my face, will I totally fail looking cute.

This week was the first time I ever looked in the mirror and saw myself and really liked what I looked like. I mean I totally thought I was cute and there were no negative thoughts (except for the dislike of my skin apron from weight loss, but that will be fixed). Then this happens and I am worried I am on a downward spiral.

So here I am anxiously unsure what is going to happen and how to go about it. The sad thing, I am aware it is probably nothing at all and things will be fine, but that anxiety is still there.

Upgrade of HRT regimen

Things are looking up. After a pretty horrible experience with my previous provider, who told me the hormones won’t do me much good anymore… I talked with my therapist and husband (two different people) and we went to a different doctor, a trans specialist.

He saw me, totally reassured me that I am far from done. He upped my dosage from 4mg to 6mg estradiol and added in progesterone to help breast development. He believes I can get them a pretty good size and asked me to wait on breast augmentation until next April and let my natural boobs grow first, then get the augmentation. So I agreed to it.

That means I am now on a new HRT regimen and pushed back a surgery I was going to have in two months, to April. It makes me a little anxious, but I feel good about what he wanted me to do. It means only surgery in next eight months is for my lips, and only if I can get the electrolysis done.

I think it is relieving to my husband that my surgery got pushed back, but it sounds good.

In other news, I am moving my primary care back to the doctor we had in Everett. It is a long drive to get there (over 60 miles) but he was super supportive of the hubby in his transition, and since I have a transgender specialist, I want my primary to just care about me as a person. So that is good too.

I will give updates on the HRT of course, last night was the first full dose of both (3mg estradiol x 2 a day, and progesterone at night). I am hoping to get back on the hormonal changes soon.

Frustrations at work

Yesterday was quite the frustrating thing. I was dressed up in my blue striped dress, my hair was made up and I had good makeup on.

I went out to a non-profit agency with a second monitor who looks at different things. I was there to audit them and I had steeled myself to get looks or actually verbally misgendered (it’s happened before).

We came in and they weren’t polite, but when they realized we were there to audit them they were perfectly nice. While I think I got some side-eyed looks from them, I didn’t get anything overt and that was all I can ask.

My coworker was the one who actually called me he four different times in about 15 seconds. It was so jarring that even the agency I was auditing looked surprised. They looked me up and down and then back to my coworker.

Finally I got her to stop talking and I corrected her using a masculine pronoun. She did look horrified when she realized she had called me he repeatedly. At least I do t believe it was intentional and we went on with what we were doing.

I thought it was done with it (she only used she after apologizing profusely). I am not mad at her, but I woke up mad in general early this morning.

I am now just angry in general and then even more angry with myself for not being able to put it away… circle of self-loathing is strong today.

Just had to put it out here and go back to work. Hopefully now I can let it go.