Part 1: Surgery consult

So I meant to post last night because I had pre-surgery consult jitters and I really wanted to get them out on paper, but that didn't happen.

It didn't happen because MN just passed marriage equality and we had to celebrate.

It is totally awesome because it means all my wonderful gay and lesbian  friends who have been either legally married somewhere else or had a ceremony, and all those just waiting for the right time, have the opportunity to finally have their relationships recognized as equal to the rest of the world.  Hooray!

But back to me :)

The consult with Dr. Buckley was wonderful. She barely remembered us from our last visit in the fall when I went in for a reduction consultation. We didn't mention transgender issues at all that time, even though she left the door open for the conversation at one point.  So this time we're in it for real.  We brought along the new HealthPartners policy, which was a good thing, because they were still operating from the 2011 policy.

Buckley is so laid back and easygoing, it makes her so easy to talk to.  She's hilarious in that she swears sometimes and is just all around laid back.  She doesn't strike me as a cocky surgeon at all, which I really like. She's super confident, that's for sure, but not cocky or abrasive or pushy.  She's obviously at ease with the procedure and knows exactly what she's doing.

I do have to have a mammogram, which I'm not looking forward to, as well as a full physical examination with my primary care physician.  This means coming out to my PCP, which I'm a little nervous about, but mostly I think it'll be just fine. I'm not asking her to prescribe T, which she probably wouldn't be comfortable with, and I'm not asking her to do anything other than the physical and to keep being my primary care.  I think she'll be okay with it.  We'll see though! I won't go for the H&P until we get the prior authorization from HP on the surgery.

We talked about dog ears and how far back she'll go to minimize them, which is good. She's definitely conscious of the issue and says she'll do the best she can.  We talked about retaining the pedicle for the nipple, but she basically said that since I'm a bit droopy (her word :)) the pedicle will be really long and I'd end up having a bit of a boob-let, which I'm not too excited about. I will be really sad to lose the feeling/sensation I get in my nipples right now, but I'd much rather have a male contoured chest and little sensation than boob-lets and tons of sensation.  She said I could bring in some photos to show how much boob I'm willing to have, but I'm planning to lose the rest of my weight in the next year or so and I just think a boob-let will look bad and make me really unsatisfied.

So it'll be a full double incision mastectomy with nipple grafts.  She recommends working on the pectoral muscles because she's "only putting on the siding," as she said. So I'm all over that.  We have P90X on deck to start working on along with some dumbbells and some resistance bands so I can build up the pecs/chest and back before surgery.

She estimates that even if the prior authorization takes 30 days (that's the maximum amount of time the insurance company has to respond to the request for PA) I could have surgery as early as July, but that after July I could have my pick of days, probably.  She operates Monday, Wednesday and Friday and most of her top surgery patients come in on Monday.  She recommends at least a week of off work if not two, and she's willing to get you even three or up to six if she has to or you feel like you need it.  I anticipate that I will be bored out of my mind if I do more than two weeks, so that's what I'm planning on for right now.

Once I get the prior authorization I'm going to have to talk to work about it.  That's really intense and scary for me.  But I think that overall it will be okay.  We shall see!

I do have lunch with former Saint Paul Deputy Mayor Susan Kimberly on Thursday to discuss coming out in PED.  I hope she's helpful.  It is really, really nice of her to be willing to meet up with me.

I think that's it on the consult!