FFS and Recovery

(this is a consolidated section)

Sunday - February 22, 2004

Pulled from the pages of my written journal (but because my attention span never really lasted long enough, the rest I will have to pull from my notes):

I sit here in the Cocoon House recovering from FFS 4 days ago. Yes, it still hurts, but it’s more of an overall discomfort. I went full time just over a week ago, so in essence, this has been one of the greatest weeks of my life.

On Tuesday, the day before surgery, I was supposed to pick up my mom at the airport an hour before my presurgical meeting with Dr. O. I stayed up until 4am trying to get everything done before being gone for so long. I planned to sleep in until about 10, but Dad called at 8am to tell me Mom’s flight was delayed out of the Midwest. So, I moved my alarm back to 10:45, but Claire called at 10 to also wake me up. So, I got ready, then traveled up to see Mira and Dr. O. While going through all the motions, I found that my check card had a limit on purchases, so I would have to run down to the local bank branch and get a cashier’s check for the remainder of the amount to Dr. O. I did that after finishing my discussions with Mira and Dr. O. During part of my initial visit though, Mom calls to say she’s arrived. The bad part is that by the time I get out of my consult, I know it’s going to be rush hour and nearly impossible to get over to Oakland and back. So, I ask her to see if she can ride BART over and I’ll pick her up at the Civic Center terminal. (If you didn’t catch last month’s entries, my mom got lost many times when she was driving around locally with my car, so I knew this was going to be a pretty big challenge.) So, after taking care of the consult and the cashier’s check, I picked up my Mom. Yeah!!! Unfortunately, she was basically standing there in the rain. We get back in the car and Tyler calls from Dr. O’s to say that I need to take presurgery photos. So, we drive back over, take the pictures, then escort Tyler over to the Cocoon House where we meet Debra and Shannon, and I introduce my Mom to Tricia, one of the pair of wonderful women that run the Cocoon House. We’re already behind schedule and I need to fill two prescriptions before surgery, so we’re off to meet everyone over at the Cheesecake Factory. I get Mom and Tyler up to the restaurant...we’re there first...then head down to a local pharmacy to pick up the two prescriptions. I head back over to the restaurant and find I’m right behind “joanb” and the visiting Sarah. Anyway, I had a group of 10 join my mom and I for dinner, including Claire, Amy, Ani up from LA, /Amber/, “joanb”, Sarah from the Northwest, Susan, Brooke, Michelle, and Tyler. It took us forever to get seated, not the Cheesecake Factory’s fault, but due to a few people who couldn’t get there on time...we shan’t mention names. We finally sat down and I ordered one of my simple favorites - angel hair pasta with tomatoes. I splurged with a strawberry lemonade, followed by sharing a piece of Chocolate Tuxedo Cream Cheesecake with my mom. Basically, you can’t go wrong there. As time rolled on though, I knew it was time to get going. I began to give everyone hugs and started crying. I have a hard time saying “good-bye.” They could all tell I was getting emotional, but what do you expect when you’re saying good-bye to some of your best friends - people who have shared in the same journey. If I could have, I just would have stood there hugging them all night long, but I needed to get some rest. So, Mom and I walked to my lone car and drove home. I answered an email or two, then was off to bed about 1:30am. The alarm was set for 4:30am.

It rang pretty early, and I woke up my mom at that point. I grabbed a quick shower, then threw gobs of leave-in conditioner in my hair. Next, we were off to San Francisco. I showed my mom how to get to the Cocoon House first since we hadn’t been able to do that the day before. I was a little late to Admissions, but nothing that bad. They had my clothes off and me in a gown in no time (I need more dates like this!...thhhpppt!). I also had to put on these long white leg compression stockings and little booties for my feet. Mary-Lou stopped by in a very cheerful mood and said good luck. Because I did all of the driving that day and the night before, Dr. O suggested in my pre-meeting that I not take the Valium since I had been able to sleep the night before. But after the nurse plugged in the IV foundation plug, he said the anesthesiologist wanted me to take some Valium after seeing my vitals even though I know they weren’t too bad. Down they went. Dr. O stopped by in this sharp looking black outfit with his white doctor's coat over it. I again politely requested, "...and a straight nose please!!!". They then wheeled me down to the operating floor waiting area. Someone came by and then...

Friday - September 27, 2004

I remember waking up in the recovery room of the hospital that Wednesday evening with Claire and my mom in the room. I can’t necessarily remember what they said or what I said, but I remember I was there...had suction a few times in my mouth, but best of all I can remember having an oxygen mask. I think my mom said that my oxygen levels were coming up low when they checked, so they had given me the mask. The mask had a flow of oxygen, along with a very light mist. That rocked. My throat never felt dry in the hospital for my two nights there. About 4 days post-op, I tried talking to Mira and Dr. O about having that there for all, but due to hospital dynamics, it’s basically only there if your oxygen levels are too low. I joked with them about how one could try to get the mask, but it’s probably something not to be joked about. Plus, Dr. O said he would actually be concerned about the nose cast and the chin strap getting wet. I made sure to check the moisture level when I put the mask on and off, and to wipe out any excess liquid. I never had any nausea those two days, nor did I ever feel the need to throw up. Mom also said that the surgery went well and that I hardly bled during the entire operation...which is why I probably didn't puke after waking up...since there wasn't that much blood that drained into my stomach. Since I had watched Claire go through all of this, I was pretty much prepared to feel like total butt that first night, but not remember much of it later on. My first night, though, wasn't that bad...in fact, it was quite tolerable.

So, anyway, those first two days are mainly marked by me knowing I was there, but only remembering certain parts of it. I remember just Claire and my mom being there the first night. I can remember Mom snoring so loudly that first night I had to get out of bed to wake her up so I could get some sleep. (I think I yelled at her to go home so I could sleep...but she stayed, and brought her Darth Vadar sleeping machine the next night.) I can remember a nurse taking the catheter out on Thursday...ouch! I can remember a few nurses coming around to take vitals and empty out the blood bag drains connected to my jaw. I can remember them walking me around the ward once Thursday evening, and in doing so walked right past Marina who didn’t recognize me. I remember Marina visiting with flowers, but I don’t remember much of the conversation. I can remember having to go pee about 3 times, and seeing myself in the mirror for the first time. I remember an annoying person who came around with food and whined about me not peeing in the white retainer they had in the toilet. Hey, she said go pee. I saw this white thing there and put it on the sink since it was in the way. She didn’t tell me to physically go pee in it. I can remember Dr. O coming in one morning to remove the drains in my mouth...ouch! Anyway, I can remember my mom saying we would watch Survivor that Thursday night, but I couldn’t remember actually doing it with her. I taped it at home and watched it again last night, and like I told those in the room, I knew I’d seen certain parts of it, but I couldn’t actually remember it, nor did I know what was going to happen next. (On a little side note about reality television, with the appearance of two transsexuals on European reality TV over the past few years, I think we can expect to see a TS on a big-name reality TV show in the US inside the next year or two. I don’t know how or when, but, trust me, there will be one. Will it be the beginning of the Transsexual Revolution as the Gay Revolution materialized in the 80’s and 90’s? Who knows?)

With the morphine or demerol pain reliever system (called a PCA) those first two days, you just press a button which delivers the pain killers. It locks you out for a certain amount of time, but basically you keep punching that and slip in and out of consciousness. It was quite fun, and I don't remember ever really feeling any pain in the hospital. The care there was excellent, except for the one annoying person with the food and peeing bit, but I only saw her for a day.

Friday rolled around, and with that in mind, we rolled out of the hospital pretty fast. They had me dress in my clothes that I arrived in, then wheeled me in a wheelchair downstairs. (They suggest tops that either zip up or have large openings at top.) Mira was there with her fancy black car and whisked me over to the Cocoon House, where I was set up in the front room, but not against the window. I figured the light and street noise would be a little less from the other bed, but I definitely enjoyed the front bedroom better...just more positive. I was also able to enjoy Tricia and Mary-Lou’s bright faces as they entered the apartment first thing in the morning.

OK, I’ve written on and off all day, but I’m headed to bed. More later.

Saturday - February 28, 2004

So, where was I...oh yeah...being transported over to the Cocoon House. Shannon and I were up in the front room for Friday night, my first night out of the hospital and without that little machine that kept me happy.

Brooke, Michelle, and Marina all visited that Friday night (the 20th) and kept me company. I think I booted them when I started getting tired. I was popping pain pills about every 4-6 hours, especially those first few nights, and you have to sleep upright after having FFS because of the swelling in the face, which makes sleeping, uhh...., fun.

Most of Friday and Saturday I spent eating the stock of apple sauce, chocolate pudding, and yogurt. That’s about all I could handle. Mary-Lou also washed my hair on Friday. That felt pretty good since it hadn’t been washed since early Wednesday morning, and there was....well...a lot of schtuff in my hair.

On Saturday, Hin arrived, and Shannon shipped out. Hin had another reduction of her cheek bone, which she found too wide. I saw her before/after picture of FFS, and she turned out incredible...wow. Did she need the second cheek bone reduction? Probably not, but it made her feel comfortable to have it done. Hin stayed in the back room and was pretty quiet. Marina visited again that night to keep me company for a while, especially since I was alone in the front room. Tricia and Mary-Lou were also picked up fairly early that morning by a fancy black car carrying Dr. O, Mira, plus at least one other. They were all headed to V-Day in LA.

Someone told me that Dr. O had donated enough money to put on the V-Day activities all by himself, but others had donated as well so they made it a grand production. Since I handed him a check for over $27,000 on Wednesday on top of the hospital fees and the down payment back in October, I figure I was the one who actually paid for all of it. Just kidding...that’s just what I told the people who went there while I was in Cocoon since I was just jealous.

On Sunday, I tried eggs. Scrambled. They rocked, but of course, that’s about the limit of consistency I was able to manage. Mom scrambled them up for me. Afterward, I found I liked apple sauce just to cool the mouth down a bit. Tricia and Mary-Lou also were dropped back off that afternoon by the Dr. O crew after visiting LA the day before. They even brought back a souvenir program for me.

Sunday was also a big day for visitors. /Amber/, Brooke, Michelle, Susan, Julie, Diana, Minka, Susan from Helsinki, and Tyler all visited. Actually, Tyler stayed. She was having surgery on Monday. There was also the bunch that drove back from V-Day: Claire, Sarah, Rachel, and Renee. I hadn’t seen Renee in quite a while since she’s never lived in the area, only visited. We chat online here and there, and we’ve known each other since like December 2001...quite a while it seems.

On Monday, I moved into having tomatoes in the scrambled eggs. Yes, tomatoes! I still continued with the apple sauce, pudding, and yogurt. Brooke, Claire, Robi, Ro, and Y visited. Yep, three coworkers visited that night. I answered the door when they rang the buzzer, and had I not said hello to them, they wouldn’t have recognized me. Ro lives just around the corner from the Cocoon House, so they didn’t have far to go, except Y whose commute has always been pretty long. Anyway, wow...they visited. They said that “sensitivity training” was this upcoming week, and that Pete was in jury duty, so it was just Robi by herself. The good news, though, was that the problems that occurred that last week at work were finally resolved. I was right on one of the problems...whoo hoo!!!! The other one worked itself out as well, I think. It was funny, when Robi started talking work, I moved my fingers to my ears and started going “la la la la la la” as though I didn’t want to hear anything about it. I was on “vacation”. No stress. But Robi did drop off some very femme fashionable magazines that I will have to read after my mom leaves. My mom, though, was definitely making it quite easy during my recovery, as well as Tricia and Mary-Lou. Wilma Jean also arrived on Monday, and although of a different generation, she was still one of those along the same journey. She was an Irish music fan. Luckily for me, I couldn’t hear it Monday night.

I’d been changing the nose dressing, and could see all the little stuff kinda right at the base of my nostrils. Fun stuff. I enjoyed showing it to those that stopped by...and were interested in seeing it, but I never took a picture of it. That’s probably a good thing.

Monday also came with some good and bad news. The good news was that my nose packing came out, along with removal of the chin dressing and the forehead sutures. Mira pulled this nasty stuff out of my nose and I was finally able to breathe. Yes, it felt weird having all of it pulled out and was slightly uncomfortable, but I was finally able to breathe. Some say they find religion when the nose packing comes out. I found I could breathe, but I couldn’t smell. I still had the nose cast on and there were two splints up there somewhere. I also started using Saline Spray to try to keep the inside of my nose slightly moist and fresh. (Does that sound like a commercial?)

The bad news on Monday came after the nose packing came out. It seems my mom had an accident in San Francisco the day after my surgery. Although she was ok, she damaged the front end of my car. Tricia and Mary-Lou thought it was best if I wasn’t told until the packing was out of my nose since they didn’t want me going through any further stress. Although I didn’t care about the condition of my car, it was probably best that they waited. I told Mom that it’s just a car, and that as long as she was ok, it didn’t really matter. It was also the reason why I didn’t remember her being around when Survivor was on TV while I was in the hospital. But like I said, I didn’t actually remember much about my hospital stay.

On Tuesday, we moved into having green peppers in my eggs. Yes, green peppers! You can kinda see a common theme here. Chris and Line (pronounced Lee-nah) from Denmark came by to visit. They gave me a bear, which I added to the bunny Claire gave me, a bear that came from a mysterious person with the initials T. C. (who I later found to be an internet friend, not an internet person who chased me down), another bunny from my coworkers, and my own bear, Stuffed, which I brought along. Chris and Line had also attended V-Day, and Chris was up to have a consult with Dr. O as well that week. She was making the West Coast rounds.

Wednesday was Wilma Jean’s FFS, and although she tried to give a cold exterior appearance, she was a scared little girl inside. She tossed and turned all night, and she had her music going a little loud such that I could hear it. I took my pain pills and got a few hours of sleep, and figured it was better for her to try to be comfortable than have me worry about losing that much sleep. I had all of Wednesday to catch up. The alarm went off at 4 something, and we had her on her way by 5:10am to the hospital. I think she said that she slept about 20 minutes during the whole night.

On Wednesday, guess what? I had eggs with green peppers again! They rocked. Seriously. I was also supposed to go home that day, but, earlier, when I found that the nose cast wouldn’t come off until Thursday, I asked if there was room for me to stay an extra night so I could just travel from the Cocoon House up to the hospital instead of having to go all the way home. Yep, they squeezed me in, but I moved beds to the back room with Tyler who came in Tuesday.

Claire, Chris, and Line visited again on Wednesday, and we spent an hour that night watching the 48 Hours Investigates program on CBS. 48 Hours had actually called Mira/Dr. O about doing a segment in early December, and they’d asked Claire since she fell in that time period if she was interested in being on the show. Claire turned them down, but that entire night I kept telling Claire, “Hey, you could’ve been on the show this very night.” They never found someone for that segment, but they had 3 segments total. One was on Jennifer Boylan with her book “She’s Not There”. I still don’t understand why she came up with that title, because if “she” isn’t there, then who is? I guess I’d have to read the book to understand the title, but Susan says it’s just like any other sappy TS/wife transition story.

The second segment was the best, as they followed a young female to male transsexual. He was 11, and oh so brave. So was his mom. Wow. To come to realize who you are at such an early age, and to have supportive family, is just incredible. The reporter asked him, “Why do you want to be a man?” God, I hate it when they do that. ‘Straights’ just don’t understand that it’s not that we want to be a man or a woman, it’s that our brain says that it is. I’d turn the question on them and ask them why they want to be a man or a woman and have them respond with, “I am,” then have them ask me again. How would I answer? “I am,” just like they did.

The third segment had a wacky fast tracker. They had her doing all of the girlie things, with one etiquette lady telling her, “This is how women eat.” Oh bull schmidt. You can eat any way you want. Yeah, it’s polite to eat that way, but it doesn’t make you a woman. We laughed a lot during the last segment, making rash comments along the way. It hurt to laugh though, and even Tyler had to walk out of the room because she was hurting so much from the laughter. Chris and Line said we could have had our own commentary show on the program, which would have been a riot.

There was also a question asked during the program that went something like, “Are you/is she different from the person 5 years ago?” Well, duh! I think we all change over 5 years, don’t we? I mean, are you the same person you were 5 years ago? Sure, TS can change physically quite a bit, but we all grow over time.

On Thursday, I had an appointment with Mira to have my nose cast and splints removed, along with the staples that were in the incision through my hair on the sides of my head. That incision ran about an inch above my ears all the way across my forehead. Yes, the staples hurt being pulled out. Yes, the nose cast hurt when she was taking it off. Yes, the removal of the splints inside my nose hurt. But hey, they had to come off at some point...and they didn’t hurt that bad. After that, I went back over to the Cocoon House and had lunch. This time I had eggs with green peppers again!

Wilma Jean and Michelle were both discharged after my appointment, and I saw them at the house later. Unfortunately, Thursday was my last day at the Cocoon House. After lunch and a power nap, I cried as I said my good bye’s, especially to Tricia (but Mary-Lou was at work). I had really interesting conversations with both Mary-Lou and Tricia during my stay at Cocoon. They made me feel overwhelmingly comfortable there. I respected them incredibly for their energy and essence. I had finished up my entry in ‘da book’, started nearly 2 years ago at the Cocoon House. I also wrote a poem, entitled “I Forgot I Had A Nose”, in the book, and will leave to only those that take their journey along the same footsteps I took. So, with hugs and tears, I said good-bye to my stay at the Cocoon House.

OK, I’m tired...off to bed again.

Sunday - February 29, 2004

Leap day of a leap year? I think I’ve leapt.

Back to the story...we headed home from the Cocoon House after picking up some extra meds. One of my pain killers made me very very warm and caused my heart to race, so I stopped using it, and only used the other. I think they were both "triple script", so Mira wasn’t about to give me either of them, which led to her prescribing the Vicodin, which I’ve never used until now.

We got home on Thursday, and one of the first things I did that afternoon was to see how much weight I lost. I tipped the scales at 141 lbs. on the day before surgery, and weighed in at 134 lbs. eight days after surgery. I was probably less while at the Cocoon House, and for a few days, really noticed some ‘curves’ forming with a sore left bum (they probably dropped me during the bed transfers at some point...or poked me with a needle) and a shrinking waistline. I don’t have a big waistline, but with all of my muscle, it just isn’t a female waistline even though I don’t have that much fat there. Anyway, things looked cool at that weight...which will probably come over time as I lose the boy muscle....uh, well, one can dream, at least.

So, Thursday night Mom made up some mac’n cheese for me. Friday I had eggs again in the morning (Yeah! I had peppers, tomatoes, AND onions in them), and my roomie picked up some Chinese food for us for that night. I had Hot and Sour soup, but it didn’t taste quite the same....something I’ll talk about soon. Saturday, I had pasta in the city with Claire and Amy, and then leftover soup and fresh eggs for dinner. Today, I had eggs again for breakfast and Mom made up some angel hair pasta with tomatoes and garlic tonight. Yummm! She even made up a ton of it for me to eat later this week after she leaves. Oh, she’s been great out here, and very patient with me. At times, I just prefer to do nothing, but she’s still kept herself busy. She made a cake on Friday, and we’ve eaten it on and off, along with some ice cream. She’s made runs to the grocery store for me, and cooked up all of my meals. I’m going to miss her when she leaves.

Brooke, Susan x 2, Michelle, and Ally have all visited. It’s been nice to have visitors, but in the end, I usually end up booting them when I get tired. Prerogatives!!!

So, the results so far? Well, I actually feel very comfortable with the forehead and placement of the eyebrows so far. The hairline position in the middle of my forehead is fine, and I can live with the position on my left side, but the hairline position on my right side is about 1cm further back than the other side, which is not so livable.

The nose I do not like so far. It feels big in some areas, and way out of proportion on the tip, which also seems to be ‘squatty’ toward the bottom. I asked for a straight nose, but it doesn’t feel that straight so far. I was mainly concerned about a straight transition into the forehead, but it just has the standard Dr. O scoop nose transition. That sucks. I basically should have just told him to blend the forehead into the top portion of my nose, and I’ll go somewhere else to have the nose done...BUT, I could also be premature in my evaluation of my nose. Yes, I realize it’s swollen, but it just looks way off...and if it doesn’t come down in swelling to a position that I like, then I have to wait for a minimum of 6 months before I can even attempt to have another surgery on it. And, of course, who wants to have more surgery? My nose also feels like it was sewn back down onto my septum area off about 3mm, which makes it feel like it’s pointed over to the left due to that. OK, I looked at my before picture, and although I was fairly symmetrical from straight on, the nose did slightly bend to the left due to the deviated septum. He fixed the deviated septum, but I’m still having issues with my Eustachian Tube Disfunction, perhaps since there is still considerable swelling. I really hope it goes away in time.

I’m also still having trouble smelling, and for that matter, getting the full sensation of taste. If I get right up on something, I can smell it, but otherwise my sense of smell is limited to those odors which are rather strong.

The upper lip has healed up pretty nicely, besides the incision for the nose flap. The chin is still very very swollen, and I have two huge knots along the jawline about halfway along each side. I believe this is the area where he reconnects the bone to the jaw. The incision on the inside of my mouth still hurts due to the swelling of the surrounding tissue, but the incisions on the back of my mouth for the back jaw flair are pretty much healed up. The back of the jaw looks pretty good, and I can’t detect any huge problems with symmetry with that portion. The bumps are of different size though, and hopefully they will subside in a fairly reasonable fashion.

The trachea shave was pretty good, although the area around the incision under my chin is still rather swollen, but the actual incision doesn’t look that bad. I also think he might have been able to shave a little more off, but I think I can live with the results, plus if there is any swelling there, any reduction of it will just make the results better.

The top of my head is numb from about the actual crown of my head to the front incision. The area from my bottom lip to the tip of my chin has half sensation, and is close to the feeling you might have as you are recovering from having a dentist numb your mouth. I can feel it, but it’s slightly tingly. The tip of my nose is fairly numb, but I can feel all of my upper lip. The mobility of my upper lip, however, is fairly limited. I can’t quite pucker, such as when applying lipstick to both top and bottom lips. I also have this weird pain that shoots down from the teeth located directly above the large knot on my left jaw whenever I move my head in a weird manner to stretch that area. It’s almost as though the nerve in that area is surrounded or runs over swelled tissue, and it’s aggravating it when I stretch it further.

So, overall, I’m generally pleased, except with the nose, which I knew going in would probably be my most likely concern afterward. I’ll give it time to heal, though, and hopefully I will come to like it.


I went into FFS scared that the nose packing would really freak me out. It didn’t. I had the oxygen mask the first two nights and was basically so drugged up, that I didn’t have time to really think about it. Once I was over to the Cocoon House, I just made sure to take my Valium to ease my nerves and take away any anxieties, and everything came out well with it.

Tricia and Mary-Lou also draw up a little matrix of what drugs you took and when you took your last one. It helped to remember when I needed to take my next one, or when I should wait to take another one.

One of the hardest parts is sitting up while trying to sleep. I think I would make it about 4-5 hours on the good drugs, and then I would wake up with the pain. It’s not horrible pain, but it’s enough to prevent you from sleeping. At the Cocoon House they basically have you sitting up at a 50 degree angle. I threw a bunch of large pillows together when I got home, and I started out sleeping at about a 25 degree angle. I’m down to a 10 degree angle now, and will probably try to sleep in the configuration for a while because it keeps me from sleeping weird on my nose. I have sort of a little valley created in my pillows to keep me pointed up.

The baby toothbrush worked well at enabling me to brush my teeth the Dr. O recommended 3 times a day. I've been using Q-tips, and sometimes tweezers, to clean out my nose, and itch it on the front surface.

Dr. O is the best in the business with the boney work. He’s good, and hardly anyone else is doing anything like it. He’s secure in his work, which is good, but he’s basically set on one formula of how your face should be. When I talked about going over different features, he basically said he’d be doing his homework the morning of surgery. When I relayed where I would like my hairline, he stated that my ideal was right along the lines of where he would be placing it. I also asked for the straight nose. As I mentioned, I will have to wait to see how it ends up. The jaw and chin I wasn’t too concerned about as I knew the job there usually turns out pretty good. The only thing you have to watch for is if you get extra baggy skin. I was hoping that I was young and thin enough that my skin would rebound with the missing boney material. It’s hard to say how it will turn out, but at 33, I may have been pushing the limits of youth for my skin. I’d hate to have to have a facelift at 33 just to look 33. That’s pretty sad, but again, I’ll wait to see after the swelling has gone down.

Prune Juice

Ahhhh...prune juice. Well, face it, pain killer medication causes constipation. It’s just a fact. That’s why it’s really hard for me to understand how all of these celebrities get hooked on pain killers. Anyway, I took along some laxative medication, but I figured I’d try the fairly natural method of prune juice since they had it at the Cocoon House. Prune juice actually tasted pretty good to me. I was amazed. And, it had a lot of flavor. So, well, prune juice does it’s thing, and WHAM!, it’s supposed to get you to go potty...#2 style. Well, it sorta got to me, except, well, it started giving me gas. And since I couldn’t really smell....well, you know. What was really funny, though, is that sitting there in bed with gas I noticed that it smelled like prune juice. Hmm...it tastes like prune juice going down, and smells like prune juice coming out. How wonderful??? When Tricia took the Cocoon House gang down to the local cafe, I noticed upon entry that, well, the entire place smelled like prune juice to me. As I walked around, I also noticed that if I did smell anything, it smelled like prune juice. OK, well, I knew that in several of those places I had never done anything, yet it still smelled like prune juice to me. Everything I could smell was smelling like prune juice, or was it perhaps, that anything I smelled was actually registering as only one smell which I similarly recognized as prune juice? Who knows. Anyway, yesterday, when my mom, Claire, Amy, and I were walking around the Haight-Ashbury area, I noticed that the cafe Claire was ordering some coffee in again reeked of prune juice. All of them had already heard my story on prune juice and what I was smelling, so I asked my mom how close the smell of coffee was to that of normal gas as she went into the cafe. As she walked out, she’s smiling and nodding her head up and down. It seems she did, in fact, think that the two smelled similar. I, of course, was trying to contain my laughter since it quite hurt to laugh. Anyway, just know that the stuff does work, and it doesn’t taste that bad.

Tuesday - March 2, 2004

The past two days have been hard. I’ve been going through spells of depression due to a culmination of events. The recent surgery, recovering from that surgery, not feeling pretty, having the nose feel like it is way off, having facial hair popping out, being “sir’d” at the voter booth today, dealing with the car, dealing with all of the name change stuff, my mom going home, dealing with going back to work as Kara (I actually had a dream about this last night), and just going through what I call the Superman syndrome has caused me to be pretty down.

So, yes, I’m going through the post-surgical depression and I know that I’m going through it. Even though I know what is affecting me, I still have to deal with all of the motions and emotions. It’s kinda like knowing that the bridge is washed out, but still not being able to cross it.

What does all of that mean...well, in my opinion, the Superman syndrome is that Superman deals with all of the stress of being Superman, but he still has Clark Kent in which to live that regular life. Up until this facial surgery, I could go out as Kara and have fun, but I had “him” to go back to...to walk around in the regular world and not be labeled a freak. But now, I’m Superman full time without a Clark Kent to fall back on, and it’s not easy...not that I’m a hero or anything, but just using the similar situation.

Last night I cried myself to sleep thinking that I’ll never have a normal life. I’ll never be able to have children, never be considered a real woman, never be in a normal relationship...blah, blah, blah...woe is me. Yeah, I know...stop feeling sorry for myself.

With the small things I see wrong with my FFS, I feel depressed because I know that I’ll have to have revisions...which means more surgery, more recovery, and more money. I also feel ugly because I’m still swollen. Also, my nose feels like it is way off to the left. I know...wait for the swelling to go down, but it still feels off. My mom and everyone else says that it’s not noticeable, but I didn’t do all of this for them...I did it for me. I also paid a ton of money...money that I’m going to have to repay to my 401k out of my regular pay for the next 5 years, and for that type of money you’d think there wouldn’t be any major screw-ups (that hopefully don’t exist once the swelling goes down). Mom tried cheering me up, and she knows that I'm not taking it out on her, but just trying to explain that for the amount of money I paid, I should have gotten what I asked for.

I also have a hard time saying good-bye, and today I said good-bye to her after she was out here for two weeks taking care of me. I cried as I drove back home. I think that the surgery/recovery is also a very exciting time in my life, and now I’m also coming down off the excitement to regular boring days, and that’s depressing as well. It’s like living a lifetime for one event, then that event being over all of a sudden, and you’re stuck sitting there going, “Ugghhhh...what do I do now?” I have plenty of things to do now, but I think it’s relative to the situation.

Like I said, though, I’ve been feeling pretty crappy the past two days. I thought about calling “joanb” to talk to her about it, because she’s always been willing to talk to me about all of this, she's been through it before, and she gives it to me straight without all of the BS. Funny thing...after I dropped off my mom at the airport this afternoon, “joanb” actually called me, and mentioned that this is the time period when depression usually kicks in after this type of surgery. It was a good talk, and as usual, she kept it real. Brooke also called after that, and I talked to her about it as well. My phone bill is going to be insane this month!!!

Friday - March 5, 2004

I got out of the apartment this afternoon for a little light walking...around the mall. My head was starting to pound after about three hours of walking around, so I headed for the car and started to leave, but ran into Ally (who didn’t recognize me at first) and Laura, both who were familiar with Dr. O’s work. I sat with them for a few minutes as they reviewed my progress at 16 days post-op. They said I was doing pretty good with the swelling, and that my nose wasn’t as bad as I thought it was. We talked about the large radius from the forehead to the nose, but Ally said that was the way Dr. O did all of them. I know. I just hoped to avoid it by asking for a straight nose. Yeah, right.

Saturday - March 6, 2004


On a lighter note, I think I’ve sneezed three times since surgery, and during all three sneezes none of my brains have come out my nose. Whoo hoo! No, seriously, most of the “air rush” comes out my mouth, so I haven’t really let anything go through the nose yet.

Mira basically told me that I shouldn’t blow my nose until early April, and that I should try to inhale any....uh...schtuff...back through my mouth. Nice!

I’ve also noticed “strings” along the bottom edge of my mouth where the sutures are. It appears they are either dissolving or just being more noticeable. I can feel them on both sides of my mouth. I wonder how long I’ll have those sticking around in there as it’s getting harder and harder to distinguish the strings from bits of residual food.

Say, what did Dr. O actually do to you?

Uncle Jack emailed wondering what exactly I had done with FFS, and looking back at my entries, I realized that I didn’t exactly talk about what I had done. So....I had my forehead recontoured, my hairline was moved forward, my nose was feminized, the distance between my upper lip and my nose was reduced, the back flair of my jaw was shaved off, the chin was shortened and narrowed, and my Adam’s Apple was shaved down.

The specifics include that Dr. O made an incision from about 3cm above my ear, along my front hairline, and down to just over the other ear. Total length of cut = 35cm. He then peeled the skin and tissue forward exposing the forehead bone. He then cut the boney brow off and reformed it into a smoother surface. Because the cut exposed the front sinus cavity, it had to be reformed. He used titanium wire to piece it back together and then ground down the surface to a nice round shape. As he was sewing it back together, he cut out 2-3cm of the forehead skin and moved the hair-covered skin forward to make a new hairline. He made an incision right under my chin and was able to shave off my Adam’s Apple that was about 4-5cm below the incision. He cut inside the back portion of my mouth to expose the jaw bone, shaved off the back flair of my jaw bone, and removed some of the muscle that was also quite prominent there. He then cut along the bottom portion of my mouth, between the base of the gumline and the inner cheek. This exposed the chin bone. He then cut out a horizontal wedge to shorten the height, then tapered the chin to narrow it...I think. He then modified my nose by doing an open rhinoplasty. He made an incision in the base of my nose and lifted the flap up to expose the interior of the nose. He narrowed the nose from the forehead down to the central base. He undeviated my deviated septum, and slightly reshaped the bottom portion of my nose. Sometime while working on my nose, he also cut out a 1-2mm section of the skin just under the nose, then resewed the skin back together. He installed tubes in the jaw cavities that led to little plastic bags. They would create a vacuum in the bags which would pull excess blood built up in the area he cut and ground on along my jaw. I also had sutures along my hairline, and metal staples in the incision actually in my hair. There were sutures along the bottom of my nose, dissolvable sutures in my mouth, and internal and external sutures along the incision under my chin. I had two splints up my nose that were attached to one another through my septum, a nose cast, and bandages along the base of my nose which covered the nose packing that was shoved up into my nose (which made it impossible to breathe through my nose). Finally, I had a chin strap to keep the skin tight against my chin and in place, along with dressing over my entire head.

Nice, huh? The numbness on the top of my head will hopefully return over time, which can be months to years, and some people never fully regain sensation there. This is all due to the way he reforms the forehead. He basically has to cut the two nerves that run up to the top of the forehead because he peels back everything to expose the bone. The chin/bottom lip tingly sensation should hopefully return to normal inside the next few months, along with sensation in the tip of the nose. Since he removed some of the jaw muscle, I’ve had trouble fully opening my mouth, but over time it’s returning to normal. I’m not supposed to return to very hard foods until early April.

Oh yeah, another funny thing I’ve noticed is that once I got home from the Cocoon House, I felt cold (still do slightly), and turned up the temperature in my apartment. I noticed the same thing with Claire immediately following her surgery. My mom and roomie both felt the place was getting hot since I’d turned on two heaters in the main living area, even though I felt quite comfortable. I turned them off when I realized that I was the one that was off on the temperature.

Sunday - March 7, 2004

I was back to having eggs again today, since I actually backed off of them the past 2 days. I figure I’ll probably eat them a little more as the back jaw muscles are still working to get back in shape.

I took a shower this morning, and during the course of it, I hawked up this huge snot ball from my nose/sinuses. Yuuuckk!!! After the shower, I had some drainage coming down my nose, so I had to dig it out with Q-tips and a pair of tweezers. Also, I’ve had this crusty thing kinda sitting near the inside base of my nostril since surgery, and I wasn’t sure if it was a scab or a dried up booger, but it finally loosened today while I was digging out the softer stuff, so I kinda eased it out of my nose as well.

Tuesday - March 9, 2004

I had my 3 week follow up with Dr. O this evening. He said I looked remarkably good for three weeks, even though I’m still quite swollen. He checked where the sensation ended on top of my head and asked if I had the creepy crawlers up there yet. I’ve felt a little weird sensation so far...sorta like something is crawling around in your skin, but you can’t quite feel it. “JoanB” said that the phantom itches are a real joy to deal with. You’ll get an itch up on the top, but when you try to scratch it there, you’re not getting it. She said that when that happens, try scratching your forehead or the hairline, and that should probably get it. That’s so funny, but so far, I’ve had two phantom itches. I will go to scratch it up on top of my head, but I can’t feel the area I am scratching, and the scratch doesn’t go away. So, I tried itching the eye brow and the hair line, but the itch basically subsided. The creepy crawler feeling comes and goes. It’s almost a pretty cool feeling...sorta like a little head massage.

The first 10 days.

The night of FFS.

Left - Before FFS.  Right - 3 months after FFS.