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		<title>2 months, 4 days post-op</title>
		<link>http://geekbynature.wordpress.com/2009/08/22/2-months-4-days-post-op/</link>
		<comments>http://geekbynature.wordpress.com/2009/08/22/2-months-4-days-post-op/#comments</comments>
		<pubDate>Sat, 22 Aug 2009 22:31:02 +0000</pubDate>
		<dc:creator>geekbynature</dc:creator>
				<category><![CDATA[Entries with photos]]></category>
		<category><![CDATA[Topsurgery]]></category>
		<category><![CDATA[Transgender]]></category>

		<guid isPermaLink="false">http://geekbynature.wordpress.com/?p=436</guid>
		<description><![CDATA[21:10 At eight weeks, the incision scars have flattened out to the extent that they can hardly be felt when running fingertips across my chest. The colour, after a month of Kelo-Cote usage, has also faded considerably, although more in tone than contrast; while obviously still evident, the colour more resembles a light sunburn pink [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=geekbynature.wordpress.com&amp;blog=1751204&amp;post=436&amp;subd=geekbynature&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>21:10</p>
<p>At eight weeks, the incision scars have flattened out to the extent that they can hardly be felt when running fingertips across my chest. The colour, after a month of Kelo-Cote usage, has also faded considerably, although more in tone than contrast; while obviously still evident, the colour more resembles a light sunburn pink rather than a deep scarred purple. The areolae, as well, have taken on a natural pinkish-beige in contrast to the radiant pink displayed of late. They have regained a very slight amount of sensation; while unable to recognize pain, both the nipples and the areolae are capable of feeling the pressure associated with touch. This is a tremendous development, as complete numbness had persisted up until merely a few weeks past.</p>
<p>The small translucent sutures have fallen out; or rather, were not actually attached at all, a fact I discovered in a moment of annoyance as I happened to pull on them, and, to my great astonishment, they came out quite effortlessly. Some fatty tissue has migrated back into the breasts, providing both padding and a pleasing pectoral contour, more natural than the flattened, sunken chest wall that had remained after surgery. I have also rather rapidly gained back a large amount of body fat and muscle, although my overall weight remains at a concerning 15 less than ideal.</p>
<p>In the midst of the summer, I realize how astonishing the change of body temperature is. Without the heavy, dual-layered, spandex binder hugging my torso from neckline to hip, I realize that the intense and unbearable heat experienced last summer, through which I felt I barely survived, was not caused by the testosterone as much as I had believed. Though certainly exacerbated by such, without the extra layer I experience none of the heatstroke, dehydration, chronic fatigue or constant sweating suffered throughout the previous year.</p>
<p>After a month without the surgical binder, as well, I have begun to become accustomed to the idea as well as the profound sensation of wearing only one shirt &#8212; no matter what shirt. I had, I realize while wearing each one for the first time since surgery, subconsciously memorized its look and feel; as I prepare to step outside for disposal of trash or recycling or to check the mail, the initial thought springs to what I am wearing; a selection of shirts, namely those with large logos covering the chest portion, were able to hide me without a binder with the help of some slouching; and these I often would wear around the house or to short trips outside to avoid the constant discomfort of binding. Others, such as muscle shirts or sleeveless basketball jerseys, were not only revealing but also, simply not designed to fit over such extremities. In this, I have also noticed that a large collection of my shirts are rather uncomfortable. As most of my shirts were tested, bought and worn with the binder, I seldom felt many of them against my skin; particularly, I am acutely aware of and exceedingly bothered by tags, loose threads and bunching of seams where a loose thread may have once been pulled.</p>
<p>In the middle of August, I am able to not only wear a t-shirt, but also to tuck it in; where previously, tucking any shirt in would manifest a personal volcanic sauna between shirt and binder.</p>
<p>My range of motion has recovered almost completely, with minor pain only during high reaches or concentrated use of chest muscles, such as lifting a heavy object from a height. Though I lack the energy for much exercise, I am able to produce push-ups, pull-ups, sit-ups and crunches with no difficulty. Although I still exert caution with things heavier than 50 or 60 pounds, my lifting capability is no longer limited by pain tolerance.</p>
<p>I find, surprisingly, that I am comfortable shirtless in the presence of others, although the only people to witness it as a daily occurrence have been my mother and a childhood friend, having recently spent several nights in each other&#8217;s immediate vicinity. Even to those who are entirely unaware of my transition, I no longer experience the paranoia of someone seeing my chest upon waking up, walking to the bathroom, showering or dressing.</p>
<hr size="2" /><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/08/08-22-09-2.png">Today, nearly 9 weeks.<br />
</a><br />
<a href="http://geekbynature.files.wordpress.com/2009/08/08-22-09_l.png"> The left nipple.</a></span></p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/08/08-22-09_r.png"> The right nipple.</a></span></p>
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			<media:title type="html">Jace</media:title>
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		<title>1 month, 2 days post-op</title>
		<link>http://geekbynature.wordpress.com/2009/07/23/1-month-2-days-post-op/</link>
		<comments>http://geekbynature.wordpress.com/2009/07/23/1-month-2-days-post-op/#comments</comments>
		<pubDate>Thu, 23 Jul 2009 20:58:28 +0000</pubDate>
		<dc:creator>geekbynature</dc:creator>
				<category><![CDATA[Entries with photos]]></category>
		<category><![CDATA[Topsurgery]]></category>
		<category><![CDATA[Transgender]]></category>
		<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://geekbynature.wordpress.com/?p=418</guid>
		<description><![CDATA[20:15 The healing process has taken a tremendous leap in the past week, physically as well as in regards to capability. Although I have yet to gain back any of the weight lost prior and during surgery, my strength and muscle mass has been slowly returning. After believing to be witness to minor changes after [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=geekbynature.wordpress.com&amp;blog=1751204&amp;post=418&amp;subd=geekbynature&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>20:15</p>
<p>The healing process has taken a tremendous leap in the past week, physically as well as in regards to capability. Although I have yet to gain back any of the weight lost prior and during surgery, my strength and muscle mass has been slowly returning.</p>
<p>After believing to be witness to minor changes after four days of use of the small Kelo-Cote sample provided by Dr. Brownstein, I was encouraged to purchase a larger quantity as the recommended usage is three months. As a majority of sizes are intended for smaller scars of 4-6 inches, my 12 inches of scarring required purchasing the largest tube available, which although retailing at a costly $130, so far seems to be well worth the expenditure. Although much effect cannot be observed, there has been a definite immediate decrease in the striking colour.</p>
<p>The ends of several small, translucent sutures can still be felt on the right side, at the very end of the incision where I assume the knot must be. Although both sides have flattened considerably, there is a concerning grey color to the inch-long vertical section of scar under my arm. It is slightly painful, but I surmise the reason may simply be the sutures taking their time dissolving; and not, I hope, a developing infection.</p>
<p>I have also, somewhat on accident after intending its purpose to be for the scars, begun applying a thin solution of vitamin E oil to my stretch marks; which, after a little under a week, have to my utter astonishment disappeared nearly entirely. While I cannot be truly certain whether this is my body itself healing or cause of the vitamin E, nonetheless I find a new faith and no desire to discontinue the treatment.</p>
<p>The grafts are healing well; the left one still remaining a bit raised, in addition to the strangest occurrence of dryness; almost as though the thing is suffering the peeling aftermath of a sunburn. While it is neither painful nor harmful to its appearance, as well as that there can not be any evidence of such a thing found anywhere else on my body, its presence perplexes me.</p>
<p>Reaching, lifting and general movement reaches a new milestone day by day. Directly following the removal of the binder, the area of my breast between the incisions measured roughly 3/4 of an inch and was extremely tight, so much so that I could feel its tautness under my fingertips. In the month to follow the skin has relaxed considerably, to the point that it now measures nearly 1.25 inches. Other areas having relaxed as well, I find that moving my arms no longer tugs on the incisions as it once did; the tissue is beginning to move as it should normally. I find that I am also capable of lifting most objects under 40lbs without pain, whereas even this past week my range was limited to 30lbs; and immediately after my return to work, was barely 20lbs. I am able to raise my arms entirely vertical above my head, although the last inch or so to straighten out pulls slightly.</p>
<p>My bodily hair, strangely, seems to be growing at an exceedingly fast rate of late. Not only has my beard appeared to grow twice as fast and thick since our return from San Francisco, I find that the dark hair on my stomach and chest has been multiplying daily. I had noticed an increase in hair growth during the week in California, but had expected it to cease immediately upon return to my own hot, dry, high-altitude climate; which leads me to ponder whether the removal of breast tissue might have anything to do with my testosterone level. Though it is obvious that a small line of hair was shaved near the incision site, it has already grown back in full form and there remains only a small area between belly and breast that is hairless. This belief is further accentuated in my mind as an acne outbreak on my chest is to be observed; which, oddly, was a very distinct and recurring bother at the onset of female puberty, seeming to worsen near the beginning of my cycles.</p>
<p>Incidentally, a visit from a 30-year friend of my mother&#8217;s took place several days past, which although he was aware of the change, had not seen me for three years at least. His first comment after introduction: &#8220;Nice beard.&#8221;</p>
<p>&#8220;Thank you,&#8221; I said. &#8220;I grew it myself!&#8221;</p>
<hr size="2" /><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-23-09.png">The site today, one month.</a></span></p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-23-09-2.png">Sort of sickly lighting; also, it looks like I have one arm.</a></span></p>
<p><a href="http://geekbynature.files.wordpress.com/2009/07/pose1.png"><span style="text-decoration:underline;">A pose.</span> </a>The scarring on my arm is a remnant of adolescence, and, obviously (one might hope?), not an effect of the surgery.</p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/pose3.png">Slightly different angle</a></span>, more from the front.</p>
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			<media:title type="html">Jace</media:title>
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		<title>3 weeks, 2 days post-op</title>
		<link>http://geekbynature.wordpress.com/2009/07/16/3-weeks-2-days-post-op/</link>
		<comments>http://geekbynature.wordpress.com/2009/07/16/3-weeks-2-days-post-op/#comments</comments>
		<pubDate>Thu, 16 Jul 2009 20:00:58 +0000</pubDate>
		<dc:creator>geekbynature</dc:creator>
				<category><![CDATA[Entries with photos]]></category>
		<category><![CDATA[Topsurgery]]></category>
		<category><![CDATA[Transgender]]></category>

		<guid isPermaLink="false">http://geekbynature.wordpress.com/?p=406</guid>
		<description><![CDATA[20:00 Today, I experience my first continuous 48 hours in six years without a binder. I have worn it intermittently during the night for the past week, but as it is now possible to sleep on my stomach without discomfort, the support is no longer needed. The nipples have healed almost completely, though still without [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=geekbynature.wordpress.com&amp;blog=1751204&amp;post=406&amp;subd=geekbynature&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>20:00</p>
<p>Today, I experience my first continuous 48 hours in six years without a binder. I have worn it intermittently during the night for the past week, but as it is now possible to sleep on my stomach without discomfort, the support is no longer needed.</p>
<p>The nipples have healed almost completely, though still without any sign of sensation returning. The areolae are very raised, but appear to be acquiring a pleasingly elliptical shape instead of the initial oblong oval.</p>
<p>While still sore, I find that I am capable, albeit slow, of a great deal of previous activities, the scope of which continues to expand day by day. Raising my arm to the height required of hanging it out the car window is not longer painful, although any object above my head is still difficult to reach. I am becoming accustomed to the appearance of the scars; yet, the more they heal, the more prominent I find my natural bodily oddities to be.</p>
<p>&#8220;I have <em>never</em> heard of such a thing happening before.&#8221; My mother traces her finger along the angled scars near the base of each incision in relative awe; like claw marks, they stand out brilliantly against the taught skin. &#8220;I never had stretch marks on my breasts when I went through puberty.&#8221;</p>
<p>&#8220;Well,&#8221; I say, with the intention of continuing a half-hearted explanation; there is nothing to say. I had been aware of the stretched skin along the inner side of my breasts since their inception into my life, but perhaps somehow had hoped that they would be removed along with the better portion of the tissue. They have not.</p>
<p>&#8220;They&#8217;re really the worst part,&#8221; she says, attempting to ease my opinion of the scarring.</p>
<p>Ironically, it is this that causes the revulsion now; that spurs a new obsession with hiding my chest. While I had been nervous yet eager to show family and friends initially, I no longer harbour any desire to display the results of the surgery, even to those who ask in curiosity.</p>
<p>The battle is never-ending.</p>
<hr size="2" />
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-14-091.png">At three weeks.</a></span></p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-14-09-2.png">With the flash on, slightly from the side.</a></span></p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-14-09_l.png">The left nipple.</a></span></p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-14-09_r1.png">The right nipple.</a></span></p>
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			<media:title type="html">Jace</media:title>
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		<title>Day 16 post-op</title>
		<link>http://geekbynature.wordpress.com/2009/07/09/day-16-post-op/</link>
		<comments>http://geekbynature.wordpress.com/2009/07/09/day-16-post-op/#comments</comments>
		<pubDate>Thu, 09 Jul 2009 21:03:33 +0000</pubDate>
		<dc:creator>geekbynature</dc:creator>
				<category><![CDATA[Entries with photos]]></category>
		<category><![CDATA[Topsurgery]]></category>

		<guid isPermaLink="false">http://geekbynature.wordpress.com/?p=397</guid>
		<description><![CDATA[20:00 After 48 hours of air and activity &#8212; as well as my slow acclimation to them &#8212; the incisions have, at a great relief to my peace of mind, improved slightly and even begun to flatten. Some of the swelling, I believe, is actually due to the dissolving sutures, which can be observed to [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=geekbynature.wordpress.com&amp;blog=1751204&amp;post=397&amp;subd=geekbynature&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>20:00</p>
<p>After 48 hours of air and activity &#8212; as well as my slow acclimation to them &#8212; the incisions have, at a great relief to my peace of mind, improved slightly and even begun to flatten. Some of the swelling, I believe, is actually due to the dissolving sutures, which can be observed to lessen day by day. The end of the incision on the right remains raised and slightly pinched, and a small protrusion of clear thread can be seen from the tip; while the left, devoid of noticeable stitches, has relaxed and flattened. While still striking, the appearance is not as ghastly as it seemed upon first revelation.</p>
<p>The areolae, as well, have healed with increasingly considerable speed in these past days. Nearly all of the scabbing has fallen off; and though the nipples themselves remain numb to the touch, the tissue underneath appears to be regaining feeling. I have noticed a distinctly odd sensation of late, being that when I happen to drink cold liquids, in addition to the coolness felt as it travels down my throat, I am also acutely aware of the chill <em>in my nipples</em>. My only explanation would be that of the damaged nerves attempting to both recuperate and distinguish where on my body they actually are, given the large number of them now missing or rearranged. While not, perhaps, as strange the amputee who subsequently <span style="text-decoration:underline;"><a href="http://www.pbs.org/wgbh/nova/mind/note_nf3.html">experienced his orgasm in his missing foot</a></span>, it is nonetheless a fairly unexpected sensation.</p>
<p>There was a singular black stitch remaining at the top of the left areola this morning, with which I was not quite sure what to do; I resolved to leave it alone, and I find after the course of the day that it appears to have fallen out on its own.</p>
<p>The most obvious obstacle has been a constant fatigue. My range of motion is still rather limited; while only a dull soreness is felt throughout the day, I have discovered several activities that produce a sharp pain: including uncapping or capping pens, hanging my arm out the car window, hiccuping and the precise reaching angle of using the drive-up ATM. Arching my back, however, an impossible feat for the past two weeks, has been accomplished only in the past day with no pain at all.</p>
<p>A great deal, I realize now, of my initial reaction to the scars was the surrounding tissue &#8212; spotted with marks every few centimeters to estimate the location of a stitch and outlined with a muddled dirty substance, dark pink further accentuated by a contrast of colour. Following my shower tonight, during which I made attempt to scrub the area surrounding the incisions as much as sensitivity would allow, I find that it appears much cleaner and certainly less horrific.</p>
<p>My body itself, as well, is recovering. Partly, I am sure, due to the lack of food and extremely limited movement throughout the first days of the surgery, I found that I have lost a measure of muscle mass, and felt that I appeared rather sickly. This has not dissipated entirely, as I still feel slightly weak and nauseous as though I am coming out of a long-lasting flu.</p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-09-09-2.png">The site this afternoon, prior to showering</a></span>. Still a bit dirty, but the nipples are looking better.</p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-09-09.png">After the shower.</a></span> There seems to be a slight dye still on my skin from the protective yellowish film applied during surgery.</p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-09-09_l.png">The left nipple.</a></span></p>
<p><a href="http://geekbynature.files.wordpress.com/2009/07/07-09-09_r.png"><span style="text-decoration:underline;">The right nipple.</span></a></p>
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		<title>2 weeks post-op</title>
		<link>http://geekbynature.wordpress.com/2009/07/07/2-weeks-post-op/</link>
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		<pubDate>Tue, 07 Jul 2009 23:51:30 +0000</pubDate>
		<dc:creator>geekbynature</dc:creator>
				<category><![CDATA[Perceptions]]></category>
		<category><![CDATA[Topsurgery]]></category>
		<category><![CDATA[Transgender]]></category>

		<guid isPermaLink="false">http://geekbynature.wordpress.com/?p=384</guid>
		<description><![CDATA[23:40 Inspired by the midday heat, today I removed the binder halfway through my workday. I was surprised to find such a difference in tolerance within a day; aside from slight uneasiness due to an unshakable concern that someone might notice my breasts, it was an immediate relief in regards to temperature and brought only [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=geekbynature.wordpress.com&amp;blog=1751204&amp;post=384&amp;subd=geekbynature&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>23:40</p>
<p>Inspired by the midday heat, today I removed the binder halfway through my workday. I was surprised to find such a difference in tolerance within a day; aside from slight uneasiness due to an unshakable concern that someone might notice my breasts, it was an immediate relief in regards to temperature and brought only vague discomfort. After nearly 12 hours of activity without it, however, I find that I am extremely sore; particularly near my underarms at the edge of the incision, almost too sensitive to touch. Although today marks the end of my medically assigned binding period, I worry for both the pain and the exposure and may wear the binder during the night for some days more at least.</p>
<p>The removal of the surgical tape was also to take place today. I had peeled away a small portion from each incision at the front some days past, it having become saturated and, as well, for my own curiosity as to the appearance of the developing scar. Some slight scabbing was peeled away with the tape, leaving an evidently pink line from sternum to side. Having not been washed nor even touched since the surgery, the skin surrounding the incision was dirty and sticky. Although it is not recommended to wash the area, the crumpled skin was unsightly but did seem to improve after several minutes of patting with a warm washcloth. The edges both at the middle and at the underarms are distinctly raised and somewhat pinched, leaving me with concern of their healing ability; having a disposition of developing slightly keloidal scarring.</p>
<p>&#8220;It looks so&#8230;. real.&#8221;</p>
<p>My brother observes my chest with a touch of mirth for the first time this past Monday, eager to see how nearly $12,000 has transformed my body. &#8220;Is it worth it?&#8221;</p>
<p>&#8220;I can&#8217;t tell yet,&#8221; I say. My nipples dark and scabbed, my incisions obscured with tape, I have not yet seen the final result. Only after I emerge from the shower, expecting somewhere in my mind the femininity which has been ever reflected back to me, am I presented with the image that will redefine how I perceive my body.</p>
<p>I am horrified.</p>
<p>The lines cut in vivid angles beneath my breast, bunching in small areas where the muscle within tender tissue has been severed; not in a smooth semicircle as I had, for whatever reason, anticipated or hoped for. The incision surrounding my nipples seems to jump out in striking colour the more that I stare. As I acknowledge the fact that I have given everything I have to afford completely and utterly irrevocable plastic surgery, I cannot help the revulsion that I feel as I realize that the image in the mirror is not someone else&#8217;s body.</p>
<p>Perhaps it is the obvious masculinity that conjures this thought. While my body has changed dramatically in the past two years, the ever-present appendages, despite how I chose to perceive them, projected an undeniable female shape into my subconscious; and, perhaps, continued to fuel the childhood allusions that my body did not in fact belong to me. Without them, and with the crafted appearance of male, there is nothing to disprove possession of my body. I realize that I am seeing myself for the first time, and in realizing, I am unable to process what I have created. I can only stare as media coverage of Michael Jackson&#8217;s death cascades uncontrollably through my mind, projecting images of disfiguring plastic surgery to the result of an unrecognizable body. I don&#8217;t want to think about it. I don&#8217;t want to look. I put my shirt on.</p>
<p>Hours later, as I observe photos, I am struck with the impressive result. It does not feel as though the body in pictures is the one that I will see when I look into the mirror &#8212; they are, merely, as the countless other post-op photos I obsessed over for years in anticipation, never expecting to arrive at the other end.</p>
<p>I feel ruined.</p>
<p>Is it worth it? The question reverberates in my head as I attempt to disassociate my revulsion, forcing myself to look past the scars. Then it is worth it. The flatness when wearing nothing but a shirt is a sight so surreal I can hardly comprehend, and I cannot believe what luck I have had. But the horror that I cannot help but see when it is removed, when I tend to the areolae each morning, when I take a shower, when I undress is far too reminiscent of the childhood feelings of utter wrongness that took so much effort to overcome. I feel as though I am beginning my transition from scratch all over again.</p>
<p>I do not know how to cope. The overwhelming agony of being unhappy with the body that I so recently learned to accept, and indeed to enjoy looking at, is almost too much to comprehend. While the shock of the initial view has worn off, still I can hardly stand to look. <em>I should have left the tape on.</em></p>
<p>The thought tortures me.</p>
<hr size="2" />
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-07-09.png">Today, 14 days post-op</a></span>.</p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-07-09-2.png">Also today, slightly different lighting</a></span>.</p>
<p><a href="http://geekbynature.files.wordpress.com/2009/07/07-07-09-3.png"><span style="text-decoration:underline;">From the side</span></a>.</p>
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		<title>Day 12 post-op</title>
		<link>http://geekbynature.wordpress.com/2009/07/05/day-12-post-op/</link>
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		<pubDate>Sun, 05 Jul 2009 07:01:29 +0000</pubDate>
		<dc:creator>geekbynature</dc:creator>
				<category><![CDATA[Entries with photos]]></category>
		<category><![CDATA[Topsurgery]]></category>

		<guid isPermaLink="false">http://geekbynature.wordpress.com/?p=377</guid>
		<description><![CDATA[19:00 I have felt very fatigued since arriving home; most of the previous days have been spent much as they were in the hotel: sitting or sleeping, and making the effort to move for only bathroom breaks and food. Before, with room service to clean and provide for me and thus most activity taking place [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=geekbynature.wordpress.com&amp;blog=1751204&amp;post=377&amp;subd=geekbynature&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>19:00</p>
<p>I have felt very fatigued since arriving home; most of the previous days have been spent much as they were in the hotel: sitting or sleeping, and making the effort to move for only bathroom breaks and food. Before, with room service to clean and provide for me and thus most activity taking place at waist level with minimum effort, my incapabillity did not seem so obvious; I now find that returning to my lifestyle has presented several unanticipated difficulties.</p>
<p>My reach is limited to a 45º angle at best; the majority of dishes and pantry shelves require a tall stool to access. My mother has arranged a selection of cups and bowls on a countertop, which I anticipate on rotating through for another week at least. My bedroom being on the second floor, I have also found descending the staircase rather painful.</p>
<p>The tissue above and beside the areolae feels very bruised and slightly swollen, although the areolae themselves appear to be healing well. The left one is of some concern to me as nothing of the scabbing has shown the slightest sign of falling off, leading to an increasingly blackened and hardened appearance. However, the edges of the incision are pink and holding securely, so tissue death does not appear to be an issue. There has been a little bleeding around the nipple itself and the bottom edge of the incision on the right for the past few days, although it ceases quickly.</p>
<p>The tape covering the breast incision is becoming slightly saturated, and although its removal is recommended around two weeks, I am hesitant to do so as the incision itself is rather sensitive and I worry about the possibility of it opening during a high reach or quick arm movement, in particular given that tomorrow I return to work for the first time in a field that is quite physically demanding. While for the past few days I have hardly been able to stand to not wear the binder for the feeling of tension, exposure and tenderness, just today I find that it is becoming more tolerable to go without it.</p>
<p>Nonetheless, the overall healing process seems to be progressing with little obstacle. A natural stomach-sleeper, I have as of yet been unable to accommodate such a position as I am very aware of my skin stretching and of the weight on both the grafts and the bruised tissue, which causes a lot of discomfort. Sleeping on my side is both comfortable and painless, however; so it has become my position of choice.</p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-05-09.png">The site this morning.</a></span> Very little aesthetic change so far. The smudges here and there are tape residue from the nipple gauze, and there is some faint indentation from the binder.</p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/07-05-09-2.png">From a different angle</a>;</span> not the best photo as my hands occupy half of it, but there can be observed some swelling above the areola in the upper left. The drain holes are beginning to close.</p>
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		<title>Day 9 post-op</title>
		<link>http://geekbynature.wordpress.com/2009/07/02/day-10-post-op/</link>
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		<pubDate>Thu, 02 Jul 2009 21:47:07 +0000</pubDate>
		<dc:creator>geekbynature</dc:creator>
				<category><![CDATA[Entries with photos]]></category>
		<category><![CDATA[Topsurgery]]></category>

		<guid isPermaLink="false">http://geekbynature.wordpress.com/?p=358</guid>
		<description><![CDATA[8:00pm At last, we arrive home from California. The removal of the sutures was less painful than I had expected ; while I was aware of a slight sensation of pulling, the fact that the areolae are completely numb continues to surpass my conscious thought. There has been a level of pain following their removal, [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=geekbynature.wordpress.com&amp;blog=1751204&amp;post=358&amp;subd=geekbynature&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>8:00pm</p>
<p>At last, we arrive home from California.</p>
<p>The removal of the sutures was less painful than I had expected ; while I was aware of a slight sensation of pulling, the fact that the areolae are completely numb continues to surpass my conscious thought.</p>
<p>There has been a level of pain following their removal, mostly localized around the edge of the chest incision, which seems to be a target for irritation from clothing, the binder and general arm movements. While not unbearable, on occasion it has become a cripplingly sharp, yet quickly subsiding, stab at the attempt of rapid movement or the act of pulling; difficult this past night as maneuvering into a bunk on the train involved a small level of bodily lifting. There is also a bruise-like sensation throughout the general chest area, in particular directly between the incisions in the middle of the sternum where the skin is rather taught.</p>
<p>Today was my first shower in 9 days, which was a great relief. Showers are to be taken facing away from the water for the next few weeks, while as the incisions can become wet they cannot be hit with a direct stream. I encountered slight panic as I happened a glance downwards sometime during its duration and found the grafts covered with shampoo suds despite my efforts to shield them from any foreign substances; &#8212; this being their first contact with air for more than a 30-second period &#8212; but they appear to be fine and, in retrospect, soap was likely the best of a number of possible things with which they may have had contact. As I removed the gauze for the first time prior to showering, a moment of Dr. Brownstein&#8217;s session wherein he recounted the occurrence of someone pulling off their newly grafted nipple haunted the recesses of my consciousness, but they are secure and a slight wetting of the gauze allowed its removal with ease.</p>
<p>It was also to be observed that the somewhat revolting, bumpy and blackened skin is not severely bruised areolae, as I had originally assumed, but in fact merely a gigantic scab covering the entirety of the area. A small flap seems to have peeled away during the shower, revealing a very pink and healthy nipple beneath.</p>
<p><strong>These pictures are graphic.</strong></p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/pre.png">My chest prior to surgery.</a></span></p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/05-30-09.png">The site prior to the removal of the sutures, one week post-op</a></span>. The lighting is rather sickly as the hotel bathroom fixtures left something to be desired. The tape will remain on the incisions for another week. The small red dots are where the drains were sewn in, although the faint scar lines directly below them are from an infantile surgical procedure.</p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/05-30-09-2.png">One week post-op, from the side.</a></span> Definitely obvious that I spent the past week in bed in comparison with the pre-op photo.</p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/06-02-09.png">Prior to showering today, after removing the nipple gauze.</a></span> Most of the purple marker had worn off over the past few nights.</p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/06-02-09_l.png">The left nipple today, a little squashed.</a></span></p>
<p><span style="text-decoration:underline;"><a href="http://geekbynature.files.wordpress.com/2009/07/06-02-09_r.png">The right nipple today.</a></span> This is rather nasty; but I was loath to peel away any of the scabbing for fear of bleeding or infection.</p>
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		<title>Day 7 post-op</title>
		<link>http://geekbynature.wordpress.com/2009/06/30/day-7-post-op/</link>
		<comments>http://geekbynature.wordpress.com/2009/06/30/day-7-post-op/#comments</comments>
		<pubDate>Tue, 30 Jun 2009 16:54:07 +0000</pubDate>
		<dc:creator>geekbynature</dc:creator>
				<category><![CDATA[Topsurgery]]></category>
		<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://geekbynature.wordpress.com/?p=354</guid>
		<description><![CDATA[09:20 Today Dr. Brownstein removes my sutures. It will be a great relief to be rid of the gauze and surgical binder, as its tendency to slip down has become an increasing annoyance in these past days. I am now nearly fully mobile and able to raise my arms above my head; a small yet [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=geekbynature.wordpress.com&amp;blog=1751204&amp;post=354&amp;subd=geekbynature&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>09:20</p>
<p>Today Dr. Brownstein removes my sutures. It will be a great relief to be rid of the gauze and surgical binder, as its tendency to slip down has become an increasing annoyance in these past days.</p>
<p>I am now nearly fully mobile and able to raise my arms above my head; a small yet significant feat, considering some days past the farthest they could reach was horizontal with my shoulders. There is still a measure of pain down the side of my chest, from the underarm to the bottom of my ribs; particularly when the binder has slipped, as both the incision and the graft become partially exposed and are almost too sensitive to touch. A good deal of feeling has returned to the exterior of the areolar graft site, although directly along its incision is still devoid of sensation.</p>
<p>With the minimal bandaging I have, somewhat guiltily, found it quite easy to pull at the front to allow peeking. The nipples are hidden behind gauze and tape covers the incision lines, but I can clearly see the obvious flatness. Despite this and the fleeting glance on Friday, I am slightly nervous to see the end result this afternoon.</p>
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		<title>Top surgery, part 3</title>
		<link>http://geekbynature.wordpress.com/2009/06/27/top-surgery-part-3/</link>
		<comments>http://geekbynature.wordpress.com/2009/06/27/top-surgery-part-3/#comments</comments>
		<pubDate>Sat, 27 Jun 2009 00:27:10 +0000</pubDate>
		<dc:creator>geekbynature</dc:creator>
				<category><![CDATA[Topsurgery]]></category>

		<guid isPermaLink="false">http://geekbynature.wordpress.com/?p=346</guid>
		<description><![CDATA[6:00pm, day 4 post-op. Yesterday morning I had my first post-operative appointment with Dr. Brownstein. I had been hesitant about the removal of the drains and had considered requesting that they remain until Monday, as at the event of their last cleaning there was a significant amount of fluid yet. While in the waiting room [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=geekbynature.wordpress.com&amp;blog=1751204&amp;post=346&amp;subd=geekbynature&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>6:00pm, day 4 post-op.</p>
<p>Yesterday morning I had my first post-operative appointment with Dr. Brownstein. I had been hesitant about the removal of the drains and had considered requesting that they remain until Monday, as at the event of their last cleaning there was a significant amount of fluid yet.</p>
<p>While in the waiting room during surgery, my mother had made friends with the mother of another young transman &#8212; incidentally whose surgery was scheduled immediately following my own. The similarity was discovered after Dr. Brownstein came to give them both updates while her son was being prepped, shortly after my release to recovery. This was a fortunate occurrence indeed; as we realized after meeting that not only are we exceedingly alike in history, perception and surgical experience, but also that they are in possession of a car and are vaguely familiar with the bay area. It so happened that his post-op appointments were scheduled directly after mine, lending the opportunity for us to carpool to Dr. Brownstein&#8217;s office for this first.</p>
<p>&#8220;Oh, you&#8217;re awake,&#8221; he said, somewhat amusedly, at the sight of me.</p>
<p>I was taken in first and instructed to lie back on the exam table. After some minor struggle unwrapping the binder, the at least inch-wide padding was removed from the right side. As he began clipping the sutures around the drains, he prepared me for the imminent yet minor pain to follow as he would detach the tubes. The right side having been the most localized pain throughout the past days, I was not entirely prepared at the moment in which he decided to pull it; although it was not altogether too painful, and ceased nearly immediately. The left side was barely felt at all; though the acutely unique sensation of a tube being pulled through a small hole cannot possibly be analogized or explained.</p>
<p>Following the removal of the drains, he also cut off the thick pads of gauze surrounding the areolar grafts. I don&#8217;t recall noticing any sensation at all during this; although, as we both discovered later, it may have been due to the fact that the surgical site is almost completely numb to the touch; which I had both failed to notice and anticipate.</p>
<p>&#8220;Do you want to see?&#8221; he asked, brandishing a small mirror in my vicinity.</p>
<p>Unsure of what potential horrors I would encounter from a head-on view, I waved away the mirror and glanced downwards across my torso: the thin, pink outline of the incision wound its way in a flattened semicircle just below my armpits, to meet at the center of the sternum. The areolae were half their original size, flattened and symmetrically grafted; although they were extremely bruised and for this hardly recognizable. The tissue was slightly dented where the nipple gauze had been squashed against it, though it will recover in some days. Most obviously, the area was <em>entirely flat.</em> I could see a few fading purple marks where the incision was made; the rest of them lost on tissue no longer in existence.</p>
<p>&#8220;Holy shit,&#8221; I said.</p>
<p>Small, flat rectangular gauze pads were taped over my nipples, and two larger pads to cover the chest before reapplication of the binder. Sans drains, I was surprised to find that there was no longer almost any pain at all, even raising my arms horizontally to put on my shirt. Standing was easier as well; as the original bandaging had rendered a straight posture quite impossible, forcing me to lurch around in the appearance of classic teenage grumpiness, despite my mood being rather elated these past days. Without the extra padding, however, the binder does tend to slip down; a slight yet manageable annoyance. On occasion, there occurs the feeling of muscle tremors mostly localized around the grafts. With any luck, this may signify the slow return of sensation to the area.</p>
<p>Though the view was short and foreshadowed, I am confident that I will be happy with the results. The sutures will be removed come Tuesday, and Wednesday morning we board the train home. Having left a full week ago on the previous Saturday, the restlessness of hotels, restaurants and taxicabs has begun to set in; unfortunate given that we have six more days until departure.</p>
<p>In the meantime, I have found that the binder makes a very suitable place to tuck one&#8217;s napkin.</p>
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		<title>Top surgery, part 2</title>
		<link>http://geekbynature.wordpress.com/2009/06/24/top-surgery-part-2/</link>
		<comments>http://geekbynature.wordpress.com/2009/06/24/top-surgery-part-2/#comments</comments>
		<pubDate>Wed, 24 Jun 2009 21:38:58 +0000</pubDate>
		<dc:creator>geekbynature</dc:creator>
				<category><![CDATA[Entries with photos]]></category>
		<category><![CDATA[Injections]]></category>
		<category><![CDATA[Topsurgery]]></category>

		<guid isPermaLink="false">http://geekbynature.wordpress.com/?p=336</guid>
		<description><![CDATA[3:40pm, one day post-op Not being allowed to eat anything prior to surgery, I woke up and remained hungry the entire morning as we prepared to leave. I took my last shower for the next week, as the bandages are not supposed to get wet at all. The hospital owns the hotel we&#8217;re staying in, [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=geekbynature.wordpress.com&amp;blog=1751204&amp;post=336&amp;subd=geekbynature&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>3:40pm, one day post-op</p>
<p>Not being allowed to eat anything prior to surgery, I woke up and remained hungry the entire morning as we prepared to leave. I took my last shower for the next week, as the bandages are not supposed to get wet at all.</p>
<p>The hospital owns the hotel we&#8217;re staying in, and for their patients&#8217; convenience a shuttle between the two hospital campuses and the hotel is provided; however, the first shuttle departed at 6:15, so we had to arrange for a personal shuttle arriving at 5:30 to allow us to reach the hospital by 6.</p>
<p>Once there, we were greeted by a friendly man named Billy who charged my debit card for the anesthesia, had us sign various paperwork and led us into a small pre-op patient room where I could change into the hospital gown; which I was pleased to find closed entirely at the back and hung below my knees &#8212; nothing like the short, open-backed white gown worn during my brief stay at the psychiatric hospital. Also provided were rubber-bottomed socks and skin-tight elastic nylons which went up to mid-thigh to assist with blood circulation during the procedure.</p>
<p>It was not long before a nurse arrived to take my vitals, attach the ID band to my wrist and talk us through any concerns. Dr. Brownstein came in shortly afterwards to mark my chest with his famous purplish-blue marker. An IV was attached to my arm &#8212; not as bad as I had anticipated, though not altogether as easy as I may have hoped either. After a short waiting period, we were wheeled into the elevator and then to a public waiting room, where the anesthesiologist went down the beds one by one. The reality began to sink in at about this time, and as I was the last in the line, I had plenty of time to begin freaking out. Several tears were shed between the two of us; and after about 5 minutes, the anesthesiologist reached my bedside, where he asked if I was ready.</p>
<p>By this time it had been roughly an hour. Mom was allowed to accompany me until the door leading into the OR, but no farther. Upon our arrival I vaguely recall being transferred onto the surgical table, but I cannot be completely sure. I do recall noticing the world seeming to take several seconds to register after my eyes moved.</p>
<p>&#8220;Woah,&#8221; I said. &#8220;Is that the anesthesia working already?&#8221;</p>
<p>&#8220;Yep,&#8221; someone answered.</p>
<p>&#8220;Oh,&#8221; I said; and, promptly afterwards, conked out.</p>
<p style="text-align:center;">~~~~~~~~~~~~~~~~~~~~~~~~~</p>
<p>I had anticipated having some notion of, &#8220;so when are we starting?&#8221; after waking up; although immediately upon waking I could remember having a number of dreams, and was aware that some time had passed. I couldn&#8217;t feel a thing; nor could I keep my eyes open in the slightest. I recall being wheeled back into the pre-op room, where Mom was waiting.</p>
<p>&#8220;Sup,&#8221; she said.</p>
<p>&#8220;Sup, yo,&#8221; said I, and fell asleep.</p>
<p>I was feeling unnaturally groggy and kept fading in and out as the effects of the anesthesia waned; when I had regained no consciousness around 3:00pm, nearly five hours later, we began to worry slightly. Most patients seem to leave around 4 or 5 hours following the procedure, however, so we waited. A generous dose of morphine as well as antibiotics were injected through my IV.</p>
<p>I went to the bathroom several times with Kate, my nurse&#8217;s, help; completely draining all energy once returning to the bed. It was determined during this time that my nurse call button was broken; which was discovered after I had repeatedly pressed it to no avail upon feeling nauseous. By 6:00, I was feeling even more tired than I had ever been, and found it physically impossible to hold my eyes open for more than 5-second time periods. This was beginning to be a problem as the daytime ward closed at 8, and if anything I was showing decreasing signs of ever waking up.</p>
<p>After talking to several nurses, on their recommendation I was brought ice chips and a few Saltine crackers; which, though their taste was tolerable, were exceedingly difficult to eat on a dry mouth. I managed to ingest two full crackers and half the cup of ice chips, yet still with no possible chance of regaining coherency. Concern turning into slight panic, I began to feel truly doubtful that I would ever wake up at all; particularly as I had not yet actually fallen asleep; simply, I <em>could not</em> open my eyes. Reluctantly, particularly given the extra $425 fee for overnight stay, it was determined that the cab ride home would likely kill me in such a state and arrangements were made for my boarding overnight; it would seem that I am among the 1% population with such adverse effects from the anesthesia that would require such a hold.</p>
<p>I was wheeled to a lower floor, situated in a small private room and switched to another bed. My nurse, Fabio, a small but very friendly Latino man, took it upon himself to make the room as comfortable as possible, ensure that his call button was functioning properly, and even locating a plush reclining armchair for my mother to stay the night in beside my bed. With the IV feeding me saline at a constant rate, the night was restless as I had to go to the bathroom every hour or, later, every half-hour. This required unhooking the IV, removing the finger-clipping heart monitor and several other medically attached devices; after the second time, a portable toilet chair was set beside the bed so that I could simply roll over to it and take the IV with me.</p>
<p>Dr. Brownstein had another surgery scheduled this morning shortly after 6:00, and he arrived to take a look at the site around the same time. He assured us that my vitals were stable throughout the entire procedure and that there were no complications whatsoever. He was unconcerned at my yet persisting inability to wake up; some people, apparently, simply do not take well to the sedatives. He did however insist that I get up, walk around and above all, eat; being Wednesday morning I had eaten nothing since 8pm on Monday. I managed to ingest a small container of jell-o and a few more ice chips, and my mother and I took a short jaunt around the hospital corridor. Feeling slightly more functioning, I was able to dress myself and even remove the elastic stockings. I was loaded onto a wheelchair and taken down to the lobby to await the shuttle.</p>
<p>The shuttle back to the hotel was a bumpy and uneven ride, and though I had not yet felt any nausea, when we stopped I felt sure that I would throw up. Our hotel room had been changed overnight, as we had found the original room a bit too small and had been annoyed with its various idiosyncrasies, including being <em>as far as physically possible </em>from the elevator. Our new room is closer, much larger, and includes amenities such as a a desk and two small armchairs. I did my shot after we got back and was surprised that I could hardly feel the needle going in; no doubt to the morphine not yet having worn off.</p>
<p>By mid-afternoon, I am now quite high-functioning and have been able to eat two bowls of cereal, half a yoghurt and half a container of Cupnoodles. Dr. Brownstein wrote me a prescription for Vicodin, although I have not had to take even one yet. There is definitely an all-around pressure surrounding the incision site, particularly as the binder is wound very tight around the dressings; but there is really not much pain at all short of if I attempt to raise my arms or sit up completely straight. The only real pain that I can pinpoint is the drains at the place where they are stitched into my skin. They require flushing every 6 hours, and though at first they were almost entirely filled with blood, I can tell that the emissions are becoming more fluid.</p>
<p><a href="http://geekbynature.files.wordpress.com/2009/06/drains.jpg"><img class="alignnone size-full wp-image-338" title="drains" src="http://geekbynature.files.wordpress.com/2009/06/drains.jpg?w=464&#038;h=411" alt="drains" width="464" height="411" /></a></p>
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			<media:title type="html">Jace</media:title>
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			<media:title type="html">drains</media:title>
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