I learned last week that I am now on the waiting list for a psychiatric assessment for hysterectomy coverage. I will need to travel to either Victoria or Vancouver, BC for the appointment with Drs Knudson and Robinow, which will likely take place in January or February. In the meantime, I need to obtain reference letters from one client and an organization that I volunteer with to to verify my Real Life Experience (RLE). (The letter I previously obtained from Dr. Preece was enough to get on the waiting list but does not satisfy MSP’s requirements completely.)

I had a HUGE day yesterday of appointments yesterday, including a consultation with Dr. Matthew Bagdan, the OB/GYN who can perform my hysterectomy. He did a PAP test and pelvic exam (and I think his touch was perhaps even better than my much-loved physician’s, who is renowned for her excellent care) and based on his findings, he has recommended that I undergo a laparoscopically assisted vaginal hysterectomy, as opposed to a total laparoscopic hysterectomy. Apparently, my uterus is tiny, facilitating this approach. He has plenty of experience with laparoscopically assisted vaginal hysterectomies, and the complication rate is a little less than total lap. I saw some photos of this procedure online and had to go lay down after viewing them (holy!) but have reminded myself that I won’t be the one who has to watch this procedure—I will be in la-la land!

Here are some excerpts from our Q&A:

Once funding is in place, how long until I could have surgery?
About 6 weeks.

Should I stop testosterone pre-operatively?
Yes. Have a final shot two weeks before surgery, then resume two weeks post-op, meaning one missed shot. If I’m having menopause-like symptoms post-op, then resume with a half dose one week post-op.

The hospital where the procedure will be done is Catholic. How trans-friendly are they? Will I be placed on a maternity ward or a general ward?
Two of the OB/GYN’s who operate at the hospital are openly gay, and aside from not allowing abortions to be performed here, the hospital is quite liberal. (Dr. Bagdan has performed this surgery on transmen before, though I wasn’t clear if he’s done it at this hospital or while he practiced in Vancouver.) Dr. Bagdan will consult with all of the nurses who will be involved with my care to inform them of appropriate pronouns and related trans issues. I am listed as male with MSP and my documentation will reflect this (barring any accidental errors.) I will probably not get a private room, but will be placed in a general ward, not a maternity ward. (My main concern there is that I wouldn’t want to make women feel uncomfortable.)

How long will I need to stay at the hospital?
If there are no complications, overnight. If my surgery is done early in the day and I’m able to get up and urinate later that day, then the catheter could be removed and I could actually go home that evening! It will most likely be an overnight though.

What are typical complications with this procedure?
Bladder infection rate is about 10%. Vaginal infection rate is about 2-5%. Bowel complications are very rare in his experience.

How long until I can return to full time work?
4-6 weeks. The biggest obtacle will be that I will be tired for some time after the surgery, though probably less than an average woman having the surgery because despite the lack of estrogen being produced I will have testosterone in my system.

How long until I can return to my regular exercise and workouts?
Get back to my 5km daily hike as soon as I feel able to. Hold off on the weight lifting and workout routine for 6-8 weeks. (This is a month less than what my physician suggested.)

WIll I have any post-operative prescriptions?
Something for pain: T3, demerol or percocet. Get off them as soon as I’m able, switching to just Tylenol. An anit-biotic would only be prescribed if I have a post-op infection.

Will I need any tapered estrogen to offset menopausal-like symptoms?
No, testosterone will take care of this.

Who will advise about adjustments to my testosterone dose post-operatively?
My endocrinologist.

Side note: Dr. Bagdan mentioned that I have a heart murmur. I’ve never had a doctor tell me this before, so I don’t know if it’s something that was just missed, not mentioned, or if it’s recently developed.

Other appointments on my docket for the day included a meeting with my insurance advisor and financial and mortgage advisor. I have outgrown my life insurance policies want to re-work those, and I also wanted to find out if there was anything in my existing policy or a new policy that would help me pay for my time off when healing up from a hysterectomy. (I am self-employed, so there’s no such thing as medical leave or vacation pay.) The answer was no: nothing in my existing policy, and because I know of the surgery beforehand, any insurer would simply turn me down for coverage and recommend that I re-apply for a new policy post-op. Oh well, it was worth a shot.

My F&M advisor offered me a massive line of credit to do “whatever” I want with! Immediately, my mind started spinning about being able to pay for lower surgery with some of this, but I very quickly declined it. I hate the idea of too much credit and debt. My mortgage is enough, thanks! It’s important to me personally to earn my stripes for lower surgery, and working hard/smart and saving is more my style. (Check back with me in a year or two and see if I’m any more desperate!)

On that note, back to work and saving pennies!

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