Hey folks. It’s been about three weeks (will be three weeks, tomorrow) since I underwent my double-incision mastectomy. I have been jotting down reflections, anecdotes and facts I thought would be worth sharing with you all about what the surgery and recovery process has been like for me so far. I am continually floating in a deep sea of gratitude for all of the love and support I continue to receive from you, my community, my family and my workplace. Thank you, thank you and thank you.
I’ll start with my initial impression of things three days out, then we’ll fast-forward to the three week mark.
Still pale and feeling a little dizzy sometimes, I finally feel clear headed enough to write. Perhaps all the water and laxative tea I’ve been drinking is finally starting to pay off. The anesthesia is slowly filtering out of my body, a body whose sole focus the last three days has been to clear out and close up these new, traumatic, beautiful chest wounds. And they are beautiful, down to the green and yellow bruises that have settled under my right pectoral muscle and the bloody pulp of a nipple bubbling proudly out of the left.
The night before surgery, my mom, aunt, partner, niece and I all went out for dinner. Since I was having surgery, it was suggested that I be allowed, like a death row prisoner, to choose my last meal. I decided on a local barbecue joint in hopes of pleasing both my craving for meat and my family’s appetite for southern cuisine. Awkward conversation ensued during the meal, but since my niece works as a hostess there, we got a huge discount on the bill. After dinner we returned to the apartment, finished packing, and headed for San Antonio to check into the hotel before surgery.
I decided I wanted Wednesday morning to be holy, even though it was going to be a busy day–or maybe because I knew it was going to be a busy day–so I woke up early and went to a local coffee shop to use their internet to set up a meal train for myself and a coworker of mine who is also recovering from surgery, as well as have a moment away from the house and all of my errands so I could clear my head. I walk in and order a decaf americano (I had been decreasing my caffeine intake the last week or two in hopes of eliminating the need for caffeine as a stimulant laxative after surgery). The barista regretfully informs me that the decaf espresso did not get delivered the previous day, but that any other coffee I want is on the house. Excellent. I sit down with a cup of cold brew and begin setting up the Facebook event and meal train, downloading Instagram to my phone for all the post-op selfies and, for the first time in about a month, relaxing. This was what I had desired for so long; a moment to just release, to let go, to write, and to relax.
A quick jog and some light stretching was the final pre-op workout I had decided upon. I can remember from band competition and track meets that we never rehearsed or practiced too hard the day before we were to perform. It is best to rest the body some, to refresh the memory with some simple motions, but nothing more. There is nothing more to gain the moment before one goes on stage: the music is either in you or it’s not.
I think I don’t fully realize what I’ve done. When I look at my chest in the mirror, I still think I’m wearing a binder. I’m still waiting to go on stage, but the concert is over. Performances have always been a rush for me, a whirlwind of light and sound. I’m so infused with my instrument, the sway of the conductor, the energy of my band-mates, that it’s all over before it begins.
“Goodnight” the anesthesiologist said to me with a smile.
“Goodnight everyone” I replied, grinning under the breathing mask.
“Good morning, Seamus, how’re you feeling?” The nurse sits next to me as I lift my head to turn and look at her. It bobbles like an infant’s head, quivering with curiosity and desire and complete lack of control.
“Good morning” some hoarse blues singer replies from my mouth. I squint across my recovery cubby to the clock: 9:30AM, I think. Everything is blurry and white and I am naked and bandaged under this gown. I arrived at the surgery suite at 6:00AM and probably went under around 6:30AM. Out and back, just like that.
I felt really hungry the rest of the day. I was prescribed phenegren for post-op nausea, but I have yet to use it. I was eating Thai food later Thursday afternoon and have continued eating a combination of solid food and soup/broth. I felt nauseated this morning, but I believe it was due to taking my antibiotics on an empty stomach, a wretched sinus headache, or the agitation of both by a car ride to the doughnut shop (doughnut/kolache shops, while common in Texas, do not occur in North Carolina, so my partner and I decided to treat my family to such delicacies). I have kept a very slight headache since last night, but I refuse to treat it with pain medication. I am drinking plenty of water and tea, so I consider it to be a natural part of the post-op detoxification. I’m keeping a close eye on my blood glucose levels (which were almost uncontrollable on Thursday post-op) and they are staying quite steady and within normal range, for the most part. I am finding that I have to consciously relax my body. I find my jaw clenched and my chest tight. I don’t know what I’m worrying about so hard. Everything looks great and I am, now three days post-op, feeling better and better. I really need to let myself off the hook. I feel upset about my heart rate being higher than normal and for my body to feel less than completely strong and sturdy. I did just put myself under physical trauma, and it is only natural for my body to be working a little harder than usual, as it is healing.
I love my mother and my aunt dearly. They were such an incredible presence and support. I did not expect such loving acceptance from both of them, but they showed up in a gracious, nurturing way. Mom spent the weekend correcting herself with my name and pronouns. We spent most of the weekend laughing through such blunders, which helped us both be kind to ourselves and each other. My aunt hardly missed a beat. This was the first time my aunt and I had spent quality time together since I was a toddler, and as I paid attention to her, I found myself in awe of her wisdom. She reminds me of an old sage, full of childlike energy and simplicity and engaging every situation presently, matter-of-factly and unattached. The four of us—mom, aunt, partner and self— sat around and talked about everything from travel to economics to religion, and then the conversation inevitably flowed into stories about family.
“Oh, I know a funny story about you I’ve just got to tell” my aunt said with an endearing smirk.
I learned that as a toddler I was terrified of Jell-O, and would not as much as touch it. My aunt would place it on the table of my highchair, and I would respond with blood-curdling screams. I apparently also stood on my aunt’s coffee table and played air guitar concerts along with whatever happened to be on.
“Your facial expressions and emotions, they were spot on with the music. It looked like you were really singing/playing” she recalled.
The funniest bit, though, was when she mentioned that, whenever “Whipping Post” by the Allman Brothers would come on I, in nothing but my diaper, would hug the speaker and swing my hips in a circle.
“It just moved you, baby” my aunt told me.
I found a live recording on YouTube later that day and listened to it. I felt the tug of the Spirit tide sweeping me away into that place I thought I could only find in church, and have only recently rediscovered in certain Stevie Wonder songs. Something about music has moved me from the beginning. What I can’t figure out is, where does it go? Why does it hide or, why do I hide, this connection? Is it the fear of not being unique enough (I mean, come on, everyone in this town is a musician or into music)? No, it’s the fear of being consumed, and being useless for anything else. Would that be so bad? Would a love that consumes really bring about uselessness? No, but it would bring about terrifying wonders and mysteries of the Soul that could only be explained in another dimension; in other words, there’s the possibility that I would return to sanity of another kind.
Now I just sit and wait.
“Okay, now the easy part” Dr. Lawton said to me just before surgery. He was right. I can’t believe I have had my breasts removed. It seems surreal–unreal, really. I have worn a bra or a binder for the last seventeen years of my life (since I was ten years old), and now I am to believe, after recovering from surgery, that I can just “throw on a sweater and go”? But right now I just wait. I just sit here, milking drains and changing bandages, and wait.
Welcome, cocoon. Welcome, new life molded from the murky waters of Spirit. Welcome rest, incubation, dreaming (oh, have I been dreaming) and restoration. I love you, Seamus, and I love you, Melissa. We are love.
08.13.2104: Three Weeks Out
Fast forward almost three weeks. I got my drains out two weeks ago. They were JP Drains which, if you have never had drains in, let me just go ahead and tell you that this was the most painful drain removal I have experienced. To be fair, the drains they removed from my back after my scoliosis surgery did not cause me any pain, so I may also have an unfair means of comparison. JP Drains are constructed with a long, flat paddle-like structure on one end (which goes inside the body) and bulbs on the other (for collecting fluid). This “paddle” is outfitted with two rows of small holes. For me, this paddle ran the entire length of my pectoral area on each side and, when this was pulled through the soft tissue of my chest and out the side of my body, produced quite the sting. Thankfully the nurse was very skilled and pulled as quickly as possible. The holes from the drains closed up and scabbed over in about three days, and itched.
I also had some stitches removed from the ends of my incisions (the rest of the sutures cannot be seen and must be under the skin) after one week, as well as had the steri-strips that covered the incisions removed. I was instructed to continue bandaging my nipples and applying silver sulfadiazine cream to them twice a day. This silver cream is typically used for severe burns, because silver is both a powerful antibiotic and promotes local stem cell generation, causing tissue to repair/rebuild at a faster rate. These qualities also make it a great choice for nipple grafts. I was told I would probably be applying the cream to the nipples until the four week mark; however, when I went back for my two week follow up appointment to get the stitches removed from my nipple grafts, I was told I could discontinue the cream. Things are looking really healthy and I am very pleased.
I am still bandaging them for work, mainly because the skin around them is so sensitive and it hurts for my shirt to touch it. I do not have any sensation in my actual nipples, but both have blood supply and the tissue immediately surrounding them is almost hypersensitive. I am very pleased with the progression of things so far. What’s more, my chest is now completely free! I can walk around the house without any bandaging. I will start compression at four weeks, which will mean more binder-wearing, but for now I am free to strut in all my shirtless glory.
Body image issues. Leave it to your Personal Critic to beat up on you for being swollen and retaining fluid after surgery. For those planning on having top surgery (or any surgery), please be sure to remind your PC, when it starts railing on you for retaining fluid, that this is a normal side-effect of surgery and anesthesia and that it can take its little insult dagger somewhere else, like up its ass, the river, or a shallow grave. My clothes are fitting differently, meaning, they’re touching me (Oh no! Did you just have body parts removed?) and I’m feeling flabby. I came prepared for this, and it is still difficult to handle sometimes. Life is a crash course is learning how to love yourself.
I must address, and emphasize, that my recovery process has been tiring and difficult, even though it has also felt exciting and has been marked by triumph and healing. I am someone who hits up the gym five days a week, who runs and squats and loves to be active. I have reveled in every added pull up I have performed since starting testosterone, and having to consciously tell myself that I cannot so much as lift a gallon of water or get my heart rate up AT ALL (no cardio!) is starting to wear on me. So is the no sex decree. I am three weeks out, and half-way through my preliminary recovery period. The doctor said that we would discuss me returning to cardiovascular activity at my four week appointment, but I am refusing to get my hopes up.
The thought of “doing nothing” for a while sounded great: it is more difficult than it seems. I guess if I liked to watch television (I don’t own one) or play video games (I don’t), it might be easier. I have watched movies ad nauseum, and don’t feel like reading because I feel so restless. Setting up the meal train was quite a relief, and allowed my partner to take a break from ceaselessly cooking, cleaning and helping me do everything (a huge thank you to everyone who came by) and helped me feel more human and less like the walls I was staring at all day. After the first week, I tried taking some walks, but the Texas heat is unrelenting on this North Carolina native, and I cannot comfortably be outside for long. Being able to return to work, however limited my duties, does help some, although having to consciously not assist my coworkers is also a struggle.
Okay, now the easy part. Dr. Lawton wasn’t kidding.
I’m going to add this contact form to my site’s homepage, but I thought I would go ahead and add it here, too. If you or anyone you know wants to talk with someone about top surgery, transition or anything related to gender identity and gender process, send them a link to this post and contact me via the form below: