Work Notes 

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Dear Reader,

I wanted to beam in today to talk about top surgery. How it went, what I learned, what I survived. What me and Katy learned about caretaking and being cared for.

In some ways it all played out like an episode of The Pitt, except Noah Wyle being hot and in charge wasn’t there. Nothing went as expected and yet the gender euphoria manages to sneak through.

It ends with cutting all my hair off to look like Ilya from Heated Rivalry. Here we go!

The journey to top surgery begins with not being able to drink or eat anything the morning of, my surgery being at 11am. This was the hardest around coffee because I do enjoy my morning cup. Otherwise I felt ok, nervous, and more than ready to go. Little did I know, not being able to have a cup of coffee would be the least of my worries.

My phone was flooded with friends lighting candles, sending well wishes, and checking in. I arrived at the surgery center feeling loved and ready.

We had about an hour wait in the waiting room. I tried to distract myself with a little Animal Crossing and reading The Trauma of Money but all I could really think about was the strange reality of going under anesthesia.

Finally it was our turn. Me and Katy got called back into Dr. Wolf’s office and sat in his flamboyant chairs and waited for him to come in.

We went over the surgery in which he assured me my old scars would be removed and my new scars would be at the bottom and I would have no nipples. This is what we had also agreed to over our email consultation.

Katy took my backpack and I went in the other room to get marked up. I felt a little lump in the back of my throat and teary eyed to say goodbye.

Dr. Wolf met me in the room and we ONCE AGAIN went over exact scar placement. He never once gave me any indication that there would be complications considering my last surgery scars. He even tested the density of my breasts and exclaimed YEP looks good and confidently measured me for my compression vest and left the room for me to meet with Steve, the anesthesiologist, who was the only person I heard get my pronouns right.

Steve seemed nervous around my jokes about getting a freebie with the valium they give you before you go under and he assured me I could tell my sponsor he was in complete control of administering the medication. I assured Steve I was just kidding and it was ok. He nervously laughed.

I walked back to the operating room and it was surreal. Unlike the last time I had surgery where I was wheeled in, or don’t even remember getting wheeled in, I literally just hopped right on up to the surgical table and laid down.

It took sweet Steve not one, not two, but three times to find a vein for the medicine to flow through me. I have a gnarly bruise on my wrist still from a vein “blowing” which I did not ever want to hear someone say and I apologize I even typed it.

Once Steve found the third vein everything was in, the dreamy meds were going through me, and the next thing I knew I was waking up asking for Katy and to have someone tell her I made it (I’m gay and sappy what can I say!).

The speed in which they get you out of the surgical center is astounding. I didn’t even get a juice box! Katy was already around the corner with the truck out back waiting for me and they wheeled me out, helped me in, and off we went. A quick stop at Whole Foods for the juice boxes I craved, applesauce, and crackers, and back to the Rutt residence we went.

At first I just felt out of it and wanted to watch Empire Records. Shortly after the movie ended I got very nauseous and began the many hour journey of throwing up everything in my body. I was still coming out of anesthesia so this is all very blurry to me. Katy called her mom who is a nurse who suggested we go to the ER, and while my head is in a bag next to the bed I yell I DON’T NEED THE ER. I was sure it would just pass.

At some point it became clear to me it wasn’t passing and Ellen chimed in that we should go. So off we went to the ER. It seemed I had had a horrible reaction to the anesthesia, and I remembered for my last surgery I was given a special drug to take and patch to wear BEFORE surgery that prevented this. If you are having top surgery : GET THESE THINGS. I cannot express how uncomfortable it is to throw up with fresh incisions and drains coming out of you.

We arrive at the ER and after a handful of foils me and Katy are wheeled to the hallway to wait for a room. This is when Katy describes her personal hell, when I joined the symphony of moaners in the emergency room hallway. Every breath I took ended with me moaning in excruciating pain having not been able to keep down any pain medicine and being incredibly nauseous still. Everyone else in the hallway hitting a different note, not a one of us in tune with the others.

Eventually we got to a room where my head lived in the iconic pink throw up bucket and Katy held my hand. The doctor came by and wanted to check my incisions but I told her I couldn’t take the vest off. At the same time I noticed blood pooling around the bottom of my vest and this scared me until I realized it was from my drains not my incisions. She peaked a little and felt fine about it and ordered me pain meds, anti nausea meds, and fluids.

Once I got those it was like a small miracle. It was almost instant that I felt like myself. Still sick and feeling weird but no longer in crisis. After my fluids were done it took a long time to find someone to discharge us but once we did and were on our way home we both felt a huge sense of relief.

UNTIL! The following two days I couldn’t take any pain meds stronger than Tylenol because they were making me nauseous AND I had one of the worst migraines of my life. So for two days I tried my best to just sleep. I had taken some anti nausea pills the night of the ER but had just thrown them all up. It was on day three that I vaguely remembered the doctor giving me a different anti nausea med script with my discharge papers that I had forgotten to inform Katy about. This changed the game. Once I was able to take the Percocet with the new nausea meds I started to be on the mend.

A note about caretaking : I really watched Katy feel like she couldn’t help me and how scary that was. That her job as caretaker was to make me feel better and instead just felt a level of helplessness. I want to remind all caretakers of top surgery (or any major medical procedure!) — this is a hard job. The person you love might be in a ton of pain. Your job is not to make the pain go away, but to just stay with them through it. On my end I felt like Katy was an absolute all star dealing with me.

On around day four I decided to peak down my compression vest to see what I could find. Looking for a glimmer of a flat chest, what I found instead was an incision that was incredibly high up. I looked at Katy whose face suddenly dropped.

She explained to me that when I was out of surgery Dr. Wolf came to speak to her and told her that because of my past surgery and where the nipple line was he could not do what he had committed to. My old scars were still there at the bottom and a line up to the top where my nipple was, and then the new incisions across the top. So basically my scars were now in the shape of a giant letter I.

I felt totally devastated. Not again. Not again for a surgery to not go as planned, to not be what I paid for, to not be what I was promised. I tried to let it go so I could keep resting and healing, but I felt so nervous to see what had been done.

At my post op appt on Saturday Dr. Wolf took off the vest and showed Katy how to change the dressings. I asked about my incisions and in the most nonchalant way he explained how they had to change course. I was in such a vulnerable position I didn’t really have much else to say. Katy snapped a quick pic and I couldn’t see much other than the most foundational thing : I had a flat chest. And that was amazing.

We began the four hour drive home and settled in. The next day we went to change the dressings and I saw my full chest for the first time. Bruised and swollen it looked strange, but I was used to this from before. It takes many months to fully settle into its new form.

The scars are … Unique! I’ll say that. I have never seen anyone else with this scar shape. I think once it all finds the right shape it will end up looking cool. Like a genderless alien. My therapist encouraged me to just keep healing and when it’s time I could write Dr. Wolf an email about how disappointing and jarring it was to wake up with totally different results than were promised.

Speaking of genderless alien, I got an amazing haircut from Grace Guba in Traverse City who cut my hair to look like Julia Roberts as Tinkerbell in Hook meets Ilya from Heated Rivalry. I took a pic of myself shirtless with the new haircut and was like WHOA! This is the gender I’ve been dreaming of!

Ok if you got this far wow good work your attention is intact! I hope if you are getting top surgery it helps to know one route things could go. Every reddit thread I looked at people were just like YEP IT WENT GREAT. And I was not prepared for the twists and turns.

And if you are a caretaker - be gentle with yourself. You’re doing great! Even if they forget to tell you because they are hopped up on pain meds and moaning in the chorus of discomfort, they love you and are so glad you’re there I promise.

My drains remain sticking out of my sides doing their thing into the gauze in my compression vest and come out Sunday in which I will throw a party for them. Thank you drains for keeping me healing and safe and I hope I never ever see or feel you again! Then it’s back to work!

I really tried to only take one full week off of work but after the events written about above and the discomfort of my drains it was clear that in order to facilitate a zoom room I’d need another week of healing. (Thanks to all of you for being patient!)

And if you work in an Emergency Room, specifically at Henry Ford Hospital in Detroit, MI — you are a saint and I am so grateful for you and the care you provide.

Thank you for reading today. Many Blessings.

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