Wednesday June 19, 2013 Day of Surgery
I am a horrible patient. Controlling. Obsessed. Spoiled. Negative. Critical. I can go on. Inconsiderate, vain, selfish.
Strange. I draw the line at lying. I try to be honest. Others, that know me, would respond to that by saying I am also in denial (just about the lying part, on the other attributes, she would say, I am perfectly truthful. (I guess I need to add “sarcastic” to my list.)
I write all that to put into perspective my ironic comments regarding the Clínica Adventista Belgranoyou. Understand from where they come. Consider the source. Also, when I write that Dr. Di Maggio does the best forehead bone work in the world, I hope it carries some weight.
Strange. I draw the line at lying. I try to be honest. Others, that know me, would respond to that by saying I am also in denial (just about the lying part, on the other attributes, she would say, I am perfectly truthful. (I guess I need to add “sarcastic” to my list.)
I write all that to put into perspective my ironic comments regarding the Clínica Adventista Belgranoyou. Understand from where they come. Consider the source. Also, when I write that Dr. Di Maggio does the best forehead bone work in the world, I hope it carries some weight.

The surgery was finished at about 2 PM and lasted about 4 hours and 20 minutes. Apparently, it should have lasted about 3 ½ to 4 hours. However, I had an allergic reaction to my intravenous antibiotic. The effect of this was, I am
told, that I began vomiting while I was still unconscious. Dr. Di Maggio seems confident my vomiting was not related to the anesthesia. In recovery I was extremely nauseous. I vomited a few times in a recovery area adjacent to
the operating room. And then I vomited more when I returned to my personal room, number 317.
I hate being nauseous. When I started throwing up, I immediately felt good – The moments during which I was vomiting was the only time I felt good. When I stopped, within two or three seconds, the nausea would return. And I would throw up again. And then someone would come running with a syringe full of anti-nausea medication and plunge it into my IV. That stopped me from spewing but didn't make me feel any better - it actually made me feel worse. It would make my lungs burn. And it didn't reduce my feeling of wanting to vomit it just seemed to stop me from retching.
Other feelings in the recovery area that were unexpected: my heels hurt. It felt like I had a vice grip attached to each heal, particularly the right one. Until I actually reached down to touch it, I had wondered if they had cut it open. Some sort of new HFS (heal feminizing surgery.) No, this heel pain was because I hadn't changed position while I was laying on the operating table for such an extended period of time. I can't imagine what it would be like to go through an 8 or 12 hour full multi-aspect facial surgery. The patients that go through that, wow, I think it would be easier to climb Mount Everest without oxygen… or Sherpa's.
This is one of the reasons Dr. DiMaggio likes to break his procedures up into two halves. He thinks 8 to 12 hours lying in one position on the operating table is simply too long. With me, the result of laying in one position on the operating table for about 270 minutes, was that even my toes hurt. This was from the blanket resting on the same spot on my toes. My back and right shoulder were also particularly uncomfortable.
told, that I began vomiting while I was still unconscious. Dr. Di Maggio seems confident my vomiting was not related to the anesthesia. In recovery I was extremely nauseous. I vomited a few times in a recovery area adjacent to
the operating room. And then I vomited more when I returned to my personal room, number 317.
I hate being nauseous. When I started throwing up, I immediately felt good – The moments during which I was vomiting was the only time I felt good. When I stopped, within two or three seconds, the nausea would return. And I would throw up again. And then someone would come running with a syringe full of anti-nausea medication and plunge it into my IV. That stopped me from spewing but didn't make me feel any better - it actually made me feel worse. It would make my lungs burn. And it didn't reduce my feeling of wanting to vomit it just seemed to stop me from retching.
Other feelings in the recovery area that were unexpected: my heels hurt. It felt like I had a vice grip attached to each heal, particularly the right one. Until I actually reached down to touch it, I had wondered if they had cut it open. Some sort of new HFS (heal feminizing surgery.) No, this heel pain was because I hadn't changed position while I was laying on the operating table for such an extended period of time. I can't imagine what it would be like to go through an 8 or 12 hour full multi-aspect facial surgery. The patients that go through that, wow, I think it would be easier to climb Mount Everest without oxygen… or Sherpa's.
This is one of the reasons Dr. DiMaggio likes to break his procedures up into two halves. He thinks 8 to 12 hours lying in one position on the operating table is simply too long. With me, the result of laying in one position on the operating table for about 270 minutes, was that even my toes hurt. This was from the blanket resting on the same spot on my toes. My back and right shoulder were also particularly uncomfortable.
The actual event of going under the anesthesia and waking up is, as I think most describe it, practically instantaneous. They didn't even tell me I was, "going to go to sleep". Suddenly, I was just out. Then I remember about 30 seconds of very pleasant feelings. Ethereal – I may have been dreaming a little bit. I remember a white haze and just floating. During this dreamy, comfortable, state apparently I was retching, my heels were being sliced open, my scalp peeled down and a hammer and chisel were being used on my forehead. Nevertheless, I felt such a sense of well-being. And then someone was grabbing my nose.
Gently, and very slowly, moving my head left and right, using my nose as handle, was one of the attending surgeons. He was saying, "Your forehead is very good, next we do this. Right? Next we do this?" He rubbed my nose a little bit more and moved my head back and forth.
I said, "Yes, yes… I feel queasy… Very queasy." I opened my eyes and I noted that I could see. Additionally, my eyes seemed to be able to focus. This was good news. It help push the queasiness into the back of my head for a fraction of a second. One of my irrational paranoia's was that during the operation someone would slip and pierce my eyeball with a scalpel, or a burring wheel or even a hammer. I didn't know what they were going to use on my orbital rim. So, it was with some relief that I did not wake up blind.
But the nausea keeps banging on my stomach and climbing my throat. To say it felt like severe food poisoning would be to downplay it. I felt like I had eaten a chicken salad sandwich, with mayonnaise, mercury and plutonium. A sandwich that had sat, marinating and melting, in a baggie, on dashboard of pickup truck, for two days, in the humid, July, Alabama, sun. "I'm queasy." I said, "Very queasy, very queasy, very queasy…" I kept repeating it over and over because I was so nauseous and someone needed to know. Someone needed to do something. I was trying to let them know I was going to puke. I thought they should know.
Nobody came rushing to help me, and I just started spewing. The blood that came out of my mouth, out of my stomach, was a coagulated blackish red color. It cast a remarkable pattern against the white sheets and bleached floor. It got attention.
So, it was wonderful, in the recovery room, to get the reassurance (even though I'm sure they say to everybody) that the forehead turned out great. I was happy that one of the attending surgeons was more focused on the size of my nose than any of my other problems. Really, it helped me feel more secure. It help me feel like the nausea wasn't as big a deal as it felt to me. And to know that my forehead was done! Even through all that discomfort sitting there on the operating table trying to keep from throwing up, knowing my forehead was done! That good feeling did come through. Dr. Di Maggio came over to talk to me. Told me my forehead was tougher than he expected but that the result was good. To which I responded, "I'm very queasy."
He told me he thought I had an allergic reaction to the antibiotic. He told me I would feel better in a few hours. What? Oh my gosh! I panicked, my thoughts raced, I'm going to feel like this for the next few hours? Did he say "hours"? He did not say, "Give it a few minutes." Not, "Oh, this is normal, you will feel better in just a bit." He did not say, what I most wanted to hear, "Oh, that old queasy feeling? Sorry, drink this it will fix you."
I was startled, "A few hours!"
He responded, "I need you to use your head, I need you to be tough, the surgery is done, we did our work, now you have some work to do. Don't throw up anymore. Use your head" He stopped short, thank goodness, of saying, "Don't die on me now."
As he talked, he slowly tapped, his finger, near my temple. His talk was a firm, fatherly, matter-of-fact, pep talk. Because, that's really all there was to be done. I had had an allergic reaction. I needed to ride it out. I needed to be tough. There was no choice. "I am very queasy." I said, "But, I will stay focused, I will do my best.” I stopped short from saying, “coach.” But I did ask, “May I have some water to sip?"
"No, you can't have water for a few hours. You will only throw it up."
And with that they asked me to move from one gurney to another. Which meant I had to actually use my arms. I did not want to use my arms. I did not want to use my legs or my back or anything. My heels hurt. And I didn't want anyone to touch me. I just wanted to keep hanging over the rail of my, currently assigned, gurney and wait for the waves of nausea to go away. Because that is what I was doing. Leaning on, clinging to, my bed rail like a shipwreck survivor, in the middle of the ocean, clings to hope. If I absolutely had to move, I wanted them all to lift me and move me over to that other gurney. But they wouldn't.
About three people were standing around me. Though, it could've been two people, it could've been four people, I wouldn't know the difference at this point. But, all those people, the small crowd, however many there were, they were all staring at me and they told me I had to move. So, I tried to move.
Astonishingly, I had some strength in my arms. I don't know where that strength came from but my arms worked. I was able to lift my butt up and slide it over to the other gurney. And then someone helped push my legs over.
And then they started to wheel me back to my room 317. Which meant an elevator ride – but this description has gotten too long. I'm sorry. Let me get to a
positive point – the results.
The aesthetic (that word is different than anesthetic) results are everything I had hoped they would be, and – amazingly - more than I had hoped. And the ridiculous part is that I had high expectations. I selected Dr. DiMaggio because my impression was that he was the best in the world at contouring foreheads and orbital rim's. Well, he exceeded my expectations.
There's much more to write about regarding the recovery in room 317, a couple of humorous anecdotes about Dr. DiMaggio, details about the wound care, the first shampoo, why Argentina, why I choose to only have forehead surgery, visits from Amanda Rosenfeldt and Charlotte, etc., etc.
But what I will close with is that before the surgery people would accept me as female sometimes – not all the time - about 85% of the time, (and this is important, only when people viewed me straight on.) The number declines to about 40% to 50% of the time when they got to look at me for more than 15 seconds. And probably less than 10% of the time if they interacted with me for any extended period.
I went out to eat at a restaurant, The Plaza Grill, four days after surgery. The looks I got there, the reactions, the treatment, everything had changed.
OK, here is an example from last night, five days after the surgery, I went (alone) to a different restaurant, a Peruvian – Asian fusion restaurant, I asked to use the bathroom. I was guided to the men's and women's bathrooms the doors to which were side-by-side. I could either go to either, which (I know now) was, the men's on left or the women's on the right. The problem was at the time I could not figure out which was which. There weren't any words on the doors to tell me which was the men's room and which was the women's room. There were just some strange symbols. And I did not interpret them correctly. So I started to push on the door to the left. The waiter just about tackled me. He only speaks Spanish, and I only speak English, but in any language "no, no, no, no" is pretty easy to understand. And with substantial alarm and concern he touched my
shoulder with one hand and tapped on the door to the women's room with his other hand. Indicating that's where I needed to go. This was the waiter who had been waiting on me all night. Just me, alone, so he been completely focused on me. Not in a creepy way, but just in a way, that in the past, would have always led to people realizing
that I had lived most of my life as a male.
And, while this bathroom experience is anecdotal, I simply go back to the looks I get now. We all know the looks, I have described them on the first page of this journal and again earlier on this page. Well, I see now that the looks can change. For me, so far it seems they have changed. I realize I'm still not going to be perceived as female 100% of the time. Even if I have additional surgery. I'm not sure for the rest of my life I will ever achieve 100% - no matter what I do. But it has gone to the point where it really doesn't matter anymore. It's interesting, I don't seem to really care if after 5 minutes or 20 minutes, or three days, people start to wonder. Maybe that feeling will also change. But, I never really thought I'd be able to get this point, this point right here. And right now just feels so good.
Gently, and very slowly, moving my head left and right, using my nose as handle, was one of the attending surgeons. He was saying, "Your forehead is very good, next we do this. Right? Next we do this?" He rubbed my nose a little bit more and moved my head back and forth.
I said, "Yes, yes… I feel queasy… Very queasy." I opened my eyes and I noted that I could see. Additionally, my eyes seemed to be able to focus. This was good news. It help push the queasiness into the back of my head for a fraction of a second. One of my irrational paranoia's was that during the operation someone would slip and pierce my eyeball with a scalpel, or a burring wheel or even a hammer. I didn't know what they were going to use on my orbital rim. So, it was with some relief that I did not wake up blind.
But the nausea keeps banging on my stomach and climbing my throat. To say it felt like severe food poisoning would be to downplay it. I felt like I had eaten a chicken salad sandwich, with mayonnaise, mercury and plutonium. A sandwich that had sat, marinating and melting, in a baggie, on dashboard of pickup truck, for two days, in the humid, July, Alabama, sun. "I'm queasy." I said, "Very queasy, very queasy, very queasy…" I kept repeating it over and over because I was so nauseous and someone needed to know. Someone needed to do something. I was trying to let them know I was going to puke. I thought they should know.
Nobody came rushing to help me, and I just started spewing. The blood that came out of my mouth, out of my stomach, was a coagulated blackish red color. It cast a remarkable pattern against the white sheets and bleached floor. It got attention.
So, it was wonderful, in the recovery room, to get the reassurance (even though I'm sure they say to everybody) that the forehead turned out great. I was happy that one of the attending surgeons was more focused on the size of my nose than any of my other problems. Really, it helped me feel more secure. It help me feel like the nausea wasn't as big a deal as it felt to me. And to know that my forehead was done! Even through all that discomfort sitting there on the operating table trying to keep from throwing up, knowing my forehead was done! That good feeling did come through. Dr. Di Maggio came over to talk to me. Told me my forehead was tougher than he expected but that the result was good. To which I responded, "I'm very queasy."
He told me he thought I had an allergic reaction to the antibiotic. He told me I would feel better in a few hours. What? Oh my gosh! I panicked, my thoughts raced, I'm going to feel like this for the next few hours? Did he say "hours"? He did not say, "Give it a few minutes." Not, "Oh, this is normal, you will feel better in just a bit." He did not say, what I most wanted to hear, "Oh, that old queasy feeling? Sorry, drink this it will fix you."
I was startled, "A few hours!"
He responded, "I need you to use your head, I need you to be tough, the surgery is done, we did our work, now you have some work to do. Don't throw up anymore. Use your head" He stopped short, thank goodness, of saying, "Don't die on me now."
As he talked, he slowly tapped, his finger, near my temple. His talk was a firm, fatherly, matter-of-fact, pep talk. Because, that's really all there was to be done. I had had an allergic reaction. I needed to ride it out. I needed to be tough. There was no choice. "I am very queasy." I said, "But, I will stay focused, I will do my best.” I stopped short from saying, “coach.” But I did ask, “May I have some water to sip?"
"No, you can't have water for a few hours. You will only throw it up."
And with that they asked me to move from one gurney to another. Which meant I had to actually use my arms. I did not want to use my arms. I did not want to use my legs or my back or anything. My heels hurt. And I didn't want anyone to touch me. I just wanted to keep hanging over the rail of my, currently assigned, gurney and wait for the waves of nausea to go away. Because that is what I was doing. Leaning on, clinging to, my bed rail like a shipwreck survivor, in the middle of the ocean, clings to hope. If I absolutely had to move, I wanted them all to lift me and move me over to that other gurney. But they wouldn't.
About three people were standing around me. Though, it could've been two people, it could've been four people, I wouldn't know the difference at this point. But, all those people, the small crowd, however many there were, they were all staring at me and they told me I had to move. So, I tried to move.
Astonishingly, I had some strength in my arms. I don't know where that strength came from but my arms worked. I was able to lift my butt up and slide it over to the other gurney. And then someone helped push my legs over.
And then they started to wheel me back to my room 317. Which meant an elevator ride – but this description has gotten too long. I'm sorry. Let me get to a
positive point – the results.
The aesthetic (that word is different than anesthetic) results are everything I had hoped they would be, and – amazingly - more than I had hoped. And the ridiculous part is that I had high expectations. I selected Dr. DiMaggio because my impression was that he was the best in the world at contouring foreheads and orbital rim's. Well, he exceeded my expectations.
There's much more to write about regarding the recovery in room 317, a couple of humorous anecdotes about Dr. DiMaggio, details about the wound care, the first shampoo, why Argentina, why I choose to only have forehead surgery, visits from Amanda Rosenfeldt and Charlotte, etc., etc.
But what I will close with is that before the surgery people would accept me as female sometimes – not all the time - about 85% of the time, (and this is important, only when people viewed me straight on.) The number declines to about 40% to 50% of the time when they got to look at me for more than 15 seconds. And probably less than 10% of the time if they interacted with me for any extended period.
I went out to eat at a restaurant, The Plaza Grill, four days after surgery. The looks I got there, the reactions, the treatment, everything had changed.
OK, here is an example from last night, five days after the surgery, I went (alone) to a different restaurant, a Peruvian – Asian fusion restaurant, I asked to use the bathroom. I was guided to the men's and women's bathrooms the doors to which were side-by-side. I could either go to either, which (I know now) was, the men's on left or the women's on the right. The problem was at the time I could not figure out which was which. There weren't any words on the doors to tell me which was the men's room and which was the women's room. There were just some strange symbols. And I did not interpret them correctly. So I started to push on the door to the left. The waiter just about tackled me. He only speaks Spanish, and I only speak English, but in any language "no, no, no, no" is pretty easy to understand. And with substantial alarm and concern he touched my
shoulder with one hand and tapped on the door to the women's room with his other hand. Indicating that's where I needed to go. This was the waiter who had been waiting on me all night. Just me, alone, so he been completely focused on me. Not in a creepy way, but just in a way, that in the past, would have always led to people realizing
that I had lived most of my life as a male.
And, while this bathroom experience is anecdotal, I simply go back to the looks I get now. We all know the looks, I have described them on the first page of this journal and again earlier on this page. Well, I see now that the looks can change. For me, so far it seems they have changed. I realize I'm still not going to be perceived as female 100% of the time. Even if I have additional surgery. I'm not sure for the rest of my life I will ever achieve 100% - no matter what I do. But it has gone to the point where it really doesn't matter anymore. It's interesting, I don't seem to really care if after 5 minutes or 20 minutes, or three days, people start to wonder. Maybe that feeling will also change. But, I never really thought I'd be able to get this point, this point right here. And right now just feels so good.
I think I am also self-aware. Even “hyper” self-aware (would be fair.) And apologetic, I can apologize. I dislike when people around me are uncomfortable. I think I notice when I am making people uncomfortable and I am quick to apologize.
So is this why I am rearranging my face? Because I fear it makes others around me uncomfortable and then makes me uncomfortable? Am I changing my forehead for the simple reason it will make me more comfortable? I think the answer seems to be that simple and that answer makes me angry.
The discomfort of others, by my appearance and incongruous gender, is expressed many ways. Wide eyes, dropped jaw, amusement, fear, divorce, verbal harassment, violent assault, isolation. But I also admit that my reaction, to the reactions, makes me weak and wimpy.
*The antibiotics I was given were Metronidazole & clindamicina/Clindamycin. Dr. Di Maggio is speculating that it was the Metronidazole that triggered my allergic reaction.
So is this why I am rearranging my face? Because I fear it makes others around me uncomfortable and then makes me uncomfortable? Am I changing my forehead for the simple reason it will make me more comfortable? I think the answer seems to be that simple and that answer makes me angry.
The discomfort of others, by my appearance and incongruous gender, is expressed many ways. Wide eyes, dropped jaw, amusement, fear, divorce, verbal harassment, violent assault, isolation. But I also admit that my reaction, to the reactions, makes me weak and wimpy.
*The antibiotics I was given were Metronidazole & clindamicina/Clindamycin. Dr. Di Maggio is speculating that it was the Metronidazole that triggered my allergic reaction.