Surgical and Insurance Timeline

DISCLAIMER: So here you will find a lot of personal feelings and notes. Unedited, I just literally copy and pasted from my personal journal. So please be mindful when using this information these are MY ACCOUNTS. To many a time folks have read things online and assumed it was law in the world. Take what you need from the provided text but ALWAYS double check with your primary and other providers when it comes to KP and your care. The content should only be used as basis of where to start not base everything I do on how you will receive services and/or care. Also be mindful some events have yet to occur and as they do I will plug in pertinent information. I just have a time frame in my mind and so far things have been going exactly aligned with it.

July 2012

• first contact is made with Dr. Crane via email and phone. Friendly personable and very warming to the ideas and wants I had for phalloplasty. Discussed MLD which was the great that I originally have been seeking.

March 2013

• second phone consultation to discuss forearm phalloplasty. Updated due to personal feelings, wants, and needs changing for the better.

April 2013

• in person consultation to discuss my options further for surgery and access to said surgery. Decided on 18.5 x 12.7 cm ( 7.28346 x 5.019 in) forearm phalloplasty. From working out and measuring body muscle I know my forearms are 10 inches around so 5 inch girth is an easy accommodation.

May 24 2013  

• intake appointment with Lyon Martin

June 2013-Jan 2014

• fucked off due to depression! Booooo

Jan 2014

• placed on wait list for 2015 RFF phalloplasty with Crane

Jan 3 2014

• Consult for Kaiser insurance ( I had a personal Covered CA Rep, if you would like his contact information please us the contact form)

Jan 30 2014

• Kaiser insurance is submitted!

Jan 2014

• Found out I am number 8 on the waitlist!

Feb 5 2014

• Contacted film crew about ‘Masculinity: A Surgical Exploration’

Feb 6 2014

• Made first phone call to MST Clinic

Feb 7 2014

• Terri from MST calls me. We speak about the process of surgery which entails me speaking to a a Kaiser Mental Health Professional. Once this happens I will be referred out to the Approval Board. Which consists of Terri, Dr Anooshian, and  a Kaiser social worker. Terri went ahead and put me down for an April date for the Approval Board!!! So now it is just a matter of getting things in order to be referred which will happen no later than March 15th as my coverage is current as of March 1st.

Feb 19 2014

• Called Kaiser after being the usual impatient man. Which proved to be very useful in my need for reassurance regarding insurance as past experiences have been crappy. But I found out I was in fact in the Kaiser system. The rep explained to me that they were still catching up with invoices but regardless of this I will have coverage 3-1-2014! Very reassuring to know this and settles a lot of things for me. I called MST Clinic soon after speaking to member services to set up my evaluation that is required prior to my approval meeting.

Feb 20th 2014

After careful consideration and multiple talks with those post ALT I have decided to reroute my plans for forearm. Decided on 18.5 x 12.7 cm ( 7.28346 x 5.019 in [realistically ill be 5.5-6]) ALT phalloplasty. It will be done in 2 stages detailed below:

1. Stage 1 – Creation of the phallus with burying of natal penis at the base with fully extended urethra. Scrotum will also be redone using the V/Y technique for forefront placement.

2. Stage 2- glansplasty  upgrade to large testicles  (6 months later, at this point in time I am not getting an erectile device)

Proximity to my surgeon makes this multi stage procedure cost next to nothing, so it is way more feasible to have multiple stages of surgery. However just for the record though I detail the procedures as 2 stages I will actually only consider my phalloplasty as a one stage phalloplasty seeing as though I do not consider glansplasty a stage. I see it more so as circumcision at this point in my life as I am not circumcised now. As well the testicle implants are there already replacement is just a want not a need but its being done since he’s in there lol.

 

Feb 24 2014

• Gets Kaiser plan premium paid! 59.29/mo, thanks to the affordable care act my insurance plan is not $295/mo as the gov is paying a majority of the costs. Even if it was $295/mo for the coverage I have I honestly would pay that without thinking about it twice.

Feb 26 2014

• Self advocacy is the key! Called Kaiser customer care and got my medical records number. This number is very important as it is the number that allows MST Clinic to schedule me for any services! So it was great to get this information from customer care, who I need to add have been some of the nicest insurance personnel I have ever encountered. I have found a bona fide winner when it comes to customer service. The MST staff so far have been beyond amazing, I can not even really rationalize why I was so nervous about this. Well yes I can, coming from the demographics I am used to it is very normal to feel uneasy about medical services. However, it is great to know that things have improved in that arena for myself at this point.

March 1st 2014

• Kaiser insurance coverage goes fully active!!!!

March 5th 2014

• Cranes office schedules Kaiser mandated consult for May 5th.

March 12 2014

• Appt with primary 10:50 am!!!. So after about a week (5 business days) I went ahead on my own accord and decided to see about finding a primary. As the Kaiser rep when signed up told me I can get my own primary I would not have to wait on MST. I wanted to wait just for GP and see how things went. Followed the gut once again and glad I did as I felt the anxiety creeping so I have to stay proactive during all this. I got referred to my primary through another gentleman in the area, Dr Slovis, shes about 5 mins from my house so this is totally awesome indeed. Kaiser was great getting me set up with my Dr who ONLY specializes in transgender care which is PERFECT as I have been trying to find a primary who does nothing else but T care for a while. Called for my appt the 11th they gave me next day of the 12th! That is bad ass!

March 12 2014- UPDATED POST PCP APPT.

• I arrived to Kaiser hospital which is located about a 13 minute bike ride from my home. So of course I got my daily cardio in today well worth it as I see it was best to do my vitals after being a bit active to see what that does to me. They were perfect! Dr Slovis’ front desk personnel are very personable and helpful. I love the clinical setting as it is Adult medicine nothing specifically saying transition anything even though my Dr ONLY sees trans patients. I had no issues with registration even with my insurance not showing as fully active in the system yet due to delays she made sure I was seen and paid nothing! Normally there would be my co-pay but that will not take effect until after fully active.
• So on to Dr. Slovis, she is by far the best PCP I have had yet. I loved my previous primary when I lived in NYC but Slovis takes the cake! She first welcomed me to Kaiser then we got right down to business. She asked me about myself and we spent a good 10 mins just talking about my transition and experiences. I felt completely comfortable and not rushed or hurried in any way. She immediately got to work asking had I contacted Terri from MST, I explained the whole setup I have going on she was like awesome. She said I am virtually good to go for approval and I may even be able to bypass the the therapist due to me already being at this point in my transition. She explained unless I had something I personally want to discuss they won’t mandate it. She also explained that I had nothing to worry about in the meeting, as its something they have to do by law but it is a “SLAM DUNK” approval! This alone has given me so much relief I can not even begin to express. And if they are they same time every month my approval meeting is the first week of April!!!! OOOO SHITTT lmao
• She ordered my T which feels awesome to have full access to T under insurance and my pharmacy is on the first floor, talk about convenience. She also made sure I had an inhaler on order when I needed it as well so when I’m ready they are there for me. Its so cool to know that theres never a stall in my T from now on. So no more compounded T its back to the regular stuff which is good because I honestly think my body responded better. I lost two pounds yay lmao not that worried about it the weight is steady at this time. My BMI is kind of high (26.46 says the machine) but I have been doing that on purpose pending my chest revision. She only orders T levels once a year but since I’m new to Kaiser i get to get poked YAY! lol but the way they do it is I do it the morning of my next shot so I will be going on Monday morning to get all my levels done and a wonderful Tetanus smh so not thrilled about that at all. After all this was ordered she explained how i can contact her online via email if i had any issues and that all my lab work will be available online at my leisure. That so freaking cool that they do things like this so the patient has control over the information they get to see as well.
• Over all this has been the best PCP appt I have ever had and I am so totally appreciative to those that told me about the quality care Kaiser offers. This is going to be the full medical experience I was waiting for, now I feel like my money is going towards care that actually does something for my well being. At this point I refuse to be in a state that does not cover my health care and I refuse to have any other coverage outside of Kaiser. So that just made my nation a little bit smaller, hopefully this will change as time passes but for now I am a happy Californian!

March 2014

• Appt with therapist (found out this was not a requirement for my specific approval case during my PCP visit)

April 1 2014- GET OFFICIAL SURGERY DATE OF: ???? – LMAO I KNOW SOMETHING YOU DON’T KNOW!!!! 

• I will make an official announcement when its time!

April 7 2014

• MST approval for top revision with Dr. Anooshian and phalloplasty with Dr. Crane
• UPDATE POST APPT: I started off my day late as all hell so of course this means going into MST late, which totally screws with my anxiety about being late lol. After going into the wrong dang building (Kaiser takes up literally 2 blocks) I finally get to the Moss Building and head to the 7th floor. I’m immediately greeted and welcomed to Kaiser (they do this to every new member no matter where you go lol), handed my paperwork, then almost 5 secs after I sat down they called me back for vitals. (speedy!) seeing as though I ran half way there due to tardiness, my blood pressure of course was like 143/98, we rechecked after I calmed down after talking to the Dr it was a norm 122/80 roflmmao. The MA almost called the Drs but I had to explain to her I just ran here hence why i was covered in sweat lmao. Since I was late, I did have to wait a moment for the Psych/Social worker to get done with a patient. But that only took about 2 mins. I was then called back to the office and it begun. I met with a Dr that’s on the TSB (im going to assume that stands for Trans Specialty Board but don’t quote that lol), I forget his name, but he was very nice and well mannered. Due to my tardiness we had to speed through as there were others waiting, but 20 mins was all I literally needed. He asked me about myself, my previous surgery, my health history (SMOKING CIG’S WILL GET YOU DENIED!!! don’t lie about it you’re just risking your phallus dying), my support system and who is taking care of me after;YES this is a HUGE deal and you must have support in place for your recovery I think this i a great requirement as many will go at it with no one and end up in bad situations. The last thing he asked which I knew was coming is “Why do you now at this point feel like you want Phalloplasty?” I love answering this question and I feel as though guys asking me this over the years prepared me to give the best well thought answer I have ever given in my life. By the end of this statement, he then said “At this point there is nothing else to assess, my recommendation for approval is given, and there is no want for you in this I can clearly see and feel your need to move on tot he next phase of your life”. I don’t get emotional over too much but that one was pretty damn affirming to hear that finally folks see this is NOT a want it is a NEED. And now I understand why he worded it at first with want which makes total sense when you think about it long enough. Im just soooooo freaking relieved that this part is over and Friday I will meet with Dr. Anooshian for my surgical physical and preop consult for my chest revision to see what we can do to get me comfortably shirtless this summer! After wrapping up I went to get lab work that I have neglected to get since the 12th ooops lmao. Just didn’t feel like getting stuck I suppose lmao. But all in all I am a very happy camper and can not wait to move on to the next phase of things!!!

April 11 2014

• Consult for revision w/ Dr. Anooshian
• UPDATE: My meeting to discuss a revision turned into something much more. After years of debating and trying to compromisebwithbmyself anooshian told me what’s best and that would be to have my chest fully reconstructed using double incision technique. I was hesitant at first but after thinking about it and assessing his work I believe it is the best thing for me to do in order to gain the look that I want with my chest. So now I just have to await the call with my date. Likewise there that was also my physical for surgery approval! I did tell him about some urologic concerns I had and he then referred me out to Dr Carl Thomas who is a urologist with Kaiser and sees all the transmen who have lower surgery or urological issues.

April 15  2014

• Met with Dr Thomas
• UPDATE: Dr Thomas was awesome! He’s a really jolly guy and knows his stuff. He’s worked closely with both crane and miro on cases so he has me double covered. He went in and did a scope of my urethra while I was still totally awake it was a little weird seeing myself on the tv screen lol. But he showed me and explained what could be the issue at hand. (nothing life threatening more annoying than anything) he explained everything to me and reassured me Crane would fix the issue permanently with mg phalloplasty. He gave me his card and told me to contact him post phallo to follow up. It’s awesome knowing I have a personal urologist now with Kaiser. And to think all of that cost me 3 dollars loving it!

May 5 2014

• Consult for phalloplasty, revised VY scrotoplasty, and few remaining questions/interview with Dr. Crane.
• Golden gate transit 42 @Richmond to the 29…Bart $7.00 charge. Credits back when you get off so don’t freak out. The benefits of a clipper card!
• UPDATE: after being fashionablely late as usual seen crane and nothing special was talked about as I’ve seen him a zillion times by now and had all questions answered outside of where does the hair need to leave from. As my thighs are a little bigger for my size so I wanted to double check. Glad I did I need to lose about 2 cms of subcutaneous fat so my phallus can be closed in one stage. Other than that he said I was good to go for electroylsist and he’d see me soon!

May 7 2014– so initially I thought I had to have a review board meeting. Terri calls me and explains there has been a mix up and I actually did not need a TSRB meeting as I’ve already had lower surgery there’s nothing to really assess besides I want to finish and move on with life which I discussed with Carlos back in April. She then tells me she does however have my electroylsist referal and I can get started the following week! I’m so freaking happy right now and 155 days away from the end of this journey!

May 12 2014 – made contact with Dimitria’s skin care and medi-spa for hair removal appt.

June 3 2014 – first electroylsist appt with Jeannine from Dimitria’s. Everything is going awesome. She cleared 3/4 of the bottom third of my thigh. $5 copay

June 5 2014 – second electroylsist appt with Jeannine. Land is cleared! I’ll post more pics when I have time. I take pics and video every session.

June 10th 2014 – third electroylsist appt with Jeannine. She’s so freaking cool and keeps me occupied. Not that it hurts but it’s great to have good conversation. I found out what 12 needle electroylsis looks like and let me tell you this that is some stone age looking apparatus indeed! I am so thankful she uses the Apilus Machine with a one needle method. It is A LOT quicker and zero pain. I’ll post the pamphlets she gave me shortly.

June 12 – fourth electroylsist appt, my leg is so almost clear! But the waiting game will continue to see if anything sprouts back through. My body is weird I wouldn’t doubt they just stay gone lol. But time will tell as my appts are now going to get spread out. As the worst is really over, had I been any hairier I would be totally screwed and have to continue to follow up after surgery. Which I still will just for GP.

June 17 2014 – electroylsist appt (details pending)

June 24 2014 – electroylsist appt (details pending)

UNTIL Surgery continue to do electroylsis, holistic therapy, exercise, proper skin care and stay up on everyday medical needs. Also redefine my body and core in preparation for surgery. Continue to stalk the phone for cancellation calls from Katrina.

September 10th 2014 – SURGERY! Officially post op and post transition finally!

Oct 15 2014 – minor revisionary surgery on larger fistula 

June 26th 2015 – stage two