I was lying in my hospital bed on Friday, slowly recovering from having been fully put under for the laparoscopy procedure when the gynaecologist and a host of other doctors came drifting into the room. Even though I hadn't expected to hear much else, to hear that they had not seen anything resembling formed ovaries or a uterus in my abdomen was still a sobering message. All that they had done was remove a number of locations where tissues had become stuck together, which might have caused at least part of the pain I was experiencing.
Unfortunately they had decided to not open the perinal side to check upon the vagina, as the skin had already become quite scarred from the first surgery in that area. Still, the gynaecologist - who had performed the surgery - found it necessary to say that he had not seen a vagina with the laparoscopy, even though it would be stuck snugly below the bladder, unreachable from the top of the lower abdomen where I am now left with the three incisions. Also the remark that it looked 'like one would expect to see by a male', or something to that extent. I was still quite dazed at that point, so I hope I just misunderstood something.
The gynaecologist had mentioned previously that he hadn't expected to find anything special, same as that he didn't expect to see anything special with the currently still on-going cycle monitoring of my hormone levels during one month. Next week the last blood will be drawn for that test, with the full results supposed to be available in two weeks time, when I have the next gynaecologist appointment. Which will likely be the last appointment, with probably just a simple dismissal and a 'nothing special found'.
In how far do I trust and believe this gynaecologist? In so far as me not having fully formed ovaries and a uterus is something which I will believe, as neither MRI scans or ultrasounds have shown anything like that so far. As far as the presence of a vagina, that has been confirmed by the first surgeon who operated on me, so I'll put that down to them aborting a full examination. To hear the gynaecologist say that they found 'no female genitals' thus seems rather poorly formulated.
I guess I will see what happens in two weeks time. I would love to be proven wrong, but so far it appears that all that I'm going through at this point is another repetition of me losing a little bit more of my humanity, without getting any kind of useful answers in return. It becomes so hard to keep a grasp on reality, especially when I experience one thing, and doctors keep insisting that my interpretation of reality is wrong. Like this gynaecologist essentially already insisting that I cannot be experiencing a monthly cycle before even have received the full results of the blood tests. It almost feels as if a certain reality is being forced upon me.
It's been like that for the past thirteen years, basically. And doctors have constantly proven other doctors to be wrong, and the reality which I'm experiencing incredibly more correct. Yet reality is nothing next to the opinion of specialists.
The one good thing which happened to me the past days was me meeting this woman and her father at the same hospital on Thursday during the pre-surgery work. She was also there to have a laparoscopy, in order to remove a cyst from an ovary. As it turned out, we lived pretty close to each other, so her father offered me a ride to the hospital on Friday, which I gladly accepted.
After our surgeries, this woman and I shared the same room as we recovered over the next two days. None of it was fun, but by being able to share our experiences, I think it became somewhat easier for us both. Being able to care for someone else at the same time as that I was recovering was a good thing, distracting me from my own issues. This woman also had a number of friends and family members come visit, with most of the chatting done in Spanish, which I found very interesting as well.
Through these visits, and by talking a lot with this woman and her father, I felt like I could slowly become immersed in this other world. A world of people who care so much about each other, who are doing their best to get through life, even leaving their country of birth - much as what I did - and making the best of things as they get alone. It made me feel happy that I could be a part of this, even if it was just for a few short days.
Now that I'm out of the hospital, it's back to the same old grind. Yet something has changed. It's hard to describe it, really. Maybe it's because the hopes I had before the surgery got dashed, yet without the leeway provided by the ambiguity of an MRI scan. With the images that were made of the laparoscopy, there is a lot which I cannot question about what is slowly forming into nan undeniable truth.
What maybe has changed is the realisation that after first having any possibility of me having a functional male side dashed in 2011 with the biopsy of the testicles that were removed, finding them to be essentially undeveloped, now something similar has happened for the possibility of a functional female side. Though I do appear to have something generating normal levels of female hormones, and I still have some kind of vagina, I do not have and will not ever have ovaries or a uterus. I'm nothing like a male or female. I'm something... else. Something... empty.
As if with every new revelation like this, I'm becoming something more agender, more asexual. Something of which I less understand what it is, or could be.
Together with this there is the fear that if there's indeed a monthly cycle, and uterine tissue that responds to it, then I essentially have what one could call the worst kind of endometriosis one could imagine. Something that just fills up the abdomen without nothing to guide it. Together with a closed-off vagina, that's pretty much a recipe for disaster. At this point it's just an unsubstantiated fear, however.
I wish I had a doctor who understood these fears, doing their best to investigate and alleviate such fears to get an outcome that made me somehow at peace with things. Not this constant battling and doubting of those who are supposed to be providing me with this help. I don't know what to believe, or who to trust any more.
Not just doctors, but people in general. The past days the contrast between me and this woman with whom I shared a few days of our lives couldn't have been more stark. I felt so weak and fearful, with her taking the initiative on a number of occasions, to ask something of the nurses and the like. Things which would have made me freeze up in terror just thinking of doing something wrong or improper.
I guess I felt somewhat jealous, as well. The idea of having a regular female body and just a common issue like a cyst. Not a host of questions, worries and maybe another batch of big surgeries. If I'm lucky.
Maybe I'm just too tired of trying to make sense of things any more at this point. It's gone far beyond merely trying to live my life, finding a job and a place to live. This goes to the very fundamentals of who and what I am. How I fit in with the whole. Once I thought I was just a male, which delusion got destroyed, to be replaced with the thought that I might be more female. Even though I will always look more like a woman, I guess I have to find a way to deal with this emptiness I feel inside now.
I need to figure this out. I need to make sense of this. I need help with this. Not people trying to force things on me. People who wish to help me feel better. Regain some of what I have lost.
The past days I have felt myself struggling with my emotions more and more strongly. Since returning to this apartment that I'm currently inhabiting and what somewhat feels like my old life, it's become even harder. I cannot seem to focus on anything but this emotional and psychological struggle now. It may destroy me if I fail to figure this out. What happens at the appointment in two weeks may make things much better, or much worse.
I don't think that anyone who wishes to help me can do so. I don't believe that anyone who can help me wishes to do so.
I cannot tell what may happen next. I will just have to live through this hell one day at a time. Trying to keep my sanity intact. Trying to stay myself. Whatever the heck that may be.
Is there hope for me? I'm doing my best, but I'm falling apart. Worse than before. Unable to define myself, unable to provide answers to questions, I remain stuck dealing with the same issues. Issues which I cannot resolve on my own. Issues which may require that my body first breaks down further before I get the required help and answers. By which time it may already be too late for the easy and best solutions.
I don't know. I don't know anything. I cannot deal with this. I don't know how I can keep living like this. I don't know whether I'm truly alive at this point. Do I even exist? Am I crazy? Maybe that's the only reasonable answer.
Maya
Sunday, 18 February 2018
Saturday, 10 February 2018
Living one's life at the mercy of others
On Thursday this week I had my 12th MRI scan. This one was a repetition of the 11th scan, in order to get a better look at a presumed site of inflammation in my spinal cord. For this contrast dye was required, which was a second time for me. After an hour-long wait in the waiting room of the clinic, I was allowed to go through the scanning routine.
Take of all clothing items, boots and the like which contain metal, change into a shift and walk to the MRI scanner. Lie down and get 'comfortable'. Get the needle for the contrast dye jammed into the large vein in my right arm. Nod as the use of the emergency signalling bulb thingy is explained. Get the sound-dampening headphones put on. Sensor-enhancing cage is placed around the head. Personnel leaves the room. One slides into the scanner and spends the next twenty or thirty minutes kind of dazing as the noisy MRI scanner does its thing.
With the contrast dye there's the warm sensation in one's abdomen and sometimes chest. Other than that it's all the same as every other time. Once the scan is done, one is slid out of the scanner, the sensor cage is removed from around one's head, and one is further extracted from the scanner bed. One walks back to the dressing cubicle, gets dressed again and waits in the waiting room until called by the radiologist.
The good news? With the enhanced resolution courtesy of the contrast dye there was no sign of any inflammation in my spinal cord. This means that next month I should get the all-clear from the neurologist. After three MRI scans, one lumbar puncture, a nerve conductivity and a visual stimulation test, any of the symptoms of pain and numbness which I'm experiencing are most likely not due to anything neurological.
This then shifts the weight of the medical investigation to my gynaecologist. During next week's appointment I hope to discuss the laparoscopy which he proposed, and hopefully plan it for this or next month. At this point the cause of my chronic pain and discomfort has to lie in my abdomen. The main question is what is happening.
That fluid is being produced every month seems certain. That I have a regular monthly cycle is clear to me, and the cycle monitoring using my blood hormone levels should provide further data on this. The questions then seem to revolve around what tissue is present in my abdomen that is responding to these varying hormone levels, where this fluid is being produced and where it goes to afterwards.
One of the possibilities the gynaecologist mentioned was a fistula (rectovaginal fistula [1] ), which basically means a hole formed between the vagina and rectum. This would allow fluids to pass from the vagina to the rectum, and vice versa. That there is regular damage occurring to the inside of the rectum since I was a teenager has been established at this point. This might be an underlying cause.
If what underlies the symptoms of pain and distension in my abdomen - as well as the numbness and pain in my arms and legs - is the formation of such a fistula, caused by the trauma from fluid gathering in the (closed-off) vagina, then this should be easy enough to spot with the laparoscopy. The solution then would be to create an exit for the fluids, meaning creating an exit for the vagina by attaching it to the perineum, creating a regular vagina, even with fanciful labia and everything.
That way the fistula could heal up, I would just have to mess around with tampons and such wonderful things, but I would be free of pain and numbness. Beyond what's deemed acceptable for a regular woman, naturally.
I just hope that this laparoscopy thing works out. That it gets good results and any required follow-up surgery will be readily available. That it'll hopefully be the end of over thirteen years of looking for answers and medical help. That after the surgeries all I have to deal with is healing up and start processing the pain and traumas of about two decades worth of experiences related to this body and society's response to it.
I'm looking forward to telling my medical coach that I won't need any more 'help' from those 'intersex specialists'. Yet the anger and frustration I feel towards intersex 'specialists' and intersex organisations is something that will take a lot of time and energy to process and give a place. The realisation that all of those were utterly useless and a complete waste of time, that all I needed to do was to wait for my body to start suffering symptoms so that I could go to proper doctors and specialists who actually do have a clue.
My body is no different from that of a regular woman. They too suffer development issues of the vagina, fistulas, fissures and so much more. I should never have needed 'special' doctors. That's the take-away message for me here. I'm sick of what ultimately comes down to discrimination.
What stresses me even more than all of the above is the realisation that in addition to all of that, I also have to somehow manage getting a new job, find a new home to move into, deal with the job office in the meantime, and wait to hear what the court will decide in the matter of the eviction case against me.
Honestly, I don't really have the energy to care about any of it at this point. The medical stuff and constant pain management is more than enough already. I regularly communicate with headhunters about potential new jobs, of course, but it is so hard to commit myself to anything when I don't even know how my health will hold up over the coming months, or what will come out of any surgeries.
What'll be the right choice to make? When will I be available for a new job? I don't know. At this point I cannot function any more without constant painkillers. The hoped-for surgery should resolve this, but at this point that's nothing but wishful thinking, more born out of desperation than out of cold reality.
Not to mention the possibility of surgical complications. I just cannot tell. Yet it's not easy to communicate this to others, even if it are those others who will decide over my life the coming months.
It feels so incredibly lonely and terrifying.
Maya
[1] https://en.wikipedia.org/wiki/Rectovaginal_fistula
Take of all clothing items, boots and the like which contain metal, change into a shift and walk to the MRI scanner. Lie down and get 'comfortable'. Get the needle for the contrast dye jammed into the large vein in my right arm. Nod as the use of the emergency signalling bulb thingy is explained. Get the sound-dampening headphones put on. Sensor-enhancing cage is placed around the head. Personnel leaves the room. One slides into the scanner and spends the next twenty or thirty minutes kind of dazing as the noisy MRI scanner does its thing.
With the contrast dye there's the warm sensation in one's abdomen and sometimes chest. Other than that it's all the same as every other time. Once the scan is done, one is slid out of the scanner, the sensor cage is removed from around one's head, and one is further extracted from the scanner bed. One walks back to the dressing cubicle, gets dressed again and waits in the waiting room until called by the radiologist.
The good news? With the enhanced resolution courtesy of the contrast dye there was no sign of any inflammation in my spinal cord. This means that next month I should get the all-clear from the neurologist. After three MRI scans, one lumbar puncture, a nerve conductivity and a visual stimulation test, any of the symptoms of pain and numbness which I'm experiencing are most likely not due to anything neurological.
This then shifts the weight of the medical investigation to my gynaecologist. During next week's appointment I hope to discuss the laparoscopy which he proposed, and hopefully plan it for this or next month. At this point the cause of my chronic pain and discomfort has to lie in my abdomen. The main question is what is happening.
That fluid is being produced every month seems certain. That I have a regular monthly cycle is clear to me, and the cycle monitoring using my blood hormone levels should provide further data on this. The questions then seem to revolve around what tissue is present in my abdomen that is responding to these varying hormone levels, where this fluid is being produced and where it goes to afterwards.
One of the possibilities the gynaecologist mentioned was a fistula (rectovaginal fistula [1] ), which basically means a hole formed between the vagina and rectum. This would allow fluids to pass from the vagina to the rectum, and vice versa. That there is regular damage occurring to the inside of the rectum since I was a teenager has been established at this point. This might be an underlying cause.
If what underlies the symptoms of pain and distension in my abdomen - as well as the numbness and pain in my arms and legs - is the formation of such a fistula, caused by the trauma from fluid gathering in the (closed-off) vagina, then this should be easy enough to spot with the laparoscopy. The solution then would be to create an exit for the fluids, meaning creating an exit for the vagina by attaching it to the perineum, creating a regular vagina, even with fanciful labia and everything.
That way the fistula could heal up, I would just have to mess around with tampons and such wonderful things, but I would be free of pain and numbness. Beyond what's deemed acceptable for a regular woman, naturally.
I just hope that this laparoscopy thing works out. That it gets good results and any required follow-up surgery will be readily available. That it'll hopefully be the end of over thirteen years of looking for answers and medical help. That after the surgeries all I have to deal with is healing up and start processing the pain and traumas of about two decades worth of experiences related to this body and society's response to it.
I'm looking forward to telling my medical coach that I won't need any more 'help' from those 'intersex specialists'. Yet the anger and frustration I feel towards intersex 'specialists' and intersex organisations is something that will take a lot of time and energy to process and give a place. The realisation that all of those were utterly useless and a complete waste of time, that all I needed to do was to wait for my body to start suffering symptoms so that I could go to proper doctors and specialists who actually do have a clue.
My body is no different from that of a regular woman. They too suffer development issues of the vagina, fistulas, fissures and so much more. I should never have needed 'special' doctors. That's the take-away message for me here. I'm sick of what ultimately comes down to discrimination.
What stresses me even more than all of the above is the realisation that in addition to all of that, I also have to somehow manage getting a new job, find a new home to move into, deal with the job office in the meantime, and wait to hear what the court will decide in the matter of the eviction case against me.
Honestly, I don't really have the energy to care about any of it at this point. The medical stuff and constant pain management is more than enough already. I regularly communicate with headhunters about potential new jobs, of course, but it is so hard to commit myself to anything when I don't even know how my health will hold up over the coming months, or what will come out of any surgeries.
What'll be the right choice to make? When will I be available for a new job? I don't know. At this point I cannot function any more without constant painkillers. The hoped-for surgery should resolve this, but at this point that's nothing but wishful thinking, more born out of desperation than out of cold reality.
Not to mention the possibility of surgical complications. I just cannot tell. Yet it's not easy to communicate this to others, even if it are those others who will decide over my life the coming months.
It feels so incredibly lonely and terrifying.
Maya
[1] https://en.wikipedia.org/wiki/Rectovaginal_fistula
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