Vaginoplasty GCS Disaster from the Beginning.

For the second time in two days, I wrote a letter to Dr. Gallagher about the Vulva issue. I was becoming increasingly bummed about how this “Fix” was done as I watched it pull apart looking more and more like something out of a Chainsaw Massacre movie. My appoint was the next day and I wanted to make sure she addresses this issue with me personally. ----- start email

I'm not apologizing for anything else.

Fri, Dec 1, 2017, 2:35 AM

Dr. G, To quote the late John B. McLemore of S-Town fame,

"It's a clusterfuck of sorrow"

[Results link removed]

I have nothing but respect for both you and your mad skills plus the fact that you put up with my gameshow of [RS bleep] almost daily, well, maybe not daily, but close enough. You've heard me sing your praises often enough that they should be permanently lodged in the back of your head. I've put all my trust in you to make this work for me. But I have to admit, I'm about ready to tell you to sew it the fudge up and be done with this whole surgical parade of shame. I'll go right ahead and sell my body to science and let my wife put me on display in a vat of formaldehyde at a Ripleys, Believe it or Not, museum. Seriously, If I need to come into the SOPA Clinic and just sob endless buckets of tears over how much this is getting to me, I'd be more then willing. Queue the tiny violins and some epic sappy-ass music on the intercom and break out the kleenex. I've got waterproof mascara for days.

It's already been two weeks now and I still can't walk around without feeling like I have a marathon's worth of chafing between my legs. Not to mention it looks like someone slipped a dozen piranhas in my bathtub or worse that I saved a dozen soldiers by squatting on a live grenade. This isn't post-op depression speaking. This is pure unadulterated raw incision vulva-hating frustration and me begging you for help. I feel like I've got the Donald Trump of vaginas, and just like him -- NONE OF IT IS NORMAL!

You are so lucky it's Amish Pastry Day tomorrow so I can get all gooned up stuffing my face with frosting and cake to take the rage off. I might even toss down a block of cheese just to be doubly sure. Maybe some brownie chips too.

I want to scream! Emma

----- End email

Remember, this is the 2nd email that I’ve sent the few days week expressing my dissatisfaction with the vulva repair. I’m not really focused on the giant scar at the moment because I’ve been placated into believing it’s going to heal just fine and fade into the background. You can see in the pictures, my vulva looks like it was attacked by a shark and the incisions are coming apart. I haven’t liked it from the beginning. She didn’t reply to either email, which is fine, but I put it out there. She knows I’m unhappy about this and she’s had more than enough time to come up with the right words or explanation as to why she performed the surgery like that and why it’s all of this coming apart at the sutures.

I get in the appointment and prop my butt on the table/chair, the nurse does her usual routine vitals and Dr. Gallagher comes in. She washes her hands and circles around to take a look at her work. Then she says smiles and acknowledges my unhappiness in how she repaired my vulva and how it’s becoming a mess just like my other surgery.

She gives me the floor to explain and I just reiterated things I've already said about not wanting a gaping hole for a vagina and was the one thing I told her before my original surgery. And then asked her the basic question I asked in my emails. Why did you do this? She then gives me the most epic line of [RS bleep] I have ever heard from a doctor or a surgeon. She tells me: “That’s what I do for all my girls”. My heart just sank. I didn’t even know how to respond to that because it simply wasn’t true. I knew it, and she definitely knew it. She went on to tell me out how many trans-women have come to her with narrow vulvas and this the solution she provided.

The first thing that went through my head was why do I care what she does for other trans-women? That’s not what I wanted. Is this how it all works not. You just say, “I want what most people get”. She never said a word about doing this for other trans-women. Never. If this was such a simple straight forward fix for her, why didn’t she just explain it to me and show me a diagram of what she was going to do at any time? Why go through 2 consults and discuss a solution with her colleagues? Why tell me she was going to use a skin graft and then tell me that she had figured out a way to fix it without using a skin graft weeks later. She may not remember all of these moments, but I do, and I discussed these issues with other people. This, I-do-it-for-all-my-girl's stuff is straight up nonsense. I’m still waiting for the real explanation after 24 months.

How do I handle this office drama? I sat there in shock for the most part. I didn’t get angry or belligerent or start arguing with her. I don’t remember saying anything as a rebuttal to her absurd explanation. I just listened. It is an insult on so many levels when your doctor gives you some marginally-true excuse or answers your question with some statement that’s cleverly designed to sound like an answer but in reality, it’s a general handwave. The colloquial term that most people use to describe this type of interaction is being, “blown off”.

I can’t even imagine how little respect Dr. Gallagher had for me at that point that she was willing to make up terrible excuses and gaslight me into submission with some exam room cheerleading and a little acknowledgment that I was having a rough time. when I leave, I have to lower my self-respect another 2 notches for not calling her out. And get this. The next day I write her a thank-you note for the encouragement! This is how pathetic I had become in wanting this all to be over after 9 months into my 10-week recovery.

So, the next period of 5 days is a lot of waits and see. I basically wait and do what I’ve been instructed to do and the revisions cure into the miraculous examples of aesthetics and sensitivity I’ve been waiting for to finally emerge. Not that I feel that picky at all, I'm just not. I’m willing to put up with an awful lot of pain and difficulty -- and I have.

At some point, I need to start drawing a line in the sand when I see the same problems/mistakes/complications start to arise from the same core failures as last time, the sutures. Then I’m reminded of the other reasons that my recovery is now bothering me and that’s due to Dr. G failing to explain exactly how she planned to “fix” the vulva problem, that now looks like a bigger, uglier vulva problem. Except to add insult to injury, there’s a majestic crucifix-shaped scar that’s 6 “above my vulva brazenly pointing the way south. And where is my damn LABIAPLASTY?

These new problems like almost everything else I was promised upon starting this journey with Dr. Sidhbh Gallagher MD, Eskenazi Hospital and IU-Health are part of clear patient rules and expectations they boasted and then failed to meet the most basic of them. They provided such rock-start clarity and instructions about the entire process; I didn’t even know which program umbrella I was under until after multiple conversations with Dr. Gallagher and her staff.

Yet on my end, I have made every effort to mitigate the failing suture damages, engage in my own treatment, follow Dr. Gallagher’s directions, and do so with a big fat stupid smile on my face asking them what else I can do to help THEM!

Let’s see how things are unfolding. And I mean unfolding.

This is really the first point, post-revision, that it starts to feel that my recovery is going to end up going in the same direction as my first surgery. This is made worse by a trifecta of unforeseen circumstances and miscommunications on top of the first serious wave of post-op depression hitting me like a ton of bricks.

I’m aware that it’s happening, but I’m not prepared for the severity or the length of time it will take hold. What triggered this avalanche of slight was have volunteered a considerable amount of time assisting them with considerable input on their new website content and design, then randomly discovering the site had gone live weeks prior. They obviously thought so little of me, that they didn’t bother telling me it was live and online or what domain name they ultimately chose. This is a project that had lasted for the last 4-5 months. Launching a website like this isn’t a trivial matter it’s something to be celebrated for most organizations. Ya, so that one stung.

On top of that it’s clear that that once again, the sutures are all tearing apart in my revision incisions. And just like the previous surgery the only person this seems to bother, is me. I’m trying to be a “trooper about everything, but I can see very clearly what is happening right in front of my face. This is not a problem that requires Dr. House to come in and miraculously diagnose as mysterious. Add the giant scar that I wasn’t expecting -- and we never discussed. Toss in the labiaplasty wasn’t done and newly installed “robust” vulva hatch-fix that was separating at the incisions and you can see where this is going.

And no one cares.

Out of pure frustration, I emailed Dr. Gallagher on Nov 22nd, 2017 calling it quits notifying her that I’m returning to my PCP. I’m not proud of falling prey to the depression or feeling overwhelmed by all the post-op complications. Sure I was throwing a fit, but bloody hell, after everything they had put me through I, felt both cornered and damaged under the circumstances.

I also want to point out something very important here in my email that will become relevant in THE MONTHS AHEAD WHEN ALL OF THIS IS STILL GOING ON. Even at my worst, I’m quite able to write an email to Dr. Gallagher or her Coordinator without a lot of vulgar language or profanity or harassment. This will remain consistent in my communications with Dr. Gallagher's office her staff.

Dr. Gallagher responded to my email sincerely and empathetically. In her moment of integrity, she acknowledges my anguish, which was more than welcome in the moment. Between Dr. Gallagher and my wife, they manage to talk me down from the ledge and reconsider. I did. I also acknowledged her indication of post-op depression.

[Staff-names in this email were replaced]

LAST EMAIL - YOU’RE FREE
Nov 22, 2017, at 5:32 PM,

Dr. Gallagher,

I am going to make your day here.

I feel as if everything has run its course and I’m not one to stick around where I’m not wanted, so I'm moving on. Yes, I know, your brokenhearted. No more emails, questions, and stupid jokes or sticking my nose into your business. I wish I could say it was fun, but it really hasn't been very much fun for me even though I’ve tried to make the best of it. At this point I see little reason to sit around wasting energy and pondering things that might have been done better or wishing people would have been better listeners and then blah blah blah blah. It is what it is and all the back-patting testimonials saying otherwise do little in making my experience feel less arduous.

It’s terribly hard to convey the ever-pressing weight we have to carry being transsexuals all the while trying to keep our head up. Sometimes if you're lucky you can drown out the constant droning of people actively working to erase us from every corner of every community across the planet. I don’t care how well adjusted you are, it gets to you at times and if you let sink in too far it will consume you. The filter that I use to keep this oppressive menace outside of my life is called TRUST. It’s that simple. My circle of trust is small, and I designed it that way because I didn’t transition to be Transgender and the last thing I ever wanted was to do was wear that like some kind of badge of honor. Much less share the dreams I’ve carried with me for a lifetime in regards to getting GCS someday.


As it happens, that opportunity literally fell out of the sky into my lap with no warning last year. Now that my kids were out of college and considering the political environment bearing down, I weighed the risks and put my life on hold for what I thought would culminate into an epic milestone in my life. And that Trust that I referred to before, I placed it in your hands and skills to see it through. Maybe the winds were just coming out of the wrong direction that day because everything seems to have manifested itself into a complete and overwhelming quagmire of unexpected consequences. It’s left me feeling depleted, unappreciated, and kicked to the curb. With that said, I did get the vagina.

I can deal with your condescending assistant, but from surgery day 1, NOTHING worked as planned. The Coordinator gave us terrible instructions leaving us waiting in a dark lobby by ourselves for 2 hours. And that was just the first time of many she made plans to meet me only to never showed with absolutely no explanation or apology as to why. It was literally me, Charlie Brown, trying to Kick Lucy's football over and over and your Coordinator yanking it out of the way every time. And let me tell you this. If I showed you, or any of the hospital administration, some of the emails that I received from your Coordinator, you would see why people make the comments about her they do on those Internet reviews. I actually, had to ask her if she thought I was five years old after one of her snippy emails. It was really that inappropriate. There’s no easy way to say this, Your Coordinator is going to destroy your reputation because she doesn’t know how to talk to people in situations outside the box. I told you this is a small connected community and people talk. Well, they are talking and I have never said a word publically, so don't think any of that is coming from me, I respect you too much to be a part of that kinda thing.

Anyway, after that, you know what happened. The promise of being cared for by the Trans-trained staff in the burn unit abruptly ended on day 2 with a couple of clown-school escapees shuttling me off to the 9th floor. Lucky for me I arrived 30 minutes later during shift change only to be paired with the ESL foreign nurse. She was nice except for the misgendering and the fact I couldn't understand her. Queue, the incoming effects of the pre-surgery “Prep”, and this all went to hell in a handbasket pretty quickly, with a nurse that didn't have any idea of what was going on and refused to call you because she didn't want to get in trouble. I just felt really bad for her having the situation dropped on her like that and the way the nurses were googly-eyeing each other they knew exactly what they were doing. After a few more hours of this ongoing and embarrassing disaster and it finally, crescendos to what I can only describe as the single most terrifying experience of death sweeping, in and collapsing over me while being completely unaware that it was some kind of level-eleven panic attack and the people around me were oblivious --yes, I went Spinal Tap there.

But sure, you popped in finally on Thursday and then tell me I'm out the next morning at 8:00 AM. That wasn't the plan either. But ok, whatever, roll with it right? What other conclusions could I draw from the first few days? Plans, it seems, are only a general guideline as to what might happen should the planets all align correctly. We’ll let you know.

This is pretty much how it's worked since. I'm not going to go on and on about my experience of me telling you something isn’t right and you stone facing me on it. Hell, I still pee my pants if I touch any water. How many times have I brought this up and you always give me the same look, like I'm full of it So yea, this was MY experience. The one I wake up to every day wondering what I could have said or done, or even not done, to have had it all work out. Well for your sake and my mental health and anyone else who thinks they're involved, it's time that I let this go and move on.

I'm sure that my over exuberance to participate in the process of my own healthcare unusual. I think much of this might stem from some kind of misguided belief that I wanted to work there or take someone's job. This caused a lot of pushback from people feeling guarded. Unfortunate, because it wasn’t my intention, and it couldn't be further from the truth. I never wanted to step on anyone's toes and It's regrettable that my willingness to help on the website or offer insight into dealing with the trans community might have felt that way.

I've already apologized for overreaching several times and I must tell you the silence from the email I sent to your personal account was soul-crushing. That was indeed the moment where you lost a huge fan and I became indifferent about this entire ordeal. It was a real wake up call. It’s clear you were sending me a message, so rest assured, the message was received loud and clear. The fact that you didn’t even send me a link to the new website pretty much sums all this up for me. I even mentioned that I couldn't find it in an email two weeks ago when I found that other review crap people had written. No response. If there was any question that you weren't giving me the big middle finger right there that pretty much answered it. [RS bleep], that hurts my feelings. Again, I'll get over although it's your name that might come up every time I wet my pants. You'll just have to live with that too.

From here on out, unless there's some kind of emergency, I don't see any reason why I would need to return to the SOPA clinic to see you. I think from here I'm going to return to my PCP and deal with things like any other woman with a robust vagina. I can go back to answering questions about the time of my last period and if I’m absolutely positive that I'm not pregnant. PLEASE don’t be concerned that I have some kind of ax to grind, or that I feel a need to lash out online and try to persuade people to rethink their plans for coming to Indy for surgery. That’s not who I am. Your Coordinator seems plenty sufficient at that already. My place is in the woodwork and whence I shall return and see if I can get any of my self-respect back.

I hope the best for you and your practice. You work really hard and I’m glad I had the opportunity to get a glimpse of the Irish Tornado even if was only when it was running over me.

Goodluck
Emma
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Dr Gallagher’s Response

On Nov 22, 2017, 6:05 PM, "Gallagher, Sidhbh" wrote:

Emma,
I am very sorry you are feeling this way. I have asked before that you please don't interpret my lack of responses as slights. I get ALOT of emails and to be honest I'm in a constant triage situation here. I don't email any other patients.
However I can see it has deeply upset you so I apologize.
Here's my suggestions regarding the problems you brought up

1- if the incontinence is persistent we can look into this and get a referral for urodynamics - there are meds that can help if the PT isn't
2- I would really prefer to see you back as an outpatient because you still have a ton of questions that I want to answer in person. Also I do really need to check on it!
All the other things we can discuss in person if that's acceptable to you.
This has been a roller coaster for you I fully acknowledge.
Hoping to see you at the next appointment,
Dr G