[Another lengthy post for the keenly interested]
Link had their top surgery in mid-January, the snowiest and coldest part of winter. There is only one clinic in Eastern Canada that offers both components of the surgery, and the Ontario government will pay for. Luckily, GRS Montreal has an excellent reputation. We both had to travel from afar to Montreal. Because of potential weather problems, I booked a flight to Toronto where Link lives, stayed overnight there, and the two of us took the train to Montreal together. Otherwise, one of us could have missed the operation! We arrived to find a fresh foot of snow on the ground from the previous day.
For the 3-night stay, we each brought a carry-on bag and tried to pack light because Link wouldn’t be able to lift anything on the way home, and I would need to manage all the luggage.
Since it’s an approved and insured surgery, the province took care of most of the expenses. We paid for our travel to Montreal, but when we arrived, a taxi was waiting to take us to a nearby B-and-B that the medical clinic books its patients into. It was a lovely house in a residential area of Laval. The owners have a contract with the healthcare system and most of their rooms are used by surgery patients, all the time. The owners were accustomed to being around trans people and knew what they were experiencing, whether it was pre-surgery nerves or post-surgery discomfort. But they set boundaries and didn’t engage in personal conversations about the bodies of their guests. We arrived the evening before the surgery and needed to report to the clinic at 7 am the next day.
I had some challenges communicating with the B-and-B prior to our arrival. It may have been a language barrier. I was allowed to stay in the same room as Link, to save the cost of an extra room, but when we got there, we found out we were expected to share a bed! Luckily this was not a big issue for us, but we were both shocked! On the plus side, we were given a deluxe loft room, quite unlike the other guests’. Some other patients travelling with parents had booked into larger suites in another building, but I am sure our plan was the most cost-effective! Link’s stay was free, but I had to pay an extra-person charge.
The B-and-B provided all meals, but of course, no one awaiting surgery could eat much! The meals were home-cooked and delicious and served in a dining room with an enormous shared table. Link’s meals and my breakfasts were free; I paid $20 for any lunches or dinners I ate there. My favourite part of the trip was meeting all the others who had travelled for their surgeries and were scheduled for the same day. There were 7 besides Link: 4 young trans men for top surgery, a young trans woman for bottom surgery, and two older (my age) trans men for bottom surgery. Link was the only non-binary person, but nobody was divisive. It was such a joy talking openly with everyone. I felt like I had been let in to an exclusive club! The young folks complained they hadn’t been allowed to drink alcohol before the surgery and they missed it. They talked about their parents and jobs, and about coming out, and how they were treated at school and work, and how long they waited for their surgery approvals.
In the evening I ran out to the dépanneur to get snacks for my wait at the clinic the next day. I was glad I did, because it is not a full-scale hospital and there was no food service! I could have left and gone out for lunch but of course I was afraid I would miss news from the operating room. Meanwhile Link had to shave their chest and under arms, and not have any food or drink after midnight, even water.
Laval only has one taxi service. Despite our reservation, we were unable to get our booked car in time for the morning surgery. Everyone was affected and apparently the clinic is used to its patients arriving late. Talk about stressful! But it did end up being a bonding experience with the other parents. Three of the other patients had a parent along and one had a partner; two were with each other and one was alone 😦
At GRS, Link and the others had a check-in process and were asked to fill out an optional and very lengthy survey about their family histories. Family members waited right inside the front doors by the reception desk, wearing our disposable hospital slippers. There was a ring of patient rooms around the desk, and the operating rooms were upstairs. All the staff spoke French to each other and I couldn’t follow their conversations.
Link was called up two hours after our arrival, and we were told the surgery would be about 2 hours. I didn’t hear anything for over 4 hours which was a big worry, and then suddenly Link was being wheeled past me into a patient room. Link had “come to” at the 2.5 hour mark but the staff were too busy to tell me that Link had moved to a second floor recovery room. I wasn’t upset because I could see how busy they were – in addition to the 8 surgeries, there were many other patients who had stays of several days and needed ongoing care. There were new candidates in for consultations, and others in for follow-up.
I was very surprised that Link was lucid and talking, but of course I didn’t know they’d been in a recovery room for 2 hours. I had imagined that Link would be in excruciating pain and would be nauseous. But they’d already had pain meds. A nurse came around with crackers and juice. Lan told me about “going under” and “coming to,” and was amused that the surgeon had used a Sharpie and had checked his work with a laser level phone app! The best news was that the surgeon didn’t use Jackson Pratt drains (tubes running from the incision into plastic squeeze bottles, to collect excess body fluids) – typical for these surgeries. The nurse came in with meds, for which Link paid $40 – 5 days’ worth of oxycodone for pain, and an anti-inflammatory. I had been really concerned we’d be sent home with prescriptions and I would have to leave Link alone and go to a drugstore, so I was relieved.
Link dozed on and off. Within two hours, Link was asked to get up from bed (which they were able to do) and get dressed (needed some help.) They received full instructions for follow-up care. I had bought Link a couple of soft, button-up flannel shirts and they were just right. It would be some time before Link could lift their arms.
We walked next door to the admin office where the staff prepared a letter for Link to give their employer, verifying they were off work for medical reasons. Then we got a taxi back to the B-and-B. Before long, everyone met for dinner – celebrating their long-awaited big day, in good spirits, but tired and sore. And with much better appetites than you would expect! The owners of the B-and-B had ice in the freezer for everyone’s ice packs that night. And we were all distracted by the in-house, cute and very yappy dog. Link was able to sleep OK and wasn’t throwing up, as I had feared, so all was well.
The next day was a complete day of rest. I read a book and did some cross-stitch while Link played Fire Emblem and had a visit from a local friend. We had all three meals with the crew from the day before, and we got to know everyone better. We would be leaving by train the next day, so I walked to the grocery store to get food for snacks and lunch for the trip. I needn’t have bothered – the prices for meals on the train were not terrible, and it was hard to carry everything! When we boarded the train, I ran interference for Link – I felt like a proper mama bear, and I would have given a sharp elbow to anyone who dared bump or jostle us! One of the other parents and kids were on the same train with us as far as Toronto. When we got to Union Station, we had to get transit across town, and that was the most difficult part – I could barely manage our luggage (and I consider myself pretty tough!) And we did have to stop at a drugstore after all, to buy gauze, tape and non-stick bandage pads.
One more thing had to be resolved. Link needed two medical appointments that week to check everything over, and Link’s doctor was simply unavailable. After 6 days, it would be time to remove the dressings. We had no idea who would do any of these appointments. While we were in Montreal, we called around trying to get tips and referrals. Finally, one of the other patients gave us a lead that worked out, and Link was able to book all their follow-up care with a new trans-friendly doctor. This was nothing short of miraculous since all physicians have long waiting lists. If we had come up empty-handed, Link would have had to go to a walk-in clinic or emergency room. Besides waiting hours, a lot of sites are not trans-friendly and they don’t respect the patients’ names, pronouns, or gender choice.
Link couldn’t shower properly until day 6 when the wrap bandages were removed. There was surgical tape underneath which came off in the shower. Dissolvable stitches were under that. The smaller bandages from the nipple grafts were replaced daily. The nipples were distinctly unpretty, and they had to scab over and renew themselves. The area had a small amount of puffiness and discolouration but not bad; after the tape was gone, there was no blood to look at. The incision marks were large and red, and they will gradually fade over the next year or more. Link had to re-wrap the chest area with gauze daily and cover that with an elastic “Ace” bandage for 3 weeks (needed help with that).
Within the next 2 days, Link could get their shirts and coat on, and had a reasonable range of movement, except for reaching, and couldn’t carry anything over 5-10 pounds. I didn’t have to do any medical care, but I was happy to be there to take care of grocery shopping, meals and cleaning; and to accompany Link to their medical appointments. When Link ran out of the “strong stuff” painkillers after 5 days, they switched to extra-strength Tylenol and that went fine. Link said the pain was not piercing and felt more like strong pressure.
I stayed for 2 full weeks. After the first week I felt that Link was quite functional, and after 2 weeks, they were substantially improved. I felt comfortable going back home, knowing Link could simplify their routines and get along.
After I returned home, Link was off work for 4 more weeks (a total of 6 weeks) and they were bored but healthy. The healing was problem-free and Link got back to work right on time. Link does unpacking, stocking, display unit assembly etc. and was able to resume physical work without difficulty.
I am thrilled for Link that the surgery went so well and the recovery was so easy. It was a remarkable experience for both of us, especially the camaraderie at the “trans house”!
With much appreciation for Dr. Bensimon and the staff at GRS Montreal, the owners of Gite du Marigot (B-and-B) in Laval, and Dr. Chan at Church-Wellesley Health Centre in Toronto. And for my lovely employer who gave me two weeks’ paid family sick leave! I am grateful.