A Rare, Post-FFS Infection!

One week ago, I wrote about my facial feminization surgery (FFS). I thought after almost 5 weeks, I was on the road to recovery. This week showed me that the road was anything but straight, as I write from my hospital room.

In the last post, I mentioned that I was having more swelling on one side of my jaw than the other. Last week, that swelling suddenly became large, firm, and sometimes painful. I contacted my surgeon’s office, and they suggested I come in for an urgent appointment the next day. Maybe just a possible fluid build-up, they conjectured. The team would drain it, and I could move on.

Unfortunately, when they looked at it last Friday, they determined that there wasn’t really fluid there. Something else was wrong. They suggested I come back at my next scheduled follow-up appointment on Wednesday so that the surgeon himself could take a look. So, for five days, I continued life. I pushed through worked. I spent time with the kids. I started taking ibuprofen to help with the swelling and bouts of stinging pain that would occasional strike me. There was clearly problem. My jaw line began to turn red. My neck puffed up.

On Tuesday, I went to see my primary care physician on a previously scheduled visit to talk about routine lab results. She was very concerned about my jaw and neck, and she preemptively prescribed me two antibiotics as a just in case. The next day, I finally was able to see my surgeon. He took one look at me and decided we needed to aspirate the infection. A few minutes and a few needles later, and he had pulled a vial of pus out of my face. I felt a little better from the immediate release of tension, but plenty of firmness still remained. He sent that culture to the lab for testing. In the meantime, he wanted me to start the antibiotics my PCP prescribed and return two days later to evaluate progress.

On Friday, I went to work an opening 4-hour shift at work, and then I headed to San Francisco with my family to the follow-up appointment. The infection had shifted slightly towards my throat and was certainly no smaller than it had been two days prior. He aspirated again, and then sat quietly for a couple of minutes in the procedure room. He then came to the conclusion that I needed to be admitted, and that we would need to go back into surgery to clean out the infection. After discussing it with my wife, we agreed to walk across the street to the hospital for direct and immediate admission to start broad spectrum IV antibiotics and to prepare for surgery the next morning.

On Saturday, the surgery lasted about 30-45 minutes, paling in comparison to the nearly 7 1/2-hour initial surgery. Within hours, I was out of recovery and back in my room, now equipped with a drain attached to my face Then, it became a waiting game. We waited for the results of the cultures from last Wednesday to come back. We waited to see what kind of output the drain would produce. The whole thing was supposed to take a day or two. It did not. The labs took forever to determine that I was being afflicted by two different bacteria, and they needed to determine the best antibiotic to combat those bacteria narrowly.

Further, a strange complication arose: I was experiencing double vision. How was that possible, since the infection and surgery only concentrated on my jaw and neck? So now I had consultations with ophthalmology, complete with eye tests. They initially concluded the issue was a congenital palsy, indicating that this was something I always had and that surgery may have just triggered it. I thought they were nuts, as I have had excellent vision all of my life. The simpler answer, as we know from Occam’s Razor is usually the correct answer, was that something happened during surgery, as the vision problems did not start until after I came back from surgery.

There was talk of me going home with the drain in my face. There was talk of me going home with the vision problem and returning in a few weeks to the ophthalmologist’s clinic to treat my new eye condition. I complained. Luckily for me, the drain situation took care of itself. Output reduced to the point where it was determined it could come out before I left the hospital. On the crazy eye issue, my surgical team asked the ophthalmology department to see me again with an attending physician to see if a better explanation and treatment could be found.

All in all, between the surgery, recovery, drain issues, and eye issues (let alone my poor, bloated right arm from several days of continuous IV), I am still in the hospital after five full days. Barring a sudden change for the worse, I should be going home tomorrow without a drain, with the proper antibiotics, and a recovering eyeball.

This infection came out of nowhere. Most post-op infections occur in the first week or two. Mine waited 4 1/2 weeks to manifest. Quite rare. I am happy we took the steps to properly treat it, but pressing the pause button on my life has been very difficult. I lost work. I lost time with the kids (although, they did visit me everyday in the hospital). I was not able to contribute to the family’s greater good from my hospital bed. That took an emotional toll on me this week, as it did on the family. My son has been sick. My wife has been stressed running the house solo and worrying about me. It has been tough on everyone.

Those that do not understand why I had FFS in the first place may think that I made a bad decision, especially since it led to this infection. Those people do not get why I had the initial surgery in the first place. This week, it was easy to ask myself, “Why am I here right now?” Those thoughts made me cry. What makes it right is remembering why I had the initial surgery: to address my dysphoria, to make right what I felt was wrong. FFS is more than a cosmetic procedure. It is life affirming. Unfortunately for me, I had to deal with a severe infection that landed me a second surgery and what looks to be six days in the hospital. However, that does not mean I regret going through this process because ultimately, I had to do it. It was a need, not a want. It was a good decision.

I look forward to going home and finalizing my recovery from both surgeries. I relish jumping back in to my mom role and kissing the kids good night, watching TV with my wife, petting my cat who has not seen me in a week. Work has been stressful, but I need to be there, too. It is time to un-pause, press play once again, and move forward with life with my improved, non-infected feminized face.

Although, I will miss the awesome view of the Golden Gate Bridge outside my hospital room window—even if my blurred vision makes it look like it has four towers instead of two. Recovery continues.

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