Azure Jane Lunatic (Azz) 🌺 (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
azurelunatic) wrote2016-08-16 12:47 am
azurelunatic) wrote2016-08-16 12:47 am
Entry tags:
Hysterectomy: The Musical (or something)
The original of this was written on Thursday, August 4th, after I got home from the hospital, and sent to a selection of friends and family. I have redacted some bits, added other bits, and corrected some details.
I am settled in back at home, and have been up and walking around, sitting up at the computer, and napping. I am sore, but not more than is reasonable. I have a dotted line of five 4x2" bandages across the middle of my abdomen, and a not-so-mysterious sore spot where my cervix used to be. There are marks of adhesive tape on my hands and arms and basically everywhere which I am slowly scrubbing off with alcohol wipes, and I'm still discovering little stick-on snaps from the monitoring leads that they didn't entirely remove after I came out of surgery.
I'm doing okay and will hear more back from the doctor in about a week, and I have a follow-up appointment for the 22nd. They think they got everything of concern out with the uterus, tubes, and ovaries, but they will follow up to make sure. I should be able to resume normal activities in 6-8 weeks. I probably shouldn't be driving for several more days, but I've been sitting up and walking around without any particularly large amount of pain for the past 6 hours, so I may be ready for that sooner than I initially thought. [I wound up driving on Sunday.]
The long version follows.
It's very weird for me to be separated from my watch, necklace, glasses, and phone. Those were the things that I missed when they sent me in and brought me out, before I was reunited withryan. I'd left the necklace and watch at home, they put my glasses with my clothes (wrapped in a paper towel and put in a baggie, since I'd forgotten to bring a case), and Ryan had custody of my phone. In the absence of my necklace, I had written an "If lost, return to..." message on a leg (well out of the way of the surgical site, but nicely visible), in teal sharpie, which caused a number of medical folks to have the giggles. I gave Ryan the PINs to my phone and iPad, a list of email addresses with annotations on who all these people were, and instructions on where to find the file with my master passwords, general preferences, and other information in the unlikely case it was needed.
I'd also had an interesting conversation with one of the admissions people about names. The effect of growing up under a familial nickname, and only being addressed as my legal name for taxes, school, and deep trouble means that I have never lost the flinch-reaction when being addressed by my legal name, and am unlikely to acquire comfort with it at this late date. (Meanwhile, being addressed by the familial nickname by people other than family and close friends has always seemed like an inappropriate liberty, so I've never had a single consistent name that everyone can use for me.) I'd recently started using my initials in professional life, which is more comfortable but still fits badly. Acquiring an internet nickname in addition to the familial nickname meant that a wider range of people could use the same name for me, but did not improve my reaction to my legal name. I discussed this with the admissions person, who assured me that they wanted to ensure my comfort, and they would put my preferred name right up top, but that I should be sure to introduce myself to each member of the team with my preferred name.
I woke up oddly chipper, a contrast to my moderately upset mindframe the night before.
I decided that a French braid was likely the most durable and tidy hairstyle that I could manage, as I knew I likely wouldn't be able to brush my hair for about a day. I took the portion of my morning meds that I was allowed to take. I collected Ryan around 10:30, and he drove us (via a supply stop near the Internet Archive, so I got a picture of their building) to the hospital. He dropped me off while he parked, right in time for my 11:15 check-in.
We were re-united in the waiting room of the 4th floor Ambulatory Surgical Unit (which they call ASU, which always means Arizona State University to me), where a nice young man with a grown-out undercut and some very nice indigo-blue hair inquired after my name and birthday (the standard greeting in this hospital, apparently; this would be the first but very far from last time that I confirmed the legal first name and then insisted on the real one) put a laser-printed hospital bracelet on me, handed me a urine sample bottle, and complimented me on my hair.
(At my dubious-faced urine sample bottle selfie in the bathroom, the internet (ghoti) suggested that I pee in the baggie instead of the bottle, and other parts of the internet (sithjawa) told us that unfortunately, that would probably not be the worst sample that the lab got that day. I peed in the bottle. This time, I did not drop it in the toilet.)
I had suggested that Ryan go off for lunch once I got settled in. It turned out that this took a little longer than we might have thought. I got called back fairly quickly, where I was weighed, measured, stripped, gowned, given comfortable socks with treads, and popped under an inflatable hot air blanket that kept drifting off. I was fairly extensively quizzed on this, that, and the other. In between all the bits, I kept live-tweeting the process and taking environmental pictures and selfies. They asked after allergies; I have no known allergies to medication (other than the soon-to-be-of-no-relevance spermicide Nonoxynol-9) or latex, but included some of my food allergies, notably, walnuts, bananas, and shrimp, though I neglected to mention the metal allergy to copper, lactose intolerance, or egg aversion. For my troubles, I got a bright red ALLERGY bracelet, in addition to the normal hospital bracelet. This would prove mildly interesting later, and prompted a round of wisecracking (both in the room and on the internet) about how replacing my uterus with walnuts is not how you perform gender-affirming surgery.
Despite not having eaten since the night before, my blood sugar had climbed out of the range they wanted it; I was on the pointy end of the insulin needle for the first time in my life. I also learned that I have one of those rarest of San Francisco area amenities, the apartment without stairs. There are stairs available to me should I care to climb some, but they're not necessary to my daily life. This is apparently a good thing for recovery, and several people commented on it.
My main prep nurse was named Rose and had a great sense of humor, and got the spare of the See's gift cards that I had helpfully stuffed in the pocket of my Jacket of Holding. She said there was a surprise birthday party taking place the next day, and she could share the bounty with the entire department. Yay! I got two IV lines placed, one in the back of each hand, one for hydration and medications, and the other in case of emergency. Rose told me that I'd actually be in what I termed "the turkey position" for the operation, face-down and uterus up, with my hands behind my back, though they would arrange me like that after I'd been knocked out. Dignity!
The nurse said that I'd probably be able to ask them to take the second IV out after the surgery, if it turned out to have been unused.
I hadn't actually got the See's gift cards with the *plan* of distributing them to people, but since I had them on hand ... I askedryan if he had a Sharpie. He did.
Various members of the medical team came into the prep area and introduced themselves to me. Because I am great with names and faces (as various family members will have observed) I promptly forgot most of them.
The surgeon was able to answer a few more of the questions that I'd come up with in the interim; most were about recovery, but the long-term one was that this surgery should not affect my ability to sweep friends off their feet and twirl them around while hugging them; that was more a question about my knees and/or back. Also, the opinion of the friend on the matter; I've been told that this can be a disconcerting habit.
The surgery was pushed back about a half-hour from the originally planned start time of 2:17 due to operating room scheduling.
Ryan and I overheard a discussion near us, where two medical people were arguing about whether someone was having something on one side, or both. Ryan observed, with some sarcasm, that this was exactly the kind of thing that gave you faith in the medical process. We started speculating whether it was me they were talking about, and whether they were planning to remove only half of my uterus.
I had been sending little emails with tiny updates to (Mumble). I sent one last one, barely coherent but full of affection, to them. Just in case. They had been telling me, all along, that I would be okay. I tried to believe them, because I had to believe. I had to be okay. (At home, on my desktop, I had a document with instructions in case of the unimaginable. It included a mix of the practical, the internet-helpful, and the painfully sentimental.)
I was separated from my phone, my glasses, and Ryan a little after 2, and wheeled back into yet another prep area.
ryan commenced emailing everyone at this point.
Everyone kept asking me if I knew what procedure I was having. I did. Very helpful to make sure that the patient understands, and that if they're talking to the wrong person, that it get corrected, quickly.
I chatted with the anaesthesia team, who peered into my mouth and had me bend my neck around so they could make sure they could place the lung tube(s) correctly. The main anaesthesiologist and I share a birthday, so we wished each other a belated happy birthday and fistbumped. They told me what I could expect (they'd give me something to calm me down now, then knock me out in the operating room before placing the tubes, and they'd remove them before waking me up), and the team put the stickers for the monitoring leads on me.
They put the pressure tubes on my legs, like calf-sized blood pressure cuffs, except delivering a soothing (and firmly circulating) alternating pressure on my lower legs, to keep any unwanted clots from forming. I had written the aforementioned "If lost, please return to:" message on my left calf, in teal sharpie, the night before. This gave the prep crew the giggles, and they asked whether I usually had that written on me. No, usually I had various possible forms of jewelry which could be arrayed to symbolize the sentiment, but not for the operation.
Then we waited for everything to be ready. It was a quiet corner back in the back, with a phone and a cluttered desk and a visible clock. There was one person back there with me; someone asked them if they'd be okay back there by themselves (yes).
I was too calmed to be nervous, at that point, but I was moderately bored, and wanted my glasses, or a book, or my phone. (Especially my phone. I very much wanted to tell (Mumble) what I was up to, what was going on, that I was still okay.)
Then it was time (about 2:45), and they wheeled me back into the operating room.
It was a very large room filled with all sorts of equipment, jam-packed the way you might expect a pretty cluttered tool shed to look like, with all sorts of interesting lights and things I didn't get a good look at.
They transferred me onto the adjacent surface, which was flat with several sections of thick black foam padding, and a padded ring for my head to rest in, and settled me down on my back. It was not as dreadfully uncomfortable as I was dreading. I think they asked me one more time what I was in for.
I believe that what happened next was the anaesthesiologist told me that he was going to knock me out. That part is hazy. After that I have no more memories of the operating room, not even counting down. (I assume they ask you to count down; he'd said something about that.)
The next thing I knew I was leaning up in my rolling bed again, feeling high off the ground, set against a wall with a good view of the clock in a large, open recovery area, with a bunch of similar beds against the wall, and not a curtain in sight. After remembering my name (Azz) and that I was alive, I felt a sense of euphoria and glee: I was okay, and needed to specifically text (Mumble) to share this information. I knew I needed my phone for that, but Ryan was not in the room.
There was gunk in the top part of my lungs. There was an oxygen tube feeding gently into my nose. There was an oxygen monitor on my finger. My IVs were still in.
I was also very sleepy, so after someone noticed that I was awake, I was not particularly able to communicate this, and they wandered off. When I did manage to flag someone down, it was for pain (the place where my uterus used to be had started to feel like it had menstrual cramps of the sort that was bad already and only going to get worse), a tissue to spit out the crud that my lungs had started to reject, and ice for my angry throat. I had to manually flag someone down, as there was no call button that I was aware of. (There may have been a call button. I wasn't aware of one.)
I vaguely recall the time being 6:50 when I first registered the clock, and then observing the time slip past in 5 and 10 minute intervals between moments of coherence. I was near the bathroom, so the only moment of actual unpleasantness came when someone else was having a moderately bad reaction to their medication, and I only really had one hand to stuff into my ear.
While all this was going on,ryan had gotten a call from the surgeon, been informed that I was out, been informed that I was starting to wake up (possibly), and emailed people dutifully.
At length they decided it was time to move me to my room, and wheeled me out. I was still sufficiently disoriented that all of this made me dizzy, which was not super fun.
The night crew asked me if I could walk from the hallway to the bed. I thought I would be physically capable of standing and walking, but that the dizziness would make this unwise. So they wheeled the thing in, lowered the bed so I was lying flat, put the bars down on the adjacent sides of the two beds, and told me to cross my arms over my chest. ("Obfuscate!" I said, as this had been the gesture that my old Vampire: The Masquerade LARP had used to indicate that we were invisible.) They then inflated a thing that had been under me the whole time, and used this medical hovercraft to slide me onto the new bed. They deflated me, then sat me up and propped me up with pillows.
There was a whiteboard just inside the door, on the wall-side. People approaching the room with my door on their right hand and the curtain open would see it as they came in. (People approaching the room with my door on their left hand, or people who were washing up in the prep area inside the room, would not see it. As I would learn shortly.) The board had things like:
* my preferred name
* my pain level
* my medications
* my medical goals for the nursing shift
Guide Dog Aunt and Ryan appeared at approximately this point, and Ryan reunited me with my phone and glasses. (Phone first.) I quickly alerted the internet (and especially (Mumble)) that I was back.
Talking with Ryan and Guide Dog Aunt soon annoyed my throat and exhausted me, so I resorted to text and hand signs. The increased level of coherence in the texts reassured Ryan, because I'd been forming words so incredibly badly out loud.
![[twitter.com profile]](https://p2.dreamwidth.org/e0caa790ec10/-/twitter.com/favicon.ico)
oakandsage expressed sympathy.
Apparently the standard jury-rig method of choice around the hospital is the nitrile glove, as we found a number of them used to tie things together. Guide Dog Aunt and Ryan suggested blowing some up and festooning the room with balloons; I suggested they tie the fingers together to make it a long string.
The surgeon had long gone home by this time, and hadn't talked to me afterwards, so Ryan filled me in on the details he'd been given (the operation went nicely and so forth; there were still a few lab tests that would take a while to come back). He reunited me with my iPad, cloud pillow, and rainbow peace blanket. All the comforts of home.
They figured out car-based logistics for the next day, and then headed out around 11pm. (The plan:ryan would keep my car for the night, and do whatever errands he needed to do. My aunt would pick me up in the morning when they released me. Meanwhile, ryan would bring back my car, and then my aunt would take him back home.) That left me with the nurses.
That was about when the barrage of names began. There was a whiteboard on the wall, printed with helpful things like a pain scale, a place to put medication names and goals for the shift. It also had a place for the patient's preferred name. It seemed that of the people interacting with me, only the people specifically assigned to me and/or my department got to see the place in my chart that had my preferred name, and nobody actually looked at the ever-loving whiteboard. So that was ... helpful.
(By 6am, I would become much less patient with the constant barrage of "[legalname]", to the point of bluntly saying "I'm Azz." in unamused tones any time someone asked me if I was [legalname] for the first time. When I did not couple this with a stern finger indicating the whiteboard, this sent a few people out of the room in the confused belief that they had the wrong room entirely.)
They had wanted to get me up and walking around as soon as possible, and I was almost feeling like that would be a good idea. They gave me a bitty wee white painkiller, and a cup of jello. That was a lot of jello for someone who had not eaten in the past 24 hours.
By 12:20 or so, I had got my latest dose of pain medication (by mouth this time, a tiny white pill) plus some jello, and it had kicked in, so I was finally un-dizzy enough to get up and walk around. Or so I thought. They unhooked me from various things, and transferred all the attached things to the IV pole, but I only got about 10 steps down the hall when I came to the conclusion that I was not going to be going anywhere without oxygen, because I couldn't breathe properly yet. (Thus validating the surgeon's decision that he really wanted me there overnight.)
The nurse got a rolling tank, and we set out on a stroll around the floor. They have improved the usefulness of IV poles since Dad was in the hospital in the early 90s, and they now have helpful grab bars so you can use them to steady yourself if you're still shaky on your feet. I walked around basically the entire floor, and was ready for another turn, but the nurse decided I was done and steered me back to my room and put me back in bed.
atavistique observed that I looked happier already.
I did doze off for a while, but my natural bedtime still isn't until 4am or so. Thus I was up at various points in the night, poking at my phone. All the tubes and wires did get fantastically tangled, so there were periodic untanglings. The oxygen tried to come off my face. Early in the night, I did notice the oxygen monitor thing beeping at me, and then I noticed that I'd been holding my breath while adjusting my position, so that's a thing that annoys it. By 3am, I was just tired of everything, and my throat hurt, and some of the tubing was just plain painful and undignified.
6am is about when the nurses start coming around to commence more poking and prodding. Sometimes they turn lights on unexpectedly. Couple that with the name thing, and I was well on my way to grouchy. Eventually I gave up on sleep.
The doctors and nurses were all very nice, but there is no polite way to remove a foley catheter. The nurse asked how it felt (she has never had one herself, but has always asked so she has points of reference to reassure people). It felt sort of like having duct tape ripped off, but without hair. Not duct tape that's been stuck lightly, but duct tape that was good and stuck. "That's not so bad!" she said, very chipper. I reserved the right to disagree. They also unhooked me from the oxygen. I kept doing fine; eventually, they didn't bother to plug the oxygen monitor back in, which meant a lot less wiring to contend with.
branquignole sounded impressed with how I managed to not look completely zombified in the hospital.
It was the surgeon's day off, but his alternate came in and chatted with me; they've sent stuff off for further tests, but it looks like everything of concern came out with the uterus, tubes, and ovaries.
It hurt to pee. Very badly.
The rest of my digestive system was offended, and took a while to start back up as well. I'm told this is normal.
Breakfast arrived: jello, tea, apple juice, and broth. That probably would have been entirely okay for how I was feeling, but apparently they wanted to give me actual food. Second breakfast arrived somewhat later: cheese omelet, hash browns, milk, a banana, cream of wheat, and a muffin. (Averse, bland, intolerant, allergic, even blander, and possibly contaminated with walnuts.) I did find something to eat amongst the mess, eventually.
I made eye contact with the banana. I made eye contact with my bright red allergy bracelet. Someone was going to be having words from me, and I wasn't sure who yet. I wound up sending an email and talking with the nurse, and between them they will try to figure out how it was that someone with an allergy warning in their file got blatantly presented with something that they're allergic to. While it wasn't a concern for me (I'm pretty vigilant about what I eat, and it's merely unpleasant if someone sneaks raw and not sufficiently ripe banana into something that touches my mouth, and hasn't been fatal yet), the fact that it happened at all meant that there's a hole in their process that could catch someone in a vulnerable state in a bad way.
I was going to get to go home; I texted Guide Dog Aunt to let her know that they were probably releasing me sometime between 10:30 and 11, then I started gathering myself together. The guy from the pharmacy visited with a brown paper sack full of various pills and their instructions. Then I waited. And waited. And waited. Guide Dog Aunt texted me to tell me she was there. I wasn't near to done yet, as I still had to have the IV ports removed and some vaccinations. Guide Dog Aunt came up, and finally I got to leave.
Ryan returned my car, and Guide Dog Aunt gave him a ride back home. I have been catching up on the internet, walking, and napping.
I will get to take the outer bandages off my abdominal incisions tonight; there is tape under there, protecting some stitches. The tape stays on, either until they tell me to take it off, or it falls off by itself. I am still discovering the little sticky patches with the metal snaps that they use for the sensors, as they didn't take them all off me in post-op.
I expect to hear back with a more detailed report on what they found in about a week, and my follow-up appointment in the office is on the 22nd. I am already feeling reasonably energetic, although I'm still coughing out goo, my neck muscles want to know why I hate them, my throat thinks maybe I should just stop talking entirely, my abdominal muscles are moderately annoyed any time I disturb them, I have intermittent pain where my cervix used to be, and the less said about my pelvic floor probably the better (it's angry, and it does not miss an opportunity to inform me of this). But I am so very happy that my uterus is gone. It's been a source of worry and a pain in the ... neck ... for years, and I'm glad to see the last of it.
So that's what I've been up to.
I am settled in back at home, and have been up and walking around, sitting up at the computer, and napping. I am sore, but not more than is reasonable. I have a dotted line of five 4x2" bandages across the middle of my abdomen, and a not-so-mysterious sore spot where my cervix used to be. There are marks of adhesive tape on my hands and arms and basically everywhere which I am slowly scrubbing off with alcohol wipes, and I'm still discovering little stick-on snaps from the monitoring leads that they didn't entirely remove after I came out of surgery.
I'm doing okay and will hear more back from the doctor in about a week, and I have a follow-up appointment for the 22nd. They think they got everything of concern out with the uterus, tubes, and ovaries, but they will follow up to make sure. I should be able to resume normal activities in 6-8 weeks. I probably shouldn't be driving for several more days, but I've been sitting up and walking around without any particularly large amount of pain for the past 6 hours, so I may be ready for that sooner than I initially thought. [I wound up driving on Sunday.]
The long version follows.
It's very weird for me to be separated from my watch, necklace, glasses, and phone. Those were the things that I missed when they sent me in and brought me out, before I was reunited with
ryan. I'd left the necklace and watch at home, they put my glasses with my clothes (wrapped in a paper towel and put in a baggie, since I'd forgotten to bring a case), and Ryan had custody of my phone. In the absence of my necklace, I had written an "If lost, return to..." message on a leg (well out of the way of the surgical site, but nicely visible), in teal sharpie, which caused a number of medical folks to have the giggles. I gave Ryan the PINs to my phone and iPad, a list of email addresses with annotations on who all these people were, and instructions on where to find the file with my master passwords, general preferences, and other information in the unlikely case it was needed. I'd also had an interesting conversation with one of the admissions people about names. The effect of growing up under a familial nickname, and only being addressed as my legal name for taxes, school, and deep trouble means that I have never lost the flinch-reaction when being addressed by my legal name, and am unlikely to acquire comfort with it at this late date. (Meanwhile, being addressed by the familial nickname by people other than family and close friends has always seemed like an inappropriate liberty, so I've never had a single consistent name that everyone can use for me.) I'd recently started using my initials in professional life, which is more comfortable but still fits badly. Acquiring an internet nickname in addition to the familial nickname meant that a wider range of people could use the same name for me, but did not improve my reaction to my legal name. I discussed this with the admissions person, who assured me that they wanted to ensure my comfort, and they would put my preferred name right up top, but that I should be sure to introduce myself to each member of the team with my preferred name.
I woke up oddly chipper, a contrast to my moderately upset mindframe the night before.
Gmorning!
— Lin-Manuel Miranda (@Lin_Manuel) August 2, 2016
Hold my hand!
Oh, I don't know where I'm going either.
But isn't this better? pic.twitter.com/OJYCCKvUjj
I decided that a French braid was likely the most durable and tidy hairstyle that I could manage, as I knew I likely wouldn't be able to brush my hair for about a day. I took the portion of my morning meds that I was allowed to take. I collected Ryan around 10:30, and he drove us (via a supply stop near the Internet Archive, so I got a picture of their building) to the hospital. He dropped me off while he parked, right in time for my 11:15 check-in.
On track to arrive on time. @teshiron is driving; we are at 7-11 so he can refill his Cup of Holding.
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
Said hi to the Internet Archive as we cruised past. You do hella work, folks.
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
Hi there! pic.twitter.com/97J1sXawcy
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
@teshiron 4th floor, Ambulatory Surgical Unit. They will call it ASU.
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
We were re-united in the waiting room of the 4th floor Ambulatory Surgical Unit (which they call ASU, which always means Arizona State University to me), where a nice young man with a grown-out undercut and some very nice indigo-blue hair inquired after my name and birthday (the standard greeting in this hospital, apparently; this would be the first but very far from last time that I confirmed the legal first name and then insisted on the real one) put a laser-printed hospital bracelet on me, handed me a urine sample bottle, and complimented me on my hair.
Really. pic.twitter.com/YTIPELeSLO
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
@azurelunatic just pee in the baggie
— marafish (@marafish) August 3, 2016
(At my dubious-faced urine sample bottle selfie in the bathroom, the internet (
ghoti) suggested that I pee in the baggie instead of the bottle, and other parts of the internet (sithjawa) told us that unfortunately, that would probably not be the worst sample that the lab got that day. I peed in the bottle. This time, I did not drop it in the toilet.) Waiting with @teshiron, making terrible jokes.
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
Being warmed up with a hot air blanket. pic.twitter.com/eB8pd4D60x
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
I had suggested that Ryan go off for lunch once I got settled in. It turned out that this took a little longer than we might have thought. I got called back fairly quickly, where I was weighed, measured, stripped, gowned, given comfortable socks with treads, and popped under an inflatable hot air blanket that kept drifting off. I was fairly extensively quizzed on this, that, and the other. In between all the bits, I kept live-tweeting the process and taking environmental pictures and selfies. They asked after allergies; I have no known allergies to medication (other than the soon-to-be-of-no-relevance spermicide Nonoxynol-9) or latex, but included some of my food allergies, notably, walnuts, bananas, and shrimp, though I neglected to mention the metal allergy to copper, lactose intolerance, or egg aversion. For my troubles, I got a bright red ALLERGY bracelet, in addition to the normal hospital bracelet. This would prove mildly interesting later, and prompted a round of wisecracking (both in the room and on the internet) about how replacing my uterus with walnuts is not how you perform gender-affirming surgery.
Walnuts. pic.twitter.com/XeKrf5BE5v
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
@azurelunatic If they’re putting walnuts up there then something has gone terribly wrong.
— John (@semanticist) August 3, 2016
.@semanticist That would be the wrong kind of nut even if I were getting a sex change. #agender #hysterectomy
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
@azurelunatic Onion. Please defert unruly body.part! To victory and beyond.
— Nora Bombay (@norabombay) August 3, 2016
Despite not having eaten since the night before, my blood sugar had climbed out of the range they wanted it; I was on the pointy end of the insulin needle for the first time in my life. I also learned that I have one of those rarest of San Francisco area amenities, the apartment without stairs. There are stairs available to me should I care to climb some, but they're not necessary to my daily life. This is apparently a good thing for recovery, and several people commented on it.
.@branquignole Yes; the prep nurse is lovely and making me laugh. @teshiron is cracking wise as well.
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
.@branquignole Relayed love to nurse!
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
Showing the nice and non-techie nurse what Twitter looks like.
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
My main prep nurse was named Rose and had a great sense of humor, and got the spare of the See's gift cards that I had helpfully stuffed in the pocket of my Jacket of Holding. She said there was a surprise birthday party taking place the next day, and she could share the bounty with the entire department. Yay! I got two IV lines placed, one in the back of each hand, one for hydration and medications, and the other in case of emergency. Rose told me that I'd actually be in what I termed "the turkey position" for the operation, face-down and uterus up, with my hands behind my back, though they would arrange me like that after I'd been knocked out. Dignity!
IV time! I will be getting two. #medical pic.twitter.com/ZBIfz6wGRD
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
All plastic, no metal. #medical pic.twitter.com/y33TM66Phi
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
I will be in turkey position for the operation. #medical
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
@azurelunatic affixes sign: STRICTLY NO VOTING FOR CHRISTMAS
— Tim Sweetman (@demigoose) August 3, 2016
@rahaeli @azurelunatic affixes sign: STRICTLY NO DUCK TYPING
— Tim Sweetman (@demigoose) August 3, 2016
2nd IV is in. This one is just in case of emergency. #medical pic.twitter.com/SgFxrucXVo
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
The nurse said that I'd probably be able to ask them to take the second IV out after the surgery, if it turned out to have been unused.
Also they always ask me to rate my pain on the pain scale and won't take "potato" as an answer
— rahaeli (@rahaeli) August 3, 2016
@azurelunatic *sneaks in some hugs* sounds like you are not panicking too much! <3
— (((Rainbow Inoru))) (@Inoru88) August 3, 2016
@Inoru88 @HeOfHIShirts only about a 2 <3
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
@azurelunatic @Inoru88 @HeofHIshirts 2 on a scale of .... 3? or 10?
— marafish (@marafish) August 3, 2016
@marafish @Inoru88 @HeofHIshirts @rahaeli 10. (Potato.)
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
— Carrie Stevens (@coffeechica) August 3, 2016
@coffeechica 😙📱☕☕☕🍷💙💙💙
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
My nurse in prep is named Rose.
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
I hadn't actually got the See's gift cards with the *plan* of distributing them to people, but since I had them on hand ... I asked
ryan if he had a Sharpie. He did. — Azure Jane Lunatic (@azurelunatic) August 3, 2016
Recovery room selfie. Beforehand. pic.twitter.com/wo9p3neCsc
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
Various members of the medical team came into the prep area and introduced themselves to me. Because I am great with names and faces (as various family members will have observed) I promptly forgot most of them.
The surgeon was able to answer a few more of the questions that I'd come up with in the interim; most were about recovery, but the long-term one was that this surgery should not affect my ability to sweep friends off their feet and twirl them around while hugging them; that was more a question about my knees and/or back. Also, the opinion of the friend on the matter; I've been told that this can be a disconcerting habit.
I will likely be able to resume my habit of hugtwirling friends once fully recovered, so I may yet have the chance to sweep Mumble off feet.
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
@evithermique was 2:17, now will be 2:30ish.
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
Almost time. pic.twitter.com/CVaZAo3JAJ
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
False alarm, perhaps? Rose is off shift, and a short Asian lady with long very straight hair and eyeliner is on. #faceblind #badmemory
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
The person next to me in prep speaks Mandarin, which always puts me at ease despite not understanding enough. #childhood #safety
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
The surgery was pushed back about a half-hour from the originally planned start time of 2:17 due to operating room scheduling.
Ryan and I overheard a discussion near us, where two medical people were arguing about whether someone was having something on one side, or both. Ryan observed, with some sarcasm, that this was exactly the kind of thing that gave you faith in the medical process. We started speculating whether it was me they were talking about, and whether they were planning to remove only half of my uterus.
Half a uterus is in fact not better than one. I could get only a little pregnant, if so...
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
It's time!
— Azure Jane Lunatic (@azurelunatic) August 3, 2016
I had been sending little emails with tiny updates to (Mumble). I sent one last one, barely coherent but full of affection, to them. Just in case. They had been telling me, all along, that I would be okay. I tried to believe them, because I had to believe. I had to be okay. (At home, on my desktop, I had a document with instructions in case of the unimaginable. It included a mix of the practical, the internet-helpful, and the painfully sentimental.)
I was separated from my phone, my glasses, and Ryan a little after 2, and wheeled back into yet another prep area.
ryan commenced emailing everyone at this point. Everyone kept asking me if I knew what procedure I was having. I did. Very helpful to make sure that the patient understands, and that if they're talking to the wrong person, that it get corrected, quickly.
I chatted with the anaesthesia team, who peered into my mouth and had me bend my neck around so they could make sure they could place the lung tube(s) correctly. The main anaesthesiologist and I share a birthday, so we wished each other a belated happy birthday and fistbumped. They told me what I could expect (they'd give me something to calm me down now, then knock me out in the operating room before placing the tubes, and they'd remove them before waking me up), and the team put the stickers for the monitoring leads on me.
They put the pressure tubes on my legs, like calf-sized blood pressure cuffs, except delivering a soothing (and firmly circulating) alternating pressure on my lower legs, to keep any unwanted clots from forming. I had written the aforementioned "If lost, please return to:" message on my left calf, in teal sharpie, the night before. This gave the prep crew the giggles, and they asked whether I usually had that written on me. No, usually I had various possible forms of jewelry which could be arrayed to symbolize the sentiment, but not for the operation.
Then we waited for everything to be ready. It was a quiet corner back in the back, with a phone and a cluttered desk and a visible clock. There was one person back there with me; someone asked them if they'd be okay back there by themselves (yes).
I was too calmed to be nervous, at that point, but I was moderately bored, and wanted my glasses, or a book, or my phone. (Especially my phone. I very much wanted to tell (Mumble) what I was up to, what was going on, that I was still okay.)
Then it was time (about 2:45), and they wheeled me back into the operating room.
It was a very large room filled with all sorts of equipment, jam-packed the way you might expect a pretty cluttered tool shed to look like, with all sorts of interesting lights and things I didn't get a good look at.
They transferred me onto the adjacent surface, which was flat with several sections of thick black foam padding, and a padded ring for my head to rest in, and settled me down on my back. It was not as dreadfully uncomfortable as I was dreading. I think they asked me one more time what I was in for.
I believe that what happened next was the anaesthesiologist told me that he was going to knock me out. That part is hazy. After that I have no more memories of the operating room, not even counting down. (I assume they ask you to count down; he'd said something about that.)
The next thing I knew I was leaning up in my rolling bed again, feeling high off the ground, set against a wall with a good view of the clock in a large, open recovery area, with a bunch of similar beds against the wall, and not a curtain in sight. After remembering my name (Azz) and that I was alive, I felt a sense of euphoria and glee: I was okay, and needed to specifically text (Mumble) to share this information. I knew I needed my phone for that, but Ryan was not in the room.
There was gunk in the top part of my lungs. There was an oxygen tube feeding gently into my nose. There was an oxygen monitor on my finger. My IVs were still in.
I was also very sleepy, so after someone noticed that I was awake, I was not particularly able to communicate this, and they wandered off. When I did manage to flag someone down, it was for pain (the place where my uterus used to be had started to feel like it had menstrual cramps of the sort that was bad already and only going to get worse), a tissue to spit out the crud that my lungs had started to reject, and ice for my angry throat. I had to manually flag someone down, as there was no call button that I was aware of. (There may have been a call button. I wasn't aware of one.)
I vaguely recall the time being 6:50 when I first registered the clock, and then observing the time slip past in 5 and 10 minute intervals between moments of coherence. I was near the bathroom, so the only moment of actual unpleasantness came when someone else was having a moderately bad reaction to their medication, and I only really had one hand to stuff into my ear.
While all this was going on,
ryan had gotten a call from the surgeon, been informed that I was out, been informed that I was starting to wake up (possibly), and emailed people dutifully. At length they decided it was time to move me to my room, and wheeled me out. I was still sufficiently disoriented that all of this made me dizzy, which was not super fun.
The night crew asked me if I could walk from the hallway to the bed. I thought I would be physically capable of standing and walking, but that the dizziness would make this unwise. So they wheeled the thing in, lowered the bed so I was lying flat, put the bars down on the adjacent sides of the two beds, and told me to cross my arms over my chest. ("Obfuscate!" I said, as this had been the gesture that my old Vampire: The Masquerade LARP had used to indicate that we were invisible.) They then inflated a thing that had been under me the whole time, and used this medical hovercraft to slide me onto the new bed. They deflated me, then sat me up and propped me up with pillows.
There was a whiteboard just inside the door, on the wall-side. People approaching the room with my door on their right hand and the curtain open would see it as they came in. (People approaching the room with my door on their left hand, or people who were washing up in the prep area inside the room, would not see it. As I would learn shortly.) The board had things like:
* my preferred name
* my pain level
* my medications
* my medical goals for the nursing shift
Guide Dog Aunt and Ryan appeared at approximately this point, and Ryan reunited me with my phone and glasses. (Phone first.) I quickly alerted the internet (and especially (Mumble)) that I was back.
Groggy as hell but feeling pretty great. No more uterus! pic.twitter.com/zqmv5wQZoJ
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
Every new medical professional through the door has a novel way of mispronouncing my dead name. Cannot count the # times said "I'm *Azz*."
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
Talking with Ryan and Guide Dog Aunt soon annoyed my throat and exhausted me, so I resorted to text and hand signs. The increased level of coherence in the texts reassured Ryan, because I'd been forming words so incredibly badly out loud.
Still far more coherent on Twitter than spoken. Hella sore throat plus drowsy = not good talking. @teshiron
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
One thing I have always appreciated about @KPSanFrancisco’s standard of care is the way they make sure you are comfortable and informed.
— Ryan C (@teshiron) August 3, 2016
@teshiron Haven't had sore throat this bad since call center.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@azurelunatic Why have it on the board if they’re not going to look? ??
— Ryan C (@teshiron) August 4, 2016
@oakandsage Would be purely funny if throat did not hurt to talk.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
Apparently the standard jury-rig method of choice around the hospital is the nitrile glove, as we found a number of them used to tie things together. Guide Dog Aunt and Ryan suggested blowing some up and festooning the room with balloons; I suggested they tie the fingers together to make it a long string.
The surgeon had long gone home by this time, and hadn't talked to me afterwards, so Ryan filled me in on the details he'd been given (the operation went nicely and so forth; there were still a few lab tests that would take a while to come back). He reunited me with my iPad, cloud pillow, and rainbow peace blanket. All the comforts of home.
They figured out car-based logistics for the next day, and then headed out around 11pm. (The plan:
ryan would keep my car for the night, and do whatever errands he needed to do. My aunt would pick me up in the morning when they released me. Meanwhile, ryan would bring back my car, and then my aunt would take him back home.) That left me with the nurses.That was about when the barrage of names began. There was a whiteboard on the wall, printed with helpful things like a pain scale, a place to put medication names and goals for the shift. It also had a place for the patient's preferred name. It seemed that of the people interacting with me, only the people specifically assigned to me and/or my department got to see the place in my chart that had my preferred name, and nobody actually looked at the ever-loving whiteboard. So that was ... helpful.
(By 6am, I would become much less patient with the constant barrage of "[legalname]", to the point of bluntly saying "I'm Azz." in unamused tones any time someone asked me if I was [legalname] for the first time. When I did not couple this with a stern finger indicating the whiteboard, this sent a few people out of the room in the confused belief that they had the wrong room entirely.)
They had wanted to get me up and walking around as soon as possible, and I was almost feeling like that would be a good idea. They gave me a bitty wee white painkiller, and a cup of jello. That was a lot of jello for someone who had not eaten in the past 24 hours.
Jello time! pic.twitter.com/KTqhrQTiGu
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
By 12:20 or so, I had got my latest dose of pain medication (by mouth this time, a tiny white pill) plus some jello, and it had kicked in, so I was finally un-dizzy enough to get up and walk around. Or so I thought. They unhooked me from various things, and transferred all the attached things to the IV pole, but I only got about 10 steps down the hall when I came to the conclusion that I was not going to be going anywhere without oxygen, because I couldn't breathe properly yet. (Thus validating the surgeon's decision that he really wanted me there overnight.)
Not quiiiite ready to walk without oxygen yet. Dratted lungs. Nurse has gone to fetch the portable thingy. pic.twitter.com/Pc6IOvm4P0
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@evithermique I'm awake and about to take a little walk!
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
The nurse got a rolling tank, and we set out on a stroll around the floor. They have improved the usefulness of IV poles since Dad was in the hospital in the early 90s, and they now have helpful grab bars so you can use them to steady yourself if you're still shaky on your feet. I walked around basically the entire floor, and was ready for another turn, but the nurse decided I was done and steered me back to my room and put me back in bed.
Walk was nice. Pain from surgical site is about a 0.5 post meds; pain from throat is a 2. #nodeepthroatingthisweek #thingsyouneededtoknow
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@atavistique I feel happier!
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@evithermique 💙💙💙 🌺 🐠 There are a few more tests that they are waiting on, but I feel physically pretty good rn.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@branquignole Pretty good! I got to take a walk with the portable oxygen now that I am not feeling dizzy as hell. I am pretty mobile.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@azurelunatic @branquignole Whoop whoop! Sounds like recovery is off to a good start ??
— Isla Stevens (@IslaStevens) August 4, 2016
Throat is a 2 when I try to talk. 0.5 otherwise. I have ice chips.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
Let us see if I can actually get into a cozy sleeping position in this hospital bed. #sidesleeper
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
I did doze off for a while, but my natural bedtime still isn't until 4am or so. Thus I was up at various points in the night, poking at my phone. All the tubes and wires did get fantastically tangled, so there were periodic untanglings. The oxygen tried to come off my face. Early in the night, I did notice the oxygen monitor thing beeping at me, and then I noticed that I'd been holding my breath while adjusting my position, so that's a thing that annoys it. By 3am, I was just tired of everything, and my throat hurt, and some of the tubing was just plain painful and undignified.
People who are allowed to request things of me: lots.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
People allowed to issue me orders without me arguing: a rather shorter list.
List includes:
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
Darkside
(Mumble)
!!!!
?
Purple gets argued with. ;)
6am is about when the nurses start coming around to commence more poking and prodding. Sometimes they turn lights on unexpectedly. Couple that with the name thing, and I was well on my way to grouchy. Eventually I gave up on sleep.
Catheter removal is one of those little personal indignities, and worse when they wake you up for it.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
The doctors and nurses were all very nice, but there is no polite way to remove a foley catheter. The nurse asked how it felt (she has never had one herself, but has always asked so she has points of reference to reassure people). It felt sort of like having duct tape ripped off, but without hair. Not duct tape that's been stuck lightly, but duct tape that was good and stuck. "That's not so bad!" she said, very chipper. I reserved the right to disagree. They also unhooked me from the oxygen. I kept doing fine; eventually, they didn't bother to plug the oxygen monitor back in, which meant a lot less wiring to contend with.
Got an email last night that's still making me cheerful. Despite the general lack of sleep. #radiusofthisfinecluebat pic.twitter.com/FNoFf45gIQ
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@branquignole Possibly the cloud pillow, the sweet email, and my general avoidance of makeup so the lack doesn't change much? & french braid
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@branquignole Haven't brushed my hair in 24 hours but it is holding up well. pic.twitter.com/KBbKiHsjeo
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@branquignole It was the most secure style I could think of, with two elastics: one at the back of my head and one on the end.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
It was the surgeon's day off, but his alternate came in and chatted with me; they've sent stuff off for further tests, but it looks like everything of concern came out with the uterus, tubes, and ovaries.
9am in the hospital means that all the IVs are running out and sounding alarms. Loudly. #hearingprotectionplz
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@marafish They have silenced mine, fairly promptly. I used the call button for great justice.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
It hurt to pee. Very badly.
The rest of my digestive system was offended, and took a while to start back up as well. I'm told this is normal.
Breakfast arrived: jello, tea, apple juice, and broth. That probably would have been entirely okay for how I was feeling, but apparently they wanted to give me actual food. Second breakfast arrived somewhat later: cheese omelet, hash browns, milk, a banana, cream of wheat, and a muffin. (Averse, bland, intolerant, allergic, even blander, and possibly contaminated with walnuts.) I did find something to eat amongst the mess, eventually.
To be fair, I didn't mention the lactose intolerance. #bananaallergy #KaiserPermanente pic.twitter.com/lezLfrT8gc
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@branquignole Also I forgot to mention the egg aversion, and I should at some point tell them my feelings about peanut butter. #eww
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
I made eye contact with the banana. I made eye contact with my bright red allergy bracelet. Someone was going to be having words from me, and I wasn't sure who yet. I wound up sending an email and talking with the nurse, and between them they will try to figure out how it was that someone with an allergy warning in their file got blatantly presented with something that they're allergic to. While it wasn't a concern for me (I'm pretty vigilant about what I eat, and it's merely unpleasant if someone sneaks raw and not sufficiently ripe banana into something that touches my mouth, and hasn't been fatal yet), the fact that it happened at all meant that there's a hole in their process that could catch someone in a vulnerable state in a bad way.
@KPMemberService pic.twitter.com/qBIPisDEWd
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@KPMemberService Mentioned to the nurse who just came by as well. Thanks for your attention; I know Kaiser likes to get the details right.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@azurelunatic the people on the tray look way too excited to be eating hospital food.
— marafish (@marafish) August 4, 2016
@marafish DID I MENTION THE BANANA ALLERGY.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@marafish Oral cavity peeling. Also walnut, tomato (blistering).
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@marafish I suspect that the culprit is birch pollen.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
@lone_lilly Yup! Very little pain, except the pain in the neck. ;) (Sore throat from the intubation.)
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
#goals pic.twitter.com/241YiFVpML
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
I was going to get to go home; I texted Guide Dog Aunt to let her know that they were probably releasing me sometime between 10:30 and 11, then I started gathering myself together. The guy from the pharmacy visited with a brown paper sack full of various pills and their instructions. Then I waited. And waited. And waited. Guide Dog Aunt texted me to tell me she was there. I wasn't near to done yet, as I still had to have the IV ports removed and some vaccinations. Guide Dog Aunt came up, and finally I got to leave.
Time to go home! pic.twitter.com/QHm3rkjQDN
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
Scenic route home. pic.twitter.com/jafPwhMwTc
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
Lovely coast. pic.twitter.com/D3u1b3Z4B2
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
It is so pretty here in the fog. pic.twitter.com/jAR0FssPNC
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
Little boxes on the hillside... pic.twitter.com/ThGxlruwoD
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
Almost home. pic.twitter.com/in9bnwWu2z
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
Home!
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
Ryan returned my car, and Guide Dog Aunt gave him a ride back home. I have been catching up on the internet, walking, and napping.
Nap time, or at least something approximating that. In my own bed. Glad I was in hospital with oxygen last night, but today is for home.
— Azure Jane Lunatic (@azurelunatic) August 4, 2016
I will get to take the outer bandages off my abdominal incisions tonight; there is tape under there, protecting some stitches. The tape stays on, either until they tell me to take it off, or it falls off by itself. I am still discovering the little sticky patches with the metal snaps that they use for the sensors, as they didn't take them all off me in post-op.
I expect to hear back with a more detailed report on what they found in about a week, and my follow-up appointment in the office is on the 22nd. I am already feeling reasonably energetic, although I'm still coughing out goo, my neck muscles want to know why I hate them, my throat thinks maybe I should just stop talking entirely, my abdominal muscles are moderately annoyed any time I disturb them, I have intermittent pain where my cervix used to be, and the less said about my pelvic floor probably the better (it's angry, and it does not miss an opportunity to inform me of this). But I am so very happy that my uterus is gone. It's been a source of worry and a pain in the ... neck ... for years, and I'm glad to see the last of it.
I won't ever be able to get pregnant. 24 years of fear, gone overnight. I'm so happy and relieved. #hysterectomy
— Azure Jane Lunatic (@azurelunatic) August 5, 2016
So that's what I've been up to.
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Walnuts are not suitable for gender-affirming surgery, indeed! XD And rubber gloves tied together everywhere...inflated or not, definitely seem apropos.
Welcome back, I missed you!
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And, presumably, you never have to do that one again.
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The best possible outcome of all this! (I mean, "you have irregularities on your scans and need to have an emergency hysterectomy" may be scary and inconvenient and full of hassle, but hey, you get the hysterectomy out of it. AND insurance pays for it!)
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(There are limits to the realism of certain cosplay endeavors. Really.)
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THE GIFT THAT KEEPS ON GIVING
MOSTLY BY GIVING YOU NO MORE BLOODCANNON
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And I was rather interested in getting clearance for return to active duty. As it were.
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I remain happy that this went so well for you.
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