Another Anxiety Attack and Top Surgery

the scream

I don’t know where this post will lead today.  Let me put out a disclaimer right here and now that this is not a well thought out post and it might not make much sense to anyone.  Sorry about that.  But I need to write and I need to reach out.  Everyone in my life that I rely on is at work and I can’t reach them.  I left a message on my therapist’s voice mail but she hasn’t called back either.  So WordPress is my go to outlet when the crap hits the fan in my mental head space.

I’m coming down off of one of the biggest and longest panic/anxiety attacks I’ve ever had.  Not sure what caused it exactly.  I have this fear of losing my mind which is exacerbated by the fact that I’ve experienced two episodes of Transient Global Amnesia (TGA) and I get freaked out when I can’t remember stuff like my birthday.  It’s a snowball kind of thing that eventually leads to me feeling like I’m totally losing my mind and experiencing a full blown panic attack.  It doesn’t help that Candace is away on a business trip today and tomorrow so I’m responsible for myself.  I don’t think that’s the cause though.  It certainly makes me feel uneasy that she’s not close by right now to give me a hug but she’s close enough that if I really needed her she could be here in a couple of hours.

I’m wondering if what brought this on is that I’ve been looking into getting top surgery again and had two consults with surgeons this month.  I was hoping to maybe get it done before the end of the year because I’ve met all of my insurance deductibles and co-pays this calendar year and if I could get it covered even a little bit it would save me a lot of money.  The panic attack started shortly after I listened to a message from Dr. Beverly Fischer‘s office from the person who helps you get insurance coverage for surgeries.  She didn’t tell me any good news like that they got it approved or anything like that.  She told me I needed to get a letter stating medical necessity from a doctor or therapist to proceed with insurance.  Nothing there to really cause a panic attack I don’t think.  I’m sure my therapist and/or my endocrinologist would write me such a letter.  Maybe it’s the reality of the situation hitting home.  Maybe I’m not mentally ready to let go of my chest yet.  Maybe I got scared.  Maybe it has nothing to do with my chest.  Maybe it’s a sign that I don’t want Dr. Fischer to do the surgery.  I don’t know.

My consult with Dr. Fischer was two years ago.  I had a consult with Dr. Paul Steinwald yesterday and one with Dr. Hope Sherie two weeks ago.  I really am hoping to have a flatter chest and keep nipple sensation (erotic sensation).  Dr. Fischer is local and takes my insurance if we can get them to cover it but she does not perform the surgery I want to have and my only option with her is a double incision with nipple grafts.  The chance of keeping sensitivity in this procedure is pretty low.  My consult with Dr. Sherie, who operates out of Charlotte, NC, went very well.  She’s super nice and her staff are awesome.  She is willing to do an “inverted-T” top surgery on me and her price is comparable to those who do the standard double incision technique.  Problem is, she’s relatively new and there aren’t any after results of her work that she can show me.  I’ve seen her double incision results and they look great but I’d feel exponentially better if I could actually see her inverted-T results…even just one example.  She learned from Dr. Mangubat in Seattle who I’ve heard good things about.  My consultation with Dr. Steinwald was disappointing.  He initially tried to sway me to have the double incision surgery but did say he would be willing to “attempt” his version of the inverted-T.  That didn’t make me feel very confident.  I would fly to Denver not knowing for sure what results I would end up with.  He wanted me to stay there for two weeks to make sure the nipples took and there was still a chance I would have to have grafts in the end.  Ugg.  He’s also a lot more expensive than the others at $10,350 + airfare and hotel/food for two+ weeks.  I love his results though so I’m torn.  I know I’ll feel awful if I fly all the way to Denver and spend $5000 more dollars to end up with double incision that I could have gotten here at home for a lot less.

I’m leaning toward Dr. Sherie at this point even though I can’t find any results of her inverted-T surgeries on-line.  Price-wise she’s comparable to Dr. Fischer and I have family in Charlotte that I can stay with while I recuperate.  Unfortunately, I would be mostly on my own with trying to get insurance to cover the surgery if I end up going with her.  Her office tells me that they’ll assist me in getting coverage but they are not part of my network so I don’t hold out much hope.  Dr. Fischer’s office is part of my network and give me the best chance of getting some financial assistance with this.  It’s a bit moot though because I have the money saved to cover all of it myself, but Candace, the money manager in the family, really wants me to get insurance to cover it if I can.  For Candace, this is an easy decision.  She would send me to Dr. Fischer who is only two hours away, is the cheapest and takes my insurance.  No-brainer!  BUT…she doesn’t have to live the rest of her life with my decision.  I do.  I have the money so my opinion is that if insurance re-pays me some or all of it that’s great but my top priority is finding the surgeon who I think will give me the results that will make me the happiest for the rest of my life.  Dr. Fischer is a great surgeon, don’t get me wrong.  But her specialty really is the keyhole or periareolar technique which I am not a candidate for.  Her double incision work is respectable but not my favorite in terms of aesthetic or sensory results.

I think at this point I can rule out Dr. Steinwald.  He did say that if I wasn’t in a hurry and could lose some more weight it would make the surgery easier.  I’m leaning towards going to Dr. Sherie and, of course, Dr. Fischer is not a bad choice at all.  I like to go into these kinds of things feeling confident in my decision and right now I’m feeling pretty unsure which way to proceed.  I want to get this done ASAP but I know that rushing into a decision is not wise either.  Candace put pressure on me to get this done this calendar year because my insurance out-of-pocket/c0-pay stuff is all paid up.  She’s an insurance agent and financial adviser so that’s where her head naturally goes.  But I have to listen to my own heart and only proceed when I’m ready and sure despite the financial side of it.  I know that drives Candace crazy but it’s just the way I have to do this.  If I can lose some more weight and get into better shape who knows what my options might be down the road.  I’m thinking that that might be the route to go.  Estimates are good for 6 months from these doctors so if I give myself 3-4 months of dedicated working out and dieting perhaps I’ll have a better chance at getting the chest I really want in the end.

As for my anxiety attack, it’s mostly subsided now and my head is starting to feel normal again.  I still have a residual buzzing in my ears and a bit of clouded vision but it’ll get better gradually as the day wears on.  Eating will help too.  I’m diabetic so keeping my blood sugar level is a top priority.   I just think my head started to spin out of control this morning as a result of low blood sugar and all of this stuff going on in my mind.  Thanks for listening to my ramble today.  I’m so thankful I have this community to vent to when my life spins out of control.  Peace and hope to all of you out there who read this far.




11 thoughts on “Another Anxiety Attack and Top Surgery

  1. Made it to the end quite easily. 🙂 I think you know what you should do. As nice as it would be if you could just power on and do this because financially it makes sense, you really need to feel good about this. It is major surgery and you need to be happy with the results. Settling for less shouldn’t be an option in this case. Yesterday I just told my best friend “When in doubt, do nothing.” She didn’t speak to me for a few hours but she knew I was right. If for some reason, you are having second thoughts, now is the time to think about that. And if you are ready to move forward, a few months down the road- you will be even more ready.

    Take care and keep that blood sugar where it needs to be. 🙂

    Liked by 3 people

    • Thank you Kat! I appreciate you taking the time to read my ramblings. I actually agree 10000% with your advice and that is generally my way of going about things too. Yes, I think taking some time to improve my body and get my head right will give me a better perspective in a few months.

      Liked by 1 person

  2. I’m here and I heard, buddy. I am glad you wrote most of your anxiety out of your system. I agree with Kat, get the best you can. It is your body and your future. Take care, my friend.

    Liked by 2 people

  3. I’m here too. You should talk to Dr. Sherie about your concerns about T-anchor and make sure that she has had sucessful T-anchor surgery before. I went through a similar thing with Dr. Weiss because I couldn’t find too many guys on-line who said they’d gone to him – or many pictures of his work – and those that I did see I was able to explain away to myself about why they were irrelevant to me (peri, too young, too long on T, too skinny, etc…).
    The other thing you may want to discuss with her is what happens if you feel you need a revision either for dog ears, or nipple resizing – at least you will know what the deal is.
    If you want to talk (like a real middle aged person via telephone) let me know, I’m here.

    Liked by 1 person

    • Yes, it is hard to find much on Dr. Weiss too. I did forget to ask her about revisions and I can easily resolve that with an email. As far as successful T-anchor surgeries she claims that she has done many of them while in Seattle but not in her new office since it’s not that common for folks to request them. She suggested I look at her breast reduction pictures since it’s basically the same surgery but more drastic, which is true. Still it takes a little imagination to imagine a male chest result with those. Thanks for the offer on the phone call. The same goes for you of course. I’ll email you my number later tonight. Thanks for your words of wisdom and advice.

      Liked by 1 person

  4. Surgery is, unfortunately, not an experience you can control completely. So many factors come into play. My surgeon was unwilling to perform the surgery I requested, he was intent on avoiding scars. I assured him I do not scar badly but I did agree to his approach (I had no local community with whom to compare notes at the time so I was on my own). What I did not know was that I am prone to developing hemotomas. A massive hemotoma after the surgery caused a mess on one side. A second surgery attempted to correct things and I further fucked it up by returning to my fairly new job too soon. I found myself at a conference in a scummy hotel far from home, bleeding from my incisions and ultimately having tissue die. (relax, don’t panic)

    My chest is lopsided, another attempt to improve the situation was not effective so it is what it is. My consolation is that by their 50’s a lot of guys are less than perfect where their chests are concerned. On an intimate level it is a barrier for me as a gay man (in my mind, of course). But after more than 10 years of just being able to throw on a t-shirt and go, it is what it is and I have never missed what I had prior to this. I was 5 years into transition before I could afford the surgery so I was relieved to move on.

    That is not to say that anxiety before hand is not entirely normal and, for that matter, healthy. Best wishes.

    Liked by 1 person

    • Thanks for sharing your experience here. I forget that I’m fortunate to have options and a community to help figure things out. I do realize that all kinds of things can pop up unexpectedly with surgeries. I experienced that with my hysto. My hope is to give myself the best chance possible to be happy with the outcome. After I make my decision and sign off with the surgeon it’s out of my hands until recovery. I’m totally ok with that. I have no idea how I heal from a surgery like this so it’ll be interesting to see how it goes. I’m not nervous about the surgery process, more about the long term effects and my level of comfort with my body.

      Liked by 1 person

  5. I’m similarly having a hard time making decisions about surgery. I set up a timeline in my head to get it done this summer, but I don’t want to start putting pressure on myself if that seems too soon. I’m really not sure what to do at this point. Thanks for sharing your train of thought about it – it helps to hear your experience.

    Liked by 1 person

    • I’m glad you found this helpful. I think putting pressure on yourself is unhelpful. I’m going through this right now because of the financial pressures I felt from my partner. Plus I think, maybe it’s just in my own head, that she thinks I’m not serious about doing the surgery if I can’t make up my mind quickly about it. But even if that’s true it can’t be rushed. You’ll know when you’re ready and have found the right surgeon for the job. Good luck.

      Liked by 1 person

  6. Listen to your gut.

    From what you say here, it sounds like you really don’t want to go with Dr. Fisher, but feel that you should for financial reasons. Your panic attack suggests you’re afraid you’ll do it bur feel pushed into it. I think you need to take Dr. Fisher off the board as a possibility.

    Then take your time and figure out which of the other choices works best for you.


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