In Philly -- consult with Dr. Miro
So I am in Philly still. Until later tonight. They kick me out of my hotel in about an hour and a half though, so I am going to have to go find stuff to do. After the busy weekend I could probably use just chilling in a hotel room. Hopefully they will keep my things down there for me until I need to leave for the airport.
The conference was good, although most things I feel don't apply to me as much as they did when I was earlier on. But it was great to hang out with Jacob and Elliott again. We had a lot of fun... we ate tons of food, went to a party, went bowling, walked all over downtown and so on. Last night we just chilled out and watched the Phillys game which wasn't really Jacob's cup of tea but he suffered through it anyway. Then I watched a really amazing live show called don't order Chinese take out at 1 in the morning. Sometimes you only eat one bite of your food because its so puketastic.
The main reason for me to come to Philly was to see Dr. Miro and consult with him. He called me Friday night and apologized for not calling me earlier. His English was good, although slightly broken and heavily accented... put me in a good mood, I loved his accent. He was really so very nice on the phone about it an hoped that he would see me in the morning. When I walked in to his presentation he must have been looking for me because he came up and sat next to me and talked to me for awhile, and then invited me to breakfast. I had already had a dunkin donut but I wasn't turning it down.
His presentation was great, although in a lot of the world they still title transwomen as FTMs and Transmen as MTFs... that was a little weird for me but I just reminded myself that the world isn't centered around language used in the communitis I live in. He talked about the pros of his procedure, being he does it in 1 stage. Now this doesn't mean you won't need a revision but everything is done at once... hysto, vaginectomy, meta w/ urethral lengthening, scrotoplasty, testicular implants an if necessary a mons resection. I think their are some cons to putting your body through all of this, and ideally I'd like to have a hysto before it to cut down on the amount of surgery needed, but he did say he does all of that fairly regularly. The pros of doing it in 1 stage is less travel (costs & time) to Serbia, less anethesia, and less total time spent healing.
The procedure takes about 3 hours without a hysto and 4 with one.... which seems super quick. He says his team can complete the vaginectomy in about 20 minutes. After surgery you spend 2-3 days in the hospital and are later transferred to an apartment that he keeps for his patients. You have to pay for the apartment, but its a full one, so you can cook food and watch TV (there are American channels) and use the internet and whatever else you need to do. There is an organic market very close to the apartment where you can get food and drinks, and if needed their driver will take you anywhere you need to go. He generally likes to do 2 patients at a time, back to back in days. So you might have surgery and the next day another guy would have surgery, then in 10 days to 2 weeks 2 more patients would go through. The apartment is set up where you have 3 floors. The bottom floor is the kitchen and dining and whatever else room, then each patient has their own floor. This is important to remember that means you may be climbing 2 flights of stairs after having surgery, although obviously you will be mobile by the time you leave the hospital. He mentions you are never alon (actually used the words always in his control) which weirdly puts my mind at ease because I have fears around being somewhere in a compromised state of being and not having ways to effectively communicate with people if I needed something or had questions. They give you a local cell phone to use and program it with any numbers you need, including all of the doctors (which is actually a rather large team, not just Dr. Miro).
He does require 2 letters from therapists.
Now its always very difficult to know about what you can expect in terms of results. Sometimes in photos that I have seen of his results you will see the testicles way up high, almost like they are squishing the penis between them. All you need is time though and the skin will stretch and allow them to drop down into a sac that was created by your labia majora. He does not use expanders and seemed to think they are a waste of time and money as he said the labia is plenty big enough. He recommends for almost all patients to get a medium size silicone implant, which is 18cc. Sizes available are XS - 6cc, S- 12cc, M- 18cc, L- 22cc, and XL - 26cc. How big that is in person, I have no idea. Its fairly simple to get information on his procedure, but I was always worried about the testicles looking so high after the procedure, so it was nice to know they do settle with time (he said by 6 weeks). Another thing I did not realize is the incision he uses to place the testicles are on the top of the sac, not below. Obviously this makes sense to help keep the inicision from opening and the implants extruding. He does use a buccal mucosa graft if your mouth allows for it, sometimes he cannot do this with smokers because of the disease that can happen to their mucosa. In addition to the buccal mucosa graft he also uses the urethral plate (i think this is what he called it, I failed to write it down) and the labia minora to help get a good seal and hopefully help to keep from getting a fistula. Of course, nothing is guaranteed although in his last 58 patients he has only had 5 complications, and only 1 in his last 32.
He strongly recommends using Andractim (brand name) which is dihydroytestosterone or DHT prior to having surgery, as well as pumping before and after. He says at least 3 months but seemed to really want 6. And wants you to use it twice per day. It is kinda expensive, but a tube should last 2-3 months and is about 110 dollars. (I believe he sells it for 90)
So costs
10000 Euros for the meta, urethral lengthening, scrotoplasty, and vaginectomy.
2000 euros for the hysto
780 euros for the implants
__________
12,780 euros total
He can also do chest surgery for an additional 1500 euros and will do it all at once.
If possible I'd recommend researching as much as possible about the strength of the dollar vs the euro and if you can get the money sooner, try and buy it at its cheapest. One patient ended up paying him 7 months in advance as he felt the dollar was going to significantly weaken. I remember seeing the strength of the dollar around when he had his surgery and it was not good. It seems to weaken during our summer months and gain some strength back during the winter months. Last summer I saw it as high as 1 euro = 1.65 dollars. Right now it seems to be hanging around 1.40.
He expects you to arrive 1 day before surgery and stay about 10 days after your surgery, being in Belgrade for about 12 days. The end result seems to be between 4 and 9 cm of total length depending on your anatomy.
I will say this about Dr. Miro. He seemed to be a very genuine man. He paid for my breakfast plus the breakfast of 5 other people (former patients... I was the only non patient) and told me he really has a friend relationship with his patients because he cares about them. He offered to come to Portland if he could do a presentation for the local trans men in Portlandish - area, which I told him I would set up (probably not til like January) and he would pay his plane ticket and hotel. He's actually a really funny and fun guy, and is much younger than I expected. I am also going to try and set him up with gender odyssey. He asked me questions about my life and what was important to me in the surgery. When we parted ways he hugged me. It was a great experience for me because mostly it put my mind to rest about possibly having to go to Belgrade.
I also have had a lot of fears around whoever I would bring with me to Serbia. Two people there were the partners of men who have had this surgery and mentioned that they were treated very well and there was stuff for them to do and that while their partners were in the hospital they were taken on a tour of Belgrade and picked up and dropped off at the hospital to the apartment or got her bus passes when needed. Having the ability to watch tv and use the internet and do relaxing things helped me feel better. I know whoever goes with me may get bored, but it won't be staring at a wall twiddling their thumbs.
Another concern was revisions, or if something goes wrong. Ryan kind of helped put me at ease by telling me unless you live in the same city as your surgeon, and even then its generally the same as seeing Dr Miro. Meaning if it came down to a real emergency you need to go to a trauma unit or emergency clinic. And if its not life or death you can see a urologist, and if its just something that he can look at in a few weeks you can fly out and meet him wherever he next is in the US (which seems to be the philly area, baltimore area and miami area most often) Another man who had just had a minor revision met him in Miami just a little over a week ago. I think he said it was not at Dr. Harold Reeds office, but that he does work with him and can supervise repairs if needed.... at times it may be necessary to go back to the hospital.
As I was talking to my gay dad he was speaking about how much better you generally are treated overseas. Why? Cause they are all competing for the american dollars. Here yeah a lot of hospital rooms are nice and clean, but there they tend to make them more like hotel rooms. He was specifically speaking of areas like Thailand as he had looked at going there for his hip replacement. Yeah the doctors in the US are good, great even, but its a whole different business in some other countries. So for me I still feel fear around being in somewhere that is a bit out of my element, but meeting Dr. Miro and Dr. Marta really put a lot of fears to rest for me. They were both very nice people.
The conference was good, although most things I feel don't apply to me as much as they did when I was earlier on. But it was great to hang out with Jacob and Elliott again. We had a lot of fun... we ate tons of food, went to a party, went bowling, walked all over downtown and so on. Last night we just chilled out and watched the Phillys game which wasn't really Jacob's cup of tea but he suffered through it anyway. Then I watched a really amazing live show called don't order Chinese take out at 1 in the morning. Sometimes you only eat one bite of your food because its so puketastic.
The main reason for me to come to Philly was to see Dr. Miro and consult with him. He called me Friday night and apologized for not calling me earlier. His English was good, although slightly broken and heavily accented... put me in a good mood, I loved his accent. He was really so very nice on the phone about it an hoped that he would see me in the morning. When I walked in to his presentation he must have been looking for me because he came up and sat next to me and talked to me for awhile, and then invited me to breakfast. I had already had a dunkin donut but I wasn't turning it down.
His presentation was great, although in a lot of the world they still title transwomen as FTMs and Transmen as MTFs... that was a little weird for me but I just reminded myself that the world isn't centered around language used in the communitis I live in. He talked about the pros of his procedure, being he does it in 1 stage. Now this doesn't mean you won't need a revision but everything is done at once... hysto, vaginectomy, meta w/ urethral lengthening, scrotoplasty, testicular implants an if necessary a mons resection. I think their are some cons to putting your body through all of this, and ideally I'd like to have a hysto before it to cut down on the amount of surgery needed, but he did say he does all of that fairly regularly. The pros of doing it in 1 stage is less travel (costs & time) to Serbia, less anethesia, and less total time spent healing.
The procedure takes about 3 hours without a hysto and 4 with one.... which seems super quick. He says his team can complete the vaginectomy in about 20 minutes. After surgery you spend 2-3 days in the hospital and are later transferred to an apartment that he keeps for his patients. You have to pay for the apartment, but its a full one, so you can cook food and watch TV (there are American channels) and use the internet and whatever else you need to do. There is an organic market very close to the apartment where you can get food and drinks, and if needed their driver will take you anywhere you need to go. He generally likes to do 2 patients at a time, back to back in days. So you might have surgery and the next day another guy would have surgery, then in 10 days to 2 weeks 2 more patients would go through. The apartment is set up where you have 3 floors. The bottom floor is the kitchen and dining and whatever else room, then each patient has their own floor. This is important to remember that means you may be climbing 2 flights of stairs after having surgery, although obviously you will be mobile by the time you leave the hospital. He mentions you are never alon (actually used the words always in his control) which weirdly puts my mind at ease because I have fears around being somewhere in a compromised state of being and not having ways to effectively communicate with people if I needed something or had questions. They give you a local cell phone to use and program it with any numbers you need, including all of the doctors (which is actually a rather large team, not just Dr. Miro).
He does require 2 letters from therapists.
Now its always very difficult to know about what you can expect in terms of results. Sometimes in photos that I have seen of his results you will see the testicles way up high, almost like they are squishing the penis between them. All you need is time though and the skin will stretch and allow them to drop down into a sac that was created by your labia majora. He does not use expanders and seemed to think they are a waste of time and money as he said the labia is plenty big enough. He recommends for almost all patients to get a medium size silicone implant, which is 18cc. Sizes available are XS - 6cc, S- 12cc, M- 18cc, L- 22cc, and XL - 26cc. How big that is in person, I have no idea. Its fairly simple to get information on his procedure, but I was always worried about the testicles looking so high after the procedure, so it was nice to know they do settle with time (he said by 6 weeks). Another thing I did not realize is the incision he uses to place the testicles are on the top of the sac, not below. Obviously this makes sense to help keep the inicision from opening and the implants extruding. He does use a buccal mucosa graft if your mouth allows for it, sometimes he cannot do this with smokers because of the disease that can happen to their mucosa. In addition to the buccal mucosa graft he also uses the urethral plate (i think this is what he called it, I failed to write it down) and the labia minora to help get a good seal and hopefully help to keep from getting a fistula. Of course, nothing is guaranteed although in his last 58 patients he has only had 5 complications, and only 1 in his last 32.
He strongly recommends using Andractim (brand name) which is dihydroytestosterone or DHT prior to having surgery, as well as pumping before and after. He says at least 3 months but seemed to really want 6. And wants you to use it twice per day. It is kinda expensive, but a tube should last 2-3 months and is about 110 dollars. (I believe he sells it for 90)
So costs
10000 Euros for the meta, urethral lengthening, scrotoplasty, and vaginectomy.
2000 euros for the hysto
780 euros for the implants
__________
12,780 euros total
He can also do chest surgery for an additional 1500 euros and will do it all at once.
If possible I'd recommend researching as much as possible about the strength of the dollar vs the euro and if you can get the money sooner, try and buy it at its cheapest. One patient ended up paying him 7 months in advance as he felt the dollar was going to significantly weaken. I remember seeing the strength of the dollar around when he had his surgery and it was not good. It seems to weaken during our summer months and gain some strength back during the winter months. Last summer I saw it as high as 1 euro = 1.65 dollars. Right now it seems to be hanging around 1.40.
He expects you to arrive 1 day before surgery and stay about 10 days after your surgery, being in Belgrade for about 12 days. The end result seems to be between 4 and 9 cm of total length depending on your anatomy.
I will say this about Dr. Miro. He seemed to be a very genuine man. He paid for my breakfast plus the breakfast of 5 other people (former patients... I was the only non patient) and told me he really has a friend relationship with his patients because he cares about them. He offered to come to Portland if he could do a presentation for the local trans men in Portlandish - area, which I told him I would set up (probably not til like January) and he would pay his plane ticket and hotel. He's actually a really funny and fun guy, and is much younger than I expected. I am also going to try and set him up with gender odyssey. He asked me questions about my life and what was important to me in the surgery. When we parted ways he hugged me. It was a great experience for me because mostly it put my mind to rest about possibly having to go to Belgrade.
I also have had a lot of fears around whoever I would bring with me to Serbia. Two people there were the partners of men who have had this surgery and mentioned that they were treated very well and there was stuff for them to do and that while their partners were in the hospital they were taken on a tour of Belgrade and picked up and dropped off at the hospital to the apartment or got her bus passes when needed. Having the ability to watch tv and use the internet and do relaxing things helped me feel better. I know whoever goes with me may get bored, but it won't be staring at a wall twiddling their thumbs.
Another concern was revisions, or if something goes wrong. Ryan kind of helped put me at ease by telling me unless you live in the same city as your surgeon, and even then its generally the same as seeing Dr Miro. Meaning if it came down to a real emergency you need to go to a trauma unit or emergency clinic. And if its not life or death you can see a urologist, and if its just something that he can look at in a few weeks you can fly out and meet him wherever he next is in the US (which seems to be the philly area, baltimore area and miami area most often) Another man who had just had a minor revision met him in Miami just a little over a week ago. I think he said it was not at Dr. Harold Reeds office, but that he does work with him and can supervise repairs if needed.... at times it may be necessary to go back to the hospital.
As I was talking to my gay dad he was speaking about how much better you generally are treated overseas. Why? Cause they are all competing for the american dollars. Here yeah a lot of hospital rooms are nice and clean, but there they tend to make them more like hotel rooms. He was specifically speaking of areas like Thailand as he had looked at going there for his hip replacement. Yeah the doctors in the US are good, great even, but its a whole different business in some other countries. So for me I still feel fear around being in somewhere that is a bit out of my element, but meeting Dr. Miro and Dr. Marta really put a lot of fears to rest for me. They were both very nice people.