I had my meeting with the nurse coordinator. Outside of her checking the surgical area for clearing progress, we could have done it over the phone. Every time I go in there, I have to take a day off since getting around Boston is a bear. Usually, if I have to go into Boston, I will take the T. I used to work on Comm Ave so I learned the subways over the years. I used to love to take my kids subway surfing where we would jump from one train to another and pop up somewhere and take in the sites and then back down, but that is another story.

She was just slightly late as she had to find my file. We met and went over the process. She told me what to expect afterwards. She also noted that their process was fluid so it was possible that things could change. This was due to them adjusting their process as they only have been doing this for a year or two.

She informed me that she hadn’t gotten letters from my PCP or my endocrinologist. I checked with both, PCP said he had sent it, which they later found. My endo, I had to ask again. I posted the request in the portal and followed up with a call to her secretary. I have not heard from anyone either my endo or BMC as to the letter being sent.

Mind you, the letter is nor a requirement of WPATH which sets the standards for Transgender care. Rather, this is more for the insurance companies. BMC just wants to dot their i’s and cross their t’s so as not to have any issues with insurance down the road. Needless to say, this isn’t the first time my endo has not been forthcoming with a letter. The last time was trying to get the gender designation on my driver’s license changed. She said she had to put it through their legal department and it was months before I got the letter I needed. All it had to say was that she was treating me. Worse, I can download the history from the portal, but they need the doctor to sign off. So I could prove it, but that doesn’t help. I had to threaten to get a lawyer involved before I got a response.

That is the frustrating part. I can do everything that is asked of me, but all these “gatekeepers” have a say and need to sign off. WPATH states that I only need two letters of referral from mental health providers. I got that. Yet, my holdup is due to my endocrinologist.

Of course, getting a call from the nurse coordinator to go back over what we discussed because she accidentally deleted her notes on me, does not give me warm fuzzies. This is the person who will be handling my after surgery care and teaching me all the fun things like dilating.

I sometimes think it would have been faster and cheaper to just go to Thailand. I know a few people who have and are happy with the results. I just felt that going to a local surgeon would be good especially if there are complications or adjustments. I thought also about Mt. Sinai, but then again, a friend is going there and saying she is having the same issues. So I guess I will stay with BMC, but given the issues I have had with insurance with my breast augmentation, I definitely have to gird up the warrioress.

Oh, yeah, that is the other development. The insurance company sent me a letter last week saying that I had to repay them over $700 because they shouldn’t have paid a claim. This was to pay for the anesthesiologist. My insurance is Aetna, and so many have made claims against them that they deny claims, even if they pre-approved as they did mine.

You really have to be your own advocate when it comes to insurance and health care. Nothing is easy. We really need to get rid of insurance companies and go to single payer. Their whole goal is profit, not patient health. How much further along would I be if I didn’t keep having to get approvals for this and that.

So, last week, I did another back to back with surgical area on Wednesday and face on Thursday. The EMLA cream helped somewhat with the surgical area. She still hit a few spots that made me jump out of my skin. My next surgical clearing is June 6th. I am thinking about bathing in EMLA before I go, just to be sure. Of course, by the end of the session it is starting to wear off, but if I can get through the brunt of it.

So I am doing my part to keep this all on track. I wish I could say the same for the doctors. I have still not heard back from my endocrinologist as to whether she sent in the requested letter. I haven’t heard from BMC saying they still haven’t received it. So basically, it is a waiting game. You really need to have patience to go through all of this, as well as a high threshold for pain.

As always, my heart to your heart, one heart, one spirit.

Emma