By Thrusday morning, the pain was absolutely unbearable. Now I’ve had three knee surgeries. I vividly remember the feeling of ripping most of the ligaments out of my knee and crushing the cartilage all at once. This pain was so bad, it made that feel like a gentle ache. The only aspect of it that didn’t scream appendicitis was that I didn’t have a fever. I have enough medical background that I knew what that probably meant, so Melissa met me when I got off work Thursday and we made the trip to the ER.
I know I’m not the only person in the world dreading seeking medical care from a doctor outside my routine doctors, especially not for something in the pelvic area, but I also know well enough that a ruptured appendix can kill you. So I carted myself off to the ER and waited.
At check in, I told them about my pain, my name change, that I’m trans and I went and sat in the waiting room in the most comfortable position I could find. I went back to triage just after a guy having chest pains with a family history of heart attacks. Potential appendicitis triages pretty high, in case you were wondering.
So they get me into an ER room and we wait. And wait. And wait. Finally, the doctor and nurse come in the room together. The nurse starts putting in the IV and the doctor starts pawing around my stomach. Ow. So he starts going through my symptoms to see what else it could be in addition to or instead of appendicitis. Any constipation, blood in stool, unexplained bruising, painful urination, blood in the urine, history of kidney stones, testicular pain… wait what? Some body either didn’t put that I’m trans in the chart notes or somebody didn’t read the chart notes.
Now to be clear, this is something I would have talked to the nurse about again, if I’d seen her before I saw the doctor. But I didn’t so I couldn’t. Now it was far too late and I was far too tired to be tactful, so I just blurted out “yeah…I’m trans so that’s not a thing”. The doctor was noticeably mortified. Again, it was far too late and I was in far too much pain to read into this, otherwise I think my first thought would have been “and this is how all the trans* healthcare horror stories start”.
So he stepped out while the nurse finished putting in the IV and he came back a few minutes later. He was still noticeably flustered as he explained the he put in orders for a CT scan to confirm appendicitis, and then proceeded to ask me a few more relevant questions now that he knew I was trans… ovaries and uterus intact, history of pelvic inflammatory disease or STDs, Apparently, somewhere along the line, someone informed this guy that it is rude to ask trans people about their surgeries or lack thereof, but I’m here to tell you that in a medical context, especially with pain in the pelvic area, you better expect them and they are medically pertinent. Do not expect to walk into a doctor’s office with pelvic pain and expect them to not ask about whether or not you’ve had any bottom surgeries. It’s not rude, it’s medically necessary.
So he starts discussing the options in order of most to least likely: appendicitis, ovarian cyst, intestinal blockage, PID. So they wheel me back for a CT scan to check the appendix. The IV contrast is miserable. It gives you that warm fuzzy drunk feeling all over your body, and also makes you feel like you definitely just peed your pants.
More waiting while they review the CT scan. I haven’t eaten in 9 hours at this point and had probably only eaten a total of 300 calories all day, so I was miserable, tired, hungry and rocking a migraine to beat Hell. But I can’t eat until they either decide yes or no to emergency surgery.
Finally the doctor comes back and the appendix looks fine. They proceed to rule out everything else they can think of – all the stuff I mentioned above and eventually settle on the idea that I either sprained something really bad, passed a kidney stone and didn’t see it, or pinched a nerve. As part of ruling out ovarian cysts or PID though, I had to have a pelvic ultrasound. Now I suspect having a medical professional digging around below the belt is uncomfortable for anyone, but particularly so for us trans people. I’m happy to say that everyone was very chill, very respectful and used the right pronouns all the time….even during the more….invasive…parts of the pelvic ultrasound.
It’s been about a week since that and it’s feeling better. Still not 100% percent, but definitely an improvement.
On an unrelated note, Melissa just finished the hassle of getting the internet set up at home, so I’ll post of of our pictures from Alaska soon, as well as some new pictures of me and the beard.
Until next time,