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Last minute details before vaginoplasty

Sunday, April 4th, 2010

April 3, 2010

Good morning Dana,

You are a precisionist and very attentive. Soon I will have to do my part.

A ring pillow ideally should be soft to support your buttocks but have a sufficient aperture in the center so you do not sit on your incision line.

Some patients like the inflatable model (may pop), but hard Styrofoam should be avoided.

A bowel prep should be started 24 hours before surgery which will include clear liquids only, a half a bottle of citrate of magnesia at 8 AM and the other half at 4 PM, a Fleet’s enema at 10 AM, 3 PM and on the morning of surgery.

Also on the day before surgery, neomycin sulfate 1 gram and Flagyl 1 gram, both to be taken by mouth at 1 PM, 2 PM and 11 PM.

We can phone in these prescriptions for you, once in the United States.

Thank you for losing the weight, so important.

Have restful weekend and thank you for the many delightful and pretty photos you have sent. I could say a lot more
comment-wise on the Yahoo group, but this would only make the others envious,

Harold

At 02:48 AM 4/3/2010, you wrote:
Dear Dr Reed,
now it’s one month to go to my surgery on the 4th of may. So I would like to give you an update of my sitation.
First I lost the weight you wanted, only 3 pounds to go. My weight is 198 lb at the moment (6.3 ft. tall). I will stop taking Estrogens today and Spironolactone snd Asperin on the 20th of april as being told on the script.
Blood tests, Chest X-ray and Stress EKG is already organized by a friend, so when I come to the states on the 15th of april all will happen in time as written in the script.

The Baltic Hotel is booked with Christine and a friend is organised to stay with me.  I am doing Electrolysis here in Germany since 5 weeks now and is going on twice a week till I leave.  The therapy letters should be with you already.

The stents I will buy of you, because I wouldn’t know what to buy anyway.  Bromelain, Arnica and Vitamin C Tabletts I will buy when I return and take them a week before surgery as writen in the script.  The Ted Hose I will buy this week, but I am not sure what kind of ring pillow I need.

My English is not so good, so I need to ask you what a bowel prep is, where I get this and the other stuff I need to take 24 hours before surgery? If I have to be with you a day before surgery, when do I have to take the stuff then? I guess when I take this I won’t get off the toilett…lol…
ok..hope I didn’t forget anything…I am looking forward to my surgery..can’t wait…lol

Happy Easter to you and your family

Easter Greetings from Germany

Dana

Posted in Feminizing vaginoplasty, Vaginoplasty, sex change | No Comments »

Desirability of Touch up after “one stage” MTF vaginoplasty

Tuesday, January 26th, 2010

Good morning Kim,

Like the stewardesses say, “be careful accessing the overhead racks as articles tend to shift in flight.” I have never seen a class A result either from this office or from any other doctor, where after a few months something could be done to improve the appearance. May be a noticeable scar, or small separation that healed with a scar, or a urethral opening up too high or an elevated posterior lip, or a clitoris that is too prominent or could use more hooding, or labia majora that simply do not look youthful.

I strive to have all my patients be a visual “turn on.” Yes, I find the female genitalia very attractive and feel if someone is paying big bucks and entrusting their care to me, they deserve something really extraordinary.

We only want walking positive advertisements. For that reason, we do touch ups at no charge under local with IV sedation, with the understanding if the patient is overly anxious, or has a history of drug tolerance, or needs a fair amount of work to be done, they do have to pay for the services of anesthetist which never exceeds 600 and could be less. Everything else is on me and don’t forget to bring that ring pillow back again. Sitting on your incision line is not good for wound healing!

Sincerely,

Harold M. Reed, M.D.
305-865-2000

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Another MTF Vaginoplasty revision requested

Sunday, January 24th, 2010

Dear Dr. Reed,

You have my photographs.  Hope you can make me as pretty as what I see on your web-site   srsMiami.com

April,     PS:  here is Camilla’s enthusiastic letter.

Dearest Dr. Reed, First of all, I will d?like to say THANK YOU VERY MUCH for your wonderful revision labiaplasty you did on me. I?M VERY HAPPY! Let me say hello and thanks to you secretary Anne, as well, such kindly and lovely. I had all of kind of attentions and care about the staff, and lots of care from you. I consider to advice all the folks need procedures about any kind of ?sexual gender problems? to go to Dr. Reed. He’s definetelly, is the best of surgeon and as good person. Thank you forever. Camilla

September 23, 2008

Good afternoon April,

Thank you for your excellent medical photographs.  Very helpful.

Yes, I agree the labia and clitoral hood are the most notable areas that need revision.  I do believe you will receive a result that will make you smile at last, no more double-take looks.

Last week we did a similar case, perhaps not as exaggerated as yours, and she was very pleased.  Here is a “thank you post” from our http://srsmiami.com/blog/

Thanks for Vaginoplasty Revision

September 21st, 2008

 

  1. Camilla F. | pinko@pallino.it | srsmiami.com | IP: 87.18.47.195 Dearest Dr. Reed, First of all, I will d?like to say THANK YOU VERY MUCH for your wonderful revision labiaplasty you did on me. I?M VERY HAPPY! Let me say hello and thanks to you secretary Anne, as well, such kindly and lovely. I had all of kind of attentions and care about the staff, and lots of care from you. I consider to advice all the folks need procedures about any kind of ?sexual gender problems? to go to Dr. Reed. He?s definetelly, is the best of surgeon and as good person. Thank you forever. Camilla

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MTF Vaginoplasty revision

Sunday, January 24th, 2010

Dear Dr. Reed I recently emailed you advising that I had SRS MTF sutgery. I asked about vaginal deepening procedures and labiaplasty. You wanted me to come in to your office. I will be in the Miami SOuth Beach area 02-28-2010 until 03-04-2010 iwanted to know if i can come into your office on a friday or monday .  Please email me back or call to verify appt dt and time !!!!!!
How you heard about us: annelawrence.com

January 24, 2010

Dear Nicole,

What a pleasant surprise to hear from you.

Preesently on retreat in the Carolinas followed by 2 fully booked weeks in Miami. But do call the office on Monday February 1, 2010 and schedule in.

Anne our amiable office manager should be very helpful.

With every best wish,

Harold M. Reed, M.D.,
305-865-2000

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When will a scrotal graft be necessary?

Sunday, January 10th, 2010

Re: When will a scrotal graft be necessary, Nessie

Hi Nessie,

The use of a scrotal graft is really necessary for any one who is seeking adequate depth for penetrating sex. For the past year we counsel the patient pre-op and do it at no extra charge, because we want you to be a happy. You never know when Mr. Right comes along.

Very rarely when a patient says do not do it, if they are confirmed asexual or lot older, and it is desirable to save 45 minutes of operating time, that step will be eliminated in the interest of patient safety. Unless someone has a stretched penile shaft skin length of 7 inches, we heartily recommend that
scrotal graft extension be done.

In conjunction with this we also recommend electrolysis starting 3 months before. We have seen hair grow back on patients who have last moment epilation in the operating room. Even if successful the trauma to the scrotal tissue may reduce ideal graft take.

The scrotum will stretch almost like a latex glove, so once the graft is above the level of the pelvic floor, you can build upon our depth to suit, providing you embark upon early and dedicated stent usage, until again Mr. Right comes along.

If dilation is painful initially, this is quite normal. Then consider EMLA cream or lidocaine jelly 2%. Please do not procrastinate. Your doctor will show you, using the palm of your hand, how hard you can push safely. Even if you just gain an 1/8″ every week, it adds up.

Harold M. Reed, M.D.
305-865-200

Posted in Feminizing vaginoplasty, MTF, Vaginoplasty, Vaginoplasty revision, sex change | No Comments »

When a letter from a therapist doesn’t satisfy WPATH SOC

Saturday, December 12th, 2009

Dear Laurie,

Read the letter and this is the classic example of how a letter of endorsement should not be written. This type of letter is in fact seen when a therapist feels a certain obligation to say something but in fact has deep seated reservations about making any written commitment. This is akin to a “letter of recommendation”  for an employee.   Miss so and so worked in my office from June 1st 1999 to September 5, 2001. (Start, period, end of letter).

This is a more a letter of detachment.

The standards for how a letter should be written if the Dr. is interested are posted on WPATH.   To wit:

 

The Mental Health Professional’s Documentation Letter for Hormone Therapy or Surgery

Should Succinctly Specify:

1. The patient’s general identifying characteristics;

2. The initial and evolving gender, sexual, and other psychiatric diagnoses;

3. The duration of their professional relationship including the type of psychotherapy or

evaluation that the patient underwent;

4. The eligibility criteria that have been met and the mental health professional’s rationale

for hormone therapy or surgery;

5. The degree to which the patient has followed the Standards of Care to date and the

likelihood of future compliance;

6. Whether the author of the report is part of a gender team;

7. That the sender welcomes a phone call to verify the fact that the mental health professional actually wrote the letter as described in this document.  

The organization and completeness of these letters provide the hormone-prescribing physician and the surgeon an important degree of assurance that mental health professional is knowledgeable and competent concerning gender identity disorders.

More or less in the first paragraph the therapist should introduce him/herself by virtue of their background and training and societal memberships. Next the therapist should endorse the client for transgender surgery (“I recommend, I endorse, or Miss so and so would be a good candidate for transgender surgery, etc”).

Next suicidal ideation or attempts (yes or no) should be mentioned, as well as any drug abuse history or ethanol dependency (yes or no).

Lastly the therapist should invite the recipient to call their office for further discussion should questions arise.

Look at Dr. Mora’s letter hopefully and you will see the difference.

Sincerely,

Harold M. Reed, M.D.
305-865-2000

Posted in FTM, FTM chest, Feminizing vaginoplasty, MTF, Vaginoplasty, male chest reconstruction, metoidioplasty, sex change | No Comments »

Grant reactivated for limited time

Sunday, December 6th, 2009

Thank you for your interest in what we do.

GRANT SUBSIDIES AVAILABLE AGAIN

This January, 2010 the first 10 cases, will
receive Grant Subsidies.

Think “the first 10 in 2010.”

After reading the attached (our letter to prospective patiuents available by writing admin@srsMiami.com) , if you believe I am the doctor for you, please initiate a consultation over the phone with our office by sending us your name, address, and telephone number in an envelope along with a check for 250. We’ll get started ASAP. We’ll have a lot to talk about.

The grant should reduce your fees by about 1/3 from our typically affordable price when you agree to donate your testes to a non-reproductive research project. Certain restrictions regarding age and communicable disease may apply.

Happy Holidays,

Harold M. Reed
1111 Kane Concourse, Suite # 311
Bay Harbor Islands, Florida 33154
305-865-2000

Posted in Feminizing vaginoplasty, MTF, MTF Grants, Vaginoplasty, orchiectomy, sex change | No Comments »

Dr. Carol L. Clark holds non-stop sexuality seminar at Jackson North Hospital

Sunday, November 15th, 2009

I followed a GLBT advocate and counsellor. My talk on sexuality included as per syllabus from Dr. Clark…

Medical factors related to sexuality and sexual functioning

Objectives:

· Define the DSM sexual disorders, and discuss the following in relation to it: symptoms, factors increasing susceptibility, and prevention.
· Describe how surgical procedures, such as a hysterectomy, may affect a woman sexually, physically, and emotionally.
· Define hormone replacement therapy and explain its advantages and potential risks.
· Describe the incidence of, symptoms of, and treatment alternatives for penile cancer, testicular cancer, prostatitis, benign prostate hyperplasia, and prostate cancer. Describe tests for prostate cancer and treatment alternatives.
· Describe the reasons why women would choose to have or not have breast implants and controversies concerning the implants themselves.
· Learn how major disabilities my affect sexual function and expression. Learn coping and enhancement strategies for people with disabilities.

2 hours later with time for serious questions and answers, we were done. But aside from potty breaks their day was still going strong. Young therapists seeking their doctoral degrees, thirsty for knowledge. Commendable, Carol (who is a board certified sexologist with a doctoral degree, how many therapists can claim that!).   Dr. Carol L. Clark   (closest to our office)  305-757-6070 

Harold M. Reed, M.D.

305-865-2000

Posted in FTM, FTM chest, Feminizing vaginoplasty, MTF, Testicular Implants, Vaginoplasty, Vaginoplasty revision, male chest reconstruction, metoidioplasty, phalloplasty, sex change | No Comments »

7 MTF procedures this week

Sunday, November 15th, 2009

3 full vaginoplasties,  2 orchiectomies,  scrtoal removal, a revision of work done elsewhere.

All patients are doing excededingly well, some have already left the Baltic Hotel with a smile.

Two received financial assistancce.

We insist on hand held mirrors for each patient during a dressing change, so they can appreciate what we accomplished.

Patients are seen daily including Saturday and Sundays.

Harold M. Reed, M.D.
305-865-2000

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Vaginoplasty Touch Ups

Sunday, November 8th, 2009

 

— In MTF-SRS-FTM@yahoogroups.com, “kennyhilnager” wrote:
 Dr. Reed,
What are the typical reasons for touch ups and how much can be done
at one time?

Kenny

Hi Kenny,

Touch ups are either planned as the doctors may knows they have not been able to attended to every little detail in the interests of patient safety. The patient should be apprised during her recovery if not known at the outset. Often there will be a critique (work list) made by the patient and which is often supplemented by the doctor after he/she sees the patient. Ideally everything should be done at once, and the best time is a good 3 months after complete wound healing. This does not mean 3 months after surgery.

Areas often include: asymmetry of labia, need to lower the posterior commissure (for a more direct approach into the vagina), a urethral spongiosum rest (left over urethral erectile tissue which swells during arousal), re-siting of the clitoris or need the hood the clitoris, lowering the opening of the urethra, closure or approximation of the upper labia majora (mirror image parentheses), providing greater opening (introits) to the vagina, revising an unsightly scar.

As you know there is no charge in our office for this revision which is typically performed under local with IV sedation. For those patients who require or request general anesthesia, this amounts to 600 or less. We want you to look your very best. Please bring your work list.

Harold M. Reed, M.D.

Posted in Feminizing vaginoplasty, MTF, MTF Grants, Vaginoplasty, Vaginoplasty revision, sex change | No Comments »

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