uptown thief

Finally, a book that features sex workers as main characters, not as main victims or main outcasts! The reviewers talk about the amazing revelation that sex workers are real people, thanks to this story. The author thanks $pread Magazine, the St. James Infirmary, Bay Area SWOP, and The Harm Reduction Coalition and Training Institute in her long list of acknowledgements. Uptown Thief by Aya de Leon is the first in a series featuring the sex workers introduced in this story.

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surgery!

It took three years, but I finally had my neck surgery in June. Details and non-gross pictures to follow.

the problem

The US surgeons and doctors I spent thousands of dollars seeing were wrong in every way. First, they all missed my cracked vertebrae (aka broken neck). My broken neck could have also been very useful in a legal setting to prove the force of the plane crash. I do not have a history of broken bones (though I suspect a couple of my toes have been broken at some point).

Second, they’re all stuck on the idea of “conservative treatment” as opposed to surgically fixing what is wrong. No pills or shots or waiting two years will unherniate a herniated disc. Anyone who tries to claim differently is full of shit (and most of them were full of it).

Third, the US’s sole method of treatment for a herniated cervical disc is spinal fusion. The problem with fusing two vertebrae together with a disc of bone is that it adds abnormal stress to the surrounding bones and tissues, leading to more problems and future surgeries every couple of years. Great for the doctor’s and drug company’s pockets. Not so great for your neck and quality of life.

the solution

I have had very little experience with other countries’ medical systems but decided I could waste a little more money on a consultation with a surgeon (after I forced the front office to give me a cost estimate for the surgery to even know whether or not it was worth my time and money for the consultation). It is the best money I’ve invested in my healthcare yet.

Not only did I get an empathetic, objective doctor, I got one unbound by the US medical industry. Which means he was free to practice medicine in the way that best suits the patient and offers the most health benefits. He is the one who spotted my broken neck in my original July 2012 images. He explained the dangers of cervical fusion and why they prefer disc replacement. (The info on the US disc fusion scam I found out from one of Jill’s doctors.) After getting a new MRI of my neck, the good news is that I only need one disc replaced, the disc between my C5/C6 vertebrae. This is a simple surgery.

X-rays during surgery, lying on my back. It's easy to see the problem.
X-rays during surgery, lying on my back. It’s easy to see the problem.

The replacement “disc” really looks like half of a small plastic pencil sharpener, with grooved teeth on the top and bottom. He said it feels like a cork. There is no metal hardware left in my neck, the natural force of my spine and the grooved teeth hold it in place. I also gained 1/4 inch in height. 🙂

The cost was right at $20,000USD; when you add in consultations, images, pre-surgery workup and post-surgery medication. If I could have had the same surgery in the US, it would have been an extra $10-20K more just for the surgery and overnight stay. My surgery included a private suite because I had to stay overnight for recovery and observation. I had a TV and Wifi, I surfed a little online but mostly slept. I didn’t even bother with the TV. I had a private bathroom rivaling a decent hotel bathroom (with handicap bars for safety reasons). Jill was with me for this and she had a bench couch several feet long, with pillows and blankets if she were going to spend the night. Though she didn’t need to spend the night, it was clear they were as concerned for family members as the patient. The food was actually great, I chose from a menu and had no problem choosing vegan options. I ate like a horse after the surgery (in other words, normally).

Jill just told me today that I did indeed watch TV all afternoon after surgery, episodes of “Criminal Minds.” Apparently I thought I was watching HGTV. I have no memory of this but it makes me laugh. I hope I enjoyed whatever I hallucinated I was watching.

I’m completely sold on the idea of having my main medical care outside the US. I hesitate to use the term “medical tourism” because that implies a one-and-done attitude, which is no longer my attitude. I am in a place that is known for encouraging medical tourism but the doctors are not at all money-hungry, say-anything types. They practice medicine as it is meant to be practiced. I don’t think they realize how much it means to me. If I were a weepy person, I would have wept with gratitude several times during the process.

the surgery

You can read a detailed explanation of what is done during the surgery here. I had osteophytes (aka bone spurs), so those were shaved off while the surgeon was in my neck. The surgery itself took an hour, I think he said. I was fully under. It is the first surgery of my life. I had no major problems recovering, though I suffered an extreme bout of being hot, and had muscle spasms. I vaguely remember this. It does feel like my thermostat has been reset to “hot” and I’ve been cold-natured my whole life. I don’t know if this effect will subside or not. (I am sure the plane crash damaged my pituitary gland and I’ve been running hotter-than-normal since, but this is on a whole new level.) Anesthesia does many things, and different people have different reactions. I wore a soft cervical collar for 3 days after, which made sleeping difficult. I wasn’t doing much else anyway.

Pain was easily controlled with a mild prescription pain-killer. I only took it for a couple days for comfort. The worst pain was living with the injury for three years. Surgical pain? Hardly noticeable. (This is normal for this type of surgery.)

Screws inserted in my bone, the disc is removed.
Screws inserted in my bone, the damaged disc is removed.

Recovery has been fairly easy. About two weeks after, I started having severe pain and stiffness, as if from whiplash. My follow-up visit explained that my muscles were out of shape because it had been three solid years since the plane crash. Some muscles were used to holding my head a certain way, while other muscles basically atrophied. Now that I have normal movement, my muscles are having to adjust.

The surgical follow-up basic neurological test was completely normal. I know that immediately after surgery I raised my left arm over my head and I felt no tingling. I could rest with that arm behind my head, no problem. I can even put a full towel on my head after my shower and no pain!!! I no longer have to use my special lightweight hair-drying turban if I don’t wish to. I can toss my hair back, turn my head both ways. I still have muscle pain when doing any motion that lifts the weight of my head but it is slowly lessening.

My scar is very minimal. I’m using a scar-reducing serum and Scar Away Silicone Sheets religiously. They glued my skin instead of using railroad track stitches. I will have a scar no matter what, but it won’t be more than a faint line in a few months. I recommend the Scar Away sheets; I honestly can’t tell if the serum is having any effect or not.

There are still weird nerve issues going on in my neck and jaw. This is normal because they’ve done some disruptive work on my neck. It’s all surface issues, so I think it’s really just the nerves under my skin that are affected. My skin is clearly unhappy but it is slowly going back to normal. Again, this isn’t anything abnormal from surgery, especially when we’re talking about the skin of the neck, skin that is more delicate than many other places on the body.

Would I do this again? In a heartbeat. This has changed my life for the better. I hoped that it would and it has. It’s a huge step forward in getting my life back and getting my body back. I will always have cognitive issues, no surgery can cure that. But my physical issues are over.

Living without pain and with nearly-full mobility is kind of weird now. (I’ll regain full mobility in time as my muscles get used to it.)

but…

My surgery was on June 12. The plane crash was on June 13, 2012. It took that long. I lived with constant pain and problems and limited mobility and constant fear of further injury for three years. (Something like a fender-bender could have paralyzed or killed me.)

I know I’m not the only person in the world to live with such an injury, or even for that amount of time. I know that being able to earn the money to pay for the surgery in cash is a privilege, even though I was in constant pain. I also know that people who are stuck with American insurance as their sole source of healthcare don’t have the luxury of getting cervical disc replacement, or engaging in medical tourism. I am very thankful that things fell out the way they did because this is the best result for my health I could have hoped for.

Final step: the space is held open, artificial disc inserted, then the screws removed. You can see how the disc shows up.
Final step, the space is held open, artificial disc inserted, then the screws removed. You can see how the disc shows up.

This is something Pig could have paid for out of pocket, no problems at all. While I’m so glad I got a disc replacement and not fusion, the fact remains that I had to work my ass off to pay for surgery to fix the harm he caused me. He has not been held accountable in any way. I have to be responsible for his negligence and sociopathy.

Many people have donated and it helped, especially with basic living expenses when it was needed (thank you!!!) but the bulk of the cost I earned the old-fashioned way. This is no complaint, simply explaining how it was achieved. It has taken me longer than I wanted to fully get back on my feet.

Why did it take so long? Well, there are a lot of reasons, all of which can be laid at Pig’s doorstep. The whole first year was spent simply recovering from the plane crash, trying to assess the extent of my injuries and get treatment, getting over the emotional trauma and preparing to go into hiding. I saw only two new clients that year and one long-time regular. I was in no shape for it, physically or emotionally (my regular knew what was going on and he has been very supportive). The second year was spent living in hiding, seeing no one, and planning subsequent steps, both legal and work-related; which led into this past year, one of the main goals was getting my surgery done. That process began in January with finding a new surgeon.

I made the mistake of not returning to work soon enough and that was due to emotional trauma left by Pig and the plane crash, I’m not going to lie about it. When I did finally return, I was pretty raw and made newbie mistakes because my head wasn’t where it should be. I’m back to being a professional now but it did take some time. Had I gotten my ass back in the sling faster, I could have had my surgery six months sooner. I don’t know that it makes a huge difference in the grand scheme of things, but I still place ultimate culpability for the entire situation squarely on Pig (because he is the whole reason all this happened in the first place).

Now that it is done, it’s weird that I don’t have it hanging over my head anymore. I’m free to plan new goals and any money I earn or spend isn’t all about the surgery (especially the spending part). It’s a very free feeling. The lack of pressure is strange but I think I can get used to it.

For the most part, this also frees me to start thinking about/writing about other things. Pigshit continues but unless something truly noteworthy happens, the blog goes back to my random topics (and I have several topics to chew on, of course!).

None of this changes how I feel about Pig or negates anything I said in this post. Not one single whit.

cliches and wrong ideas

I subscribed to The Nation for a couple of years, long ago, and generally liked Katha Pollitt. But, like many otherwise intelligent people, she goes sideways when the topic of sex work comes up. Her essay, mostly taking issue with Melissa Gira’s book Playing the Whore, has a lot of juicy bits I want to chew on. Heather Berg has a completely different, and very valid, view of Pollitt’s article here.

It doesn’t matter to Pollitt that sex workers are not a monolithic group, nor does she recognize that some sex work writers might actually be leftists themselves. She is highly offended that the ideology of the sex worker rights movement doesn’t follow what she thinks it should follow. She gets downright insulting when she attacks the term “sex work.”

sex work is work

“The ‘sex work is work’ cliché is that prostitution is much like any other service job—being a waitress is the usual example. I dunno how many waitresses would agree with that…” First, I love how the extremely important statement that “sex work is work” is relegated to a cliche. Is it? I don’t think so, not until everyone in the current culture agrees that sex work is work, all sex workers are working hard at a respectable job, they’ve heard it all before, let’s move onto something new. We’re not there yet. Not even close.

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reactions v

getting paid on time

One thing sex workers have going for us is that we get paid on time. Smart ones get paid upfront (this is standard for most, but not all, of the world). While I’ve often compared mentally freelance writing work with sex work, they’re only now catching up to the pay-upon-completion model. Not the same as pay-upfront, more like pay-as-you-go but for a legal occupation, it’s a huge step forward.

make an authentic logo

Too funny! Hipster logos!

speaking of authentic

Yes, that guy I mentioned in the first section did indeed make another one of his damned “authentic” posts. I cursed at the monitor for subjecting me to it, then unsubscribed. I’ve added a couple new non-sex-work blog subscriptions and am much happier. Thank you, non-authentic bloggers, for writing more of what I like reading.

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reactions iv

authentic

Tired of “authentic” as the new buzzword. It’s either being used by completely inauthentic people, or it’s being used in a such a way that renders any true authenticity meaningless. I’m following one blog where the writer has decided to “be authentic” and if I have to read another one of his vague and presumably powerful posts about something supposedly authentic in his life, I’m going to scream and unsubscribe (and I’ve read his blog for years).

As for escorts — find a new word. Though at least authentic is better than zest. Don’t get me started on that escort trend-word. (I would love to write an escort ad that includes the line “I’m authentic, as well as genuine and real.”)

“authentic” as a “lifestyle”

This is even more irritating, as supposedly there is only one way to live authentically: eat certain foods, wear certain clothes, believe certain things, practice yoga and/or trail running, and yammer on about how it’s all changed your life on every social media platform you can find. Ideally, you’ll also sell ebooks about how everyone else can live just like you, especially if your readers are white and/or male. (Taking it further are those who have sold all their possessions and live out of a suitcase. I’ve found it’s an overrated way to live.)

The authentic trend bugs me because I do not think the word means what they think it means. It’s a good word, getting used into meaningless dust. Can’t everyone go back to using zest in an irritating way?

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