Part 4: Post Surgery (from “The Surgery”)
Note — This is a continuation of a multipart story. You should read Part 1: Leading up to “The Surgery”, Part2: Thirty Days Out (to “The Surgery”), and Part 3: Surgery Day (“The Surgery”) before reading this next installment.
On the last day of my hospital stay, I asked if all of my attending nurses and doctors who have been watching over me the last couple of days could stop by. They decided to do it during a shift change, so a ton of people came into my room to see what it was all about. The previous day, I had taken some time to write down some of my thoughts about the service they had been providing and what I went through to get there. In a very emotional reading, done a little ad-hoc where I cried several times, I thanked them for what was done to me and the service that they have been providing to the community. I wanted to make sure they understood the impact that they were having on people’s lives by offering these types of surgeries and how grateful I was to have received it. I also wanted to thank them for the exceptional service they had been providing during my stay. I could not have asked for any better. (I wish I still had the notes I had written for this, but it somehow got lost and I no longer have it.)
Funny thing is that I don’t remember a single one of their names, but can recall every one of their faces. One of the nurses would be hard to forget…she looked and sounded just like Carmela Soprano (Edie Falco)! She was the one who shared her sandwich with me that first day. I commented to her about her sound and look and I was not surprised when she told me that she had heard that comment before; but was not familiar with the show/actress. The actress was also in a series where she played a nurse (Nurse Jackie) and I was wondering if I was being punk’d or if she was moonlighting for the role. Either way, the care I received from her was excellent.
Rich, my friend and first caretaker, comes on my release day to take me back to the hotel where I will be spending the rest of the recovery. After being released, the drive through New York City was horrible. My bottom is sore and it seems like every street has some sort of construction going on (ripped up) or is loaded with potholes. I felt every one of them on our drive, even though I was mostly laying down (not sitting up) with the seat in the furthest setting of recline and I am sitting on my donut for extra cushion.
While at the hospital I had a heart to heart with my mom via the phone and I shared with her how disappointed I was with their short visit, all the miss-gendering, and the fact that they never made it back even once the rest of the week. I think it made her feel guilty and she apologized. I think they decided that they are going to make more visits while I am staying at the hotel to make up for it. The following day after release day, they make their first of many visits and offer to bring hoagies from Wawa for all of us for lunch. Who doesn’t like a good sandwich? The pic above is taken during their first visit. The black strap on my shoulder is the wound vac machine, which has tubes running down and back up my leg to the surgery site. Hanging off of it, behind my back — out of sight, is the bag attached to the catheter (who wants that in a pic….). Because of all the tubes, I am living in nightgowns; this becomes my life for the next 5 days or so.
Rich is being amazing with the care he is providing to me, being as gentle as he can. I’m happy that he is around, but sorry that he has to wait on me hand and foot. Making me meals, handing me things, etc. We are also having some nice conversations in between. I couldn’t ask for anyone better. During this first week, I am asked to spend most of my time in bed. It’s sort of a pain in the butt to move around with all the tubes coming out and the orchestration of having to carry all the stuff with you when you are mobile. I don’t like the feeling of immobility…but at least I can do some useful things while laying in the bed once situated.
I am obligated to stay near the Hospital for the next three weeks. The basic reason is that I am a bleeding risk, and if something were to happen, I need to be in the vicinity to be able to be rushed back to the hospital if needed. While it is the main reason why you need to hang around, it’s also convenient for getting back to the city for all the follow up appointments you have to do as well.
The encounters with my parents get better with each visit they make. I am happy for this, as the next planned stop is to their house for several weeks once I am released from the NJ/NY area. It would have been extremely awkward if things didn’t start getting better and I won’t say that I wasn’t considering alternatives and abandoning that visit early on. I am hopeful that the visits and spending some time together will help to heal our relationship.
On the Tuesday after (day after labor day), I have my appointment where everything was finally removed. Catheter, wound vac, and packing. The removal of the packing was almost like a comedy routine. It looks like a bunch of rags tied together in a long rope. I am watching as they keep on pulling it out and I am reminded of one of those routines pulling paper out of their mouth where it seems to go on forever. Each tug and pull gives an interesting little sensation. When they finally finish, it looks like they have pulled out my small intestines or something and I am amazed at how much stuff was tucked up inside me. They have a quick look around and perform some basic measurements before I am presented with my “gift” of dilators. I am taught/shown what I have to do with them and given a schedule of how often I need to perform it. They stress how important it is, particularly during these first couple of months while everything is still healing. I have to start out with the small purple one and gradually work my way up to the orange one over the next couple of months. They use the purple one for today’s example and it feels extremely tight and a bit strange. Every sensation I feel seems new, but I am already thinking that I will likely never get to the orange one any time soon. With its size, it currently seems like an impossibility at the moment…
With everything removed and functional, I can finally do an assessment of how things feel. It all feels a bit strange but somewhat familiar. Scientifically I had previously learned that we are all mostly made up of the same parts. So why would it feel any different than before? Surprisingly, it still feels like I have a penis, but it feels like it is all bundled up like a super tight tuck. Looks wise, there is nothing in resemblance of what was there previously. I mention it to my doctor and say it feels all a bit too “dick’ish”. The bundled up feeling is not too far from the truth, in that all the nerves are left intact but are now longer than necessary, so they are bundled up and placed behind what is left (the head) — which is now formed into a clitoris. Later on the sensation of getting a hard on returns and I am expecting to see a little clitoris standing erect down there…but when I look….nothing. So, feeling and reality are now a little bit different. (This would change with time.)
My urethra has been moved around, but the sensation of having to pee is still exactly the same. It’s always a worry that those contracting muscles you use to hold in your pee will somehow be a problem with the procedure, but they are further inside you and are never touched in the procedure. So, they work the same as they did before….which comes as a relief. I knew this beforehand, but the confirmation post surgery is still a welcome relief.
Just have to learn how to work the new structures. Don’t have anything to hold or aim, so your hips and legs become your only “aiming” tools. You can obviously no longer feel the pee coming up and through the shaft, but it doesn’t really bother me.
The labia are formed from the skin that used to be the scrotal sack. They somehow now seem even more sensitive than they were before. Then, there is the new part, the vagina itself. Overall, it feels like I traded in two parts (penis and balls) and got back 4 in return (clitoris, urethra, labia, and a vagina).
As I mentioned in earlier stories that my mind had thoughts that these pieces were already there, now that they have arrived, my mind is quickly welcoming the new pieces. I have no regrets and I am not missing the old arrangement at all. I am easily settling into the new normal, as it applies to the genitals.
Now that I am a little mobile, one of the first places I wanted to go was a nail salon. Getting nail polish back on my fingers and toes went a long way to my feeling of getting my life back to normal. So, at the end of first week, I make my first real trip out of the hotel when I have Rich drop me off at a local nail salon for a couple hours.
With the removal of the wound vac, also starts the need to have to wear and change pads every couple of hours. While it quickly also becomes the new normal, I now get to have the experience of 24 hour periods all day long (or at least the bleeding part of it). I quickly get the experience of knowing the irritation of what a wet pad feels like against your skin. It amazes me how many pads you can go through in a day and I quickly realize that we are going to need a lot more of them and need to do some shopping. So we arranged a trip to the grocery store to pick up some much needed supplies.
Rich and I also do a day trip to the Honda dealer to get the air conditioner fixed. It’s the first time Rich has driven a stick shift in at least 20 years. He doesn’t do too badly…only a couple of cringe worthy moments while he is getting used to operating a clutch again.
This second week starts a whole new world. I am starting to feel back to normal. Corinne comes in and takes over for Rich.
They asked me to do some walking, so I started out walking around the hotel the first week, but then graduated to venturing down the street. I did maybe half a mile the first walk and I am determined to start walking a little more every day as long as things feel fine. I don’t want to lose all the fitness I have built up over the last year.
Being more active is leading to a problem, as I get glimpses of normalcy. We start venturing out to local restaurants for lunch and dinner. Sitting for any length of time is a bit of a problem. I travel everywhere with my “donut”, but there are definitely more comfortable chairs out there. I began to love plushy couches. Sitting on anything hard without a pad is a major problem. Sitting in any restaurant chair with the addition of the donut cousin is also a challenge due to the extra height it adds. Banging your knees on the table supports is also becoming a regular thing. In general, sitting upright for any length of time also becomes a problem. Standing and walking is much more comfortable than sitting. Still, being able to get out of the hotel room and interacting with people is so worth it mentally.
On one outing for dinner, when getting back to the hotel, I momentarily forget what was just done to me. It feels like a normal day out, like I hadn’t recently had a surgery, and I am just on another outing with my girlfriend. My friend has a small SUV, but still has a high step down to the pavement to get out. We are in mid conversation as I slide across the seat to get out, my labia catches the edge of the seat as I am getting out. The angle was perfect, and I can feel it tear open several stitches as I step out. I immediately reacted — Oh Shit, that wasn’t good! I get into my room at the hotel, I go straight to the bathroom and view the damage. I tore open a small area about a half inch long at the bottom of my left labia and it’s bleeding, but not too bad. I change the pad and lay on the bed hoping it doesn’t get any worse. I know I have messed up….this is what they were concerned about and I was pushing things. I don’t think its bleeding bad enough to rush back to the hospital. Since the nurse is coming tomorrow, we decided we will let her assess it then and see what needs to be done if anything.
She looks at it and immediately calls my doctors. She thinks they need to stitch it back up. Some pictures are exchanged and they decide to let it go (not do anything about it). Life goes back to normal, but I don’t think we went out to dinner after that. No more risky car rides for a while…I am asked to scale back my activities.
Peeing is becoming a problem. Angle or something seems off and it seems to spray all over the place, with barely anything going into the bowl at times. Playing around with changing hip angles doesn’t seem to help much, but keeping legs close does. It crimps off the stream to slow it down enough for gravity to get the pee to go where it needs to go. Doesn’t seem right to me and it becomes a complaint to bring up with the doctor. They tell me they can’t do anything about it currently. We need to let time pass by to heal and have all the swelling go down to see what the end results will be. Everything could be fine and it’s too early to tell what the end result will be. (It doesn’t change a whole lot…)
The release from the Hospital Area
The end of my third week post op brings another follow-up visit with my surgeon. While I am not riding in cars much any more, they are upset with me when the topic of exercise comes up. I’m proud as I am up to walking 5/6 miles a day already. It comes as a complete shock to them and is way more than what they wanted me to do. We get into conversations about the definition of what is considered light exercise. One living a more athletic lifestyle, I consider walking 5/6 miles as light. Its barely raising my heart rate, I’m not sweating or getting out of breath — this is nothing! They said they were expecting no more than walking the hallway in the hotel, or maybe around the building; nothing measured in miles. They have overestimated what that would mean to someone who is more athletic. (I get an impression and ask myself if all other trans people are couch potatoes? Surely I know a bunch that are even more athletic than I am and this complaint/conversation has never occurred. But I do find the athletic restrictions to be extremely hard. I know it will be hard to resume my lifestyle when I am allowed to get back to it….)
Still, they are happy with my progress. Healing seems to be on track. Quantity of bleeding is slowing down and we go over details of my dilation schedule and what color I am using. I am asked to make sure I finish up some of the medications I am on till they are gone, others should no longer be necessary (pain killers).
We schedule my next follow up and I am told that I am no longer a major bleed risk (still have to be careful). I am asked to scale back the walking a bit but told to continue doing some. With that, I am released with my obligation to stay within their vicinity guidelines with the hospital. We discussed about when I would be able to drive a car again. I’m not allowed yet; there’s a linkage to one of the medications I am on. I can start to drive short distances a couple of days after I am off that medication. (Sorry, don’t recall which one it was…)
So we return to the hotel and make plans for how to get my car to the next stop — my parents house. Rich is going to drive the car down, hitch a ride back with my parents as they come up to the hotel to pick me up. This time he gets to operate the clutch all by himself for @90 minutes, but it’s mostly highway. I’m sure he likely did better since he wasn’t under my microscope…
With my deepest appreciation for watching over me for 2 of my required 3 weeks, I bid farewell to Rich who can now go back to his newly retired lifestyle. I will miss him, all the conversations we had, and all the Big Bang Theory and other TV Shows we watched. (Yeah, that's just some of what two techno geeks left in a hotel room with activity limitations will do…)
Next step in the process, a stay with my parents for the next 3 weeks….
To be continued…