GRS Surgery

GRS Post-Op Day 35 – To The Pain, Part 2

Thankfully, my nurse practitioner had no problems renewing the pain medications I’d gotten from Dr. Suporn. I figured it would be OK, but I wasn’t sure, given the crackdown on prescription opiates.*

I’d brought “my Thai boyfriends” to show her if needed (i.e. “I’m having to put these really large things inside me to push against scar tissue formation”), but she said the description on my dilation routine was enough to make her cross her legs involuntarily.

Not a moment too soon, because the nerve re-awakening has begun in earnest. Not fun.

Didn’t help that yesterday I went to an after-work happy hour for a co-worker who’s leaving (before I return to work), and the bar stools were very hard and small, so my pillow wasn’t that much help. During the hour or so that I was there, I ended up having to stand several times — although I suppose that’s not entirely bad, since if people were paying attention, it was clear why I need more time off. Hopefully, I’ll be better able to sit for longer periods of time by the time I return to work.

*Albeit Tramadol is the weakest of the opiate pain meds, and it also helped that she commented that I’ve shown in the past that I’ve been conservative about my use of any medications. We spent a bit of time talking about dosing, and at my suggestion, she intentionally wrote me prescription for lowest dosage per pill, so that I’ve got more flexibility in using the minimum needed to keep me out of pain.

BTW, for those who are about the suggest CBD, I’ve already got CBD pills from Highland Pharms (legal in all 50 states because they’re hemp based) that I’ve used in the past for pinch nerve pain, so I’m experimenting with those as well. Unfortunately, they are a bit pricy, whereas Tramadol is covered by insurance (and has more predictable dosing).

GRS Post-Op Day 34 – Burning Sensations

Good news: I definitely have genital sensation.

Bad news: I know this because as the nerves are reawakening, and it’s hurting like hell. My clit in particular feels like it’s on fire whenever the pain meds wear off.

Unfortunately, this is a normal part of the healing process. With Dr. Suporn’s technique* months 2 and 3 post-op are the most difficult, since that’s when nerves that were temporarily deadened by post-surgery trauma start “waking up,” and when the internal scar contraction really starts kicking in — hence the need to dilate 3x/day (or more) to prevent scar contracture from causing you to lose depth.

Admittedly, it’s not helped that due to some scheduling mishaps I’ve been sitting far too many hours during the last two days, which puts pressure on the genital area. (Although it was useful in confirming that there’s no way I could return to work just yet, since I’ve got a desk job where I sit most of the day.)

Just gotta embrace the suck.

*Don’t know about the recovery from the more commonly used “penile inversion” technique.

GRS Post-Op Day 30 – Along Came a Spider

TMI, dilation stuff….
TMW you’re rinsing yourself out after dilating and think you see a spider in the shower — and then realize it’s just a wad of stitches that came out.

And before anyone worries, this is a normal part of the healing process, since the labia stitches are designed to work their way out as the incision heals.

In fact, it was a Good Thing, since it involved some stitches that had been poking out and were really uncomfortable.

GRS Post-Op Day 29 – Ass Officially Kicked

Probably part of it is still jet lag, but the trip back from Thailand really took a lot out of me.
Dilations this morning weren’t fun, but were better. But simply unpacking the suitcases and putting away stuff has left me wiped out.
The trip definitely caused some swelling too. Been walking very slowly and carefully since I got back. I know it’s a temporary setback, but still sucks after being pretty mobile at the end of the trip.
Trying to keep in mind my advice to others: after surgery only do 20 percent of what you think you’re capable doing, since you’re running on reserves, and when the reserves run out, you can have some really nasty energy crashes. And by the time you think you might have overextended yourself, it’s far too late. (Thankfully it only happened once in Buenos Aires after my facial feminization surgery, but there was an incident where I was very seriously thinking about taking a taxi only five blocks back to the apartment because I had serious doubts about whether I could walk back myself.)
But the thing that sucks the most is having to time my life around pain killers, since at the moment I’m back to having to take them every four hours.

GRS Post-Op Day 28 – First Dilation At Home

Oh holy mother of Maude, the first dilation after returning home hurt like hell — even with the much more powerful painkiller I had leftover from a prior surgery here in the States. 😱😱😱 Far worse than the first dilation I had after being discharged from the hospital.

Took almost an hour to get to depth — it had only taken 5-10 minutes at most before I left Thailand — and I’m not sure I actually got there. Then it was the normal 15 minutes of “push and stir.”

Didn’t even attempt the second round with the larger dilator, with Dr. Suporn’s blessings. You can regain width later, but at the moment it’s crucial to not lose depth.

Probably multiple reasons why it was so tough — first dilations after returning home notoriously are.

First, with all the travel I’d gone 24+ hours without dilating instead the normal 8-hour interval. Probably made worse by my body healing quickly, and thus it was busy trying to close what thinks is a ginormous puncture wound.

Second, even traveling business class (to get the seats that convert into beds) was grueling and really uncomfortable on the surgical area. So my body is still pretty tense down there.

Being intensely jet lagged probably didn’t help get into the right frame of mind either.

Unfortunately, when you’re having difficulty dilating, the only solution is to actually do *more* dilating, to gradually loosen things up.

So once I finish dinner, it’ll be time for another round. 😭😭😭

O you who know what we suffer here, do not forget us in your prayers.

GRS Post-Op Day 28 – Bittersweet Surrender

It’s 1 a.m. and my bags are essentially packed and ready to go. There’s a little final stuff to be done when I get up at Zero Dark Thirty to dilate and put my face on. Not sure if I’ll try to get a few hours of sleep, or whether I’ll be able to. Regardless there’s plenty of time to sleep on the plane. Six hours from Bangkok to Tokyo, a brief layover and then another 10 hours to San Francisco.

Like most patients who can afford it, I’m flying business class. Expensive as fuck, but the seats that lay down into beds are worth every penny after genital reassignment surgery. You really, really, don’t want to be sitting for 16 hours.

Hard my final check-up this afternoon, and Dr. Suporn pronounced me healthy and healing well. There’s some stitches are pokey and uncomfortable as they come out and can make it ouchy to walk at times, and there’s some dead skin on the inner side of my labia (which is normal and will slough off in good time). Dr. Suporn asked if I wanted to see photos from my surgery, and being the medical nerd I am, I said I did. Didn’t particularly freak me out, even though I thought it might. The clinic actually send you home with a USB drive with photos and potentially some video. Not sure I need to see that though.

Someone asked me to summarize my experience in a word. It’s difficult because there’s some many complex emotions, but I finally settled on “intense.”

It’s emotionally intense when you arrive, the surgery and the recovery are both physically and mentally intense. But there’s also an intense bonding that occurs with your fellow patients, especially those whose surgery dates are close to your’s, so you seem them for most of the month that you’re here.

Sisterhood is a word that’s overrated, but it’s applicable here. We’ve shared a unique and grueling experience, and that leads to some intense bonds. Realistically, I may never see many of my new friends in person again — Dr. Suporn literally has patients from around the globe — but I do plan to keep in touch online. I suppose it’s a tiny bit like being in combat — you can talk about it to others, but it’s different with someone who’s actually been through it themselves.

It’s a bittersweet parting of the ways.

An appropriate soundtrack for my mood right now:

GRS Post-Op Day 27 – Pee-chievement Unlocked

TMI…. bodily functions
One of the things about genital reassignment surgery is that you literally need to re-learn how to pee again. Not only is the urethra now in a difference position, but the muscles you use to control your pee are very different.

It’s a really good thing the toilets here have a spray-nozzle bidet (why, oh why do we not have these in the States!) because immediately post-op you tend to spray everywhere.

But I realize this morning, I’ve finally learned pretty good control over the stream. Achievement unlocked!

The other not so fun thing about recovery is that the pain killers make you constipated, really constipated — which when you’re sticking an 8-1/2×1-3/8 medical dildo inside you to dilate can make things very crowded to say the least. Let’s just say I have a pretty good idea about what double-penetration must feel like — but this is definitely *not* the fun kind. Last night I was almost crying because it was so painful.

So it’s great when the laxatives actually kick in. Almost feel like we patients should get a gold star with “I pooped today” on it. 💩

GRS Post-Op Day 26 – No More Static in the Attic

One thing that’s been lovely here is watching some of the other patients really blossom.
One of them was almost manic tonight on the chat app we use here, gushing about how, after being Spock-like all her life, she’s finally able really feel emotions, and make connections to people.
It’s nothing to do with the surgery itself — albeit, she no longer has any testosterone in her system — rather it’s surgery seems to have unlocked something in her psychically.
Probably a combination of no longer having the constant “static in the attic” that comes with gender dysphoria, plus being in a place where she can truly be herself. (While there’s some official discrimination against trans people in Thailand, the Thai people here truly don’t care whether one is transgender.)
Not to mention being with others who’ve been through a difficult and intense experience, and come through the other side tends to cause some rapid bonding. We few, we happy few, we band of sisters.

GRS Post-Op Day 26 – To The Pain

The down side of rapid healing and the nerves waking up — OMG this evening’s dilation really hurt. The medium size was OK, but I ended up having to cut the time short for the large size (although I was still able to make the minimum time needed). But I was almost ready to cry by the time I called it quits.
Doesn’t hurt that I seemingly busted an internal stitch earlier today — nothing serious, it happens during the healing process — but yeah, that made things extra sensitive.
Ironically, when you’re having trouble dilating, the properly response is actually do to more sessions, albeit shorter ones, until things loosen up again. So I have I’ll have to try to do four sessions tomorrow.

GRS Post-Op Day 26 – Post-Op Care at Home

Someone asked whether, after returning home, I go back to check-ups. And the answer is, no you don’t, due to the distance involved, but you can send the clinic photos and status reports as needed.
Dr. Suporn actually doesn’t want other doctors looking at things because his technique is so different that even doctors in the States who do genital reassignment surgery don’t necessarily understand his technique and how it heals. (Obviously if there’s a medical emergency, they will have you see your local doctors.)
I’ve heard a horror story about a patient who was in an auto accident, and when she was taken to the ER the doctors there attempted to “fix” what they thought where problems down there — and completely ruined her GRS. 😱
After a year, you can return to Thailand for revisions. The revisions themselves are free, but you need to pay for your flight and hotel.
Typically revisions are things like correctly asymmetrical labias, or labias where there’s been a small detachment (which leaves a small hole), or issues around the urethra. Sometimes it’s also cosmetic things — Dr. Suporn intentionally leaves as much tissue as possible in case of tissue necrosis (so that there’s remaining tissue he can work with), but the trade-off is that some patients end up with really large labia, which they don’t like from an aesthetic POV (and yes, I know cisgender women have labias of all different shapes and sizes), but it bothers some people.
Some people also have him do the posterior commissure of the vulva (where the outer labia join behind the vaginal opening toward the perineum). Dr. Suporn doesn’t do this initially because dilating would just cause it to tear. He’ll only do it if you can skip dilation for about a month, and one trade-off is that it does make your a bit tighter (since the reconstructed skin isn’t quite as stretchy as the factory-installed tissue). It’s one of the “tells” that someone’s had GRS, but honestly I doubt very many cisgender people notice. OTOH, we trans women can be extremely self-conscious about a variety of things that cisgender rarely notice.