META: These series of posts are collated reposts from a dedicated twitter account: https://twitter.com/kybele_deployed that document, specifically, my experiences from the point of preparing for SRS, then experiences in hospital for said procedure, then the recovery process thereafter, followed by some discoveries in new embodiment and the followup surgery. As such it spans for now the mid-2020 to mid-2021 time frame, overlapping largely with COVID-19 lockdown. The original posts are still up as tweet chains. Their relative order has been preserved, but not their exact time positions. The first operation took place November 10 2020, the second June 21 2021. For purposes of being possible to upload sensibly, the collated accounts have been subdivided thus preserving, again, relative time order but not relative time position, and the time stamp of these blog posts therefore does not correspond to the actual times of the tweets.
Recovery poses unexpected challenges in terms of weakness and low mobility but all seems to go normal so far. First time in forever I let myself be helpless and I think I have needed it. https://t.co/JXg1MVBJSW
Written yesternight, posted now. I am still very tired but not sure sleep is what I want yet. Unlike yesterday this feels OK. I know memories will fade fast so want to write these down before they do. Unlike before my genitals now have a word for them that does not feel like self harm to use about myself. Still not a polite, unloaded word though. Where relevant now will use the closest medical term.
Complicated in that I don’t yet know what is what in the sensory qualia. Unsure esp what labia, vestibule vs deep vagina feels like. This matters currently re: pain. Still in no pain but that hinges on staying in exact this position. Even changing upper body creates some sensation I think contrary to immediate-scale healing. Angle shift provokes (vaginal?) swelling. Clearing throat or gut peristalsis, tugging of deep parts (neocervical anchor?). Avoiding use of local tensing muscles for now. Later probably crucial for blood flow in autograft. Staying still is a mental challenge. Easier while remaining anaesthesia makes me pleasantly slow. Feels like when waking 12-14h and then sleeping aa long earlier this fall. Reboots. Dulls but only temporarily. Nice. After gown prep I waited 3h unquietly. Severe caffeine withdrawal headache, on full fast including water. Started listening to more Galactic North. Surprised when they finally came. Took tongue piercing out and went with. Nude under gown. Rolled into basement. Anaesthesiologists were lovely, soothing, calming. Only used vein port canulla. Still has it. That was scariest part for me because painful needle. I mostly used German, shifted to English when I did not know a phrase or word. It was OK. Lay in station with canulla in, calm but headached. Old man snores like he was choking. Finally rolled in. During this waiting time silently prayed: praise to Inanna, petition for her Rite of Head-Overturning (that is, transition), and gifting to her all the upcoming shed blood and the pain and fear and discomfort, as sacrifice. Main anaesthesiologist and resident got me in specific position into, essentally, operating gyn chair. Then added drug to canulla. This was only other pain, and weird one – felt like freezing my hand far below subzero, radiating.
Then suddenly started feeling like fuzzy, drunk, blurred. And next I woke feeling like when I repaid a sleep debt in past. Happy, still tired, unable to focus but wholly safe at last. Spoke with anaesthiologist. They rolled me back to the room, gave me some whater and I try since to let my loved ones know but without pushing myself at all. Typing slow. Love you all! ♡ More later to come.
Noting with some satisfaction I had two shamans (eclectic Siberian and Celtic) and one witch (Gaian/Wiccan) sending me healing thoughts during procedure, beyond my other loved ones. Plus my own Sumerian prayers. I remain a STEM materialist but I now let myself add meaning through spiritual overlays, recognizing humans as creating meaning. I could never let myself do that pretransition, my wishes did not feel important enough then.
Healing challenges today: – vaginal packing material causes v painful intestinal gas buildup, learned eventually an approach to handle it from my roommate who had the first operation in May – got onto meds: minor painkillers, escitalopram, antibiotics, antithrombolytics – learned that if I try to sit up or stand up yet, I will faint. They do not use bedpans so must learn in next few days. But already easier. Probably due to blood loss – concern from nurses and ward residents of little catheter throughput. Mostly probably means I must drink much more as my body is a virtual sponge. Might be why my weight fluctuate so widely generally – light but stinging/hot pain in various parts of vulva. I see this as a good sign, implying thus far all is intact. May need ice pack and painkillers tonight though – pain/discomfort from just laying flat is real. Learning how much I can move but weights of sand limit that, need to ask for help – learning to use the phone to ask for help whenever needed, ask again if needed, and wait if needed – broke fast, eventually making healthier choices than default for what to request. Staying as vegan as I can, feeling good over this – little energy for anything complex but all is OK.
Met with surgeon who inspected. Overall good but some parts need extra attention for cleaning and also he advises against the antithrombolytics. Instead I should constantly move my feat while lying down, which I do worry might tear a bit. Will see. And do as he says.
Still a way to go. Could not really sleep, and felt helpless and tired as the day began, wondering how to kill time. I still feel too tired to be much use, but I don’t have to be. I will just accept mindless impressions. Tonight I may sleep better. But at least now I can stand without lightheadedness, and may be able to handle bathroom stuff, when intestines work again, on my own. Less helpless to come. My vulva still hurts, and still seeps blood and lymph from all the stitches (but nowhere near the red tide…) of the first night, and there is a minor hematoma, but doctors say it looks good. Reducing swelling and pain with an ice pack now. And had an experience which made me feel a lot better. One of the doctors cut away the hospital panties to change them, then left me lying for a while as he picked up another pair somewhere. I haven’t looked at myself yet, and I am sure so far I am a bloody, swollen mess. But where before there would be a pervasive sense of wrongness from being seen and visible like that, here it just felt like any utilitarian, medical nudity. The specifics of my body in that situation simply was not an issue any longer. I was just a person undergoing treatment, comfortable in her own skin. There is still a long way to go, but the most major step was already taken.
It dawns on me I have had the ability to give (certain several kinds of) fucks surgically removed and I think this is something wonderful, both needed and elegant.
@eirenliel I want to only give the kind of fucks I am happier for giving. ♡
I do wonder what my gut microbiome will be like (“might f**k around and find out”). Mechanical cleansing, 4 days 3rd-gen cephalosporin IV. Restarting with mostly fruits, vegetables, grains, soy, but in a hospital setting. I hope in the end will be eubiotic. Confounded by, in meantime, mechanical castration, blood loss and healing from the penectomy trauma, all of which should have some impact on inflammatory state and thereby gut microbiota too. Plus hormones, I went off blockers near a month ago, and off estradiol on Sunday but started again today, after realizing it might have contributed to the downer mood. Though main factor probably is still the relative lack of control in small everyday things, I do feel a lot better this evening. Largely this is because today I am strong enough to walk around with the catheter bag within the room, and resolve the painful and frustrating intestinal resting state. Having eaten normally for a few days, peristalsis does its job despite how the passage is narrower where the end of the vaginal canal is adjacent to the intestine, so apparently everyone has painful bloating during this stage of this particular vaginoplasty technique. Being now no longer lightheaded from standing, I could initiate normal stool with softeners and then fearfully do my best to pass it without contaminating the surgery site, the compresses or the packing material. Remembering the times I heard girls admonished always to wipe from front to back (because notably, those were the messages that stuck with me, funny how that works?) and learning very down-to-earth practical tasks again. Now relatively easier and I am less afraid – this was one of the things I dreaded most. I still will ask during the MD checkup tomorrow if all is well, if I didn’t harm any of my new self by not dealing with it right but already feeling there are more and more parts of this existence I can control better and better, where I have agency. I had expected to go very vulnerable, but so far I sort of feel mostly more confident? We shall see how it all goes. Pain is increasing more also, and I am on no serious pain medication. Might or might not need to. Worried over the hematoma, over healing issues somehow, over thrombosis impeding any capillary healing, over infection once IV with antibiotics stops tonight, over the nightmare scenario of graft not taking inside. But all of that for later. For now, I just feel good. I look forward to relearning my body while fully present in and as it. Much love! ♡
Milestone: Anxiously worrying if that rich/bloody discharge from your nethers is a sign something is wrong. (It was not, I think. There’s just still a while left until I no longer shed blood lymph.)
Also, not taking blockers every morning means I need a new routine to make sure I take my anxiolytic every morning. Probably forgot it yesterday.
And some progress already since last night in that sitting up now feels easier.
Note to self: do not neglect stool softeners.
Surgeon came by in an eccentric flurry, accompanied by his local acolyte. She literally offered “I’ll be your hands” when the gloves he wants were not available, and so the two unfolded my labia and looked around. From what I could tell, he thinks they heal well. He asked her to remove a single, specific stitch (after randomly walking off looking for a scalpel) around the clitoris so they could see healing there, which apparently was fine, and I noticed the tactile sensation. Nothing sexual with it, but I know now that part is there and that it is sensate; somehow not sure which parts of the old glans sensations readings from it corresponds to. Will see how that develops. For now, at least feeling comforted we likely are going in the right direction.
Loving the pragmatism of nurses. One helped me now in several ways; removing need for super itchy bed covers (“Hrmph. Synthetmaterial.”) by me wearing a pad instead, fixing catheter flow, and removing the back-of-hand vein IV port, as from here I take oral antibiotics. Port was much less severe to remove than I thought, not a large stretching of vein by a rigid object needing stitching, but a flexible small plastic tube. Every piece of anchoring thus gone frees me a little bit more in the moment. Embodiment and the path there is wild.
Moved to another room. No pain doing it but I have been… so physically tired for an hour since? WEIRD. Was not using my crotch for it after all. So, physical exertion being more major during recovery is a thing? Moved to a new room. Felt like no effort during, but exhausted after. Altar setup now on side table. https://t.co/QjU7K86VG4
So there is this special pain which comes from tensing the body with a catheter in place and the weird part is, I feel I have experienced that somehow before vividly even though I know I haven’t? Oh yeah. I remember it from suppositories, that is what this feels like. Huh.
Likely good sign of healing but still weird feeling as parts of my old anatomy randomly comes online in the sensory map, but 1) as parts rather than the whole segments they were and 2) without me having as yet _any idea where they are currently located_ either in absolute or relative terms. Plus, of course, it is largely a stinging pain or prickling kind of sensory data so far. Integrating this into a new homunculus whole will be a remarkable journey, but once I am better healed. For now, contributes to the pain, largely. That said, I offered this pain wholeheartedly as sacrifice to Inanna and I will bear whatever it turns out to be, to offer her glory. I am wholly happy with my choice. And might ask for painkillers soon, so I can sleep. Both of these are true at once.
Had followup with surgeon today. This time walked on my own down to surgical suites in basement, got mask and shoe and hair protections and a cardigan over my surgical gown. Led into another theatre and seated in gyn chair setup once more. I could smell how unwashed I am and felt self-conscious, lots of smell of dried wound liquid especially, musky. But surgeon and resident ignored this happily. Maybe I will try to see if I can get to shower tomorrow somehow. Would need help of resident in repacking compresses afterwards. I will ask if I can shower before he does it. It would feel so so good. Anyway. Surgeon kept smiling, comforting me in his whimsical way, like soothing a scared animal which I was I guess. He told me he’d describe all he did and I realized with some fear this would mean painful steps perhaps without anaesthesia. It was all right but left me in all quite drained, in a meaningful way. He cut the external stitches, which I had not realized were there but which I now realize were connected to some of my stinging/restricted sense of motion pain. Weird if I am already healed enough for that, but apparently. Not so painful except one in the clitoris, which felt like being cut directly. I cried out and he asked “Which means?” and I responded that it was a sign that nerves were intact. It took a while longer. Maybe it was several stitches. The pain was intense, and I groaned, staring up at the surgical lights stating within praises to Inanna and dedicating, as I have promised, this pain to her as sacrifice. It helped me to do this, made it easier. Surreal. He needed to clean that a little extra, and I think there is special packing surrounding the clitoris inside the inner labia. Apparently I must take care to ensure the catheter extends up symmetrically between the inner labia so it does not strain them. Will have to look out for this. One issue: urethra is unusually swollen and bleeding, and this must be fixed somehow. I think it was now cleaned out and hopefully will be in better shape next time we meet, in two days. He was not sure why though I am concerned maybe the catheter is hurting it when I move? The bulbus region (unique to this method: urethral segment used in the vaginal vestibule to bridge) being perhaps also unusually swollen. This is one thing the second surgery often corrects. Another would be the surplus skin folds now in the outer labia (this I see already without mirror) which allows for those revisions more readily. Then removing from the vagina itself the tightly packed compresses that filled it. This did not hurt as I feared, but I also was not yet (and won’t yet be for a while) ready to really map those sensations. Angle and direction is… unlike what I’ve known. Somehow I think I expected a rectum-like vector but of course not, this is some sort of perineum surface inverse normal vector. I worried before that I would be at risk of breaking if penetrated other than carefully (and let’s face it, I will want at some point penetration where such care needs not be taken!) so it was interesting to see the speculum parts and feel them being used to hold the sides apart quite painlessly. Apparently the canal does heal well, but the inner deep graft (which is made from scrotal skin) might not yet have. This worries me of course a lot, but less so than for the outer parts. Surgeon seemed optimistic, and filled me up, as he explained, more tightly with rolled up compresses containing some medical solutions. This higher pressure, he explained, should probably help. I will, of course, worry. But I assume that even if it does not work, he can rescue the outer part. I would have some depth at least, even if the recovery and stay here might need to take longer. I will leave this worry as I have done all I can in choosing the practitioner and procedure, it will go as well as it can. I will learn in two days whether it helped. Then he cleaned up more and more, and took me back up to the part of the clinic which looks more like a hotel. Tomorrow the resident who attended will change the bandages externally, then on Wednesday the surgeon looks again inside. At least that long with the catheter. However, I feel already with the stitches out that I can be a little more relaxed in laying down or moving around. Returning, I was tired. More emotionally than physically, unlike yesterday. And should spend tonight doing very low-effort, low-engagement relaxing tasks, I think. But all in all, gradually it is becoming more and more how my body is unfolding, and I feel joy and faith in slowly initiating that unfolding. The major parts are all behind me now. Sending you all love! ♡
Finally slept almost a full night. Probably the stitches being off, I think. Still tired but this may be sign of healing. Also helping: instead of hot cover, covering legs with the lunghi I got for that tantra workshop so long ago now, which helped me so much in working out I wanted this. It has served me well since as shawl and dress and pillow and picnic blanket, so I am glad to see it come to use now come full circle to help me rest. I should probably look into more of them, very nice quality and material.
I think exactly a week ago I must have been mid-surgery. There has been so much healing and progress since, I am honestly surprised to be this relatively pain free and functional already. Tomorrow, hoping to learn if deep skin graft (back of vagina) has begun to heal properly. And hopefully in a few more days, will be rid of catheter. Having the speculum inside me today was interesting; a little painful though largely from the opening (and I feel they kept having to use serious muscle force to dilate me?). Did not have much sensation from the canal wall itself, more from the surrounding structure, though I suppose this is something which will continue to evolve. This was again in the context of cleaning out and changing packing materials. That which seeps out is still reddish but maybe clearer now, as though I am shifting into more lymph, less blood from the sutures inside, however those are made. Was seated on a chair for first time post-op while waiting for the inspection and it was remarkable in how it was at once not very painful, and at the same time very draining. I wonder if my internal support musculature is atrophying already from a week of lying down? Or if there is competition for resources given internal healing happening. Beginning to understand therefore how people have described the recovery period as limiting activity – not from pain or steric hindrance, but from systemic quick exhaustion somehow? And is it possible this has overlap with ME/CFS mechanisms actually? Needs exploring! Later! And eventually I shall need to start practising simple activities like sitting and walking, probably still while here in hospital. Not out of the woods yet, and overall very tired, but still feeling better and better both physically and mentally? Wondering a little if I have some phenotype where damage and healing produces some internal painkiller equivalent, as otherwise so far that has been so relatively minor a factor. Maybe the injuries to parts which do not have nociceptors still trigger this? Not that I have an idea what I am talking about. Hmmmm.
Ugh. There are voluminous wound-liquid wet tissue wads hanging out of my uncomfortable hospital panties making a mess but I cannot really change them myself yet as I don’t know what packing material should go where, so it will have to wait for tomorrow somehow. Oh well. And my entire backside is a mass of dry itchy skin I am trying not to scratch to pieces, from lying down all the time, sweating and not having been able to shower. I so look forward to some stage when I can wear saner things like tights/tops/panties with just regular pads. Hopefully once catheter and packing stent is out.
Some concerns. Hoping and praying they will resolve perfectly, working on least-bad strategies if they cannot. And what fear may then still remain, I dedicate, just as the pain, to Inanna as sacrifice. For the cleaning session this morning I was woken at 7 and asked to come down to the surgical suite, freshly awoken. Surgeon heads back to his other city so wanted our appointment done before his main operation; moreover, theatre was also not available so this time I had inspection in the actual airlock to the surgical suite. Very surreal. Catheter still in place, no news on the urethral swelling, but updating on the vaginal healing. To give context to less obsessive readers, the combined method is called as such because it follows a “penile inversion” skin flap + urethra for the outer parts of the canal (same as classic Western methods) and then lengthen that with a scrotal skin graft (same as the advanced Thai methods); this is what makes it “combined”. In my case, from what I could gain from rather hurried conversation, the deep graft so far has not attached properly, meaning while it is sutured together with the outer part of the canal, it is neither binding to nor receiving vasculature yet from the body cavity. This was the concern two days ago, and the hope then being that to repack it, but back it tighter to the back wall with compresses, might speed that process. This has not worked as well as hoped, though it is still possible it might; another two days will now follow of such packing. If it does not work, what I learned during quick conversation is, it will have to be adjusted during the second stage operation in six months, making that more complex and also presumably expanding period of intensive dilation from six to twelve months, assuming it is successful then. I also am not sure what happens with the graft itself if it does not take; if it can be preserved inside and reused, or if it needs removal and the much shorter vagina needs closing in some other way then. Nor whether there is any risk of the unattached graft going necrotic under those circumstances. Nor what options then would exist for alternate graft sources: having external skin wounds as a result? Ultimately, this would seem to make for two possible outcomes: one where I am lucky and this present deep graft still takes, and one where I am looking at longer followups during next year, possibly more full anaesthesia, possibly painful skin graft sourcings and recovery therefrom, and a worst-case scenario where the vagina simply ends up quite shallow – unclear how shallow, but possibly such that penetrative sex may be difficult or more limited. It’s not possible to say yet either way on any of this, and all I can do in one sense is, try to deal with it. This too makes for multi-pronged efforts. I would need to mourn the extra time lost, try to find ways of making that time useful, and to make the most of any outcome there is. The latter is most accessible – this would still not be as bad as, say, losing the clitoris to necrosis as some do, but I honestly do feel that I want as much of this as I can, so depth also matters. However every woman has her limitations of her body, parts and aspects she is uncomfortable or have trouble with. I have had both cis and trans lovers who mourn and navigate how issues ranging from vestibulitis to damage to anatomical limitations prevent them from either vaginal or anal penetration to the extent their desires called for. I can draw on their experiences and kinship if I end up having to live with a similar limitation. I would just find the sex I can have comfortably and follow that up. The fact that I no longer am alienated by having my old anatomy there, or feel awkward having another touch or see it, already empowers me now. Likely I retain sensation, so the chance of me having clitoral orgasms at some point seems good. And if lovers want to do with me things I physically cannot offer them, I suppose I can get good at other things instead to keep them interested, if need be. I will manage, either way. I feel finally I am the one steering the ship of how I live within my body, no matter how the graft takes and what depth I achieve in the end. And if anyone can work out a solution to deepen me if needed in followup, it would be this surgeon. I’m still emotional, of course, and during the day now I anticipate that this all will be in the back of my mind causing rumination and trouble but that is just how having a mind and a heart is. I would not have undertaken this if I were not prepared for a range of outcomes, this is part of what my process on deciding on having this surgery was about. I considered a far wider range than this already. Then there is the question on whether I can now make a difference to the immediate outcome. Surgeon is unsure what the issue with the deep graft is. Probably not the skin itself, but as noted, I have had substantial issues with bloating and intestinal gas and blockage during the healing. My fear all throughout that, and remaining now, is that perhaps that has physically made it difficult for the graft to find adherence to the cavity, as it has been pushed out too often too quickly. So perhaps what I can try to do is to quiet my digestion as far as is possible. I can try to eat slightly less, and being even more diligent keeping fibre high. I will start now the use of probiotics which I brought along rather for their vaginal colonization potential, taking them orally in the hope they may shift gut functional state away from gas producers. Nurses are unwilling to provide more than two stool softeners per day but do provide “buttermilch”, which is not vegan but can serve a similar purpose, allowing me perhaps to ensure smoother, less gassy digestion. This is lay speculation, but at least a little closer to my actual expertise, and as complement when the treating physicians also are at a loss, can hardly hurt. And beyond that point, further still, is the point of the even less formally evidenced namely the spiritual. As stated, I don’t really conceive of that as anything outside of ourselves or of ways of systematizing the world, but that no longer holds me back from choosing to relate to myself and the world through such a lens when helpful. And it is here literally about something within myself – healing processes and calm centered between what some would consider sacral and root chakra. And I have framed this entire procedure within the scope of that ceremony which trans priesthoods of Inanna may have underwent so long ago, asking for her grace as they did, and offering to her all my pain and confusion and fear and response to ordeals along the path as sacrifice. Here I proceed – I continue to pray and sacrifice that this Goddess within whom I see so much of my ideals for my own womanhood transcendentally embodied may grant me relief and lead me through this to the best possible outcomes. So I act, on several fronts, and through acting, have a way to cope with the uncertainty. There are a few other things, also. Still of course no certainty yet catheter removal will be a success, if swelling has continued. If it has, it will then be a matter of further waiting. Frustrating and anxiety inducing but again naught else to do. Where I can act however is on the level of how my skin suffers. I must get them to show me how, somehow, I can shower. My whole body itches now and it is hard not to scratch. Lying in bed, sweating, for over a week, makes this near unavoidable. I need to shower, then moisturize. For both of these I need the instructions and collaboration of the nurses and doctors, so they can help me do so without harming packing materials or cathether. Perhaps there is a way I can separately wash my hair finally, or separate parts on their own, and then if they get me some moisturizer, I can use that. If not, I will try to ask my Berlin girlfriend to bring me some. Restoring moisture to the dry, dry skin should help at least make everything else more comfortable. And I sense within me, with some mourning, that I am moving to want to look into some efforts that can bring me later glory, though still not available to the world. I could do some work that I would not have done otherwise, but also would not have done now if fully relaxed and at peace with the healing flow. This in a sense serves to prepare for the potential reality of next year having a longer recovery period for the second procedure (as well as, perhaps, from procedures to deal with the sizable lipoma now seen on my side), freeing me up to not worry so much over productivity loss in that. As I wrote this, nurse came by and noted just how much my skin now was scratched from the itch. She offered much-needed sympathy, helped me apply a topical solution, gave me an antihistamine tablet, changed all bed materials away from synthetic materials to cotton and says the doctor will get back to me re: maybe changing my antibiotic, in case it is that which is triggering an allergic reaction. Thus all who saw now seem to agree it is allergy either to something in the protective sheets, antibiotic, or both, meaning we can address that part at least. A little concerned the antihistamine tablet may be counterproductive to wound healing and therefore also to the graft acceptance process but in such open-ended circumstances, must be pragmatic and consider how little certainty I have either way. So, all in all – one part of healing (urethra) still ongoing and uncertain; another part (deep graft) also ongoing but may end up a significant complication or limitation, which I am dealing pragmatically, emotionally and spiritually with, and finally for the mess of skin reaction, at least now I have allies to deal with it. Feeling affected, impacted but resolved, in action, in movement, in hope. No matter what happens I will be far better
off than where I started. Sending you all love! ♡
Update: Going off all meds for now due to the allergy – no more systemic antibiotics, no more painkillers. Luckily I don’t really need them at this stage. Pestered the junior doctors to clarify; if then there is an infection, they will use topical antibiotics for the suture sites or canal, so that is solvable if so. Re: the back end graft; indeed if it does not take now, they need to close that part (shortening the canal) and later use another skin graft (so probably would end up with another scar somewhere) to lengthen in repair or revision surgery, once everything is healed. It is conceivable this would cost me more out of pocket and need to involve more approval bureaucracy, which is concerning, but I would deal with that then. Resolving now that if I do get a disfiguring scar from needing external grafting, I will look into ways of framing that with a tattoo somehow. They suggest, we won’t know until later – another two days to wait first, then another two – if this new approach changes things. But at least this means they are not convinced it will NOT take, they see it still as a possibility. So I will try to help them by sleeping, avoiding itches, avoiding bloating etc. as above. And while the packing is in, no way to remove the catheter, and no way to shower. So there will be at least until next week with that. Which is not great. But no matter. I am the witch who faces the storm head-on, whether I weep or laugh or stare disapprovingly as I do.
Now staying off all meds for a while (well, off of pain meds and antibiotics) to verify none of them was driving the allergic reaction. Mostly OK but feeling how swelling and pain increases as a result. Hoping somehow that can be healing and aiming to sleep through it anyway.
So, some sort of allergy either to bedding, antibiotics or both, most likely. Got topical and pill form antihistamines, then back to the IV port in the hand (ugh) for IV hydrocortisone. While skin itches all over showing flame patterns. Frustrating. Though really my main worry is if this can further complicate any of the vaginal healing. It’s out of my hands though. Tired, itching less, coping. Well, even if this contributes to either a longer surgical journey or a less ideal inner outcome in the end, I will make the most of everything. Probably another week or so before catheter is out and I get to shower, I expect. Ugh.
With blood-mixed fluid slowly dripping out of me as I lie down with insufficient packing materials provided, I find myself googling whether people get similarly uncomfortable and undignified experiences while menstruating wearing pads and I suppose the scope of this diverse squicky reality does help me a little in coping with it, at least, in not being afraid or thinking that this amount of liquid going wrong places isn’t necessarily dangerous or a warning sign. Shedding a uterine lining of course is in no way the same as trying to attach grafts or skin/mucosal flaps sewn together but at least the experiences may share some overlap in being cumbersome and uncomfortable.
The adventure continues! Was wheeled down for followup not of the vaginal compresses, but the urethral compresses. Lots of messing around with pushing in fluids and… urethral speculums? Which felt remarkably painful. Especially when one slipped. But one reason may be apparently a 10-14mm bleeding tear in the urethra. They spent a lot of time trying to fix this, with several phone calls to the old surgeon and sending him pictures. Pressing down hard for five minutes a few times. Using some sort of electrified tweezers that make sparks and burnt flesh smell, making me nostalgic for laser. However, nothing to do but put in stitches. Without anaesthesia (they debated it but had no good options). I did the Golden Dawn Fourfold Breath and rode the pain. It hurt less than the way the torn opening hurt when stretched by the speculum at least. Apparently bleeding finally stopped (but now I do need blood thinners for the night) which they had not expected (but from how I understood it, old surgeon did). I hope this will solve the issues with the urethral healing at least. We will see. I was complimented on my pain tolerance and on not getting panicked, so I guess I’ll just endure whatever needed to get through this? Also they noted my clitoris as unusually sensitive at this stage and I really hope it stays that way. Thanked them, elevated back up and probably will need to largely rest tonight as all this still took a lot out of me. I hope I will not harm these stitches with how I move during the evening and night. That worries me in a way the pain does not. I wonder if perhaps my preparations really did work? In the sense of, for years even pre-transition treating every painful experience as practice for this, Gom Jabbar-style (“What’s in the box?” “Pain.”). And then slowly starting to associate prolonged pain with pleasant fuzziness afterwards. Have I succeeded in training a certain kind of pain response, I wonder?
More followups; urethral healing seems well; but most likely the deep graft won’t make it. Sad but not end of the road. Meaning about half the depth needs replacement by later skin graft. I have lots of questions but so far could not get them answered across the language barrier. But from what I can tell, they do not plan to excise the dead graft part, but just to let it shed? Which raises the question: will half the vagina before revision lack a lining? If so, what will the walls be made of? And what does this mean for dilation? I am sure I shall learn. And will navigate it optimally. And realizing that being Twitter-open with even things like this is part of how I handle it – parts of the surgery being dissatisfactory or requiring followup is easier to bear if it does not feel like something shameful that I have to hide. Life in public is safer than life in private for me, somehow.
My parents and sisters and families sent me roses! https://t.co/bz1LwKJyMH
Spots on the arm with the IV which grew dark and flushed when we added the prednisone to treat the antibiotics allergy, are beginning to fade from dark red to mid brown now. I wonder if their chief presence there implies most response was there, and if there is such a think as antibiotics deposits from antibiotics IV and if those are unevenly distributed across the body from where the IV port is located?
I am beginning to be recovered enough that my body is a bit restless, making sleep harder, but still not enough to casually move around (esp. with regards to sensitive bits). Possibly I should start trying to sit up more, but still leaking so much discharge that I fear it would get messy quite quickly. Frustrating but OK. If I understand it right, we now await full urethral healing and end of hematoma, slow sloughing of deep graft, and full healing of shallow graft, before catheter can be dispensed with. Wonder how long it will take? Well, keeping at it, slowly getting better. Allergic itch mostly subsided!
In the interest of reporting trivia, thus far to make time pass during recovery I binge Castlevania, Bojack Horseman and Queen’s Gambit. There is something missing though and as my strength returns I am getting terribly restless.
I need to try to get then to explain to me what to expect if there is a region of vaginal cavity without skin graft even during an intermediate period. I want to know what it means re: risks, challenges, discharge, dilation. I will eventually get those answers, but am impatient for them, as I want to be able to start preparing mentally. I must try to ask again once I have a doctor with good enough English around.
Inspection today was remarkable because the doctor doing it now was actually gentle with me instead of prying up my urethra with the speculum. This was nice. It does make me wonder; of the ones I was so far cleaned by, the men all have been substantially rougher and I cannot help but wonder if it has any connection with whether they know of anatomy like this firsthand or not. That said, this is way too anecdotal, way too little data to say properly. They all seem concerned about the urethra swelling though, even the old doctor. He now suggests: on Monday, we take the current catheter out. If I am able to urinate, then that is great. But if I am not, they will give me a puncture catheter and I may have to take that one home. I am not happy with that, but I will deal with it if I have to. Actually I am quite afraid of that possible scenario so I really don’t want it to happen. Meaning I should focus 100% on urethral healing and gentle handling until then, I suppose. Anyway, I still could not really get clear answers on what to expect with the deep graft. They all say different things, either positive or negative or just (as the old doctor notes) to wait and see. I hold out hope it will heal. Otherwise, at least getting confirmation I will need to dilate, and also to do regular checkups. And the area without graft skin would be some sort of hybrid material involving scar tissue. So no real clarity yet except cannot say yet either way. And very much hope, from my end, that I will be able to urinate without the catheter on Monday, because I really don’t want a suprapubic catheter; the thought of a port going surgically through my abdomen – that I could, in principle, damage by rolling over on the side! – is very scary to me, and it is a scary thought of, what if the regular urethral passage closes somehow? Not that it should though. This will be OK. Sooner or later, one way or the other, it will be OK. I will move through this until the needed outcome is achieved. There is nothing I cannot endure in the pursuit of my goals.
Idly-boredly-hopefully googling “how wipe after urination” and cross-referencing different tutorials. Still stuck in catheter limbo, but would like to have a plan for when not. Apparently children are taught this by parents. Wrote long pretentious tweet chain involving COVID and chrysalis and being a body but Twitter ate it. Might rephrase later, maybe.
It was a little unsure whether I’d get wound cleansing today but the old doctor insisted the young doctor should, and I am glad he did. The concern was mostly, is my urethra strong enough to handle specular inspection yet? Turns out that it was; sensations on the verge of being painful and sign of breaking but staying just here of that. Old blood washed out but no new blood, so maybe I am lucky and now that part is en route to healing. I am beginning to believe that the parts I feel stretchy pain in sometimes really are outer labia and that what hurts (and stains some of the packing) are the seams there. Lower perineum is a little torn but that is not new and hard to avoid under these circumstances. Have not showered for two weeks, and not showered hot for months and months. It seems likely my movements have minimal effects on the urethra except through the catheter sitting inertial within it. This time, feeling urethra stretched with the speculum actually helped me sort of feel where it was, though I have no idea which sensations correspond to its opening yet. No news on the deep graft. I don’t think they changed the vaginal packing this time, and I am not sure why, but judging from the stains on my sheets, that now mostly leaks the salve it it packed with, but little if any blood lymph. I will take this generally as a good sign, whether it signifies full or partial healing. Looking forward to know more, and at least it is new – previous days, that compress was always wet with red liquid and now it doesn’t seem to be. We will see for that part. As for putting bandages back on, the main irritating sensation now is how the catheter tube lies directly against my clitoris. It is not pain sensation (and certainly not pleasure), just the kind of sensory overstimulation and salience I remember from skin that always used to be almost-intolerable to touch directly without anything between (or substantial lubricant). Unless something goes wrong later, it seems I really will retain a lot of sensation there, which eventually I am sure I shall explore and make use of. So next somewhat unclear step is, sometime tomorrow clean again (urethra? vagina? both?), possibly remove the catheter, possibly remove the packing, possibly add another catheter? Nothing really certain either way until it happens. Until then, remaining in chrysalis. Clearly feeling stronger and a little more embodied today though! Love to you all! ♡
I guess the fact that I tweet every detail about my genital surgery recovery on a public account does mean I can’t credibly claim to be a particularly private person, can I? Well, I looked inside myself to see who I’d find there. And this self is the one I found. ♡
Catheter staying in until Wednesday when old doctor is here again. They will then presumably give me a suprapubic catheter thereafter which I can then be weaned off at whatever pace works. Not the most comfortable path forward but at least one which means I am cared for and treated as inpatient as long as possible, which is otherwise, I think, good for healing. Preparing for cleaning again now.
It is quite interesting that so far, that which has hurt, rather than been just uncomfortable, has been: 1) cutting stitches in very sensate places; 2) making stitches; 3) stretching of already-hurting urethra with the speculum. In principle, unless it really involves tearing tissue, I can just navigate it as something other than pain. Still actively working to stay calm on the operating table: fourfold breath and invocation of calm. I can absolutely see how people could end up traumatized by experiences like these, and I think on some level I am trying to protect myself from that by ensuring that I am able to contain emotions and sensations when they happen. Essentially, I am trying to stay unafraid so as to not associate genital sensations with fear. I think I am successful.
To not get too warm/sweaty and trigger allergy again, as I lie in bed these days I cover my legs in the lunghi I got for a tantra course three years ago, and which has served me as multipurpose scarf and pillow and blanket and much more since, one of my favourite pieces of clothing. That workshop was also instrumental in helping me realize I wanted this. Interesting to look back: https://t.co/HRfRPJhDmH
Somewhat chaos of what I am told continues; new catheter should go in probably tomorrow or the day after. Old surgeon prefers starting with that to give urethra time to heal without either catheter or
urine throughflow, and I’m here basically because I trust his judgment, so fine. My worrying mind is concerned that waiting too long to get off the catheter would make it harder, with long-term dependency a worst case scenario, but really, if there are issues, we will just increase efforts until they are resolved. This will all be fine. Still, keeping my emotions a bit in check (and staying in sphere of distractions meanwhile) until resolutions are definite. I observe with some interest this fear in me of complications and imperfect outcomes more generally, not just in and of themselves, but because I fear somehow that others in their heart of hearts would question my choice to do this, or pity me, if I do not solely present a success story. In response to that irrational fear and resulting pressure, I do the opposite – I try to share everything with anyone who tries to listen, thereby removing the hold those fears could have over me and making me free to just be present. It will all be all right, and either way, here I am living my life. https://t.co/x4j4hqIyVL
(Also watch the video because it is amazing and beautiful.)
(Why are my nipples itching?)
Cleaning once more. Speculum hurt less, but apparently some place in urethra is bleeding again. My guess is the catheter roughs it up, so switching to suprapubic tomorrow or Thursday probably is precisely what is needed. Some really painful sensation when the doctor pressed against bleeding, felt like something might end up torn in the connection surfaces between… things, but in practice, I suppose it will all heal up. The body is made to endure continuous damage and heal continuously after all, and especially in these parts. And without the catheter, it really should end up less of a continual insult to the poor tissue. And really, the effort as a whole is remarkable. The vestibule is so tiny yet contain at least three separate systems and interfaces each with different needs. It really is remarkable surgery. But I shall feel calmer and safer once I know all is fixed and done, and I know all parts can finish healing on their own, and all functions are restored properly. I wait patiently until then. I am good at this.
I guess I have some emotions on the urethral healing situation, worrying that there will be longer, more durable complications that take more hassle and pain and scheduling to fix. Or that any of the other parts will be hurt in the course of that healing. But then again I also know this is largely just me being anxious, it will be fine, I just need to wait this all out and let healing and interventions take place as needed so I can get to where I should. I have what I need to do so, I am well-prepared and well capable.
lost in transition 