Tuesday 20th January, 2004
I'm just about finished my evening dilation - my first since before I left the UK. Although it was very tight and uncomfortable at first (but nowhere near as bad as the one after my flight home in December), within 30 minutes I was close to depth. I've extended it to 3 hours to make up for the loss of a dilation on the flight out.
I passed the time by calling first Susie (at work - the UK is 7 hours behind Thailand at this time of year) and then my friends Carolyn and Helen, who are in room 802 at Aikchol Hospital (the room Susie had back in May). Both of them are threatening me with big hugs when I get there later today! Ironically, Carolyn tells me that room 803 (the one I had last time) is free at the moment. Wouldn't it be some coincidence if I ended up in there again?
I've just started my morning dilation. As a rule I don't normally make a habit of getting up this early (not even close!), but with the transfer to the hospital happening at 9:45am, I want to be down for breakfast by 8am to give me time to repack and get ready.
My (at best) sidewise looking sense of humour has kicked in and as I look at the clock I'm reminded of Robin Williams' quip in Good Morning Vietnam of "What's the '0' stand for in 06:00?...Oh My God It's Early!".
He was so right. I'm going to try to doze through this.
I've just arrived at the hospital, and am waiting for all the tests to be done before being taken up to my room.
After dilating this morning (which I largely slept through, as planned!) and getting ready I met Sandra (one of the girls I'd met the previous night) and we breakfasted together. Wannee arrived while we were there (all smiles as usual) and stayed with us for a short while before heading upstairs to check on the other patients. Sandra's discovered that there's an IPL clinic in Pattaya, which is useful to know...
After breakfast I went back to my room to get ready for the transfer. Last night I'd repacked what I though I might need in hospital (you can leave luggage you don't need with Reception in the Mercure) so it was largely a case of getting ready to go.
Back to the cunning plan I mentioned earlier. The last time I was here one thing I noticed while checking into the hospital was that the locals waiting to be seen downstairs seemed rather curious about me - being a Westerner I of course stood out, and no doubt the clinic is well known in town so they almost certainly guessed I was TS as well.
Before flying out I decided that if I'm going to get looked at it might as well be for a good reason, so I decided to wear that black dress - together with full makeup - when I checked into the hospital.
Well, I did it - and it was hilarious! Wannee loved the look, and when she saw me Minda's face was a real picture!
I've just come back to my room to rest, as after arriving this morning everything was rather hectic.
After arriving in the waiting area, Fai appeared and walked me through the usual tests - blood, X-Rays and ECG. When we went to get the X-Rays done (just chest this time - X-Rays of my face were taken when I checked into the hospital for my reassignment surgery in November) we bumped into another girl I know (Annie) so we had a chance to chat for a while. It was good to see her.
Once all the tests were concluded Minda escorted me to my room - which turned out to be 803 once again!
As soon as my bags were in the room I left and knocked on the door of 802 to say hi to Carolyn and Helen. Helen had her reassignment surgery on the 14th (a week before my surgery tomorrow). Carolyn is here to look after her, and to get an idea what she's in for when she arrives for her own surgery. While I'm in theatre tomorrow they will be transferring back to the Mercure so we only have today to chat until I get back there myself.
After chatting for a while, Carolyn took me to 804 and introduced
me to Sonia (who's also recovering from her reassignment surgery)
and her mum Lin. Understandably, both Helen and Sonia were curious
about how I'd healed and what to expect over the next couple of
months - so of course I showed them. It looks like I might be doing
a 9 week post-op dilation demonstration for them both later...
It's certainly encouraging to hear that none of the current patients seem to be suffering anything like the amount of pain I had back in November. Both Sonia and Helen seem remarkably comfortable and mobile by comparison to the way I was when I was in hospital.
After a late lunch Carolyn took me over to the 7-11 just outside the hospital so I could buy essential supplies - coffee, milk and chocolate. I'm told I'll be on a liquid diet for a few days after my surgery, but that if you don't try to chew it, chocolate just about qualifies...
I'm going to try to doze for an hour or so. This has been a long day already.
I was out cold when the anaesthetist (Dr. Dilaka) came to see me. She apologised profusely for waking me, before explaining that because of the sensitivity of the nerves in the face, the anaesthetic she'll use tomorrow will have to be stronger than that used for my reassignment surgery, and that as a result it might make me feel sick afterwards. She will however give me a drug to try to prevent that from happening. The stronger anaesthetic is needed.
I'll be catheterised during the operation itself, but the catheter will be inserted once I'm out and should be removed before I awake again. Dr. Suporn believes the operation should take between 6 and 7 hours.
In the event her visit was good timing, as my evening meal arrived while we were talking. Had she not woken me it would probably have been cold by the time I noticed it!
The day has passed so quickly. I've spent a lot of time chatting to Carolyn and Helen, so I've not been in my room much at all since Dr. Dilaka left. Kelly (with whom I chatted on the phone before flying out here) has now returned from her own FFS today, so Carolyn and I went to see her.
I must admit that the bandaging looks pretty gruesome at first sight - part of which is because of the bloodstains on it where the in-theatre drains for the jaw work were located. There's also a conventional drain from somewhere in the scalp, which looks a little strange. Kelly has had Upper Blepharoplasty (upper eyelid surgery) as part of her FFS, and can't see very much at all at the moment.
Fortunately, I'm not scheduled to have that - Dr. Suporn told me it wouldn't be necessary in my case when I was here last time. For that, I'm even more grateful after seeing Kelly today.
Since coming back to my room just before 9pm I've been pottering around, chatting to the others and - finally - started my dilation at 10pm. I invited Carolyn to watch since that way she'd be able to advise Helen if there was any uncertainty in what she should be doing. I also talked her through what Dr. Suporn had done for me, and explained the way everything felt.
My dilation was actually rather tight and a little painful at first - possibly because of a combination of its lateness (I was 5 hours late - my previous dilation started very early this morning) and the skipped dilation during the flight.
As I'm now using a douche to clean myself instead of the syringe I was given in November, the amount of water I'm using has increased from about 200ml (4 syringes of 50ml) to 1000ml (4 douches of 250ml), so I had to ask for a whole load of extra drinking water just to douche after my dilation. I'm going to get through gallons of the stuff while I'm here!
Postscript: Once I reached the Mercure, Wannee later told me that I no longer needed to use drinking water to douche. Tap water is just fine once the neo-vagina has healed.
Wednesday 21st January - The Big Day
The big day has dawned, and at around 7:30am I'll be on my way to the Operating Room, watching the lights slip by on the ceiling again. Then, it's all in God's Hands again. Although I've been here before (and with the same surgeon, of course) it's still a daunting prospect - especially since it's my face he'll be working on. Seeing Kelly yesterday has certainly reinforced that.
I do wish Susie were here tonight - right now I could really do with seeing the smile she always has in her eyes. I'm going to go to bed right now as otherwise I've a feeling I'll start crying again, and I have to get up at 5am to dilate anyway.
I can honestly say that 4:30am is the silliest time that I've ever woken up to start a dilation.
Although I set alarms for 5am, in the event I didn't need them and awoke with a hot flush (they're a real pain) at 4:30am. At least this way I'll not have to rush or cut my dilation short to get to theatre.
I spoke too soon, as a nurse has just arrived and told me to shower now. At least I'd only half an hour of my dilation to go, and this morning I was also noticeably less tight than last night - inserting the stent was painless.
I've done everything I need to and now I'm just waiting. I must admit that I'm feeling rather scared now (something that didn't happen last time) and I desperately wish Susie were here. Her smile would take my fears away, of that I'm certain.
I'm now sporting a rather Coronation Street-esque bit of headgear, which the nurse put on me a few minutes ago. It looks pretty ridiculous!
Carolyn came to reassure me before I went to theatre, and has just left to go to Helen while Wannee and Dr. Suporn remove the packing from her neo-vagina and show her how to dilate for the first time. I'm so blessed when it comes to friends - I often give thanks for them.
I'm feeling a little calmer now. My prayers, Carolyn's hugs and Susie's messages of reassurance have all helped.
I arrived in Operation Room 5 (the same one as before, I think) on the 1st floor, which is confusingly labelled floor 2, at just after 7:35am. Once I'd transferred to the operating table, I chatted with the two nurses there while they got everything ready.
It all seemed rather familiar. The IV was once again put into my left hand, but this time the oxygen monitor went onto a finger on my right hand. Once the ECG was connected and turned on I could see that my heart rate was mostly between 68 and 75 beats per minute. I felt pretty calm.
One of the nurses was partway through preparing my hair (separating and tying it) when Dr. Suporn arrived at 8am and took over. Once that was done he had me sit up and took lots of photos of my face from various angles.
At 8:30am I watched one of the nurses inject the anaesthetic and before the syringe was anywhere near empty I was out cold.
Thursday 22nd January - 1 day post-op
Until now I've not felt well enough to write. To add to that, my vision is blurred because of swelling on my eyelids. My whole head is bandaged and I have to say it all looks pretty gruesome. There's surprisingly little pain, but it's much more uncomfortable than after my reassignment surgery.
When I awoke I was terribly dehydrated (as a result of which I had an awful headache), but I was unable to take more than a few sips of water because of the numbness in my chin and mouth. The nurses had to syringe it into my mouth, which reduced the volume of water I could drink even more, and contributed to the headache.
Yesterday evening Dr. Suporn told me not to try to dilate as I wasn't well enough, so I was absolutely dreading my dilation this morning.
Minda stayed with me last night, but I think she managed to sleep more than I did. It was all a bit of a blur, but I remember spending a lot of time watching the clock and waiting for the morning to arrive. I was also sick a couple of times - which I'd been half expecting after what I'd been told by Dr. Dilaka the day before.
This morning Dr. Suporn came to see me. He told me that the operation took 8 hours in total (2½ hours of which was for my nose) and that part of the bandage would be removed tomorrow. A short while afterwards I was bed-bathed and then started the dilation I'd been dreading. I was pleasantly surprised to find that I wasn't tight and didn't suffer any pain - perhaps as a result of the anaesthetic.
Partway through my dilation Lin and Kelly (who's FFS was the previous day) came to see me. I wasn't at all with it, and started feeling sick a few minutes later while Kelly was still here. Although I called the nurse to give me an injection to stop the nausea she wasn't anywhere quick enough, and I was sick everywhere - the bed had to be changed as a result.
That incident pretty much killed my appetite. At least my dilation went without a hitch.
Friday 23rd January - 2 days post-op
The rest of yesterday passed in a bit of a blur. I've still got virtually no appetite, and spent most of the day sleeping - as a result of which I could hardly sleep at all last night. Although I've hardly been able to eat or drink anything I spent most of last night dashing to the loo - and my urine wasn't at all concentrated. Strange.
Aey, Wannee and Dr. Suporn all visited at various times during the day to see how I was doing.
While I was here last time both Aey and Kazzy saw the love I felt for Susie and rightly predicted we would end up together. We did - but sadly it turned out to be only for three wonderful weeks.
While Aey was here I gave her a gift I'd prepared before leaving the UK - a framed picture of us taken at Christmas while I was staying with her recovering from my reassignment surgery. It's one I'll always treasure.
At 7:40am this morning Wannee arrived and began cutting away the bandages. Dr. Suporn arrived shortly afterwards and removed the drain (a pretty unpleasant feeling). He says I've less swelling that usual, and should heal quite quickly. Let's hope so
I finished my dilation 25 minutes ago. While I was partway through it though two nurses arrived to give me a shower - they asked me to call them when I'd finished, and when I did they helped me to shower and changed my bed. I'm feeling tired out again now.
My appetite is now ever so slightly stronger, which can only be a good sign. Today has been a quiet day once again - I've mostly been resting. An hour or so after my shower Carolyn came to visit, and I woke up to feel her stroking my hand. Thank you honey.
Although it was wonderful to see her I don't think I was very good company - I was so tired, and not being able to talk clearly is so frustrating. After she left I dozed for an indeterminate time, and then sometime later Fai visited, before Carolyn came back with Wannee. I'm so looking forward to seeing her and the others back at the Mercure.
I'm still feeling pretty rough, and a little nauseous - a short while ago I asked for an anti-nausea injection which will hopefully stop me being sick tonight. Wannee visited earlier and it was really good to see her - although I'm afraid I still wasn't feeling at all talkative.
As soon as I feel less sick I'll start my evening dilation. Hopefully I'll get more sleep tonight than I did last night.
Saturday 24th January - 3 days post-op
I think I slept a little better last night, as I don't remember a great deal. I was semi-conscious when the daily routine (deliveries of bottles of drinking water, blood pressure and temperature checks etc.) began at 6am.
When I turned my mobile on this morning there was a message from Susie to say that she was going out for a curry last night - lucky girl! I so wish I was with her now.
Wannee has just paid me a visit. She removed the dressings on my jaw and I can now see where the incisions were made for the drains used in theatre during the jaw reduction. They're small - less than an inch long - so the scars shouldn't be noticeable. She also applied Betadine to the wound on my jaw and bottom of the nose, and cleaned some of the dried blood from my nostrils - a pretty uncomfortable experience.
Looking at my face in the mirror now I can begin to see my new look taking shape, despite the cast over my forehead and nose and the swelling in my chin and jaw. The bruising and swelling around my eyes seems to be going down too.
Dr. Suporn has just paid me a visit. He removed the cast (temporarily, as it turns out - I'm to wear it for at least 10 days) so I could have a look the beginnings of at my new face. The effects of the brow lift and chin reduction are really quite noticeable, although the change in my nose is less so due to the swelling.
Apparently the bone in my forehead will take around a month to heal and in that time I must be very careful not to touch or knock it. My nose should heal quicker - in around a week - but the same caution applies. He also said that I was healing quickly (which is definitely good news!) and that the stitches in my hairline should come out next Wednesday.
Apparently the swelling in my upper face will heal fastest as gravity will tend to pull the liquid in the tissues down towards the chin and jaw. I can expect those areas to be fairly swollen for a while.
Half an hour ago two nurses arrived to wash my hair - first with Hibiscrub, then with my own shampoo and conditioner. I was asked to lie on the bed with my head protruding over the end. It wasn't the most comfortable position, but I still found the experience relaxing! Afterwards I rinsed my hair in the shower, taking care to keep the water off the cast covering my forehead and nose.
Wannee has just brought me an elasticated face mask, which I'm to wear for the next 3 months to help the skin on the chin and jaw adhere to the bone, the area of which is of course now reduced. The bandage reduces the chance that I'll need a lower facelift later, but I have to say that it's pretty uncomfortable and I don't like it one bit.
Sunday 25th January - 4 days post-op
Things seem a little confused this morning. It began as usual at around 6:50am with checks on my IV, questions about whether I've used the toilet (pee-pee, poo-poo? ) during the night, etc.
My breakfast (a pot of yoghurt, a bowl of soup and a glass of orange juice - as usual only the yoghurt and orange juice got touched as I lost my appetite for the soup after the first time I failed to manage to eat it) arrived as usual, and with it a menu for lunch/dinner that day and breakfast the following day.
Knowing that I was due to be discharged back to the Mercure today I didn't think anything of the menu and ignored it. A nurse then came to remind me, and in the end I filled it in anyway!
I've had a headache since waking up this morning (which isn't unusual in itself given how dehydated I am) but it's worse than usual - and largely at the sides rather than the front of my head. That is unusual - and it was while cleaning myself after my dilation that I realised why. There are stitches (actually staples) well inside my hairline, rising from behind each ear - and they run right through the area I lie on if I lie on my side to sleep. Ouch.
Wannee's just arrived and promptly disappeared again - presumably to assist Dr. Suporn with another patient. Hopefully things will become clear when she returns.
Wannee and Dr. Suporn have both just been to see me. He says that all of the wounds look good and are healing well. I've obviously to be gentle when washing my hair, and I must of course be careful not to touch or apply pressure to my forehead or nose.
Shortly after the external stitches have been removed next Wednesday (i.e. 1 week post-op) I should be able to remove the cast. However, I'll have to wear the elasticated bandage for no less than 3 months- although presumably once the swelling has gone down wearing it just while I'm at home or in bed will be enough. I really don't feel like wearing that thing to work when I return in March!
I finally left the hospital at (I think) about 11am, and I'm now lurking in room 404 of the Mercure Hotel. After arriving the first thing I did was of course to go and see Carolyn and Helen (who're in 314). I ended up spending about 3 hours with them, and did my dilation while I was there. It's so good to be away from the isolation I felt in the hospital this time and back amongst friends again - although not being able to talk very well is infuriating, as is the constant headache that's accompanied me since I woke up after my surgery.
While I was there I was starting to feel light headed and faint - a clear hint from my body that I'm not eating enough. Certainly, my appetite seems to be recovering, although the swelling in my chin and jaw makes it very difficult to eat - I've been living on a diet of yoghurt and orange juice for the last few days.
As the others were hungry too we ordered from the room service menu. After looking at the limited selection available, I thought I'd give the spaghetti carbonarra a go. It proved to be a good choice, although eating it was a slow and frustrating business, and I barely made a dent in it. The thing I found most upsetting was the fact that the swelling and numbness in my chin and bottom lip caused the food to go everywhere - I'm certainly not one to invite to a dinner party right now!
Afterwards I came back to my room to sleep. I think I must have been out for a good 3 hours, and boy is it good to have a real bed to stretch out in (especially a double - even if I've nobody to share it with).
I don't fancy repeating the frustrating experience of eating a hot meal tonight, so I think I'll wing it on yoghurt and chocolate tonight.
When I woke up I briefly took off the cast and bandage to have a good look at myself and take a few pictures. Although my face looks pretty grim at the moment, I can already see big changes - particularly from the brow lift and chin reduction. My nose doesn't look that much different yet (apart from it's now smooth profile), but I know that's due to the swelling. Over the next few months that will subside revealing its true size and shape.
So far I'm very happy with the results. I'm still recognisably me, but the rough edges have been given a big dent. All I need to do now is heal.
I've just had a long and tearful phone conversation with Susie back in the UK. I love and miss her so much - being so far from her hurts far more deeply than I can describe, and being alone here knowing she's in turmoil too just makes the pain even harder to bear. I feel so guilty that in expressing the depth of my love for her I'm putting pressure on her when she's trying to confront issues I think I pretty much dealt with last year.
All I can do now is wait for her, and hope.