Friday 21st November - 7 days post-op
I slept rather well last night, no doubt aided by the sleeping pill and morphine shot I took at midnight. I awoke this morning to find a nurse in the room preparing an IV. She told me it was for antibiotics, and that she'd also brought me some more painkillers.
Guess what? I'm lying here on the bed with a stent inside my new pussy halfway through my first dilation! It feels a little strange - not at all painful, but slightly uncomfortable - no doubt due to pressure from my (rather full remember) bowel.
As instructed at 7am I drank a whole bottle of water. I shaved (I don't want to leave the hospital with fuzz on my face!) and at about 7:40am Wannee and Dr. Suporn both arrived complete with a trolley containing a rather daunting array of medical supplies.
Dr. Suporn told me to relax and removed the packing. It's a very odd feeling, but not uncomfortable or painful...it did tickle a bit though! He also took a close look at my labia and said that the necrosis looked like it was limited to the surface tissue, so hopefully there's no need to worry on that score.
After examining my urethra he has decided to leave the catheter in for several more days - it's still swollen, and if it was removed I may have found myself unable to urinate - in which case it would have to be re-inserted, which is apparently very painful. That's a bit of a pain in the short term, but no disaster - I'll cope.
Dr. Suporn then flushed my new vagina with drinking water from a
syringe three times, followed by a fourth time using a diluted
betadine mixture, before placing a condom on the stent I'd been
given. Wannee covered it in KY jelly and then Dr. Suporn slowly
inserted it into my vagina.
It wasn't at all painful, but was obviously a new sensation for me! They measured the depth as 7" and took photographs for the clinic's records with the stent in place.
Dr. Suporn also told me that my clitoris and the tissue around it has healed up well, so hopefully I won't have any problems in that area.
With the important tasks done, I was shown a hardcopy of the photographs of my surgery. I asked about electronic copies, and was told they can be provided on CD later.
While explaining the contents of the pictures Dr. Suporn explained that my penis was of the "high type" (i.e. located further from the anus than is normally the case) and that all but 1" of the penile skin was used in locating the vagina correctly. Without the skin graft (for which he used scrotal skin, after removing all the hair follicles) I'd only have attained 1" of depth if the vagina was located in the anatomically correct position.
The variation in the location of the base of the penis is something I certainly wasn't aware of, and could well be the reason that one girl I know who had surgery with James Bellringer at Charing Cross Hospital in London had her vagina located much higher (as a result of which dilation is at an awkward angle as the pubic bone is in the way).
After I finish dilating at 10am I'm to call a nurse to help me to clean up the wound correctly. Shortly afterwards Wannee will take us back to the hotel, and then my job is to concentrate on healing and sticking to my dilation routine. That's a little daunting, but I haven't come this far to mess things up now.
I can honestly say that today has been the most exhausting day I've faced since arriving in Thailand.
After I finished dilating this morning at 10am a nurse helped me clean myself - first by syringing my vagina three times with 50cc of drinking water, then with 50cc of drinking water mixed with 5cc of Betadine. While she did this, I sat on the toilet and felt totally relaxed. Afterwards I moved to the chair by the shower and had a wonderfully relaxing shower during which I washed the exterior of my genitals with Hibiscrub.
Once I was dried off the nurse helped me to dress and make myself presentable. Kazzy had packed everything the night before, so I just laid down on the bed and relaxed. I felt rather weak, which isn't at all surprising given how much had happened already that morning. I certainly didn't realise how draining the experience of dilating would be at first, and by the time I laid down I was physically and emotionally exhausted, and could really have done with an hour's rest.
Unfortunately, that didn't happen - by 10:45am I was in a wheelchair being taken down to Wannee's car for the trip back to the hotel. Being a Westerner and noticeably TS as well (I wasn't wearing makeup of course) I was the subject of quite a few curious looks from the Thais on the ground floor of the hospital as I was wheeled to the hotel entrance. That's to be expected, and I felt perfectly comfortable with it.
Once in the car (which was nowhere near as comfortable as the wheelchair) we drove to the Mercure. For me the journey felt very unpleasant especially as I was a little sore after dilating, and still very swollen.
Once we reached the hospital and checked in (to room 307 this time) I was so tired and light headed that I just crashed out for a while. I was very thankful I had been offered a wheelchair at the hospital and hotel believe me!
So far I have just one criticism of the Suporn Clinic - that the transfer from hospital to hotel happens much too quickly. While I understand the reasons it's done that way (after all, the next patient for room 803 had probably arrived at the hospital at 10am and the staff needed time to prepare the room for her), the transfer is so quick and traumatic that anyone who's physically weak, in pain or easily upset will almost certainly find it very upsetting.
If we were given the opportunity to lie down and rest for longer - maybe in a vacant room, an office or even on a trolley in a corridor) before leaving the hospital it could be so much easier. I intend to suggest this to the clinic staff, so maybe things will improve for those who follow. They do listen to patient suggestions (for example the use of a condom to hold the packing was suggested by my friend Susie back in May) so I'm relatively hopeful.
Postscript: Wannee's since told me that something's being done about this, and things should improve in 3-4 months time.
After a while dozing in the hotel room I was feeling really uncomfortable because of the pressure on my bowel. Bear in mind that I've been allowed to eat since the evening following my surgery (while taking drugs to suppress bowel movements) and you can imagine the result! Not only was it uncomfortable but it made dilation more difficult.
After waking I couldn't bear the constipation any longer and went to the toilet to try to relieve it. It was an agonising and frustrating experience...I didn't dare push too hard, so nothing happened for a long time. I did however manage to relieve the pressure a little, which helped enormously.
Wannee arrived while I was "in the act" so it's just as well I'm not too fussed about privacy! (I'd been warned before coming out here to leave any discomfort about being seen in such personal situations at home, and it's good advice).
Once I was finished she talked me though the dilation and cleanup process again, including little things that Dr. Suporn didn't tell me - like how to apply a condom to the stent without touching it (you use the inside of the wrapper it came in, which is of course sterile). She also talked me through the pills I've been given (antibiotics, painkillers, laxatives and an anti-inflammatory to help with the swelling) and when to take them.
One thing I should mention is to expect a fair bit of blood to come from the vagina initially - if it's brown it's fine, and a sign of dead tissue coming away. If you have any fresh bleeding however, hold a cotton wool pad over it for a few minutes and then sterilise the area with dermazin cream.
Also worthy of note is that the bag of supplies I was given contains very few condoms - Wannee brought me a large additional supply of condoms, together with KY jelly and incontinance pads (to protect the bedsheets from bloodstains, as the hotel will most likely charge you extra for cleaning them). I was charged 1510 Baht (about £23) for the lot, which is still good value considering the size of the bag of condoms alone.
This being a dry run I didn't dilate for long, and afterwards went with Wannee to the bathroom to clean myself. While walking I held an incontinance pad between my legs to prevent any blood going on the carpet, and once there, Wannee reminded me how to clean myself after dilation - but this time in the context of the hotel environment. To syringe, she instructed me to place one foot on the floor and one in the bath and crouch a little. However, with me still being very unsteady on my feet I found this impossible and suggested using the toilet as earlier.
She agreed, but wanted me to stand over it (which I can understand as the vagina will drain faster if it's vertical) but once again I couldn't manage and as I felt myself begin to blackout I gripped the sides of the toilet bowl and lowered myself down quickly but gently. Once I was able to stand again (albeit unsteadily) she helped me to the bed where I literally collapsed. I've never felt so weak and emotionally exhausted in my whole life. I could barely move.
I slept for hours, missing lunch completely. Kazzy rested too, and by 6pm we were both hungry and ordered a light dinner from room service (which turned out to be much more substantial than we expected, particularly as we both felt we'd earned a treat and ordered dessert too!). Delicious.
Afterwards I drank my first coffee in over a week (I didn't dare drink it in hospital as it acts as a laxative on me) and sure enough half an hour later I needed to go for a bowel movement. This time was far easier than the last, although still painful, frustrating and time consuming.
With that out of the way it was time to dilate again - but this time without medical supervision. I prepared everything as Wannee had instructed, and showed Kazzy what I was doing and why.
My dilation passed pretty quickly this time as shortly after starting we had visitors - Toni (who I know from home) and Freeda (who I briefly chatted to on Trans-Surgery before coming out here). We all chatted for ages and it was wonderful to feel the support of friends. Dr. Suporn carries out several surgeries each week, so there are always quite a few patients in the Mercure recovering, and it doesn't take long to meet them.
Once I finished dilating I of course had to clean myself, which was a daunting prospect after the earlier experience. Kazzy helped enormously in sorting out the things I'd forgotten (like bringing the hand mirror to me in the bathroom) and providing moral support. Afterwards, I douched sitting down on the toilet, but lifting slightly to allow the water to flow out of my vagina. Even with that support, I was still very weak when I got back from the bathroom and again collapsed on the bed, where Kazzy again came to my rescue by cleaning the wound for me. She's been absolutely wonderful.
I've finally finished writing this entry, and it's now 1:30am! You can tell I'm a night person, can't you?
Saturday 22nd November - 8 days post-op
After the very tiring day we had yesterday we slept in a little this morning. I awoke first and made us both a drink - coffee for me and tea for Kazzy. After quickly cleaning up and dressing we headed downstairs for breakfast at 9:30am - which turned out to be brilliant timing as several other girls were there and we all breakfasted together.
Knowing how much dilation wiped me out yesterday I decided to dilate after breakfast. Had I tried to dilate first, I doubt I'd have had the strength to make it down for breakfast. As a result though I've started my dilation a couple of hours late (last night I did 9-11pm) and boy can I feel the tightness that extra delay has allowed to happen. They aren't joking when they tell you to dilate for 2 hours, twice a day and ideally at 12 hour intervals. It was quite uncomfortable - no doubt compounded by the fact that my bowels are still rather bunged up, although I did manage to pass a little before breakfast. More coffee I think!
Nevertheless, it only took a few minutes to reach my full depth.
This morning before breakfast Wannee visited briefly and I asked for stronger painkillers (bless her - shortly afterwards a packet of tramadol capsules was delivered). She suggested that I spend most of today in bed after yesterday's ordeal - which is exactly what I intend to do. I'm glad I went down for breakfast though - I needed the change of scenery and to prove to myself that I could do it.
I'm 15 minutes into my dilation now and already I can feel the difference - the stent is now much looser than it was when I first started.
I'm feeling so much stronger today, and much more confident. Before I travelled to Thailand I was a little concerned that I wouldn't look after myself (with regard to dilation, cleaning the wound etc.) as well as I should, but now that concern is fading quickly as I discover that it's nowhere near as daunting or complicated as I thought it would be. I'm learning fast.
Shortly into my dilation this morning Toni, Oceana and Freeda paid a visit. Having the distraction of talking to friends not only passes the time but takes my mind off the discomfort I do feel sometimes - pressure on either the bowel (still a little full, but getting better), prostrate of bladder (if it's full - although I'm still catheterised Wannee has asked me to record how much I'm drinking and passing, so the tube is tied most of the time).
After they left Kazzy and I chatted for a while until she went into town with Toni and Freeda at about 3pm. I dozed for a while, then rang Susie back in the UK to give her an update on my progress. She said it was a lovely surprise to hear from me, and we chatted for about 45 minutes - stuff the phone bill!
While we were on the phone Kazzy returned from her shopping expedition with some really wonderful gifts for friends and her children. She'd also bought some clothes for me - including a couple of gorgeous miniskirts which fit perfectly (and they're shorter than any I have back home! ) and a lovely little heart framed mirror bearing the legend "Your Best Friend".
I've been in a fair bit of pain from the lower parts of my labia minora all day and I'm taking painkillers to make it bearable, as well as keeping an eye on the stitches in that area to make sure they aren't being disturbed by my dilations. So far all looks OK, and I'm told by the other girls that the pain is a sign of healing. Knowing that almost makes it welcome!
I'm losing some fresh blood but it's not fresh so I'm not concerned. That is part of the healing process too.
I'm approaching the end of my evening dilation - I started late, but then I did this morning too, so that's OK. It took about 15 minutes to reach full depth - possibly a sign of the skin within my vagina starting to thicken as it heals (I'm 8 days post-op today). Dilation has been painless so far, although uncomfortable at times - particularly when my bladder or bowel is full. Another sensation to get used to is pressure on the prostrate from the stent - not pleasant if you're not "in the mood" (stimulation of prostrate through the anus in males can lead to orgasm if you didn't know - but if you're not in the right frame of mind it's profoundly uncomfortable. *
* In case you're wondering, no, I haven't done that with a guy. A while ago I was curious and wanted to find out what my body could do - and if you clean yourself first and use common sense there's nothing to worry about. Now I have the real thing, and that's got to be a hundred times more fun!!
The reason I started dilating so late is that Kazzy, Freeda, Toni and I went down to the Terrace Restaurant for dinner tonight. As I only arrived here yesterday that was quite a challenge for me, but I managed with no problems - although it did take me a little while to find a comfortable sitting posture (not surprising really!).
Kazzy suggested earlier that I wear some make-up tonight as it was a special occasion, which I wholeheartedly agreed with! However, by the time I was ready I'd been standing for longer than I was used to and was feeling light-headed, so I lay down for a rest for a while before we went down. Toni and Freeda joined us in our room to chat for a while before we left, but I still found myself light headed and could feel my pulse racing - nerves over whether I would be able to manage.
In the end I suggested that they go ahead and order for me, and I'd rest for an extra 10 minutes before joining them. Even after they left I was still woozy...but then one of those little "coincidences" which seem to occur so often in my life happened. We had VH-1 on the TV this evening, and a song by the rock band Poison came on - I think the title was "Something to Believe In".
It was when I heard the word "Jesus" in the lyrics that it got my attention - and as I listened that song struck such a chord with me that I was moved to tears. After it finished I prayed and gave thanks to The Lord for all the help and support I've been given on my difficult journey. I know many will call an event like this pure coincidence, but for me it always seems to happen when I most need it. Thank you Lord.
Immediately afterwards (and feeling more confident than I dreamed possible) I headed downstairs to join the others, and we had a wonderful meal together.
Afterwards it was dilation time of course!