Week 11 Update

I’m in the final week of the 3 month healing period and it seems to be smooth sailing right now. The tightening seems to have ended and I may try going up to a new dilator size today. There hasn’t been any bleeding from the granulation tissue for a few weeks now but I’ll get those chemically burnt off (painlessly) next week at my final post-op appointment.

My only concern is that I still can’t feel any kind of definition on my clit which has me worried that either something happened to it during healing when that tissue fell away or that she just didn’t build a very useful one. Not much I can do about it now other than fret because that’s who I am.

Next week I can finally take baths, go in the hot tub, lift things, and have sex again. It has been hard to remember the last couple weeks not to lift things because I’m feeling better now. I also get to go down to dilating once a day instead of three times and return to full time work. I feel like I’m ready for work now but I still have to spend so much time dilating and I’ve been enjoying sleeping in.

The part I’m really not looking forward to is being on a plane during a pandemic… Wish me luck in not catching anything!

9 Week Update

This week has been pretty uneventful. The only thing going on with healing is that things have tightened up and lost their elasticity temporarily. Luckily I was warned that this would happen and make dilation more difficult and so far it isn’t as bad as they made it sound. Once this is over, I think I’m ready to move up to the next size dilator.

Other than that, healing is going well and it’s starting to feel more like a normal part of my body instead of something new and unfamiliar. 3 more weeks until I can start exploring it more!

Week 7

The mantra I have to keep chanting to myself is “Healing is not linear.”

Content warning: Gross medical shit below

It’s been 6 and a half weeks since surgery and while the exterior of my labia look great, the interior is still a mess. My clit is still obscured by yellow tissue that is apparently called exudate and while it is apparently normal for this stage, it looks disgusting. I have a lot of the brownish proteinaceous discharge which means I’m going through a lot of pads. And I have some granulation tissue on my inner labia that bleeds easily.

On the upside, dilation is going easier now that I’ve gotten used to the new size. I’ll give it a couple more weeks and then upgrade again. I also talked to my primary care doctor yesterday and she assures me that this is great healing for this stage. I am so grateful to have a doc who is one of the most knowledgeable people about neovaginas in the city.

My mood has been pretty down still and while it’s not as bad as the day I think I had my period, I’ve had a hard time finding ways to get through the day. The mood lighting from the smoke in the air definitely doesn’t help and it is triggering my Seasonal Affective Disorder early. To help, I got back on OKCupid and I’ve been chatting with a lovely trans woman. I know I can’t meet anyone new right now but it feels good to start planning for the future.

I also started back at work half time which is where I’ll stay for the rest of my 12 week healing period. It is exhausting to even do 4 hours a day of computer work but it is nice to feel useful and talk to my coworkers again.

Anyway, that’s where I’m at right now. Healing is not linear.

Post Surgery Blues

I really didn’t expect week 5 to be the hardest week. I guess I expected that by now I’d be in the clear mostly but healing isn’t linear.

When I graduated from the surgeon’s care, she warned me about a phenomenon called the “post surgery blues” that usually hits around the 2 month mark. It is caused by all your body energy going into healing and depleting the brain’s reserves. So eventually you hit a wall and your brain is starved for happy chemicals.

I’m not sure if that’s what’s happening early but it sure feels like it this week. It could be just my period hitting but today I’m constantly on the verge of tears and anxious about everything. Yesterday I was tired all day and I woke up at 4 am and couldn’t fall back asleep for over an hour this morning. My brain kept fixing on all the things that could go wrong.

What if I’m dilating my urethra accidentally? I have had a dribbly stream when I pee lately. What if my blood clot has actually moved and I’m tired from it being in my lungs? What if I caught COVID in the ER lobby?

Then this morning I cleaned my new bits and discovered that my clit is yellow and swollen and doesn’t look right. So I messaged my doctor and anxiously waited for that response. Turns out it’s very normal for this phase; enough so that she has slides on it for her presentations. That doesn’t mean I’m not freaking out though.

Everything hurts this week and it sucks. I’m sure it will get better but for now all I want to do is complain and cry. That’s the full answer to how I’m doing this week.

Blood clot warnings

When I started estrogen 2 and a half years ago I got the standard lecture about how hormone use (including birth control pills) can make you higher risk for a serious thing called “deep vein thrombosis.” Basically blood clots in your legs that can cause pain and swelling and potentially move to your lungs and cause serious damage or even death. I listened to the symptoms and for awhile, I was pretty conscious about any of the signs. Every time I have a hormone check I get asked if I’ve had any leg pain but it’s become so normal I barely think about it anymore.

Fast forward to surgery and I get those warnings again. Having a surgery and the resulting inactivity puts you at higher risk of clots which is why they have you stop hormones ahead of time (causing hot flashes) and only restart after you are walking again. I once again thought I took in the symptoms and was aware. I tried very hard to walk every day to avoid it.

Then comes time to drive home. Long travel and inactivity is another risk factor so we made sure to stop often and walk around. We made it home a week ago now and I thought I was past the worst risks. And I let my guard down.

Monday morning I woke up with my calf hurting. I didn’t think much of it and honestly thought I had over extended it in my sleep. But it was bad enough pain that I was limping. Well the pain didn’t go away. It got better at points but every morning it was hurting again. Still I didn’t connect the dots.

Finally today I posted complaining about my shitty week and a couple friends pointed out that it could be serious. So I reluctantly went to the ER. It was very crowded and took me nearly 2 hours to be seen and almost as long to get an ultrasound. But they confirmed what I was increasingly getting anxious about. I had a couple blood clots in my calf.

I’m now on blood thinners to get rid of the clots and I’ll likely be ok without any permanent damage. But it could have been so much worse.

So please, heed my warning and get leg “cramps” checked out, even if they don’t swell. Especially if you have any risk factors.

Graduation

Last Thursday I had my “Graduation Day” from the surgeon’s care. Or “Vag Grad” as I call it. The final in person appointment with Dr. Wittenberg went really well and I seem to be healing great. Her staff were all so wonderful and excited for me.

Immediately after the appointment we hit the road and 13 hours later over two days of my partner driving, we made it home. I am so thankful to be back in my own space and much more comfortable in my own bed and recliner. Today I even managed to cook a family dinner for my house.

As nice as San Francisco is, I really wish that Seattle had trans surgeons here. It added a LOT of expense and really decreased my comfort to have to go that far away for surgery. I live in a major city with one of the biggest trans communities and it’s still baffling to me that we don’t have anyone in Western Washington.

So if you know any surgeons in training, please tell them that Seattle has a huge demand for bottom surgeons. The trans folks here could save hundreds of thousands of dollars every year that we could invest back in our community instead of trading funds back and forth for out of state surgeries. Trans people deserve health equity and access locally.

3 Weeks

Today is my 3 week mark from surgery and last night the itching started in strong. I know that means the scars are healing but the urge to scratch is very overwhelming and distracting. I checked with the surgeon’s office and sadly there’s nothing I’m allowed to put on them. So for now I just have to grit and bear it and hope it passes soon.

The past few days have had a lot more ups and downs than the second week. The area around my clit swelled up and I’ve had a lot more discharge and pain. I think it’s all within the realm of normal from what I can tell and it seems to be receding but it was scary to worry that something was going wrong.

I am so paranoid that things will turn septic and I’ll lose the area. I know that risk is rare (<2%) but it still scares me. I’m sure everything is fine but I have to keep reminding myself of my check up report from last week.

Only 3 more days until my “graduation day” and I get to travel back home! I can’t wait to be back in my own bed and fancy recliner chair. It will make the rest of recovery much more comfortable.

An old friend

When I look at my reflection in the mirror and see my groin where once there was a different set of genitals, I don’t feel like what I have now is new. It feels like the restoration of something that was always there, hiding underneath. Like the last 32 years were an anomaly and now things are how they were always supposed to be.

That’s why we call it gender confirmation or affirmation surgery, not “sex reassignment” or whatever BS that cis doctors came up with. I didn’t have anything reassigned. I had them rearranged back to how they should have developed in utero. The way that matched my brain and who I actually was.

Peeing now similarly feels very “right” and natural where it always felt so unnatural and weird the old way. Sure, it’s more convenient for peeing in the woods, but it never felt right and for a long long time I didn’t know why.

Things are finally how they are supposed to be and it’s hard to describe how much of a difference that makes for my brain.

3rd Post Op

Today I had my third post op appointment with the surgeon. They were amazed at how well I’m doing. The swelling was a lot less than they expected, I was really clean, and there was barely any wound separation. Apparently I’m doing everything right.

I also got my catheter out (again) and had to do the horrible pee test. They filled my bladder with saline and in order to leave without a catheter I was supposed to pee into a bucket to measure that I got it all out. Last time I couldn’t do it and I almost thought I couldn’t do it this time. It feels so awkward to just pee while sitting in an exam chair surrounded by stirrups.

This time, after trying for an awkwardly long time, I asked to try it on a toilet seat to see if it felt more natural. So they brought one in on one of those hospital carts and I was able to pee almost immediately! My hunch was correct that it was the setting, not the swelling or learning new muscles that was the problem.

It’s such a relief knowing I’m doing things right and I’m doing so well. And to finally be free from the catheters. This week is about continuing to clean and ice and start weaning off the gabapentin. I also need to walk more which means getting to know our cute San Francisco neighborhood better.

Week 3

Cleaning, dilating, douching and icing is pretty much a full time job. I’m trying to stay on top of the swelling and keep infection at bay. The pain is pretty easy to manage though my back pain has increased with all this laying in bed.

I spend all this time tending to my new vagina and holding up a mirror to it. And yet, it still doesn’t feel real. I think because I haven’t gotten most of the sensation back yet and can’t use it for what it’s meant for, it hasn’t fully connected to my brain. I can’t wait for late October when it will supposedly be healed enough to test out.