Mtf Surgery And Post Surgery Experience

[Guest Michele H]

Following my surgery last June, I was asked via message if I would share my post op experience with someone getting ready to have her surgery She was primarily interested in if you have to have someone with you for the week after you get out of the hospital. I sent her a reply and then on the boards made a promise to follow up with more information – which sad to say I have been remiss in doing. So roughly 4 months post surgery, here is my original reply that covers the period immediately following surgery and additional material covering the 4 months post surgery:

First off, I continue to be very happy with Dr. McGinn. She is the only Surgeon I know that puts as much emphasis on after care. She REALLY wants the results to be everything you hoped and dreamed for. This does require an equal commitment on the part of the patient! so keep that in mind as I discuss the feasibility of going it alone. In part the answer is going to depend on the time of year - The winter months limit the options you have as to where to stay after you get out of the hospital. Since my surgery was in the summer, we elected to stay in the Ramada close to the hospital and drive up to New Hope for the Dr. Visits. This had the advantage of providing Karen a place to stay that was close to the hospital. The drive up to New Hope is beautiful, but you would NOT want to attempt the drive in a snow storm - making this a viable option only when there is no chance of snow. The answer also depends somewhat on if you are getting both GCS and a breast aug or only the GCS. Your mobility will be much more constrained if you have both done.

Assuming a Monday Surgery (shift dates accordingly based on your date), you will be in the hospital until Friday and not much interested in anything except sleeping - Karen took a few days during this period to take a mini vacation and drove to where she was born. I had to spend an extra day motionless while in the hospital as the bleeding wasn't stopping as fast as desired (everyone is different as to how much they will bleed - you are not moved, the sheets are not changed and they take a marker and mark the perimeter of the blood along with the date/time to monitor). My instructions on release from the hospital was that I was allowed to walk to the bathroom - and NO farther until the first exam on Tuesday - I think this is standard for everyone. You will have a large blood soaked pad that by now has turned to concrete. This sown to your vagina and I think it's primary purpose is keep you from walking! Sitting up in a chair and walking will not be easy until this is removed. From when you are released until after your doctor visit you will be dependent on either someone delivering food to your room or someone goes to get food or you live off what has been stocked in the room. The Ramada had both a refrigerator and a microwave - the Nevermore, which is ¼ mile from Dr. McGinn’s office did not - at least in the room I had. I think that generally, you are allowed some freedom after this first visit but I was not. It was two more days of bed - bathroom - bed. At least I was allowed to SHOWER!! I was allowed to venture out a bit following Thursday's appointment but you are still required to stay in the area for at least one more day (we came back on a Sunday). You MUST have someone to check you out of the hospital and take you to your hotel room. In the pre-op package that is sent out when you book your surgery will be contact information for in-home nursing care and if you must do it alone, you can arrange to have nursing care for that first day – or longer. Dr. McGinn WILL NOT do the surgery unless you have pre-arrangements for someone to be with you when you are discharged from the hospital.

So can you do it alone - yes if after leaving the hospital you check into a motel in New Hope, find someplace up there that will deliver food (avoid pizza - you need to eat food that will encourage your bowels to work and work easily and cheese isn't on the list. I would also check the Nevermore to see if they have rooms with a frig and microwave - you could stock up on TV dinners and Ensure is much better cold. If your wife has limited time, then I would recommend that she fly in the day before you get out of the hospital and stay until after your first checkup. Assuming you fly into PHL, when you book your return flight make sure you request on the ticket wheel chair assistance (do this even if you have someone with you). Do not attempt to drive - take a town car to the airport (McGinn's office staff can arrange that for you). BTW, you can have someone in the room with you during the unveiling during that first office visit when the concrete is removed, the packing pulled out, catheter removed, you experience your first pevic exam and get a lesson in dilation. A lot happens during this first visit in a short amount of time so having someone in the room with you is not a bad idea.

What is life like after you get home? First I should say that I’m 64 so don’t have the resilience of someone younger and over an 11-month period was under anesthesia for 20 hours in multiple surgeries. It takes roughly one month for every hour under for full recovery and I was not fully recovered from the first surgery went I underwent my second. I took a full 8 weeks (from date of surgery) this last time of short term disability and needed every day of that time before going back to a high stress job that requires very long hours. I was allowed to ‘ease back into work’ by starting out working only 40 hours for the first couple of weeks. You WILL have problems with depression for the first 4 months or so following surgery – and this depression has nothing to do with feelings of regret. I haven’t talked to anyone who had any regrets at all. For reasons that are not clear, the depression hits its peak around the end of month 3. From what Dr. McGinn has said, this peak around the end of the third month is very typical. I went in to see my gender counselor for one of my regular visits, she took one look at me and wanted to call 911 and send me to the hospital – it took the full hour of the session to talk her out of it – that session was at the 90 mark. In another week, I will be at the 120-day mark and the depression is finally clearing. If you have had any problems with depression in the past, please have a support network in place before having surgery. You need people who will call you on a regular basis and check to see how you are doing. One way of viewing our hormonal transition and the period following surgery is that when we start on hormones, it’s puberty, the period immediately following GCS is our menopause and then we are postmenopausal women. At least that was the way my OG/GYN doctor explained it. We condense 50 years of hormonal experience into a few years – talk about a roller coaster ride!

Dilation: You will receive two dilators during your first office visit and dilation instruction and it will seem that the first week following surgery is spent sleeping and dilating. Different Doctors have different standards but for Dr. McGinn’s patients, she wants you to dilate 5 times a day for the first 8 weeks (a very big reason to take as much STD as possible) for weeks 9-24 3x day and then once a day for the remainder of the first year. Beginning the second year for the rest of your life, it’s twice a week. The 3x day routine required me to dilate once each day at work (a room with a locked door is available to me) but as work has gotten crazier, I find that I’m only getting in one session in the morning and again before bed at night, to compensate, I dilate longer than the required 30 minutes and haven’t lost any depth. The two dilators are a set of four – each one slightly larger in diameter. You start with the smallest and use only that one for the first week and then graduate to using both. You can order the other two. It does help to step up through the sizes – though I rarely use the largest one. I either read or watch a movie during dilation so dilation is sort of my down time. There will be some pain at first and some bleeding but you have spent a lot of money, make dilation part of your routine so you don’t lose what you have paid for!

I have been asked about phantom pain – the sense that an amputated limb is still there – don’t know about others but I haven’t experienced it. Everything feels exactly where it should. My clitoris is sensate and has been from the get go so those of you young enough to still be interested in sex, don’t worry. The equipment will work. It is my understanding, however, that some adjustment is required pre-sex. Especially at first, you may have to dilate prior to having sex to open up the vagina a bit as well as lubricate, as you will not have the same level of natural lubrication as a natal woman.

And on the 7th day she rested: You spend years of your life preparing for and going through transition and then the last surgery is done, documents are all in the right gender and name and you are done, not much energy yet and you rest, it feels good, it feels right and your happy (in between the bouts of depression) and you then have to confront the question “what’s next” and for me and some other women I have talked to – regret. Regret for not doing this sooner. For waiting so long.

As for the next chapter in my life, I just applied for the position of Executive Director of PFUND which is a foundation created specifically by and for LGBT communities. Wish me luck.

[Paula ult]

Michelle hon,

I am happy see you back, as you know i am scheduled with Dr. Mcginn in May 2011 and was awaiting a report to see how you were

doing post op and it sounds like things are getting better.

HUGS!

Paula