Post Op Yeast Infections & Others

[VickySGV]

In response to Drea's post in this thread http://www.lauras-playground.com/forums/index.php?showtopic=53758#entry499899--- where I mentioned that I had had a yeast infection

ALL post operative infections REQUIRE medical evaluation, DO NOT attempt DIY. DO NOT use medications or OTC unless you are instructed to do so. Self medication cannot be done without Medical advice.

The first and foremost part of dealing with a yeast infection, or any post operative infection, is to have your own primary health care providers alerted to the fact you are going to have the surgery and be ready for follow-up. While my health care insurance plan does not cover or perform the surgery, they are very open to helping me post surgically. At my major health care center, two of the gynecologists will treat post op Trans women, and have been given training in dealing with us.

The next part of this, is complete willingness on your part to have all your medical providers able to talk to each other via THEIR chosen communication path which meant that I provided and will continue to provide waivers of confidentiality for doctor to doctor. The major U.S. surgeons that I know of are very willing to help and consult with your primary care physicians or your new gynecologists.

On my specifics, dilation had become less comfortable with a feeling that I was rubbing salt into a paper cut, and it was making the insertion of the dilator up to a 6 to 8 on the pain scale. The entire new area near the vagina had also become red and inflamed. I had called the surgeon's office who instructed me to go to my primary care physicians office. I was refered to the gynecologist who took a look at the surgical healing area on the outer surface, and did a quick test for the yeast which she knew by a smell issue as well as appearance and lab results. The yeast type they found was Candida which is common in genetic women.

I was prescribed an oral medicaton for women with vaginal yeast infections, which in my case turned out to be a single pill taken immediately. Additional meds included the use of an over the counter athletes foot / general fungus cream, and an over the counter vaginal yeast cream that was inserted in the vagina. My instructions for this were for use at the end of two of my dilation periods AFTER taking sitz baths to clear the lubricant and discharge from the vaginal area, but could have been more or less often at my doctor's discretion. My gynecologist had phoned my surgeon's office, and this was the agreed treatment from both doctors.

A sitz bath, is just sitting in clear water that will cover the new vaginal and vulvar area for ten to fifteen minutes. I got told to air dry the area afterward with a hair dryer on lowest or coolest temperature, and then apply the OTC medications.

The worst of the infection was gone in about 3 days, but for the next few months, no sexy nylon panties allowed, and change your panty liners whenever you urinate. If you have diabetes like I do, also keep your blood sugar under careful control since the yeast can up your sugar, which feeds the yeast as well - viscious cycle.

I was assured that I was not the first trans girl to have this happen, and it is likely to happen if you are sitting for long periods of time as I had been on my trip home. We do have fluid discharge in a dark place down there which is yeast's favorite home. Neither I nor my doctors or surgeons did anything "wrong", and the best treatment and care, is use of your entire medical team, and following their instructions to the letter.

[Guest KimberlyF]

Yeast infections are very common after a course of antibiotics. The fungus is present on the skin at all times just waiting for the right conditions.

My son was put in neonatal IC at birth and given some antibiotics. Shortly after we got him home, he had thrush and a yeast infection at the tip of his penis. It's all the same fungus, just depends on where it's located. If it was his bum, it would have been diaper rash lol. But the key is always to keep the body dry when possible, esp after any illness or surgery.

[Guest rikkicd64]

I am so glad that you are better Vicky, and thank you for being so up front in your personal life as it may help some of the rest of us.

Gently with the hugs, Rikki.....

[VickySGV]

Thanks Kim, thats an element I overlooked. I was prescribed a course of anti-biotics for ten days after I was released and was using an anti-biotic vaginal gel along with my lubricant on the dilator when I inserted it. I had used up the vaginal anti-biotic just the day before I saw the gynecologist, but would have had to discontinue it once the yeast was discovered. It is a bit of a catch 22 but it was better to use the anti-bio AS DIRECTED by the doctor until another one intervened. Both doctors agreed on the discontinuance.

[Drea]

Good stuff Vicky.

Certainly it is good to work with one doctors. During one's "transition" such should be easy.

In the case of a yeast infection one of the cautions I would offer about OTC medications is that there are some these days that reduce the number of days medication has to be inserted. With a thicker medication it can last longer, but since post-op MTF don't have significant "flow" there isn't a mechanism that will cause this material to move out.

One thing that many tend to overlook is that over time the professionals one sees (therapist, endo, surgeon) retire, close practice or otherwise move on. At the same time things have become routine and one is likely to find that the replacement professionals don't have the same kind of experience. Also one's own experience with one's body has grown. So one should prepare oneself and get to know some of the pitfalls one's newer docs might not really think of.

[KathrynJulia]

Vicky

Question, didn't they discuss yeasty beasties with you at discharge? It's common for many woman to develop yeast infections following a course of antibiotics. Miconozole cream inserted into the vagina is a safe and effective treatment for yeast as is taking Fluconazole tablets. I suffered with yeast in my mouth (thrush) and in my urethra following almost every course of antibiotics that I take, yuk . It's no fun as the burning and itching has made life miserable for many a woman.

I plan to use the same surgeon as you used and I plan to discuss a backup plan to deal with yeast with her knowing that I am suseptible to an overgrowth of Candida yeast. I can almost count on a visit because like you, I have diabetes and following surgery and the trauma that follows, blood sugars become difficult to control. I happen to have a prescription for fluconazole on file as I have serious issues with yeast, an old friend. Kathryn

[VickySGV]

Kathryn -- we did not specifically discuss the possible yeast issue, but Dr. Bowers' staff whom I did contact had me get to my own doctor to look at the problem. Actually because of the diabetes, a primary suspect with what I described at first, was a separation at one of the suture lines. Turns out the pain was not really where I described it, but what did I know.

Anyhow, the gynecologist who saw me at my health plan center got me under control fast, and yes, my Fluconazole prescription can be refilled. I used the Gynelotrimin vaginal cream for a couple days, although the Miconazole was on the list too. I am still using straight Lotrimin cream in the creases between my labia majora and my legs every other day since that area does get wet from healing discharge.

[Guest Gregg Jameson]

Great post, Vicky!

So glad your docs are so willing to converse with one another and are ready to help you at any moment!

You do such a good job of coordinating your care, Vicky!

Please note when reading posts on OTC meds that people can quickly become allergic to any med, including topicals and/or OTC vaginal creams. Sometimes, people suddenly find themselves having a ragingly painful reaction to one vaginal anti-yeast preparation , while they can easily tolerate another. Miconazole is very commonly available. In some areas, the clotrimazole is less available on the shelves, but is often behind the counter with the pharmacist and/or s/he can usually get the clotrimazole within a day if its not at that store's location upon request. (This is a great option for those with Miconazole allergies.)

Please also note: the "azole" group of meds can interact with many prescribed medications, so PLEASE be sure your doc and your pharmacist are aware of any use of these OTC meds when using any prescribed meds. You may also check for interactions online at a reputable pharmacy site. Please be careful, even with OTC topicals and intravaginal preparations.

Some integrative medicine approaches involve using specific formulations of "probiotics" if yeast infections are often/common, to help with the vaginal balance of vaginal microorganisms, as well as assisting with correcting/balancing vaginal pH, in genetic females. You may ask your gynecologists more about this and/or may search more online.

I have just started to learn more about pelvic pain and trigger points developing in transwomen after surgery. Quite enlightening, to say the least, and truly makes sense this might be an issue for some. I have heard more about this from a physical therapist specializing in treating these abdominal and pelvic floor types of trigger points (internal and external release of myofascial trigger points), in both genetic females and also in transwomen. This physical therapist states many transwomen have ongoing pelvic pain and they find this PT approach very helpful in releasing the trigger points and the pain. If I access more info soon, I may do a thread with pertinent info. Please keep this info in mind if experiencing ongoing pelvic/abdominal pain and docs seem to not have an explanation. It can be caused by myofascial trigger points and is not uncommon in transwomen, according to this PT specialist.

Back to you, Vicky! I am so glad all is going so well for you! Gentle hug!

Warmly,

Brad

[VickySGV]

I am grateful that you have added this information here Brad. This is one of those things not often talked about on boards, the fact that trans women become vulnerable to the same issues of cis-women, but in ways that are not always the most pleasant. I had dinner with my ex spouse last night, and when I told her about the infection, she snickered and gave me a humorous dirty look and said "boy did you get on board with this total female thing fast". They never say this will happen in Trans 101.

[Guest]

Hi VIcky,

I was on some board somewhere... and ran across a bunch of postop girls recounting their yeast infections and other joys of womanhood. It did leave my head spinning.

And, then a few months back, my wife's bout of pneumonia and steroid treatments brought on a big case of yeast for her. It's not something minor, and preventive measures as well as swift treatment are essential.

Yes, thank you for sharing. Sometimes we do have to talk about icky things, lest they become worse.

Love, Megan