Number 168

One Post-Surgical Reality (part I)

 Preface

Hello, world. Before reading this post you must be aware of one thing. This post is specifically intended for my trans sisters that have not yet had, but are planning to have, a type of "bottom" surgery known as vaginoplasty. In many ways I was unprepared for the realities of the long-term recovery process before I had my surgery. I read a great deal, yes, but my feeling now is, six weeks after surgery, that much of what I read was generalized and vague. My intent is to provide my sisters with more accurate and truthful information As such, I plan on being blunt, specific, and graphic about areas of the human body that are sometimes euphemistically referred to as "private parts." If that type of candor leaves thinking 'TMI,' while you simultaneously stick your fingers in your ears and loudly declare, "I can't hear you! I can't hear you!" this post might not be for you. On the other hand, if you're curious and wanna learn something new, by all means, keep reading.

Chapter One: Disclaimer

This is what happened to me. That doesn't mean it will happen to you.

Chapter Two: My Clueless Doctor

Five days after I had my vaginoplasty surgery, my surgeon entered my hospital room to check on my recovery and perform a few post-surgical procedures. I was exhausted, and every nerve ending I possessed in my heavily bandaged groin was still sending my tired brain an endless stream of "SOS" messages. In other words, I was a bit of a mess. "So, Nora," he asked out of nowhere, "Would you do this again?"

Chapter Three: Hospital Time

Interestingly, I have no memories of the surgery that I had long hoped and planned for.

I have a few brief memories of being in post-surgical recovery. Mostly about trying to regain consciousness and make my brain work. Full reality didn't occur until I was in my hospital room. I was utterly exhausted, but I was not yet in pain. I was content to just lie there, fading in and out of sleep. Imperceptibly, the pain meds began to wear off, until I realized I was becoming uncomfortable. About then, my nurse came in and gave me a dose of oxycodone. "What a wonderful coincidence," I thought to myself, as I faded out again.

Here's the thing about the 'pain' I felt during my week in the hospital. It was rarely sharp and piercing. It was usually an all-consuming, dull ache that I felt throughout my body, not just my groin - although there was plenty of specific ache centered there. Every nerve ending in that region had been 'insulted' by the surgery and wanted me to know it. One mistake I made in the hospital was trying to wean myself off the pain meds too soon. As a result, I didn't take pains meds when they were offered, instead waiting until I was truly suffering, which meant more agony as I waited for the meds to take effect. During that first week I would recommend staying on a regular schedule of pain meds in order to be as comfortable as possible. Also, a 'bulster' had been inserted into my new vagina to ensure it retained its shape. I saw it after it was removed. Essentially it was an eight inch phallus wrapped up in surgical gauze. It was uncomfortable and left me feeling like a stuffed Thanksgiving turkey.

Perhaps the greatest source of discomfort during my week in the hospital related to getting my digestive system working again. Prior to surgery, I had been on a restricted diet which culminated in a liquid only diet for the last 24 hours. I had also completed a bowel cleanse. My tank was empty. Afterwards, the first sign of success is passing gas. Of course, you can't "bear down," as you usually do for a good fart or bowel movement, for fear of tearing the sutures at the nearby surgical sight. I experienced powerful cramps throughout this entire process, which had me wondering if I was experiencing PMS for the first time. I eventually farted and moved my bowels but it was an uncomfortable, multi day struggle.

Speaking of PMS, there was a fair amount of blood and other discharge to deal with. (There still is, six weeks after surgery.) Although it isn't painful, it has fulfilled any curiosity I had about menstruation.

Another big milestone that needed to be accomplished before I could be discharged was the need to urinate on my own. The catheter was removed on the morning of the 5th day, and the waiting game was on. I was full of both questions and anticipation. I had been sitting to urinate for the last three years in order to feel less dysphoric - now, I didn't have a choice. Did starting and stopping a urine flow work the same way as before? After all, it was the same brain, nerve endings and muscles at work, wasn't it? It was a bit of a mystery. 

Unfortunately, the one thing I wasn't full of was urine. The next six hours became a misery. You see, my bladder started sending vague messages of being full almost immediately. This was in large part because all the 'insulted' nerve endings in my groin area were still sending messages of annoyance to my tired brain. This led to frequent trips to the commode where I sat there and did nothing. Was I broken? Had my bladder forgotten how to function over the last week? I commenced to drinking water, and as the day progressed, the message from my bladder became more insistent. When I felt sure I was close to bursting, a sonogram was done on my bladder that indicated that it was, at best, about 1/3 full. "You've got to be fucking kidding me," I thought. Soon I was in tears, wondering what was wrong. I was at the point that if I were traveling on a highway, I would have pulled over immediately and peed by the side of the road without caring who saw me. This time when I sat down on the commode, before I could even think about it, I heard the telltale sound of urine hitting the water below. Thank god!

Surprisingly, another source of hardship for me was getting out of bed and walking.  PT or OT came by the day after surgery to assist me in standing up. A big part of the challenge is moving to a standing position without putting any pressure on the many sutures associated with surgery. Standing up without bending in the middle is a tricky proposition! In any event, when all was ready, up I stood. Yay! But my victory was short lived. After about thirty seconds, I began to feel light-headed, so back to bed I went. The next day went a little better but a lot worse, in that I stood up, felt fine, and started to take small shuffling steps, before I passed out and gracelessly went to the ground. Thankfully, I had two people with me who ensured that I went down easy. They had to bring in a motorized hoist to get me back into bed. What a fucking embarrassment. Eventually, on the fourth day, I was finally able to get up and take short walks around the hospital unit I was on. Though I got tired easily, it felt good to move around.

I don't believe I had a sustained sleep of over two or three hours during my entire hospitalization. That was partly me - I have insomnia and I didn't have my sleep meds with me, and partly because of the frequent visits from my nurses to administer this or that medication. Not to mention the noise the IV machine made when a bag of fluids emptied. Bodily discomfort, and the inability to move around and change position in any meaningful way also contributed to sleeplessness.

Another thing that happened during my stay was the casual way I began to feel about people seeing me naked. It became almost automatic. If someone walked into my room, I'd pull up my gown and let them examine my new vagina. This was in large part do to the professionalism demonstrated by the nurses and doctors, so good on them for that. Also, I learned that if I surrendered just a little bit of my dignity, the nurses were there to help me feel as clean and comfortable as possible. Hell, when I finally pooped - and it was a messy affair - there was NO way I could have cleaned myself afterwards on my own.

Speaking of my new vagina, it wasn't until the day of my discharge that I got my first "full monty" look at it. Until that point, my only point of view was looking down at my groin from a prone position in my bed. Standing in front of a full length mirror, my first reaction was not one of euphoria. In fact, it was rather flat. "Huh, that's different," I thought to myself. It wasn't cognitive dissonance exactly so much as it was a bit shocking to see that the object of so much angst and dysphoric feeling was no longer there. In the time since I have come to love seeing it in the mirror, and being able to say, "my vagina" is a fantastic feeling.

Having said all that, I definitely experienced 'phantom penis' sensations while in the hospital. (Still do, for that matter - just not as frequently.) At first, when someone would come in to inspect the surgery sight, I felt that my (former) genitalia was flopping around in the breeze for all to see. I had to consciously think to myself, "No, it's not there anymore." Other times, by myself, I would put my hand down there and delight in the fact that there was nothing there :)

On the seventh day, I finally went home.

Chapter Four: The Question Answered

Here's the truth. My week in the hospital was a messy, achy, painfully yucky affair. There were many hardships that needed to be overcome. At the time that my doctor asked me if I would go through it again I hadn't showered in a week, my hair was a stringy mess. I hurt all over, and I was exhausted. It felt a little bit like a 'trap' question, so after a pause, I quickly said "Yes, I would." But I imagine I didn't sound very convincing. Since then, however, I wish I had said, "Not at the moment," because that would have been a better reflection of how I felt in that moment. The real answer to that question, upon further contemplation is something like: "Yes. A thousand times, yes. Very little about my gender confirmation process has been easy or fun. In fact, much of it has been emotionally and physically exhausting. I have cried many tears, and I thought my heart would break a few times along the way. This is the hardest thing I have ever done in my life, but my answer, doctor, will always be 'yes,' because once I learned that the true secret to living a happy life is to be my authentic self, there was nothing that was going to stop me from achieving the congruency that I now feel. Yes."