What's the Rush?

That's the question I was asked this week: "What's the rush?" Why am I having my labiaplasty so soon after the vaginoplasty? One of the reasons why this is a two step procedure is that the vaginoplasty is very traumatic on the vaginal/abdominal area and needs to heal; vascular damage precludes doing the labiaplasty sooner than 3 months post-op. My labiaplasty is scheduled for 4.5 months (20 weeks) post-op. I scheduled it then because it was my understanding that this should be done between 3 and 6 months. This particular date was open and allows me to use the MKL Day holiday to save a day off. However, the biggest reason for the "rush" is that I feel like an unfinished project. It's hard to "get on with my life" without putting these surgeries behind me.

Business As Usual

It’s been a very uneventful week, pretty much business as usual. Dilation with big Max is getting easier, but is definitely not easy. Parting the PC muscle doesn’t feel too bad anymore, but advancing the dilator is uncomfortably. I’m pretty sure that Big Max is as large as I’ll ever go. I feel filled to capacity. One thing I’ve just noticed is that each time I step up a size I seem to be trading width for depth, almost 1/2 an inch with the step from 2 to 3 and another going from 3 to 4.

Treating my granulation tissue is a pain both figuratively and literally. I now call the pain “the ring of fire” as it’s a burning sensation surrounding my clit. The immediate, intense pain passes fairly quickly but is replaced by a lingering, duller pain that eventually makes my entire abdomen hurt. As I said before, this better work!

About a week ago Michele asked me something to the effect of when does it all feel like you, when do you stop looking in the mirror to see what things look like because you’re used to it (my counselor asked a related question wondering if I was accepting of the rest of my body). She wanted to know why I hadn’t written about this. I think the bottom line is that I’m not there yet. Dealing with this granulation tissue and wondering if/when/how it will heal up and also knowing that I have another surgery in January makes it impossible to know what the final me will be like. Add to that the still numb areas that may or may not improve and my “untested equipment” and it’s obvious that I’m just not there yet. I’m still a work in progress.

Milestones

This week I:

• Went an entire day wearing heels without abdominal discomfort;
  
• Decided that I am more comfortable without the donut;
  
• Discovered that all of my sutures are gone;
  
• Said hello to "Big Max" (dilator #4)

Clitoral Complications

In my last post I mentioned the ugly red area around my clitoris. I spoke with Nurse Janet and she asked me to send a picture. She then responded that it looks like "granulation tissue". According to the OneLook Dictionary this is "new connective tissue and tiny blood vessels that form on the surfaces of a wound during the healing process". Although it seems that this may be a normal part of wound healing this tissue is also very fragile and prone to damage, oozing, and bleeding and can develop into scar tissue. God knows I don't want scar tissue surrounding my clit! Anyway, the treatment is to apply silver nitrate to the granulation tissue. It comes as a stick that looks like a match with the match head being the silver nitrate. I'm to apply it to the area twice a week for two weeks. Immediately, it turns the tissue a silvery black. Later the entire area was covered in a yucky, silvery, staining, oozy mess. This better do the trick because it also hurts! I specifically asked Janet if this would hurt and she said no. I doubt she's ever had the "pleasure" of the experience.

Post-op Checkup

On Thursday I had my first post-op appointment with my primary care physician. I brought her the little bit of info for follow-up care provided by Dr M’s office. We went over my current meds and my general wellbeing. I’m supposed to have my first speculum exam at 3 months so we talked about what I was told she’s supposed to be alert for during the exam. Since Dr M’s office also has an info sheet on this I called today to get it faxed. She also sent me home with a speculum to “practice”. It turns out to be smaller in diameter than Junior but it opens up larger than Big Max; she also needs to be able to move it around to see everything. She also mentioned that lubricant interferes with a pap smear. I haven’t “practiced” yet so I don’t yet know how this will work out without lubricant. Thankfully, I don’t need a pap smear until about next August so it’s not much of an issue at this time. We then moved on to a physical exam. As I was getting into the stirrups I remarked that this was my first time, at least while conscious. Her first comment was “Wow, he does nice work!” Of course, this felt really good. She noted the remnants of my sutures that are still hanging in there. She also noted that I have some discharge. Unfortunately, I forgot to ask from where the discharge is coming. I go back in 7 weeks for the speculum exam. Oh boy! Thursday evening, or the next day, I took a good look at the area to see if I could notice a discharge. I was alarmed to see that the area right around my clitoris is quite red. It looks to me like the sutures that were holding the skin to the clit have finally dissolved and the skin has pulled back a bit. I don't know if this is normal so I put in a call to Dr M’s nurse but haven’t heard back yet. In the mean time I'm using the Bacitracin twice a day.


"The Dreaded Speculum"

Blogging on a Comment: Vaginas, Sexuality, and Transsexuality

My last post, PC Muscles Explained, elicited comments from Anonymous. We got off to a poor start based on misunderstanding. Instead of responding at length in another comment I’m going to respond here.

Sex, Gender, and Sexuality
These are three independent variables of a person’s personality. If you can imagine a combination, it’s sure to exist. They are not even sure to be stable over time. Gender and sexuality are actually far more fluid than most people are comfortable to admit.

Vagina: to have or to have not.
I’ve heard it said “Why would you want a vagina if you don’t intend to have intercourse with men?” Wanting intercourse is one possible reason for wanting a vagina but there are many other possible reasons for a male-to-female transsexual to want a vagina. One of the most important to me had to do with body image. For me it was just wrong to have a penis. While I’ve never hated my penis once I realized that I was transsexual I knew that I wanted a vagina. Note that at this point I had not yet figured out my sexuality. Once I realized that I was lesbian I was quite troubled by being a lesbian with a penis. What’s wrong with this picture? Oh, the penis! So, for me I needed to have a vagina because I knew it was right for me. Oh yes, I want to be penetrated, but not by a guy’s dick.

Sexuality
Transsexuals are a diverse lot. I will go out on a limb and say that most MtF’s probably started as “heterosexual”, at least, they were trying to live the life that’s expected of a male in US society. After transition and surgery all bets are off. Unfortunately, there are no good statistics on this. For me, from the first moment I left the house dressed (age 38!) I knew I wanted to experience being out on a date with a guy. There are a large number of guys out there who seem to have a thing about MtF’s so it wasn’t terribly hard to find date. I quickly found that I wasn’t actually turned on by these guys but that I was turned on by their attention to me. This left me wondering if the problem was with these particular guys or with guys in general. My first date with a woman answered this question for good. Wow, zing! I never experienced a spark with the guys. It’s not a requirement that a TS know their ultimate sexuality before starting transition or before surgery. We’re all free to change our minds…and then change them back…repeatedly. It should be nobody’s business but their own.

The art of vaginal maintenance
I suppose it’s possible to just have a penectomy and not to have a vagina constructed but it’s not something you generally hear about. So, it’s pretty much a given that regardless of your sexuality, or your desire or expectation to ever have intercourse, a post-op transsexual is going to have a vagina to maintain. This maintenance consists of dilation, initially 4 times a day, eventually tapering off to once a day or less, but possibly lasting forever. It’s a big responsibility, but after all the time, pain, and expense it’s hard to believe that someone would stop dilating and let their vagina close up. Hard to believe, but true. I can’t begin to guess why.

PC Muscles Explained

In researching the vaginoplasty I had always read about how an opening must be made through the PC muscle for the vaginal canal. I’d also heard of the PC muscle back when my ex was pregnant with our kids. In all that time I don’t think I’ve ever really knew what the PC muscle is. It turns out that PC is short for pubococcygeus. It surrounds the urethral and rectal openings and it sort of forms a hammock that supports all the abdominal and pelvic organs. Now I better understand why piercing it for the vaginal opening makes everything hurt! I found all of this info here.

The Worst Work Day So Far

Today was a bad workday. From the moment I arrived at my desk I was feeling uncomfortable. I’m not sure why, but there are several possibilities: today was the day that the kids go back to their mom. This entails schlepping all of the stuff they can’t live without (guitars, gaming systems, dolls, school stuff, etc) over to the other house. I had my son load up the car last night, but it was up to me to get it all from the car and into the house. Could be that I over did it. Second, today I tried wearing my “sensible pumps” rather than my flats. Third, my slacks were tight across the waist. Could be all of these, something else entirely, or just one of those things. Bottom line, from the first moment at work I was wondering how long I would last and how soon I could realistically head home. I toughed it out until 3:30, drove home, dilated, dozed, spoke with Michele (she’s in France until Sunday), and then did some shopping. Unfortunately, this required more lifting and carrying. I should probably have left it until tomorrow but I had been looking forward to a grilled chicken salad all day.

Speaking of food, when I left for surgery I weighed 149 pounds. When I returned I was at 152. Middle of last week I was at 157! It’s time to get serious again about dieting and weight control. In the past, I’ve never been disciplined enough for a diet to work, but adding in my exercise does the trick. Unfortunately my body is telling me that it’s too soon for any serious exercise. It’s all going to be a struggle for a while.

3x3

The dilation routine is now Trey three times a day. I've made the full transition to dilator #3. The Deuce Coupe has had its last ride; I no longer need it to prep me for Trey.

The 3x per day dilation schedule is working out OK so far. I'm doing the first around 6am, second after work, around 5:30, third before bedtime, around 11pm. Unfortunately, this schedule stretches my day a bit on each end, cutting into my sleep time. Before surgery this would have been enough but right now it's not; I need extra sleep.

Work is good and bad. The work itself is fine but the all day sitting is uncomfortable. I find it hard to even get to 4pm; 5pm seems out of the question. I need to give it more time.