Thursday, October 9, 2014

Post Op Reflections at 15 Days

It's hard to believe that just a couple of weeks ago I visited the stunning Notre-Dame Basilica of Montreal.  I was moved by the beauty, enormity and significance of the most fabulous chapel I'd ever laid eyes on.  In addition to it's visual marvel, the spirit within that place was something I could feel deeply within my soul.  That day I said a prayer for change and, lo and behold, 2 days later I lay in a hospital bed on the other side of Montreal recovering from what I am told is life changing surgery. 

While there was an abrupt change to one part of my body, other changes have been subtle so far.  The surgery knocked me off my feet for a couple of days, and I'm still spending more time in bed than out of it as I regain my strength and abilities to sit and walk.  Overall pain is down but the daily aftercare schedule, extremely intense in the first month of recovery, is both time consuming and painful.

I think I may be feeling a bit different inside now.  When I see you across the room I will hobble over to hug you, and the love that I feel for you is the same.  How I feel about myself is a little bit different, though hard to describe.  This surgery of less than two hours in duration was physically successful but I think it may have been significant in other ways as well.  Could it have brought about a change in my spirit as well as my body?

*****

Physically, I have a long way to go with recovery, no doubt about it.  Besides getting my general strength back, the actual surgical area has a lot of healing left to do.  I'm very sore all the time.  I still have swelling, burning sensations and get stinging pains that come and go.  Some of that, I am told, are nerves reconnecting.  That's a good thing for sure, but many of the sensations are just those of the body healing itself after a severe trauma.

Blood is becoming a less frequent visitor and most of it now is very light colored and watery, possibly mixed with other bodily fluids as it slowly makes its exit from deeper parts of the affected area.  The affected area itself is still quite sensitive, making walking and sitting very uncomfortable if something has to come in contact with it.

My daily aftercare schedule consists of dilating 4 times a day, one shower, 2 "sitz" baths and 2 douches.  Dilating consists of inserting phallic shaped plastic dilators into my vagina, pushing them to maximum depth and holding them for a set period of time.  The actual dilating time is a total of 25 minutes 4 times a day but it can easily take twice that long with cleaning, preparation and insertion time.  In such a swollen, sensitive area this doesn't happen quickly.
The dilators.  Currently I am using the blue and the green.  Next month I "graduate" to a regimen to include the orange.
Sitz baths are simply short baths in slightly soapy water.   This is supposed to help break up blood clots that formed after surgery, and in fact I am mostly clear of them now.  It also helps clean the area and I enjoy them because they remove the excess lubricant, blood etc. from dilating.  Douching is pretty straightforward and is done in the morning shower and the last sitz bath of the evening. 

At first, douching was sort of an adventure.  Back at the recovery house, my roommate Samantha took her shower first on the day of our initial douche.  She told me that I could leave the door open when I did it in case I needed to talk to her for moral support.  OMG what was I getting into, I thought?  In fact, that first time did bring gobs of thick bloody substances that ran down my leg and fell into the tub.  Not for the faint of heart, this initial douche was sort of a rite of passage.  Now it's mostly just the clear, saline solution from the douche that comes out but it might contain a hint of blood or the lube from dilating.  Or perhaps something else?

Eventually douching will be something I do only occasionally.  When I got home, there was one oops moment, when I realized I had inserted the douche into "the wrong hole."  Luckily I had another douche available, as I threw that one away to avoid contamination.  Everything we do now has to be super sanitary.  I have hand sanitizers all over the house and am extra careful not to touch the surgical area unless I have sanitized.  So far I have avoided infection and over time the risk will continue to decrease.

Urinating can still be sort of an adventure.  Depending on swelling and how badly I have to go, it can sort of spray in different directions and make a bit of a mess.  The nurses told us that some of this is normal for women, but at this point in recovery urination isn't completely normal.  I do understand why women require more toilet paper than men when going "number 1" although I am sure mine will become more regular over time.  We are told at 60 days it should become more regular and if a problem persists after 6 months we can contact the surgeon.  I've had a few occasions, now becoming more often, where urination was sort of straightforward so I think that is closer to what I can expect eventually.

I started my hormone regimen back last Friday but I am easing into it.  Having been off for about 23 days and with my body still reeling from this major surgery, I want to take it easy for awhile.  I restarted at 1/4 of my pre op dose and yesterday, 2 weeks from surgery, increased it to 1/2.  At the end of the month I'll increase it some more and soon after will get a blood test to see where my levels are now. 

There has been major change to my endocrine system, namely my body will now only produce a fraction of the testosterone it once did.  Needless to say I don't need testosterone blockers anymore and will have to figure out the correct estrogen dosage.  I'm not anywhere close to being ready to be post menopausal yet, as I still feel I have a good ways to go with "teenage" puberty, so I will continue with an "aggressive" hormone therapy for some time to come.


*****

So, how have I changed inside since my little visit with the French-Canadian doctors?  And has my spirit been changed by this life changing event?

These are questions that are going to have to be answered over time, and it will  probably take a long time to really figure that out.  All I can do now is give you a few examples of how my feelings have been affected in these last couple of weeks.

While I was still in the hospital, nurses would come in periodically to check the bandages around my surgical area.  Several times a day they would change gauze etc. to keep the area as clear of blood and as dry as possible.  Remember, during this time my genitals were covered in a sewn in bandage to protect everything for a few days.

As they would pull the sheets back to make their check, something inside me flinched.  It was a gut reaction to having someone look at me "down there" and the initial feeling I got was embarrassment.  Then I would remember having the surgery and I would be a little more at ease with having them pull the sheets back and check on me.  I knew they had good intentions and I realized that I was different than I had been just hours before, so I was more at ease with having them look.  It is hard to describe, but this is the feeling I had every time they pulled the sheets back.

Looking back, as the days to my surgery drew nearer I seemed to have more and more problems with such mundane tasks as "tucking".  What had been so easy to do for so long, almost instinctive, was to tuck everything away after visiting the bathroom or when getting dressed, so it wouldn't be seen in my pants.  I'd do the same thing to a lesser degree if wearing a skirt or dress.  As the time of surgery drew nearer, especially the first few days I was in Montreal, it seemed like I just cou
ldn't get it right.  I'd spend an extra few minutes in the bathroom trying to tuck satisfactorily.  This compounded the feeling I'd always had in public ladies rooms that someone would see me doing this in the stall and expose me.  I'm not sure why this got more difficult right at the end.
 
One feeling that had been always with me was not wanting to take my clothes off around other people.  I'd worked through this, over time, with a very few people I was intimate with, but I could never completely escape a body modesty rooted in shame.  As a kid, when we got old enough to take showers in gym class or the YMCA, I quickly realized this was something I couldn't do and would go to great lengths to avoid.  For example, I remember once going to a university for a week for a journalism seminar and staying in a dorm that had the large, "open" showers for men.

I still don't understand why men are forced to shower openly in rooms like that, instead of using private stalls.  Even now, to me this seems like a brutal practice.  The handful of times I had to take showers in situations like that or fully change in men's locker rooms were traumatic to me.  I would always avoid those situations but that week at the university I got up at 4 AM to take my showers just to avoid any possibility of showering with someone else.  Anyone that knows me realizes that this was a big deal because I am far from an early morning person. 

My fears of these types of showers kept me away from certain activities as I grew older, like athletics or joining the military.  When I went to college I made sure I stayed at one of the few dorms where the men's showers at least had dividers with curtains. That dorm was also one of the few at the time that had air conditioning so there were other perks to staying there.

At L'Asclepiade, the recovery house adjacent to the hospital, there wasn't much privacy.  There was a private bathroom that Samantha and I shared, but much of the time in the rooms were spent in some state of undress and of course the nurses would come by and inspect our genitals during their rounds.

I don't think my modesty has completely left me, but the feelings I had having to be so exposed were completely different than those I've experienced previously in my life.  My roommate would often lie in her bed completely naked and I did that some but I would usually have a gown on, although to "air out," dilate etc. it was usually hiked up so that everything "down there" was exposed.  I would not have been in that situation if I hadn't just had surgery but I would have freaked out having to be so exposed if it were not for this surgery.  Could this aspect of my physical dsyphoria be gone now?  Only time will tell but obviously the feelings I have about parts of myself have been changed.  As messed up as it is at this point, I am more comfortable with my body now.

Some have said they see more of a sparkle in my eyes in pictures I've taken since my surgery.  I really don't see that but maybe it was from pain meds, I don't know.  Through the pain and constant discomfort I have been able to smile at least.  And it is a smile that comes from deep inside.  I do feel a little more peaceful. 

I hope everything heals up and turns out okay because at this point I really don't have many good feelings coming from my surgical area, although the pain is decreasing.  This is all considered normal and I just have to wait it out, which is ok. 

This surgery is a radical procedure and it certainly isn't something you do for short term gain, that is for sure.  I've had a few moments of worry that everything will not heal correctly, but I just have to trust in the experts who handled my surgery. 

Many report experiencing a post op depression when they get home.  I've been on the lookout for it but haven't really had any of those feelings.  Most that experience this depression are not sure what causes it and it is something they have to work through but I am hopeful this is something I can avoid. 

In the darkness, at night and alone, there can almost come a feeling that one has been injured and will never heal.  I did feel it coming on a couple of times and it cost me sleep but didn't send me into depression or reaching for the anxiety medication.  I'd gotten some of that medicine from my doctor before traveling north just in case I got anxious at any point.  I will do what I have to to make it through this tough time but so far I haven't had to resort to medication.  I can see how this long, brutal recovery process can wear on a soul but I feel my soul was prepared for this long before I packed for Montreal.

*****


Sitting in the Notre Dame Basilica, looking up at the fantastic images before me that depict a spirit more ancient than the religion that inspired the building of that chapel (indeed more ancient than life itself I believe) I asked that my body be prepared for this change.  I asked that my spirit be ready for what lay before me.  The answer I got was one that I already knew inside. I'd been ready for this my whole life.



Hey from back home, on a beautiful October day.