Monday, August 3, 2015

10 Month Post Op Update

Wow, I'm now into my 11th month since GRS and things are going great.  Even though any complications I had seem far behind me, they told us that full healing would take a whole year.  I guess I still had a few questions, like what was that mysterious swelling that caused me to get an ultrasound, was everything healed alright inside and was the area that had the granulation and silver nitrate treatments going to be okay?  All of those questions and more were answered last week when I finally went to a gynecologist for the first time and had a full physical exam from my regular doctor.

Going to the gynecologist was an affirming experience overall.  I drove a couple of hours to see this particular doctor as she came highly recommended and is someone who's worked with trans women before.  The office had mailed me paperwork which I brought in with me, so the processing nurse knew of my condition before we sat down to talk. 

The only "trans" question she asked me was if I'd had the surgery and when it occurred, even though I had stated that on the paperwork.  This discretion was a good thing because there were other people in the adjoining waiting room who might have been able to hear that conversation.  Considering that a lot of the women in the waiting room were pregnant or had babies with them, some aspects of being in that office did highlight (in my mind) some of the differences I have with most other women.

When I finally got to see the doctor, she interviewed me in her office for awhile before going to the exam room.  She asked me about my surgery, hormones, mammograms etc.  She asked if I'd had breast surgery as she looked at my top and asked me what was going on there.  I guess just me and a slightly padded bra was enough to make her question that.  She's very nice and about my age so talking to this doctor was very easy.  I hoped that the exam part of the visit would be as easy.

Luckily, the exam wasn't bad at all.  I had to take off all my clothes, put on a gown and lay back on the table.  First she felt around for glands in my neck and abdomen.  She did ask me if I'd had throat surgery, apparently because of my lack of a discernible Adam's Apple.  A lot of trans women get that done along with GRS (a couple of the girls in Montreal had this) but it was something I didn't think I needed. 

Next she did a breast exam in which she noted that I'd had good results so far from hormones and that I needed a mammogram.  I think this is a standard thing for doctors to request but I really don't think I need one, having only been on hormones a little over 3 years. 

It's like I am a 15 year old girl in that respect but then again we take a lot of pharmaceutical estrogen and progesterone, so maybe there is an elevated cancer risk.  Anyway, it looks like a mammogram is in my not so distant future.  When checking out of this office I scheduled that test for October and the lady at the desk asked me to bring records of my old mammograms.  I didn't want to ruin the moment by telling her this would be my first.

The vaginal exam was thorough but surprisingly easy.  The doctor felt around my outer labia, which is a routine part of the exam, and could not find the little lump that had been a big concern for me just a few months ago.  I haven't been able to feel it lately either and the discomfort if caused me when crossing my legs etc. is gone.  So I guess that is just one of those things they never can pinpoint but that did resolve itself on its own.

I feel that my vagina is very tight and from talking to other post op women this is not unusual.  In a lot of ways that's a good thing, but I was a little worried that it could make the exam more difficult.  She did the exam with her fingers and speculum and it was easy, so there was no need for worry.  She asked me what kind of tissue was used to make the inner lining of my vagina and the truth is I don't know.  I never learned the specifics of the operation, as I would be sleeping anyway.  That it was a penile inversion surgery is all I know.  This doctor did tell me that the vaginal wall was mucous tissue which explains why I am able to get moist there, even enough for sex without artificial lubricant sometimes.  Apparently she has seen other patients who have a different type of tissue there.

It's nice to be able to tell my doctors that I am sexually active with my boyfriend and that everything is going great in that respect.  I don't think my experience is completely typical, but I am able to have orgasms more easily than I did before the surgery.  I'd always heard, and was expecting them to be more difficult to achieve but possibly more satisfying after surgery.  In my case now, they are easier to achieve, often multiple and very often more intense than before my operation, as well as generally being much more satisfying because I now have the right part for me.

In the end, she said that I had a normal looking, functional vagina and that everything was fine.  I did get a prescription for Estrace cream, that is applied into the vagina with an applicator.  She told me the amount of estrogen from the cream is like a drop in the bucket compared to the hormone therapy I'm already on.  This cream is supposed to help with vaginal elasticity and was one of the things I'd wanted to get from this doctor as I've heard good things about it from my friends.

There is some scar tissue where I had granulation and treatments for granulation, but they are fading as well as the general surgical scars.  This doctor told me that they looked like normal scars from a regular woman who's had labiaplasty, so they do not necessarily give me away as trans.  She also told me I would not need labiaplasty, or a stage 2 surgery, which was encouraging to hear.  I am truly done with all the "trans" surgeries, having escaped with only having to do one.


I also saw my general practitioner (GP) last week.  We had scheduled a follow up to my Bell's Palsy episode and it was also time for another physical.  There is a problem with my thumb that I needed to talk to him about as well and you will be hearing more about that in future installments.

As far as my Bell's Palsy, I am rating it 97% gone.  My voice therapist recently did another evaluation of my voice, partly to see if the Bell's had any lasting effect there.  She found some slight anomaly that showed up on a graph and may or may not be a result of this palsy episode (as it didn't show up before).  At any rate it really doesn't affect my voice to the naked ear or affect the way I am gendered.  She said I'd achieved the mastery level of voice feminization which I guess is not too surprising because I never get called sir anywhere, even on the phone, and really don't have to think about my voice anymore.  After my last couple of sessions with her I will be done with voice training too.

The only thing my doctor's evaluation could only find was slight asymmetry in my smile, which I believe I had before but don't remember for sure.  I realize that there are a few lingering effects from the palsy (for instance the affected side of my face gets "tired" sometimes) but they get better with each passing week.

He also wanted to give me a full exam as well as take blood work (which I haven't gotten back yet).  He decided not to do a speculum exam to look inside my vagina, because I'd had one a couple of days earlier. 

This is the same doctor that started me on hormones back in 2012 and last gave me a physical before I left for Montreal.  He has a couple more post op patients but I am the only one who's been with him from first hormone through the complete sex change, so I know he was anxious to examine me and I was glad to show him how far I've come in this ~ 3 years.

This doctor always has a nurse in the room when he examines me with clothing off, even though it was a different nurse now that he's changed offices.  I guess that's just his procedure as the gynecologist didn't have anyone in the room when she examined me.  Anyway, I am not nearly as embarrassed to take my clothes off these days, which has been a positive effect of my surgery.

He also asked me if I'd had breast surgery and when I said no he said I had grown there since he saw me last spring.  As he was examining me he told the nurse my breasts were from the (hormone) replacement therapy.  He then took a look downstairs and asked me a couple of questions about being sexually active, which I was glad to answer.  He made note of everything being in the right place, clitoris, urethra, vaginal opening, so everything is normal and looks good.  Great reports!

July 2012
Since I'd posted it recently as a throwback picture, after the nurse left I showed my doctor this photo from 3 years ago.  It was taken on my way to see him after I'd been on hormones 2 months and was going to get my dosage doubled.  After that my transition took off and has not slowed down.  I did not reduce my hormone dosage after GRS.  In fact I changed to injections and have higher estrogen levels now than I did before surgery, so I am still changing a lot in just about every way.

The one thing that hormones could not change I addressed with my surgery in Montreal and today I could not happier with the outcome or my "decision" to have it done where I did and when I did.  For me, GRS was the missing piece of the puzzle for sure.

When I showed him that old picture I told my doctor that wherever I go people treat me and accept me as any other woman.  In fact, few know that I am really trans.  He prefaced this statement by saying that I Am a woman, but he told me he wasn't surprised to hear that, and that I look like any other woman with my clothes on Or off.  Hearing that from the man who started me on this (physical) transition truly made my day.