Post-Op: Day 11 (August 12)
Today was another mostly uneventful day with regards to healing. I woke up, ate breakfast, downed antibiotics, a probiotic (Florastor, which my doctor in the U.S. recommended to accompany the antibiotics), and Tylenol. I took a shower, making sure to wash all crevices of my genitals, then let myself air dry for a while, before re-doing the dressing around the catheter tube, applying Bacitracin to all sensitive areas, flushing the urethra, and getting dressed. At this point, the only 'foreign' stuff I have in or on me are the suprapubic catheter (which is small and not very bothersome), a piece of gauze taped around the entry point, and a cotton pad in my boxer briefs to catch any blood. Nothing is coming from my stitches; I just have a little blood that occasionally seeps from the urethra. Miro said that is normal at this point in healing. I also have the 2L catheter bag, which I attach to the catheter and unclamp the tube whenever I need to 'go.' Standing at a toilet waiting for that tiny tube to drain my bladder takes too long, though it is workable if necessary.
Marta stopped by later in the day. She dropped off four little sugar-covered pastry-like things with fruit in the middle. She said her mother made them and she wanted us to try them--very nice of her. We talked a bit about Marta's dog, Sara, a 12.5-year-old rottweiler, who had just had surgery to remove a tumor. We saw Marta giving the dog an IV earlier in the day and we wondered what was wrong. Hopefully Sara will pull through; the members of Marta's family have been in the backyard keeping an eye on her all day.
I went for a short walk down the road in the evening. My hips hurt more than my balls due to my odd walk, but I'm still determined to walk with my legs apart for a few more weeks. Miro seemed to recommend taking things very, very easy for the first two weeks definitely, and preferably for the first month. It is the middle of summer here, so all the trees which line the street have full foliage. The neighborhood is nice. Some of the buildings are brand new, while others are older but are kept up. There are a lot of plants and ivy. The street is narrow, so the cars have to parallel park on the sidewalk, but it works. Down the hill from us is what looks like a bar or restaurant, which was lit up when we passed. There was a band playing; I saw an upright bass, a fiddle, and I believe a guitar. I was tempted to go inside to watch, but it seemed a bit crowded and sitting still isn't my most favorite activity. I stood outside awhile and listened, then headed back. Just that short walk (not even a quarter of a mile) had tired me out.
Later, I popped in a DVD that was in the apartment--"World's Greatest Dad"--and tried one of the pastry things. It was good; I was expecting something like a jelly-filled doughnut, but the bread was heavier and the filling was a whole piece of fruit, something like a plum (an improvement over sugary glaze filling, I thought). A note on the DVD player: it can play U.S./Canada Region 1 encoded DVDs. Had I known that, I would have taken some of my DVDs to watch at the apartment. I don't know if is compatible with other regions, though.
Post-Op: Day 12 (August 13)
I can't believe today is our last full day in Belgrade. We fly out at 1PM CEST tomorrow. Dr. Miro stopped by this morning, just to say goodbye and make sure that everything was OK. He gave my mother and I coffee mugs that say Beograd, which was a nice gesture. Mine has buildings on it, while my mom's has laundry hanging on a line. For the record, while there is a small washing machine, there isn't a gas or electric dryer in the apartment. There are clotheslines in the backyard and there is a folding metal rack. We used the rack, and clothes were dry within 24 hours.
Dr. Marta is supposed to come by later today to give me the picture CD of surgery and to say our final goodbyes. In the meantime, I'm going to go write something in the Admiral's "guestbook" that is on the living room table. The book is a good read when you first arrive before surgery, as the entries are very positive and encouraging.
Marta called to say that she would be by in the morning instead. So, my mom and I went to eat supper on the Danube (or maybe it was the Sava--it was near the confluence of the two rivers, anyways) at the restaurant Malevilla, which Marta pointed out to us when we were driving around the city. Our cab driver, Igor, dropped us off as close to the restaurant as possible, after performing some very talented cab driving that would not go over too well in the States. We had a nice time at the restaurant, which is actually anchored in the river. It was a fairly fancy place with good food (a nice fish menu, but I ordered veal). The menu was dual language (Serbian/English), so that was nice. We saw the sunset and watched as the riverwalk became very busy. It was a Saturday night and the atmosphere was like that of a carnival. Set up all along the sidewalk were inflatable playgrounds, carnival rides (including bumper cars), an arcade with pool, foosball, and air hockey tables, and food and merchandise vendors. Across the river, Usce tower was lit up. There was a full moon out. After eating, we walked along the riverwalk for a short distance before I got tired. I wish we could have seen more; it definitely went on for a long distance.
So then we headed back to where Igor dropped us off and pulled out the cell phone to call his number--and we couldn't get him. All we got was a recording in Serbian that neither of us could understand. We tried calling Marta's landline, which was programmed into the phone, and couldn't get that either. Great. My mom tried talking to a very helpful man in what looked like an information booth. He didn't know English, but he understood her when she said 'taxi' (I'm pretty sure the Serbian variant is written 'taksi' and is pronounced about the same). So he ran off, I'm not sure for what purpose--maybe to check where the nearest place to grab a cab was--and came back a while later, talking and gesturing towards the nearby highway. I thanked him with 'hvala' and we headed in that direction. Along the way, we began to have some misgivings about just grabbing any cab, remembering what Marta said about cab drivers who might take advantage of foreigners. I could say the address of the apartment fine, but I'm sure I have one helluva accent.
I looked through the call log on the cell phone, which had Marta's cell number listed. I called that and, thankfully, got through. She said she was just about to call us. She was on duty at the hospital, but her dad apparently contacted her because he was worried we were out so late. We explained the situation, and she called a cab for us. So, in the end, we got back safely and were even charged the correct amount, thanks to Marta.
Guestbook Entry
July 30 - August 14, 2011 - Metoidioplasty
I cannot thank the Belgrade team enough. The level of care here is wonderful and the doctors and nurses are some of the most compassionate that I have ever met.
Dr. Miro is clearly a talented and dedicated surgeon. He is full of energy and excitement when he speaks of his work. I feel lucky to be his patient. I have never known a surgeon who actually visits his patients after surgery, let alone gives them a big bear hug and greets them as friends. Miro, thank you for your work and for all that you have done for people like me. Thank you for trying to organize a drive to my family's home town in Croatia, where my grandfather was born. Even though I wasn't quite up to the trip--the gesture speaks volumes and is deeply appreciated.
Dr. Marta is completely awesome. She helped make this possible--all the details about scheduling surgery, what to bring, where to stay, what to expect. But she went far beyond taking care of details. She made us feel welcome, at home, safe. Any worries or concerns I had--she addressed them and made me feel better. She even brought us delicious food her mother and sister made for us. She knew that we did not get to see very much of the city, so the opportunity arose where she was able to take us to the mall and give us a driving tour of Belgrade. We enjoyed it immensely; the city is unique and beautiful. Marta, you do so much so well--you are amazing. Take care.
Miro and Marta, thank you both for being friends and going out of your way to help my mom and me.
To all the other doctors--Dr. Korac, Dr. Stanojevic, Marko, Vladimir--I may not have seen as much of you as Miro and Marta, but I know you were involved and I thank you. To Vessna and all the other nurses, thank you for taking such good care of me at St. Medica.
To anyone who has recently arrived at the Admiral and is reading this for the first time, anticipating surgery: you are in good hands.
Post-Op: Day 13 (August 14)
Today was the big travel day. Marta came by in the morning, as promised, to say goodbye and to give me the picture CD of my surgery. George picked us up, brought us to the airport, and even carried our bags into the airport and put them on a cart. Nice guy. We paid him for the ride, which was 2000 dinar, and bid farewell.
We waited at the Lufthansa check-in desk, checked our bags, got our tickets, and headed upstairs to security. The security screening is less rigorous than in the U.S. There was a metal detector and an x-ray machine for carry-on baggage. I put my laptop, shoes, and liquids in a bin, though I don't know if all that was necessary. I didn't have any issues going through security, at any rate. Nobody cared about the pills I had in my carry-on (antibiotics, probiotics, and Tylenol, all of which I needed on the plane) and I was even able to get a visual screening of my pills and T vial without incident. (The reason for the visual screening is simply because I don't like having my meds, especially the T, X-rayed.) My 36 boxes of Cialis were packed in my checked bag along with my other medical supplies, including syringes/needles, bandages, and spare catheter bags.
I did not have the catheter bag connected (the suprapubic catheter tube was hidden in my underwear) and the donut was stashed in a bag out of sight. Apparently if it looks like you have something medically wrong with you at a Serbian airport, you can be detained until a physician clears you for flight (which might cause you to miss your flight). Thankfully, I didn't have any issues. After security was a customs check, where they stamped our passports and took the police cards that Marta got us when we first arrived. Another note: my passport still said 'F', while my name and picture are clearly male; nobody in security or customs gave me any trouble over this. We spent some time in the Duty Free shop before heading to our gate. FYI, our gate had another metal detector and X-ray machine, presumably operated by Lufthansa; I followed the same procedure as the first security check and it was fine. Unfortunately, one would have to undergo screening again if they wished to leave and re-enter the gate. This is an inconvenience, since there are no restrooms in the waiting area.
All our flights were on time (yay, Lufthansa). The flight from Belgrade to Munich was relatively short (around 2 hours) and I was not in pain, having preemptively taken a couple Extra Strength Tylenol. I had packed one new 2L catheter bag (given to me before I left St. Medica) in my carry-on backpack, which I put in my pocket and attached in the plane restroom. I bought a 1L catheter bag with leg straps in the U.S. for this purpose and tried it out before the flight, but I found it uncomfortable. Plastic against the skin isn't nice, and the curve of my leg meant the bag didn't have much room left for liquids. So, what I did instead was wear cargo shorts with big leg pockets. I didn't want the catheter tube showing, so I threaded the small suprapubic catheter tube from my abdomen, out and over the waistband of my boxer-briefs, and under my shorts. I cut a small hole on the inside of one cargo pocket, put the 2L bag in the pocket, and threaded the larger catheter bag tube through the hole, under my shorts, and up to connect with the suprapubic catheter tube. When I needed to empty the bag, I just went to the restroom, took the bag out of my pocket, unscrewed the port on its bottom, then re-capped it and stuffed it back in my pocket when done (taking care not to kink any tubing). It worked well and, as long as I didn't let the bag get too full, did not look odd.
Like the flight to Belgrade, the airplane did not stop near the terminal, so there was a short bus ride to the terminal. I was able to walk between gates at the Munich airport, where we underwent another security/baggage check followed by another passport check. A wheelchair would have been faster, though. Also, nobody cared or even took note of the catheter bag in my pocket.
This flight was much longer at around 10 hours. Surprisingly, I was not in pain, although I was definitely uncomfortable by the end of the flight. Reclining the seat to take direct pressure off of my genitals helped a lot. At O'Hare airport, I got a wheelchair. It was just way too far to walk, and I was honestly walking more slowly than the little old ladies that I saw in the terminal. On the upside, people in wheelchairs (and their companions) get to go through a separate expedited line for customs. This was nice, since the regular line was long. Also, the woman who was pushing the wheelchair knew exactly where to go, which made things easier.
In all, the trip wasn't as bad as I thought it was going to be, though I did notice that my urethra had increased bleeding, probably due to all the movement. The swelling of my penis, which had been going down, also got worse.
Post-Op: Day 14 (August 15)
Today we drove home. Again, Extra Strength Tylenol took care of any pain I may have had (I didn't feel any, just somewhat uncomfortable) and being able to sit in the back seat, where I could sit with my legs apart and recline the seat, helped a lot. I alternated between using the donut and slouching on the seat. Changing positions seemed to help, too.
I fell asleep soon after we got back (7pm local time), happy to be in my own bed. I am still sleeping flat on my back. I am normally a belly sleeper, but the suprapubic catheter is in the way. Side sleeping would be out of the question at this point, I think.
Post-Op: Day 15 (August 16)
I woke up at 4am. Jet lag is weird. At least I got to watch the sunrise.
I haven't taken any pain pills today. Nothing really hurts (I'm also not walking much, just wandering about the house occasionally), but the sutures on my penis itch like hell. Showers and Bacitracin help soothe the itch. The urethral bleeding is still there, but it is back to being a very small amount (<1mL per 12 hours). The odd swelling on the underside of my penis shows no signs of subsiding soon, unfortunately.
I really don't have any plans for this week (or next week, or the next) other than keeping the surgical area clean and sitting/laying down and taking it easy. I'll be glad when the swelling resolves and when I can get the suprapubic catheter out. It isn't very bothersome, actually, but it reminds me that I have just had surgery and am not back to 100% yet.
I am drinking plenty of fluids an still walking like a cowboy. I am taking one antibiotic (Augmentin) and one probiotic (Florastor) in the morning, one probiotic in the evening, and Tylenol as needed. I have read that other guys flush their urethra with saline until they begin urinating, but Miro told me I did not need to flush my urethra once I left Belgrade. I forgot to ask him why.
Post-Op: Day 16 (August 17)
Today, I woke up sore at 4:30am. My scrotum feels kind of like my chest did after surgery. Parts of it are numb to the touch, yet tender, and there are occasional sudden shooting pains and general soreness. I have come to associate these things with damaged and healing nerves. I put off taking Tylenol, just to see if I really needed it, but gave in at 8am. The pain isn't killer, but it is distracting. It makes me want to massage my balls to make the pain go away, which probably isn't the greatest idea since my testicle capsules are likely still forming.
The area just above my penis is sore and still swollen. I think this may be due to the ligaments that were severed above my penis. The soreness feels similar to when I pumped my penis out a bit too far pre-op.
The side of my mouth where the buccal mucosa graft was taken is healing nicely. I can now open my mouth all the way without my cheek feeling tight. I have one lingering long stitch. The inside of my cheek feels lumpy and I hope it evens out with time. I can chew food on that side of my mouth, but I still avoid it.
I still have blood exiting my urethra but am not bothering with any pad or gauze in my underwear at this point. It usually happens right after a bowel movement, and the blood seems to be diluted with a clear liquid. I wonder if I am simply urinating a little bit whenever I make a B.M. It wouldn't surprise me, since this is what usually happens.
The reason I am not bothering with anything beyond a pair of loose cotton boxers right now is because I am experiencing the, ahem, joys of having balls in the summer. It is hot and humid and, despite moving as little as possible, I am sweating everywhere. I do mean everywhere. I woke up yesterday morning with a red, bumpy rash where my still-swollen scrotum rubs against my inner thighs. Owowow. I'm trying to give it some air.
It probably didn't help that, the night this happened, I went to bed with some sort of non-breathable pad in my boxer-briefs. I had run out of the pure cotton pads they had in Serbia and couldn't find any kind of cotton pad or gauze in Walgreens, Shopko, or Walmart and the independent drugstores in the area have sadly been run out of business. Everything was synthetic--polyester, rayon, plastics--so that is what I had to get, though I suspected this might happen. So yeah, my plans for the day are pretty much to just chill on the couch with a fan pointed at my junk.
Today was also the first day post-op that I dared go near my genitals with a razor. The hair was just getting too annoying and itchy, so I shaved the front and part of my scrotum, taking care to give wide berth to all incisions, the suprapubic catheter, and of course the rash. I couldn't get it all, but even a partial shave made things feel better.
