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My experience of SRS with Dr Chettawut - July 2014

Started by Monkeymel, July 23, 2014, 09:52:48 PM

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GendrKweer

I would point out that in my experience Tramadol is addictive, and even after a month of using it (post Suporn SRS) I had some significant adverse reactions to coming off it. Although it is not as bad as stronger opiates, go sparingly would be my advice.
Blessings,

D

Born: Aug 2, 2012, one of Dr Suporn's grrls.
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Monkeymel

A new daily schedule


Its 10 days post op and a new daily schedule has started revolving around eating walking dilating and sleeping.

First a quick comment - my tramadol consumption in clinic was 3/day. At the moment I'm taking max 1/day as paracetamol is sufficient (even that I'm cutting down). Unfortunately I know people who did get addicted and it ruined their health... I'm already concerned enough because of trapped wind for the past 2 days (no Daniella I don't have super powers). But that's easing now. Thanks to being upright. My system has really not coped well with laying down so much and I'm just glad I can walk easily.

So how does the new daily experience look like... (Some slight alterations to recommended times from the clinic to support my sleep patterns)

6:00 - alarm. First antibiotic of the day. One hour before eating. Drink lots and start shower process
7:00 - breakfast. Nothing too heavy - fruit, ham omelette, lettuce, green tea and maybe a bit of fruitcake
8:00 - back to room and anti inflammation pills and some paracetamol. Use bathroom for bladder and bowels
9:00 - first dilation for 30min. Actually with prep time; and cleaning time; it's close to 45 min. Relax or walk to reduce gas.
11:00 - alarm. Next antibiotic pill. One hour before lunch... Do something interesting like ironing or walking.
12:00 - lunchtime - something healthy off the hotel menu. Caesar salad?...
13:00 - back to room and anti inflammatories and paracetamol. Herbal tea perhaps...
15:00 - second dilation for 30 min. Relax or walk... Ideally catch up on sleep or meditation.
17:00 - alarm. Next antibiotic pill. One hour before dinner. Wow it's dinner already. What healthy thing off the menu can I find this time? Without milk, bread or too fried...
18:00 - evening meal. Either downstairs or in room (as I feel).
19:00 - anti inflammatories for the last time today... Walk or relax as you need.
21:00 - third dilation for 30 min. Again most of the hour has passed and you really want to relax now. Except...
22:30 - alarm. Last antibiotic pill and sleep.

Mixed In here somewhere is write an update on Susan's and enjoy your "free time". Perhaps a coffee or tea wit other guests / chats.
The next 14 days will pass quickly.

One thing which I could recommend is having some long dark coloured nighties to cover your nether regions. There will be some blood drops after dilation (it will decrease) and your new genitals will rub on the pads and one size larger knickers. Having a fresh supply of long nighties which can get blood / lube on means a much easier sleep / resting time after dilation. And held the skin heal.


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Danniella

Loving the detailed walk through of the day, good to know what to expect in terms of life after surgery ^^

Have you met any other trans girls in and around the hotel yet?

Although...eeep to the tramadol thing...I have had...drug problems in the past...specifically a few very dark years spent gradually destroying myself with various painkillers during my younger years...I will have to take this into consideration when dealing with the painkillers post SRS >.>

Do you see the nurse daily still?
You say "Using humor as a defence mechanism" like it's a BAD thing!



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Monkeymel

The Queens Birthday...

It's Tuesday 12.08 and it's the Thai Queens Birthday - a national holiday and Mother's Day rolled into one. Honorable Greetings your Majesty.

I've not written an update for a while as nothing much really happened. My mum left on Friday and another friend arrived on Saturday. No peace here (laughing). Friday I was allowed out to the Seacom shopping mall. Not sure if I'm classed as a responsible adult... But it was great to by able to buy some inexpensive long cotton nighties at the Tesco (upper floor). It means I'm relaxed sleeping without knickers / pads if I want. And can also lounge in the room like it.

Outside the temperature is 32C but with 55% humidity and hot winds it feels closer to 36C. Lounging by the pool is great - but hot and the sun does strike hard. So I allow small doses at a time. Unfortunately not allowed into the pool - there is no way I would voluntarily place myself at risk of infection by going for a swim.

As mentioned above I stopped all tramadol last week and have perhaps one paracetemol a day. It's not that I'm blanking pain - I do feel stiff and and sore around the groin. I continue to use the neck pillow but am sitting more and more on bum and just using it to relieve pressure on different Points. Again I'm taking my time and listening to what the body says it wants or not.

Yesterday was the start of number #2 dilator. Ouch that hurt and generated a lot more blood than I was used to. The muscles are definitely not used to being stretched... And hydraulic lock caused by suction from the lubricant was a real possibility. I was frightened... Mostly because of surprise and very bad sleep.  Approaching the second dilation things were easier and the amount of blood returned to more normal levels. Even going in was slightly easier... For a variety of reasons.

I have been getting bad cases of trapped wind which caused excruciating muscle spasms under my right ribs every time I breathed out. Especially at night, causing a real lack of sleep and tensing the body massively. Anti-flatuence pills have helped things a lot - and I really need to be careful about what I eat, when, and keeping bowel empty. This sounds a lot easier than it feels as the dilation touches similar muscles used to push - and the brain refuses to relax. But I'm in the baby phase and learning everything new - and so it is... Perhaps too much information but written I case others get similar problems.

Please realise this is not a direct result of surgery but a complication caused by many factors which have to be understood. Changing antibiotics, and other medication and learning to relax the body have really helped. finally last night - my first slumber with more than 4 hours of continuous sleep. Felt good!

And so the adventure continues. Learning to feel, relax and listen to your body. Pamper it, own it. And reward it with peace and love. It's the only one we have - we've just done something drastic to it - and now it deserves our respect and attention.
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Danniella

Quote from: Monkeymel on August 12, 2014, 02:08:51 AM
The Queens Birthday...

It's Tuesday 12.08 and it's the Thai Queens Birthday - a national holiday and Mother's Day rolled into one. Honorable Greetings your Majesty.

I've not written an update for a while as nothing much really happened. My mum left on Friday and another friend arrived on Saturday. No peace here (laughing). Friday I was allowed out to the Seacom shopping mall. Not sure if I'm classed as a responsible adult... But it was great to by able to buy some inexpensive long cotton nighties at the Tesco (upper floor). It means I'm relaxed sleeping without knickers / pads if I want. And can also lounge in the room like it.

Outside the temperature is 32C but with 55% humidity and hot winds it feels closer to 36C. Lounging by the pool is great - but hot and the sun does strike hard. So I allow small doses at a time. Unfortunately not allowed into the pool - there is no way I would voluntarily place myself at risk of infection by going for a swim.

As mentioned above I stopped all tramadol last week and have perhaps one paracetemol a day. It's not that I'm blanking pain - I do feel stiff and and sore around the groin. I continue to use the neck pillow but am sitting more and more on bum and just using it to relieve pressure on different Points. Again I'm taking my time and listening to what the body says it wants or not.

Yesterday was the start of number #2 dilator. Ouch that hurt and generated a lot more blood than I was used to. The muscles are definitely not used to being stretched... And hydraulic lock caused by suction from the lubricant was a real possibility. I was frightened... Mostly because of surprise and very bad sleep.  Approaching the second dilation things were easier and the amount of blood returned to more normal levels. Even going in was slightly easier... For a variety of reasons.

I have been getting bad cases of trapped wind which caused excruciating muscle spasms under my right ribs every time I breathed out. Especially at night, causing a real lack of sleep and tensing the body massively. Anti-flatuence pills have helped things a lot - and I really need to be careful about what I eat, when, and keeping bowel empty. This sounds a lot easier than it feels as the dilation touches similar muscles used to push - and the brain refuses to relax. But I'm in the baby phase and learning everything new - and so it is... Perhaps too much information but written I case others get similar problems.

Please realise this is not a direct result of surgery but a complication caused by many factors which have to be understood. Changing antibiotics, and other medication and learning to relax the body have really helped. finally last night - my first slumber with more than 4 hours of continuous sleep. Felt good!

And so the adventure continues. Learning to feel, relax and listen to your body. Pamper it, own it. And reward it with peace and love. It's the only one we have - we've just done something drastic to it - and now it deserves our respect and attention.
Good to hear from you again Mel :D (I was getting a little worried at no update ^^#)

So would you recommend the hotel then? I was considering the cottages at the ranma when I was going, but I keep hearing great things about the hotels and it is making me wonder what would be better o,O

I shall also add (anti flatulence pills) to my items to purchase pre-op in preparation for recovery time...just in case ^^ So yeah! keep all the intricate details coming! I know I am loving them!
You say "Using humor as a defence mechanism" like it's a BAD thing!



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Donna Elvira

Quote from: Danniella on August 12, 2014, 03:00:29 AM
Good to hear from you again Mel :D (I was getting a little worried at no update ^^#)

So would you recommend the hotel then? I was considering the cottages at the ranma when I was going, but I keep hearing great things about the hotels and it is making me wonder what would be better o,O


Hi Daniella,
I'm booked into the Rama ( a 40m2 super deluxe cottage)  and will provide feedback on what it's like. Since I'll be meeting up with Melissa at the Dusit I'll be in a good position to compare the two.
That being said, I think the two options also correspond to slightly different choices in terms of how you manage your stay. I really like to be autonomous, especially for a lenghty sejour and that's what decided me on the Rama as the rooms come with a big fridge, cooking facilities etc..  My plan is to stock up on all the basic stuff  I need post-surgery so that I can look after myself with a minimum of hassle.
However, if it's really crappy otherwise I'm sure I can change when I'm there. I'd just want to make up my mind a day or two before the surgery...  :)
Hugs
Donna
 
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Julia-Madrid

Quote from: Donna E on August 12, 2014, 06:58:49 AM
My plan is to stock up on all the basic stuff  I need post-surgery so that I can look after myself with a minimum of hassle.

My heavens Donna, you are a brave and strong woman!  Melissa had commented to me about how useful it was to have her mum around, and unless I'm mistaken, you will be there on your own?  And you'll be with new breasties as well as the other bits.

I assume you'll be doing some cooking in advance...? Or at least have a bunch of chicken soup tetra bricks ready to open...

Hugs
J/A
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Julia-Madrid

Well, it might be the Queen's birthday in Thailand, but here in Madrid we are all looking for treasure!

Hello, Mel, Donna, Danniella et al  :)  Yes, it's that time of year when the minds of MadrileƱos all turn to looking for treasure.  Treasure buried beneath the streets and treasure hidden behind walls.  In other words, we're suffering the annual onslaught of summer roadworks, as well as the multitude of neighbours who all remodel their kitchens or bathrooms during the summer.  Since we mostly live in the cities and in apartments, you canna escape the noise of any number of diggers and second-rate builders taking down supporting walls. 

Melissa, you sound like you're coming on spectacularly, complete with cultural visits to the Mall and everything.  It must be a wonderfully new and transcendental experience to be doing all of this as a Complete Woman.  (Danniella, is my humour too subtle here, maybe ?  :o)  So keep going.  I do expect that you and Donna send us a selfie when you meet up!!

As you can see, I'm trying to avoid working this afternoon.  Actually, after the past few weeks of hard work and the FFS I am in need of some holidays, truly.  As for the FFS, it's coming along fine.  Today was the first time in a week where the discomfort in my jaw actually lessened, so maybe this final bit is now on the mend.

Hugs to y'all

A/J
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Monkeymel

#68
And life goes on...

So another week passes by. Sunshine pool and relaxing.

Moving up to number 2 dilator was interesting - it still takes time to slide in but good relaxation techniques help. Discussing with Dr Chettawut yesterday he said everything is fine - just strong thigh muscles thanks to sports and ballet. It's much better to take your time rather than rush to get deep or wide. Your vagina is your responsibility - I still can't understand those who rush to exercise it. Each to their own.

One nice aspect is that I am allowed to do 2x 1hr dilations - but not regularly. The Dr clearly prefers three times a day for the first month or two. Allow the nurse to guide you with these decisions. I know many people might be headstrong - we have to be to get here. But there is a time to listen and accept their professional experience with hundreds of patients.

I doubt there will be another post on this thread - life progresses as normal now. My new arrangements are great / deeply peaceful.
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Julia-Madrid

It's been great to follow you on your journey, Mellissa. 

Hope to meet you in the flesh in one or another European city soon enough.

Hugs
J/A
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Monkeymel

Wheelchair Princess
I left Bangkok on the overnight flight back to Zurich last friday (00:40). It really was time to leave the hotel - four weeks is a long time away and things get repetitive and boring after a while. The Doctor provides a certificate to have a wheelchair provided at the airport - and this is a really good option which should really be taken. I had already requested one during my booking process - however the check-in assistant thought I looked 'too fit' for one. The certificate unlocked that issue very quickly.

We arrived at the airport at 21:30. I had booked Thai Business Class, and was really glad of this, as the queues for International Economy Class (all airlines) were massive and chaotic. The Business Class area is separate without queuing  >:-). There is a baggage security directly beside the Business check-in, and the lounge is directly behind. Being wheeled through security was fun, with a quick pat down whilst sat inside the wheelchair. I really did feel like a Dusit Princess..

The lounge was worth it - free wifi, cakes, soups, pastries and drinks. Comfortable armchairs and sofa's. I know many people taking the Bangkok SRS option probably wont want to pay the additional price of the Business Ticket - but I saved additionally for it, and considered this as part of the overall package. The ability to have a nearly horizontal bed when flying 12 hours was very soothing; and I managed a couple of 2-3 hour sleeps. I also booked the ticket about 4 months in advance, and paid approximately 1.8x an economy ticket (3200 CHF vs 1700). Im sure other cheaper deals can be found.

The wheelchair experience also means you get to board early, and have a wheelchair provided at the arrival airport. And a guide to move you around. Take the time to enjoy it. Even if you feel able to walk, sudden wobbly legs after jet lag is not what you need now.

So now I have been home a couple of days, getting into my own rhythm in my own place. This is more deeply relaxing than at the hotel; knowing you can eat, sleep, dilate and relax whenever you need. The medication also stops this weekend - no more anti-biotics or anti-inflammatories. I did notice that I became more wobbly in the evenings, and that tiredness creeps up suddenly to jump on you unexpectedly. But I can retire to bed when I need and relax.

Sitting is not really a problem - although some of my kitchen chairs still need the partially inflated neck pillow cushion (more in a minute). However trousers are definitely an ouch - swelling still exists around the pubic bone / clitoris and trousers tend to apply too much pressure there - compared to the flowing skirts I used mostly in Bangkok. Unfortunately the temperature here is a measly 20C when the sun is out - compared to the regular 32C (feels like 36C) of the city (even when cloudy). So I have to learn... or use Reiki to apply heat to the swelling area to help it go down. In reality this is going to take a long time.

Dilating at home is much easier than in the hotel. You can fit the sessions into your own schedule, not waiting for breakfasts or the nurse. I also appreciate having a slightly darkened room and warm quilt which helps me relax much more than the air-con blasted room in the Dusit Princess. I also returned to 3x 40 minute sessions a day. Although it takes up more time, I found that it helps the muscles relax more, so that stent #2 slides in much easier than with 2x60 minutes. Although you do end up using more lubrication gel, and cleaning up each time is annoying. Dr Chettawut made it clear that it is better to take your time and ensure dilation is smooth and easy before moving up to stent #3 (and after 3-4 months, #4). Being cold, or having a tense body does not help at all, and it is nice to be able to wrap up warm in a slightly darkened room, and zen out on some meditation and music.
  •  

Monkeymel

Most Important things to take with you
Here is my summary of the most important things to take with you - or at least acquire once in Bangkok...


  • Inflatable Travel Neck Pillow. Partially inflated, and placed with the gap under your bum, this little device will provide instant relief when sitting. You can use it to prop up your legs, or cushion you sitting bones. It can be deflated into a handbag, or carried carefully without arousing suspicion. You can change the cushioning to match your needs (more or less air).
  • At least 3 flowing skirts. They are a godsend when you are walking and have inflamation which trousers can irritate
  • At least 1 nice cocktail / smart outfit. I didn't take one as I did not consider I would be attending anything posh. However when a national holiday (Queens Birthday) coincided with my visit, you can feel out of place. Besides it is nice to dress up!
  • Toilet wipes. Whilst you are provided a big pack of baby wipes, they are not so suitable if you are not in your room. A smaller pack of moist toilet wipes can be easily slipped into a handbag and carried with you. I did not find these in the Tesco at Seacom, so bring some from home.
  • Herbal teas. The Thai like their coffee, and some Jasmine and Green teas can be easily found. However anything else more exotic was very difficult to find in the Tesco. So if you like special herbal teas consider bringing some from home
  • Extra long T-shirts / nighties. These can be found in the upper floor of Tesco (about 250 Baht) but if you have your own then bring them. Be prepared that they will get dirty especially if you want to sleep without pads at night. So bring a few which can be easily washed
  • Lots of comfortable knickers. I had bought extra ones (one size too big) but found they did not work well when using a pad. Some older Hipster style underwear worked much better - it helped stop the pads rubbing / moving during the day, and meant there was much less pressure on the pubis. But each to their own
  • Kindle, iPad or equivalent. I brought too many books and read only half of one. I realised that holding in a stent to apply constant pressure and reading a traditional book is not easy at all. Whilst I always loved the idea of a paper book, I will be buying a Kindle (or equivalent) so that I can read one handed in the future. iPads are great for videos but terrible when outdoors.
  • Inflatable Travel Neck Pillow. What another one? Well not necessarily. Holding in a stent for 30-60 minutes can be tiring. So reusing the neck pillow as an arm / elbow rest is really useful. It will also help you relax your upper body which in turn will help relax the central core muscles. I could provide the references behind this, but the less tension you have in your upper body / spine, the less abdominal tension, and the more relaxation for dilation.
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Monkeymel

Costs of surgery

Back home and checking through the credit card... the total costs for the Hotel - 30 nights for a twin room, breakfasts for two people, and some meals (for the first three weeks) was about 2200 CHF (about 1800 Euro, 2400 USD). This works out at about 75 CHF / night for two people. I would not find B&B here in Switzerland for that price!

Business Class return flights with Thai airways was about 3200 CHF (so more than the hotel - wow) but definitely worth it for the ease.
Economy class return flights with Thair airways are about 1500 CHF (in comparison).

The surgery was about 11,000 CHF in total - which I hope to get reimbursed by my health insurance company. When I get a receipt from the clinic. So the total upfront cost for me is about 17,000 CHF (14,100 Euro, 18,500 USD) which includes some additional spending money at other restaurants / Tesco etc. This is a lot of money if you are paying privately, but also provides a good guide if you are contemplating surgery in Bangkok. Accommodation at Rama cottages will cost less.

Back home in Switzerland i'm enjoying relaxing and learning about my new body upgrade, and relaxing into regular dilation schedules. Im determined to return to fitness and gym in the coming months, but not at the risk of my health.

Upgrading to Dilator #3
Over the past week I have been regularly dilating 3 times a day, keeping myself warm under the quilt and allowing the body to relax. This has been really helpful as using Dilator #2 became much easier than when doing two dilations a day. It was also important when upgrading to using Dilator #3 this week.

Madeline B had suggested taking your time to introduce the next size up, and don't try for full depth (unless it slides like warm butter). I quite agree. The first attempt I hit my public bone... and had to learn how to direct it down further than I was used to with #2. I keep using #1 (10 minutes), #2 (20-30 minutes) and then attempt to introduce #3. The first time it got stuck (hydraulic lock) and took a while to come out. Last night I bled a little, but this morning was able to relax with it inside for 15 minutes without bleeding. Each attempt will be sore, but will become easier. And I hope that this process will be over in the next few days.

I am really grateful that I do not have to rush back to work - I still have a few weeks signed off. This means I can really relax at home and take my time with sleeping, dilation and recovering and healing. Some days I am bouncing with energy, others I need regular Siesta (but these are becoming less). Give yourself permission to take time. It is important!

Over and Out
Special thanks to Madeline B who provided some good hints and tips from her experience at Dusit...

That's it from me... I wont be around the forum much unless there are major questions / issues which arise. If anyone comes across this thread in the future and wants to ask questions then please feel free to add a reply to this topic (im watching it) or send a PM.
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Julia-Madrid

Thanks for this Melissa... it will help me greatly with my planning!

More offline  :)

J/A
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secret

Thank you for that great story about your srs with Chet. I wish you a good healing and i hope you can relax enough next few weeks.

I'm new here and have been reading this thread since you began posting. Yet i'm thinking about my SRS with Dr. Chettawut too, or Supporn... still not sure about that decision.
As i live in switzerland too, there is something very interesting for me what i would like to ask you. Can you please tell me more about your insurance company? It's very difficult to find insurance for something like that, a surgery outside switzerland.
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Monkeymel

Hello Secret

Currently I have paid everything privately, and am awaiting the final receipt from the clinic before I send the bill to CSS. I am not sure I will get anything refunded though. I will update the thread as and when I know.

A friend has an insurance with Helsana (?) which is semi private, and this allows operations abroad with prior consent from the insurance company. However she has not applied for her operation yet (at least a year away). One thing to be aware of - once the insurance company knows you are transgender, and you have been submitting doctors bills, hormone rechnung, etc then it will be very hard to change the policy. Normally you have to have change the policy (e.g. to semi private) 1-3 years before the diagnosis... which clearly I did not do.

Another friend of mine had her surgery in Basel a few years ago as it was paid entirely by her Insurance. Two operations, over 8 weeks. Although very happy with the outcome, she told me Bangkok is far far superior.

Im really happy with the outcome. The experience is different from the  private / semi private hospitals here in Switzerland - but I preferred it as I was far more independent and had more of a holiday feeling.

Healing is going well - still occasional bleeding as internal stitches relax - but nothing problematic. And you can really appreciate what cis women go through monthly.
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