Wow, I blink and some replies come in. First of all, thank you for the well wishes. I am doing well, although I am experiencing a few complications. Nothing hugely major though, just some fistulas and localized necrotic tissue at the tip and base of the phallus, which Dr. Chen said were the most likely areas to have limited blood flow. Let me try and cover everything that was asked.
My inpatient recovery went well, and I will include a detailed description of my hospital stay later in this post.
It wasn't quite difficult to start walking again, but there was pain putting weight on the leg they took the skin to cover the arm with. Little steps are helpful.
I was admitted to the hospital on Friday and discharged on Wednesday, so six days including surgery day and discharge day. Five nights. I imagine it could have been longer if there had been some sort of complication, such as lack of adequate blood flow in the phallus or developing an infection. I know they would not discharge me before making sure I could walk, so if I couldn't walk on schedule, it would have been a longer stay.
Long description of my hospital stay:
This was my first experience being hospitalized. Dr. Chen and (for now) Dr. Crane perform phalloplasty at the California Pacific Medical Center: Davies Campus. Overall, I had a great experience. When they first took me back to prep for surgery, they had me get into a surgery gown and offered warm air, which I passed on. They had me sign a couple forms on a computer to verify that they were doing the correct procedure and using the correct donor site and the like. They also put my IV in and wrote the date on it. I guess they change the IV every five days or so. Dr. Chen stopped by to say hi and to let me know the operating room opened at 9. My micro surgeon was Dr. Watt, and he came by to say a few things and to mark the donor arm. The anesthesiologist and a couple different nurses came by also. When everything was ready to go, I walked into the OR and got onto the table. Next thing I knew, I was out.
I don't remember if I first came to in the recovery area, which I am told is the same area as the prep area, or in my room in the transitional intensive care unit (TICU) on the fourth floor. I was in a private room, so that was good. I want to say for the rest of the day, I was only allowed ice chips, which kind of sucked, but if I needed to go back into surgery, they needed my stomach empty. I was hooked up to a whole bunch of things. I had my IV, which has both a saline drip and antibiotics, as well as pain killers that were controlled by a button that I pushed as needed. There was a wound vac on my donor arm, which was wrapped and splinted. All of my fingers, with the exception of my pinky, felt like they were asleep. The doctors said that was normal and would wear off in a few days. I also had a bunch of wires connected to my upper body to monitor my heart and other vitals, as well as a blood pressure cuff on my right upper arm. At the time, most of my pain was in the right upper arm from the cuff. I let a nurse know pretty early on, so they took the cuff off and just took my blood pressure manually when they came to check my vitals. I was also connected to a supra catheter, and my phallus was attached to a doppler to monitor blood flow and had a catheter tube in it to keep the urethra open for healing.
It was pretty difficult to sleep the first night. Every hour, a nurse would come in to check for blood flow in the phallus. I am also a stomach sleeper, so trying to sleep on my back is not the easiest. The nurses were not able to bring in a cot for my boyfriend to sleep in because they were all in use, but they were able to get a recliner that reclined to almost flat, so he stayed with me. I was offered a sponge bath and bedding change at the end of the night before the shift change. It was good getting clean, but it was difficult to roll over on each side for the bedding change due to my right thigh.
The next morning, I was cleared to start eating. I was worried that I would not like the hospital food, but my worries were unfounded. There was a whole menu to choose from, and I (my boyfriend) had to phone in my order for each meal. We were able to get enough food to split, so his meals were pretty much taken care of while I was in the hospital. That morning, the dressings were taken off my right thigh to expose it to the air and allow the xeroform scab to begin drying out and forming. Mostly, it oozed blood for a day and then dried out over the next few days. I accidently brushed my hand on a not quite dry scab more than once. Pretty gross.
The next few days were pretty stress-free as I focused on healing. Every so often, the nurses gave me a subcutaneous heparin shot in my stomach to prevent blood clots. I had a small laptop with me to pass the time, which it did very well. The hospital has wifi, and it wasn't insanely slow either. I went in for surgery on Friday, and on Monday, I was moved from the TICU on the fourth floor to a regular room on the third floor. At that point, the nurses come in less often so it is easier to sleep for longer periods. On Tuesday, I was able to get out of bed and into a chair right next to the bed. I sat there for breakfast, had a bout with nausea, the nurse got me some anti nausea meds, and I got back into bed.
Wednesday was a big day. The microsurgery team blew in like a hurricane that morning to remove drains and unwrap and re-wrap my arm. They worked like a pit team and everything was over very quickly. A little bit later, someone named Olga came in to make a splint for me that would allow me to use my fingers. She told me about what I should do to care for my arm and start regaining use. Even later, I got out of bed with help and walked for the first time. Most of the pain was due to the scabbing on the right thigh. It was a little difficult to put weight on my right leg. Baby steps are still steps though. I was cleared to go home around 2 or 2:30 that afternoon. They called for a wheelchair and wheeled me to the entrance where my boyfriend pulled the car around to pick me up.
Overall, I was very well taken care of and I had no problems with the hospital. All the nurses were very respectful and you can tell that they take care of many phalloplasty patients. No misgendering or anything like that.
