Please excuse my verbosity, brevity has never been my strong suit.
TLDR, for those who want such things: I recently had SRS with Dr. Chettawut, here's a few random babbles about my experience that may, hopefully, be of some minor use to others making plans for a similar trip.
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Greetings from beautiful Bangkok. Or, at least, noisy and fascinating Bangkok, as while this city has much to recommend it, I fear beauty is not high on the list.
In any event, I arrived here on the 25th of September, had surgery with Dr. Chettawut on the 30th, and will be leaving to head back to the US on the 22nd. I figured maybe I'd write out a bit about my experiences in case it's of use to anyone else contemplating coming here.
First a bit about me: I'm 52 years old, though thanks to Native American genes and way too much time spent in the gym you'd be hard pressed to find anyone who believes that. Nice thing about being NA, we always look younger than we are until that fateful day when we start looking much, much older without any apparent transition between the two states.
I transitioned back in the dark ages, when dinosaurs still walked the earth. Well, perhaps not that long ago, but sufficiently long ago that I couldn't really tell you when, save to say more than one decade has passed since. Sufficiently long ago that the only people in my life who know anything about my being TS are my sister and doctor, neither of whom cares.
I first started trying to schedule for surgery back in 1998. I was in the midst of getting the details sorted when my spouse was diagnosed with cancer. SRS was suddenly the least of my worries, especially after it was discovered that said cancer was terminal. I spent the next decade caring for my increasingly frail spouse and my elderly and likewise increasingly frail, not to mention annoyingly and gleefully sexist and ornery as hell, father-in-law. My father-in-law died in 2010 at the age of 87, my spouse died in 2012 at the age of 57.
I was a bit of a mess after the death of my spouse, to put it extremely mildly. During that time I lost a ton of weight and took up bodybuilding as a hobby. Yeah, a weird hobby for a TS, but I had to do something to keep the weight off and that turned out to be something I liked doing. It didn't hurt that I was good at it, very good, with just the right mix of eating disorders, body dysmorphia, and obsessive personality found in pretty much every good female bodybuilder on the planet.
I also started seeing a therapist, something I had long been loathe to do as my prior experiences with them had been disastrous. At the start of my transition I discovered the hard way that some therapists don't deal with androgynes any better than the average person does. Not a pleasant experience. But, to be honest, after the death of my spouse I was worried I was losing it and wasn't sure I was ever going to recover. Worse, I couldn't talk to my friends about it, since most of them were hovering non-stop, worried that I was going to do something silly or just fall apart entirely. I couldn't tell them how close I felt to one or the other happening, I just couldn't. So I started seeing a therapist. Being that multitasking is a virtual requirement for anything I do, I picked a therapist with an eye towards eventually getting a surgery letter. Someone who was said to be familiar with TS issues, but was not their focus.
I saw her off and on for a year. Didn't really talk that much about TS stuff, it'd been so long since any of that had been an issue, or even anything I really thought about, that I'm not sure what we would have discussed had it not been that I had far bigger problems. And she was a big help in my dealing with the grief, in part because it was nice to hear that what I was going through was normal, whether I really believed it or not, and it was a godsend to be able to talk honestly and not have to put on a brave front, as I felt I had to for my friends.
Eventually I decided I'd had enough of New England and decided to move back to Utah to be close to my sister and nephews. My sister and I have an odd relationship, the usual sibling issues magnified somewhat by our extreme childhood, but, along with my three nephews, we're the only family each other has and we are in many ways very close.
Once I got out and settled in Utah I continued making sure I had all the pieces in place to have surgery. I found a doctor to handle my HRT – mind you, I have no problem self-medicating, and did for many years, but surgeons tend to frown on that sort of thing for some silly reason – a rather odd OB/GYN who is perfectly happy to help TSs even if I'm not entirely sure she grasps the whole concept. I also started seeing a psychologist with the expressed purpose of getting a second letter when or if I needed one. That turned into a rather annoying waste of time and money, but at least provided the desired result.
So I got everything lined up spent time and energy doing things I didn't really want to or feel were, strictly speaking, absolutely necessary, and then I did... Nothing. I'm not even entirely sure why, I think by that point I'd convinced myself that surgery wasn't going to do me a hell of a lot of good, perhaps wasn't worth the risks and the cost. I didn't, and don't, believe it would solve all of my body dysmorphia, nor have I ever been silly enough to buy into the whole notion that it would somehow make me more of a woman or any of that rot – I've never had any doubt about who and what I am, genitalia be damned. I guess I felt its main utility was in 'edge cases', a phrase that, oddly enough, panicked the psychologist, who apparently had no idea what it means, and in getting a legal change of sex. Since no such edge cases had ever come up in over twenty years, and since my driver's license, the only ID that matters most of the time, already has me as female, I guess some part of me wondered if it was worth it.
In June some time I was over at my sister's and we had a chance to talk alone, something that doesn't happen often as usually my nephews are around and, given my sister's odd schedule (she's a night shift nursing supervisor) I don't get to see her all that often, let alone get to chat without little ears close by. She mentioned that I hadn't said anything about surgery plans in a while and asked me if I'd talked to any of the surgeons. I told her I hadn't, and when she asked why told her basically what I said in the paragraph above. Her response was basically to tell me I was full of crap, she knew it was important to me, and that I was a fool if I didn't start doing something about it while I still had the time and money to do so.
I don't always agree with my sister, perhaps the understatement of the century, but I do take what she says seriously and give it due consideration. She is highly intelligent and in many ways knows me better than anyone else ever could. So I spoke with my doctor about getting any tests needed done, and started making enquiries of various surgeons. My doctor heavily pushed for Montreal, saying she doesn't entirely trust those "foreign doctors" – amusing, given that she herself is Danish, rather obviously so, and that, contrary to what many think, Montreal does not reside in a US state, thus qualifying, if loosely, as 'foreign'. For my part I did contact Montreal, among others, but I had a soft spot for Chettawut, as he's who I had been making plans to see back in the days before I became a widow at a much younger age than I ever imagined.
Getting things set up with Chettawut's office went way faster than I ever imagined. They first offered me a surgery date of August 18th, tempting as that was I didn't think there was enough time to get everything together by then. I was especially worried about getting a passport, there being a depressing number of possible hold-ups, first among many being that I wasn't born in the US. I was born in Japan. Unfortunately that has always meant that government paperwork takes three times longer than it would for anyone else. As it turned out, I was right, it took several weeks longer to get my passport than would be normal, I never would have had it in time for the 18th.
Discussing things further, Chettawut's office offered September 30th as a surgery date. I discussed it with my sister, thought about it for a day, and told them I'd take it. The next week or so was a flurry of running around figuring out how to get an international money transfer done (turned out to be easier than I'd feared), get my passport application in, and suchlike.
Almost as soon as the date was set I discovered that my sister had been right. The possibility of finally having surgery out of the way was way more important to me than I'd let myself believe. I found that I was downright impatient to be on the way and wished that there had been some way the first date could have been reasonably achieved.
So fast-forward through all the silly medical tests and such, I finally left SLC International the afternoon of the 24th. Going through TSA was a lot less of a pain than I'd expected, they barely glanced at me and I spent maybe five minutes waiting in line and a minute or two waiting for my carry-on bags to go through the x-ray machine. The flight to San Francisco was barely a hop, not even quite an hour from SLC. Waited around for a while in San Fran, then got on a giant 777 headed to Tokyo. That was one ungodly-long flight, and unfortunately I wasn't really able to sleep for much of it. It didn't help that I was seated next to two Japanese women, one of whom wore a surgical mask she insisted on spritzing with this annoying cloying scent every half hour or so. Going through Tokyo airport to my connecting flight I set off a metal detector somehow, not really sure how since the only metal on me was some jewelry and underwires, and got a very cursory pat-down by a sheepish Japanese woman who could barely reach my chest height, let alone any higher, and was clearly just going through the motions.
The flight from Tokyo to Bangkok was about five hours, which wouldn't have seemed all that long had I not just spent an eternity or two in the air already. I was seated next to a Japanese businessman who fell asleep before the plane was even in the air and stayed that way pretty much through the entire flight. I did my best to emulate his good example, with mixed results – I suppose it's a skill that probably takes years of experience to develop. At Bangkok customs I ran into a minor issue where they wanted to know what hotel I would be staying at. Unfortunately by that point my brains were mush and I couldn't recall the hotel's name as I hadn't really considered it important data, since I knew there would be a driver waiting to take me there anyway. Finally I think the customs guy just picked a hotel name at random, stamped my passport and sent me on my way. Once I'd gotten my bags I picked the first place I saw and got a temporary SIM for my phone and went to another kiosk to covert the US cash I had on me to baht. Then I went in search of Dr. Chettawut's driver, an eternally smiling Thai man of indeterminate age who, somewhat to my surprise, recognized me right off.
It was around 5AM when I got into Bangkok, I was very glad to collapse into the car while the driver dealt with the utter life threatening insanity that is driving in this country. We got to the hotel, The Vertical Suites, and there was some sort of issue. I never was very clear on what, I guess something to do with my being early, albeit I'm unsure how I could be since I was pretty much exactly on time per my itinerary. There was also some confusion with my name, Thais don't really seem to 'get' diminutive forms or any of that and treat "Christina" and "Christa" as two entirely different names. Whatever exactly the problems were, the driver dealt with them and I was really too tired to care as long as things were settled. And they were, after a bit I was brought up to my room and the driver told me he'd be back to take me to see Dr. Chettawut at 10AM.
I was a bit unhappy about that. After nearly 22 hours in the air my dress was mussed, my feet were tired of the damn heels, my make-up was a mess, and I looked like ten miles of unpaved road. I would have preferred having some time to shower and maybe even a quick nap, but it was not to be. At 10AM I went down, mussed dress and all, and the driver took me to see the good doctor.
I'll be honest, I was more than a bit taken aback to realize that Dr. Chettawut's clinic is a small storefront in a very dingy looking strip mall – this was before I'd been in Bangkok long enough to realize that, for whatever reason, the outside of pretty much every building, even that of high end malls, looks pretty dingy. I was greeted by half a dozen smiling Thai women, most of them sufficiently small, as many Thais are, that I felt like maybe I should roar and stamp around like Godzilla or something. I sat at a desk and talked with the only person I've met here in Thailand who was completely fluent in English – the same Ms. Som I'd dealt with in e-mail, I assume, though I wasn't with it enough to ask and be sure. I gave her copies of my referral letters, medical tests, and all the rest, she had me sign the usual medical forms, and then I was taken back to see the good doctor himself.
That was not fun, much as I'd been expecting it and knew it had to be done. I'd scheduled for a tracheal shave, breast augmentation, and GRS. The tracheal shave was an iffy thing, my sister felt it was wholly unnecessary and I should forgo the risk, I kind of felt like while strictly speaking she was right, the added cost and risk was so minor in the grand scheme of things, why not? The breast augmentation was pure vanity. When I was heavy I had very large and very nice breasts, one of the few things about my body I've ever been vain about. Unfortunately, losing almost half my body weight hadn't been kind to them. Becoming a bodybuilder with a body fat percentage in the 12% range had been even less kind. There's a reason breast augmentation is near universal among female bodybuilders, when your body fat is that low you end up with two half empty balloons where a pair of nice breasts once had been. As for the GRS, well that's self-explanatory.
Of course the surgeon needed to see me in the nude, as it were. Chettawut was worried about the amount of weight I'd clearly lost. I guessed right that his big worry was that I was just going to end up putting it on again, a natural enough thought given statistics, but I pointed out to him that it'd been over three years and I'd managed to keep it off by exercising a lot. He wasn't too pleased about the bodybuilding, I've yet to meet a doctor who was and I've really no idea why, but seemed mollified that it had been sufficiently long that I wasn't likely to go home and put all the weight back on. Not that it couldn't happen, but hopefully won't. He was also quite bothered by the, as he put it, lack of material. I pointed out to him that I'd discussed that in my correspondence, he brushed that aside with a "Everyone says that".
So I got labeled a difficult case, at least I'm consistent, and there was going to be an extra cost for skin grafts and such. Meh, I'd expected and planned on that, I would have been shocked if it wasn't the case and though it turns out to not be an issue, depth and even functionality was never a huge concern to me. While I know better than to say 'never', I have my doubts that I'll ever be in that sort of relationship again and I'm frankly fine with that. Fact is, in the years since my spouse died I've had a few guys show serious interest, a couple of whom I was very attracted to, but I've never felt ready and I'm not sure it would ever be fair to be with someone with all my baggage and history.
Anyway, after getting back dressed I went back to the desk, had the extra fees transferred from my bank, and the driver took me back to the hotel.
The doctor had given me a bunch of paperwork on preparing for surgery and post surgical care, as well as some drugs. The next day I was to start bowel cleansing. No solid food, only clear liquids, fruit juice, and such, followed by Docolax, a bulb enema, and, then Swiff solution on successive days. Reading through the paperwork it was clear that once I was back in the hotel I wouldn't be able to leave my room for several days, so I went wandering around looking for some place to buy supplies. Fortunately right across the street from the hotel are two gigantic malls and one smaller, half empty, mall. One of those gigantic malls, Seacon Square, has a Tesco-Lotus, roughly the equivalent of a Target in the US, at one end. Most of the things you could get at a US supermarket, including many of the same brands, you can get there. Also, most packages, signs, and such have enough English on them that you can easily figure things out and beyond that supermarkets work pretty much the same here as they do at home. Some minor differences, like you have to weigh and get a sticker on your fruit before you go to check-out, products tend to only come in small sizes and Thais just tend to buy a whole bloody cart filled with multiples of three items, stuff like that. Nothing difficult to figure out.
So I spent the next three days living on fruit juice and my beloved Pepsi Max (only available at that one store, that I've found, Thais aren't too big on diet soft drinks) while I made two or three trips a day laying in supplies for after surgery. I suppose I didn't really have to, I probably could have gotten anything I needed via room service or something, honestly I don't know as I haven't used room service, it's not really my style and I'm not entirely sure, given the general lack of much grasp of English I've run into and my total lack of any meaningful grasp of Thai, how well that would work. It just seemed prudent to lay in the supplies I knew I'd want. Water, especially. Room cleaners leave two bottles a day, but I know how important pushing water post-surgery is, my sister never stopped reminding me, and two small bottles a day wasn't going to cut it. That, my beloved Pepsi Max (hey, it's close to being water!), some crackers, and fruit juice along with some noodles for when I was up to something a little more solid.
I also had to search for something that turned out to be a bit more difficult to find. During my visit with the doctor I was told that nail polish would be a problem, since the anesthesiologist felt that it potentially could interfere with the O2 monitor. Unfortunately I'd had my nails done just prior to leaving, and, worse, they were gels. Gel polish is very durable and a real pain to remove. I'd known that it was possible nail polish would be an issue, but honestly it has been eons since my nails were bare and I figured I could just find a nail salon to get the polish taken off if necessary. It turns out that, well, as far as I can figure Thai women don't tend to get their nails done. There are a few nail salons around, but they mostly seem to do pedis, at least from what I can see, and what polish I've seen has been kids stuff. I've not seen proper base or top coat or even decent quality polish anywhere, and finding polish remover took a lot longer than I'd expected. Still not sure why, exactly, you can find pretty much all the usual hair care, skin care, and make-up brands here – Estee Lauder, MAC, Lancome, I've seen pretty much everything short of a Sephora and it wouldn't surprise me at all to see one of those – but I've not seen a decent selection of Revlon nail products, let alone OPI, anywhere. I was able to eventually find polish remover, cotton testicles, aluminum foil, and, with some effort remove the polish. My nails have been sadly nude ever since, one of the first things I'm going to do once I get home, after taking a mega-nap, is go to the nail salon and rectify that.
On Wednesday the 30th, at one PM, the driver came and picked me up. I wore a simple black dress, stockings and flats, picked mostly based on what I thought would be easiest to come home in – turned out to be a good pick. Once I got to the clinic things went quickly. I was brought into a room and asked to strip down. A reverse-robe was put on me and I was brought into another room and laid down. My genital area was shaved – expected, but still humiliating – and an IV was put in my left hand, barely even felt it go in. I was helped up and taken to the surgical bay where I was laid down on another table and a man introduced himself as the anesthesiologist. He said he was going to put me to sleep and immediately started doing an IV push. I remember a nurse putting an oxygen mask on me, and the anesthesiologist asking me if my arm was getting cold. It was, but all I could do was giggle and I was out.
The next thing I remember is just flashes, just a few seconds of someone – or maybe many someones, I'm not quite sure – calling my name and telling me to breath, take deep breaths.
I woke up in a hospital bed in the recovery room, god knows how many things going in and out of me, with no idea how I got there. There was a nurse sitting next to the bed, she talked to me and I think Chettawut came in to see me, but honestly it's just a blur. I do remember her turning on the TV and showing me where the remote was. I didn't care, I just went back to sleep. I think I slept most of the next 24 hours away. Periodically they'd come in and give me a little cup of pills to take and I asked for lots water and tried to drink as much as I could every time I woke up, but mostly I just slept and had no real idea whether it was day, night, or what. Nor, frankly, did I care.
Sometime in the second day or so I was a little more with it... And wished I wasn't. Nothing really below the waste hurt much, except when I moved. I was so taped up and all down there and things were so swollen I could barely feel anything. When I moved sometimes there was a really sharp pain as, I suspect, the drain tubes rubbed against annoyed nerves, but that was about it. My neck also didn't really hurt. I mean pretty much at all. Maybe if it'd been all I'd had done it might of hurt, but as it was I never noticed any real pain or discomfort from the trach shave. At all. My bustline, on the other hand, was a whole nother kettle of fish. My boobs hurt like bloody hell and through this whole thing the breast augmentation has been the source of the bulk of the pain.
As long as I lay still I was fine, except my butt really started to get annoyed after a day or two of this. Moving my arms, let alone trying to roll onto my side, was agony. Unfortunately periodically I had to. A few times a day one of the nurses would come in to do a clean up/sponge bath and would want me to roll to my right, and then my left so she could clean my back and sides. I dreaded that, really, really dreaded that.
At some point, and I'm rather vague as to the exact chronology as I was a bit out of it for a lot of my time at the clinic, they started bringing me meals – if you can really call those meals. Mind, for obvious reasons they don't want you having anything solid. I gather a lot of people throw up a lot when recovering rom the anesthesia, not a problem I had but the last thing they want is you to start having bowel activity before things downstairs have had some time to heal. Not, in any event, that I can imagine anyone really feeling much like eating under the circumstances. Meals consisted of a cup of hot liquid, usually hot chocolate, and a small bowl of soup – miso, to start. There was some confusion where I was concerned, however. Being of mostly NA descent, lactose and I do not get along and the last thing I wanted under the circumstances is to have cramps. Oddly, they kept asking me if soy milk was okay, I assume they normally used real milk to make the hot chocolate, but on the other side of things they seemed wholly unaware that most cream soups have a milk base. I kept having to tell them that soy milk was fine, but that cream soups were not and it'd be best just to stick to the miso.
Sometime after the first day, not really clear on when, they wanted to move me from the recovery room to a longer-term room downstairs. I'd known this was coming, but it worried me quite a bit. Firstly, I was in one hell of a lot of pain and not feeling at all stable. Secondly, the nurses there are near universally tiny. Not all Thais are, I've seen some best measured in orbital radius and a few that were my height or even taller. But these women were pretty universally tiny. At nearly six foot tall, I outmassed most of them by an order of two, at least, and am several multiples of their strength. I seriously doubt that had I started to fall they could have done a whole lot about it. Fortunately I didn't fall, and made it downstairs to the secondary recovery room just fine, if a bit painfully so. Still, I can't help but think there has to be a better way.
Over the next couple of days the number of things I was hooked up to was slowly reduced. For the first two days, maybe three (honestly my memories are a bit hazy), someone slept in the room with me, presumably in case of emergency, though there were cameras in every room and I know someone was watching as one of the nurses commented on my having started to feel good enough to lay on my side for a bit, something I'd done when no one else was in the room. I think it was the second day post-surgery that the tight wraps around my bustline were removed, which helped the pain level some, and a bit later the drains were removed. There were at least four drains, two in my groin and one in each breast, the tubes coming out felt very weird but didn't hurt as much as I'd worried. Or maybe it was just the drugs kept the pain down, no real way to be sure.
The doctor came in to see me briefly once a day, mostly just to tell me he felt things were going well. Can't say as I was a good conversationalist, something that bothered some of the nurses, who kept telling me I could talk to them. Problem is that when I'm not feeling well I tend to shut down and not talk much at all, it's just the way I am. That, and frankly with most of them their grasp of English, both their speech and understanding, was far less than they seemed to think it was. Often what they were saying was just this side of unintelligible and their responses to what little I did say often made it clear that though they believed they understood me, whatever they thought I'd said wasn't anywhere close to what I actually said. People vastly overestimating their grasp of a foreign language seems to be a common flaw, especially prevalent here in Bangkok, but it's a tad bit worrisome in medical personnel you're reliant on for care and is really one of only two – the other being the trip downstairs – complaints I might have about my time in the clinic.
For the most part I watched TV – they have just about every channel imaginable, about half of them in English – and slept a lot. I more or less kept track of time by when they brought me pills, came to check my vitals once I was unhooked from all the monitors, and when they brought meals. I had brought a tablet and a laptop to the clinic, but never asked for them as I just never really felt up to even the minor amount of concentration some aimless web surfing would have required.
The morning of the 4th of September it was time to go back to the hotel. I definitely wasn't looking forward to trying to stand up, I was pretty sure it was going to be more than a bit painful, and it was, but I was seriously looking forward to getting out of that bed. Hospital beds have never struck me as overly comfortable, and my time in that one had resulted in my bum being seriously sore.
It was painful getting up and situated, but once I was I found that I was a bit more stable than I'd expected. A loose dress turned out to have been the perfect choice, not sure how I would have even put on a pair of slacks with my groin area still taped up ten ways from Sunday. The driver and a nurse brought me back to the hotel and insisted on bringing me upstairs in a wheelchair. Strictly speaking I probably would have been fine walking, but I didn't argue. Once in the room the nurse gave me a quick once over, showed me how to empty the catheter bag – not exactly a complicated task – and they left, telling me she'd be back to check on me the next day.
If they expected me to stay in bed they were going to be severely disappointed. Among other things, they'd left me a donut cushion – most helpful, even now – which I used to situate myself as best I could on the couch. For days finding any kind of comfortable position, sitting, laying, or otherwise, was pretty difficult, so I ended up alternating around a lot. Being tethered to the catheter bag didn't help things, either. While the catheter itself wasn't particularly uncomfortable, and having to go empty the bag every few hours – I drank as much liquids as I could manage – wasn't any real big deal, it was still fairly limiting to have a line going inside me to a bag on the ground. Also a bit weird to know that I hadn't gone to the bathroom in days, at least not the normal way, but really you don't even notice, it's not like I ever felt like I needed to go or anything.
The next day the nurse showed up around noon or so. She comes every day, save Sunday, often with an assistant and, unfortunately, at somewhat random times – any time between eleven AM and four PM really, though mostly around noon, give or take.
I forget if it was the second or third day I was back in the hotel, one or the other anyway, that she showed me "breast massage". The doctor had mentioned this but I'd more or less stuck it in the back of my mind to be dealt with later, given that at the time I had a lot of other things to worry about. It turned out that there's no real 'massage' in 'breast massage', it's really more breast compression. And it hurt like bloody hell, as one might expect when someone pushes down with all their might on your breasts that have been stretched to near breaking by implants and swelling. The idea is to expand the area around the implant and to push them down in a more teardrop shape. This serves the dual purpose of giving a more natural looking and moving profile as well as to reduce the risk of capsular contraction.
In theory, anyway.
I discussed this with my sister who is, as I mentioned a nursing supervisor as well as someone who herself had implants done after having her second child and subsequently losing a lot of weight. Her take was that anyone who'd tried to push down on her breasts after surgery would have quickly found themselves bereft of a vital organ or two. She said as she remembered it her recovery had been quite painful – something she neglected to mention when we were discussing my plans, probably just as well – and that her surgeon hadn't said anything about breast massage. Further research on the net reveals that there are a lot of split opinions on the matter, with some surgeons feeling it helps greatly and others feeling it's a huge waste of time. I haven't had the energy to do an in depth search into the subject, I will when I get home, but at a cursory glance I couldn't find any hard evidence one way or the other. So for now I do the breast compressions three times a day, as instructed.
That Thursday the nurse told me on that visit she'd be removing the packing and the catheter. I was really looking forward to being rid of the catheter, if for no other reason than it would mean I could go out of my hotel room, not so looking forward to the removal of the packing as I expected that was going to hurt. For better or ill I have a habit of anticipating such things being painful and getting rather tense about it, which in the end usually turns out to be less than helpful.
The packing coming out didn't really hurt, but it felt very, very strange. First there was removing all of the tape and bandages, and let me tell you that stuff is on to stay, and then it seemed like she was pulling stuff out of my insides forever, how they ever got that much gauze inside me I'll never know, and am probably better off not knowing. Then she had a little look-see with a speculum. Oh, goody, aren't those little torture devices fun? Then a look with a bigger speculum, more fun! Then she got out the smallest of the dilators, poured lubricant on it, and stuck it inside of me while I tried, unsuccessfully, to tense up so much I'd levitate away. That hurt, sort of, mostly because she pushed it in way too fast. Once in it just felt... Weird. At that point things were so swollen down there that a lot of it I couldn't feel at all, and what I could tended to by hyper-sensitive, ludicrously so. Still, I survived somehow and didn't kill anyone, so there's that. And it turned out my depth was good enough, how exactly they managed that I don't know but when I talked with him later the doctor was quite proud of having managed to do so well with what he had available.
Unfortunately I wasn't free of the catheter just yet. She said there was some swelling around the urethral opening and she was worried about my being able to urinate on my own without the catheter. So I was going to be stuck with the bag for a couple of more days.
The next day when she showed up she showed me how to use the dilator myself. It was a lot less shocking both because I knew what was coming and because I could do things relatively slowly and relax some. Still not exactly what I'd call fun, but not nearly as bad as I'd feared.
Saturday when she came she finally removed the catheter, again not an overly fun experience but not too overly painful or anything. She gave me pills to take to 'help' with urinating, not really sure what they were since they weren't labeled, but I already had (and have) a bunch of pills to take daily – antibiotic, muscle relaxer, pain pills when needed (the narcotic of which I only tried once, it made me feel worse, not better, and since the pain has generally been tolerable enough I never bothered with it again), and suchlike. She then had me do my dilation and told me to start doing it three times a day for 20 minutes each time – ugh. Lastly, she said I could go out if I wanted, which kind of surprised me. Mind you, I was going to go out anyway, but I figured they'd prefer to keep me in as long as possible. Nope, they were fine with me going out, though I gather from later conversations with her that we have somewhat different ideas of what entails a quick walk. I'm someone used to five mile runs and three hour gym workouts, I don't gather they really can grasp that worldview any better than I can theirs.
I should say at this point that while the assistants she brings seem to have little to no English skills, for the most part, the nurse herself is close enough to fluent in English that there's no real problem with her communicating what she needs to or my being able to make myself understood.
So over the next several days I fell into a routine of doing my breast compression and dilation three times a day, waiting around for the nurse to come and check how things were healing, and then wandering around trying to walk a couple of miles a day as studies pretty clearly show that the quicker you can get back to being active the better you'll recover.
On Friday the 17th I went to see Dr. Chettawut for a follow-up visit. He examined the mark on my neck from the trach shave, it's 90% healed at this point and almost invisible if you don't know to look for it. He examined and took pictures of my breasts. Then I went back upstairs, got undressed and was taken to the surgical bay so he could have a look at my Shiny New Vagina™. He was very pleased by how things were healing and seemed surprised at the depth – 7 (inches, I assume) on the dilator, how that is compared to 'normal', if there is such a thing, I've no clue. I then got dressed and talked with him a bit more.
He's very much into trying to manage expectations, I suppose that's unsurprising but he's a bit nervous in his approach to it. I tried to make it clear that in my case there wasn't any reason to bother. As far as I'm concerned my goals have been met or exceeded. Does that mean everything will be perfect? I dunno, it'll be months, if not a year, before everything has settled down, all the swelling is gone, and all the nerve endings are back online. But my goals were fairly simple and my outlook, I hope, realistic. Mostly I wanted to have my boobs not look like two half deflated balloons, and to have my genitals be some semblance of the shape and appearance that matched the rest of my body, mind, and self instead of having a freaky hybrid innie-outie that, well, I didn't want attached. Breast size wasn't really a primary concern one way or the other, nor was sexual functionality. While certainly sufficient depth for intercourse, let alone orgasmic capacity would be nice, frankly I don't honestly think I'll likely ever be in a sexual relationship again and I'm fine with that.
So overall I'm very pleased with how things have turned out and kind of surprised at just how much I feel it has changed things for me internally – it's going to be months before I've fully processed that, as well, I think. For the next couple of days I'll see the nurse daily, though at this point it's more pro-forma than anything else. Very early Thursday morning the driver will come and take me to Bangkok airport where I'll have a flight back to Tokyo and then from there to LAX where, sadly, I have a six hour lay-over before catching a quick flight to SLC, where I should arrive about 10PM on Friday, if I'm lucky I'll be home by midnight. Then it'll be a matter of re-adjusting to life. My sister has been watching my dog for me, a friend has my cat, other friends have been taking care of my place.
And that's all I can think of at the moment, I hope this overlong babble has been of use to someone in making their own plans. Any questions or whatever, let me know.
Well there is one other thing, a question aimed at any post-ops reading this: How in god's name do you manage the dilation schedule? I mean, I knew dilation was required to maintain depth, of course, but Chettawat's schedule has me doing 50 minutes three times a day for most of the next year. I just don't see how that's sustainable. Twice a day? Yeah, I can see that, but really how in the long term do you find fifty minutes in the middle of the day to do dilation in private? I'll do my best, of course, but I don't honestly see how that schedule is reasonably sustainable for an entire year, let alone throwing in the time he wants me doing 'breast massage' as well. Maybe I'm being unreasonable, I dunno, but it has me a bit concerned.
