So, the pain and the bleeding are still going on.
However, I'm still kinda in the ballpark of thinking that it's not a deeper problem, it's just overexertion. Now that I'm back home, I'm sort of out of the routine that I had in Thailand where lunch and dinner were always two steps away from my bedroom and a simple matter of heating things up in the microwave or just eating whatever dish Mom had grabbed from Seacon Square for the day, and spending the entire rest of my day in bed. My bedroom is upstairs, which means at bare minimum walking up and down the stairs three times a day for meals, and I've done a lot of preparing my own. Yesterday when the pain and bleeding started getting bad, I cooked breakfast, then spent a couple of hours cooking dinner with Mom, and in general spent a lot of time walking around.
Also, because the dilator wasn't quite going to full depth, and because I'm now a couple of days behind schedule with starting the #2, I'll admit, I started forcing it a little bit. I started pushing a little bit harder than normal with the hope of stretching the skin out. And most of the sharp pain is coming from the vagina area, with the worst of it coming when the dilator hits the very back where I was applying all of that pressure. (There's also a "bruise" kind of ache coming from the stitches and the clitoris, which I believe is very likely just from being sat on for 23 hours on the planes, because that's what it feels like.)
So, I think I overdid it. And I think that's probably where the bleeding and pain are coming from. I've noticed the bleeding is a lot worse when I'm up for long periods of time, while when I stay in bed the pain and bleeding does subside, and this afternoon when I take it easy while dilating and didn't try to force it, there was no blood at all.
I'm not ruling out that there might be a deeper problem, I'm going to stay vigilant and watch out for any abnormal discharge, abnormal coloration, abnormal swelling, or other symptoms of infection like fever. But for now I've had none of those things. All of the discharge has been normal-colored pale pink discharge, bleeding mostly just happens when I've been up and exerting myself, and there's been no abnormal swelling at all. (In fact, I'm finally starting to form a more normal-ish urine stream finally, so that's a sign that swelling has gone down.) Also, my energy level has been recovering each day since we got off the plane. So for now, I'm going to give it another day, take it easy tomorrow, and see if it improves. If not, I'll contact a doctor.
(Also, I don't know how much of the pain might be due to me being back off of pain pills. During our last week in Thailand, I was taking two tramadol pills every single time we left the hotel for any reason to mitigate the pain of being up and about. So this is the first time I've really been up and active and gone outside to run errands without the aid of tramadol, so I'm not sure how much of the pain is just from lack of painkillers.)
Things to think about. This hasn't been a fun couple of days, this is by far the most painful that dilation's ever been, and I'm still at a pain level and energy level that feels like I've lost two weeks of recovery progress, but hopefully it will improve.
I am at least going to send an email to Dr. Chettawut's office and ask them whether pain and bleeding are normal after a 23-hour international flight or if they're something to be concerned about so that I know.
