Its been 19 days since I had GRS and breast augmentation with Dr Sherman Leis in Bala Cynwyd (Philadelphia) PA.
I had done my best to find stories of other women who had been operated on by Dr Leis but there was very little to be found in the way of post-op 'reviews'. So, on behalf of all the other women out there trying to do the same research I was, I will share my story in the hopes that it helps others make informed decisions.
Dr Leis is one of the older surgeons operating in the continental US and was the instructor for several of the younger and more 'famous' surgeons. What reviews I did find were mixed - as all medical reviews are - with equal numbers of horrified horror stories and stunning success stories. So I elected to meet with him and Dr McGinn, also in Philly. Dr McGinn had a year long waiting list just to get a face-to-face consultation whereas Dr Leis was able to see me just a month after I called. I have come to find out that Dr Leis is a remarkable workaholic who seems never to sleep.
I scheduled an appointment to meet Dr McGinn in May of 2017, and Dr Leis in October 2016.
In October my Fiancee and i traveled from central Ohio to easter Pennsylvania and made a weekend trip to coincide with our visit to Dr Leis. My very first impression upon arriving at his 'office' which looks for all the world like a house in a nice neighborhood, was OMG What Am I Doing Here!? This is how horror movies start!! But once inside I was immediately impressed with the professionalism of his staff and the attractively modest office. After a short wait we were ushered to his very luxurious office and had our hour long 'consultation'. Dr Leis is the most friendly and warm caring fatherly figure of a surgeon you could ever hope to have. He is funny, thoughtful, pleasantly inquisitive and immensely intelligent. At this first meeting he made only a casual assessment of my 'figure and features' and made some recommendations on what procedures I could, should, and should not have. My original intent was just GRS but he offered to do a breast augmentation at a VERY reasonable cost. We discussed various FFS procedures but ultimately there was, in his opinion, very little that should be tinkered with. In many of the reviews I read about his practice, there were mentions of him examining women with his bare hands. During that initial assessment he did in fact touch my face with his bare hands. Now, I'm no germiphobe but I could see how that would be disturbing to some women. At the end of the consultation we set a tentative surgery date for August 2017. One of the unique features of Dr Leis' practice is that the 'house' is office is in, is actually a three-story apartment kinda thing. The offices and a recovery suite are on the first floor, a recovery suite and his son live on the second floor, and there are two more recovery suites on the third floor. These "recovery suites' are, except one, multi-bed hostel-like apartments with carrying degrees of shared amenities. There is one suite that is a completely self-contained apartment. These suites are available to patients when they're available. He has a very busy practice so these suites are usually full. We got lucky and reserved the self-contained apartment for August. I left with some detailed instructions on hair removal (already done) and weight loss (.....no comment.....).
Then November happened.... My easy-to-ignore insecurities about the future of LGBT equality became an impossible-to-ignore dread. My fiancee and I had elected to hold off our wedding until my transition was complete so we could have a proper (lesbian) wedding. Fearing that marriage equality, among other things, could be repealed or restricted in the near future, I called Dr Leis' office and asked if we could bump up the surgery date a bit. They offered 9 January 2017. EGAD! That was just 60 days away!!! I agreed. Oh dear....
So I made a million frantic arrangements with my employer and insurance, and set about planning for a four-week medical leave. Luckily we were able to secure the first-floor three-bed recovery suite and would have it to ourselves. I also had to prepare for dramatic weight loss.... About that... Dr Leis does strongly (STRONLY) advise that you be in the lower range of the BMI for your age. The thing is, at 5'10" 195, I am no where near the lower range of the BMI scale but my body fat percentage is in the low teens. My profession requires a degree of athleticism... So, the likelihood of me getting to that target BMI was pretty much not happening.
So 9 January came VERY fast. When I arrived for surgery, I was well over his target weight and got a good scolding for it, but that was the last time he mentioned it. We were shown to the recovery suite and my visions of the movie Hostel came flooding back. ITS NOT THAT BAD!!!! I just tend to get a bit melodramatic when I'm nervous and who doesn't get nervous before a major surgery?! The suite had three twin beds along a wall, separated by wire cage cart/tables. Each had a lamp and was well stocked with wound dressings and various like stuffs. There was a 32" flat screen TV on a little table on the opposite side of the room, a window overlooking the neighbors back yard, and an attached bathroom with a shower. just down the hall was the staff's kitchenette that was available for our use. It wasn't the hilton, but it WAS just two doors away from his office, and three doors away from the staff. And they are plenty attentive.
I had expected to have to do the whole GI purge thing but he said that wasn't necessary. Just no food after 6pm, no liquids after midnight, and a laxative and enema in the morning. (And a 10 minute shower of scrubbing with Hibiclens). I didn't sleep that night anyway. So the plan was I'd get up at 4, do the enema and shower thing, be totally cleaned up and ready to go by 6:30am. He arrived exactly at 6:30 and drove me to Roxburry hospital. My fiancee followed in our car. So The Roxburry, from the outside, is another scene from a horror movie. That or I am a HUGE snob (could be...). But once inside I was relieved to find that it was a thoroughly modern hospital with very friendly staff. Surgery prep included all the usual stuff - strip and put on the backwards paper dress, sit shivering in the cold while they start an IV, and then get piles ( i mean PILES) of warm blankets heaped on while waiting for the doctors to get ready. I was an absolute nervous wreck. A basket case. Have you ever seen that warner brothers Bugs Bunny cartoon where the little cat is terrified of everything and at the slightest noise jumps to the ceiling and clings there? That was me. They let my fiancee wait with me, and walk beside he gurney when they wheeled me towards the OR but eventually they ran her off to a waiting room and I was left alone for what seemed like forever, with nothing to do but thing about all the terrifying things that could happen. I was terrified. Not that I was second guessing my decision, but that hospitals terrify the bejesus out of me. And I wasn't here for some small cut or illness. This was kind of a big deal. Scardy Cat.
Then this older black lady walks in. The sweetest kindest, most reassuring and gentle should I could ever have hoped for. She immediately calmed me and made me feel a lot less terrified. She stayed with me right up until I fell asleep. And its a good damned thing - that process of OR prep is the stuff of nightmares! (for me anyway) (go ahead and laugh, I know Im plenty melodramatic). Nothing painful happened while I was awake. Let me reassure ALL of you about that. The staff were kind, calm, gentle, and very sensitive to my fears and nerves. But then I fell asleep.
Pain. Non specific at first, just....ouch...damn ouch. As I gradually came to life, the ouches became more and more specific. Not agony by any means but really seriously ouch. My heels and ankles had DEEP grooves from the stirrups. These hurt pretty bad for two days as my body slowly recovered. The back of my head had a welt in the shape of an arc from ear to ear. I don't know what they had my head strapped to but it pretty much cut my scalp. Ouch damn. I was immediately aware of a new weight on my chest. A LOT of weight. I had boobs! They were HUGE. Yikes, that's a lot more than I imagined. The 'down there' was not painful exactly, but felt like the most sever duct tape tuck ever tucked. Tight, stretched, and packed. As it turns out, I was in surgery for about 7 hours. Yikes, no wonder my ankles and head hurt. The recovery room staff were very kind and i came back to life very smoothly and without any bad side effects. After a time, they called in my fiancee and we were wheeled to my room. And that's where the good staff left and the not-so-good staff took over.
As you read this next bit, know that I was in a LOT of discomfort from the stirrups, head brace or whatever, and the surgery, so I may have been (was) a bit sensitive to things. So read this with the understanding that it may not have actually been as bad as I felt like it was.
The bed was partially elevated putting me in a reclined seated position. As i found out later, this was putting a fair amount of pressure on the new parts and wasn't doing anything to help healing. I had an IV that had a stead stream of antibiotics and saline, but there was no 'automatic' pain medicine being administered. I had to ask for it. We didn't know I had to ask for it until the OR meds wore off and FULL sensation came gradually flooding in. Then as is normal at any hospital, the time between asking for pain medicine, getting that medicine, and then feeling the effects, can take A LONG TIME. At the roxburry, it sometimes took over two hours. Yeah, that sucked. So i was told that, if i needed it, I could ask for morphine but they were supposed to just use this IV ibuprophin stuff. I just had Roto Rooter rearrange my entire down there and jam two balloons into my chest, have tubes, trains, and sutures all over, and they thought Advil would be enough! So I asked for, and got, morphine but the interval they'd let me have it was longer each time. When I was adamant that I was having A LOT of breakthrough pain they agreed to allow me to have oxycodone orally. Those worked pretty good at dulling the sharp pains but the extreme pressure down there was a constant painful ache.
Sometime after falling asleep in the OR, they put in a foley catheter. My body HATES foleys. My bladder will continuously spasm on that balloon and the little tip of hose that sticks up stabs my bladder from the inside and causes excruciating pain. I asked the nurse for something specific, she had to call Dr Leis who had never heard of such a thing but prescribed a medicine to specifically stop bladder spasms. (more on the side effects of that later). It immediately alleviated the sharpest of the bladder pain but because of the nature of this surgery, the foley is routed down out of the bladder, then back up onto your belly, then over the side to a catch bag. Because the hose goes up before going down, it doesn't drain on its own. That sucks. Bad. Like in so many awful ways. So while Im getting a constant feed of saline, and chugging water to try and overcome the worst imaginable dry mouth (side effect of the bladder meds) I was producing a near constant flow on the output end. But it couldn't get out, it just built up pressure. It took me most of the first day to realize that one of the many pains was my bladder about to explode. So my fiancee and I figured out that if we manipulated the hose, we could 'siphon' it out over my belly and into the catch bag. I filled that bag every hour or two. We also learned that if there was ever any back flow from the hose back into my bladder, it caused an excruciating spasm. That sucked. The night staff were pretty decent people who seemed to have some minimal concern about me and would respond within 20-30 minutes of me buzzing them. The day staff not so much. One of the day nurses grabbed the foley bag and just started walking away with it, while the other end was still IN me! I snatched the hose and jerked it back before she tugged my innards too hard...she was like 'Oh, Yeah, I should drain this into something else Ha ha ha" WTF?!?!?!? Another nurse came in on day 3 with a hypodermic that looked like something they use to sample amniotic fluid saying she needed to inject blood thinner into my hoochie. NOPE. NOPE and NOPE. I told her to take the Nope Train to Nopeville, I wasn't letting anyone inject anything into my down there! She was adamant that they had done this every day since coming out of surgery. No...they had not. So i deliberately refused a treatment. Another of the day nurses was physically very rough in the room, frequently knocking the bed, my feet, my foley bag, and scolding me for being in the way (Seriously? Im immobile in a friggin bed!) She hooked up an antibiotic IV but never actually put the antibiotic medicine in. Later she hooked up the Advil IV but but didn't actually connect it to me. Later she unhooked the IV feed from the needle in my hand and injected the morphine there, then rebooked the IV. I told her to never do that again - there's a port on the IV line for a reason. I contacted the head nurse and said I would not be allowing Nurse Cratchet to enter my room anymore. Wednesday night the vein where the IV was disintegrated in a burning searing flaming explosion of pain engulfing my entire hand, wrist, and forearm. Since I was to be discharged the following morning they didn't bother with another IV, i had to rely on oral percocet and advil for pain.
So I was in the Roxburry for four days (Monday AM - Thursday AM) and somehow managed to survive their many attempts to actively injure and ignore me. Thursday morning release coincided perfectly with the end of my last dose of pain medicine. It had completely worn off when it was time to move. I had been begging for something all morning but they had 'closed my chart' already and weren't allowed to administer anything. They kept insinuating that I was being a 'pill seeker' and that the advil was more than enough for the pain I was experiencing. Finally, just before being wheeled outside, one of the day nurses comes over saying she had a present for me - two percocets. Gee, thanks.... I was released from the hospital and moved to the recovery suite at the Dr's office. (Flashbacks of Hostel, thinking this is how horror movies start). But Dr Leis and his staff were so very kind, very attentive, and very caring. We wanted for nothing and had a very peaceful time there. Dr Leis came in every day, often several times a day, to check on me. About those reports of not using gloves.... sometimes true. So to be fair, he NEVER EVER EVER touched anything anywhere near anything sensitive without protection. But he did touch the blankets and my clothes occasionally without wearing gloves. It was a bit unnerving at first but I know from my own experience that not every encounter near another person requires full body encapsulation. He was absolutely hygienic but to those who may be sensitive to the risks of infections it could be a little unnerving.
A few days into my stay at the office and he removed the drains. I was absolutely certain that it would be excruciating pain but to be honest i barely felt it. I thought he was just getting ready to pull them and they were already out. The next day he pulled the catheter. Remember that anti bladder spasm medicine? This medicine is usually prescribed to people with massive kidney and bladder stones to prevent their bladders from contracting over the stone and causing internal damage. One of the side effects is a wicked case of dry mouth. Like, you can't breathe, and you can't swallow, you can't taste, you can't talk, all you can do is drink (which floods the kidneys and keeps the output at about 1liter/hour. This dry mouth is so bad, that people with those massive kidney stones will often quit the medicine and endure the pain of the stones than endure the dry mouth. It's that bad. Im not exaggerating. Another side effect is that the medicine effectively paralyzes the sphincter muscle that holds urine in the bladder. So without a foley, you can't pee. At all. So, when the Dr removed the foley, I was utterly incapable of voiding, no matter how bad the urgency. After 6 hours I was begging for him to put a foley back in. Remember how much my body hates foleys? Yeah, it was that bad. So the hospital used a clear silicone catheter. Dr Leis used a silicone coated latex catheter. My body reacted badly. The urethral tissue, inside and out, swelled massively. Like tripled in volume and was extremely swollen and tight. My vagina literally looked like it was turning itself inside out. And that's not very comfortable. Two days later the second foley came out along with the packing. Passing the foley was a lot easier than the packing. I can't say it hurt hurt, but it felt like my intestines were being pulled out. Some Drs will put the packing inside a condom inside the vagina. This prevents sticking, but it also prevents the packing from drawing discharge away from the healing tissues. Dr Leis did not use a condom. The removal of the by-then-mostly-dry packing was an ordeal to endure. By the end of that day I was voiding liquids and solids without problem. By this time I had weaned myself of the percocets and was managing tolerable pain levels with 800mg advil. By no means pain free, but tolerable. Dilation started the next day.
I joked with my fiancee that I lost my virginity to an old man and his plastic tent peg....it was about that special. Because the events leading up to that milestone moment were generally so fraught with fear and pain, I had never really been able to 'soak it in'. That night I did. I wept. Hard. In Joy, in pain, in fear, and in hope. It's been an emotional roller coaster since then.
On Saturday, day 13, I had my final post-op exam with Dr Leis. He found some granular tissue and some hyper granular tissue (think fleshy growth like a tumor protruding into the vaginal canal) and showed me how to use silver nitrate on myself. (Is that a thing? Can I do that? ....I guess so....) We were discharged and my fiancee drove us 8 hours back home. That was a truly uncomfortable journey. Ugh. Trying to change dressings every time we had a potty break at some gas station or truck stop was an adventure in selective blindness. Yuck.
Finally at home! Two more weeks of bed and light duty recovery at home before going to work and WOW am I glad to have it. It's Thursday, day 18. The wound for one of the drains is still not entirely closed over, the wound for the other is. The sutures on my labia have all healed very well. There is, however, a suture separation at the bottom of the introitus. About 1/2cm. Really scares me but I've been able to text Dr Leis (with pictures) daily and he responds within a couple minutes, reassuring me, advising me on dressing the wound but not stopping dilation.
Dialation goes on 4 times a day. Its not pleasant but it doesn't hurt. I've graduated to #2 after getting things open with #1. I am scheduled to go back to see Dr Leis at the end of February for a final followup and he expects me to be on #3 by then. I think I can do that.
So just before we left the Drs office, he used that silver nitrate to cauterize some of the granular tissue, and the hyper granular tissue. I watched it die immediately. Some of the hyper granulation tissue he cut out. (Terrifying but painless). But the complete death of the cauterized tissue didn't become apparent for a few days. My body is still sloughing off the dead goop where he used those nitrate sticks.... very gross. See, no one prepares you for the little things like this - the multitude of frights and fears that no one seems to talk about. Well, no holding back here! So over the last few days, that tissue he cauterized continues to slough off and be shed. It doesn't hurt, it isn't 'raw' its just....gross....
The swollen urethral tissue is WAY less swollen and things are starting to look more like a normal body down there. There is occasional light bleeding but it's VERY light. There is the constant sloughing of dead stuff. I can (and do) shower daily. Douche every other day, and keep constant moist dressings on the introitus wounds. They ARE healing. Slowly.
So its Day 18 and things are by no means done cooking. Things are by no means ready for business. Things are definitely healing and healing faster each day.
For the past three weeks I have alternated between terrified, horrified, certain of disaster and hopeful of recovery, with the occasional giddiness that this all really is working out and things really are shaping up the way they're supposed to.
My breasts are about half numb yet, they're softening and settling but still very uncomfortable and my cat just loves to step on them. All the nerves in the Down There are slowly reconnecting which causes electric shocks at random intervals. Im still learning to re-map the sensations for the new arrangements Down There. Most parts are sensate though my brain is still struggling to make sense of what those sensations mean. I feel good and energetic at times but it wears off quickly and I get hot flashes and feel very nauseous and faint. Those spells pass too.
I've got another week of at home recovery before I have to go to work. I'm not really looking forward to that. In the mean time, constant dressing changes, four times a day "Homework" (dilation), and plenty of healthy food and rest.
I've written this rather graphic tail so other women may have a better idea of what to expect for their own journey- with Dr Leis or with whomever. Surgeons techniques differ slightly but patients recoveries differ dramatically. Its quite likely that no one else will have an experience like I have had/am having, but at least you'll have an idea of what you;re in for.
If you have any questions, and I DO mean ANY, PLEASE ask. I am the most un-judgemental person and will happily do my best to answer any questions you have- trivial or momentous. I'm here for you.
