GCS with McGinn (After so many years waiting)

[HappyMoni]

Thanks to both of you for this dialogue.  Its now filed under "2 weeks" in my Post Op file so I can look and compare notes when I'm laying there 5 weeks overthinking just about everything except the upcoming full Eclipse in the Midwest I'll be missing . . . 

Hi Gail,
   I can't speak for anyone but myself, but I will offer you a few of my thoughts. I hope if you or anyone else is afraid of the surgery, I would urge you too make room for the positive thoughts as well. If you are this far, Gail, your decision making is over. Be at peace with the choice, enjoy the experience. I know I had some hard times and I have a ways to go, but I would have (in my mind) been a fool not to appreciate that this was a transformative moment of my life. I look back on it fondly. The thoughts of pain leave very quickly. I am glad I focused, savored the moment. I am enjoying, as much as possible, things as they unfold. I don't even mind peeing all over myself while the plumbing figures itself out down there. One thing about doing this when you are older. You have done the male thing to death. Why would I not thoroughly enjoy this new world opening up before my eyes. Why lament the male things that I did over and over that I mostly grew to despise. The water is warm Hon, come on in.
   I guess I took your over thinking comment and ran with it. Sorry if I got your feelings wrong. I have not always been a positive person and I need a reminder sometimes. For this experience, I honestly think it wasn't so bad because of the attitude I chose. You know, like convincing yourself it will be bad and then proceeding to make it that way in a self fulfilling prophecy type deal. Maybe the opposite can happen too.
   Am I right that you will go with Dr. Bluebond Langner? I met with her before she moved to NY. She is an awesome person, very caring. You go in August? Where is recovery? Well good luck.
Moni

[Rachel]

Hi Monica,

Take a pic of the stitch opening and send it to Papillion  for review. They are awesome and review picks often. At the pre-op desk today they were looking at patient pics and discussing. I could not hear the specific. Just that pics are the way to get answers of questions.

5 dilations a day is daunting but needed. It is the time you can gain the most in depth. You also get to know your vagina by looking at it in the mirror and feeling the dilators penetrate.

You are a pretty tough woman and had to deal with a lot of difficulties, you rock. Also your support rocks too.

[HappyMoni]

Thanks Hon, you are awesome! (And you have BOOBS) yea.

[HappyMoni]

I do have a question on dilation. It goes in easily with the smallest (purple). It bottoms out with basically 2 dots out and 1 dot at the opening.  They say 5 inches. If you do the pressure as she says, can you actually gain depth or is it more of a maintaining depth type thing. I push enough that it feels slightly uncomfortable but not painful. I feel pushing harder would only cause issues.
Moni

[SadieBlake]

Monica it's my understanding that dilating too large diameter too fast is a common cause of granulation I can't imagine that pushing too deep too fast couldn't also cause granulation. So yeah I would not be doing it that's just my two cents and what I've read, no actual experience hugs

[Dena]

Even now when I first insert the dilator, it doesn't go all the way to full depth. It now takes me a minute or two for the dilator to go all the way to full depth. The best way to do this is by maintaining a constant pressure of around 4 pounds on the dilator throughout the entire session. It shouldn't hurt though at this stage of the game, there may be some discomfort. Excessive force risks opening up a spot where something is healing and you might start bleeding again. This is why sex isn't permitted in the first 3 months as it take a while for everything to heal properly.

[Rachel]

Hi Monica,

Did you have them demonstrate hand on hand them to you the force to use.

If you did not ask them to demonstrate the force to be used then ask them what pound force to use then get rice or something else to weigh that weight to use as a calibrated dilation force reference.

Dina's 4 pound force sounds about right. I gained 1.25 inches.

I quickly went to the larger dilators, with Papillion's direction. 30 minutes is the time. When you have 3 dilators it is 10 minutes per dilator. 4 dilators was 8 minutes per dilator. 3 months I dilated 3 time per day. At 6 months 1 dilation per day with purple for 5 minutes and orange for 25 minutes.

I had an issue that eventually required prescription hydrocortisone. At a point the scars started to contract and the prescription hydrocortisone relaxed the scars. If it did not work then estrogen cream would have been prescribed, it was not needed. The point when the scars, and I have ample, contracted I had tears in my eyes when I dilated; I did not miss a dilation. I cried and did controlled deep breathing.

[HappyMoni]

I am very invested in avoiding issues rather then causing them and having to repair them. I was told a pressure like it takes to push open a door. I will do this, but I don't see it changing depth at all. Also my little walk today has brought about swelling down there. I didn't think I went that far, but I will back off that and be more conservative. Oh, the hot flashes are killing me. I go from shivering to steaming constantly most of the day. Wow!
Moni

[SadieBlake]

Moni, I should also say I've lost about an inch of depth somewhere along the way but half of that may have been swelling. Pressing relatively hard now doesn't hurt in the least and depth increases by up to 1/2 inch during dilation -- I'm given to just leaving it in place a while as I actually enjoy dilating when I'm not so tired that I can't keep my eyes open. Whether I'm slowly regaining some depth will be seen. I find it easiest to keep pressure going by pulling on a pair of panties over the dilator and tight enough to get the pressure I want, looks funny but works.

Fore swelling of my labia was caused simply by being vertical, whether on my feet or sitting and I attributed it to blood pressure. Out to about week 6 time on my feet or seated caused this and when working in the glass shop I would take every opportunity to lay down for a few moments. This caused some consternation with my coworkers and I had to spend some time reassuring them it was simply a matter of comfort.

YMMV, for me, time standing, walking or seated all caused equal pain down there and so I adopted my policy that o was either actively resting horizontal or actively getting stuff done / walking.

[Jacqueline]

Moni,

Hi! Wow, congratulations! I totally missed your little project. Work had me off for over a month and am just catching up with things. I had completely forgotten you had this coming(sorry).

Sorry to see you have had some little bumps but I think that is pretty common. I have only read the first page then jumped here. I am going to go back and read through it all.

Take care of yourself.

With warmth,

Joanna

[Rachel]

Monica, I think you are close to when you can take E again, It will be so much better when you can go back on E. I had a boob growth spirt when I went back on E. But I gained some weight too. Now you need calories (good calories) to heal. This is not the time to worry bout a few pounds. There will be time to diet later.

Dilating can become very boring so watch or do something when dilating. When I dilated at work I did work e-mails. When at home I did Face book. I never post on FB but reply to a lot of people's posts.

[HappyMoni]

Hi Joanna I was wondering where you were Girl. That pesky work thing can sure get in the way sometimes. Hope otherwise you are doing well.
Sadie, I seem to have maintained depth so far. I am at status quo. Supposed to do the five times a day for a week before going up to blue. Sometimes I wonder if McGinn says 5  times a day because she thinks most folks will cheat n do less. Did this occur to you Rachel? I am a rule follower, so I will try to stick to it. Love the panty hold in place idea. I will take exercise slow as I did swell a bit yesterday. Rachel I started with 1 pill of E yesterday. I will double that today. The hot flashes are too much. I wrote a friend about my day to day, at what, 16 days postop. I will copy it here for reference for anyone looking forward to the surgery. Here goes. Oh sorry one sexual reference so if you are younger than 35 get parental permission 
before reading.
I seem to have not relearned all bladder control yet so as soon as I feel anything I have 2 minutes to get to toilet. This means multiple  wake up times at night. By the time I get back to bed, I shiver for about 3 to 5 minutes. (could be from my blood loss during surgery)  Often this is followed by a 'walk on the surface of the sun' hot flash. I alternate all day between hot flash and needing a blanket. No fever. It is from hormones. I wake up and dilate. I do that every 3 hours but it seems more like every hour if you try to do anything. A shower once a day. It is weird still because I have a one inch open wound down there for drainage and I fear getting water in it. I am also supposed to soap up a finger and clean the vagina as well as I can. Energy, well I get brief bursts but half way through it, I poop out. Sitting is hard. 20 minutes max usually. I am glad we bought the minivan as I can lay back enough to make it comfy. I am to eat like crazy. I probably lost 10 pounds before surgery and during early recovery but it is all back. I stay busy talking to friends and haven't watched much TV. So that is my life now. Pretty awesome if you ask me. Oh, I also get lightening strikes  from the nerves connecting down below. It makes you jump sometimes. It is a good sign though. I look forward to exploring down there. You know the feeling of going over a bump while in the back seat. Like your junk ends up in your throat. Well if someone gets close to toughing my abdomen I get that feeling. It is just so sensitive all over down there. I have had some erotic thoughts since surgery. It is weird because I feel what feels like a mini erection down there. I guess I thought that would not feel that way. I am sitting back and accepting it all. As crazy as I was before surgery, I am calm and peaceful now. Well, still crazy to be honest. Doubt they will ever cure my silliness. I will say that so far no signs of dysphoria. Is that too good to be true? In 60 years I have had my share of it. I am only asking for a quick break from it for, say..., the next 60 years.
SillyMoni

[Gail20]

  I guess I took your over thinking comment and ran with it. Sorry if I got your feelings wrong. I have not always been a positive person and I need a reminder sometimes. For this experience, I honestly think it wasn't so bad because of the attitude I chose. You know, like convincing yourself it will be bad and then proceeding to make it that way in a self fulfilling prophecy type deal. Maybe the opposite can happen too.
   Am I right that you will go with Dr. Bluebond Langner? I met with her before she moved to NY. She is an awesome person, very caring. You go in August? Where is recovery? Well good luck.
Moni

Hi Moni,

I was not very clear and there was a missing word. . . sorry . . .  I meant in my post that I can see myself lying there 5 weeks from now in recovery looking down at myself and "overthinking" the results as in, "oh my, whats this" or "whats that", "I can't believe how swollen I am", "Is this normal" What did Moni say that time", "what did Sadie say about this?  I also know what my answer to my own questioning will be, "calm down, enjoy the process, in a couple months regardless what happens none of this will matter, it will be all OK. . . . and now, added to this will be . . .remember Moni's calming post . . .

Yes, Dr Bluebond-Langer moved up from Maryland and is now at NYU heading up their new TG surgery program. My surgery is August 11th, and after a week in the hospital which she requires, I'll be going down to Princeton where a friend has an Aunt who has opened her home up to my friend and I. I'll be there thru the 29th (my last scheduled followup appt wtih Dr BL) I know these last 4 or 5 weeks are going to go by in a flash. . . .

[SadieBlake]

Gail, I took your meaning, you're gonna be fine :-). I was referring to Ruby Aliza's posts during my healing and recovery, she went to the same practice I did, Dr Satterwhite just about a year before me.

Moni, I'm pretty good with following orders, my 2-dilation days early on all involved sleeping through the appointed time. Since I got back to work, some days I get home and I'm just so tired I forget -- and there is no practical place at work :-(. At this point I'm definitely not losing any depth and go to twice daily in another week anyway.

My doc let me back on HRT at 8 days but I still had lots of temp regulation problems for the first month or so. Early on I used a combination of chux and towels under the sheets to minimize soaking the mattress.

Can I say I really don't miss that, also don't miss needing chux for dilating!

[Rachel]

Hi Monica, no the 5 dilations are needed. At some point the scars will contract and dilation is what keeps the size you have. All doctors have different rules. I followed Dr. McGinn's schedule and am glad I did.

I thought the dilations were excessive then the scar contraction hit and I was in pain. If I had less dilations I do not know what would have happened.

I am glad you are back on E. I never had a hot flash but got really depressed and e helped.

Look out for post-op depression. You just had life changing surgery and life will catch up to you. You put your body through the ringer and went off E for a month and had major surgery. When and if depression hits remember to do things to raise your spirits. Aroma therapy and mindfulness work wonders.

[Gail20]

I've been on Estrogen for 17 years!  I'm somehow missing the rationale for us stopping Estrogen. My surgeon wants me to stop 4 weeks in advance. . . Tomorrow!!!

Cis Women cant stop their Estrogen just because they're having major surgery. My doctors, who have treated lots and lots of TG people for almost 20 years, say they don't see why I should have to stop Estrogen at all.  My therapist is concerned about the psychological impact . . . I don't get it. . . .

[HappyMoni]

The simple answer of course is fear of blood clots and maybe lack of research on trans folks. I was told to expect crazy emotions post surgery n I had a trial run last year with FFS surgery. I think I have some good circumstances to cope.

Gail, you are gonna 'kick butt and take names.' We all know nothing is ever perfect but we are realizing a dream and that is the main thing to focus on. If need be revisions can be done. Worry can only take away from the experience I think.
Moni

[SadieBlake]

Gail, estrogen taken orally has a significant effect on likelihood of throwing a blood clot and of course surgeons are going to want to eliminate all possible risks (liability issues are going to dictate this).

Being conservative creatures, even if you take your estrogen by injection or transdermal patches - which are functionally equivalent to a natal females - they still want you to discontinue. And because the release is delayed with injection, in my case the doc had me stop a month in advance of surgery, would have been 2 weeks if I took pills.

It's only a month and honestly post-op you're gonna have other stuff on your mind. Yes that month sucked for me, the moreso because I had a huge amount of work and absence of HRT sure doesn't help my coping skills. Flip side for me was I dealt with it - I was effective, scheduled well and stayed organized. Those wouldn't normally be my strong points and that I managed sure told me how motivated I was to get to Dr Wittenberg's door on April 26 :-).

And post-op, I have to say, HRT was pretty low on my list ... not that I didn't think about it and the peace of mind and return of my more emotional self was truly welcome but the day I was permitted was also the day we had to take a 25 mile Uber trip for the first post op appointment and. I was so tired, I didn't get to doing my injection until the next day.

Hugs &c

S

[Gail20]

Thank you both. I know you're correct.

Yesterday after I posted here I looked it up and there was so much about HRT's association with higher blood clotting I was surprised my doctors were basically unconcerned. . . oh well . . .as you say there will soon be other more important issues and it will all be OK in the end. . .

Thanks again for the support

Gail

[HappyMoni]

Hi all,
   Hey Gail I hope you tell us of your journey when the time is here. Okay?

   I may have figured something out that was bothering me. When I went off HRT for a longer time last year for FFS I just started to get the return of the male smell. It wasn't too bad, but HRT made it go away again. This time, I am off meds less time, and the scent is stronger. Yuk! Well it just occurred to me that this time I am getting really bad hot flashes. I guess this has brought on the stinky underarms. Come on E, kick in. I loved the fact that I could perspire some and it smelled like daisies. Well, it didn't smell like guy anyway. lol
Moni