Dilation is the name of the game

[Valeriedances]

Now that I am past 3 weeks from surgery, the focus of my daily life has shifted from the surgery itself and immediate aftercare to dilation. It is now the center of my world, something I think about from waking to bedtime.

I am amazed at how much time I spend on dilation preparation, dilation itself, cleaning and restocking all the materials, bathing, air drying, additional care for my fourchette wound requiring me to be on my back for extended time, dressing, eating, resting, then repeating the process again and again throughout the day and evening. It is all consuming, at least for now.

I do have discomfort when dilating at this stage. I have found that lubrication is my friend. One thing I am trying to find a good solution for is the best method for applying gel to the dilator. The recommended way is to put some on the tip without touching the dilator with your hand. I found this to be very inefficient, so much of the gel hits the sides of my labia and is wasted.

So I decided to scrub my hands extra well and spread the gel manually on the dilator. This is helping me tremendously, I am much more comfortable and am obtaining depth easier.

Does anyone have a better way to apply the lubricant? The concern using the hands is bacteria. My Dr. office did approve as long as I wash my hands well.

Thanks,

Valerie

[Kristyn]

I am amazed at how much time I spend on dilation preparation, dilation itself, cleaning and restocking all the materials, bathing, air drying, additional care for my fourchette wound requiring me to be on my back for extended time, dressing, eating, resting, then repeating the process again and again throughout the day and evening. It is all consuming, at least for now.

Hi Valerie What are you doing to tend to the Fourchette wound and how long did Dr. Brassard say it would take to heal?

[Kristyn]

The only thing to do is keep it dry as much as possible and let it heal on it's own. It's a fairly common complication.

What I am doing specifically is spending alot of time in bed on my back letting the ceiling fan keep it dry. Since I figured that out yesterday it is healing faster. It is no longer raw or bleeding, but begun growing some tissue. I put a pillow under me so there is no drainage from the vagina hitting it. Once I get up of the bed, though, all bets are off, heh.

With all the dilation it is impossible to keep it dry. I do the best I can, after each dilation I go back to drying it out again. I am spending alot of time in bed.

Dr. Brassard's office told me it could take 4-6 weeks.

Does the stretching from dilating affect it at all?  Couldn't you put some of that liquid band-aid on it?

[K8]

Valerie,
I'm sorry I missed this thread.  I hope you are healing well.  Between the BA and torn fourchette, you have a lot more to contend with than I do.

I have a big knot of stitches at my fourchette.  Sometimes I brush against it when inserting the dilator (#3) and sometimes not.  (It stings when I do.)  I think the advice to keep it clean and dry is probably best.  My nurse said to keep the whole area as dry as possible (hence cotton panties instead of nylon, etc.).  My daughter told me that when she was young her mother told her not to wear panties to bed because "you've got to let that stuff air out."  I have been sleeping without anything around there other than the sheets and blankets.  (I've gotten a little staining of the bottom sheet, but Spray'n Wash takes care of it.)

The way I was taught to put the lube on has worked for me.  I have never gotten binding of the dilator due to a dry area.  I put a ring of Surgilube around the dilator just below the curve of the tip.  I then put a dollop of Metrogel about the size of a pea on the tip.  Then I take a clean finger and gently smooth it all out so it is even, covering the top inch and a half of the dilator with gel less than an eighth inch thick, wiping the excess that ends up on my finger on a clean paper towel.  I sometimes but not always get a dribble of excess when I insert the dilator.

I hope this helps.

- Kate

[Birdie]

I had the same concerns when I was dilating. The lube wasn't spreading properly but I didn't want to touch the dilator with my bare fingers. My solution was to buy a big box of food handling gloves (you can get them in boxes of 100 from the supermarket) and just wear one to spread the lube. It's worked for me so far.

Good luck with the healing Valerie, I hope it gets better soon!

[Kristyn]

I am getting granulation tissue growing there now, I don't know if that is good or not. It doesn't look right at the moment. Will see how it heals in a few days then I will update my Dr. office with a new pic. I don't know why they couldn't re-sew it when I was there, but then I'm not a medical professional. Dr. B. told me at the time it would trap germs if he did something then.

Granulation tissue is a good sign--it means that the wound is healing

The appearance of granulation tissue is a good sign. When a wound starts granulating, it means that the body is starting to rebuild after the injury. This highly fibrous tissue is usually pink because the body produces numerous small blood vessels to provide a supply of oxygen and nutrients to remove waste. It is also commonly bumpy and uneven, and may be moist to the touch. In the beginning, granulation tissue can look reddened and irritated, but this is simply because of the numerous blood vessels it contains.

In the case of proud flesh, the tissue overgrows. Doctors often treat this problem with topical applications which cauterize the granulation tissue so that it will stop growing, encouraging the body to move on to the next stage in healing. Sometimes more aggressive tactics such as surgery to remove the excess tissue may be necessary, depending on the specifics of the situation. A doctor can evaluate a given case and determine the most appropriate course for treatment.

I'd call Brassards office on Monday and let him advise you on the next plan of action.  The important thing is to let the area breathe because the cells that develop granulation tissue need oxygen to create the extracellular matrix which is necessary for wound healing--so sleep raw honey.  Your body needs collagen and one of the precursors to collagen in the body is vitamin c.  So , if you have supplements, high doses are fine as vit c is water soluable.  Time released ascorbic acid should not be taken in high doses as it is fat soluable

[bethanypahl]

hi hope your doing well   I  use a small shampo bottle (travel size) with a cap and mineral oil and i drizzle some on the lower half of the dialator over a small glass to catch the extra this works for me both at home and when I had to do it at work  glad that part is overwith  any way give it a try hope it works for you
bethany

[K8]

I'm returning to work next week after the holiday. I think I'll be ready.

It sounds like you are, Valerie.  Congratulations!   (Oh.  Work?  Really?)

- Kate

[FairyGirl]

hi hope your doing well   I  use a small shampo bottle (travel size) with a cap and mineral oil and i drizzle some on the lower half of the dialator over a small glass to catch the extra this works for me both at home and when I had to do it at work  glad that part is overwith  any way give it a try hope it works for you
bethany

I use the same method, and rather than cases of K-Y I got a couple $8 quart bottles of pure mineral oil (the drinkable kind) which at the rate I'm using it should last me several months lol I use my hands to oil up the dilator after cleaning them with Germ-X (kills 99.9% of germs) and touching nothing else.

Dr. McGinn took her first look with the speculum today and told me everything looked really good in there, which was a relief.

[K8]

I'm curious about the messiness of mineral oil, too.

My surgeon came by my room several times before I left Montreal but there was no internal exam. Just a quick check, how are you feeling, do you have any questions sort of thing.

Me too.  The only ones who've looked at all were the nurse who unpacked me and my family doctor when I thought I wasn't healing properly - and both of those just looked at the outside.  No one's looked inside, but it feels great so I'm not concerned.  (But it would have been nice to have the surgeon review her work, y'know? )

- Kate

[Kristyn]

(But it would have been nice to have the surgeon review her work, y'know? )

I wonder if any of the Thai doctors do?

[FairyGirl]

the messiness is not that bad. I dribble the oil on the dilator from a little dispenser bottle over a small plastic cup (really only a few drops drip off) and then smooth it around with my index and middle finger. I then use a feminine wipe or a clean paper towel to wipe my fingers, which is easy. Right now it's taking me about 5-7 minutes to achieve full depth with the #2, then the rest of 30 minutes just pushing on it. I'm still pretty sore down there but it is getting better, and the mineral oil seems to be working just fine for lubrication.

Also right now I'm getting into this whole feminine energy aspect of dilation, and how it represents such a passive acceptance into your body yet with the quiet strength required just to get through it 5 times a day. Hope that doesn't sound too dumb but what I mean is, it's really great just to be here.

[kyril]

Over the long term, mineral oil (or anything else not meant as a female personal lubricant) *may* be a bad idea. From what I understand, post-SRS you ladies begin to develop mucosal tissue on the inside similar to what other women are born with, and oil in general is bad for that tissue, like any fluid that's not a water-based pH-balanced body-fluid mimic.

But in the short term after SRS, you probably want to use whatever reduces irritation the most, so if that's an oil and your doctor's ok with it, it's probably fine.

[FairyGirl]

actually mineral oil is the only thing Dr. Mcginn wants her patients to use. She says other lubricants such as K-Y can dry in there and cause a buildup over time. Mineral oil is absorbed into the skin but you're right Kyril, too much of anything is prolly not good and I would love to become self lubricating! lol

[K8]

Also right now I'm getting into this whole feminine energy aspect of dilation, and how it represents such a passive acceptance into your body yet with the quiet strength required just to get through it 5 times a day. Hope that doesn't sound too dumb but what I mean is, it's really great just to be here.

I hadn't thought of it that way, Chloe, but you're right.  It doesn't sound at all dumb to me - I know what you mean and agree.  I think that it is in a way related to that little secret nod that women exchange - that acknowledgment that I've experienced from other women that I never got when I was pretending to be a guy.  You are a wise woman, Chloe.

And the tenderness will moderate and then disappear.  And then...

- Kate

[K8]

When I was using the smaller dilators they slid right in until I hit a ring of tissue about 4 inches in.  Once past that they would slide in the rest of the way no problem.  With the #4 I have problems toward the beginning – more like muscles for the tops of my thighs that I need to relax – and then it slides in pretty well with a little tightness through the ring until about half an inch from full depth.  Then I spin it, kind of screwing it in, and can hold it in place.  If I don't keep pressure on it then it comes out about a quarter inch.  I'm at full depth at the end of the insertion process, which takes perhaps a minute.

(I think the ring of tissue about four inches in may be the end of my penile tissue and the beginning of tissue from the scrotum.  There seems to be more room – more girth – available past that point.  If I try to spin the dilator before passing that point it hurts, but after that it just feels ... interesting – neither bad nor wonderful.)

In the beginning of the process, I have to aim the dilator down.  Once it gets started, it slides more horizontally with a downward slant.  I kind of let it find its own way.

I don't know if any of this is helpful to you, Valerie.  Are you still getting pain or tenderness from your fissure?  My clitoris still has a bit of white tissue on its tip and the hood is still a bit swollen, but the rest of the stuff is feeling pretty natural now.  I think any tenderness/pain from your fissure will go away eventually as the tissue heals.

- Kate

[katgirl74]

K8, that ring of tissue is where the penile skin graft meets the scrotal graft, it is one area that can retract and cause issues if not properly dilated to full depth. I recently found, after struggling with my #3 for weeks, that it was all about the angle I was sitting at. I always had a difficult time with getting number three in, often taking five minutes or so. Now, in a more reclined position, with less or almost no tension on abdominal and pelvic muscles, the dilator slips right in without pain and without occasional bleeding.

Valerie, the resistance you experience right as you insert the dilator is in fact a ring of muscles. Those are the muscles that gave me a lot of resistance until I found the current position that I am using now. I prop up a few pillows on my bed, and dilate while at about a 30 degree angle, and my legs slightly apart and bent about 45 degrees. This seems to be ideal and allows for the most effortless insertion of my dilators.

[Kristyn]

K8, that ring of tissue is where the penile skin graft meets the scrotal graft, it is one area that can retract and cause issues if not properly dilated to full depth. I recently found, after struggling with my #3 for weeks, that it was all about the angle I was sitting at. I always had a difficult time with getting number three in, often taking five minutes or so. Now, in a more reclined position, with less or almost no tension on abdominal and pelvic muscles, the dilator slips right in without pain and without occasional bleeding.

Valerie, the resistance you experience right as you insert the dilator is in fact a ring of muscles. Those are the muscles that gave me a lot of resistance until I found the current position that I am using now. I prop up a few pillows on my bed, and dilate while at about a 30 degree angle, and my legs slightly apart and bent about 45 degrees. This seems to be ideal and allows for the most effortless insertion of my dilators.

How do you know you've gone as far as you can go?
Post Merge: July 10, 2010, 06:42:45 AM

How do you know you've gone as far as you can go?

Oh well.  I guess I'll find out soon enough.  Thanks for your help 

[K8]

How do you know you've gone as far as you can go?

I can tell when I get to the end – it no longer feels like it's trying to squeeze through but is bouncing off resilient tissue at the end.

Katgirl, I lie on my back with my upper back and head supported by a couple of pillows.  My legs are spread about 45 degrees.  Sometimes to ease it past that middle ring of tissue I raise my pelvis up to angle it more.  I've always been able to ease it in gradually, achieving full depth during the first minute.  I have never tried another position, but this one seems to work for me.

I haven't had any bleeding or spots of other stuff on the dilator since about the second or third week. 

I guess we're all built a little differently and we each have to find what works for us.

- Kate

[FairyGirl]

dilator #4?? I'm still on #2 but plan to start on #3 in a few days. I'm only one week and 2 days into dilating so far. It seems the last inch or so in is very stretchy, almost like it's rubber in there lol But you can definitely tell when you "hit bottom". There is also the pelvic bone in there a couple inches in which you have to get under. I start at a steeper angle and then angle it more upwards toward my belly button once I'm past that front area. In the beginning when things are healing it's a bit tight and sore, but it gets better every day.