Dilation routines

[Buggy-pie]

Still havent got my prescription yet, hopefully it will be with the GP tomorrow as i will be there for my bloods anyway, would like to get started with it now i know its recommended.

The tenderness has lessened however, perhaps by dropping to 2x a day now or coincidence.

Something i should has asked when at CHx was when do i try 1x per day?  Their literature suggests within 6- 9 months most patients are down to 1x per week, Dr Thomas said in person i should be to 1x to 2x per week within 12 months.  Pretty much the same info said in differant ways as you would expect from a team.

So, if at 8 weeks (2 months) one should try 2x per day then something fantastic has to happen to have the potential at 6 months to be at 1x per WEEK. At 3 months i could try 1x per week but then that means at start of month 4 there is only 8 weeks left to reduce it from daily to weekly!  Doesnt seem right.

I'll ask the CHx nurse their official stepping routine but am intrigued how others have stepped down to longer intervals and what the signs of success or time to try are.

Ta

Nat

[K8]

Bowers' routine is 3x per day for the first 3 months, 2x per day for the next 3  months, and then 1x per day until 1 year.  At 11 1/2 months I've dropped to every other day and am having no trouble.  Around 11 months all of a sudden it felt like everything was going to stay put, so I became more relaxed in the routine.  As Valerie said, if you do it less and each time is easy, then you don't need to do more.  If each time is a bit of a struggle, then don't do it any less.

It will get easier eventually.

- Kate

[NikkiJ]

I couldn't tell it helped a lot either and quit using it after a while. The lanolin cream had a better effect.
Good luck with your knee

Thanks Fairy Girl! I saw my Doctor the day before yesterday, and learned I have a torn medial meniscus in my right knee. I go and see the same orthopedist that fixed my broken hand in 2004 tomorrow to see what he says about it.

My Doctor performed my first speculum exam on me, and apparently there is some granulation tissue that is probably causing friction when I dilate. She took a culture too. She's going to talk with my surgeon's nurse so they can coordinate treatment, as I'm my local doctor's first TS patient, but she's very good. It was funny, my dr. and nurse and I were in the room with the table with the stirrups, and my dr. said "So, you've done this before..." "No, this is my first time!" Nurse: "We should get T-shirts!" They get me into position: Dr "So, here's the clear speculum, I put this light inside it..." Me: "Cool!" Nurse: "Most patients aren't this thrilled!" me: "It's a rite of passage." Nurse "Are you going to Facebook it?" LOL, love my dr and staff

[Buggy-pie]

Hi,

Ah, speculum! I nievely thought it was forceps but yes, sounds the same device as i experienced at my 8 week checkup.

Still waiting for my prescription, apparently my GP has it now so expect to collect tomorrow.  The letter writer at CHx was off last week hence the backlog.

I spoke with the nurse at CHx today (she mentioned a word like speculum bit i didnt quite get it until i read the previous post) to discuss dilating and she advised that i should try reducing the frequency every 4 weeks to see how it goes.  If its difficult at the next session then resume the previous frequency for another 4 weeks .

Apparently i should know very quick if my body cant cope, for example, at present within 24 hours.  Not too sure on this as yesterday i dilated 3x and again today, this is following an 8 day period of doing 2x  since the last 3x routine.  This might be required simply because i want this cream so the granulation soreness can go away as i hav felt more sore the last few days and a bit swollen.  Its possible if i wasnt so sore that i would have been ok to stay at 2x but i dont want to risk staying at 2x, having the cream and then finding it wasnt related and i need to go back to 3x and am back to work.

Hopefully i can let you know the name of the cream tomorrow, finally!

Nat

[missyzanta]

I am curious.  I have been on this site since my surgery last may and all of the problems I have seen have been with other dr's besides dr. bowers.  I have had NOT A ONE problem since my surgery and I stopped dilating in OCTOBER and hadnt since until i read this post a week ago out of fear.  The dilator went RIGHT IN all the way to the bottom with no hesitation whatsoever.  I stopped dilating on a regular my 3rd mth BUT, i was having sex daily. 

I was wondering is it the Dr or is it more the patient in their dilation schedule?  Not blaming the person who started this thread but do most who are successful with dilation feel that SOME people just didnt do it properly and it isnt the dr?  Also are there any horror stories from Dr Bowers patients? I havent read any.

[Buggy-pie]

Hi,

I wouldnt say i have reported I have had any problems with dilating (I initiated the thread), but i asked how others went about reducing their dilation frequencies.  I originally mentioned 3x a day and how it drops over time because i was reading the literature i was provided by CHx and didnt know when to judge enough time had been done at one stage before moving on to the next.

I spoke with the nurse today and she explained how everyone is differant and that the first 2 - 3 months are the most important, after that simply try reducing the freqency at 4 week intervals to find your 'happy place'.  For some this will be in months and some up to a year, guess you are one of the fortunate ones, perhaps an age consideration, and daily sex and just body type.  Foe example, in all, the whole process for me has been something as uncomfortable as a night on a big drinking session, hangovers have been far worse for me so by and large, this has been nothing.  Yet for some, this can be agony.

With regards to the negative bit i have mentioned, its a normal expectation to have some granulation.  I also try to write in degrees, ie i feel sore but at the mo i also have a couple of grazes on my inner thigh, they are worse and make me feel uncofmortable, but as the thread is anout the post op dilation process i mentioned the soreness as it may help others another time.  I have mentioned the granulation cause my Dr did to me and gave the soreness a name (granulation). i have grumbles at having to wait for the cream and am impatient now i know i can do something about this to make it go away, otherwise i just thought it was normal at this stage of healing

I dont think i have lost any depth, just the swollen parts are less swollen, i still have over 5 inches but less than 6 so am happy with that.

Hard to say about dilation routines in other patients.  It appears that the Dr's have their own routines so mine would be of relevance to CHx patients but it has been interesting see how it compares to others.  I guess i have to follow the one provided to me so that if i have any problems then i do have a 'warrenty' heh heh.

Nat

[Buggy-pie]

Hi,

Yay, ok, have the cream and have just used it, not worked yet heh.

Its called Betamethasone Valerate cream, i have yet to read about it on the internet, my hound wants to go for a walkies.  Interestingly it says External Use only and not to put on genitals...um, well, its gone in those very same No No's heh heh.

Ta

Nat

[Buggy-pie]

Hi,

I have used the cream 3 times so far however, with the first dilation last night about 6 hours after 1st application i noticed an improvement.  I dont know if its the granulated tissue causing swelling or dryness through failed healing or if its the cream adding to lubrication but the first insertion slid in much easier than normal.  I have been having to reapply lube whilst easing it in previously since at 2x during initial opening up of the vagina.

What i have previously thought was sloughing seems to have slowed greatly too today so i guess this was part of the discharged material so can only be better as the next few days passes.  Been hard to say whats normal as never been here before so is enlightening.

Nat

[FairyGirl]

skin sloughing will continue for some time as the skin readjusts itself to its new environment and literally becomes inside vagina skin. I still have a bit of it going on at almost 10 months. My internal skin however has become somewhat self-lubricating at this point so that I can now insert my first dilator to full depth without applying any additional lubrication. Hopefully this is a trend

[Debra]

Also are there any horror stories from Dr Bowers patients? I havent read any.

I've read some horror stories for every single surgeon including Dr. Bowers. It just shows how everyone's body is different and of course how each of us handles it.

I, myself went to Dr. Bowers a month ago and I had a bleeding complication on the 2nd day. She had to come in and add more stitches to staunch the bleeding. This in turn caused extra swelling such that when they took the catheter out, i couldn't pee. I had to literally hold my labia open to get it to come out. That being said, all of this has resulted in a very slow healing process for me plus I have some nasty granulation tissue on the floor of the vaginal opening. I still have swelling and in turn numbness at this point in time.

All that being said, even with my frustrations with how slow the healing process is going, Dr. Bowers has been nothing but helpful and there for me. And I'm just trying to be patient.

skin sloughing will continue for some time as the skin readjusts itself to its new environment and literally becomes inside vagina skin. I still have a bit of it going on at almost 10 months. My internal skin however has become somewhat self-lubricating at this point so that I can now insert my first dilator to full depth without applying any additional lubrication. Hopefully this is a trend

That's just awesome! I hope that happens for me!! =)

Hi,

Yay, ok, have the cream and have just used it, not worked yet heh.

Its called Betamethasone Valerate cream, i have yet to read about it on the internet, my hound wants to go for a walkies.  Interestingly it says External Use only and not to put on genitals...um, well, its gone in those very same No No's heh heh.

Ta

Nat

Sorry I missed where this was talked about in the thread, what is this cream for exactly?

[Buggy-pie]

Hi Debra,

My CHx surgeon, Dr Thomas, prescribed Betamethasone Valerate cream to aid my healing of granulation tissue within the vagina.

I have to use my finger to apply it inside after each dilation (offcially 2x daily)

I have had a lot less discharge today, a bit more late pm (i noticed as i changed my pad) which is probably as the cream is wearing off but overall less than usual throughout a day.

Nat

[NikkiJ]

Buuug, and others, I was tellling my physician about the Betamethasone Valerate cream this morning, as an alternate to the Premarin cream and she is open to that. Do you know the strength of the cream?

Much appreciated,
Nicole

P.S. I had my first internal silver nitrate treatment this a.m., and it didn't hurt at all. I'll have about 3 more of these treatments weekly.

[Buggy-pie]

Hi Nikki,

My cream is 0.1% w/w, i apply twice a day.

The silver nitrate will produce some brown sloughing, mine lasted 24 hours i think.

Good luck!

Nat

[Siren]

I had the Silver Nitrate treatments, hurt like **** and didn't work at all!

I have just today got the Betamethasone Valerate cream (thanks Nat!) so hopefully it will help.

[Debra]

I'm not looking forward to Silver Nitrate =/

[Buggy-pie]

Oh i wouldnt dread it. 

I havent had a lot treated with silver nitrate, just one line about an inch and half long but didnt hurt at all.  Dr Thomas pointed it out at the 8 week checkup, showing me with a mirror and drew along the area and that was that. 

On the way home on the train i needed the loo and noticed the brown sloughing, not entirely realizing the cause if i'm honest until later.  I recalled a bit of stinging every once in a while but had put it down to the seat i was in on the train, it felt like nothing more than a pinch or a snagged hair, nothing eeky.

Nat

[NikkiJ]

Hi Nikki,

My cream is 0.1% w/w, i apply twice a day.

The silver nitrate will produce some brown sloughing, mine lasted 24 hours i think.

Good luck!

Nat

Thanks Nat!
Wh

[NikkiJ]

Just to update, the silver nitrate treatment didn't hurt a bit, and I get my second one tomorrow. The Betamethasone Cream is helping too, I'm sure. I stopped bleeding after dilation already, and dilation has become a bit easier now.

Thanks everyone!!!

[Debra]

Just to update, the silver nitrate treatment didn't hurt a bit, and I get my second one tomorrow. The Betamethasone Cream is helping too, I'm sure. I stopped bleeding after dilation already, and dilation has become a bit easier now.

Thanks everyone!!!

Great thanks! Good to know =) I have my first treatment from my family doctor on Wednesday. I have a lot of granulation tissue on the lower part of the vaginal opening though. I need to ask about the Betamethasone Cream too.

[NikkiJ]

Great thanks! Good to know =) I have my first treatment from my family doctor on Wednesday. I have a lot of granulation tissue on the lower part of the vaginal opening though. I need to ask about the Betamethasone Cream too.

Hi Debra!

The second silver nitrite treatment went well, and my doctor thinks maybe only one more is in order, which is tomorrow morning. My granulation is not very far in from the opening also. She gave me a plastic syringe about three inches long and about 3/4 of an inch wide with which to inject the Betamethasone Cream with, and it's not hard to insert, and can always be lubricated.

And, in other news, I'm having knee surgery on the 17th of May. I hope that stops my pain and limping!