Susan's Place Transgender Resources

Hi everyone!

I'm having bottom surgery with Dr. McGinn in two days. I thought I'd leave this post here in case I want to leave any updates about what this whole process is like. I'll talk to you when I'm on the other side!

Yeah!!! So happy for you. Good luck!
Moni

Congratulations and best wishes for amazing results! 😊

We have a consultation with McGinn coming up in March for my spouse. We'd love to hear an account of your experience. As the caretaker, I'd especially like to hear about your experience getting to the hospital from the airport (if you're traveling to get there) and to her office after surgery. I'm trying to find the best option, especially for return trip. We live in the South and have to take a flight to get there. I'm hoping the long trip home wont cause any medical issues. I'm not sure if it's better to use the train system, a taxi, or to rent a car (my lease favorite option).  I wish Dr McGinn would take care of this part since we're paying so much money. Anyway, good luck with your journey and congrats.

I have never been there but you should add Super Shuttle to your list of options if it's available. I use it to take me from home to the airport and I find the costs are reasonable. It cost less than airport parking and they alway get me to the airport on time. You might need to share the ride with somebody else but there is plenty of room in the van.

Hi ShadowCharms. Hope you are doing ok after a successful surgery.

Hi everyone!

Sorry for my lack of posts. This recovery turned out to be a lot rougher than I expected it to be. I am now two and a half weeks post-op, and doing pretty well. I am back in my home state and staying with my mom while I recover some more.

For people wondering what it's like having surgery with Dr. McGinn, here are some of my experiences. My first impression of Dr. McGinn was that she had kind of a harsh, brash personality. That was okay with me, because I was going to her for her skills as a surgeon, and not for her to be warm toward me. Once I was actually there for surgery I felt like she warmed up quite a bit. She was very caring toward me during my recovery, and her staff was wonderful. I felt that Dr. McGinn was very, very competent and clearly focused on my wellness and my outcome.

Waking up from surgery was awful (I'm guessing no one is surprised by that). My first few days of recovery were spent in the hospital, and I was kind of astounded by how hard those few days were. I was in a lot of pain, and I basically could not move at all. I wasn't paralyzed or anything, it was just that it was painful to move, and clearly not a good idea. On day two of my hospital stay, the nurses informed me that my goal for the day was to stand up. That was it for the day - just stand up for like, 5 seconds. That was amazingly hard to do. I pushed myself a little harder and asked them if I could try to walk. They said I could walk a few steps, but that was it. I did it, and then immediately got back into bed and slept for a few hours. On day 3, my goal was to walk around the hospital ward. I did that, but man was it hard. Once I was able to walk unassisted, they were ready to release me from the hospital.

The first time I saw the result of the surgery, I have to admit that I was kind of horrified. Everything down there was just a mess of stitches and it looked like someone had punched a hole inside of me. It looked more like a wound than a vagina to me. I had kind of expected that, but it was still scary to see for real.

Once I had been released, my mom drove me back to the Gaia House. The staff there was absolutely wonderful - they were kind, helpful, and understanding. The place itself was quiet and peaceful, and really felt like the kind of place where you'd want to recover when you were in a lot of pain and very injured.

At first it was really hard for me to even get into and out of bed. I made a lot of really uncomfortable noises every time I tried to shift myself into a comfortable position. It was very rough at first. I struggled to sleep, and I woke up in pain every time. Part of the reason for this was probably because my mom and I decided to skip the Vicodin altogether and go directly to Tylenol. There's a history of addiction in my family, and every time I have surgery we try to get me off of the narcotic pain meds as fast as possible.

I had a few days at the Gaia House where I was in so much pain that it was just a matter of trying to get through the day one moment at a time. Oddly, these days seemed to come and go. I would have one day where I felt so good that my mom could leave me alone to go shopping in town, and then the next day I would feel so terrible that she was afraid to let me out of her sight.

I had my first post-op appointment a week after surgery. This was the first time they took the packing out of me and the first time I saw the full extent of the damage. To be honest, it was pretty scary. The inside of my vulva and the inside of my vagina both looked like a dark shade of purple to me, as if someone had just stabbed me and not sewn up the injury. I was expected to dilate for the first time. First Dr. McGinn's assistant showed me how to dilate, and then she had me do it. The sensation of it was like knowing I had a wound, and then intentionally shoving something inside of it. It was frightening and very unsettling, but it was over very quickly and I realized that I was okay.

Dr. McGinn's assistant had me hold a mirror up to my vulva while she spread them a little bit and showed me all of the different parts. Even in my wounded state, I could see that Dr. McGinn and her staff had done an excellent job. All of the parts you would expect were there, and looked pretty good. My clitoris looked especially fantastic, and was perfectly situated under the hood of the vulva.

Once I got back to the Gaia house, I began my dilation schedule. I was really afraid of my first dilation, but it really wasn't so bad. It was a little bit painful the first few times, but I quickly figured out that I could reduce that pain by being careful about the angle I used while inserting the dilator. There is still some pain at the very back of my vagina while I dilate, and usually after I finish there's some soreness for 15-30 minutes afterward. Otherwise, I mostly find the experience to be annoying and boring. I've taken Dr. McGinn's advice, and chosen a few TV shows that I will only watch while I am dilating. That helps me to make myself do it.

At my second post-op appointment a few days later, Dr. McGinn's assistant double checked that everything was healing alright. She confirmed that my depth was excellent at 6 inches, and gave me some additional instructions. Apparently some of the thickness of my incisions was actually a special glue they put over the incisions to keep them in place, and she informed me that it was okay to start scraping that off in the shower. She also took out an enormous q-tip, and told me that she needed to ensure that my clitoris had sensation. She poked it lightly, and I squeaked out a loud: "YEP!" My mom seemed extremely amused at that part.

Dr. McGinn's staff gave us a very formal looking letter stating that I had surgically transitioned, and that I met the legal requirements to change any documentation I needed to.

The next week or so after that was basically a blur of sleeping and gradually feeling the pain reduce. Eventually, getting out of bed went from being agonizing and scary to being a little annoying. I started taking short walks around the floor we were on once in a while.

When it was time to go home, my mom and I took it careful and slow. We checked out of the Gaia House a day before we were set to fly home, and stayed at the airport Marriott the night before our trip so I would be less at risk of a setback in my recovery. Even just the 30 minute drive to the Marriott exhausted me so much that I had to sleep once we got to our room.

The next day we took a shuttle over to the airport. Dr. McGinn had strongly advised me to use a wheelchair at the airport even if I felt well enough to walk, and so I did. I was wheeled to my gate, and wheeled onto the plane later. I was well enough that I took a short walk around our waiting area, mostly because it seemed to help with my discomfort to alternate between sitting and walking. For our trip home, my mom had bumped us up to first class so that I would have more room to be comfortable. It turned out to be a great idea, since I seemed to really need the leg room to get remotely comfortable. We were in the very first row, so I was able to actually press my feet up against a little wall for part of the flight and lean back considerably. Those two things ended up being very important in keeping me comfortable enough to tolerate the four hour flight. I also took two short walks around the plane, and stood briefly a few times. When we arrived, a wheelchair and airport employee were there to take me to baggage claim. I ended up feeling very grateful for that, because I'm not sure I could have walked that whole distance.

Once we got back to my mom's place, I basically felt like doing nothing but having dinner and sleeping. Even the following day, I basically slept the whole day. Even though I had barely walked on our trip home, I was totally wiped out. I must have slept for like, 16 hours total. I was barely awake enough to dilate.

At this point, I feel like I have healed considerably. I had my first day with no pain medication two days ago (2 weeks and 2 days after surgery). I'm starting to recognize the outcome of the surgery as more than just a wound. The incisions are healing nicely, and the color inside of both the vulva and the vagina has changed from purple to my normal skin color. Dilation is still uncomfortable, but it's less painful than it was. More and more, I look at the results as being a normal part of my body.

Personally, I am not quite sure what to think of my surgical outcome so far. I have never seen a cisgender woman's vagina in person, but I have seen pictures. The labia look pretty good to me and the vulva fully hoods the clitoris. Right now, I also interpret everything as being set pretty deep inside me. Even the urethra seems to be set deeper than I would have expected based on pictures I had seen of other surgical results. I notice that my vulva tend to remain slightly open any time my legs are spread apart, and I don't know if that is how it works in cisgender women. The labia minora do fully surround the vagina, which I am happy about.

Overall, I am happy with McGinn's work. I think there are some differences between what I'm seeing and what cisgender women have, but I think she did a good job. My mom has seen the results in both of my post-op appointments, and she says that she is amazed at how close it looks to the real thing. I guess she would probably know better than I do, since I have not seen the real thing.

I am scheduled for another post-op visit with Dr. McGinn 6 weeks after surgery. My mom and I plan to fly back to New Hope for two days to have that visit. Until then, Dr. McGinn's orders are bed rest and only very short walks as I can tolerate them. I am not even really supposed to be sitting up in bed as often as I am, but it's hard to lay down for weeks on end. I am trying to dilate 5 times a day as requested, but I have slipped a few times due to sleeping too much.

I'll keep everyone updated on my recovery as I progress.

Quote from: marctravis on February 05, 2017, 08:51:18 PM
We have a consultation with McGinn coming up in March for my spouse. We'd love to hear an account of your experience. As the caretaker, I'd especially like to hear about your experience getting to the hospital from the airport (if you're traveling to get there) and to her office after surgery. I'm trying to find the best option, especially for return trip. We live in the South and have to take a flight to get there. I'm hoping the long trip home wont cause any medical issues. I'm not sure if it's better to use the train system, a taxi, or to rent a car (my lease favorite option).  I wish Dr McGinn would take care of this part since we're paying so much money. Anyway, good luck with your journey and congrats.

The way we dealt with hotels and travel was by renting a car, and then using a hotel close to wherever we needed to be at the time. Prior to my surgery, we stayed at a hotel right near the hospital. My mom kept that room during my hospital stay so she could take showers and sleep in a bed. It turned out that the hospital gave me a room with an extra bed for a guest, and so my mom mostly slept in the room with me. She did appreciate having the hotel nearby for showers, storing our luggage, and just getting away from the hospital once in a while.

After my surgery we stayed at the Gaia House. Originally our plan had been that my mom would drive to the Gaia House and check us in the day before I was to be released from the hospital, but ultimately we decided that we didn't like that plan. With a bed in the hospital and me in pretty rough shape, my mom really wanted to be there until it was time for me to go with her to the Gaia House. The people running the Gaia House were nice enough to let us alter our reservation by one day so we didn't have to pay for time when we weren't staying there.

We were able to make the drive directly from the hospital to the Gaia House. My mom loaded our luggage up into the car while I was in the hospital, and then when I was released, we just drove right to New Hope. I would say that was about a 30 minute drive. I was very, very uncomfortable, but we managed.

At the Gaia House, my mom and I had booked two adjoining rooms. That ended up working out great. It allowed us to close the door when she was ready to sleep and I still needed to dilate, or when I needed to sleep and she wanted to watch TV, or even just when we had had enough of each other. I think trying to both sleep in the same bed while I was recovering would have been a total disaster. I really needed a full bed to move around and deal with my discomfort. Having the two rooms connected kind of felt like having a suite, which I think we needed given how difficult my recovery was.

For the final leg of our trip, we booked a room at the Airport Marriott the night before we were to fly out. That allowed us to split up our trip back over two days, which ended up being extremely helpful. The Airport Marriott had a nice restaurant inside of it, which made it very easy to get food and rest both after our drive there and before our flight home.

I would say that a rental car is probably the best option to go with for travel. New Hope is quite far from the Philadelphia airport. I think it might be as much as an hour drive even without traffic. It's basically a completely separate town from Philadelphia, rather than a suburb. I found navigating relatively easy, because most of our travel consisted of one highway and a few small roads we needed to memorize. We drove from our hotel to the hospital twice before the day of my surgery, and from the hospital to the Gaia House as well to make sure we knew how to get there. Once we had it memorized, it was pretty easy.

Wow.  Thanks for the update, Shadow.  Sounds like this is going to be even worse than FFS.  I didn't think that was possible.  I was undermedicated for pain management then, but that was not by design, and I don't intend to let it happen again.

Anyway, congratulations on making it through!

With kindness,

Terri

I'm still finding it hard to decide whether this was worse than FFS. I think FFS was actually worse psychologically for me, because there's just something about having a major injury to your head that's scary. This was scarier than I expected, but it didn't feel as personal or quite as vulnerable as FFS did in terms of the injury. I think the pain from this was worse than FFS, but not by a whole lot. This surgery is exacerbated by the fact that you have to be able to move the areas that are injured, as well as dilate them. My FFS was mostly a matter of just tolerating discomfort until I healed. Ultimately, I'd say that they're about comparable in difficulty.

I would note though, that Dr. McGinn has herself been through both FFS and GRS (she even went to the same facial surgeon as I did), and she told me that her opinion is that this one is worse than FFS.

One other thing I would point out is that this was my fourth surgery (three of them being transition related), and I had learned a few things from experience that I applied to this surgery, and which I think helped considerably. One of the most important things I learned is how important bowel prep is prior to surgery. I started taking colace, metamucil, and drinking prune juice a week before surgery. Dr. McGinn doesn't expect a patient to need to poop until about a week after surgery, but in my case I started doing it while I was still in the hospital. Thanks to my preparations ahead of time, it was painless and doing it actually relieved some discomfort at the surgical site (probably pressure on the vagina from the colon). I would recommend that anyone who's going to have this surgery start doing bowel prep 1-2 weeks before surgery. For me, it probably saved me a huge amount of discomfort and some potential complications.

I don't plan on ever having surgery again without starting bowel prep at least a week in advance.

Another thing my mom and I learned from experience prior to this surgery was the importance of staying hydrated while recovering. She and I had me pushing water pretty much non-stop during my recovery, and I think it made a difference. Dr. McGinn's assistant remarked during both of my post-op appointments that I was healing quickly, and I think our attention to my water intake was a big part of that. Hydration will, of course also help avoid any problems using the restroom which are very important with this surgery in particular. You don't want to be pushing at all when you poop, because a lot of the incisions are right next to the colon.

I had also learned from experience to take Vitamin C supplements starting before surgery. I started taking them a month before surgery, and continued taking them throughout my recovery. When I had facial surgery, my surgeon told me that taking Vitamin C increases your healing speed, and now I take them any time I have surgery.

Thank you ShadowCharms for the very detailed description of your experience. It's really very helpful. I'm thinking our experience will be similar bc our flight will be around 4 hours too. Would love to be able to afford first class. I'm glad you mentioned staying at the airport hotel before your flight. I was considering doing the same thing. I'm not looking forward to my spouse being in pain but I guess it's unavoidable. I also didn't realize we had to go back for a follow up appointment.  It's good to know. Congrats on your good results. Keep us updated if you have the time.

Hi Shadow,

Congratulations :)  Did you get your pendant? I love mine. 

I went to Dr. McGinn too and had GCS 11/15/2016. You mentioned no labia minora. I too have no labia minora. I was wondering if that is typical? I see Dr. McGin 5/15/12017 and I was planning on asking her if it was possible to make the labia minora and the cost. Any information would be appreciated.

From what I understand, Dr. McGinn does offer a procedure called a "Labiaplasty". I believe that that procedure has to be done after the patient has fully recovered from the original surgery, and is intended to improve the appearance of the vulva. It's quite possible that that procedure could have the result you're looking for. You can read more about it here: http://www.drchristinemcginn.com/services/srs/labiaplasty.php

It also occurs to me to note that while I still had the catheter in, I started to notice that I was peeing around it sometimes on the toilet. I had read on these forums that other people had experienced that, and that their doctors had told them that it was a sign that they were healing, so I didn't worry about it; I just let it happen, and made a note to ask my surgeon about it. I mentioned it to my surgeon's assistant, and she confirmed that it's a sign that your swelling is going down quickly. I figured I would mention that in case it happens to anyone else during their recovery.

I had expected to possibly have some problems with not being able to control when I peed (peeing myself), and I did not have that problem at all. I seem to have no trouble at all controlling when I pee. I had thought there might be some kind of learning curve involved in that, but it just came completely naturally.

Hi Shadow! Just wanted to see how you are doing. I hope everything is going ok for you. We have scheduled my spouses surgery for the end of May with Mcginn. Our consultation went well. We really like the doc. Very nice lady. Just trying to fill out all the forms and get all the prerequisites completed. It's a lot. I just wish we had insurance for these procedures.

Anyway. Take care and if you feel up to it let us know how you're doing.

I'm doing pretty well now. The pain is gone, and the random twinges of sensation are decreasing in frequency. My energy and focus are slowly returning. I am scheduled to go back and visit Dr. McGinn in a few days for my 6 week follow up.

I had my first gynecological appointment today. I have been getting my hormones though a local women's health center. They are very trans friendly, and have basically adapted their practices to include trans people in every way. I saw my doctor mostly just so she could get a baseline on my healing and surgery results, and so we could plan out our next steps with hormones. My doctor (who is also a gynecologist and works with cis women) thought everything looked great. I think she was impressed with Dr. McGinn's work.

At this point, I think I just need to keep on letting myself heal. All I need now is time.

I want to amend one thing about the lengthy post I made a few weeks ago on what it's like to work with Dr. McGinn. I had suggested that I didn't think I had labia minora. I have since realized that I was mistaken. I was just misunderstanding what I was supposed to see because I haven't had any experience seeing the real thing. I looked over some diagrams again, and realized that I do have labia minora. I was just confused about what they were supposed to look like. I also double checked that with my hormone doctor/gynecologist during our visit today. She looked, and confirmed that I do have labia minora.

I am increasingly happy with the visual and functional outcome of my surgery. I have always been a skeptic as to whether this surgery would be "enough" for me, and I have to say that I am quite satisfied. It is a very impressive surgery, and the more I heal, the more confident I feel that it will be what I need throughout the rest of my life.

That's great news, I'm glad for you (I'd missed your first long post-op post).

I'll be having the procedure with Heidi Wittenberg in 6 weeks and butterflies are already accumulated in my stomach. I've had 3 surgeries, two orthopedic and one hernia repair in the lower abdomen. I know the worst anticipation I have is for the coming out of anesthesia period, that couple of hours always feels like a week of agony.

And all that aside, I'm really psyched to finish this major bit of my transition.

Hi Shadow! I'm glad you're doing well. And that you found a good GYNO. That's going to be a challenge for us where we live. We're gonna try to find one before we leave for the surgery. It's all very overwhelming right now. So many forms to fill out and tests to take in a short amount of time. But it's comforting to hear how your experience is positive. I'm hoping the best for you. And thanks for sharing your story.

Hi ShadowCharms, thank you so much for your post-op description of surgery with McGinn, and also your pre-op tips!  My daughter is scheduled for surgery with McGinn in a few weeks, so it's always nice to read a recent experience.

As a mom and caregiver, of course my concerns are different to those of my daughter.  I was wondering if your mom would be interested in giving her perspective and any tips she might have for me, and other caregivers such as @marctravis.

It was interesting that there was a bed for your mom in your hospital room.  I'm wondering if I'm going to wind up doing that, or staying at the hotel (close to the hospital) for those few days.  What was the deciding factor for your mom to stay at the hospital?  Did she have anything to do with actually taking care of you physically, or did the hospital staff do that?  Did you *want* her in your room all that time, or did you want some privacy?

After release from the hospital we're not staying at Gaia, as it's out of our budget for two rooms.  We found a hotel about 30 minutes away where I've booked us a room with 2 queen beds, plus a fridge and microwave and free breakfast.

My mom seems pretty open to communicating with other caregivers. We met a few other moms who were there with their daughters, and they all kind of formed a mini support group for each other over text messages. If one of their kids was having a problem, they would text the others to see if their daughters were having the same problem. I think my mom would probably be open to communicating with you prior to your daughter's surgery, but I will double check with her.

We didn't expect the hospital to have a bed for my mom. When I had my facial surgery, the hospital pretty much just gave my mom an uncomfortable chair to sleep in. We had a hotel room near the hospital based on our assumption that my mom would need to go back there to sleep. When we realized that my mom could sleep at the hospital, she just decided to do that. I think she just wanted to be close by.

Our initial perception had been that I would need a lot of care from my mom in the hospital. When I had my facial surgery, my mom basically did more to take care of me than he nurses did. She was constantly getting ice packs for me and stuff like that. This time around, my mom didn't have nearly as much to do. With this surgery, the hospital stay is pretty much just a matter of putting up with pain and waiting it out. My mom did help with a lot of things like contacting nurses when I was too tired and weak to, getting water for me (I couldn't even get out of bed on my own), and just providing moral support. However, there were a lot of times when my mom was free to go do something else; she would go have coffee downstairs, or drive back to the hotel to have some time for herself, or take a walk. In a lot of cases, there were long stretches of time when my mom was free to do whatever she wanted to. Ultimately, her decision to stay at the hospital was largely out of a desire to be there with me.

I didn't mind my mom being in the room at all. Our hospital room was huge. I felt like I had plenty of my own space, especially given that I couldn't move more than a few inches in either direction. It was really nice to have my mom in the room for moral support, and also to communicate with the nurses when I couldn't muster the energy to contact them.

One thing I needed a lot of help with from my mom was getting things I couldn't reach. I literally could not reach my bag even if it was on the floor next to me. If my cell phone (which I used a lot to distract myself) came unplugged, there was nothing I could do about it. The nurses were kind and helpful, but they were also helping people who were dealing with real problems like extreme pain and bleeding - they could not be expected to come fix my phone cord for me right away if it came unplugged. I could potentially have gone for an hour without help if the nurses had a real problem to deal with and my mom had not been there.

The bed my mom had looked pretty big. It was not a hospital bed, but rather a pull out couch. It was still helpful for us to have a hotel room though, because sometimes my mom just really needed to get out of the hospital for her own sanity. There was a shower in the bathroom attached to our hospital room, but my mom preferred to go back to the hotel and just get away for a little while. Our way of handling things was that we would make sure I had my phone next to me and charged before she left, and then I could call her if I really needed her. Our hotel was only about 12 minutes away by car, so it was easy for her to get back if I needed her. It basically gave her the freedom to get some air while still knowing I was okay.