Susan's Place Transgender Resources

As I said in my intro I'm Getting my penectomy with Dr. Arnkoff tomorrow (Thursday), There have been some changes to his procedure since the last user reported on this site. I'll try to keep a daily log as we go along.

For those wondering why the orchi (done two years ago) and the penectomy instead of a full monty SRS. The answer is simple, age & money, there simply isn't enough of either or the inclination for anything else, as much as I'd like. Read my intro for more.

Day 1, meet Dr. Arnkoff.

I arrived at his office in Farmington Hills, Mi. Nice facility which he shares with other Doctors and a large medical group.

He has all the professional Medical degrees on his wall and is highly qualified as a urologist and surgeon, so no issues there. He is really nice and we spoke about my needs, why I was there and about the surgery.
The cost without orchi has changed and is now $6,500, $8,500 with orchi.

Orchi's alone are still done at his office , not requiring a letter, using Local anesthetic, however Penectomy's are done at the Birmingham Cosmetic Surgery Center, In Southfield Mi, about 6 miles from the Doc's office. Their charge is $1,850 for that facility. I think there might also be a charge for the anesthesiologist as they use general anesthesia for that surgery.
Additionally, the surgery center requires a therapist letter (As they all do these days) But Doc Arnkoff arranged that for me in the building for $300. A very good counseling session and worth every penny. 

The doc gave my Scripts for pain killers, antibiotics and, in my case, some Ambien for sleep. Much appreciated.

And we were done, Part 2 Tomorrow.

Leslie 

So exciting! I'll be there with you in spirit, Leslie! Keep us updated.

Hugs, Devlyn

Hello  again all,
Arrived at the Birmingham Cosmetic Surgery center at 0700 and was shown right in. Really Nice staff, efficient, quick paperwork with a lot of humor. I changed out of my blouse and long skirt (I thought the long skirt was better than tight pants.)Doc came in and told me what was going to happen and to expect quite a lot of light oozing and bleeding, apparently this area is quite vascular. At this point I was getting very relaxed, something in the IV I suppose. They took me into the operating room and set me up with my arms on rests and my feet in stirrups and all splayed out. The nurse started telling me a joke the end of which I didn't hear.

The next thing that happened  was my SO was talking to me and it took a few moments for me to realize it was over. I asked her if it was done to completion and she said it was, I was elated and began crying tears of joy. The nurse asked if I was in pain and my SO told her It was a joyful cry. I think the nurses were touched by that, they were all young and I suspected they'd never experienced this before because I'd be willing to bet most of us on the forum would cry too.

They bundled me into a wheelchair and loaded me in the SUV (Thank goodness for a vehicle with a big door.)
at this stage of things I haven't felt any pain whatsoever with exception of the discomfort of the catheter in my new urethra  location and my bladder. The last time I had one the bag was a real PITA because you had to hand carry the darn thing. But the newer ones have a smaller bag that mounts nicely to the inside of your leg. They also have a drain valve which allows a 24' hose which makes draining dramatically easier. I can empty standing up next to the toilet.

As i write this I'm lying in the hotel bed still bleeding and oozing but the Doc said to expect that. I'm still in no pain but I started Norco (Hydrocodone) as soon as we got back to the hotel.

I have looked several times and when I do I see the P and S gone I start tearing up again - I wish I had done this many years ago instead of being poisoned by T and ruled by the second head.

I'll do part 3 tomorrow after the doc sees me and changes the dressing, only minor swelling so far.

Stay tuned.

Leslie

Big hug! Congratulations, Leslie. Definitely don't want pants on a day like this. Glad you are sharing your experience with us.

Hugs, Devlyn

Saw the Doc this AM and he was pleased, not a lot of swelling and minor oozing which should stop today. We could have left today but the area is too sensitive to the road bumps so we'll try Monday afternoon, the Doc said great and he'd see me for one last time before we pull out.

Last night was well controlled by Norco but finding a comfortable position was hard And I ended up on my back all night icing and replacing the pads due to oozing. Normally they put in a drain tube to handle that but this is usually removed several days later and that would have kept us in town too long. Dressing is off and I can shower this afternoon.

I can't begin to convey how wonderful it is to see my new look, my only regret is that I waited so long to do it. I now officially have zero male parts, internally or externally.

Updates to come!

Leslie

QuoteI can't begin to convey how wonderful it is to see my new look, my only regret is that I waited so long to do it. I now officially have zero male parts, internally or externally.

Prostate?

That's really poor form, Anne.  :-\

Congrats on the new you! Best wishes for a speedy recovery and resumption of activities.

Prostate was the cancer, it's gone too.

L

Really good it's gone then.

BTW, Dev, my question wasn't intended to be poor form.  Sometimes the prostate is removed as part of the penectomy, because it can cause problems, including cancer, as Leslie had.  As I have mentioned here, I am currently getting care for BPH.  One of the things I'll be discussing with the urologist next month is whether surgery might be warranted..  So, if it has to come out anyway, and you're getting a penectomy, why not get both done at the same time?

Anne, My BPH eventually led to a PSA which was only mildly elevated at 6. Because when previously tested it was only a 2 the Doc decided a biopsy was needed. That came back at a terrible Gleason of 9 and we discussed options. I wanted a Radical Prostatectomy with castration which raised some eyebrows in the room. After more discussion my opinion won out. Obviously I didn't share my REAL reason for this disused treatment. As it turned out they found a single Cancer cell in my lymph nodes which made them go ahead with the Castration right then. After some months I convinced them to give me HRT too (Estrogen is often used as a T replacement in cancer patients.) I didn't have the balls ( ;D) to ask for the Penectomy at the same time. So far PSA remains undetectable but I have no illusions about the future, hence the decision to forgo the full monte SRS.

This afternoon the swelling is up and painful but the oozing is almost stopped.

Leslie

Quote from: AnneK on September 22, 2017, 01:51:38 PM
Really good it's gone then.

BTW, Dev, my question wasn't intended to be poor form.  Sometimes the prostate is removed as part of the penectomy, because it can cause problems, including cancer, as Leslie had.  As I have mentioned here, I am currently getting care for BPH.  One of the things I'll be discussing with the urologist next month is whether surgery might be warranted..  So, if it has to come out anyway, and you're getting a penectomy, why not get both done at the same time?

Ah. Well, certainly you can see  how your single word post could be read more than one way.

QuoteAnne, My BPH eventually led to a PSA which was only mildly elevated at 6.

My PSA tests also came back OK, but ultrasound showed my prostate was about 3x normal size and it also caused problems for my bladder (I had a cystoscopy a couple of weeks ago.).  While I really would like certain surgery, I most certainly don't want it for cancer.

I didn't look at Anne's prostrate question as poor form, I was curious myself. Cancer certainly explains it but geez, that's really tough. Wish I could make that same claim but not getting there that way. Thanks for posting your experiences Leslie, very interesting.

Latest update,

Well, this has certainly been an experience. Bleeding and oozing finally stopped and swelling is about the same. I slept all night last night, which was a first. However, because I did sleep all night I missed three doses of pain meds and discovered it takes a lot longer to get rid of the pain once it sets in.

I've read here and elsewhere about phantom sensations and I noticed that today. Feelings for stuff that isn't there, kind of an itch you can't scratch.

Last doc appointment is tomorrow and then we'll head down the highway for home. I can't sit down straight so have to lean the seat all the way back. We'll see how that goes after two six hour days. I am really looking forward to being in my own bed. Hotels are not the ideal place to recover.

On a pain scale I'd say the worst I've experienced has been a 5/10. Prostate surgery/recovery was way worse.

Leslie

Since you are graciously informing and I am now curious, I will ask this question. Do they have to angle the urethra in any way to accommodate peeing angle ? I am thinking it might be an issue peeing forward.
Moni

It is relocated to a different location further down, downward and slightly forward angle.

L

Love the avatar picture, pretty lady.  :-*

Hugs, Devlyn

Made it home and the trip was very difficult. Couldn't really sit down and laying down caused me to start bleeding for some reason. Two seven hour days. The pain is about the same and seems to be concentrated in the area of the new urethral opening. BM's are TOUGH! Seven days since the operation and the swelling overall is down but the stitches in the urethral opening area are very sensitive. especially when I get up or down. The catheter is a Real PITA  ::) and I'll be happy when I get rid of it in two weeks.

Thanks everybody!

Leslie

Congratulations and be well!

Big hug! I assume we're in agreement that these procedures feel like a kick in the crotch?  :)

Speedy healing!

Hugs, Devlyn

That would certainly be one way to describe it. Another might be shark attack!
All kidding aside though, I'm glad this resource exists so we all have an idea of various ways one could experience the surgeries. Some have breezed through it but my guess is it's probably painful to varying degrees for everybody.

Leslie

Hello miss leslie i have a question regarding the pricing. I'm planning an orchi with dr. Arnkoff in a couple of month. Do you happen to know how much the orchi it self cost.

Sorry, I don't. I got my Orchi done by Dr. Greenwald in Tampa $3,500. I recommend him although He might require a letter.

L

Hello all, latest update.
It's been a little over three weeks since the surgery. Still in a lot of pain around the site of the new urethra location although I was finally able to get off the oxys and just stick with Advil. Biggest problem is still sitting down, must use a doughnut. The catheter came out yesterday without problem, we did that ourselves following a youtube video. What a relief to be rid of that thing! Most of the stitches have either broken or fallen out although the remainder are very annoying because while the area where they're gone doesn't hurt much the last holdouts try to pull as the skin stretches. Probably another week should see those last few finally break (I hope).

Doc. Arnkoff took me off Estradiol a week before the surgery and because I'd already had the orchi I had no hormones and the hot flashes and other symptoms hit me kind of hard, although I restarted Hormones yesterday. ( I think Doc was concerned about blood clots)

A big issue that has arisen has been constipation caused by the pain meds. And going was a real adventure because in the course of a little too much straining to get things out it pushes on the surgical site and great pain ensues. Ouch! Still a good bit of leakage of urine since removing the catheter probably because of the catheter which we hope will abate soon. We're using panty liners for now.

I dressed fully today for the first time and even managed heels all day and felt really the best so far. I wake up feeling good but by late afternoon I start getting really tired.

Check back in a week or so, Cheers to all!

Leslie

Leslie, thank you so very much for posting your experience. Informative to say the least so please continue, there are those of us out here that truly do want hear more. I've considered what you are going through but not so sure now. My orchi was 17 days ago and I've kinda been rolling it around in my head ever since why I didn't at the same time have at least the scrotum removed. To late to worry over that now but I am following your posts with much interest. Congratulations on the new improved you.

Latest report, at 7 weeks now.

Still having at lot of sensitivity below and can't seem to find panties soft enough that I'm not really sore by day's end. Especially if I've done a lot of walking. Still can't wear tight fitting skinny jeans.

Other than that I'm semi back to normal and beginning to put a little weight back on. (Lost 20 pounds post surgery due to almost complete loss of appetite)

BMs are back to normal and for some reason I can't seem to get enough protein, always craving steak or hamburgers - very strange.

Rode bicycle and did ok so dragged out Harley and rode a few miles, seemed OK. Rode in a car for 5 hours and was sore as hell toward the end of that.

I can't say enough bad things about Oxy. I sure don't see why people crave it. Makes me feel like crap and I finally gave up on it because it made me so dizzy I couldn't drive. I sure never got any kind of buzz from it.

The post surgical pain could hit hard when I have my belt too tight so I'm guessing it'll be months before that resolves. The pain overall is about done. There are still some post-surgical bumps where the thing was and I really hope those go away because it sure affects the smoothness of the pubic area.

My SO says I'm a totally different person, more affectionate, WAY less angry (very calm, she says) I was able to go to the Veterans Administration Transgender group and managed OK in the hard chairs without the donut. Everybody was glad to have me back at group although I had everybody crying at one point. I have to say group is the situation where I am least self conscious.

More updates to come.

Leslie

Thanks for the update, Leslie. I wish you were doing better on the back to normal part. I still have a hard knot on one side of my orchi site after two months. Not large, but very firm and it also affects the smoothness on me.

Hugs, Devlyn