Susan's Place Transgender Resources

Community Conversation => Transsexual talk => Post operative life => Topic started by: Sonoshee on August 06, 2018, 01:44:34 PM

Title: 6 months post-op, difficulty dilatng
Post by: Sonoshee on August 06, 2018, 01:44:34 PM
Hey, I'm just over 6 months post-op with Brassard. I've been having a difficult time dilating, I dilate twice a day and each session takes about 90 minutes because I need to insert the dilator extremely slowly or deal with extreme pain, even with ibuprofen. At 6 months I attempted to move to 1 dilation per day as my guide instructed, but after a few days I found it even more difficult and time consuming and only getting worse, so I returned to dilating twice a day. I'm also still having yellow, bad smelling discharge. I'm trying to see my doctor ASAP.

This really doesn't seem right and it's leaving me feeling discouraged and drained. It's like I'm stuck and things are not improving. I'd really love to hear if someone else was in a similar situation and things turned out to be okay.
Title: Re: 6 months post-op, difficulty dilatng
Post by: HappyMoni on August 06, 2018, 02:20:24 PM
Yes check out the discharge and pain. I started to lose some depth when going to once a day so I continued trying to do 2 for longer than they required. I think my thinking is the doctor gives general direction to all patients. I am the one who owns my vagina long after that doctor is out of my life. I will do whatever it takes to get a good result regardless of what the guideline is.  Don't get discouraged. You are still healing.
Moni
Welcome to the site, Sonoshee, glad you are here.
Title: Re: 6 months post-op, difficulty dilatng
Post by: sushi776 on August 14, 2018, 11:22:08 AM
I'm experiencing the exact same problem other than my surgeon being Dr Chettawut. seems to have some residual hair inside as well. removed more than 5 strands recently. supposedly all hair follicles are supposed to be removed prior to using the skin graft (my vagina is constructed from groin skin graft + scrotal skin graft). but there's a chance he missed out. saw him today for a follow up as I happened to be in Thailand but he denied having any possibility of missed out follicles.

so yes I have difficulty dilating. used to hurt as hell and depended on tramadol + paracetamol, but I tried to go off it. now not using any painkillers but I try to dilate just like that. used to take 30mins to insert. have smelly discharge and a visit to the gynae showed likely infection. now I take like 10mins to insert via deliberately trying to open up my PC muscles (exert a little like I'm pooping or peeing) and using good silicone lube.

I have 5 dilator sizes. used to go up a step but due to the problems it hurt and I literally hurt it. so went back to the first size. now about 5.5 months post op but I'm still on the first dilator size. and also dilating twice a day because 3x a day just doesn't fit into work life. need a bed to dilate in my case. since it's not easy insertion.

anyone have any idea if it's still possible to go up further sizes in future when my dilation is less troubling? my vagina, as said, is from groin and scrotal skin graft.
Title: Re: 6 months post-op, difficulty dilatng
Post by: Brenda80 on August 15, 2018, 06:01:20 PM
Quote from: sushi776 on August 14, 2018, 11:22:08 AM
I'm experiencing the exact same problem other than my surgeon being Dr Chettawut. seems to have some residual hair inside as well. removed more than 5 strands recently. supposedly all hair follicles are supposed to be removed prior to using the skin graft (my vagina is constructed from groin skin graft + scrotal skin graft). but there's a chance he missed out. saw him today for a follow up as I happened to be in Thailand but he denied having any possibility of missed out follicles.

so yes I have difficulty dilating. used to hurt as hell and depended on tramadol + paracetamol, but I tried to go off it. now not using any painkillers but I try to dilate just like that. used to take 30mins to insert. have smelly discharge and a visit to the gynae showed likely infection. now I take like 10mins to insert via deliberately trying to open up my PC muscles (exert a little like I'm pooping or peeing) and using good silicone lube.

I have 5 dilator sizes. used to go up a step but due to the problems it hurt and I literally hurt it. so went back to the first size. now about 5.5 months post op but I'm still on the first dilator size. and also dilating twice a day because 3x a day just doesn't fit into work life. need a bed to dilate in my case. since it's not easy insertion.

anyone have any idea if it's still possible to go up further sizes in future when my dilation is less troubling? my vagina, as said, is from groin and scrotal skin graft.

Hiya, well you got the surgery pretty close to mine as well under Chett.
I had mine in early April. Did the same using the skin graft.
Agree that the dilation is pretty taxing and taking most of the time including preparation and the process combined. I have cut to 2 times but lengthen each time by 50percent. It's tough especially working long hours meaning sleeping about 4hours a day barely to accommodate the schedule. But well it's a small price to pay for coming so far onto this journey.
Chett recommended to do this for 2 years and reducing to 3times a week thereafter. Perhaps then shall be a relief or rather the 3times can be replace by possibly a partner then? Heehee.
Ok anyway back to the dilation you were mentioning about, I am presently at the largest stent, I believe you referring to number 4 (starting from size 0). It takes sometime to accommodate till size 4. You need to gradually change to the next size after finishing the smaller size time allocated. I am puzzled is that I presume you are at size 1 stent and can't go further to size 2? Hmm, I guess the skin should be able to handle size 2 quite comfortably. Size 3 might be challenging due to the jump in size. (Took me awhile to get in initially) of course size 4 was even a notch more difficult than 3 without saying. Depth is my more concern aspect in my opinion as the frequency of reaching the depth varies each time sometimes reaching sometimes falling short by quarter inch.
Give it a try to go a size up to 2 once you done with 1 in the same session. What I discover is that you need to prep the dilation using a smaller one before able to accommodate the bigger one.... Presently I start with 2 progressively before going to 4 in the same session. So pertaining to your last question in your post, the answer base on my experience is yes. But have to be diligent thou. Once the skin has accommodated to stretch should not be an issue.
As to infection, well I have as well. Seen the gynae and she explain that it's due to the abrasion or rather friction of the dilation stent stretching and shoving in (Perhaps some twisting?). It happens near the entrance of the vaginal wall shaft. Is yours the same? My gynae gave me some antibiotics and ask to touch daily to kill the virus of the infection. For dilation she mentioned to use more lubricant and more gently (hmm...).

Good luck and hope all goes well for you ahead.
Title: Re: 6 months post-op, difficulty dilatng
Post by: sushi776 on August 22, 2018, 05:51:30 AM
hey, thanks very very much for the reply. I was cluelessly waiting for an email notification to inform me of a reply of some sort. but I decided I should just check in on here.

a bit confused regarding the possible numbering differences we might be referring to, but yes I'm on 0 right now and I was hoping to go up to 2 (3rd size). its a relief to hear your answer. that I could still possibly stretch it further in circumference being 6 months post op.

I don't think a partner can replace my dilation in future because I'm a lesbian. and fingers, while stuffing in a few at a time can mimic circumference, it can't mimic the length. haha. most people here have middle fingers maxing out at 3 inches.

i had a swab done by my gynae and diagnosed as group B streptococcus positive. I will have recurring infections from time to time. to which I need to be put in antibiotics. right now I'm trying to finish my course of antibiotics.
Title: Re: 6 months post-op, difficulty dilatng
Post by: Brenda80 on August 22, 2018, 03:27:28 PM
Hope you are doing ok on the infection. My gynae never do mentioned about the term of my infection to me, what he refers to is caused due to skin abrasion likely caused during the dilation process.
I think concern wise not so much about the circumference as skin natural properties should be able to accommodate stretching. How about depth wise you experiencing difficulty hitting the depth that chett mentioned to you that you should be able to achieve?
Once depth is lost its very hard to achieve back or nearly impossible after a period of time.
Title: Re: 6 months post-op, difficulty dilatng
Post by: sushi776 on August 25, 2018, 01:53:21 PM
Quote from: Brenda80 on August 22, 2018, 03:27:28 PM
Hope you are doing ok on the infection. My gynae never do mentioned about the term of my infection to me, what he refers to is caused due to skin abrasion likely caused during the dilation process.
I think concern wise not so much about the circumference as skin natural properties should be able to accommodate stretching. How about depth wise you experiencing difficulty hitting the depth that chett mentioned to you that you should be able to achieve?
Once depth is lost its very hard to achieve back or nearly impossible after a period of time.

I can only achieve 4" now. original depth is 5.5" (personal request during SRS consult not to make it too deep). originally I planned to hit 4" (after gradually letting it shorten) after a span of 2 years post op. but I'm already at 4" while being 0.5 year post op. I'm concerned. I'm at my target depth at 0.5 year post op instead of at 2 years post op. not sure if part of the missing 1.5" is blocked by a clump of discharge or hairball at the apex of the vagina.
Title: Re: 6 months post-op, difficulty dilatng
Post by: Dena on August 25, 2018, 04:10:08 PM
Quote from: sushi776 on August 25, 2018, 01:53:21 PM
I can only achieve 4" now. original depth is 5.5" (personal request during SRS consult not to make it too deep). originally I planned to hit 4" (after gradually letting it shorten) after a span of 2 years post op. but I'm already at 4" while being 0.5 year post op. I'm concerned. I'm at my target depth at 0.5 year post op instead of at 2 years post op. not sure if part of the missing 1.5" is blocked by a clump of discharge or hairball at the apex of the vagina.
Your overdue for an internal inspection which should have occurred at about 3 months. There could be improper healing or other  issues that should be checked out. Most issues can be handled in the office at the time of your appointment but without checking internally, it's anybodies guess as to what's going on.
Title: Re: 6 months post-op, difficulty dilatng
Post by: sushi776 on August 26, 2018, 03:38:11 AM
Quote from: Dena on August 25, 2018, 04:10:08 PM
Your overdue for an internal inspection which should have occurred at about 3 months. There could be improper healing or other  issues that should be checked out. Most issues can be handled in the office at the time of your appointment but without checking internally, it's anybodies guess as to what's going on.

I happened to have a casual overseas trip to Bangkok 2 weeks ago. Dr Chettawut inspected me again and said all is fine. However my local hospital gynae tested positive for group B streptococcus with discharge and hair in vagina with 2nd degree vaginismus.

Dr Chettawut used only long lubricated q tips to inspect inside while my gynae used a speculum.
Title: Re: 6 months post-op, difficulty dilatng
Post by: Dena on August 26, 2018, 11:51:49 AM
Quote from: sushi776 on August 26, 2018, 03:38:11 AM
I happened to have a casual overseas trip to Bangkok 2 weeks ago. Dr Chettawut inspected me again and said all is fine. However my local hospital gynae tested positive for group B streptococcus with discharge and hair in vagina with 2nd degree vaginismus.

Dr Chettawut used only long lubricated q tips to inspect inside while my gynae used a speculum.
Hopefully your doctor covered all this. Treatment for the vaginismus (https://www.medicalnewstoday.com/articles/175261.php), antibiotic and when when the pain is under control, a bit more pressure on the dilator to maintain or gain depth. When you don't have something that causes you to hurt, it's possible to place quite a bit of pressure on the dilator.
Title: Re: 6 months post-op, difficulty dilatng
Post by: Brenda80 on August 26, 2018, 12:31:55 PM
Quote from: sushi776 on August 25, 2018, 01:53:21 PM
I can only achieve 4" now. original depth is 5.5" (personal request during SRS consult not to make it too deep). originally I planned to hit 4" (after gradually letting it shorten) after a span of 2 years post op. but I'm already at 4" while being 0.5 year post op. I'm concerned. I'm at my target depth at 0.5 year post op instead of at 2 years post op. not sure if part of the missing 1.5" is blocked by a clump of discharge or hairball at the apex of the vagina.

Agree with Dena, it could be anyone's Guess. Your local gynae found any issue with the depth?
Not sure why you wish to reduce the constructed depth, but well Guess you have your reasons.
Since it's at your preferred depth well thou occur a bit earlier, I reckon that if after inspection by your local gynae, then just dilate to maintain the 4' depth. Human recover or heal at different rates perhaps yours heal much faster I Guess. Another logic that I could think of is that healing occurs fast in the initial phase which is why dilation reduces after 2years as the body condition has adapted due to the dilation.
Title: Re: 6 months post-op, difficulty dilatng
Post by: sushi776 on August 26, 2018, 12:37:29 PM
Quote from: Dena on August 26, 2018, 11:51:49 AM
Hopefully your doctor covered all this. Treatment for the vaginismus (https://www.medicalnewstoday.com/articles/175261.php), antibiotic and when when the pain is under control, a bit more pressure on the dilator to maintain or gain depth. When you don't have something that causes you to hurt, it's possible to place quite a bit of pressure on the dilator.

Thank you.. any idea how to remove pubic hair at the apex of the vagina? the last gynae that saw me refused to do it (it was during the speculum examination) as he feared liability issues due to possible furthering the infection (exposed hair follicles) in case the hair is not pushed in from the outside and rather grows from the skin graft inside..

Quote from: Brenda80 on August 26, 2018, 12:31:55 PM
Agree with Dena, it could be anyone's Guess. Your local gynae found any issue with the depth?
Not sure why you wish to reduce the constructed depth, but well Guess you have your reasons.
Since it's at your preferred depth well thou occur a bit earlier, I reckon that if after inspection by your local gynae, then just dilate to maintain the 4' depth. Human recover or heal at different rates perhaps yours heal much faster I Guess. Another logic that I could think of is that healing occurs fast in the initial phase which is why dilation reduces after 2years as the body condition has adapted due to the dilation.

he said 4" is normal for cis women. that's all he said.. and thanks for the hypothesis though.. I only have a few concerns now:

-circumference. I still want to minimally hit the 3rd size (dilator #2).
-infection
-hair in vagina apex
Title: Re: 6 months post-op, difficulty dilatng
Post by: Dena on August 26, 2018, 02:12:24 PM
Quote from: sushi776 on August 26, 2018, 12:37:29 PM
Thank you.. any idea how to remove pubic hair at the apex of the vagina? the last gynae that saw me refused to do it (it was during the speculum examination) as he feared liability issues due to possible furthering the infection (exposed hair follicles) in case the hair is not pushed in from the outside and rather grows from the skin graft inside..
There has been a post or two about somebody in Asia who can do it with electrolysis but it would be a difficult procedure if true. Another member mentioned it possible to use your finger to roll the hair and remove it that way. I think it was Kayxo that described the procedure.  In either case, it would be best to wait until the infection is completely cleared up before attempting anything.
Title: Re: 6 months post-op, difficulty dilatng
Post by: Mendi on August 26, 2018, 09:18:42 PM
Quote from: sushi776 on August 26, 2018, 12:37:29 PMhe said 4" is normal for cis women. that's all he said..

Don´t let your depth be reduced of because of this comment. The cis woman vagina is different, it can stretch and accomodate longer penis. Width wise it will stretch also differently, even a baby can come out that way you know.

Ours wont stretch like that. That´s why you need all the depth that you can, if you like men and straight intercourse.

Of course if you have a permanent partner and he´s 4 inches long and you know you will stay with him for the rest of your life, then it is ok.

Otherwise, don´t let the depth gained be reduced!
Title: Re: 6 months post-op, difficulty dilatng
Post by: sushi776 on August 27, 2018, 11:46:29 PM
Quote from: Mendi on August 26, 2018, 09:18:42 PM
Don´t let your depth be reduced of because of this comment. The cis woman vagina is different, it can stretch and accomodate longer penis. Width wise it will stretch also differently, even a baby can come out that way you know.

Ours wont stretch like that. That´s why you need all the depth that you can, if you like men and straight intercourse.

Of course if you have a permanent partner and he´s 4 inches long and you know you will stay with him for the rest of your life, then it is ok.

Otherwise, don´t let the depth gained be reduced!

Erm.. I think you misunderstood the sentence. I was replying to someone asking me if my gynae said anything about the depth. as mentioned in my above and previous posts, at the point of Pre-SRS consultation, I personally requested shorter depth of 5.5" because of personal preference. and that I want most toys to be able to hit the apex of the vagina. it simply shrunk to 4" (which is my target depth) within 6 months when I originally wished for 4" only after 2 years.

partner will not be able to hit more than a bit past 3" because all my partners will be female. where I live, most girl's middle finger is around 3" long at most.

you might wanna.. keep track with my previous replies above :)

Quote from: Dena on August 26, 2018, 02:12:24 PM
There has been a post or two about somebody in Asia who can do it with electrolysis but it would be a difficult procedure if true. Another member mentioned it possible to use your finger to roll the hair and remove it that way. I think it was Kayxo that described the procedure.  In either case, it would be best to wait until the infection is completely cleared up before attempting anything.

hmm. would there be a more efficient way to remove the hairball (if it exists) in a more efficient way though? I know speculum and extractor would be best (at least I think), but the gynae probably would be all defensive about their liability... so other than using fingers... what else can I do..?
Title: Re: 6 months post-op, difficulty dilatng
Post by: Mendi on August 27, 2018, 11:51:26 PM
Quote from: sushi776 on August 27, 2018, 11:46:29 PM
Erm.. I think you misunderstood the sentence. I was replying to someone asking me if my gynae said anything about the depth. as mentioned in my above and previous posts, at the point of Pre-SRS consultation, I personally requested shorter depth of 5.5" because of personal preference. and that I want most toys to be able to hit the apex of the vagina. it simply shrunk to 4" (which is my target depth) within 6 months when I originally wished for 4" only after 2 years

Ok, sorry. It´s just that people go to all possible things, to be a cis woman. So, just worried a bit, because it´s not the first time I´ve heard the sentence, that because cis...

But you know what you want. Good for you  :)
Title: Re: 6 months post-op, difficulty dilatng
Post by: Kendra on August 29, 2018, 10:36:15 AM
I'm a bit past the half year mark so my experience with this is limited, but my understanding is the #3 width dilator (3.5cm diameter, 1-3/8 inch) is a good goal because that's the diameter of a standard speculum commonly used for follow-up exams. 
Title: Re: 6 months post-op, difficulty dilatng
Post by: Lucie on August 29, 2018, 01:30:39 PM
Quote from: Kendra on August 29, 2018, 10:36:15 AM
I'm a bit past the half year mark so my experience with this is limited, but my understanding is the #3 width dilator (3.5cm diameter, 1-3/8 inch) is a good goal because that's the diameter of a standard speculum commonly used for follow-up exams.

Chettawut #3 is 29 mm large (diameter). I understand that she is still using the dilator #0 which is 20 mm large.
Title: Re: 6 months post-op, difficulty dilatng
Post by: sushi776 on August 30, 2018, 01:38:19 PM
I just tried dilator #1(23mm diameter) I'm about exactly 6 months post op now. I couldn't get it past the 2.5" depth (I can reach 4" with dilator #0, 20mm diameter). it just hurts and a lot of resistance. felt like my vagina is a hand gripping the dilator.

and folks, I need help please - is there an efficient way to remove any pubic hair that's at the apex of the vagina? because my local gynaecologist at the hospital seems not to dare to do it for liability reasons.
Title: Re: 6 months post-op, difficulty dilatng
Post by: Lucie on August 30, 2018, 01:44:29 PM
When you say "apex", you mean the end of the vagina?
Title: Re: 6 months post-op, difficulty dilatng
Post by: Kendra on August 30, 2018, 02:13:33 PM
Quote from: sushi776 on August 30, 2018, 01:38:19 PM
>and folks, I need help please - is there an efficient way to remove any pubic hair that's at the apex of the vagina? because my local gynaecologist at the hospital seems not to dare to do it for liability reasons.

I am surprised the surgeon that performed your GCS didn't use a speculum for a followup exam and relied on just a long q-tip, and then asserted there is no hair inside.  My understanding is a small amount of hair can cause a problem, all hair sheds at some point as part of the growth cycle.  I can't imagine any amount of hair would block a dilator but it may have triggered some other complication. 

Douching shouldn't be over-done but I'd be trying that in case it's possible to rinse anything out.  With my GCS I was provided a gizmo with a long rubber tube and a soft end for the spray. 

If your local clinic is not willing or able to permanently remove hair, they should be able to at least document what's inside with a camera designed for this type of exam.  (And a quick reminder don't post that sort of photo, it's just for your own medical records).  Based on your description it's possible you have granulation which is fairly common during the GCS healing process - depends how your particular body heals and responds to this type of surgery.  Your gynecologist will know much more than I do on this, and they should be able to help fix the granulation.

Once you're certain hair has grown and needs to be permanently removed for health reasons, I don't know anyone who does that but try contacting Electrology 3000 (http://www.electrology3000.com/) in Dallas Texas.  They specialize in transgender electrolysis and have physicians in their office licensed to apply dental block-type anaesthetic. 
Title: Re: 6 months post-op, difficulty dilatng
Post by: sushi776 on August 31, 2018, 01:14:20 AM
Quote from: Lucie on August 30, 2018, 01:44:29 PM
When you say "apex", you mean the end of the vagina?

yes
Title: Re: 6 months post-op, difficulty dilatng
Post by: sushi776 on August 31, 2018, 01:21:15 AM
Quote from: Kendra on August 30, 2018, 02:13:33 PM
I am surprised the surgeon that performed your GCS didn't use a speculum for a followup exam and relied on just a long q-tip, and then asserted there is no hair inside.  My understanding is a small amount of hair can cause a problem, all hair sheds at some point as part of the growth cycle.  I can't imagine any amount of hair would block a dilator but it may have triggered some other complication. 

Douching shouldn't be over-done but I'd be trying that in case it's possible to rinse anything out.  With my GCS I was provided a gizmo with a long rubber tube and a soft end for the spray. 

If your local clinic is not willing or able to permanently remove hair, they should be able to at least document what's inside with a camera designed for this type of exam.  (And a quick reminder don't post that sort of photo, it's just for your own medical records).  Based on your description it's possible you have granulation which is fairly common during the GCS healing process - depends how your particular body heals and responds to this type of surgery.  Your gynecologist will know much more than I do on this, and they should be able to help fix the granulation.

Once you're certain hair has grown and needs to be permanently removed for health reasons, I don't know anyone who does that but try contacting Electrology 3000 (http://www.electrology3000.com/) in Dallas Texas.  They specialize in transgender electrolysis and have physicians in their office licensed to apply dental block-type anaesthetic.

It wasn't just a clinic. It was the gynae at the government hospital. And it wasn't permanent hair removal that the gynae refused to do for me. That one is a definite "no". As in, they will definitely not do that. What they didn't even dare to do was.. They did not even dare to remove the strands even with a tweezer or anything of that sort. They were afraid doing that might result in more infection, if the hair is not a loose strand but rather attached to a follicle.

The recommendation is in the US isn't it? It's going to cost a lot for me to fly over. I live in Asia. Singapore, specifically. Travelling is not quite an option for me if I'm going to have regular appointments to permanently remove hair.
Title: Re: 6 months post-op, difficulty dilatng
Post by: Kendra on August 31, 2018, 09:47:59 AM
I don't know of any such clinic in Asia that can do this type of electrolysis, but Dena mentioned there is probably one somewhere in the region.  I'm hoping someone spots this thread and knows of a solution near Singapore.