So things got a little more difficult before they got any easier...
So I had RFF on Sept 1 in Belgium.
Day 5 I developed a pretty bad, rapidly developing abscess under my r) groin/hip incision.
Day 12 (I think) the Abx hadn't done enough and I needed to be surgically debrided. During which a section of my penis was necrotic and needed removing (part approx the size and width of your little finger) and part of the hip/groin incision was left open to drain, as was the penis.
Wounds were cleaned and packed twice a day where needed. After some improvement on Day 19 I went back to the OR with the plan to take a groin free flap (initially) and use the existing urethra from the RFF which was still ok (but not perfect). However I woke up in pretty much the same condition as I had gone in - they were unable to do the groin flap due to the infection still present in some of the tissue.
So another week(ish) of cleaning and wound packing - none of which was overly fun by the way, the foley catheter was still in situ so sitting was unpleasant, they let me up to walk for a couple of days as I've been on pretty much bed rest for a month, and of course I was worried as fk!!!
Anyway - Day 25 saw me back in the OR as everyone was very happy with the tissue and the plan was now a groin pedicle flap where they used the skin to recreate the urethra and then took another graft from my leg to cover the rest of the flap (like a quarter/bottom side of penis) saving what they could of the original RFF.
So it is now 31 days post RFF - vaginectomy site, scrotum, arm and original leg grafts are fine, apparently always have looked quite well, apart from a little sweaty, itchiness I get which I'm told is normal.
I am also 7 days today post groin flap creation/revision - and although it doesn't look exactly as I pictured (yet) - the tissue is healthy, the urethra looks good and the graft is healing well, aside from a small blood blister which I am told will solve itself. But for aesthetics I am told I will need a revision (fine with me, at least I have managed to keep everything I have been fighting for).
It has been a massive test...no wait, saga. I spent the first 2 weeks here at the UZ alone (by choice as I had arranged for a friend to come at the 2 week mark to maybe help me once potentially discharged for a week), but just as things were getting bad with the infection that friend arrived, which was a gift from who or whatever is looking out for us all!! Also, via a Yahoo! group I think, a younger fella (Alex) started emailing me and then facebook chatting, before he could get up and actually come to visit me as he was healing well from ALT a week after me - he was really great and in turn introduced me to another bloke and basically helped waste the days and who are still coming to visit me.
So I have my dressings and wound packing changed once/twice a day at the moment. I am still on bed rest - I have been up for visits to the bathroom and to sit in a chair but since the start I can count both of those occurrences on my hands...and maybe a couple of toes. So I can't wait to walk. The next dilemma is getting out of the hospital. Actually just had a discussion with a social worker as to my plans after I'm discharged. Potentially it will be next friday (10th or so) but I still need to have catheter removed and see if I can actually urinate etc so I have refused to make any plans (as they have just not worked for me so far) and now I set goals instead...
So things are definitely better - this is the first time I have turned on my computer in a month (unheard of for me). I've only really recently started to feel more like myself, listening to music, playing games and puzzles on my phone etc. I need to change my flights home (thankfully I sprung for business class and fully flexible), I need to contact my boss as I have honestly been avoiding that as I have no other leave to take so it will be leave without pay I imagine (pretty sure they can't fire me for getting sick on my leave, no matter what I'm doing).
So that is where I am. I feel better in myself and I am more me - I speak or message friends and family daily and all have commented on the change in me and that I sound more happy etc... Decisions about where to stay, if I can get someone else over to help me etc and the ole how much is it all going to cost me chestnut - thus far the hospital stay has been paid for up front so really I haven't had much expenditures at all since being admitted....maybe up to 100 euros for snacks, drinks and some hand cream coz holy hell is my skin dry in here...
But just wanted to say thanks for being there guys. There have been some dark days and not gonna lie a few tears shed. I did everything possible within my power to be in good shape for this - ate right, hit the gym, quit smoking 2yrs ago etc etc but I honestly believe everything happens for a reason....whatever that may be. I was prepared for fistula, stricture, pain, non healing wounds, limited ROM of my arm/hand but the infection and abscess completely blindsided me, ok I guess the extent to the effect a localised infection had on the tissue I desperately wanted blindsided me, I knew infection was a risk. But it is done now. At the moment everything looks good and I just hope they let me up soon to walk coz I'm getting a sore ass!!!!!
Thanks again brothers, I sincerely hope everyone recovering at the moment is well on that road.
Jay