October 29, 2015
When we arrived in Bangkok on the 29th. We were able to bypass the long lines of people seeking a 30 day visa since we already had our tourist visas which are good for 60 days and extendable to 90.
Our driver, Dome, was waiting at door #3 to take us to The Vertical Suite hotel one of three hotels at which all of Dr. Chettawut's patients stay. Our one bedroom suite was not ready in the morning so we left our bags at the hotel and went shopping at the huge Seacon Square shopping center just across the street. A second shopping center, Paradise Park, is also across the street from our hotel, so we had plenty of choices for purchasing things we would need. We stocked up on bottled water, Gatorade, fruit juices, and other things that I could eat when on my liquids-only diet ahead of surgery.
Our hotel room is on the 14th floor providing a nice view of Bangkok. It has a fully equipped kitchen including a washing machine that also dries the clothes. We have wifi in the room at no extra charge, and a free buffet breakfast each morning with a large selection of foods to choose from. I was only able to eat solid food the morning of Oct 30th before having to go on the liquids-only diet. My wife, Cheryl, had no such restriction, however.
October 30, 2015
We had a full breakfast at the hotel that was quite good. Dome picked us up at the hotel at 9am and drove us to the Chettawut Plastic Surgery Center for my pre-surgical consultation with Dr. Chettawut. It went well. There were a lot of documents to read and sign. Cheryl even had to give her consent -- that was a surprise. I wonder what would happen if she refused......We were able to rent a cellphone for our stay at a cost of 1000 BHT ($33).
Dr. Chet had me pull my pants down to expose my genitals, and a nurse took a picture. His initial opinion was that I wouldn't need extra skin grafts from my groin area. The amount of scrotal tissue appeared to be sufficient. He asked what my expectations were for the surgery, so I told him that I was hoping to end up with a depth of 5-1/2" to 6". He said he always tries to attain that depth but it may not be possible due to the existence of scar tissue connecting the rectum and prostate gland, but he would do his best.
The prep starts tomorrow. I'm only allowed to consume clear liquids then, so today is my last chance to taste Thai food. This morning we went grocery shopping at the big Tesco Lotus supermart in Seacon Square which is just across the street and very convenient. They take Visa, Mastercard, and several other credit cards. All the guide signs are in English as well as Thai so it's easy to do shopping here. It's amazing how many familiar US merchants have store fronts here in the mall. Kind of takes the mystery out of coming here.
The old Thai neighborhoods are another story though. Nothing familiar about them. Our driver, Dome, took us through one of these areas on the way to the surgery center this morning. Fascinating mix of traditional and modern Thai life. The trip from the hotel to the clinic took 15 minutes. By taxi it costs 100 baht ($3).
Seacon Square in Bangkok is one of the largest shopping malls in Southeast Asia. It's just across the street from our hotel. We have yet to explore all of this vast shopper's paradise.....We had a nice Thai lunch today at MK Restaurants. I can't get over how inexpensive it is to eat here. Drinking, on the other hand, is expensive. A bottle of wine that costs $7 or $8 in the US runs $20 here.
October 30, 2015
As my gender transition rapidly draws to a close (at least the physical side of it), the question has been asked whether I will stay involved in the trans community. I would certainly like to be a part of the movement to end discrimination against transgender people, but there is a personal cost to doing so openly.
Most trans women and trans men elect to go "stealth". That means that they try to conform to the binary gender conventions of society and avoid disclosing their history. Many trans people are indistinguishable from non-trans people, and by hiding their past, avoid anti-trans discrimination. There is always this fear, though, that someone will 'out' you.
Although I'm very open about my being transgender to most people I know, in other real life situations, I don't normally call attention to my gender change. There's little to be gained personally, and often much to be lost. Most cisgender people of my generation want nothing to do with us 'freaks'; some are openly hostile. It makes life much easier to simply be perceived as a 'normal' person.
I AM a normal person, and, as I see it, not mentioning my gender past is to not invite a scornful reaction based on someone's ignorance and past conditioning. I'm also not putting someone else on the spot of having to confront any lingering doubts about how they feel about trans people. I leave them to judge me on my personal character and other things that really matter, not on my medical history.
On the other hand, if I hide my history, people won't see another of the many transgender people who contradict the myths and misrepresentations of what it means to be transgender. When you think about it, my being transgender has about as much bearing on 99.9% of the people I come in contact with as, say, someone having recovered from prostate or breast cancer. That would be ZERO!
October 31, 2015
I had one last WPATH SOC hurdle to get past before I could proceed with GRS surgery. It was obtaining a 2nd referral from a licensed psychologist. Dome picked us up at 11:00am and drove us to the Praram 9 private hospital in central Bangkok. After a wait of over an hour, I got in to see the psychiatrist who asked me several questions that altogether took about 10 minutes and then said he would recommend GRS surgery. That was quick, and only cost 10,000 baht.
In the afternoon it was back to shopping. We bought more bottled water, chicken broth, bread, peanut butter, and a few other items. I was unable to find an HDMI cable to connect my Dell XPS 13 Ultrabook to our flat panel TV, so I ordered one through Amazon to be delivered to our hotel. So far, watching movies and TV has not been a favorite activity.
November 1, 2015
Day 2 of clear liquids only. I'm well stocked with water, sports drink, apple juice, Jello, and Campbell's chicken broth. Tried to buy a six pack of Heineken's but it was not permitted until after 5:00pm at the Tesco Lotus supermarket.
I didn't feel like going back later just to get beer. I felt a sore throat coming on and decided to put on my PJs and climb into bed. All I needed was to have my surgery date slip due to a virus! (sigh)
So here it is, 5am, and I'm feeling a bit better sipping on what looks and tastes like lemon-lime Gatorade, but who knows. The Thai alphabet has over 60 characters, each one beautiful in form, but impossible to sound out.
I plan to stay in today and just read a book, watch a movie, and take naps.
November 2, 2015
The sun is just up here this Nov 2nd morning (it's 5:30) and I'm just a few hours from doing my first Swiff bowel cleansing treatment. I do a second treatment later today. Tomorrow is my big day. The surgery is scheduled from 3 to 9 pm. Yes, 6 hours, under general anesthesia. This is serious invasive surgery. I've been under nearly that long before, so I'm confident things will go smoothly tomorrow. It's a strange feeling to one second be counting backward from 100, and the next second hearing, "How are you feeling, Clara?" No sense of time having passed during the operation. I'll spend four nights in the surgical center recovery area under the watchful eyes of my beautiful Thai nurses who are friendly and attentive. Pain? Just push the morphine button or pop a pill. Nausea? Well, I'm hoping I don't experience it. Cheryl will be allowed to visit me for one hour the next day and three hours each of the next two days (kind of stingy on the visitation policy, imo).
The Swiff was no big deal. I think my bowels were nearly empty from having been on a liquids only diet for two days. Still I had to stay close to a toilet. My sore throat is gone, so I don't think that will prevent me from my date with the Dr. tomorrow.
November 3, 2015
Okay, so here I am waiting for my ride to the clinic.
What's going through my head at this moment? Let me organize my thoughts.....
I'm excited. I'm filled with anticipation. This is the most momentous step yet in my gender transition, and the decision to have gender reassignment surgery is obviously going to be life changing.
It marks a huge discontinuity in my life. Most of my life was spent living as a man. It was a constructed persona of a man, but to the world, I was a man. That person is no more, and later on this evening will never be again.
The finality of my decision is a testament to my confidence that I know who I am. Being true to oneself is the greatest gift anyone can hope to receive next to life itself. That's really all it is; so simple, yet so hard to achieve.
This is the final step in my rebirth, a rebirth which will correct the mistake that was made so many years ago. If my mother were here she would hear the doctor announce: "Mrs. Smith, it's a girl!"
Any links to my past identity that remain will be broken today. I will escape out from under the shadow of my former existence and face what remains of my life as a woman, sure and strong. The need to drag parts of my former life along with me will fade. I'll replace my looking back with only looking forward. Every new day will be an adventure and an opportunity.
But first, I'm going to be awfully sore.....
November 3, 2015
We arrived at the Chettawutt Plastic Surgery Center shortly after 1:00 PM. Dome arrived to pick us up at the hotel exactly on time as is his practice. I was hustled into a small room and told to undress and put on a robe. I had worn my wig as well, so I also took that off, and put everything in my suitcase. I was then taken up a flight of stairs to a room with a bed, and told to lie down on it. A young Thai nurse came into the room and said she needed to shave me. It became clear that the robe was just in the way, so I took it off for the duration of my four day visit. It quickly became clear that this was no place for modesty. Having someone shave your genitals was an interesting experience. Were I a fully T'd up man, I'm sure I would have gotten an erection. Thankfully, that was not the case.
Nothing much happened right away after I was shaved. Eventually I heard voices and laughter outside the room. That lasted for another 15 minutes. It was approaching 3:00 when someone came into my room to insert an IV in the top of my left hand. I think it was Dr. Chettawut. He then said a few words while the anesthesiologist connected me to whatever it is he used to knock me out. I heard him asking me if I could hear him over and over again until I couldn't. The operation took place.
When I awoke from surgery not long after 9 PM. I was back in the same room where I started. Everything is rather vague at that point, but I remember Dr. Chettawut telling me the everything went very well and that he was able to achieve my anatomical goals. He also said it was one of his best GRS surgeries, whatever that meant. The operation took 6 hours, as was expected. Cheryl, who was back at the hotel, was informed by phone of my coming out of surgery in good shape at about 10:00 pm that evening.
I spent that first night in the upstairs recovery room. Cee, the young Thai nurse who was assigned to me, spent the night on a mattress on the floor next to me. She would get up every so often to check on me – mainly to check my heart rate, BP, and temperature. She did this in the middle of the night, too. I don't remember much about that first night although she bathed me, had me brush my teeth, emptied my urine bag, and gave me a bunch of pills. I think I slept pretty good that night and really had no sense of pain at the surgery site.
November 4, 2015
The next morning I was awakened rather early. The days always started out with my nurse coming in, measuring my blood pressure, pulse, temperature and administering two antibiotic tablets. Then, she'd have me brush my teeth and finally she would wash my body with a cool water solution of something that smelled like floor cleaner.
They helped me get out of bed and put on my robe. I was quite shaky and dizzy, but still had no sense of pain. Then, these three nurses, one on each arm and another in front of me, walked me down the famous Chettawut stairs, complementing my every step. I wasn't all that sure I could do it with my legs being very weak, but I made it to cheers all around. It was then just a short walk down to the last recovery room on the left where I would spend the next three nights.
I was fed a breakfast of cocoa and soy milk. The cocoa had soy in it too, I think, and it tasted alright, but the taste of the plain soy milk was something I never took a liking to. Still, I ate everything along with about eight more pills. Yes, lots of pills every day.
At lunch it was miso soup and more soy milk. The miso soup was alright but had chewy stuff in it that made me think it wasn't the best quality. They don't ask you what you'd like for a meal. You get what they feel like giving you or what you last had. There were three other patients at the center, so maybe they try to feed everyone the same thing.
At supper I asked if there a choice of drink and soup. The more senior nurse offered me miso, creamed chicken or creamed mushroom soup. I chose the mushroom soup and plain cocoa (no soy in it). That was a mistake. Too watery. All in all the food was lousy, but I was having symptoms of nausea that made eating and drinking disagreeable, in general. They don't want to give you normal food right away in order to avoid you having a BM before the vaginal incisions are healed up pretty well.
Cheryl came to visit me at 1:45 PM for an hour. That's all the time they allowed that first day. I always looked forward to her visits. It was the highlight of every day. I filled her in on all the details that I could recall. It was not much time. I was still feeling pretty good. Cheryl shot this photo of me in my recovery room.
I was fed a supper of mushroom soup again and cocoa, again, not asked if I wanted something else, but between soy milk and watery cocoa, there wasn't much of a choice. I tried to read a little, to go on-line, and watch TV, but nothing worked out for me. I was becoming more and more uncomfortable. Lying in bed is not helpful for me. I seem to get headaches if I lie in bed and try to read or chat on-line for more than a few minutes. That's what happened. I was plagued with a headache in the frontal lobe almost from the start and my nausea got worse. The pain meds they gave me didn't help, and, in fact, I wondered if the meds were actually causing the headaches.
Dr. Chettawut came to see me twice during my recovery. He is such a sweet man. I was also experiencing itching on my upper body. I told him about it, and he said it was a side effect of the morphine he gave during surgery. He prescribed something to quell that itching, and shortly after the nurse administered the injection through my IV port, the itching subsided.
Evening brought a return of the data monitoring, bathing, and urine bag emptying ritual. I was then encouraged to drink more water....drink more water. I would have if I could have, but it was hard to drink water from a bottle lying in bed and the nausea didn't help either.
Whenever meals were brought in, the nurse would always flip to the FOX Family channel which had cartoons. She never asked me if I wanted to watch TV, it was a given, I guess. I usually switch the TV off. I watched very little TV programmming even though there was quite a lot to chose from and most of it in English. When you've got a headache and feeling poorly, TV does nothing for you.
Communications with the nurses was often a problem. They speak only a modicum of English so it's impossible to explain the simplest things to them -- like how I was feeling. Forget about carrying on a conversation. Nor did my regular nurse make any attempt to ask how I was feeling or if there was something she could do for me. I found that sometimes, it just didn't seem worth the effort to get a point across. There were lots of smiles and nodding of the head, but no real understanding when I'd talk to them. The nurses were sweet enough in their way, but even that seemed scripted. I sometimes felt like my nurse was a little robot programmed to care for me but with whom I could barely communicate my needs
The senior nurse spoke better English, so I was always glad when she came around. It surprised me, though, when twice she said, "You are a lucky man." What? In a transsexual clinic the nurses don't acknowledge one chosen gender?
Nov 5, 2015
I was getting more bummed out than ever today. Cheryl visited me from 2 until 4. She could have stayed another hour, but she said I slept most of the time she was there. I guess that's true, but I had a hard time recalling that being the case. Good thing she brought a book to read. Still, it was nice having her there in the room with me.
The headaches continued and were getting me down. They gave me more pills for that but they didn't help much. I think my headaches stem largely from lying in bed with my head elevated with pillows. They are muscle tenstion headaches that only respond to my lying flat or stand up straight. I'm writing this back at the hotel sitting upright on the sofa, and although my butt hurts sitting on the donut pillow, my head does not. I guess I have to take my pick....LOL.
My recovery experience seemed not to have as much to do with the site of the surgery as with the condition of my to head and stomach. Go figure.
Nov 6, 2015
Nothing much to add. No change in my status except that I was becoming increasingly depressed by the state of affairs. It's been reported that other trans girls have experienced depression after their surgery. Is this what they were talking about? If so, it has little to do with the decision to have the surgery and everything to do with the recovery from the surgery. Maybe the two are linked. I certainly didn't experience any of this after my FFS surgery.
I will say, however, that during recovery, my gender issues were the furthest thing from my mind. My presentation was forgotten. There were times I wondered what the surgery staff though of me, but only for a fleeting second. Pain and sickness have a way of putting things in perspective.
One thing that started to come on was a sense of claustrophobia. There's no window in the recovery room to look out on the world, no sunshine to brighten my day, and the constant running of the lower leg massagers (to prevent DVT) was becoming an irritation. I had not been out of bed for three days, and it was really getting to me. Gawd, I am such a winer. Man up, girl!
Still, there was hope. Nov 7th was my release day. I would cling to that rainbow in the waning hours of my stay. When I heard that I would be released early Saturday morning, I almost yelled out for joy. This joy was enhanced when the senior nurse came into my room that evening to remove the two drains that had been installed to drain fluid from the incisions on either side of my vulva/vagina. The pain was minimal and very short in duration, but reminded me why I had come to Thailand.
Nov 7, 2015
I was awakened at 5:45am by my nurse who did her morning ritual. After breakfast of chicken soup and soy milk (I hope never to eat these concoctions again) and a cracker (thank god for crackers), she began to ready me for my departure. The senior nurse reviewed all the medicines that I must take continuing my recovery at the hotel. They gave in two bags of goodies including the dilators that would come into play once the bandages and packing have been removed. I got dressed and walked assuredly down the hallway to the front door where Dome was waiting to take me back to my home away from home.
Today has been a pleasant day of relaxation, some logging of my week's events, eating a modest amount of solid food (crackers) and taking a couple of short naps. The pain at the surgery site is minimal and easily discharge with one of the pain pills in my stash. More later.
