And another update! I spoke with my boss today about upcoming surgery dates, and we met with my coworker whose wife is pregnant. Apparently she is not due on St. Paddy's Day like we thought she was, and is instead going to be induced at the end of February - on the exact date I had asked the surgeon for unfortunately.

So boss asked if I could push to have it done next week. That was what I had been leaning towards anyway, but thought he would have wanted more notice. Since it works out better for everyone that way, that's what I went with. I called the scheduler and let her know the situation, and she happily scheduled me for next Thursday. A friend will be chauffering me around for the day, and I'll be taking a week off from work to rest.

I confirmed the surgery with my boss, filled my prescriptions, and got my visitor parking pass back from a friend so that my family can come visit next weekend. I also spent the last hour making juice and some other liquid "food", as I tend to do better recovery-wise if I keep a liquid diet before surgery. I've got two pitchers of apple-carrot-ginger juice, a smaller pitcher of orange juice, and a week's worth of Soylent.

Tomorrow I need to call the hospital's registration team and stop in for blood work. I also need to send an email to my doctor and let her know that my hysto is scheduled so that we can make an appointment to adjust my T dosage in a few months.

I'm excited! I've felt like I've just been spinning my wheels the last few months, and this is the first real progress forward.

Quote from: FTMax on February 04, 2016, 08:07:05 PM
And another update! I spoke with my boss today about upcoming surgery dates, and we met with my coworker whose wife is pregnant. Apparently she is not due on St. Paddy's Day like we thought she was, and is instead going to be induced at the end of February - on the exact date I had asked the surgeon for unfortunately.

So boss asked if I could push to have it done next week. That was what I had been leaning towards anyway, but thought he would have wanted more notice. Since it works out better for everyone that way, that's what I went with. I called the scheduler and let her know the situation, and she happily scheduled me for next Thursday. A friend will be chauffering me around for the day, and I'll be taking a week off from work to rest.

I confirmed the surgery with my boss, filled my prescriptions, and got my visitor parking pass back from a friend so that my family can come visit next weekend. I also spent the last hour making juice and some other liquid "food", as I tend to do better recovery-wise if I keep a liquid diet before surgery. I've got two pitchers of apple-carrot-ginger juice, a smaller pitcher of orange juice, and a week's worth of Soylent.

Tomorrow I need to call the hospital's registration team and stop in for blood work. I also need to send an email to my doctor and let her know that my hysto is scheduled so that we can make an appointment to adjust my T dosage in a few months.

I'm excited! I've felt like I've just been spinning my wheels the last few months, and this is the first real progress forward.

Max, this is so great!  Things are moving along well.  Personally, I am glad I had/have 6 months out from hysto before vaginectomy.  I had some bleeding for quite a while after surgery, plus spotting for several weeks, so I am glad the "hole" was still there for it to drain out.  It made me think that it was good to have that extra time to heal, as well.

I hadn't considered that one would get some draining after hysto and still having a hole for it to come out would be best.  I want the hole gone for sure.

Fantastic news! When you said that next week was too soon, I was kind of sad that you were going to wait. Now you don't have to.

Will a week off be enough? I'm not sure what you do for a living.

Quote from: Arch on February 06, 2016, 01:05:27 AM
Fantastic news! When you said that next week was too soon, I was kind of sad that you were going to wait. Now you don't have to.

Will a week off be enough? I'm not sure what you do for a living.

I'm a hospitality consultant. Basically I go into bars and restaurants, audit their alcohol stock against their sales to see what's missing, and then write reports to managers and owners on how to improve. As soon as I go back, I'll have someone with me to do all the manual labor aspects of the job, so I'd basically just be driving to work, wandering around collecting paperwork, and then wandering around to find discrepancies. I usually do 2-3 venues per day so it's a bit of walking around but it's all self-paced.

I'm feeling okay with it. Glad to be getting it over with. My boss has said that if I need more time or if I have complications, we'll figure things out. So I'm sure if I needed longer off, it would be fine. I don't want to dip into too much vacation time though, since I want to have bottom surgery in June.

I took two weeks off from work and would have liked more, and I wound up leaving early on the first day. But because I'm alone, I had to do all of my own stuff and was more active than I probably should have been. And, frankly, I was a little too eager to portray a "business as usual" front to someone who doesn't know I'm trans.

If you take a week off, I hope you can take it completely off and not do anything at all. Below is a recreation of my timetable for the first couple of weeks, including surgery day.

Monday--surgery
Tuesday--went home in the afternoon; walked to the nearby grocery store to feed a food craving
Wednesday--home all day
Thursday--therapy, groceries, and a few errands (Christmas Eve, so I faced long lines and delays)
Friday--Christmas--left my friend's house after a few hours because I felt like crap
Saturday--drove about forty miles round trip to adopt a new cat I also had to set up his habitat and spend hours dealing with him and the other cat

Sunday--home all day
Monday--went to my friend's house again, and stayed much longer; didn't feel half bad
Tuesday--very tired after the dinner party; stayed home all day
Wednesday--home
Thursday--therapy and errands
Friday-Saturday--home all day, recovering from therapy and errands!

Sunday--worked at home all day to prepare my new class; moved around A LOT and slept only five hours that night
Monday--first day of work; had some period-like bleeding and left early
Tuesday--saw the doctor and ran an errand or two; he said I was fine
Wednesday--got through a whole day of work--three hours of driving, two office hours, three one-hour classes

Whenever I was home all day, I still had to feed myself (mostly microwave fare), feed the cats and pay attention to them, clean the litter box, run laundry, do other little household chores, that sort of thing.

I hope this gives people an idea of the activity level and healing process of one person. I was in my early fifties at the time of the surgery and had been mostly sedentary for a couple of years due to a chronic injury. Younger and fitter guys will probably have an easier time, and guys with someone to help out during that first week will be able to rest in ways that I just didn't (sometimes by choice).

Thanks Arch! I've been trying to figure out what everything will look like. I'm in my 20s and fairly fit, so I'm hoping that will mean good things. Both of the doctors at my consult said that while they'd prefer I take the full 2 weeks off to rest, they'd be very surprised if it took me that long to feel up to it.

I still have my consult on the 24th with Schechter in Chicago, so I'm hoping to ease back into more activity at the end of the first week. Today I made and froze 20 single servings of chicken noodle soup and a couple loaves of bread. Tomorrow is laundry, dishes, and general cleaning. I'd like to get everything taken care of by Tuesday so I can relax on Wednesday and mentally prepare. Even though it is something I want and something I'm ready for, it is sooner than I thought it would end up being. It feels like I have a lot less to do for it than I did for top surgery, so that's good at least.

Surgery is at 11:20 on Thursday. It's being done outpatient, so I'm expecting to be home in the evening, and I'm planning to *try* to eat a small dinner and go straight to bed. My only real activity planned for the weekend is taking care of my dog (walks around the block 3-4x per day). I'd like to get up and around a little more by Monday and start driving/leaving the house.

The good part about my job is that there's a lot of room for teleworking. Plus the hours that I am usually out and about don't fall into rush hour. I don't drive more than 10 miles each way, and I'm rarely in the car for more than 15 minutes at a time.

As a question for anyone reading this who has had a hysto - were there any supplies that you needed? They told me I didn't have to stop T, and advised that I wear loose, dark comfortable pants. My girlfriend bought me a box of pads so I don't have to worry about spotting, and I've got all the pain prescriptions. Is there anything else worth getting in advance?

Also - should I shave anything? They want to make an incision in my belly button and one over my pubic bone. Everything will come out of the opening downstairs. I know they'll shave stuff if they need to. I'm just wondering if it wouldn't be better to do any of it myself in advance.

Apart from food and meds and basic toiletries, I didn't need anything unusual except the pads. I had bought a box of panty liners much earlier but should have purchased full-size pads as well. Note to all: Get some maxipads. Even if you never use them, you're better off prepared.

I took stool softener tablets for a couple of days, but I don't know whether I needed to.

I bought pads eventually, but not in the best circumstances. I stopped at Target on my way home after the heavyish bleeding started. I needed to install my last liner, but the men's room was packed, and I had nowhere to toss my old liner. Then, I was standing for ages in the aisle as I tried to figure out which pad was which; I hadn't needed anything like that in ten years, so I was very much out of my element and felt spooked about the bleeding and conspicuous in the women's hygiene aisle. I eventually grabbed something and came home to discover that I had chosen THE biggest and most heroic pads on the market--not really what I wanted!

I feel that if I'd truly taken the first week off and done nothing at all, my healing process would have been hastened, and my first day at work might have gone better. On the other hand, my doctor said that as tissues shift and knit and as stitches stretch and dissolve, period-like bleeding can happen to anyone. He also said that bleeding can be precipitated by all sorts of seemingly innocuous events.

When I went back for my six-week check, he extended my restrictions for a further two weeks. I kind of wonder whether my early activities interfered with the healing process. I've never been a particularly fast healer, though.

Max, you really do seem prepared. Pay the bills, make your calls, run your errands, clean the house--and then come home and do nothing for a week.

Hysto Update!

I had my hysto today (2-port laparoscopic vaginal assisted total hysterectomy with bilateral salpingo-oophorectomy). Surgery was scheduled for 11:20, so we had to be there at 9:20. With DC traffic, we decided to err on the side of caution and left my house (ten minutes away under normal conditions) a little before 8. Picked up a bottle of ginger ale and some nutrigrain bars for the trip home.

We got to the hospital, parked, and were checked in at admissions by 8:30. They were super prompt in taking my friend and I back to get settled in. It's a teaching hospital, so there was a lot more foot traffic than you might experience elsewhere. Once I got assigned a bed, I changed into my robe and non-slip socks. The first person to come by was a medical student under the anesthesiologist. In addition to her pre-filling the paperwork, we had a really good (incredibly respectful) talk about the procedure and my transition in general. She said it would probably sound strange, but she wanted to thank me for choosing to come to a teaching hospital for the procedure since it would enable her and the other student assigned to me to learn more about trans folks. Very, very sweet.

After that, other folks stopped by and ran me through similar questions as they filled out their forms - attending and resident anesthesiologists, OR nurse, my doctor, another OBGYN, and several more nurses. Signed a bunch of consent forms. Everybody was very cool, and understood that I wasn't super comfortable with the idea that they were all going to be seeing me naked. The OR nurse put a large bandage pad on my butt, and told me that it would catch any drips since I'd be laying down for at least 3 more hours. My doctor came back by and drew on me a little bit. I asked her if she would take some pictures of the organs for me, just out of morbid curiousity. Around about 10:30, the attending anesthesiologist came back by and started my IV. Since I normally get incredibly nauseous when I wake up, she made a note to get me some anti-nausea meds in the IV prior to taking me back to recovery.

And then we were off! They wheeled me down the hall to the OR, moved me from my bed to the operating table and got me comfortable. The anesthesiologist reminded her resident and student that we were going to up my anti-nausea meds at the end of surgery. Then she hooked me in, and I was out.

I was taken back to recovery at 1:15 and woke up shortly after. No pain, no nausea, just exceptionally cold and shivering. It took me about ten minutes to warm up. My nurse walked me down the hall to use the restroom once I wasn't shivering anymore. After I got back in bed, she brought me a few packs of saltines and a ginger ale just in case. I finished everything, was sitting up, and very comfortable by the time my doctor came to visit. She was very happy that I was going well, cleared me to go home since I could walk, keep food down, and pee. Reminded me that if I was in pain, I could call her and come in before my post-op appointment. My friend came up to visit, went over post-op instructions with my nurse, and left to go grab the car. I downed two little bottles of water while she was gone.

When the nurse came to wheel me out to the car, I requested to walk just to be sure that I could do it. No issues, no pain. My last dose of pain medication was at 2pm. I'm supposed to take something at 6 if I'm starting to feel pain, but it's 5:55 and I'm not. The worst for me right now is my throat. It is a lot more sore this go around than it was during top surgery. My roommate is currently out buying me some lozenges, and I'm drinking water in the mean time. I have very little abdominal pain - it is akin to menstrual cramping, but is the most mild I've ever experienced. I wouldn't call it pain, but I am very aware that there was an incision in my bellybutton. There is also a bit of burning when I pee, which I would guess is catheter related. I've never had one before. Since coming home, I've removed all of the IV bandaging and electrodes. I'm leaving the butt bandage on for now since I've been laying down. My friend and I went for a regular paced walk around the block with my dog, I've changed my clothes, had a little bit to eat, and taken a short nap.

Overall I'm feeling very good! It went much better than I was anticipating, and I'm very happy with the care I received.

Damn, that's good news. I was in the hospital overnight. My throat was cranky for a full day, and peeing was a bit burny for a day or so. Sounds like my experience might have been fairly typical.

I hope you are as happy as I am about the results. For a few years, I was thinking, "Out of sight, out of mind," but it wasn't TRUE. At that point, I was thinking about those parts every damned day of my life. I am so glad to have all of that stuff out of me.

I could not sleep last night. There is a figure that Dr. Crane throws out there that has been bothering me for some time now, and I think it finally came to a head for me this week now that my consult with Dr. Schechter is less than a week away. Dr. Crane has said that of all of his metoidioplasty patients, 75% of them return for phalloplasty.

I don't know if these numbers are representative of the experiences of other surgeons, but it has had me second guessing myself this entire week. Thankfully, when I started researching bottom surgery options, MLD phalloplasty was at the top of my list. So I'm not having to do any additional research in that regard. I've been talking to several guys in a phalloplasty support group who have gone from meta to phallo and for all of them, it came down to size and meta just not being enough. What's upsetting is that for many of them, size did not matter to them until they were post-op. I am very worried that this would happen to me. I don't care about size now, but I also didn't care much about having a penis until a year ago. Who can say whether or not things will change?

I have also heard that the rate of complication is much higher to go from meta to phallo than to just get phallo from the start (but don't have an exact % to compare). So while I am young and healthy, if I did end up going from one to the other, my experience may be worse just due to the added risk. And then there's the issue of erectile devices. They are arguably the most complication-inducing part of phalloplasty, but unavoidable if you want to have penetrative sex. Dr. Monstrey released a study of erectile implants in 2009 that expressed ridiculously high complications - 59% had had their implant replaced, 41% had needed implant removal or revision. I know I would ultimately not be happy not being able to get an erection, but I do not like those odds.

Thankfully, Dr. Schechter performs both MLD and meta, so he can give me a good idea of his average complications, patient experiences, etc. I'm interested in what percentage of people he sees coming back for phallo post-meta. According to a friend's consult with him in 2014, instead of doing a 3 stage surgery by default like most phallo surgeons do, I could have everything but testicular implants and an erectile device placed in stage 1 and come back in 12 months to get both put in at the same time. If I still wasn't settled on an erectile device, I could come back in 3 months for testicular implants by themselves.

I am going to sit down tomorrow and start writing down all of my questions for the consult. At this point I am still leaning towards meta, but I will not be making up my mind until I talk to Dr. S and hear what he has to say on the matter. If anyone has any questions about bottom surgery that they would like answered by Dr. Schechter while I am in Chicago next week, feel free to message or write them below.

Quote from: FTMax on February 20, 2016, 09:32:35 AM
And then there's the issue of erectile devices. They are arguably the most complication-inducing part of phalloplasty, but unavoidable if you want to have penetrative sex.

The implantable erectile devices are not necessarily "unavoidable" to achieve penetrative sex with a phallo. Some guys have reported being able to get by without one. It has its own drawbacks, but there are sheath/sleeve-type products out there, including one specifically for guys who got phallo:
https://www.ftmprosthetics.com/sheath.htm
There was a thread here awhile back on the subject that may be of interest:
https://www.susans.org/forums/index.php?topic=160922.0

Since the implant has to be done at a later date anyway, not much to lose by trying the comparatively cheaper non-implant options out there first, for those who decide on phallo.

If you wouldn't mind, as for Dr. Schechter I'd be curious about:

1. How many times he's performed phallo
2. How many times a revision was necessary for urological reasons
3. Of those, how many times follow-up revision(s) were necessary before urological issues were fully resolved
4. Most number of revisions/longest time frame a patient has ever gone after phallo before all the plumbing down there worked without further issues, or if he's ever had a patient that has ongoing urological problems after multiple attempts at repair
5. Cost for the one-stage phallo with urethral lengthening including all the hospital fees, etc. if paid out of pocket
6. His policy on cost of revisions when they're medically necessary or for urological functioning reasons (as opposed to aesthetics)
7. If he's aware of any long-term effects on urinary tract infection predisposition after phallo, or meta, respectively, in either direction (either more or less common once everything is healed properly)
8. What in the world do they do if, despite all the electrolysis, a hair ends up growing in the urethra somewhere. This is something I think about too much.

Sorry I keep adding things.

Quote from: blink on February 21, 2016, 03:45:36 PM

Quote from: FTMax on February 20, 2016, 09:32:35 AM
And then there's the issue of erectile devices. They are arguably the most complication-inducing part of phalloplasty, but unavoidable if you want to have penetrative sex.

The implantable erectile devices are not necessarily "unavoidable" to achieve penetrative sex with a phallo. Some guys have reported being able to get by without one. It has its own drawbacks, but there are sheath/sleeve-type products out there, including one specifically for guys who got phallo:
https://www.ftmprosthetics.com/sheath.htm
There was a thread here awhile back on the subject that may be of interest:
https://www.susans.org/forums/index.php?topic=160922.0

Since the implant has to be done at a later date anyway, not much to lose by trying the comparatively cheaper non-implant options out there first, for those who decide on phallo.

If you wouldn't mind, as for Dr. Schechter I'd be curious about:

1. How many times he's performed phallo
2. How many times a revision was necessary for urological reasons
3. Of those, how many times follow-up revision(s) were necessary before urological issues were fully resolved
4. Most number of revisions/longest time frame a patient has ever gone after phallo before all the plumbing down there worked without further issues, or if he's ever had a patient that has ongoing urological problems after multiple attempts at repair
5. Cost for the one-stage phallo with urethral lengthening including all the hospital fees, etc. if paid out of pocket
6. His policy on cost of revisions when they're medically necessary or for urological functioning reasons (as opposed to aesthetics)
7. If he's aware of any long-term effects on urinary tract infection predisposition after phallo, or meta, respectively, in either direction (either more or less common once everything is healed properly)
8. What in the world do they do if, despite all the electrolysis, a hair ends up growing in the urethra somewhere. This is something I think about too much.

Sorry I keep adding things.

Thanks blink! I have been talking to some other guys about non-device ways to have penetrative sex, and there are definitely ways all with their own pros/cons. It's definitely something I'll be thinking about over the next few days.

I will definitely ask him your questions though! I'll try to stop back in this thread on the day of my consult just in case anyone has anything else.

PS blink - to clarify, when you say stage 1, what all are you hoping is included? I believe with Dr. S it is vaginectomy, phalloplasty, urethral lengthening, scrotoplasty, and glansplasty. Just wanted to make sure that is all you were meaning.

Quote from: FTMax on February 21, 2016, 05:05:26 PM
PS blink - to clarify, when you say stage 1, what all are you hoping is included? I believe with Dr. S it is vaginectomy, phalloplasty, urethral lengthening, scrotoplasty, and glansplasty. Just wanted to make sure that is all you were meaning.

That was actually more than I was hoping for in a stage one (didn't think glansplasty would be included in the first OP, but if he does that in stage 1 as well, that's awesome). Was hoping at least the vaginectomy, phalloplasty, urethral lengthening and scrotoplasty. Does he do the scrotoplasty like Dr. Crane, i.e., fused and hanging in the front?
Every time I think I've exhausted my pool of questions there are more.

Would be useful to know if he has someone operating with him to do a hysterectomy + oophorectomy at the same time or if that has to be done in advance.
And whether I'd be needing to bank my own blood - I'd rather not have a blood transfusion if avoidable. Some surgeons have more bleeding than others, especially with the vaginectomy, from what I've read.

And here'd be a pretty major question, should've thought of it sooner:
Have any of his patients ever experienced complete loss of the new phallus, and if so, what were the circumstances surrounding that (health issues etc.)?

I can answer some of these!

The glansplasty is done for sure for RFF in stage 1. I believe they wait until stage 2 for ALT. If I get phallo, it'll be MLD so I'll ask about that. I'll confirm the other two, because you're right that it's not the norm. Now that I'm thinking about it more, he may have done it earlier for guys who were traveling quite a ways and weren't coming back for a while.

He does do a fused scrotum and it looks very similar to Dr. Crane's.

I asked if it was possible to have my hysto done at the same time and they said no, regardless of which combination of procedures (meta vs. phallo). They could refer me to someone in Chicago if needed, but the hysto needs to be done 3 months prior to stage 1 of any procedure.

I'll check about the blood banking. When I got my hysto, they said they only recommend blood banking to people who have received multiple transfusions in the past due to developing antibodies and the increased risk of having a reaction from donor blood. But the vaginectomy does create a much greater bleeding risk, so it's a good question to ask.

I will ask about complete loss as well. After I finish working today I'll post my entire list of questions I'm planning to get answered (for myself and others).

Awesome. Will keep checking back to see how the Q&A turns out, thanks for sharing all this information.

Hey guys,

I tried to paste all of these here, but the formatting wasn't working out. This is the link to all of the questions I'm hoping to have answered tomorrow. If Dr. S is cool with it, I will be audio recording our consult and will either post that directly or a transcript of it.

https://docs.google.com/document/d/16QWdiVxGgiORFvNAAOnweWRY-83mGiyZoiTRhq22lCg/edit?usp=sharing

If you have anything you would like added, or if you think I'm missing something crucial based on my own needs, please message or comment! I will be checking this thread one last time around noon tomorrow Central time.

I'm going to continue hogging the questions and ask another thing if it's not too late. Sorry it's gross.

Is MLD contraindicated if the guy has bacne? I don't know if it's the skin itself, or because that's where a shirt goes and I'm physically active. I do not want to do the forearm, worried the only viable option is going to be ALT and that means a lot more extra time and $$$ for electrolysis (and goes back to my hair-in-urethra worry).

I'm planning to ask about skin quality of the donor site in general. I have some back acne, but thankfully it hasn't extended into the MLD zone. I have not heard that it is a consideration at all from other guys, but I also haven't asked. Will find out today!

I got to Chicago just fine, got my rental car, and I found a Panera a block away from Dr. S's office to hang out at until it's closer to consult time. Got a free upgrade to 4WD on the rental car since they're expecting snow here. Hoping I don't get stranded in Chicago! My flight home doesn't leave until 9:30.