In other notes, Jesus, Chett is a freaking wizard with scars. She showed me her forehead scar from FFS and the BA scar under her armpit, and they basically might as well already not be there at all, only about 2 weeks after surgery.

Chett is a super-skilled plastic surgeon. Goodness. I am seriously considering coming back here for FFS now, because I'm just so blown away at how good he is at making surgically-altered parts and the scars on those parts look like they weren't even operated on. And her forehead work was completely amazing. Flat feminine forehead, eyes open and shining, it's one of the reasons I was so jealous.

And in final news, dilation is still painless, just a time-consuming thing that starts and then is over in exactly the duration of one episode of Bojack Horseman, so easy. It's just an excuse to chill and watch Netflix shows or anime. But my urethra with the catheter in it, which I apparently injured last night, hurts like a ***(censored)*** ***(censored)***. I keep hitting the tubing of the catheter with my left arm by accident, and every single time I've done it today, it's been so painful that I wanted to cry.

I'm really really hoping that I haven't hurt my urethra too badly, popped a stitch or something, because this is seriously REALLY painful. Like, the sharpest pain I've felt during this entire recovery process. I'm walking on eggshells every single time I stand up because I'm so scared of the pain that would result if the catheter tubing moved in the wrong way.

I had bladders spasms and urethral irritation from the catheter, and it was seriously the worst pain of the whole surgical period, by far. Like, if the surgical site pain was a 3-4 at worst, the catheter was about an 8. So I sympathize a lot; it sounds like you didn't cause serious injury, but the whole bladder and urethra can get irritated from the catheter alone, and accidentally making it a little more raw will hurt like hell.

(Also, that wax dilator sounds so weird and inconvenient. I would have been utterly terrified to use something like that - I was scared to death even with the designated plastic ones.)

Nurse was here early today, so I asked about the severe sharp pain that I'm having in my urethra every time the catheter tube moves around.

She looked inside, but said that there's no injury, it's just very red and swollen, so I guess on the one hand I'm happy that I didn't hurt it or pop a stitch or something, but on the other hand this means days and days more of pain, because it's the catheter tubing itself that's causing the irriration. So the pain's not going to go away until they take the catheter out on Wednesday.

So, freaking great... three more days of really bad pain every single time I move the wrong way, every single time the catheter bag or catheter tube touches anything, and having no choice but to just deal with it.

Jenna wasn't lying, this actually is the sharpest pain that I've felt during this whole recovery process. It's enough that I scream "Ow!" every time it happens, and because it happens so often, it is REALLY mentally draining to deal with that kind of pain so many times a day. And there's basically nothing I can do about it, because not moving the catheter tube in the wrong way is kind of impossible. Probably half of the ways that I try to move it constitute the "wrong way" that causes that sharp pain.

In better news, swelling is still going down really well, I can feel that there's a bit less pressure on everything. And I'm definitely starting to notice an increase in stamina and my ability to sit and walk without my body feeling like a weak recovering-from-surgery body. I was sitting in a chair for almost 4 hours yesterday afternoon while I was talking to my neighbor with basically no pain whatsoever, and I can feel that I'm moving around, standing up, laying down, just in general being mobile, MUCH freer than earlier this week. So that's a positive.

I still feel like there's a little bit of constant pressure on my clitoris from the inside, and the clitoris itself is still in the hypersensitive range, so I'm still dealing with that annoyance, but it's slowly getting better.

Recovery as a whole is still way less difficult than I thought it was going to be, especially compared to the Brassard recovery pics which I was preparing myself for by saying "when you see this, don't freak out," but I haven't really been much of a happy camper for the past few days. Chronic pain, especially chronic pain this sharp and unavoidable, and especially when it's combined with the constant low-scale discomforts of a slowly-healing slowly-de-swelling surgery site, is very mentally tiring. And even my mom is starting to notice that my moods have soured. She even lashed out at me last night when I screamed "OW!!!" after hitting the catheter and after my crying-in-the-bathroom bout of dysphoria. "You were doing so well until yesterday... what happened?" So... ugh... pain... I guess I'll just be thankful that the dysphoria is over and I'm feeling better about myself this morning.

Oh yeah, and also I think I have a cold. So yipee. Sniffling, sneezing, and a hoarse voice to go with all the other stuff.

I'm so sorry that you're having to deal with the same stupid catheter from hell. It may or may not be useful - I don't know what drugs they have available - but I ended up on Oxycodone for 2 days until the catheter came out. Yes, that meant I needed painkillers again for the catheter, after I'd weaned myself down to Tylenol by day 3 post-op, but on the other hand, it worked really well. Even if that's not an option, painkillers of *some* kind for the catheter pain is a totally valid choice. As you say, chronic pain wears you down, and you shouldn't have to suffer through that.

(I also think you may have seen a set of Brassard pics from the scarier end of the range, because I basically looked like I had a vulva from the day they took the packing off, just a really swollen and kind of irritated version. The stitches were visible and there was some of the usual wound-healing aspects, but it didn't look anything near as bad as I'd been told to expect either.)

Quote from: Jenna Marie on August 20, 2016, 08:50:14 PM
I'm so sorry that you're having to deal with the same stupid catheter from hell. It may or may not be useful - I don't know what drugs they have available - but I ended up on Oxycodone for 2 days until the catheter came out. Yes, that meant I needed painkillers again for the catheter, after I'd weaned myself down to Tylenol by day 3 post-op, but on the other hand, it worked really well. Even if that's not an option, painkillers of *some* kind for the catheter pain is a totally valid choice. As you say, chronic pain wears you down, and you shouldn't have to suffer through that.

(I also think you may have seen a set of Brassard pics from the scarier end of the range, because I basically looked like I had a vulva from the day they took the packing off, just a really swollen and kind of irritated version. The stitches were visible and there was some of the usual wound-healing aspects, but it didn't look anything near as bad as I'd been told to expect either.)

Fortunately, I weaned myself from the strong painkillers and down to nothing but the SaRa acetaminophen VERY quickly, pretty much as soon as the packing was removed, and I'd been slowly reducing my dosage from 3X per day down to 1X per day even before that, so I still have 6 days' worth of them left. I'm probably going to take that advice and go back on them until the catheter is removed.

Also, in terms of the Brassard results that I saw, there were two of them. In both, yes, the vulva looked like a vulva, but there was a LOT of blood, swelling, clotting, some necrosis, severe bruising of the entire lower abdominal region in one case, and raw bloody-looking tissue on the insides of the labia. The healing was amazing, it looked beautiful and nearly-perfect afterward, but the first two weeks of recovery in both cases looked like they were going to be really hard. So I was shocked when after my surgery there was basically no blood at all, no raw tissue whatsoever, and it didn't look like the outer labia was swollen like a balloon.

I hope the painkillers do the trick! It may seem silly to use them for the catheter, but you're in serious pain. Another 2-3 days of taking those will be less of a risk to your recovery than suffering through the pain (and the fear that you'll move wrong - I remember that too, and not fondly).

Huh. I guess I was lucky that most of what I got was tremendous swelling; no necrosis, thank goodness, and no serious blood or clotting either. I was braced for the "raw hamburger" thing, and it wasn't like that. I did have the huge bruising, but it didn't hurt at all - it's not like regular bruises, where an injury caused it, but more like bruising from giving blood, where it's just blood leaking under the skin. On the other hand, the woman who shared a room with me at Brassard's hospital and who had surgery as #1 that day, had bleeding severe enough that the bed was soaked and they had to rush her back to cauterize something. (She was fine in the long run.) I guess it's partly the luck of the draw. I'm so glad things are going so well for you this early in recovery, aside from that awful catheter!

Well, the pain pills immediately perked my mood up. Hooray for opioids, I guess. :/

(And honestly I kinda don't like that, because while I enjoy feeling happy, I don't want it to be a drug-induced happiness. I don't like that, because I don't want to be dependent on a pill to make me feel happy. It's actually one of the reasons why I wanted to get off of the strong painkillers as soon as possible, because I knew that the opioids were artificially inflating my feeling of elation, and I didn't want to feel good because of pills, I wanted to feel my own genuine elation, my own genuine emotions. Anyway... whatever.)


Also, I switched dilators this morning, my 2nd wax dilator has turned into this hideous misshapen monstrosity after 3 days of use, so I was overdue for a new one.



And it feels WAY better to have a nice clean straight one again.

Dilation isn't painful. Nor is it really annoying anymore. Just time-consuming, and limiting of the activities that you can do while you're doing it. Like, normally I can sit on my computer and either game, type, click around social media, watch movies/TV/video, whatever I feel like doing. When dilating, I'm stuck in a single position with only one hand free, so I'm basically limited to just watching videos. Usually I just find a 30-minute video to watch (usually Netflix or anime or watching the Olympics on Thai TV,) and once it's done I'm done. But that's the only thing that really makes it annoying, is just that I'm an information maven, I like being free to browse or search or do whatever my brain wants to find out, so I have to take a break from my usual train of free thought and exploration and set aside 30 minutes to just sit and watch something. It's a minor annoyance at worst, though, even though I've already caught myself procrastinating and doing it a couple hours late a few times because I didn't feel like it.

I'm going to be watching a LOT of anime in the coming year, though, because I'm going to need a lot of video content to take up the dilation time. So I guess just think of it as a medical diagnosis that requires you to sit in bed watching TV for 2 hours every day.

So, I guess I can't dump on the pain pills too much, because yes, it's an artificial happiness, and I hate that, but now with pain and discomfort suddenly down to a 0/10, me practically feeling completely healed thanks to the magic of controlled substances, I guess I didn't realize how much I needed a break like this. After 2-3 days straight of pain, annoyance, swelling constantly bothering me, catheter constantly bothering me, I will admit, it is very nice to get a mental break from all of that chronic pain and to just be able to relax and enjoy a quiet afternoon without constantly having to tolerate persistent discomfort.

I was honestly starting to feel overwhelmed. When you come here solo, generally, it's unbelievably boring because you're just in your room all day alone. It's not boring for me. Not in the least. Because I'm here with my mom, and she's working on her promotion packet for work, so she's all stressed and hyper and bouncing off the walls and always asking me questions and talking and she has this habit of asking me a question and then asking me another question before I've even finished answering the first question, it feels like her brain is operating three times as fast as mine right now, so it's a bit frustrating. Plus I constantly have acquaintances on Facebook messaging me and asking me how I'm doing which then evolves into like hour-long conversations. So I've been anything but bored. Combine all of that social hyperactivity with the strain of the chronic pain of recovery, and I've REALLY REALLY REALLY been wishing I could just lock the door and not talk to anyone and let my brain relax, do some breathing exercises, take it all in, give myself a while to just think in solitude without people messaging me and asking me questions every 10 minutes, let my body heal, let my mind heal, enjoy some blissful quiet.

I was getting to the end of my rope, and starting to get unpleasant and confrontational and impatient again because I was getting so exhausted.

Now I get a break. No pain for a while. No constant negative emotional stressor making me short-tempered and exhausted constantly. My brain can breathe. I can relax. I can heal. Social interactions don't exhaust me as much as a result. So yeah, I really needed this break. And I don't think it's a good idea to take the pain pills constantly, and I'm not going to, but every 3-4 days or so when the chronic pain of recovery combined with the constant hyperactive socialization becomes too overwhelming and I just need a break, yeah... not much of a choice.

I just hope that once the catheter comes out and therefore the biggest source of that chronic pain is done with, I'll feel like this naturally again. (I did for the first couple of days after the packing was removed, but then the hypersensitivity and the urethral pain started and it's been emotionally overwhelming ever since then.)

I... think I just had a phantom pain.

That was weird.

Basically, suddenly one of my nerves started going in to that painful "shock" feeling, it persisted for a while, and it felt like a nerve that my brain associated with being somewhere on the surface of the left part of the scrotum, which is now generally the outer labia. But when I reached down to touch the left part of the outer labia where I believed it was coming from, it wasn't there. I kept feeling for the nerve but couldn't find it, and then I realized that my brain was registering the pain as floating in midair about a half-inch above where the labia actually is. So for a few seconds there, I was feeling pain in a part that's either not there anymore or has been moved somewhere else that my brain doesn't recognize yet and still thought was in the old position.

So yeah, weird.

And there's been many times where I've felt that "it's cold, my genitals are shriveling up" feeling only to reach down and the labia isn't.

So honestly, I was completely expecting to have no phantom sensations whatsoever since I'd always had a phantom vulva, but I was wrong. I am having a few phantom sensations.

Also, for the most part I don't feel like I have "nothing" down there. It still feels like my genitals. Newly-shaped, but still my genitals. And honestly most of the time it just feels like I'm tucked really well. And yet even though it kinda feels like being tucked, at the same time there isn't the feeling of a "shaft" or an "erection" or any of the pressure and stretching that comes with being tucked to go with that feeling, everything feels completely free and loose, so it's kinda like not being tucked, and it feels like there's no penis or testes there and yet at the same time it kinda still feels like the same anatomy, and yet it doesn't... It's weird sometimes.

I'm honestly glad the pain pills helped, even temporarily, because the "chronic" part of the pain is what's so hard to cope with; even a brief break can be a huge benefit. I also wouldn't expect you to need them past the catheter removal, so it's 3 days at most. You were recovering well and with low levels of pain until the catheter injury, and a lot of that will go away almost instantly when the darn thing comes out. (The urethra may stay raw for a little while, but it won't be nearly as bad without something to jab at it and cause those jolts of pain, and it'll heal pretty quickly when the irritant is out.)

Oh, and "medical prescription for TV" is kind of still how I feel about dilating. It should get easier to tolerate being forced to sit and watch, too, with the routine setting in.

Dilation's officially a piece of cake now. When I first started dilating, for the first few days I often had trouble getting the dilator in the last inch. It would go in 5 inches and then I'd have to force it to 6. That doesn't happen anymore. I've basically been able to get it straight in to 6 with no problems for the past few times, so basically now there's no hassle, no pain, it's in, I hold it, set the timer, done.

I'm really happy that it's this easy, frankly. And hopefully it will stay easy when I start moving up sizes.

I used to minimize the use of painkillers when I was younger, but I really can't see the point these days. I'm not sure what I was thinking before. Its like I had some philosophical problem with them, but I realized I don't like suffering more than anything. As long as your not going to get addicted or accidentally overdose why worry about it?

*
Carrie Liz:

Congratulations and welcome yourself to the Chettawut sorority and alumnae.  It is one fine club. 

Yes, to all who choose but have yet to make their acquaintance with Dr. Chettawut and his staff - the are all very nice personally and very experienced professionally.

Carrie Liz you have done a fantastic job describing your experience here at this site. 

If I might add my two cents on a few topics.  Many people feel that catheter as pain; it is actually your body telling you that you are ready to remove it.  Also be careful with dilation that you do not press on either your bowel or urethra - that can create pain.  Maintain your appliance along your internal structure.  Relax.  Some people use a towel or pillow to hold it in place or cross your legs - those options will free both hands.

Follow doctor's orders and you will pass your final exam with flying colors.

You are good to have taken in the sights before getting to business.  Many people arrive in time for their first exam, hole up alone in their recovery residence without a companion, and depart the day of their final exam not seeing the people and culture of a wonderful country.  I am so happy for you that you had you mother to help you.

Your final responsibility will be going to Chaengwattana to get your papers notarised.

Dr. Chettawut's medical release should also help you get extra seating space at each leg of your journey home.  Keep your donut pillow handy for long sit-downs; feel free to move about the cabin to stretch your legs.


*

My mom left for Seacon Square to get lunch and get her hair done at 12:30, and now it's been 5 hours, it's 5:30, and I'm starting to really really freak out and get worried...

Because our phones don't work here, there is absolutely no way for me to check to see if she's okay. And if something happened, I don't even know if they have a way to contact me. I'm just praying she comes back soon now, and that nothing happened...

EDIT: as soon as I wrote this post, she came back... thank God...

Well, dilation is officially no longer a painless thing. I just had something go VERY wrong.

I've been getting scared for the last two days or so because I could feel that my vagina was getting tighter around the dilator with each day, but I ignored it figuring that the nurses kept clearing me, so it was probably supposed to happen.

Well, today something happened that turned that concern into an emotional meltdown.

Basically, as I mentioned, Chett's nurses gave me 2 wax dilators, one of which was getting bent beyond recognition after days straight of use, and one which they gave me 2 days ago as a "backup" in case the first one broke. The first one not only was bent, it had holes in the latex, so I stopped using it as of yesterday. Well, today during my afternoon dilation, the latex glove which was covering the non-bent wax dilator unexpectedly broke. It wasn't salvageable, and I had to discard it. And you can't use the wax dilators without the covering, because they can and do break, and it would be very bad to have a piece of wax break off inside of you.

So basically tonight, I had two options. Either use a dilator that was completely bent out of shape and had multiple holes in the latex covering, or try using the official clear-plastic Chett-certified "#1" dilator.

I chose the later. I figured, I'm the only one using the wax dilators, everyone else started out using those #1 dilators, they're not that much bigger, I should be fine. I made sure to use extra lube to make it easier to insert, I tried to be extra careful when putting it in, and I was just assuming I'd have no problems.

It was tight. I could feel it stretching the outsides of the vaginal opening as it went in. I kept inserting it, figuring it was okay, but it didn't get easier, the stretching feeling kept going. After it was in about 3 inches, the feeling of stretching became painful. The pain kept going. And finally I realized that it was too tight, I couldn't keep it in.

And then as I was pulling the dilator out, the dilator's lube coating was now mixed with a coating of blood.

I started panicking. I had a breakdown. I cried. My brain was racing "what do I do? I can't get the #1 in... I'm bleeding... what if I just damaged something? What if I just popped a stitch? What in the world am I supposed to do? I can't use either of the wax dilators but I can't just skip dilation tonight? And what does this mean for the future? What if I can never get the #1 in? What if I've already lost too much width from using the wax ones for this long? What do I do? /panic /panic /panic.

And then the worst thing happened. I woke my mom woke up, (after coming back from Seacon Square 3 hours late, she went to bed early so that she could be rested for a tour of Bangkok that she's going on early tomorrow morning,) because I was panicking, and I started frantically asking her for advice on what to do, freaking out about the fact that I was bleeding, not knowing what to do. And she yelled at me. First she impatiently said "just use more lube," which I through tears told her I did, then she said "well just be careful. You can't go too fast." "I WAS careful! I went as slow as I could!" And finally she just said "Look, you've woken me up THREE times now!" I appealed, crying, "Mom, I'm BLEEDING. And I think I hurt something, and I just hurt myself but I can't not dilate tonight, it might close up and I couldn't even get the wax ones in, and I don't know what to do!" But she just told me "Just go to bed. A nurse is coming tomorrow." Then she scolded me again for waking her up, rolled over, and went back to sleep. And so basically I had to keep myself from crying, keep myself from making any noise, and clean up a horrible bloody mess of paper towels and dilators and figure out what the heck I was going to do, having a panic attack the whole way, tears coming from my eyes the whole time, but I couldn't make a sound because I knew Mom would just yell at me.

This was hard. And this is the lowest I've felt during recovery so far. I really just want to cry right now. And I'm terrified that I've hurt myself, and I'm terrified that I've permanently lost width, and I don't know what to do about it, and I'm scared that my entire time with the larger dilators is going to be nothing but pain and bleeding, but I can't say a freaking word because Mom's still asleep, she yelled at me "The nurses are coming tomorrow, be quiet and let me sleep!" And I feel abandoned and like my pain doesn't even matter, and I'm still crying about what just happened.

I did eventually dilate with the bent wax one. I was too scared of losing depth not to. And it still didn't hurt, and there wasn't blood (at least no more than was already there,) so I did finish the chore, but I was basically spending the whole time trying to keep myself from having a panic attack.

All I can do is write about it. I'm sorry. I just don't know what to do, I had to say something, and I'm going to be crying myself to sleep tonight worrying.



The bleeding wasn't too serious, there wasn't ever a continuous flow of blood, so if I did hurt something it's not a major surgery-threatening injury, but I'm still terrified. And I'm sitting out in the dining room crying, worrying, as I type these words

Carrie Liz,

I don't know if you are still up. I am so sorry you experienced this. Is there not an emergency number for the nurses  or Chett's office? I also want to remind you that the human body and mind are very accommodating and flexible. We heal, we are able to bend.

Easy for me to say the following. Deep breathes and breath exercises. Try to distract yourself and lose your anxiety. I know it is easy to get lost in the forest of self loathing and bad experiences. Look at how far you have come. Try not to look to others for whom it all seems easy and who have hit the genetic lotto. You are a strong independent woman with the ability to overcome. You are becoming one of my heroes.

With warmth,

Joanna

First of all, so much sympathy. The first couple weeks are tough emotionally as well as physically, and that isn't discussed much; you go into surgery healthy and strong and come out of it physically "broken" and coping with all sorts of new experiences to boot. I'm so sorry that your mother wasn't kinder to you.

If it helps, some concrete advice: width is an issue with the muscles and can always be [re]gained (depth is what can be lost permanently), blood is a problem if it soaks through a surgical pad in 1-2 hours (said Brassard's nurses) but anything less than that isn't likely to be serious (and blood mixed with lube can look like a LOT when it was just a few drops of actual blood), and even skipping one dilation session is not likely to cause long-term issues as long as it's a super-rare occurrence. You're almost certainly fine in all respects, but I'm still sorry you're having such a hard night.

Those wax dilators just do not sound like a good idea, with the breakage and the getting softened out of shape.

Hi,

First of all, some bleeding at this stage isn't unusual, especially when going up a dilator size.  I seemed to just accept a bit of bleeding from time to time and if I wasn't bothered too much, neither was anyone else.  With time, you will start to take the bad dilations in your stride and look forward to making the next one better.  Sri is not one to raise unnecessary issues during her visits.  She is very experienced with surgery recovery.  If she doesn't mention something, it is OK. 

I too was on just the candle for the first week or so (but I didn't manage to bend mine out of shape that much!).  I was still using it to start dilation when I was back at home.  It broke later when I was putting new latex on it so I threw it out.  Ask Sri for some spare gloves as the latex is just a finger off a glove tied off.  When mine broke, I just started off with the No 1 and went very slowly.  I am now at 8 months and this week I am trialling once a day to see if I appear to lose anything.  Looking good so far.  So after about 520 dilations, it seems it might be time to cut back.  I only did 3 times a day for 7 weeks.  Once I was back at work, I did 2 x 1:15 instead of 3 times a day.  I am replacing that time with sleep!!

Oh, and the odd meltdown is OK too!  I was alone at the Vertical Suite and had to sort of manage the ups and downs alone.  Not the easiest thing to do when you are using a candle instead of the real thing because Chet had to start you very small.  Looking back at what I went through, at the time I tried not to underestimate the recovery required, both at the op site and elsewhere and emotionally.  As others have said, breathe, relax and go with the flow.  Recovery takes time.

All the best

Emma

Quote from: Carrie Liz on August 21, 2016, 08:20:21 AM

Also, for the most part I don't feel like I have "nothing" down there. It still feels like my genitals. Newly-shaped, but still my genitals. And honestly most of the time it just feels like I'm tucked really well. And yet even though it kinda feels like being tucked, at the same time there isn't the feeling of a "shaft" or an "erection" or any of the pressure and stretching that comes with being tucked to go with that feeling, ...

It's kind of funny you said that about feeling like being tucked.  A friend of mine had surgery several months ago.  A few days ago she was sitting at work and suddenly had the "distinct feeling" she came untucked.  She said the feeling was so real she actually started to check before she realized it was now an impossibility.

Glad to hear you're doing well.