SRS in Melbourne Australia

[warlockmaker]

I'm not sure its Dr Ives but my girlfriend just had her surgery and it was my first time I have helped a girlfriend go thru the GCS (SRS) in Australia, and what happened was quite frightening to me. She had her surgery last Monday at Masada Hospital Balaclava, outside Melbourne. The surgery went well but she woke up from the anesthesia and had a coughing issue which made it difficult for her to breathe and each time she coughed she suffered great pain. She had bronchitis a year before, but her X rays pre surgery showed no problems, but it seemed that the anesthesia may have caused the problem to re-emerge. Thus, she had oxygen continually supplied to aid her breathing. She was given morphine for pain, but because of the breathing issue and the necessity for oxygen, she was given in low dosage and thus her pain level was significant, it's hard for me to describe the pain she had with limited morphine, suffice to say that it freaked me out.

I'm used to the Thailand surgery schedule which would like you to walk after 48 hours but in her case they kept her immobile for 5 days, and an 8 day stay in the hospital. Well, she has yet to be able to walk without aid and seems that she may now stay a little longer.

I'm not sure how many other has had such pain level to continually bear or if it's even normal. I'm writing because I'm going for mine in January in Thailand and I just want to be prepared for the worst case scenario......and need more information.

I note that the original post by serenation said that she had a pain level of 7 even with the pain medication. My girlfriends who had surgery with Suporn, Chett and Sutin described the pain level in the first couple of days at a 2 or 3. Maybe its just the pain tolerence level.....

[Cindy]

That level of pain sounds terrible! I'm surprised she wasn't given an alternative to morphine. I'm wondering if she had an allergic reaction to the GA?

As for 5/8 days immobile, again I can only conjecture that the fear of stitch tearing due to coughing prolonged the immobile period.

I did read a post on the ANZPATH list-serv on pain relief/tolerance post GRS and it was very variable ranging from manageable with Panadol-Forte to agony that was hardly controlled with opiates ( at this level it was suggested that psychiatric involvement be considered). It appeared to be an individual reaction and nothing to do with the surgeon or procedure; which as you know is pretty standard.

Please pass on my love and concerns for her and I do hope she is OK.

Cindy

[Serenation]

Hi warlockmaker, Hope your friend is ok. Think day 3 I was out of bed. After a quick google it seems Suporn uses morphine for recovery. I just had paracetamol (head ache pills).

I have a high pain tolerance so I didn't really feel the need to ask for anything more.

[warlockmaker]

Thank you both and I will pass the message to her. Maybe she just had bad luck, but OMG the pain she had to go thru.

[Dena]

When I had the surgery it was 6 days of bed and then two days mobile before leaving the hospital unless there were complications. After 6 days in bed, you were as weak as a kitten and I am not really sure how most made it home after they were let out of the hospital. I had about full week of being mobile due to complications and took advantage of it to build up my strength but the trip home was still exhausting.

The first mistake I made on this site was telling somebody about the 6 days of bed rest after surgery. Others quickly corrected my mistake and told me how quickly they get you out of bed now days. It made me much more cautious about the advice I provide on medical procedures because so much of what I knew in that area was obsolete.

As for pain, I seem to have a high tolerance and didn't ask for any pain medication after surgery. Other girls ask for and received morphine.

[Jenna Marie]

It does sound like she was exceptionally unfortunate. She has my sympathy... and so do you, because I sort of know what you're going through. My roommate in the hospital had been in a car accident, ended up with chronic pain, and had a very high tolerance to painkillers as a result; she was wheeled back writhing and SCREAMING just as they took me to the operating room. I was a nervous wreck.

And then I'd say my pain from the GRS itself never exceeded a 3-4, and that was in the first couple days. With painkillers it was more like a 2, and by the time I went to Brassard's recovery residence (day 3) I was able to go down to Tylenol only for pain. Oh, and they had us up and walking by 18 hours post-op, but I'm sure Cindy is right and the coughing/complications changed her schedule.

[warlockmaker]

I just spoke at length with my friend and after 12 days she continues to be in alot of pain and is on a slow release strong pain medication pills. The doctor says her pain tolerance is low.

What has now shocked me is that she is required to keep a condom stuffed with Styrofoam 24/7 for 3 weeks, changing it 2 times daily. Dialiating will not start until after 3 weeks. This is very different from the Thai surgeons who have you dialiating after 5 days. She tells me that it's standard in Australia???

[AnonyMs]

Regarding the condom thing (stent?), I'm not sure standard in Australia means a lot when there's only one surgeon.

I've heard of it being used Europe, but it seems to be not very common. I'm curious if anyone knows the reason why?

[thegirlinblue]

I have heard that a number of srs surgeons use the condom styrofoam stent.

I dont think it's all that rare.

[Ms Grace]

She tells me that it's standard in Australia???

That's not my understanding. Maybe her circumstances has necessitated a change in practice?

[warlockmaker]

Hi Grace. Kira is a really timid person and she was told about this before her surgery and just assumed it was normal. She only informed me in the last few days because it was terribly inconvenient and restricted her mobility. I asked her to challenge the surgeon on this but she seems reluctant lest she upsets him.......I only know the Thai surgeons requirements. 

[Cindy]

Warlockmaker,

It is clear in his pre-op briefing. In writing.

It is explained.

It is or shouldn't be a surprise.

As you know I do not comment on my whether I had or not surgery.

But..........

I am confused.

[warlockmaker]

Yes Cindy it was in the pre op instructions and she assumed it was similar to other surgeons in Thailand and USA. She should be more diligent.

[bmapwv]

Standards and techniques vary from surgeon to surgeon. I knew beforehand that I would likely be bedridden for 5 days depending on how I progressed. In the event I was allowed out of bed on day 4. Another UK surgeon likes you out of bed on day 2.

Due to his technique my surgeon did not require me to dilate until until 6 weeks post-op and within a week of starting dilation I was on the largest 35mm dilator with no bleeding and no pain.

Just because this surgeon does it differently from what you expect does not mean it is wrong.

[warlockmaker]

Thank you all. I have never stated what is right or wrong, I respect the forum philosophy not to dis any surgeons and I am not critical. Just was suprised at the differences on dialiating schedule . I now know what is my preference.

[Serenation]

There was some pretty detailed about info about the foam in my thread but aside from being a pain to source, I had to go to multiple stores trying to get the right foam and they all kept asking me what I needed the foam for.It is not styrofoam! it's just a thin sheet of comfy squishy foam, when it's in you it is very soft and if it's in correctly you wont even know it's there.

I did get quite a pain on one day from the foam as a nurse got blood on it, and made up another one which was incorrect size.

The nurses thought I just being whiny and gave me an endone pill. I think finally after about 8 hours a head nurse was able to fix it and Andy was fairly annoyed when he came in. In hindsight I should have contacted Andy myself. Suffice to say that should never happen to anyone else as they all know now how important this is now to use the exact moulds Andrew makes. I ended up having to stay in hospital over, I never really talked about that because I'm certain that I was the first and last to have that problem.

I was having to check every few minutes it was still in correctly. It was also meant to stay in when you pee. I ended up having to hold it in with a latex glove on every time I pee'd.

The foams don't work for everyone and you can start dilating instead of using foams on a case to case basis, one girl that had srs same day was me switched to dilaters almost straight out of hospital, I think I started on them a week early because the foam drove me bonkers.

To be fair I don't think any interaction with a vagina at that point would have been pleasant, either dilators or foams, so I can't say which I'd prefer but everything got easier when I switched to dilaters, sitting, walking, pee'ing everything.

Things get easier each day, best wishes for your friend.

[warlockmaker]

Thank you Serenation for the perfect note which is so helpful and I passed this to Kira. She thanks you so much for the information. Just wish she was tougher about her views and be less meek .

[Serenation]

You're welcome warlockmaker, if she ever has any questions I'm happy to answer or talk to her etc, I've been bugging a few girls that had been before me and alongside me, so I'm happy to help a fellow sister. There is a lot of info on susans, but something's like the foams there was pretty much no info on. (and not a lot of info about western scrotal grafts either)