We removed my catheter at 23.00 the night before. This was a stinging affair, a little like the drains but once over it went away quickly. I settle down to sleep and expect at some point in the night to have to go to the toilet. Given my high fluid consumption, this probably wont be very long.
00.30 was when I awoke busting to go. I got out of bed, sat on the toilet and felt the feeings of going but nothing coming out. I relax and try again but to no avail. I kept this up for 10 minutes but it was not going to happen. I press the call button and the nurse arrives. First she can't believe that I actually need to go 90 minutes into my sleep but I assure her that I definitely do. She suggests a bath and weeing in that, sometimes laying in warm water can relax the urethra and get it all moving. Whilst I do that, she was going to get the ultrasound so she could look at my bladder.
I run the bath, do what she asks but no amount of relaxation was achieving it. I get out, dry myself and lay on the bed. She puts some gel on the top of the groin and starts probing around. I ask whether it's a boy or a girl but she smiles and says it's too early to tell. My bladder has 800 ml's in it and I am going to have to be re-catheterised. While she gets everything, I suggest one last try but this was to no avail.
She starts unpacking everything, and this is when the tears start flowing. It's not the pain or needing to go, but the feeling of setback. Everything else has gone so well and it was hard to accept this little bump. She assures me that this is the one part of the whole procedure that no one can control. You can be the best patient and keep the catheter for weeks and the worst patient will walk out without one. Whilst she says this, she's inserted it! I hardly felt it and I am quite shocked. I couldn't believe that it could hurt more being removed and less reinserted. I can also feel the relief at my bladder emptying and for the night I was on a bag so I can sleep without having to get up. To try to help with the setback she suggested a cup of tea and a biscuit. 00.30 is not a normal time for hot beverages but I could see no harm. She returned with a tray, cup, milk, teapot, the whole experience. It was interesting, that going through the whole ritual was therapeutic and not so silly an idea for a stupid hour.
I slept fitfully and awoke a little tearful. I pulled myself out of it though and decided as soon as the nurse came around with the drugs, I was going to get a tap back on my catheter and retrieve my freedom. Even though I was due to have three baths this day with dilation, I was going to have a shower first thing, wash off the night before and also wash my hair properly because it was getting so greasy and horrible. This was a good plan and that simple comfort helped lift me for the day ahead.
Breakfast was the first order and once this was completed, it was time for the first dilation. One thing I wanted to do today was to take my time because yesterday felt very rushed and I did not get much chance to actually take it all in. I was left with an underwhelming feeling, and to be honest what I had seen was far from my idea of a vagina.
I set out everything I needed on the trolley which included lubricating gel, dilators, paper towels, alcohol gel, wipes and mirror. I also laid out an incontinence sheet on the bed as well as preparing a small pot of warm Hibiscrub solution. I lay on the sheet and put my glasses on, again something I had forgotten yesterday. I hold the mirror in my hand and slowly have a good look around.
It looked completely different than from the day before and is a much more pleasing sight. I take in the labia and although they are swollen, making them look smaller, they do look good. The clitoris is a bloody mess as well as the urethra still having a tube coming from it. It is well documented that this will take some time to come right. I move down from the labia and have a good look at the opening. Yesterday it looked an angry and bloody gash down below but today with good light and vision it looked very real and pleasant.
I could have laid there for some time but there was work to be done. The first job was to take a wipe, dip it in the Hibiscrub solution and wipe down the suture lines, along the labia and down towards the base. This is repeated on the other side with a fresh part of the wipe and more solution. This only needs to be done once per day.
Next is the dilation itself and I get the lube and put a big glob of it on the palm of my hand as I was shown the day before. I unwrap the small dilator from it's paper cocoon from yesterday and lube it up as I was shown. I then dip my forefinger in the lube and start finding the pelvic floor muscle inside myself. I angle the dilator in and then drop it once it is past the muscle and within 5 seconds it is there. No bounce yet (this is the term used to describe it hitting the back and "bouncing" off) but it definitely gets to the end because I can feel it pressing on the inside. Slightly over 10 minutes is counted off and I gently withdraw it. I wipe it down and then the same was repeated for the big dilator and this slides in very easily, much quicker than the previous day. Another 10 minutes and that is withdrawn and wiped. A towel is used to wipe the mass of gel left on the opening and then it's off for my bath. I run the water and prepare my douche. I wash down and probably more thoroughly than the day before because I am much more confident in my new anatomy. I let the water out, douche myself and that's it, all over. I looked at the clock and even with my slow look around, it took 50 minutes all in with absolutely no rushing with anything. So much for the 2 hours I have heard some say.
It's time for a bit of rest and while doing so, Liz Hills pays a visit. We talked a great deal about the whole process and the benefits of doing what the nurses ask. It seems that my current state is far advanced of many, my swelling is low and my bruising is minimal. I explained that yesterday was underwhelming and it was good today to have had a slow explore and that my dilation was very easy. She told me that I will fly through my recovery and everything looks very good for a very successful outcome.
I suppose bleeding is worth a mention as this is now a factor in everything. I now have to wear a sanitary towel to catch discharge and blood and to be honest, blood is the overriding factor. You are taught from the start that there will be blood and it will often look more than it actually is. The discharge notes say the same but yet despite knowing this, it can be alarming when you see it on the towel. Yesterday saw my first bowel movement in since before surgery and unfortunately even with laxatives, I managed to strain my sutures a little. I was getting spotting from the labia and some minor trickling from the base. This did worry me a little overnight and possibly contributed to the general low mood in the morning. Since dilating and cleaning up, the bleeding has slowed greatly and the worry diminishes. I managed another bowel movement this morning and with less strain although it did take some time. Thankfully, no bleeding ensued.
There is also the mobilisation issue and yesterday and today have seen me needing to mobilise and get my fitness back up. I also need to rest and this takes some skill. It's finding the right balance where you are resting but also keeping the muscles and joints active. The body only heals when it is at rest and this is why I am advised to be housebound for the next two weeks. I will stick to this anyway, but a walk around the garden will be permitted.
Lunch arrives and slowly my thoughts turn to my second dilation. I am actually awaiting a nurse to arrive so I can ask for some lube, but to be honest because my obs are so good and I am now mobilising, they seem to have abandoned me for the day. In the end I set out everything else and press the call button. A nurse arrives and I ask for some which she gets. I close the door, lie on the bed again and commence another good scrutiny. I am surprised, since the morning and having had another clean, I find it is looking much better again. It is like a different vagina since the morning. The dilation is perfect again, everything going exactly as it should. The bath was nice and I had a little soak as well as a good clean of my parts. I felt a new confidence and managed to give it all a good clean. Yesterday it looked like it was going to fall to pieces but now I can get my fingers into the folds of the labia and wipe away the sloughing tissue. Douching went perfect and suddenly I felt on top of the world, the pain of the night dwindling.
Cleaned up and tools packed away, I felt elated. I decided that I deserved a treat and this was my last opportunity to go and visit the Costa downstairs. I donned my dressing gown and walked out to the nurses station, down the stairs and into the main reception. It was a little scary, a whole week of being in my room has caused me to have a sense of reclusiveness and being in amongst everyone in normal attire with my dressing gown is a little unsettling. I order my coffee, a full fat latte, and the lady offers to bring it over for me. I sit in the window and it's then that it hits me full in the face. I'm sat in my dressing gown, no makeup and tousled hair and I am not bothered in the slightest. The days of needing to look perfect for fear of being read are long gone and I can sit here in amongst everyone and be myself. This nearly created an emotional moment, but I held that one back. I wasn't ready to inflict that on the outside world just yet!
So all in all, the day started of shit and became amazingly good. There is another dilation to go and again, I am looking forward to it. Slowly my time here is drawing to a close and although it will be sad to leave these kind and caring people, going home is now looking quite attractive.