Friday, 27 February 2015

More ups and downs

It's been another of those weeks, a big low point at the beginning and then a massive high at the end. My emotions have been so up and down for the last few months and it is well worth another write about to try to make some sense of it all.

I have a feeling that a lot of this is down to hormones. In this respect, my body has had the equivalent of being dragged through a hedge backwards, and then put through a shredder for good measures. It started back in October actually when my bloods revealed an estradiol level that was far too high. I had to reduce my dose, which then triggered the start of testosterone production.

In December, I stopped taking oestrogen (E) completely in readiness for my GRS and this then saw a full blown testosterone (T) surge. This probably explained why there was no gentle ramp up of the T, it was full blown within a few days of stopping E. Those 6 weeks were phenomenally difficult and to be honest I was clinging on by my fingernails by the end of it. Of course the GRS brought about a removal of those T producing factories and within a day, I could feel peace and quiet internally. There was also the euphoria of being post-op and this was a very powerful and emotional time.

Then there was a three week period of having no hormones whatsoever. This was initially not too bad and I was riding on that wave of euphoria. It didn't last forever though, and halfway through the second week, I found I was struggling. It was a blessed relief to restart my hormones. I then discovered that very few make it through those three weeks and some even restart as soon as they get home from hospital. I have even read more than one story where they took their hormones in hospital!

I am over three weeks of being back on my hormones and it does not feel right. I have a test in a couple of weeks which may or may not indicate the correct levels, but I am not feeling the effects I had before surgery. The most obvious should be tender breasts and they were untouchable prior to stopping E, now I can beat them with my fists. The hot flushes thankfully have stopped, but only just.

So it's entirely possible my E levels have been all over the place for several months. Of course, we can look at another factor that is likely to be contributing to this and that is of course the GRS itself. I was warned by many that it could be difficult afterwards, but nothing has prepared me for this. Overall, the euphoria is still there and when I am up, I am really up. I am super emotional and this can then lead to severe crashes which shoves the euphoria to one side. There are times when I can't stop crying and negative moments will leap into my mind and get stuck in there. It then needs a positive happening to bounce me back up again.

There is of course the physical aspect of the surgery itself, and this takes a fair toll on the body and mind too. I have ruled out the anaesthetic, I got that out of my system very quickly by drinking a phenomenal amount of fluids whilst in hospital. There is the small matter of pain and although that has not been a major issue with me, it is still there even now. Further on from the surgery is that fact that mobility is a little more limited, it is harder to get out of chairs and off the bed as well as other things. Everything simply takes more thought and effort. Dilation, I can rule out because I have no issues with that and I even use it as coping mechanism. There was also the element of isolation when back home from hospital, I could have used more visitors and even a couple more trips out but our remote location made this difficult. Most of these physical issues have lessened but now I have a sensitivity in the clitoral area that although is not too bad, it constantly there with very little relief.

This brings us to the week in hand, and this is fairly typical in how my moods have been swinging. Tuesday saw us with an appointment for my partner at the hospital with the optician because she is having some serious issues with her sight. This was very difficult to attend as I still can't lift her wheelchair in and out of the car (another issue that is distressing me). We managed to enlist the help of a friend though and after battling our way through traffic, arrived at the correct reception. We waited 20 minutes only to be told that the optician had phoned in sick an hour earlier. They could actually have rung us at home and cancelled so we didn't make the trip in, never mind make us sit there for those 20 minutes.

There was an issue making another appointment and the receptionist I was dealing with was very nasty in her talking to me. I found this very difficult to take and became even more upset when 5 or more staff then decided to cluster around me, almost as if I was going to become aggressive. I expressed my discomfort at this and on reflection felt it was a kind of misgendering, would they have crowded a cisgender woman to the same degree? In the end the ward sister came and took over, and she was actually quite a kind person. By the end of it, we were out at the front desk of the hospital with me in tears in front of everyone around. I did complain when I got back home, and a few hours after the receptionist in question rang me to apologise. I was not happy about this as I do not feel I was ready to speak to her.

Once I am on a low, it will hang around until something happens to kick me out of it. Very little I can do seems to bring me out of it and I and up with anhedonia (I experience little pleasure in usually pleasurable activities). After last years depression and anxiety, I developed some coping strategies and one of them is to go out and have a coffee. At the moment, this I have to do on my own, but I take a book and go and read whilst enjoying the bustle around me. The next morning I decided to do just this and when I ordered my coffee, the person on the till decided to call me sir. I was not ready for this at all, I objected in probably not the best way and his excuse was pretty pathetic - he calls everyone sir. This then ruined one of my coping mechanisms and it was all I could do to drink that coffee, get my shopping done and then get home - I was crying in the car most of the way. I get home to a message saying that someone was ringing about my complaint within 20 minutes. I was not ready for it at all and when the phone did go, it was very tough. I decided to tell them in the end everything, who I was, what my surgery had been and how rough things were with my hormones. I wanted them to understand that virtually everyone visits a hospital with something going on and staff should be more understanding of that. This helped a little but the day ended still very low. I even tried talking it out on a self help group on Facebook, but it didn't really get anywhere. I felt my problems were quite trivial compared to others.

The improvement came the following day. Nicola who owns the salon where I have my electrolysis had rung me the week before to ask how I was. I made an appointment for this week and decided that I could have something nice with the money I was saving from not having my electrolysis. A hot stone full body massage was booked and this was Thursday's treat. To be honest though, I was still in a trough and was not too fussed about it all. This soon changed when I walked into the salon. Everyone was there, asking me about everything and how it had gone. I was then given a bunch of flowers and all of a sudden the world seemed a much better place. The massage almost seemed irrelevant although it was very nice!

Today saw me deal with the issue at the coffee shop. Once upon a time I would have written a complaint to the head office, but I decided instead to have a gentle word with the manager. Given most there know me by name, I was going to use this and I felt much happier that I had dealt with it quietly. I walked through town to visit my new voluntary workplace and encountered a bunch of window cleaners. They had a good snigger, but I didn't care but I was on an up and nothing was going to stop me.

So this is how it seems to be at the moment, peaks and troughs and all of them quite extreme. The hope in it all is that the troughs, whilst extremely low are generally short lived and the peaks seems to outweigh them. Generally it is just lows, they are nothing like the black dog of last year and it usually just ends with massive spells of crying. I have been told by some that this is actually very normal and can take some time to level out. I am hoping that settling the hormones down might help but until I have that blood test, there is little I can do except to try cope when it is bad. I think it's important to understand that this is part of GRS and anyone proceeding down this path needs to be ready for it. I knew about this, and it has totally taken me by surprise. It still wouldn't have stopped me though!

Tuesday, 24 February 2015

6 weeks post op

A fortnight since the last update has seen quite a bit of change in many areas of my recovery and leaving things a fortnight has made for a good way of seeing more change.

The surgical site itself is now a two-part story. Externally, all of the suture lines are now completely healed. There is no broken skin at all and no sutures are visible. This healing completed at just over the 5 week mark, which I feel is pretty impressive given that at the 10 day mark it was looking pretty gruesome. I have photo's I have taken every week and the different is staggering. I almost wish I could post them to show how quickly it healed, but it just aint gonna happen! The healing process has of course left scars, but they are of small consequence to me. I realise that some may desire a scar free result because those scars may be a give-away as to a trans past, but it is not that important to me. These scars will fade over time anyway and my age is favourable too. There are suggestions in the discharge notes about scarring, I am still thinking on them.

Whilst externally everything is good, the clitoral area is not quite so good. It is healing slower than the exterior and my guess is that it's because everything is hidden away underneath skin and away from the fresh air. This is where the photo's have been very handy because even with the slowness of it all, I can see how it is improving progressively. This is something that may be worth considering to anyone having GRS in the future.

We have also had some issues with bleeding in this area during the last fortnight. About 10 days ago, whilst out and about, I noticed some pinkness when dabbing after going to the toilet. When getting back home, I found some fresh blood on my pad in the upper area. I did not think to much of this and had no more issues for a few days. Then, this Saturday, Mandy was cleaning the clitoral area and we decided that we would try to remove some of the white build up in the corner. She tried quite hard and the end result was some more bleeding. I then had to take everything quite carefully that day and the found that it stopped by midday. However, a visit to the toilet late afternoon and I suddenly had quite a lot of fresh blood again. The whole weekend was a recurring theme of this and now cleaning has reverted to very gentle wiping of the area.

It got to yesterday and again, fresh blood later in the day, after urination. Another inspection from Mandy and we then had suspicions that it may be coming from the urethral area. I started to piece together all the facts and we began to realise that a lot of these problems were happening on days when I had been drinking more, and then obviously urinating more. An email was written and sent off to Brighton for advice. Amazingly, even in the evening, I received a reply and the thoughts were that it may be granulation tissue around the urethra. Granulation tissue typically has a good blood supply and the urine is disturbing this causing the bleeding. Mandy has had another good look at the area and can find little evidence of this. Provided the bleeding is not an issue, it is actually very minor, I have been told to wait until my post-op check in four weeks and then they will look and treat it if necessary.

Dilation has still presented no issues and I have moved up to a 35mm dilator. So for now, I am using the 30 and 35, three times a day. The next step, possibly in a few weeks is to try the 37.5 and then aim to start with a 32.5. My schedule says that in a week I can drop to twice a day if required but I will continue for the moment three times a day unless I have something happening during the day, but for March this is only a couple of times. I am also finding my dilation time very therapeutic and look forward to it, particularly the middle of the day one. I also found that the morning one was cutting into the day too much as I was having to wait for Mandy to get up before I could use the bed. I got around this problem by doing the first dilation on the settee instead. It's a little cramped but it works and I can be ready for the day ahead much sooner than before.

Hormones are still a slow process. I am now three weeks back on to them and the hot flushes have only just disappeared along with the night sweats. I still feel I am not yet at the right level because I am emotionally all over the place and I have no physical signs of feminising effects. I was on a relatively low dose anyway and it simply be taking time to build up in my system. A blood test is booked in a fortnight and then science can determine whether everything is ok.

Finally emotionally, as mentioned with hormones, I am everywhere. Up one moment, very down the next. It is difficult sometimes to know where I am too and I still get overwhelmed in an instant. Today saw a very unpleasant experience at hospital with my partner and there was an issue with staff trying to intimidate me by crowing me. I got quite upset and this had a good effect of scattering them out of the way and a ward sister then having to calm me down. I must mention that the ups are quite pleasant and regaining my freedom by being able to drive again has had a positive effect generally. It is like the physical recovery, I just need time to get there.

My GRS time-line :

Friday, 20 February 2015

Returning to normality

My last entry described my feelings about where I was intending to go with my blogging. I was unsure of how long I would continue with writing and whether it would be relevant to anyone now that the main part of my transitioning was over. Interestingly, this post attracted comments from two people that had never commented on before. They were full of encouragement and made me rethink my position that my time here might be limited. I attract very few comments for the wordage I put out, and although I am not writing for comments, it was very rewarding to read those comments.

So for the time being, I feel that there is a good future for my writing here and I hope that I can keep things alive and interesting. Ironically though, this post focuses on normality!

I had had a full week of my friend Susan visiting, and we managed to get something in every day. I was fully aware of not over-exerting myself after my surgery and felt we pushed it to the absolute limit on a few of these days. We made sure though that our activities were morning focused and returned home for my afternoon dilation, usually resting for the rest of the day. Last Sunday was a good day, she (Susan) made the step to full time and asked me to be the witness on her deed poll document. I felt this was a privilege and made sure that I help her celebrate by taking her our for a meal.

She went home on Wednesday and I was quite happy for a rest. During our time, Susan had accompanied me driving in the car for the first time. If I had had any difficulties, she could have taken over and got me home. to be honest, it was some effort to have kept myself from driving before she came down - I was starting to feel quite isolated in this flat. Once she had gone, I was happy in the knowledge that I now had some freedom to get out, have a coffee somewhere and pick up supplies. Not being reliant on others for lifts and food was a great relief.

So after a very restful day on Thursday, Today (Friday) I decided I would make use of this new freedom and go into town to sort a few bits and pieces out. I started with a coffee in my favourite Costa. I didn't have Mandy for company, as I can't lift the wheelchair in and out of the car for some time, so I took my book instead and spent a nice half an hour in a comforting environment supping coffee and reading.

The next stop was Argos to pick up my engagement ring - Mandy had proposed to me on my hospital bed in Brighton. It is very difficult to find rings for my big finger, and it is ironic that a general goods retailer would be the place that I would find something suitable. I tried on the ring, it was tight over the knuckle but fitted well on the finger. We boxed it back up, I paid and left. Next stop was the jewellers to collect Mandy's ring and again, this was pretty easy going. I finally stopped in Sainsbury's and collected a few bits of food we needed. Then it was off down to visit dad and finally a stop in Lidl's before heading off home.

I reflect back on the last five years of transitioning and realise just how normal all this has become. Those heady moments in the early days seem like distant memories. Going and asking for a coffee used to need buckets of adrenalin, now they know my name and even what I want to drink! The thought of having to deal with those rings were not even possible in the early days, now it's just, well, normal. Supermarkets too used to make me wary, they could be very hit or miss and now I just do it without thought.

Even post-GRS, it seems more normal still. Whilst what is between your legs should not make a difference to how you are in public, the reality is that is does to some degree. GRS wont cure any social anxiety you have and it should be noted I had none of these issues anyway. But the truth is that now the physical dysphoria is gone, I feel even more normal. That unpleasant reminder is now no longer there and even the soreness of what is there now reminds me that I am now fully "me". 

 So here's to the banality of normalily and long may it continue.

Wednesday, 18 February 2015

Where to go with blogging?

It seems now that I am at a point where the future of this blog is in question. It is clearly mis-titled in that I think I have found Lucy, and quite some time ago! I am also at the end of the transitioning side of my journey. Yes, there are more years of feminising effects from the hormones, but to all intents and purposes I am physically there with everything.

However, whilst I may have left my dysphoria behind now, I will always have a trans past and helping others is in my mindset. This means that I will probably continue to do my current work with the trans community. Blogging is one such way I can help people; by sharing my experiences I can reassure others as to how they can proceed with their own journeys.

Debunking bullshit is one such passion of mine. Recently I witnessed someone stating that they had been close to death on the table during their GRS and it took 2 hours for them to be revived. This same person was stating they were walking around the ward 24 hours after this event. 

This makes me incredibly angry and the only reason for someone to post crap like this is for attention seeking. My fear is that people who may desperately need GRS to help with the physical dysphoria, may feel apprehensive after reading such a thing. We need to be mindful that there are risks involved with the surgery, as with any surgery, but they are not excessive. We also need to be reminded that the satisfaction rates (those that are happier with their lives) following GRS are as high as 97%, which is staggering compared with any other major surgery. When I hear someone spouting bullshit as severe as this, I feel I must do something to counter it.

My blog is one way I can do this. On here, you get the truth. Everything is a reflection of my own experiences and anything else is a result of serious research. When something is researched, I often say that is the case and often link to some of that research. Someone recently thanked me for what I had written about my GRS, on the eve of their surgery. They said it was a great insight and they didn't feel so lost. This made me feel very happy, that my words had helped calm someone down. This person reading that someone was near death might have been in a much worse position. I had very little to refer to prior to my surgery, but as a person, I was very calm and relaxed; even as I was being wheeled down to theatre. Even Liz Hills commented on how calm I was. I knew that was the best place to be in mentally but many are not so blessed with this kind of control.

We have the dilation myths and I recently wrote a long FAQ's about this process. I received a comment on Facebook almost immediately about how some found this a private matter. I responded saying that people must know about the ins and outs prior to their GRS because at the moment, it is all myths. The most common, and no one knows why this is, is that it takes two hours for each session. This is so prevalent, even I believed it before a friend proved to me that she could do it in 40 minutes including shower (no, I did not watch, I was just in her flat whilst she dilated in her bedroom). The longest I have taken for a standard dilation (2 dilators) was 50 minutes and that was the first solo dilation in Brighton which included a first time exploration as well as running and having a bath. I have since recorded 30 minutes including shower. Even the staff at Brighton know about this 2 hours myth, but seem unaware as to why it pervades the trans community.

So for the moment, I feel the need to continue blogging and spread truthful words. I have updates on my recovery and something else I want to do is delve back into the past of my transitioning, material that was on my old website. I really don't want it to become too mundane but may struggle to come up with material at times. When it does feel a struggle, I may have to think again about it all.

Friday, 13 February 2015

Lists revisited

Now that I am a few weeks home and well into my after-care, I felt it may be worth looking a little closer at the lists of post-op supplies they suggest you need and how much you actually use. I have just started driving again and am now at the point where I can pick up more supplies should I need them. I will suggest minimum amounts needed for a 4 week period on returning from hospital.
  • Kitchen towel - This is the one supply that you are told to have plenty of. The list suggest 8 rolls to start with, but everyone I spoke to said get much, much more. I wont say exactly how many because it was a fairly crazy amount but for 4 weeks I will have used about 10 rolls (55 sheets per roll of 3 ply). If you have thinner 2 ply, you will need more. I also save several sheets per day because instead of using kitchen towel to wipe my hands, I use flannels instead and then wash them.
  • Baby wipes - You need these to wipe on every toileting, 1's and 2's, to prevent nappy rash with any potential spraying. You will need to drink plenty of fluids so toileting should be much more frequent. I have found an 80 sheet packet lasts about 4 days so a 4 week period needs 6-7 such packets.
  • Toilet paper - This is not on the list but does need to be considered. You will have had many years of not needing this for urination, now it's all changed! It's even worse with 2 ladies in the house and we are using 3 times as much as we did before. A 6 roll pack with 400 sheets per roll is lasting about 9 days, so 3 packs are needed for 4 weeks.
  • Sanitary towels - The amount of these I used seriously surprised me. I felt when I bought 200 of them (seriously!), I was going very overkill. I have less than half of them left and it was not uncommon to use 8 or more in a day to start with. Everybody discharges different amounts and you could use even more. I was advised to buy the cheapest available so long as they were maxi. Sainsbury's do a pack of 10 for 30p.
  • Hand sanitiser - Hygiene is so important initially, and this is an important part of your it. I have used 2 x 200 ml bottles so far.
  • Antibacterial Hand wash - Again, important but I am still on my first 500 ml bottle.
  • Hibiscrub - I was sent home with a full bottle and another that had been started in hospital and is primarily for washing you dilators but I also wash my douche with it now I have stopped using Videne. This was enough for the first 4 week period but I also bought some more in readiness from Amazon. It is seriously expensive from the chemist and much cheaper online. You can use antibacterial hand wash but I think HiBiScrub is a good way to go for the first few months, it's far more robust than hand wash
  • Aqueous cream - You need this to wash your vagina for the first few months because It's a lot gentler than soap. A 500gram tub has lasted 3 weeks, so 2 are needed to start with.
  • KY Jelly - You need lots of this and the expectation is that you will use an 82gram tube every single day. This has not been the case for me and I was able to reduce from the day I came home but many report needing this much for as much as two months. Simply put, you need at least 30 for the first four weeks - 28 for dilation and a couple for lubing the douche.
  • Paracetamol - I am not in a massive amount of pain and never was but I still need to take four doses of this a day. Take time to stock up on this, we have a bizarre anti-suicide situation in this country where you are limited to buying a maximum of 32 tablets in one transaction so it needs multiple purchases to get this together. I will have used over 200 tablets in this first four weeks.
  • Laxatives - These are quite important because you will be resting a great deal and this promotes constipation. You may also be using codeine which exacerbates this and your food intake may not be as healthy as normal. Fybogel is a very good natural laxative and is available over the counter. I was given Laxido by my GP but this is very aggressive on the body and I have left them alone. Senna is also worth a try and I have been using it alongside the Fybogel (as recommended by Brighton).
  • Food - Unless you have someone to cook for you, fill your freezers up with meals that you can put in the microwave. Get in plenty of tins, even when you are able to get more food, you wont be able to lift much so get heavy stuff now. Buy anything that keeps, if you don't use it initially, you can always use it later.
That covers the after-care needs and hopefully this gives a good idea of how much you will need. Remember that everyone's recovery is different and less, more or much more of everything may be needed.

My GRS time-line :

Tuesday, 10 February 2015

4 Weeks post-op

It does seem hard to believe but it was exactly 4 weeks ago (at this time of writing) that I was expelling my enema and showering myself for surgery. It has been such a quick recovery and my perception of time seems distorted as it seems to me to be much longer than that.

The operation site itself is starting to look very tidy. The sutures lines I described last week as being an open semi circle (I liken it to a smiley face!) is now almost completely healed apart from a 5-7mm long part at the very bottom. I had been having problems when wiping after toileting, particularly the end of the day, when I would aggravate this wound and it would start bleeding. This hasn't happened in a few days and the healing is accelerating. I am guessing at a few more days and there will be completely unbroken skin on the eintirety of the external site.

Moving up to the clitoral area, there is still the wound on one side but Mandy reports that this is healing very well. It is very hard to see this progressing myself because it is further away and I am looking in a mirror but she can observe closely and says every sinlge day when she cleans it all down, it looks better. The sensation in the clitoris is lowering a little, although it is still super sensitive. The lowering sensation gives me hope that it will be usable down the line for pleasure purposes. 

I have had some soreness in some of my suture lines but it is short lived. First I had a problem with a small area of one side of the labia majora. A suture had protruded and was causing irritation around the area. I had the option of trimming the suture but this would have severed it and then the two ends could have disappeared back inside the labia possibly causing further irritation. In the end I left alone and because the wounds were dry, I put some Sudocrem (nappy rash cream) on it which seemed to do the job. Lately I have had the same soreness on one of the labia minora which causes a little more aggravation. There is little I can do for this, the wounds are still wet and I am reluctant to put anything on them. Because it is closer to the opening, you can feel it when dilating but not enough to make it difficult.

On the subject of dilation, this is getting easier. I was given a schedule when I left Brighton and it advises that if you feel it is easy, you can reduce the number of times a day sooner - 6 week being the advised time and I am at 3. I am still keeping to three times, simply because I have time to do this. We have Susan visiting us this coming weekend and this may be the time when I allow for a little flexibility but I will be very careful about this. Something else that I have changed is that I have removed the need to use the 25mm dilator. I can now start with the 30mm with very few issues. The first one of the day requires slower insertion but it is still effortless. This means I am now using 30 and 32.5mm dilators 3 times a day now. Soon, I will be getting the 35 out of its packet, sterilising it and very gently seeing if I am ready for it. 

I am very pleased at the easiness of the dilation and it is something I am very grateful for. Speaking to many others, they seem to encounter pain for a great deal of time. Some, I know have not followed the schedule rigidly enough but I have also talked to some who have and I trust what they are saying. Further talking seems to reveal that it is down to the size of what you had before and although obsessing about sizes of penises is the ultimate masculine past-time, it seems this is one area where I was more than adequate. It also seems that managing to avoid testosterone blockers and being able to suppress my testosterone with oestrogen alone was another major factor. Shrinkage of the appendage is very common and this is something I never really observed. I do also wonder if those 6 weeks of erections whilst enduring testosterone did benefit me too? Liz Hills at the Brighton Nuffield said it didn't, but I am not so sure now. I still would have had that injection and not endured that nightmare but I like to also think I did get something from it.

Toileting is becoming a bit more routine. My direction is getting better and initially the flow is forward but down slightly, the perfect direction. Towards the end of the void, it starts to slow and then I get dribbling round the labia. Mandy reports that this happens with her so I guess I am normal now in this regard. This I am greatly relieved about because many/most experience spraying everywhere and I have not had any of this. I mentioned consumption of toilet paper last week, but it really is greatly increased. Admittedly, I am trying to drink lots of fluids to keep everything well flushed and of course when the hormones start to work, my need to go may increase even more. Luckily I anticipated toilet paper consumption and we have lots of it ready.

With regards the hormones, I restarted a week ago and there has been little change so far. Originally, I was led to believe that the hot flushes and night sweats cease within a few days. I was then surprised to find they actually started getting worse for that time. This led to some worry about whether my dose was now correct. I got to the weekend and then found that the hot flushes had stabilised. It is hard to say for sure, but they have possibly improved although evenings and nights still seem to be difficult. I have recently spoken to someone who confirmed that their flushes lasted for a couple of weeks and Mandy has spoken to someone who said the same. I will be glad though when they are over, they are quite intense when they do happen and I find I have to shed clothes to cool off. 5 minutes later, I find myself cold and needing to wrap up again.

Pain, I am still maxed out on paracetamol at the moment. There is little pain in the overall area but sitting anywhere is still an issue with pain behind the whole clitoral area. It's not intense but I am using the paracetamol to keep on top of it, which in turn reduces swelling and as a side effect helps me reduce my temperature and ease the hot flushes a little. The stabbing pains are few and far between although there is still a touch of phantom limb sometimes. This is coupled with that damn itchy foreskin, and that is quite annoying!

Emotionally, this is still a difficult area. I wrote about this in more detail last week, here, and I am finding it still very up and down. It is cyclical and a moody period will be a few days long followed by a stable happy period. The two low periods I have had so far have been at weekends but I think this is just coincidence. I also think my situation at being stuck in this flat and unable to go anywhere is a massive contribution to the problem. Susan is here on Thursday, she will accompany me on my first drive that day and then I am free to do what I want any day I wish. I am not expecting this to eliminate my blue days, but I really hope that having some freedom to go out will help me through them. I also spoke to someone yesterday about this on Skype. Having a conversation with someone who has had the same made a massive difference. We both understood the difficulty of dealing with being unhappy when you feel you should be happy and this is perhaps the most difficult element of it all. There is almost a guilt attached to this unhappiness, I have everything I need and this is more than some others, and yet I sometimes feel down. We also feel it's definitely hormonal, I have just had 9 weeks of no oestrogen as well as 6 weeks of testosterone (she didn't have that) and now there is no testosterone at all (or very little) and I am trying to re-accustom to the oestrogen again. It seems that this may go on for 3-6 months so I need to keep at the coping strategies and ride it out. 

In general though, it's all going really well. Even with the emotional issues, the little bit of pain and the hot flushes, I would say there are no regrets whatsoever and I would go through it all again. To have what I have now is very special and I am so glad this surgery is even possible. The result looks fantastic and is more than I ever thought possible. At this time of finishing this post, 4 weeks ago I would have been comfortably anaesthetised and well on the way to becoming complete and this is still very hard to believe.

I think it is time to finish the weekly updates as the progress is now slowing. I'll update when I feel there has been more change, probably in a couple of weeks now. I'll be hopefully writing other things so feel free to keep checking back.

Lucy x

My GRS time-line :

Friday, 6 February 2015

Post GRS emotions and coping with them.

Even at a shade over three weeks from the surgery, the mass of emotions I have experienced have been very broad ranging. I have been updating with my general updates but very recently, I have been "through the mill" so to speak and felt it warranted a whole post of its own.

I should add that I was warned about all that was going to happen. There is a section in the discharge information about emotions, and even depression. Lynda at the Laurel's had briefly touched on how different I would feel and more than one person had mentioned how up and down it could be. Even with all this knowledge, it still hadn't quite prepared me for what was to happen.

Physically, there is so much to deal with from the very start. Once back in my room after surgery, I am being given exercises to do to keep my limbs moving, I have to practise deep breathing to help my lungs stay healthy and I am told to drink lots of fluid to help flush out the anaesthetic. There are issues with backache and trapped wind which add to the pain from the surgery itself, although this has been relatively trivial for myself. Once the bed rest is over, suddenly I am thrust into the world of after-care. Dilation becomes a massively important three times a day process. Wound care is a constant issue, you have to be super careful when wiping after toileting or else the wounds bleed. Urination is a new experience entirely too along with showering/bathing with douching needing to be integrated in this. Every task around the home needs to be thought about, can I lift that object safely? Sitting can be difficult especially for long periods and sleeping can be a whole hit and miss affair. There is also a difficult 3 week period with no sex hormones, the testosterone was eliminated from me within 15-18 hours and suddenly my body is confused. Towards the end of the three weeks, my body is panicking and I am in a period of menopause with hot flushes and night sweats.

It is small wonder that this had played havoc with me emotionally. Initially during my hospital stay I found I could handle myself extremely well in this regards. There were many long periods of just gazing out the window reflecting on everything. In fact, within 5 minutes of being settled in my room, I found myself crying whilst looking across the Sussex Downs. The relief at finally arriving post-op was so massive, I could do nothing other than cry. I do not know how long this went on for, but it was quite some time. I vaguely remember a nurse coming in, seeing this and leaving me to my tears. This was a cycle that was going to be repeated many time during my hospital stay. I would be reading my book, and my mind would wander and I would be crying again. It was very therapeutic and seemed to get me through this slow and tedious time.

On returning home, I found myself back in the cycle of life and the difficulty is that it becomes hard to take this time out and deal with those emotions. Having GRS leads to many different changes in life both physically and emotionally and it can be very overwhelming. The emotions are both positive and negative and the contrast has really surprised me. There is also another issue in that during the time in hospital, you are the centre of attention with a great number of people caring for you. These people also offer an opportunity to offload some of the feelings and once home, it is not so easy. I have Mandy and friends and they have helped. For someone going home on their own, I can only imagine how difficult it might be.

I found initially on returning home that the post-op euphoria was still in place and I felt really good about myself. Susan was still around to add in a distraction and even when she went home, we were getting plenty of people visiting. Last Friday came and Mandy returned to her day centre for the first time leaving me to myself. The peace and quiet was quite a pleasant change from the bustle of the previous fortnight and I even broke my house arrest and went for a gentle walk in the country lanes. Those twenty minutes were very special and I suddenly woke up to the fact that my physical transitioning was really over. The last 40 odd years were in the past and now I was free to move on and live my life. A fog was lifted from my mind and everything seemed much more vivid. The air smelt different, colours were brighter and everything took on a clarity I had never witnessed before in my life.

I got back home and found myself reflecting quite deeply on this profound moment. I felt I was a much different person despite all my insistence that my GRS would not change me. My afternoon dilation found me in thought and not reading a book as has been the norm recently. Mandy arrived home mid-afternoon and it all fell to pieces from there. She was excited about her first day out in some time and was eager to impart her experiences of the day. Within a few minutes of her being home and chattering away, I found myself shrunk back on the settee with tears streaming down my face. It was not her fault, but her eagerness had overwhelmed me and I could not cope. I explained this and she realised, backing off a little. It took a considerable amount of time for her to actually relay on her day and me to process it. What did not help was getting a little deep into a heated conversation on Facebook later in the evening and again, I found myself very upset. 

The weekend was a very wobbly affair. Saturday saw Mandy and myself talking about these changes and I was worried that she might not be able to deal with the new me. My fears were groundless and she was as upset as I was for thinking this. Our relationship has managed to evolve over the last five years and I was hardly going to become a worse person as a result of this. We worked through this but I was still a little unsettled for the whole of the weekend and into Monday.

I was troubled by the whole affair though. This is not the first time I have been in the position of being unhappy when I should be happy. Talking to others has revealed that this "post-op blues" is actually a very common phenomenon. It is such an emotional time generally, and you can find it hard to deal with it all. I could intellectualise this to death if I wanted, but I do not think I will get completely to the bottom of it all. My thoughts are that it is better to deal with coping with these moments as they happen rather than trying to work them out. Reading around and talking to others has revealed that a great many of us go through this during our recovery period and often beyond. We have had so many years of struggling and dealing with everything, and it can take quite some time to relax into our newly corrected bodies.

So some ideas for anyone about to have GRS or finding they are struggling post-op:
  • Take your time - There is absolutely no rush to do anything when you are post-op. Do not cram too much into the day, there is always another day to do things. Apart from dilation, there should be no other priorities in your life.
  • Be kind to yourself - Don't beat yourself up for being over-emotional. Just for once in your life you can be as emotional as you need to be. Surround yourself with people that will accept and understand this. Get them to read this page to help them understand. DO NOT be alone. You will need contact, especially since you had so much care at the hospital. Treat yourself with some nice food, you can worry about your figure further down the line and you need to eat well anyway as your body is still healing. Take painkillers, you are not a wimp for doing so and there are no prizes awarded for being strong. Keep warm or cool, try to forget the costs of heating if it is winter - you need to be comfortable. If you have a bath, take a long soak.
  • Avoid conflict - The advent of the Internet means the whole world is now with us all the time. Try not to get involved in deep debates and discussions. Be mindful of what you watch on the TV. News stories may be triggering.
  • Avoid negative influences - In the same way to avoid conflict, avoid those people who always want to moan about how bad their day is. This is your time, cut those people out of your life for the time being.
  • Cry, talk and cry some more - Don't bottle it up, express your feelings and find someone to talk to. If you are really struggling and have no one in your life, call Samaritans (08457 909090). Email me if you think it would help, I can't guarantee a speedy reply but talk to someone.
  • Be patient - This may take some time to settle but you have the rest of your life to look forward to. 
  • Do not worry - The anxiety should have been left at the theatre doors. Your wounds will heal in time, the pain will ease and any issues should get better. You may be spraying urine everywhere and so what? At least you are now weeing properly. Dilation may be causing pain - stick to the regime and it will get easier. 
  • Enjoy your body - Look at your new vagina and find solace in knowing you are now "correct". Explore yourself; it may not be a sensual experience initially but get to know how you feel down there. Use plenty of lube and you will not cause any damage.
  • Talk to others - Slightly different to the cry advice above, this is more along the lines of reaching out to other post-op people. This can be a hit and miss affair but if you can find someone else kind enough to share their experiences, it may help affirm your own.
  • Listen to your body - Watch our for signs of infection (you will have been advised in your discharge information). You will almost certainly have issues with hormones; mood swings, hot flushes and night sweats are all symptoms of no sex hormones. You will restart your hormones at a specified point and these symptoms should ease. If they do not, contact you GP or gender clinic. Be aware of anything else you feel is unusual physically, anaemia (low iron) can occur post-op and will exacerbate low mood. Again, see your GP if you are worried. You have had major surgery, these people are there for you now.
I hope this helps anyone that has experienced this post-op. For me, just knowing I was not alone in this helped more than anything else. It is perfectly normal and will improve over time. There will be happy and sad times and it is normal to feel unhappy when you should feel happy. I would also like to point out that the majority of the time, I am blissfully happy and very satisfied with my life.

Tuesday, 3 February 2015

3 weeks post-op

I can report that at 3 weeks, everything is going really well. The surgery site is looking very healthy and clean with the suture lines healing well. There is an open wound, about a 40mm long and 3mm wide semi-circle at the very bottom but this is getting smaller with every single day. It was caused by the sutures popping open and this is a very common occurrence. There is also a gash like wound about 30mm long down one side of the clitoris but the other side is unbroken skin. After much discussion with Mandy, we have decided that this was the way this area was constructed, an incision was made on one side to pass the urethra and clitoris through. Now that we have realised the asymmetry of the surgery, it is not so alarming - we thought originally one side had healed and the other had torn. Mandy cleans my lines and wounds every day and it is slowly getting to the point where very little discharge is being removed. The cleaning process whilst not painful, does feel very sensitive especially around the clitoris area. It's certainly not sensual yet, just really over sensitive and in time this should hopefully stabilise. There is discharge on my panty liner but this decreases almost daily. The most is usually after the morning clean because wounds and lines have been disturbed.

Toileting is now a whole new experience and adds a completely new dimension to it all. There is a part of me that is partly glad to have remained with a catheter for an extra week because this gave me an opportunity to get used to everything before adding in this new feature. Urination now feels correct, to sit properly and void in this way is a very profound feeling. Even more incredible is the sound, it is a noise I have heard from Mandy for all these years and now I am making it too! Our consumption of toilet paper has increased dramatically, perhaps threefold because I am taking extra care to dry the area. I feel grateful for having been prepared for this. Having two anatomically correct ladies in the house is now going to more expensive!

Dilation gets easier with every single day. I wrote my Dilation FAQ's a few days ago and mentioned in there that I was now using a bigger dilator already. You go home with a 25mm and 30mm pair, but I felt these were so easy to use and decided straight away to buy a graduated set of larger ones. They arrived on Tuesday and I decided to try out the 32.5mm one in the second dilation. I had to go super gentle and it took a good minute to insert. The greatest resistance was the pelvic muscle but once past this, it slid home quite easily. There was no pain or discomfort once inserted and 10 minutes with that was quite easy. Over the next 5 days I introduced this into my regime so that by Saturday I was using it three times a day. This then led to the 25mm dilator being very easy to insert and by Sunday I decided on the final dilation to start with the 30mm and not even use the 25mm. Although I needed to go slow with the 30mm, it was comfortable and over the next few days I will try to remove the 25mm from the middle and then first dilation. It's all about changing gradually and thinking carefully about those changes. The first time I went without the 25mm was the final dilation because that is when I am at my most flexible, first thing in the morning would not have been such a good idea with 12 hours of sleep and closing up. By removing the 25mm completely, I can save 10 minutes from my schedule which is now longer with the extra dilator.

Pain levels are worth a mention because it is still a factor in my life at this time. Discounting the backache and trapped wind whilst recovering, I found even from being wheeled out of the recovery room that my pain has never really gone above 2 on a scale of 10. I still have pain in the surgery site and it is still sometimes at that level, but a little more localised now. Most of the pain is where the base of the penis was and this now dwindles moving away. Sometimes this pain also extends from beyond the body to about 30mm outside so there is a little bit of phantom limb going on here. This is backed up by the itchy foreskin I am still getting occasionally. A nurse told me that my foreskin probably is itchy but is in a different place to where my mind thinks it is. This brings new meaning to an itch you can't scratch. I deal with any pain I am getting with good old paracetamol and still take them on a prophylactic (preventative) basis. I am also getting occasional stabbing pains where nerves are regenerating but this is a very random occurrence. This may actually get worse in the next few weeks and it's a case of wait and see.

Physically, I am in really good shape. For myself, this two week housebound rule from leaving hospital is a farce and I have recently ignored it, enjoying several 20 minute walks in the lane leading from our flat. I have been more active in the kitchen and those 4 weeks of meals I cooked for the freezer are going to now last much longer because I have been cooking more fresher food. I have been helping around the flat and resuming my carers role for Mandy. We had been bumbling together with everything but now I can reduce her workload and not aggravate her painful conditions. Even yesterday (Monday), I found myself in the kitchen baking. I feel fine, capable and I am super careful about how much weight I lift. A minor aggravation is that I am unable to drive but the plan is to attempt this in 10 days when our good friend Susan visits. She can go out with me and help me back home if there is an issue.

Hormonally, today is the day I restarted my hormones and although it hasn't seemed a desperate situation like many report, it is with some relief that I do this. I have obeyed the guidelines in this respect and not started early like some do. I have been hot flushing for the last few days like crazy and night sweating ever since surgery. Interestingly, I have had some breast development when the testosterone was eliminated and rather than the forwards growth the oestrogen brings, this has been outwards as in the diameter of the breasts has increased a great deal. My skin has gotten softer too, is less greasy and body hair growth has slowed along with facial hair.

Emotionally is where it all falls to pieces. In fact this has been such a massive issue, that I actually think it deserves a post all of its own later in the week. Suffice to say, I am all right, I have got through it and I don't think there was any danger to me. It was a difficult weekend though and talking to Mandy and Susan helped enormously.  I am hoping that with restarting hormones, this get easier.

My GRS time-line :