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 :
- Surgery recollections - The day of the surgery itself.
- Bed rest - The days following surgery and the critical resting phase.
- Vaginal pack removal and first dilations - The day I saw my vagina for the first time and started dilating.
- Catheter woes and first solo dilations - Catheter comes out, goes back in again! I also dilate without supervision for the first time.
- An adventure of a lifetime - Getting back home and reflecting on the whole experience.
- 10 days post-op - Getting back to normality and bad smells!
- 2 weeks post-op - Catheter removal and successful toileting.
- 3 weeks post-op - Healing well and advancing dilation.
- 4 weeks post-op - More healing and hot flushes.