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 :

• 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.

Also:

• Dilation FAQ's - Some ins and outs of dilation