Sunday, 29 March 2015

Returning to running

I had a positive post-op appointment in Brighton this week and in amongst it all was the news that I have had a successful recovery and that I can start to resume a normal life again. This led from asking about when I can resume my running.

Running for me last year had a double effect. In the first instance it helped me lose my weight to the point where I had a normal BMI for the first time in my life. Another plus is that it gave me time to help work through my issues and keep on top of my emotional health. The last 3 months have seen this stop, my weight has increased and I have had no easy way of number crunching my thoughts and emotions. 

So the news that I can restart a vital part of my own self-therapy was received with some joy. I had already anticipated this development and bought myself a GPS watch so that I could track my progress instead of just relying on guesswork. I looked at various watches and found that the Garmin Forerunner 10 was what I needed. There were better models, but all I really needed was a tracking device. It was the same price in Taunton Argos as it was anywhere else so I ordered it and collected it on Monday. Susan was around so we gave it a quick test on a walk, although it hadn't enough charge so we only had a partial readout. 

The watch is delightfully simple to use. You press a single button and wait for it to find it position. This has taken from 2-30 seconds depending on the cloud cover. Once it's got it's location, you press start and go running. When you finish, you press a button and have the option to resume, save or discard the run. Within the watch it saves some records such as fastest mile, longest distance, fastest 5K etc. There are just enough records so as not to become overkill. Whilst running you can select 2 displays, and they are customisable. I have Time/Distance and Pace/Distance. There is also a Speed and Calories option with the calories determined by setting a weight within the watch.

When connecting to a PC, you can then sync the watch with Garmin's own website and have all sorts of ways of displaying stats. Your runs are displayed on a map alongside details such as elevation changes, speeds, pace and much more. You can also share your runs to Facebook and other social media. 

Adding in this technological edge to my running has made it quite fun and interesting. I appreciate that some use technological devices like this to motivate themselves into exercising more. For me, I do not need that motivation as last year I "got" the running bug once and for all after five years of dabbling with it. I needed to lose weight and I was also struggling with my emotions and running solved all of that together. However, it is nice to know just how far I have been running. That was the principal reason for getting the device. All the other features are interesting and can perhaps help me to improve my fitness and pace. I remember back in January at the theatre doors in Brighton having a discussion about my ambition to run a marathon with the anaesthetist and Vicky, my nurse that day. We were all runners and this was a nice topic to pass the time with needles and drugs being administered! We all had this ambition and I can use the features on the watch to help achieve that aim.

I was not one to hang around and the day after getting back from Brighton, I decided to have my first run since my GRS. I got the watch located, and set off. I was not sure how far I would go or how often I was going to stop to walk. I had not run for nearly three months, as well as not doing a great deal of anything in that time and I would need to probably stop and walk a fair bit. 

I was amazed that I managed a three mile run completely non-stop with an average pace of 9.50 minutes to the mile (6.1 MPH). My legs were to tell me how unfit they were over the next couple of days but I was shocked at how good my cardiovascular fitness was given how little I have done. 

I had another run the next day, but the day after I found my legs were not up to it. I got as far as the end of our driveway and came back home! I got back out yesterday and had another today, all the while improving my times and distance.I am feeling quite excited at the prospect of getting back to my previous fitness as well as losing the couple of stone I have gained since my surgery. It will also be good to get back to using running as my therapy and hopefully get my mood back to a better level.

Friday, 27 March 2015

The aftermath of the silver nitrate treatment

A short post but hopefully a useful one.

Following on from my visit to Brighton on Tuesday, I have found there have been some issues to deal with after having my granulation treated with the silver nitrate sticks. There were two areas that were treated and they both had slightly different effects.

The clitoral area had an obvious lump of granulation as well as a loose flap of skin. Mr. Thomas treated this first and this was the area I reported as visibly fizzing as he did so. It wasn't so much a stinging sensation and more of a super intense tingle. I had a lot of black discharge come from this for 12 hours and it was very noticeable on the pad. I also had a lot of dark brown mucosal discharge for another couple of days. In addition, the area was covered in a dark grey coating that took some time to clean off. Even now, a few days on, I am still finding a few flecks of this coating. We've also found that the area is prone to bleeding when cleaning although it is much better than before the treatment. I also had some major swelling to the point that I could not see my clitoris but this has receded back. Overall though, the area looks a lot cleaner and better than it did. However, it is all super-sensitive at the moment. This might indicate a promise of potential for stimulation but it is going to be a few more days before it is ready for this.

Internally, this I am unable to see. I noticed the day after that the gel that oozes out after dilation was a very red-brown colour. This has not changed in the last three days and I am also still getting a lot of streaks on the ends of the dilators. The grey coating I had from my clitoral area is also coming from inside. Sometimes I douche and nothing comes out and then other times, there is so much that I get alarmed and douche again. The pain I was getting on dilation has eased a little but is still there. Overall, all the discharge is abating and it feels like it is getting easier.

Here are a couple of useful links with regards this treatment. 

A leaflet giving advice as to what to do following treatment.

The medical uses of silver nitrate.

Wednesday, 25 March 2015

10 week post-op check

Yesterday saw the arrival of the ten week mark since my surgery and this meant it was time for my post-op check-up at Brighton. We decided when I received the appointment that we would drive up and back in the same day so our friend Susan was roped in to help share the driving. 

We set off mid morning and because the appointment was in the evening, we enjoyed the ability to set a very easy going pace. Typically there was no serious traffic and we enjoyed a very straightforward drive all the way. In fact the biggest issue was what to do for the afternoon whilst awaiting my time. We parked up in the centre and managed to waste away the afternoon drinking coffee and wandering around the shops. It also showed a return of my strength with me pushing Mandy around in the wheelchair.

Prior to my appointment, I actually found myself visiting someone who had had their GRS very recently. She has just started blogging and her experiences can be found here. I was dropped off at the hospital and made my way to see her. It was a strange feeling walking back into this place. I remember last July and leaving the place in a fit of rage and then leaving in a very good place in January. To return for the final time as a patient was a slightly upsetting experience, the finality of the evening was starting to hit home.

I visited my friend and found it a profound experience being able to chat to someone going through the same thing. I knew where she was in the process, what was happening and almost jealous of what she was about to experience. 

An hour flew by and I said my farewells and proceeded back downstairs for my own 15 minutes. I checked in properly and went along to where I was directed. Liz Hills greets me with a hug and remarks how well I am looking. I am shown into the room and there is Mr. Thomas. I have remarked before how I have found him to be an enigma of a man. There are usually few words and this has made me ponder greatly on why this is. Regardless of past thoughts, this evening was very much different. I am asked straight away by him how things are going and I state just how good things are. "This will be different", he jests as if this is something unusual! Bloody hell, a sense of humour, I thought.

I am given a couple of letters and they are for the gender recognition panel to prove that I have had my surgery and that it is irreversible (as if I didn't know that!). I am then asked a few questions such as how my vagina has healed and how I am coping emotionally. The former I explained about my suspicions of granulation internally and the latter, I was managing to work through my emotional issues and why I though they were troubling me. He seemed happy and then asked about dilation to which I said I was sticking to it religiously. Depth was discussed as well as work issues, which aren't for me!

Liz then shows me into the next room and it's strip off below the waist for my examination. I was ready for this having discussed it with other people prior to this. There is a great lack of information about this examination but I can reveal that this will be my first experience of a speculum

First though, Liz has a good look and exclaims how good it is all looking. She says she can't believe the level of healing I have had and that she does not see many at this point with such an outcome. I suspected that she says this to everyone, but she states that she only says such things if she feels it is genuine. I credit Mandy for doing the cleaning work early on, she says I will have no worries further down the line and it will look indistinguishable eventually from a cisgender woman's vagina. She says to get some Bio-oil onto the suture lines to help them fade from the purple that they are.

She bangs on the wall and in walks Mr. Thomas. I am given a mirror to view everything and first up is a quick inspection. He says how good it looks externally and then opens up the clitoral area. He is then straight in with a silver nitrate stick on to the granulation I have next to the clitoris. It is a strange sensation, not painful but very very tingly. I can see it fizzing away and I am warned it will be a bit messy for a time.

Then, without any warning, the speculum is thrust inside. Now I am grateful for how well I have persevered at my dilation and it is not in any way uncomfortable. He starts moving it around and Liz shines a powerful lamp up there. He finds the problem at the back end and then he is in there with another silver nitrate stick. In the end he uses two of them and thankfully, I can't really feel this too much. I am warned that I will have a brown discharge for a time. I ask about dilation when I get home and he says to just shower and douche that night. I was struck at this point about how relaxed I was even being probed about in this manner and that I could continue with a normal conversation. 

Mr. Thomas is finished and Liz helps me to clean up. He leaves and then I am asked by Liz if I was willing to let her have some photo's so that she can show others when they come for their pre-op's. Because I have had such a good outcome she feels she can use that to encourage others to try to do everything right. I agree and I am asked if I can take one every few months to show how it progresses. 

We return to the consultation room and there is a little more to discuss. I was asked about intimacy with my partner, and I reply that I was waiting for the 12 week mark as explained in the discharge notes. There is an element of surprise at this, as if I am the first to even read those notes. I am told that I can start exploring that now, but it may bleed a little because of the silver nitrate treatment so I am advised to wait a few days until that has gone over.

I ask about when I can start running and I am told that I can start as soon as. In fact I am given a clean bill of health and can start to resume normal activities. I then get ready to leave, and thank Mr. Thomas for what he has done. I shake his hand and then thank Liz saying that I would do it all again, the eight days I had there were so amazing. I mentioned how fantastic everyone had been and then I burst into tears. Mr. Thomas is quite shocked at how moved I was with everything and he comes over and shakes my hand again, a big smile on his face. I hug Liz and say my goodbyes. Liz sees me out and her parting words were, "go off and live your life now".

I walked back downstairs and out the doors with those words firmly in my mind. It was sad to say those goodbyes but my life is now in front of me and it's time to start moving onwards. There are a couple of issues to confront, one I discussed in my post "trying to unpick my emotional issues" and after discussion with my GP it seems I may have mild PTSD. Now my transitioning is over, I have felt more able to deal with the issue that has caused this and I have since referred myself to the mental health team in an effort to help myself.

We drove back, a fairly quick run back and I douched as was suggested. It was very messy and this has continued today. My dilation is a little less painful though although there are streaks of blood on the tips when I remove them at the end. I was told this will get better so I just have to bear with it for the moment.

Monday, 23 March 2015

Growing stronger

**** Remember: Everyone's recovery from GRS will be different. Do not attempt anything I describe until you feel absolutely sure you are ready ****

I have talked a great deal about my emotional difficulties following GRS and they continue to be something I am dealing with all the time. This is in some way linked in with my physical recovery because now that I am physically more capable, it is having an effect on improving my mental health. 

This week in particular have found me doing some gardening. Of course there are die-hards that might have a sharp intake of breath at this given that I am just over 9 weeks from surgery. These will be the same people that advised me to lay in bed for the fortnight, and there was no chance of that ever happening.

No, I listened to my body and it said I was ok to do this. I looked at the weather forecast. It has been fairly good in this part of the UK this week and my roughly dug over garden was starting to sprout lots of weeds. It is only small garden, about 8 x 4 metres and the plan was to plant some fruit bushes in most of it and turf the rest. 

I started by visiting a DIY centre on Monday after a coffee in town and found all their bare root fruit bushes were half price. I grabbed what I thought would get me started, a mixture of raspberry, tayberry, gooseberry and blackcurrant. I got them home, unwrapped them and soaked them in buckets of water overnight. 

Tuesday came and here would be the moment of truth, could I wield a spade at this time? It turned out that it was no issue at all and the soil was really easy to dig over. I planted bushes as I went and was particularly careful to take lots of breaks, perhaps doing no more than 45 minutes at a time. I also did not push myself to finish the whole job and found myself at it Wednesday and Thursday. I needed to concrete in a washing line and decided that this was too heavy in it's nature and enlisted the help of my friend Susan yesterday for this task. The garden is still not finished and I am in no rush.

The benefits of getting outside and doing something have been far reaching. I find my mood much more improved and positive. Just knowing that I am moving towards getting the final piece of our new flat finished is great news. I also feel benefits from getting some fresh air and sunshine. The emotional gremlins that have plagued me for the last two months are still there but seem easier to deal with. 

The next step in my rehabilitation is to resume my running. Again, this is where others seem to know better than myself. A recent conversation led to me being "bollocked" for walking from a car park to a venue in Exeter, a distance of perhaps 600 metres. Given that the day before I had walked over 4 miles, this level of concern for my health can get a little tiring. I know, I have done this with others and only because I am concerned for their safety. But sometimes, some of the advice I get is just absurd. 

Tomorrow, I travel to Brighton for my post-op check. I will ask there when I can resume running and go by what I am told. I am almost certain I will be told to listen to my body and if this is the case, I will probably go for a short experimental run the very next day. I feel ready physically but my only concern is the pounding action running has on the body and potentially my new vagina and this is something will will enquire about.

Once I can get running, this will add in an added element of therapy for myself. I really think that this is something I have seriously missed out on the last few months, that 90 minutes of being able to run my thoughts through my mind.

So fingers crossed, in the next few days I will be getting properly back on the road to physical normality.

I'll be back on Wednesday with an update on my post-op check.

Wednesday, 18 March 2015

Trying to unpick my emotional issues

It's official now, I can no longer lay as much blame hormone levels on my recent emotional difficulties as I would like. I received my results on Monday and they are sat at a low but within range level. I see my GP tomorrow and will attempt to persuade her to increase my dose but she is well entitled to leave things as they are. I still do not feel my levels are quite right for me and there is a large scope for a safe increase. I hope she can realise that I am not just thirsting for more oestrogen as some seem to want to. I feel low in mood and virtually none of the feminising effects from before surgery have returned.

So, I can no longer attribute the majority of my issues on the hormones and need to examine closer the reasons as to why I feel so low at the moment. I am generally in a better place than I was. I wrote about turning a corner a few weeks ago, and still feel that I am on the improve. However, there are times when it comes crashing back down and it takes very little to make this happen. I have been talking to others about this and it is becoming quite apparent that this post-op experience is very common. 

When talking to someone very recently, I used the term "fog of war". I first came upon this term from playing many simulation games such as Civilization and they commonly use this term to denote game-play mechanics. It is a military term that was coined a couple hundred years ago and I feel about my whole transitioning as being in a fog of war.

War would be a very good term to equate the whole process. From my entry into the gender clinic, I did battle from day one. My fights varied from serious clinical errors to therapists not following clinic protocols and even outright lies from admin staff. I had to take them all on, writing complaint after complaint. It was fatiguing and battle weary was how I felt when I finally got everything on track for the final part of my treatment, my GRS. Of course even that was delayed as this blog has described. The fog side of things was the fact that everything else in my life was completely obscured because of being so driven with getting through my transitioning. I could not see any of my other issues developing, let alone even think about dealing with them. I had to be so driven and hardened that I now feel I have not given myself time to myself to deal with my emotions. 

Of course now although my journey is far from over, the transitioning actually is on a practical level. There are no more major fights that I can anticipate and suddenly this fog of war has now lifted. The view is very clear and at I can see everything ahead of me. Issues that were obscured have now come into sharp focus and at times I am completely overwhelmed. 

The weekend just gone brought just one such issue into my mind. Increasingly I am finding the phenomenon of triggering becoming much more common in myself. This is where an event, a phrase or even a single word brings home an unpleasant reality or memory. I was always quite resilient to triggers before my surgery but now they can be quite devastating. I was triggered in one such way on Sunday and I became very distressed because of it. It brought home a serious issue that I had ignored in the months up to my surgery; I had done this to protect myself and get past the finishing line in one piece. I was left in a position where this threatened my emotional health and I needed to deal with it. It has been a problem that refused to go away in the last 12 months despite my best attempts to remedy this.

I am now working to deal with this issue, but it is going to take some time. When trying to deal with it in the past, the core issue was always brushed under the carpet by other parties despite my best attempts to keep this from happening. Now I have managed to make the other parties realise where I am at and hopefully we can work to resolve this issue.

I am also led to wonder about my level of unhappiness and I now have an inkling of why lottery winners often seem to end up in a sorry state of affairs. They say money does not buy happiness and in practical terms I have won a kind of lottery in itself. I got several massive issues out of the way last year which included getting social housing, finalising my divorce, losing all my weight and finally getting my GRS this year. I could not want for more and yet, and I seem to be saying this a lot recently, I am not happy. Someone suggested recently that I have had too much go right for me lately and I will need time to get used to it. Perhaps they have a good point, and perhaps I have gotten so used to be unhappy, being happy is almost a scary prospect. I know when I do relax and try to take in my happy state of affairs, I feel tense and anxious. It seems to fly in the face of most of my life and it takes me out of my comfort zone.

There is still a great deal for me to work on!

Friday, 13 March 2015

2 months post-op

It's quite hard to believe that it was two months ago that I had my surgery. At times, it has felt slow but on reflection, the time has actually passed much quicker than I expected. It has been interesting getting to this point and now I am in a position to be able to look back and see how far I have come in those couple of months.

I am healing very well. As I said at the 6 week mark, externally everything is completely there. I get a little soreness on some of my scars from time to time and I just put a tiny covering of Sudocrem on it to help with this. I have also had a spot on one scar and suspect it was an ingrowing hair. It is nice now to be able to go to the toilet and not have to fear bumping any wounds and getting bleeding.

The clitoral area has probably been the most relevant the last fortnight as there has been a lot of changes here. Just after my last update, we decided to have another go at removing the white build-up in the upper corner of the clitoral hood. I was aware that it was getting bigger and it looked like it had moved one morning. Mandy agreed and had another go at it with a cotton bud. Suddenly, it just fell off and ended up on my labia. I got a tissue and dabbed it off. On examination, this lump was the size of a medium pea, quite hard and a mass of all sorts, including pieces of suture. 

Where it was attached, Mandy felt she could see a gaping hole but I assured her that it was just an indentation caused by the build-up. More exciting was the fact that suddenly the whole clitoris was now completely visible! My whole anatomy was a lot clearer now and what we had thought was the clitoris before was actually not. 

This was 2 weeks ago and there have been some dramatic changes in the whole area. The clitoral hood has been slowly shrinking back and this has made the clitoris seem to become larger. The area in general is now taking on a more pink tone as opposed to the angry red that it was. Some granulation is now evident in isolated places. I have my post-op appointment in 10 days so they can decide then if they want to try to treat this (hopefully not, the silver nitrate stick they use stings a great deal).

There have also been some interesting sensations in this whole area. The end of the day is a little difficult as it gets very tight, almost painfully so. It actually becomes an effort to even move by the finish. Morning sees it much improved and perhaps the evenings are slowly getting better but the time-scale makes it hard to notice. There have also been some days where it is incredibly sensitive and just walking down the street is uncomfortable. It is not really painful, just massively sensitive. I have also had a few attacks of stabbing sensations, although these are less painful and more on the lines of pleasurable but not quite comfortable yet. Last night saw me have one whilst dilating and it lasted for a good 30 seconds. During that time, I was hard pressed to keep the dilator held in!

On that subject, dilation continues to be quite easy. I have however noticed a little pain particularly when getting to the back end of the vault. I am not too concerned, it may simply be a sign of sensation. The important thing is that it is not getting worse and some days, I hardly feel it at all. It is also possible there may be some granulation inside and this seems to happen at about 6 weeks, which was roughly when the pain started happening. I also notice sometimes that the gel that comes out afterwards can be a light brown colour. The advice is that granulation inside would cause streaks on the dilator, but there is no sign of this, just a general brown colour occasionally. This could simply be discharge of a sorts. I am still using panty liners to guard against discharge but there is very little now, it's mostly just a little urine on the liners.

Hormones, I still feel wrong physically and emotionally and I had a blood test yesterday. I will know next week where I am at. 

Which brings me yet again to emotions and they have still been all over the place. Things got to a head about 10 days ago with actually feeling a little suicidal. It was not too serious and I used my skills from the past to help me work through it - you can read about it here. Since then, I have been ok and not got back to that low but I can be triggered very easily into getting upset. I feel I am progressing to a point, but it is slow going. I am using lots of ways to deal with it by talking about it, listening to music, reading, sewing and a little gaming (Civ 5 was cheap on Steam!). The more I ponder it, the more I realise how much of it is down to the end of my transition. I likened it to someone about it being like the fog of war having been lifted. Suddenly without my transitioning in the way, I can see everything in front of me and some of it is good but there are some bad things too. It's just very overwhelming and to be able to cope I have been having some lazy days recently. This has been quite therapeutic and I am starting to get to the point of feeling ready to start some of my projects I want to do, the main one is writing.

So that's it for the moment and I think that I will give it another month now before another update such as this. I will of course be writing other things too and I have my post-op check-up in 10 days which will of course make for something interesting!

My GRS time-line :

Sunday, 8 March 2015

Walking therapy

I am definitely starting to feel like I am on the mend emotionally. I still feel my hormones are not right and some discussion yesterday also revealed that the whole oestrogen effect is much different post-op due to the complete absence of any testosterone. There was also a wobbly moment yesterday but it was a shared experience and we got through it with some clever use of Skype and private messaging. 

Earlier in the week, I mentioned how getting out and socialising had helped. Friday was a glorious day and I really felt a good walk in the country would be of massive benefit. I have been doing some short walks since I got out and about and so far I had managed just over a couple of miles. Friday I decided was going to push this a little further and had a good look at the map. Within 5 minutes walk from our front door our several footpaths all in different directions and I found one that could lead to a nice 90 minute circular walk. I packed my new shoulder bag I had bought for just this purpose with a few supplies and set off. 

I walk down our lane towards the village of Pitminster and find the start of the footpath within a few minutes. It starts with a boundary of a ploughed field and then over the first of many stiles. These were interesting when I started walking post-op. For a couple of weeks when I started walking, these were not even a possibility and I kept to the roads. When I did decide to brave stiles, it was tentatively and holding on to anything I could for dear life. Now, they are a great deal easier and not really any great issue although I am still careful.

I traverse a couple of fields, a small footbridge and then back on to country lane for a short stint before in through a gate way and across the middle of a large field. The path was not clear and I was using a scan of an Explorer OS map to keep to where I needed to be. This building in the distance of this photo is Poundisford park, and my return path is over there. The field I am in is quite large and a small pond is over the far end and I see the next stile.

A short distance along the path is yet another stile which leads to a secluded grove. I take a photo of another stile which shows a reminder of a place I once worked. The less said about that the better... 

This grove was quite overgrown to start with and it required a little pushing through. At this point the coffee I had had in town on the morning was taking effect and I was left in a situation of dealing with my first ever call of nature, in the middle of nature! This is something many of us joke about pre-op, about how we can still find a tree or a bush and use what we still have. Suddenly post-op, I am faced with a different reality entirely. I had anticipated this and packed mopping up supplies accordingly so it's unbutton the trousers (yes I do wear them occasionally) and squat down. Nope, that wont work, the angle is going to spray it all over my ankles. I stand up and try to rethink it all but I can see any other choice. I squat down again and decide to lean forward as much as I can. Then I am faced with a problem that I can't seem to go. I need to but it wont happen. It's the stress of trying to discover a position as well as the fear of being stumbled upon. Eventually it does happen, it did go where I wanted it to and I felt quite happy I had dealt with this little demon! A quick dry off with a baby wipe and it's trousers back up and off walking again.

I go over another stile and we are back to fields again. A large military aircraft flies over and I manage to get a picture of it as it does so.I walk further on and after some more fields I am greeted with the sight of the M5 motorway

It's a noisy thing and hard to believe that I can be so close to the beauty of nature with this monstrosity next to me. However, we need these roads so I have to put up with it.

I am greeted by more stiles and then a stream with no footbridge. It's a small affair but has a slippery bank the other side which requires thought given my recovering state. I manage to get myself up and then over another stile before being greeted by a wooded area. This requires some tricky navigation as the path is not defined and more than once I ended up with the way forward being blocked. I get through this and then come across a steel footbridge that goes across it and realise that I have driven under this bridge more than a hundred times and often wondered what the footpaths that led to it were like. Now I have found out! 

I decide that for today, I am not going to cross over and continue across some more field before arriving back at Poundisford park. There is a line of daffodils along the path and in a week they will make for a nice splash of colour against the green of the field. I then pick up the road from before, across a couple fields and then along the road to home. My feet are sore and there is also a blister under one toe which is a sign that my walking shoes are brand new and need more breaking in! I am quite happy though, the weather was gorgeous and the fresh air and exercise has made me feel comfortably tired.

Oh yes, I did also take a selfie which is not so easy with a traditional camera!

P.S. Apologies for the layout of the photo's. Putting this many into a post was a new, and frustrating, experience. I will improve this with time :)

Thursday, 5 March 2015

Turning a corner and back on the up

I must admit that my writing has taken a darker turn the last few weeks but it has been an honest reflection of my emotional state. It is not good me pretending to be smiles and happiness when I am in a very unhappy place. To the outside world, I do portray that image because a happy face makes it easier to get around in public, being miserable WILL get you read more.

But once home, I have found that the mask slips and life has been seriously difficult. I am super-sensitive to everything and often I get overwhelmed when too much is happening. This has led to a great deal of tension between Mandy and myself, and we have had to try to develop coping mechanisms to get through this. She now knows that when she returns from her day centres three days a week, she needs to come at me in a more gentle manner. I often have quiet days when she is away and she returns excited and boisterous and it is very difficult for me to handle. I am also finding dealing with problems an issue and I have had to get Mandy to explain to people that although I am physically very well, emotionally I am still resting and need time before I can deal with unimportant issues.

The lowness of my mood has recently got to scary levels. It has been frustrating because looking at it from outside, I should actually be really happy. In a way I am happy in some aspects, I am still overjoyed at having my new vagina and the novelty is far from wearing off. It is healing really well and the post-op discomfort is lessening. It's just that life itself has become very unsatisfying. I then start to have thoughts of what is the point and why am I bothering any more. Whilst I have had such thoughts in the past, they were situational related but this is not so much. I was not quite at the point of reaching for the phone to Samaritans but I think it may have been close at one point. Because of my past work with them, I was able to realise that I was having such thoughts and try to deal with them.

I have tried and tried to get to the root of this and am still very convinced that hormones are playing a large part of the problem. I heard again today that some find getting hormone levels correct after GRS can be very difficult. I was told that the dosage was tripled and this is the second time I have heard this. It seems to be gel delivered oestrogen that is the culprit and although there is no evidence to support this, the theory could be skin changes over time and how the gel is absorbed. Hearing that others struggle has helped, it makes me feel less inclined to blame myself. I have a blood test next Thursday and we can look at it from there. It's however a woman's prerogative to blame her hormones, and I therefore invoke that right to do so!

That aside, I may have found a couple of other factors that may have been a major factor in my low mood. The first is isolation. I spent a week in hospital and then nearly four weeks in my flat. I was incredibly grateful for my visitors in the first week I was back home and then it all dried up. I spent a lonely few weeks until my friend Susan came over for a week and this gave me a reprieve, and it was almost the other way because it was tiring at times. I must also thank another friend, Becky, for taking me out for a coffee for a few times when I couldn't drive. Without those few trips out, I think I may have been a great deal worse.

Of course, I have been driving the last few weeks and every other day, I drive into town for a coffee and do our shopping. This is however, still very isolating because I have no one to go out with and sit reading my book or writing notes while I have my coffee. It is still better than being at home, but I was still feeling isolated. I am missing my voluntary work and being with other people but I am just not ready to be dealing with work related problems at this time.

I realised that isolation was the problem yesterday (Wednesday). As soon as a week after coming out of surgery, I was sent an email inviting me to a disability discussion forum scheduled for yesterday. I looked at the dates and felt I would be ready for this. I had been to one last October and found it to be an engaging affair with opportunities for me to push my boundaries. As important, it was away from trans* issues and more about my own issues with Mandy and myself.

So, off I went yesterday and found it to be as enjoyable as the one last year. I seemed to end up talking into the microphone a great deal, something that still scares me now because my voice is not brilliant. I even managed to bring in the trans* community because there was a lady from the local council discussing local swimming pools and I asked whether they were interested in helping the trans* community use their facilities. I did this in front of everyone and it really piqued the interest of the lady who approached me afterwards for more information. This forum also had lots of breaks and it gave me an opportunity to speak to other people and I had some deep conversations with a couple of ladies. One of these is interested in starting a group with no particular purpose other than to meet up and chat. This is exactly what I think I might need in my life and I hope we can get this off the ground. 

I was buzzing by the time I got home and I realised just what a positive experience this day had been and how the effect on me was helping me get back on my feet. Today too, I have had another group meeting although this was trans* related. It was still a positive factor and involved meeting at the Laurel's gender clinic. It was really nice to have so many of the staff ask me how it was all going. I was apparently the source of much humour when they rang me on my hospital bed in Brighton to tell me not to turn up at the last meeting. At the time, I did explain that it would have been difficult seeing as I was bed bound and it was over 200 miles to get there!

Of course there was one other factor that may be a contributor in my low mood and that is the issue of "the void". This is a phenomenon where a transgender person reaches the end of their transitioning and finds there is nothing left to do. I knew about this and felt it would not be an issue for me. Sadly, I think it has been more than I have realised. The last 5 years  have seen me have to be so driven to get what I needed. If I had not been like this, I would still be waiting for my GRS. It could even be another 12 months or more away, this is how hard I have pushed things. My determination with my transitioning was like driving a car, you need to push that accelerator hard and then suddenly you reach your destination going at full speed. You simply can't stop suddenly and I feel the momentum is still very much there but with nothing to focus on to slow it down. This could explain the feelings of "what is the point", it's like there is nothing left to strive for in life. There is no longer an end goal to work for as there has been.

I think by recognising this, I can now move forwards and start to deal with it all. It's like a grieving process of it's own, I need to lay to rest my transitioning and start to think about my future without it all. I have mentioned just after I got back from Brighton about how nice it will be to do everything without the "noise" of transitioning but I now think in retrospect that I was not ready to dispense with it at that point. Now, I think the time has come and I can use my physical recovery to speed this along by being able to do more things such as longer walks and hopefully soon get back to my running.

I truly hope that this is me turning the corner now and the future can start to develop into the life I always wanted. I will always have a trans-past but I am cis-gender now and the gender dysphoria is now gone. It is time to realise this and start doing all those things I wanted to do before my transitioning got in the way.