My surgery with Dr. Toby Meltzer in Scottsdale, Arizona

This journal is taken from my memories and gently edited diary entries about my SRS experiences.

I've decided to post this anonymously through TS Roadmap because I wanted to give something back to such a great resource for the community, but I still value my privacy and am not completely comfortable putting it on a personal web page.

G.
August 19, 2003

First a little background- I am 36, and had been living full time for about 18 months before I had my SRS in June 2003. I was in very good health going into surgery..

I researched several surgeons in the U.S.(I didn't want to travel abroad for SRS) and had consultations with Dr. Meltzer and Dr. Schrang. In the end I chose Meltzer because I was more comfortable with his recovery plans (being up and walking within days, not a week) and his history of having little blood loss, so a transfusion was extremely unlikely. I was also much more comfortable with Dr. Meltzer's "bedside manner", it just fit well with how I wanted to work with my surgeon for something this important. The one thing that initially had me leaning towards Dr. Schrang was scheduling- my first surgery date for Dr. Meltzer was more than a year later than what Dr. Schrang could offer. I was so much more comfortable with Dr. Meltzer that I put my deposit down with him, thinking I might be waiting a year longer. But it turned out after moving up due to cancellations, my surgery with Dr. Meltzer happened a week before the 'early' date I could have had my SRS with Dr. Schrang!

September 2002

My partner and I flew to Portland, Oregon for a consultation with Dr. Meltzer in late September. This was before Dr. Meltzer had announced he was moving to Scottsdale. His staff was very helpful and pleasant, and the consultation went very well. I had several questions, which Dr. Meltzer answered in detail, and then he did an exam to see if I would need any grafts (I didn't). Dr. Meltzer let me know he was possibly moving his practice, although at that point they weren't sure where. I put down my deposit to reserve a surgery date, and was given a date in May 2004 (the earliest they had!).

August 2002 through April 2003
(backtrack and then fast forward)

Knowing I was going to have SRS sometime in the next two years, I began genital electrolysis in August 2002. I went Electrology 2000 in Dallas, Texas, every 6-8 weeks from August '02 to April '03, and highly recommend them. The staff was very nice and professional, and the results were excellent. I can't imagine doing genital electrolysis without the anesthetic shots. The shots did hurt, and I have to say they were the most painful part of my SRS, but I'd never have made it through the hours of electrolysis without them.

April 2003

After months of worrying my surgery date was never going to move up and contacting Dr. Meltzer's office every couple months to see if any earlier dates were available, I resolved myself to the fact that I was just going to have to wait until May 2004. Then one night I got a call from Dr. Meltzer's office with word that they had several dates in June and July 2003! I took the earliest date I could, and suddenly went from having to wait 13 months for SRS to being only about 7 weeks away. I don't think an 11 month shift in dates all at once is ordinary for Dr. Meltzer, the movement of his practice from Portland to Scottsdale may have impacted some of the scheduling. I also may have moved up suddenly after not hearing anything for 5 months because I didn't get my second letter of recommendation to Dr. Meltzer until March 2003.

May 2003
I made my final payments to Dr. Meltzer for the surgery, and received the packet with all of the information about pre-operative and post-operative instructions (almost 40 pages!) Everything from instructions on the bowel prep to dilating was covered. I read over this many times in the weeks before surgery, and felt like I was cramming for a final exam :) Don't feel like you have to know everything in the packet by heart, the Dr. Meltzer's nurses are very good at explaining everything when you actually need to know it.

3 weeks before surgery

I stopped taking hormones, including anti-androgens, according to Dr. Meltzer's instructions. The next three weeks were a combination of PMS and menopause, with mood swings and hot flashes. I definitely felt the testosterone returning, and I'd forgotten much I hated those feelings. The only bright spot was knowing that wouldn't be a problem anymore in 3 weeks.

Around this time I received the list of non-prescription medicines from Dr. Meltzer's office that I needed to buy. They weren't too hard to find, a good local health food store had the Arnica Montana and Acidophilus, and the Colace and Bacitracin ointment were easy to get at a drugstore. Normally Dr. Meltzer's nurse also sends prescriptions for some things you'll take the morning of the surgery and post-operatively, but for some reason my state wouldn't accept out of state prescriptions so they just gave me those at my pre-op appointment in Scottsdale.

1 week before surgery

I finished packing for the trip this week, using the shopping list from TS Roadmap as a guide. I definitely over-packed, but I decided I'd rather have things I didn't need than forget something. And since we had nice rolling suitcases and my partner was going with me to Scottsdale, I didn't have to worry about lifting anything too heavy on the way home. The things I packed that I didn't use were mostly books, a gameboy, etc- I thought I would have a lot of time to fill during the recovery, but I spent most of my time sleeping, walking around the hospital, or doing post-op care.

2 days before surgery

We flew into Phoenix the afternoon a couple days before my surgery date. I remembered to bring my digital camera and we tried to take a lot of pictures. I definitely recommend bringing a journal and a camera to record the experience. The farther away you get from it the fuzzier memories get, and it's interesting to look back and read about how things looked and felt at the time. The Phoenix airport is about 30 minutes from Scottsdale, so we rented a car. My partner would be staying in a hotel the length of my recovery and she wanted to be able to get around town. We stayed at the Residence Inn recommended by Dr. Meltzer's office- a very nice place, with a full kitchen in the room. It was only 5-10 minutes from the hospital and had a very inexpensive hospital rate (be sure to ask for the Scottsdale Healthcare rate). For the liquid diet and bowel prep medicine the day before surgery it was really nice to have a fridge and stove/microwave.

That evening we went out for a celebratory dinner with some friends from Phoenix. I highly recommend eating a nice dinner that night, it's the last real food you'll have for a couple days!

The last thing we did before heading back to the hotel was to go to a nearby supermarket (there is an Albertson's not too far a drive from the Residence Inn) to stock up on jello, broth, juice and bottled water for the next day.

1 day before surgery

My pre-surgical consultation with Dr. Meltzer was in the morning. After getting slightly lost trying to find his office, we made it safely to our appointment. The staff was still getting used to the new office (I think they'd only been in it for a few months), but everything still went smoothly. The last few details (paperwork, etc) were taken care of, and then I met with Janet, one of Dr. Meltzer's nurses. She gave me my bowel prep materials and went over the instructions again. She also gave me my prescriptions (the ones normally mailed with the packet), which I had filled that afternoon. Then Dr. Meltzer came in, answered my last minute questions about the surgery and told me in more detail what to expect on the surgery day. He then gave me my final exam (hmm, sounds like I'm back in school!) and said everything looked fine. I was worried going into the consultation that I hadn't completed enough of the genital electrolysis, since my date moved up so fast. In theory I should have had one or two more sessions, but Dr. Meltzer said between the work I had done so far and the scraping he did during surgery it would be OK. That was quite a relief!

Today was also liquid diet/bowel prep day. I could only have clear liquids/gelatin and water for the entire day. Here was the schedule:
Breakfast - clear soup/broth, gelatin, unsweetened fruit juice, coffee, no milk or cream, no sugar.
Lunch - same as breakfast
1 pm - drink 8oz of water
2 pm - drink 8oz of water
3 pm - drink 8oz of water
4 pm - drink 8oz of water
5 pm - dinner, same as breakfast & lunch
5:30 pm - drink entire bottle of Magnesium Citrate
6 pm - drink 8oz of water
7 pm - drink 8oz of water
8 pm - drink 8oz of water
9 pm - drink 8oz of water
9:30 pm - Take four bisacodyl tablets with 8oz of water. Insert suppository.
Midnight - nothing to eat or drink (not even water) from now until after the surgery.

At the supermarket we had bought some individual jello cups and a couple kinds of broth (beef and chicken- the chicken tasted better for me), along with a bunch of 8 oz bottles of water and apple juice. I was glad to have the fridge in the room, since I could keep all of the water, juice, and magnesium citrate cold.

The mini 8oz bottles of water made it easy to keep track of how much I drank, plus I could line them up on the counter as I finished each one to see I was making progress :) Obviously with all that water, you are going to want to spend the day close to a bathroom. I just hung out with my partner in the hotel room, and went to the bathroom about every 30 minutes! The water and broth got old pretty fast, by dinner I didn't want anything more than a couple jello cups.

The magnesium citrate wasn't that bad, it tasted like slightly flat 7-UP, with a bit of a metallic aftertaste. Between that, the bisacodyl, and suppository, my system was completely purged. I'd guess it took about 3-4 hours, by midnight I was ready to try to sleep and only got up a few times in the night to use the bathroom.

I actually slept fairly well the night before surgery, which surprised me. I thought I might be too excited, scared, or nervous, but really the night two days before surgery was my bad night (only a couple hours of sleep). By the bowel prep day I felt more excited than anything else, was fairly calm by the evening. Not having many calories that day also may have made me tired faster.

Surgery day!

I woke up about 7 am and took a shower. It was a beautiful day outside, not a cloud in the sky. I felt amazingly calm, knowing all the details were taken care of and all I had to do was show up at the hospital. My surgery was scheduled for 1 pm, so I had most of the morning free. It was hard not being able to eat or drink anything, but I watched some TV and packed a few things to take to the hospital to make the hours go by. We were supposed to get to the hospital at 11 am, and we left about 10:30, leaving plenty of time to get there.

Dr. Meltzer performs his surgery at the Greenbaum Surgery Center at the Scottsdale Healthcare Osborne campus. It's a surgery/recovery center, separate from the main hospital building, and was quite impressive. It just opened in early 2003, and everything was state of the art. Dr. Meltzer talked about the surgical facilities in glowing terms, he sounded very happy with how it was all working out. The recovery center was incredible as well- all private rooms from what I could tell, and a good patient to nurse ratio. The food was first rate, nothing like normal hospital food, and you could order from a fairly varied menu at each meal. The best part of the Greenbaum center was the staff- the nurses were very nice to me, and I didn't have any of the normal hospital horror stories you hear about not being able to get a nurse when I needed one or having a nurse with a nasty attitude. The nursing staff had adapted to Dr. Meltzer's patients so well I would have thought they'd been seeing SRS patients for years, not months.

Back to the surgery day- After we showed up (my partner who would be there the length of my recovery and my sister who came down for the first few days), I filled out some minor paperwork to be admitted. A nurse took me back to a small prep room where I was given one of the lovely open-in-the-back hospital gowns and had some vital signs recorded. They bagged and marked my clothes and personal effects, which were taken to my room after surgery (when I first looked for them a few days after the surgery, I couldn't find the bag and panicked. Not to worry, they had been stowed in the bottom drawer of the dresser by my bed). After getting my gown on, I was given a nice hot blanket and walked over to the pre-surgical waiting area (basically an open area with several hospital beds divided up by privacy curtains). Once I was in the bed, they let my partner and sister come back to be with me. We chatted for a while, and then the nurse came by and hooked up my I.V.. The anesthesiologist stopped by and explained that I'd have a general anesthetic, and wouldn't remember anything about the surgery (which was fine with me). He came back shortly and gave me a shot in my I.V. to calm me down a bit. I was getting a bit more nervous as it came down to the last 30 minutes before surgery, so it was probably a good thing to get the shot :)

Dr. Meltzer stopped by for a quick chat while I was in the pre-surgical area, and then a little after 1 pm the anesthesiologist came back. I gave my partner's hand a squeeze and told her I loved her, then they started some meds in my I.V.. This was supposed to put me out of it fairly quickly, and sure enough, the last memory I had was seeing the doors to the O.R. open as they wheeled me into surgery...

The surgery took about three and a half hours, and after I was stable and coming out of the anesthetic in the recovery area, Dr. Meltzer went out to the waiting room to tell my partner & sister how things went. He told them the operation was textbook, and that I was fine. He also told them to thank me for losing weight (I had lost about 75 pounds in the 18 months before SRS) - since it had been lost fairly recently, the skin was loose and gave him plenty to work with.

... The first memory I have from coming out of the surgery was being wheeled into my room upstairs. My partner and sister were right there in the hall, it was very comforting to see them when I woke up. The nurses settled me into my room, and then let my visitors come in. I was kind of in and out of it most of the evening, feeling pretty loopy. I noticed my voice sounded funny, at an odd pitch, but that went away after a few hours. I was hooked up to pain meds in my I.V., so I could press my 'happy button' every ten minutes to get a shot of something that felt pretty nice :) I don't remember much pain, but with the I.V. pain meds I could have been in a lot of pain and not cared much. I was really too groggy to pay much attention to the surgical site, all I remember was ice bags the nurses changed pretty regularly, and lots of tubes coming out of that area. The nurses checked on me very regularly through the night, taking my pulse, blood pressure, and temperature.

1 day post-op

I felt pretty good when I woke up the morning after surgery, but got tired pretty fast. I was on solid food for breakfast, but didn't feel very adventurous so I just ordered some toast and yogurt. I ate one piece of toast and that was all- I was a little queasy and had no appetite. Lunch was the same problem- I just didn't feel like eating. I did have a wonderful chocolate chip cookie with lunch that I kept for a snack in the afternoon, when I felt hungry again.
Dr. Meltzer stopped by my room after lunch, took a quick peek at everything, and said the results looked good. There was a lot of swelling above the pubic bone, and the skin felt really tight. Later in the day the nurse switched me off the I.V. pain meds, and onto oral meds. The pain really wasn't that bad, but I did have to ask for another pain pill after a few hours.

I received flowers from my church and the company I work for, which were a nice surprise. They smelled great, and really brightened up the room.
By dinner time I was starting to feel less queasy and had some appetite. My partner and sister went next door to the surgery center to a wonderful pizza place called Oregano's (definitely go there if you are in Scottsdale!). They were going to eat there but the wait was really long, so they got a pizza and brought it back to my room to eat. I was feeling good enough to have a couple very small pieces of pizza, and it was excellent. I couldn't believe I was only 24 hours post-op and eating pizza in my room :)

2 days post-op

Last night was a very hard one- I just couldn't get to sleep, either from feeling hot, not being able to get comfortable laying on my back, or from pain. The pain wasn't overwhelming, just nagging enough to keep me awake. Even with the pain meds and sleeping pills I didn't drift off until about 5am, and was woken up when breakfast came a few hours later.

The worst pain of the surgery happened later in the morning. My catheter was hooked up to a bag that hung down on the side of the bed. When everything worked right, the cath drained into the bag as needed. But somehow my cath line got twisted and wasn't draining into the bag. I didn't realize this at first, and just thought the pain was soreness from the surgery. After getting a pain pill and having it still get worse, I called a nurse who noticed the problem with the cath bag. Once she fixed that and I was empty I felt a hundred times better.

After lunch a nurse stopped by to show me how to plug the catheter so I could unplug it from the bag and move around. I was supposed to go no more than 2 hours with it plugged. I was starting 'bladder training', which basically meant plugging it for as long as I could stand (up to 2 hours), then emptying my bladder and re-plugging the cath. This was to get my bladder used to being full again, and not just draining constantly. At first I could only hold it for about 30 minutes before I just had to go, but after a few days I was up to an hour and a half to two hours.

Once I was shown how to plug the cath I got to get out of bed and take my first steps. I took it very slowly, and walked across the room, then felt good enough to go down the hall to the nurses station and back (about 50 feet). By the time I made it back to my bed I'd felt like I had run 10 miles. It definitely got my heart rate up, and sapped all my energy. I spent the next hour in bed just trying to recover.

After I recovered I finally got to take a shower! It felt so good to wash my hair and just get clean again. More flowers showed up while I was in the shower, from friends back home. I really didn't expect to get flowers from anyone, so it was really nice to get so many.

3 days post-op

A better night of sleep last night, but I woke up every two hours feeling like I had to pee and had to jiggle the catheter line to get it to drain (you stay hooked up to the bag while you are asleep). I just figured this is the way it worked, but when I told a nurse later she showed me that by putting the bag down lower, the line was straight enough to always drain, so I didn't wake up all the time needing to go. That was definitely nice to know :)

When I woke up I got out of bed and went and brushed my teeth- it felt like so much freedom to just be able to do that! And then I took a walk down to the nurses station, since Dr. Meltzer wants you to get up and walk around as much as reasonably possible. It wasn't as hard as the first time, so I was gaining some stamina.

I wasn't quite prepared for the amount of swelling around the surgical area- reading "there will be swelling' in the pre-surgical packet doesn't prepare you for what it feels and looks like. It was starting to get better by the third day though. I was also getting pretty stiff from being in bed much of the day, although the more I was up and walking the better that got. There really wasn't any comfortable way to lay in bed other than on my back, and I'm used to sleeping on my side, so that probably contributed to being stiff.

Dr. Meltzer stopped by to remove the drains from the surgical site in the afternoon. They look like the little squeeze bulb on a manual blood pressure cuff, and basically suck blood and extra fluid out of the surgery site. I was glad to get rid of them, they were uncomfortable and tended to get in the way when you were up and walking. It hurt some as he pulled the drains out, but the pain was over quickly. I felt a lot better not having the drains in, I didn't seem quite as sore with them out.

4 days post-op

A much better night last night. I slept pretty much through the night, now that my cath bag was arranged right. I showered and actually got up the energy to put on a little makeup, which made me feel good.

I should mention some of the amenities of the rooms at the Greenbaum Center. Each room had a nice big bathroom, with a walk-in shower. The room had plenty of light from outside (if you are on the west side of the building, it does get hot in the afternoon with the sun coming in- pull the blinds all the way or bake!). I didn't realize until towards the end of my stay I had a thermostat behind the bed- that would have been nice to know when I felt really hot or freezing. The TV was a very snazzy flat panel LCD mounted on the wall opposite the bed. AND, for any geeks out there (like me), it had a wireless keyboard that let you surf the web through the TV. It was a nice way to pass the time when I got bored. In theory you can check your email on it too, but I never got that working right. The only downside is it cost a few dollars a day to activate the Internet access, but you also got about 3 times as many cable channels as part of the deal. I decided as much as I spent on the surgery, I could afford the $30 or so it cost during my stay. I definitely recommend it, it was faster than modem speeds (which I would have had to use if I brought my laptop).

I had my first trip outside the surgery center today. My partner and I went across the street to the Oregano's for lunch. It was very hot (109!), so we took bottled water even though it was only about 1/2 a block away. I'm glad we did, it was still a pretty long walk for the shape I was in. Sitting at the table in the restaurant was interesting, I'm glad I took my invalid ring to sit on. The food was great, and it was nice to be outside for a while.

The pain was very manageable today, I only needed pain meds once or twice the entire day, and then only the smaller dose.

5 days post-op

The main stitches holding my labia together were coming out today, and I couldn't wait, they were getting very sore by now. I don't think I've described quite what the surgical site looks like yet- the best I can say is I looked a lot like Barbie, with stitches running in a vertical line down the middle :) Everything was sewn shut, with just the catheter tube coming out the top.

Cheryl, Dr. Meltzer's nurse, came by about 11 am to take out the stitches and packing. The stitches hurt coming out, but she did it pretty quickly so it was over soon. Then she pulled out the packing. It reminded me of a magician's trick where they continuously pull a longer and longer scarf out of their sleeve, it just went on forever! It wasn't to uncomfortable, just a bit of a weird feeling. Cheryl gave me a mirror to see what the end result looked like, and even though it was very red and sore, it was a beautiful sight! It just felt amazing to have things finally be right.

Cheryl then did my first dilation. The stents provide by Dr. Meltzer are very nice, clear lucite with a slight bend in them. There were four sizes, plus a tapered one between the smallest(#1) and next largest (#2). She used the smallest one, and it went in pretty easily (I suppose I was still fairly open from the packing). I had about 5 1/2 to 6 inches of depth. After we removed the stent she had me try dilating by myself. It wasn't too difficult, and the sensation was hard to describe. You could feel things shifting around a bit as you pushed, put it wasn't really painful this time.

After Cheryl left, I was tired after all the excitement and just laid back down and closed my eyes. Before I drifted off to sleep I just concentrated on the feelings from all over my body, from my head to my toes. It was one of the most amazing moments of my life, for the first time every part of my body felt in place, and connected. There weren't any parts I wanted to ignore, or pretend weren't there. It was the first time I felt physically whole in my life.

I woke up a couple hours later and had a major mood-swing meltdown. I'm not sure if was just too many emotions from before, restarting my hormones, or a combination of several things. I heard some things were going wrong back home, and all of a sudden I just burst into tears and couldn't stop crying. I got so shaky it was hard for me to do the second dilation that day. A few hours later I was OK, but it was a scary experience. I've heard most post-ops have some kind of meltdown during the recovery, just from relief and letting go of a lifetime of stress. Maybe that was it.

That first day after the packing was out I had to dilate 5 times! The second one was the hardest, and for a while I wasn't sure I could do it, it was painful. But I just kept trying and eventually got through it. It did get easier with each dilation after that.

6 days post-op

The soreness and swelling continued to get better, and I really didn't have too bad of bruising (some around the crease between my upper thing and tummy). Today we went out for lunch again, to a little Mexican restaurant. It was still hot, and a bit farther walk than Oregano's, but a nice trip. My appetite was back fully, I think I ate more in that meal than I had for several days!

Dr. Meltzer stopped by in the afternoon. I was very impressed that Dr. Meltzer and one his nurses stopped to see me separately every day of my recovery. I wasn't sure I'd be seeing them, even briefly, every day. My abs were getting very sore, so I asked him about that- he said the abdominal sutures were probably the culprit- my ab muscles were sore from pulling against the sutures.

I met a couple other of Dr. Meltzer's patients today, both had surgery a few days after me, so they were a few days behind me in recovery. They were both very nice, and we chatted for a while.

For the second or third day in a row, I spiked a temperature in the afternoon. The nurse said a lot of Dr. Meltzer's patients seem to do that after restarting their hormones. It might have been that, or maybe the sun coming in through the blinds in the afternoon and heating my room up. This was when I wished I had noticed the thermostat!

The big event of the day happened that evening, when I finally had a bowel movement. It seems like a strange thing to get exicted about, but given that I hadn't gone for about 7 days, it was kind of freaking me out. The nurses kept reassuring me it was OK, and would work again some time, but I was glad to get everything going again! It was weird to be eating three meals a day for a week and never have any output!

7 days post-op

I had some bleeding when I woke up this morning, a suture in the perineal area came loose. It wasn't a massive amount of blood, but enough to scare me for a minute. Holding a compress on it stopped it pretty quickly, and Dr. Meltzer had said it was a pretty common experience, so not to worry if it happened. It would all heal back eventually.

More excitement later in the morning. When I took a shower, I forgot to turn on the fan in the bathroom (something the nurses were very careful to point out). There were still a few kinks to be worked out at the new building, and one of them was the fire alarms being a little too sensitive. The steam from the shower set off the fire alarm, and the nurses had to shut all the doors and make sure everyone was stayed in their rooms. I think they might have even had a firetruck come by, although when the alarm went off the nurses knew right away what was going on. I felt really bad about until they told me it was happening a couple times a week, and I wasn't the first to do it. They were going to get the sensors adjusted in the bathrooms in the future, but to be safe, turn on the fan :)

I went out to lunch by myself today, which seemed like quite an adventure. There was a great fast-food Japanese place called Tokyo Express a block or so away, and I made it there safely and had a tasty lunch.

8 days post-op

The nurse came in after breakfast and finally took out the abdominal sutures! It felt great to get rid of those. She also removed the catheter, which burned on the way out, but felt good to be done with (little did I know...). I tried to pee several times after the cath was out, but no luck. Things were just too swollen around the urethra. I took a shower, and then tried again, still no luck. Dr. Meltzer came by after lunch and decided to try just using a straight cath to make sure everything was clear, to see if that would help. Over the next hour or two I tried a few more times, but it just wouldn't work. At the end, I felt like I had to go so bad I was in incredible pain, and the nurses called Dr. Meltzer to see if they should put the foley catheter back in. They did, and it was a huge relief. But I was also very disappointed and shaky- I thought I would have the last of the tubes out of my body today, and hated the thought of having to go home with the cath still in.

9 days post-op

Today was my discharge day! The whole recovery went faster than I thought it would, I couldn't believe it was already time to leave. We packed up my belongings, gave the flowers to some of the other patients and to the nurses' station, and checked out. I was a little sad to say goodbye, they had taken such good are of me. But it was nice to know I was going home tomorrow.

10 days post-op

The flight home was quite an ordeal, even though it was only about 2 and a half hours. I took two pain pills before I got on the plane, but even with my invalid ring the seats were hard as a rock. Being cramped in a small space and not able to move around much was pure torture. I was very glad to get off the plane when we landed! It felt wonderful to be back in my own bed that night.

13 days post-op

After being home for 4 days and still having to cap the catheter and use the cath bag at night, I got the OK from Dr. Meltzer's nurse to try removing the cath. They had shown me how to do it in the hospital, and gave me an extra foley cath in case I still couldn't pee and had to re-insert it. Luckily everything worked this time! Finally no more tubes, I could go like normal. The stream came out pretty much straight, and I didn't have much trouble with spray.

16 days post-op

Recovery at home continued. I was dilating four times a day, and just moved up to the #2 size stent. It wasn't easy but didn't hurt too much. There was still some swelling on the labia and mons, but it was gradually going away. The stitches that were left were dissolving, although not as fast as I'd like! They tended to poke into your clothes and rub just the wrong way :(

24 days post-op

Most of the stitches are gone, just a couple hanging around to bug me. Dilating is easier and easier, and I'm up to #3 (#4 is optional, and I don't think I'm going to ever want to try it!). Even though it's only been a little over three weeks, it's hard to remember what my body looked like before surgery. It just seems totally normal and natural now, the way it was always supposed to be. I can finally look in the mirror after getting out of the shower and not flinch or ignore parts of myself.

6 weeks post-op

Everything is almost completely healed. No more stitches, the swelling is gone, and the scars are starting to be less visible. I'm down to twice a day dilating, which is nice. Four times a day really eats into your schedule :)

Even before the labiaplasty, the results look amazing. My partner says she'd never know it wasn't a natal vagina, and being an original owner herself she ought to know :)

About this time (ok maybe a little before now :) ), I had my first orgasm. The electricity was definitely flowing. The clitoris and area just above it are very sensitive, and it did take a bit more foreplay, but was quite satisfying.

I'm heading back to work in about a week. I'm glad I took a full six weeks off, the recovery really did take that long. The hardest part of recovery was just not overdoing it- I would feel great in the morning, like I could do anything. But after being up and around for a few hours, I would get really tired and have to go back to bed for a few hours. The time I could stay up gradually got longer, and the need to lie down got less. But it was at least 6 weeks before I felt close to normal again energy-wise.

6 months post-op

In the months after my surgery my life returned to its normal pace. I went to work, got back into running, and just lived life. Dilating continued to get easier and easier, and I actually got curious enough to try the #4 size dilator. It didn’t seem nearly as scary as it did at the beginning J It definitely wasn’t as easy as #3, but with some extra K-Y it went in fine. I still do my normal dilating with #3, but use the #4 every once in a while. At six months I could stop dilating every day, and have started just trying to do it 3 times a week. Dr. Meltzer’s instructions are to gradually increase the time between when you dilate, until you find a good schedule that keeps the depth without too much work. He recommends dilating once a week at minimum.

I had two urinary tract infections in the first six months of being post-op. Between the shorter urethra and my body getting used to new bacteria down there, this wasn’t too unusual. Both times a quick round of antibiotics cleared it up. I’ve tried to be more careful keeping clean, and taking some cranberry supplements to avoid these in the future. A UTI is definitely not fun- the first one got so painful (and peaked on a Sunday night) that I ended up going to the ER to get some relief.

It’s amazing to see the results of the surgery now- the scars are virtually invisible. I think you would be hard pressed to guess I hadn’t been born this way. I’m scheduled for my Labiaplasty in about 6 weeks. I can see some things that could look a little more natural, like more hooding on the clitoris, and thinner labia. It will be good to have everything finished, although I’m so happy with the results already sometimes I wonder why I need one more surgery.

Final Thoughts

I went into my surgery with a typical "this doesn't make me a woman, I already am" attitude, thinking it was just a minor cosmetic detail to be taken care of. I was surprised how much more it really meant to me when it was over. It didn't make everything in my life perfect, but it really did make me feel different, and I never realized how much energy I used just dealing with having part of my body constantly feel wrong. To let go of that and have such a great sense of wholeness and freedom is pure joy.