Long but Hopefully Helpful Post

As promised, here is a write-up about the last 7 days of my gender confirmation surgery recovery (11/29/17 to 12/6/17). My surgery was completed on November 15th. At this point, I am now three weeks post-op.

During this past week, I mainly rested and watched tons of Netflix. My movement was still very limited at the beginning of this period. Each time I would lift myself up from a laying position, I would be sore and have to move carefully.

On Thursday 11/30/17, I had a follow up appointment at my surgeon’s office. The goal for this appointment was to check my healing progress, but it was also for a lesson in dilating, and the point at which I would begin self-dilating sessions at home. It took me a while to decide what level of detail to write about dilation. There are many posts out there about it already and each surgeon seems to have a slightly different recommended schedule. I want to again point out that my desire for gender confirmation surgery has always been about bringing my body into alignment with my gender. It has never been about a desire to have a phallic shaped object up inside of me. As I discussed in other posts, gender is experienced neurologically, and some of us are born with our body out of alignment with our gender (it really is fairly simple to explain!). Sexual preference and desire are all separate from gender. I of course read a ton about this surgery and I knew that dilation can be both tedious and painful and eventually some do find it pleasurable. I was not sure what to expect, only that along with everything I have committed to in pursuing this surgery, I was committing to eventually dilating on a schedule. The intent of my blog has always been to hopefully be a positive resource for other transgender people while also educating others about what life is like for us. Bearing that in mind, here is my recount of my experience at my “dilation appointment.” This may be TMI (too much information) for some, and if you are a family member of mine, feel free to skip this post 😉

– Dilation Details (and my appointment play-by-play)–

My Mom drove me to the appointment since I still was not supposed to sit upright and was not cleared for driving. I ride with the seat back as far as it can go and with a small pillow under one thigh to sort of side-saddle the seat. The appointment began with a brief check in with one of the nurses who just confirmed what I was there for and she gave me a gown with instructions to remove all clothing. The whole surgical team walked in once I was ready. It was my surgeon, his attending physician and physician’s assistant. At this point, I am of course familiar with all of them and being basically naked in front of them was no big deal. This appointment, like dilation itself is a procedure with a medical purpose so I looked at it as such. They asked how I was doing, we talked briefly about the additional stitches and the scare I had only 3 days prior to the appointment. One of them checked the recent stitches and said they looked good and assured me that there was very little risk of the issue repeating. 

With that, one of them asked if I remembered to bring the dilators. There were 5 dilators in total that were given to me at the hospital and I certainly did not forget to bring them. The dilators come in varying sizes from small to scary big. The beginning ones are pliable while the later stage ones are rigid. They proceeded to clean the first two dilators and told me that I would only be starting out with those two and moving up to the third only when I was ready. I was given instructions on cleaning the dilators. They are cleaned simply with non-abrasive anti-bacterial soap. I was told that I should also clean them with betadine a couple of times a week. Next, I was told to use tons of lube and that KY Jelly (of which I had already acquired a 4-pack of from amazon) was perfect for the job. 

The team were all wearing gloves of course. My surgeon personally instructed me as he began my first dilation. The first dilator is yellow and you can see it in a picture a little later in this post. It was shown to me heavily lubed so I had an idea on the amount I should use. The surgeon suggested that I place lube on my finger to locate the right position of my vagina for insertion (as it is not very easy to see looking down in a prone position, but you get the hang of it really quickly based on the length of your arm and if you are in a similar position each time), however he was going to do so this time. He quickly mentioned the location of the various parts of my new anatomy (all of which I already knew, but he was being thorough), giving each a light touch as he went.  He did ask if I could feel him touching the clitoris (as there is a very small chance feeling can be lost in any given area). I told him that I could feel it and he said “That’s good!” 

I was told to be as relaxed as possible. Using breathing or any other relaxation techniques that I know. In general, I am fairly good at easing tension in muscles with breathing and intentional “letting go” of tension. When you concentrate on doing this you can almost always find a few more muscles in your body that are still tense that you need to consciously release. However, in this instance, it did take me a bit. I will explain why in a moment. 

It was time, my surgeon began to slowly insert the first dilator at a 45 degree angle and instructed me as he went. There is a point very early on where it will stop and that is when downward pressure is also applied to change the angle of the dilator to be more parallel with my body. This is done very slowly and steadily. Imagine insertion being done at a constant very slow pace that will take 3 to 5 minutes to complete. This is tissue that is still in the process of healing and there is to be no thrusting and no tearing! With the dilator about 75% of the way in I did voice some pain. I had not relaxed my body enough. I think I was struggling because of the mindset I had been living under in the days prior to this appointment. I was treating my body like it was made of fragile glass.. especially after the bleeding scare and being rushed to the ER for more stitches. I was harboring fear of more issues and I was tense. The surgeon gently pushed down on both of my legs (I was laying in a frog-legged position) to show me that there was still lots of room to relax and that my body could do it. I breathed more, called up some calmness from somewhere and felt even my shoulders relax more. The pain eased and before I knew it the dilator was all the way in. The surgical team acted like a bunch of cheerleaders for a moment and congratulated me. I was instructed to hold it there for around 5 minutes or a little more before moving onto the larger orange dilator. This stair stepping approach teaches the body to relax and accept each larger size while keeping the vagina from losing depth. 

Removing the first dilator also has to happen slowly to prevent tissue damage, although it is still much faster than the painstakingly slow insertion. The next dilator went in just like the first as far as the angle and then change of angle after that initial stopping point. I was worried there would be more painful moments with this one and there were a couple, but I just had to again do some mental easing of tension and eventually we were there. With the orange one fully inserted it was certainly more uncomfortable to hold in place for the full 5 minutes, but I managed it. The surgeon slowly removed the second dilator and just like that we were done. I was told that cleanup would obviously be a little messy and to of course wipe front to back just like cleanup after urinating (duh!). Wearing a good pad is a must as even though you may think you have all of the lube out some more will eventually find its way out. 

I was instructed to initially dilate twice a day with these two dilators and to douche once a day after both dilating sessions. Douching involves using about 400ml of a 1-to-1 solution of water and vinegar, followed by a similar amount of just water to clear out the vinegar residue. I was also told to douche once or twice a week with a 1-to-1 solution of water and Betadine, followed by just water again to clear it out. Betadine is the same iodine based (thankfully I do not have an iodine allergy) solution that is used on skin in surgery. Its color is horrifying and as I eventually found out.. douching with it looks like something out of a horror movie. No joke. Bleghh!!

I was again congratulated by the team and I was told that everything is healing great and despite my one setback that I have been doing amazingly well. I thanked them all, and was told I may be a little shaky getting up (I was!). I was told to come back the following Wednesday to have the stitches I got in the ER removed. After they left, I got cleaned up and dressed. I stopped in the bathroom real quick and took the photo below. My head was spinning thinking about the schedule I would now be on, but I did not look too worse for wear!

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My Mom and I headed home, but not before a woman in the waiting room begged me to tell her wear I found my black sweater dress (I told her I was pretty sure it was from Macy’s but from a year or two ago). It was nice to hear a random compliment again 🙂

Once I was home, my Mom went to the drugstore for me to buy me a douching kit and Betadine (that’s a great Mom!). After she headed out the door to go home, I was left contemplating my new dilation schedule and all it entailed. I am not going to lie, I was intimidated. This schedule is just a starting point too and it will be expanded (lol, what a pun) all too soon. You all know I am a busy person when I am not recovering from surgery. I work, take care of two kids part of every week and then I blog, stream on Twitch and try to manage to have a social life. This seemed like it was going to throw a big wrench in something. 

The next day, at first it did feel like a huge production. I kind of over-prepared. Just look at my setup:

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What you see above are wipes, KY Jelly, the two dilators, a wash cloth, two small washable bed pads (I had bought a package of 4 in case of any bleeding issues on my sofa during recovery which did not happen – but thankfully they are handy for dilation at least!), a little pillow from another galaxy for my lower back, and a pillow encased in its plastic cover for my legs (easing tension remember). Not shown is my pillow for my head which is the same one I use to sleep. Also not shown is my phone, which I set off to the side playing my ‘thumbs up’ playlist on Google Play Music. This way, I don’t even need to watch a clock, once a dilator is fully inserted, I just listen to two full songs to time how long to hold it in. I am still using this setup today, so I guess I did a good job of thinking through what would work best. Also, douching felt like a huge chore at first too. The logistics of moving about your bathroom to get what you need and make a solution and clean up things all tend to take time when you are not wanting lube to be leaking from you all over the place.. but I am already getting quicker at it and have a system for that now too 😉 Perhaps life will go on unimpeded due to having to dilate 🙂

– End

Dilation Details

Now for other notes from this past week.

At my dilation appointment, I also had asked for the surgeon and his notary (she is right there in the office) to fill out my Affidavit forms for updating my birth certificate. They did so and it is now in the mail! 

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I should have my updated copies in several weeks!

The weather in the Chicago area was unseasonably warm until yesterday. As a result I was actually able to get several short walks in over the weekend. I walked in a ring around my condo complex, just in case anything happened health-wise and I needed to get back to my place quickly. 

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The weather was great and the walks were very refreshing, but I found myself falling asleep for a short nap not long after each walk. This was not bad considering I was still just barely over two weeks post op at this point and fatigue is still expected.

From Friday through Sunday and into Monday evening, I was entirely on my own. Even though I live alone, it was the longest stretch I can ever remember having without face to face human contact (other than my short walks that weekend, but I did not see anyone I knew so I did not speak to anyone). I chatted with friends online of course and had a few phone calls, but it is not the same. On Sunday, I did actually randomly cry for a bit. It was both tension release and just feeling very tired. I am allowed to feel randomly overwhelmed when my body is recovering and I am running on empty in the energy department 🙂 I was also staring at a pile of dishes and decided to clean up once I calmed down a bit. On Monday evening, a good friend came over and brought me a Jimmy Johns wrap (unwich) for dinner. We talked for about two hours and I felt a little bad about talking her ear off 🙂 It was just what the doctor ordered though because my overall mood was much improved. 

Tuesday was a nice relaxing day with just sticking to my dilation/douching schedule as my only thing to worry about. 

On Wednesday, it was time to get the stitches out! Yay! This will mean that I can take full showers finally rather than the piece-meal half showers I was doing to avoid getting my stitches wet. 

I was looking forward to having the stitches out and I think you can tell in my pics below. I was also feeling more energetic and further along with my mobility. I wore a sweater dress and warm tights as the temperature was around 32 degrees. 

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This appointment (Wednesday 12/6/17) was back at the surgeon’s office. This time it was the surgeon and his female Physician’s Assistant, although the Attending Physician also poked his head in real quick to say Hi. I have to pause and mention that I am VERY HAPPY with my surgical team. I know there are a few bad reviews out there for this office, but people need to remember that a medical practice especially in this field takes time to build and the office staff has a decent amount of turnover so there can be issues there, but my experience with Dr. Schechter’s surgical team has been nothing short of outstanding. They do care about you and show it.

The stitches came out with no pain or issues and we discussed how to care for my scars to begin to reduce their appearance over time. It was suggested that I use Aquafor for now. We also discussed when I could drive again and it was left up to me based on my current progress, but the factors I needed to meet were the ability to sit upright for longer periods of time and that my range of motion needed to be there to operate all aspects of the vehicle of course. I do feel I need more time, but that I will likely be driving by sometime next week. I am going to work on sitting upright more over the next few days. I was also told that I did not need to come back for a checkup for another month! 

All indications are that I am doing phenomenally well! I will also be returning to work the latter part of next week. 

I snapped a couple of more pictures after they left the room, wishing me well. 

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So after a nearly a week of dilating, how do I feel about it? Well, I still consider it a bit of a chore and it feels more like necessary exercise than anything that I will ever truly “look forward to.” I mean, I can handle it and it is not going to be a crazy schedule forever. I imagine a stereo-typical dude-bro out there thinking.. “Oh yeah she will crave the big D now.. “ 

(sorry, I know a lot of guys that are not like this..)

 

Um.. no, I don’t think so. I have posted about my sexuality before, talking about how I do not ever really feel lust or sexual attraction to someone unless I already have a relationship with them and truly know them. Also, I am more interested in the quality of the person than I am in a specific gender. So, to all of those accounts that message me with a picture of your junk or a phallic profile photo .. take it elsewhere please. I just block those types of accounts anyways.

On a more positive note, I am feeling rather wonderful. I am again grateful to those that donated to assist me in paying for at least a portion of my surgery.

Your girl Ariana is nearly ready to get back in the game!!

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You all better watch out!

Take care everyone 😉

-Ari

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