Stage 2- Phalloplasty - Part 2

The next day, another surgeon in the operation came to see me. I was not able to pick up his name. He check the operation sites and my drains and catheter. He said everything looks well and I would discharge today if I want. 

I will be going back home with the drain and catheter. I will have to get the urethra (penis) catheter and the drain remove one week after the operation and the suprapubic catheter three weeks after the operation. Due to Christmas and New Year holiday, I had to wait for 4 weeks before removing my suprapubic catheter. The suprapubic catheter will need to be removed in London Clinic while the urethra catheter and drain can be remove either by district nurse or my GP nurse.

The nurse that looking after was very nice, he prepared lots of catheter bag for me to bring home. He gave me about 5 leg bags, 4 night bags and a few other dressings. I then told him I would like to stay for another day just to make sure everything is okay before I leave the hospital.

I ate and drink normally on the second day onwards. The physiology girl came to see me on the second day as well and walk with me to make sure that I can walk okay. I felt pain around the vagina wall and slightly sore at my bottom area. 

My penis was tape upwards and it have to stay that way for one week until the drain and urethra catheter is remove. 

I was discharge on the second day after my operation. I was again given one leg bag and one night bag from the nurse as she wasn’t aware that I have been given a few the day before. 

**This is where you need to be careful, if I wasn’t given those bags on the day before I would have requested for more as this bags will need to be change regularly to avoid infection. 

Now, the nurse that was in charge of my discharge is again the same nurse who discharge me when I had my stage 1. She just bad at doing dressing and did not re-dress them according to how it was in the first place. She is a very nice person but I think she is just bad in her job… Anyway, after changing all the dressing and getting a new vacuum bottle for my drain, I left the hospital around 12pm to catch my train back home.

Stage 2- Phalloplasty - Part 1

I'm lying in my hospitals bed now recovering from my stage 2 Phalloplasty operation.

I had
1. Vaginectomy
2. Join up urethraplasty
3. Glans Sculpting
4. Fistula repair
5. Clitoris buried  and...
6. Tidy scars from stage 1.

My operation was yesterday morning. I was admitted on Monday afternoon, I was allowed to eat until 5pm. After that, I was just told that I could have soup and bread if I want. Around 9pm, I was given enema and told to hold it as long as I could. I didn't know what to expect after that. After a while I felt that I need to go to the toilet for some businesses and I guess that they procedure.. I went to bed feeling hungry... I woke up at 6ish told to shower and change into hospital gown. I then get back to sleep while waiting for Mr Christopher and anesthesia to pop in and ask me questions. Both came around 8 ish. I then brough down to the theatre and both the anesthesia was chatting with me while getting me prepared.. I remember nodding off looking at the clock about 9.30am..

I was woken up around 2.30pm then fall back to sleep as the anesthetic is still in my blood... I vividly remembered that they asked for my nurse to bring me back to my room. I went back to my room around 3.30pm and my gf was waiting for me there. Mr Christopher came to see me and say everything went well. He said I could discharge the next day if I'm not bleeding heavily.

I basically sleep until about 6pm. I was told to drink lots of water. My catheter bag was filled with blood and I was told it will clear once I start drinking water. Around 7pm I was asked if I like to have my dinner, I was not feeling very hungry but I just ate slowly...

Prescriptions - post surgery care

This entry is specially for those that is UK residences where you pay for your prescriptions. Post surgery I have given prescriptions to buy more dressings and antibiotic. I would have been very broke if I have to pay for each of the prescription. I did some research on Prescription Prepayment Certificate as I have came across it few years ago when I was searching for the best way to pay for my hormones.

Basically how PPC works.
You pay

£29.10 for a three months certificate
or
£104.00 for a 12 months certificate.

Following is the link about the PPC.
http://www.nhsbsa.nhs.uk/1127.aspx

Within the valid date, you can have as many prescriptions you need. Which mean if you have more than 4 prescription in 3 months it will be worth it to get a PPC as 4 x £7.85 = £31.40.

The PPC can be back dated one month. So it is not a hurry to buy the PPC before / once you are discharge from the hospital. If you wasn't prescribe dressing you might not need to PPC. However I think it will be probably worth getting it as most of us need to ask for more antibiotics.

I was only discharge with one mepitel and no other dressing, while my practice nurse run out of the dressing that I need. I was being prescribed and told to order them as it will be quicker.

I end up request for my GP to prescribe me some Nebido and some other stuff. I make sure that I get the maximum out from the PPC. I was luckily that my GP is very nice and understanding. He prescribe me some moisturizer, bio-oil and etc. So, think about what else you will need and get it prescribe while your certificate is still valid.

Back dated the PPC - Make sure you asked for FP57 receipt before you have the PPC. I was luckily that I rang up the pharmacy and asked if I still can claim it as I did not ask for FP75 at the time I paid. The pharmacist told me that she will get it sorted for me. I also have one prescription which I get from boost pharmacy without asking the FP75. Boost pharmacist/assistants gave me the FP75 form to fill and refund me when I gave them the receipt. I knew some of the pharmacy reluctant/ will not  can't refund if you did not ask for FP75 when you paid for prescription. If you forget to ask for that, called up the chemist as ask if they can do something about it, if not, do not back date your PPC!

Post Op Preparation

Post Op Preparation.

I have tried to prepare as must as possible before I become ‘disable’ for few weeks. I was told to have my thigh sutures remove two week post op and phallo sutures three week post op.

Word of advice: Make sure your GP and the nurse is nice and supportive! If not change immediately. Make appointment with your GP and the nurse to chat about your operation and book with that nurse for at least 1 hour appointment for your sutures removal.

Now back to my experience, I make appointment and speak to my GP about my surgery and post op care that I need. I told my GP I need longer appointment and he said he will book double appointment (30mins). At the time, I didn’t know that it takes more than 1hour to remove those sutures on my thigh (or arm). My GP ring me the day before my surgery and assure that he have make the double appointment with the nurse for me.

So I went to my nurse for suture removal after 2 weeks post op… and my nurse remove my dressing and she went into panic mood. There were more than 50 sutures to remove and it was covered in blood crust. She then tell said I was only booked for 15mins appointment and she have to book me back on Monday for 1 hour appointment and she will get my GP to involve helping me to remove the sutures. She removed all the staples and it feel so good to have them removed!
I then checked with Mr Christopher if I could remove my thigh sutures when I am going down for my 3 weeks post op sutures removal with the clinic nurse. He said that’s find so I leave it to that. I think my phallo was not supported properly and it create a ‘folding line’. Over there where the blue nylon sutures were start to get slightly infected.

I could have let my district nurse or my GP nurse remove the sutures on my phallo (after 3 weeks post op). However I opted to go to London and let the clinic nurse remove to sutures to have a peace of mind to know that everything is ok.

3 weeks post op and I am in the nurse clinic with Fiona. I told her that my thigh sutures need to be remove and she wasn’t aware of that. She remove my dressing and start removing the blood crust and the sutures came off easily. She insect and clean my thigh then told me that those are dissolvable sutures and I don’t have to worry about it.  She then removed all the blur nylon sutures the along the bottom of the phallo and around the phallo. She then pass a tube though my neo urethra to check that there isn’t any blockage. She then told me that everything is okay and my phallo does not need to be support with dressing anymore. I was wearing boxer when I went down as my phallo was supported with lots of dressing… and now, the phallo is hanging in my pants… I felt very insecure, felt like the phallo will drop and etc. It is definitely a very weird feeling to have something hanging in between your leg.

So I went back with my phallo sutures removed, fully expose and not supported, my left leg still cover in dressing and my right leg looking good without any dressing on it.

To be continue…

Day 6, 7 & 8 - 1st stage thigh free flap phalloplasty

 Day 6
4th day post op
My blood pressure, temperature and phallo pulse were checked every 6 hours now.

Mr Christopher finally visits me after 4 days post op. He checked my phallo and said it looks good, healthy, soft and warm. He is very happy with the outcome. He also have a look on my left leg flap donor side where the PICO vacuum dressing wasn’t working properly as there is a leak and oozing a lot. He said not to worry about it and it cannot be change as changing it will risk my skin graft coming off. I walked around the ward today as I was told to move around. I was told to try and walk more normal as I am leaning more towards my right because my my left is still very painful.

Today the nurse came in and told me that she will leave my right thigh expose to air (AGAIN?!) for 2 hours. The pain was unbearable, I could not do anything apart from sitting on the chair and trying to ‘accept’ the pain. After 2 hours, the nurse came in a dress my right thigh. I tried to walk but it was too painful for me to move around, I just get back to bed and rest.

My catheter was remove today. Huge relive however I have to keep going to toilet as I drank lots of water.

Day 7
5th day post op

Nothing much were being done today. My nurse said that he heard I was in extreme pain last 2 days when they expose my right thigh so he will not do it today. The dressing wasn’t changed as well as my right thigh wasn’t oozing badly anymore.

He was the Ward Manager and he seems to liaise with Mr Christopher patient a lot. Overall I am feeling okay. I have good bowel movement and I pass urine without any problem. My phallo looks healthy as well.

Day 8
6th day post op
I am supposed to discharge today however I asked if I could stay until Sat in order to wait for my gf to pick me up. I was then told that I would have to pay for the cost of the additional 2 days if I chose to stay for the extra 2 nights.

I have got no choice but to travel back on my own. I pack everything up and get a taxi to London Euston. From there I took 2 hours train back and my girlfriend then pick me up from the train station. I felt okay as I am able to walk with my walking stick but I am walking very slowly.

In the morning, the nurse came to change my dressing on both my thigh. It was a nightmare. She was very (extremely) inexperience. It was so painful that I cried like.. I don't know what is the words I could use to describe that.. (Keep reading and you might be able to understand the pain..)
My wound dried up on the right thigh as it wasn’t changed yesterday, so the dressing stick to my wound. At first she refuse to uses water to wet my wound and attempt to rip the dressing from my wound (bare in mind that I have been feeling the pain since they expose it to the air). I scream and cried like I was in hell, I then told her to wet it, she refuse telling me that my wound should keep dry. Then after trying a couple more tries to peel the dressing of my wound, she reluctantly opened one packet of water to wet my wound. Previous nurses uses at least three packet to wet my wound!! Then she try to rip them again while it's partly dry and partly wet. I cried and grab the bed as she was doing that. She then stop for a while and add the last drop off water she have left in the packet, then she just continue ripping the dressing apart. I was crying until I could not breathe. Then she just left those 'stuck' to my wound there without any attempt to remove them as she sees me in such pain. I'm glad she decided to leave it or I might just cried in pain and fall to unconscious although I'm slightly worry that those dressing are still there. She then proceed to my left thigh, I was about to tell her to leave it and I'll get it change when I'm back but I let her do it anyway. Thank God, the left wound is covered with slightly wet and greasy type of dressing (mepitel). So no pain at all. She then covered up my left thigh ith mepitel and then some dressing and move back to cover my right thigh. I would say overall she did a horrible job in dressing but I wasn’t entirely bothered about it. All previous nurses uses 4 massive piece of 'tape' to cover it while she uses nearly 7 or 8. She then change the pads around my phallo however it did not support my phallo properly. Not only that, she have invite one other colleagues to come in and have a look and start explaining to her about how my phallo was being build. After standing there watch the nurse cover my dressing and listen to explanations by the nurse, she thanked me for allowing her to be there and left before the dressing were done. I think the nurse have been extremely unprofessional to invite some other colleagues for show and tell without my consent. However I have no intention of complaint about the nurse. I don't mind if someone is interested to learn about phalloplasty but I think that is very inappropriate.
Around 1pm I pack up all my stuff in my backpack and went to ask for a taxi. I took taxi to the main train station and then get a train back on my own.

I was given a bags of goodies with some pain killers, dressings, undies, pads and stuffs. She asked for my GP contact and  gave her my district nurse contact number instead. She then filled a form, fax them over with instructions and gave me a copy of the form.

15.5 weeks post op - Stage 1

It have been a while since I last update this blog. I will try my best to post something each month about my progress of the phalloplasty and my transition.

15.5 weeks post op for stage 1 with no complication. I think I have been really lucky that everything went well for me. I have decided to booked for my stage 2 before Christmas and have my recovery time over the Christmas.

I have been actively reading about people's experiences and getting as much information as possible as the post op care by the team is not brilliant. Honestly, I am little worried and nervous about having my Stage 2 before Chritmas with my GP and Mr Christopher office close for  9 working days. *touch wood* if there is complication and I have to go to emergency room, I doubt they will know what to do with me. So I can only pray that everything will go well like my Stage 1.

My thigh have been healing well and I have start to apply bio-oil or Cetaphil moisturizing lotion. I have been struggling to find a compression garment for my thigh and I end up using a knee support garment for it. My GP have been very helpful on trying to get the right thigh compression garment however to no avail.

Meanwhile for my phallo, it looks great apart from being girth(y).. I was suppose to lose fat on my thigh and I guess I did not do it that well. It is about 16cm/6inch in diameter and 11cm/4.5inch in length. To be honest, I was a little disappointed with the length but I am telling myself that at least I have got a penis now and there are various size and shape out there! I am already lucky compare to some trans-guy which do not have the opportunity to have this surgery. While for the girth, I am planning to get it reduce slightly when I am having the penile implant. I tried to put on a normal condom but it's just too tight. I have asked Mr Ralph and Mr Christopher if that could be done and they have assure me that it could. So I will just wait and see what happen next.

I suppose that's one of the problem with human in general. For trans-man ,we have been looking at all the photos/images and have create a prefect body shape/chest/penis that we want. Lot's of time surgery results will varies and some times people falls into depressing when the ideal body wasn't achieved. I have been watching lot's of straight porn and at times, it does make me feel very sad and depress about the length of my phallo but I just need to get over it! Obviously those guy in porn star have above average penis!!

I can't wait for my stage 2 now that my date is set. Fears and anxiety is taking over me... less than 4 weeks to my Stage 2.

My life - pre college

When I was very young, I remember that I do not like to wear skirt, I remember I like playing with cars, trucks, guns and boyish stuff. I remember being train to performed dance in kindergarten with holding dolls in my hand and I have the biggest doll but I exchange for a smaller one because I don’t like it. I remember I was given the choice to wear kimono to kindergarten or not allow to go to the kindergarten. I remember I was crying the whole time from putting the kimono on and at the kindergarten. I remember I exchange my Red Indian hat for a crown. I remember I was again force to wear dress to have a dinner in the restaurant on top of Komtar in Penang, Malaysia. I remember I have crush with a girl in primary school. I remember being very active in primary school, climbing up and down in the PE storeroom to get some stuff while the boys standing around and do nothing. I was selected as the class monitor and I would not let the boys over power me.

When I was standard 4 and standard 5, I have a major crush on few girls (my classmate and school mate). I was courting them with all I can. Buying gifts for them, doing things for them and etc. It was all girls’ school and for some weird reason, I was always bullied by my classmate and teachers and I cried nearly every day. I don’t understand why. It sound funny because I was the strong, aggressive tomboy in the class but I was bullied in another way. Maybe my classmates hates me from being tomboy and annoying. I think I understand now why that happen, maybe I just don’t fit in there, I should fit better in a boys’ school or a mixed school.

When I have period for the first time in my life at the age of 13, I was freak out. I did not tell anyone at all and just cope it myself.

I have my first girlfriend at the age of 14 or 15 I think. It was a very long courting process and I could not believe that she actually accept me. So I was officially a LESBIAN but I never felt right being label as a lesbian. Whenever people ask me, I always say I think lesbian is between two girls. Girly girls and not between tomboy and girl. I have always see myself as a guy in a relationship. I did what guys would normally do in relationship. Now, I was always filled with plenty of guilt. I always think that I have change my girlfriend or ex-girlfriends into lesbian. Of cause the guilt is even greater when I have sexual relationship with them. The guilt with become such a massive burden when I broke up with them. I could never forgive myself from changing them. Oh well, that was my mentally back them.

Of cause we never held hands in the public due to my girlfriend(s) reputation. Which I always think that way, until once when I went to KL with one of my ex (then my gf) she tried to hold my hand and I refuse. Since then, I knew it was me that could not accept myself. Cut the bullshyt of for my ex(s) reputation.

I start binding my chest around 16 years old. I still strongly feel that being labelled as lesbian is wrong. I hated other tomboys because all I could see from them were trying to get attention from girls. I felt they are being boyish just for the fame.

I start working part time when I was 16 as well. I absolutely hate it when I was given female uniform and I absolutely hate it to be known as xxxxxxxx. Which is my very girly birth name. I hate going to public toilet. I have been chase out from girl’s toilet before and have got weird stares from girls. Well you know how girls like to go to toilet and be bitchy and check out every other girls in the toilet. I will try to avoid going to toilet if I could or look for disable far away in a shopping mall.

I remember going to camp which organize by scouts, where scouts will team up with girl guides from various girls school and the scout leader asks my patrol leader who am I cause he never sees me before. He though that I was one of the scouts.

Well that is pretty much my life time story pre college.