6 Weeks Post-Op (Infection, back to work, back to exercising)

Hey All,

I'm now 6 weeks post-op and I felt it was high time I posted an update because it's been about 2.5 weeks since my last update. To bring you up to speed, everything is good overall but I did have a little infection for a little while there. Which is a big part of why I didn't update. If you read my last post I was all ready really frustrated with healing and then I got the infection and was REALLY fed up with healing. lol So I didn't want to make a post of me just complaining about everything. I was confident I would get through it eventually but boy I was feeling negative about everything so I figured I'd write about it once I had a hold on things. And then I went back to work a week ago and got kind of busy with that. lol But now that you're up to date let me elaborate on my infection and how I'm healing so far.

The Infection 

In hindsight it wasn't really that bad. In the moment it was scary but I never had a fever. I never felt physically ill. Basically what happened, there seems to be an increase in swelling in the penis and the penis felt particularly sensitive all of a sudden. At times the sensitivity was to the point of being painful. I wasn't too concerned and attributed it to not taking the Ibuprofen anymore. But then, puss started coming out. lol Yes, very gross. It wasn't any crazy colors or anything it was just normal, albeit gross, puss. So I went to the ER. They gave me oral antibiotics as well as an antibiotic ointment to apply to the area and told me to follow up with my primary doctor in about 5 days. They took a culture of the area and said the results would be sent to my doctor. I was extremely nervous about going to the ER with my post-op penis because I have had less than adequate care in other healthcare facilities and this was going to involve me telling them my story and showing them my genitals. BUT, everyone was totally respectful and cool about everything. I'm pretty sure the doctor had never seen an FTM post-op penis, because he couldn't even pronounce the word metoidioplasty, which is okay because I'm not sure I'm pronouncing it right half the time either. lol But he wasn't weird about it in the slightest and was very matter-of-fact about it. He said, I'm going to treat you with medicine that handles all the common types of post-op infections, so you're going to be fine. Slapped me on the ass and told me to have a nice day. Okay that last part isn't true.  

And he was right! Well at least so far so good. Knock on wood. I went on the antibiotics and instantly things looked better. Although at around day 4 I had a little bit more puss come out. When I followed up with my doctor on day 5, she said the little bit of puss might have just been some that worked it's way out but she extended my antibiotics from a 7 day schedule to a 10 day schedule just to be safe. I've been off the antibiotics for 6 days now and there doesn't seem to be a problem. I'm still keeping a watchful eye on it though.

I discussed my infection with Dr. Medalie (my surgeon) via e-mail and he said he "didn't believe it was surgery related because of the area infected." In other words he didn't believe it was a typical staph infection because it wasn't in an area right around any incision lines. So I asked my primary care doctor, "how could I get a random infection in that area at a time when I'm washing it with antibacterial soap twice a day? It's probably the cleanest it's ever been!" And she elaborated that while it might not have been a "staph infection directly related from surgery" having a surgery lowers your immune system plus I had a lot of inflammation in the area which probably made me more susceptible. So basically they don't believe it was a full blown staph infection from surgery but indirectly this surgery may have caused it. Which is good, because from what I hear staph infections are terrible. I asked my primary doctor if my penis was going to fall off. She was dying laughing, but reassured me that "No, it would not." And that's all that really mattered to me at that point. lol

So things are looking good considering I'm 6 weeks post-op. There are a few very minor cosmetic things that I'm hoping will change over time. It's still really early on in the healing process to know how things are really going to look. As the swelling goes down things start to take shape. Things are going to keep changing over the course of the next maybe 6 months to a year. So at this point I'm not stressing about any asymmetries. Worse case scenario in a year I can go back and have him do some very minor touch up work. But it's still very possible that in a few months things will look even better. I know with my chest surgery, right after, it looks pretty jacked up, but by the 1 year mark it looked tremendously different. 'Gotta give the body time to heal.

Back to Work!! 

Speaking of healing, back to work and functioning pretty damn close to normal at this point. I have never been so happy to get back to work. In hindsight, I might have been babying myself more then necessary. But it doesn't matter. I'm out and about now running around at work chasing after kids and what not. lol And I feel great to be doing stuff again. I'm not the kind of guy that can be happy just sitting around watching TV all day. 

I did purchase a soft cup and wear it at work. It serves a couple purposes. As annoying and sweaty as it can sometimes be, it allows me to wear nicer pants and not have to worry about the friction against my healing genitals. Up until I started working I almost exclusively wore gym shorts and I really didn't want to go to work in gym shorts. lol Also, I really do sometimes have to run after kids in my job, and the soft cup keeps my thighs from knocking everything around, so that's nice. The other thing about working with kids is they are all at a height where it is very easy to be knocked in the genitals, so the cup also offers protection when a 100 kids are running around the playground like maniacs. I feel safe with the soft cup on. Not sure how long I'll wear it. 

I also have a couple hard cups but at this point they're way too uncomfortable to wear. I am currently working on integrating a student into the typical 1st grade class, but next week I'll be back to my normal class room where the kids are a little more rough, shall we say. Some hit or headbutt and these are little guys but they are right at that level where I'd be seeing stars if they made the right contact. lol So when I get back to working in my normal class room I might wear the hard cup. We'll see. Depends if by next week I'm at a place where I can stand to wear it for 7 straight hours. If not, then I'll wear the soft one, and be very mindful of my surroundings at all times. I'm not too worried because at this point I don't think it's going to cause any serious damage. My incision lines are pretty well healed and I only have a few stubborn stitches that haven't dissolved yet. I just think it will hurt like hell because it's still really sensitive down there. Maybe it always will be. Maybe this is just part of having external genitals. The world becomes such a scary place when you have external genitals. lol I at least want to wait until all my stitches are gone and then I'll consider losing the cup.

Exercise

Oh yes, and back to exercising. Still not doing any lower body or cardio stuff because I am paranoid I'll hurt the testicles. The body basically forms a sort of capsule around the testicle implants over the first few months and until that happens I don't wanna do anything to make it more to a bad position. One is all ready lower then I'd like it to be. It doesn't look unnatural because I know a lot of cis-men don't have testicles that are perfectly side by side but I don't want it to go any lower so I'm trying not to aggravate it.

I've been doing lots of weight lifting for my upper body. Getting the heart pumping makes me feel so good. I think that was a big part of why I've been feeling so blah. Exercise is really important to my emotional stability. When I don't exercise regularly I get depressed easily so I am very happy to be back at it. 

Well that is enough for now. At this point the changes in it are slower and a lot less drastic than the first couple weeks so I'll try to update every couple of weeks with how things are going. I still want to talk in depth about the pubic lift (aka mons resection) but I want to wait until I'm a little more healed so that I can really give my opinion of how it has or has not helped the placement of things. At this point, I want to say, yes it has helped drastically! But I don't know if in a few months when all the swelling is down I might feel differently so before I really elaborate on that I'm going to let my body do some more healing. I will also talk more about aesthetics and function etc. when my body is a little more healed. For now, I'm doing all the things I need to do. I feel almost back to normal at this point. 

And I'm still extremely happy with my result. :-]

3 Weeks Post-Op Update (physical and emotional healing)

Hey Everybody,

I am now officially 3 weeks post-op, and it's been about a week since I last posted so I'm just going to do an update about how things have been over the last week.

Physical Healing

I've definitely seen some big improvements in healing this week. A lot of the stitches have dissolved. Everything is looking better and better. I went a whole week without contacting Dr. Medalie worrying about healing! lol So that definitely tells me I'm doing a lot better. I did finally hit him up Sunday. I took pictures of the underside of the penis right where it meets the body and asked if it was looking okay. That place seems to be healing the slowest. Maybe because it's under the penis and the top of the testicles are right against it so I imagine it doesn't get very much air. But the Dr. said it looks like it's doing just fine, it's "just some scabby healing" and to continue to wash it with warm soapy water twice a day and apply Aquaphor.

Walking is becoming much easier. I mean it's still a little tight at times. Especially if I do a lot of walking or a lot of sitting, but for the most part, it's a heck of a lot easier to walk than it was before. Sitting straight up is still the hardest thing, but that has also greatly improved. Today I went to dinner with friends and if you include the car ride there and back I must have been sitting for 4-5 hours with very little standing so that's pretty good! By the time I was on the car ride home though my genital area wasn't happy. lol It didn't hurt, per se, it just felt very uncomfortable and swollen. First thing I did when I came home, shorts came off, put an ice pack on it, and took 800mg of Ibuprofen to reduce inflammation. By the time the ice was ready to come off (20 minutes later) I felt fine again.

So that's basically where I am at physically. I still have more healing to do, but I can do a lot at this point. I pretty much just listen to my body. Take the Ibuprofen occasionally and ice occasionally if I feel like I need it. I also make sure to wash it in the morning and at night as well as apply the Aquaphor to all the incision lines and irritated areas. Oh I did have one noteworthy thing that happened yesterday, I was washing the penis and it seemed like I had some dead skin on the side of each so I took one of those puff sponges and gently cleaned the sides of the penis to exfoliate and A LOT of dead skin came off. And then the penis was all raw on both sides. I think it's a matter of I probably wasn't washing it well enough because the area is sensitive so I'm still pretty careful with it all, plus the stitches above the testicles rub on the side of my penis and irritate it. So ya, that was gross, and concerning, but when I really took a look at it, it seemed fine. I had a very similar experience after my chest surgery, there was an area that was particularly sensitive so I never really scrubbed it and then like a month after surgery I finally did and there was tons of dead skin and it was gross. So I'm thinking this is the same deal. It burns ever so slightly when I first get in the shower now, but there was no blood at all and it looks fine, just kind of pink and raw, so I'm just keeping it clean and continuing to apply the Aquaphor (which is a healing ointment similar to Vaseline recommended by my surgeon). I think it should be fine but if at any point it gets worse I'll contact Medalie.

And just as a comment, my mons resection a.k.a. pubic lift (the cosmetic lift done to move the genital area to be more upfront on the body), the only time I even notice it is if I'm wearing pants that rub on the area a lot. It makes the area really sensitive and irritated. The actual incision is still almost entirely covered with steri strips so I don't have a good idea of what it looks like. I do know that it is almost 7 inches long but it is where my pubic hair is so it isn't something that will be visible until I'm naked. Also, there is an inch on one side where the steri strip has fallen off and in that inch most of it has a ton of glue so I can't see the scar but there is this tiny tiny little section without glue or steri strip and the scar line looks SUPER thin! So if the rest of the scar turns out that thin I think it's going to look fantastic. I have used silicone scar strips on other areas of my body to reduce the appearance of scars and they actually sell 7 in long ones for surgical scars so once all of the steri strips and glue is off I'm going to get the scar strips. For those who've never heard of them, you have to wear them on your scar for 18-24 hours a day, everyday, for a recommend 3 months but trust me, they work! Even if you have an old rough looking scar, try the silicone scar strips for 3 months and I bet you'll see a huge difference. They are awesome. With how awesome Dr. Medalie did in the formation of this pubic lift incision, combined with the fact that I'll be using the silicone scar strips, I have a feeling my scar is going to heal quite nicely!

Speaking of scars, the scar forming on the underside of the penis also looks pretty good, I mean at this point it's kind of an indent where there is still some undissolved stitches and still a good amount of swelling so it's really hard to say but it looks like once all the swelling and stitches are gone it will be nice. And the scar on the front of each testicle is healing fantastically well. Almost all of the stitches are gone from the testicles and you can hardly notice the scar at only 3 weeks post op. I definitely think in time those are also going to fade to nothing. I personally tend to scar pretty badly on most parts of my body, but I've always heard the genital area tends to be an area that scars very well on most people.

Emotional Healing

Now let's talk about the emotional aspect of healing over the last week. I was going a little stir crazy for a while there. I hardly left the house from Saturday until Thursday. I know I went out to like Best Buy once with a friend and grabbed a bite to eat here and there but for the most part it was a lot of sitting and laying around the house being lazy. I am normally a VERY active guy and really under estimated how tired frustrating it was going to be to heal. I bounced back ridiculously fast after chest surgery, I guess I was expecting to have a similar experience. I think during this last week I was definitely starting to experience some post-op depression. I really just didn't want to do anything because it was starting to get so frustrating to me that whenever I try to do stuff it would start to make me sore or uncomfortable or just plain tired. The week before that I had a lot of moments where I was really scared and paranoid that I wasn't healing properly (which Dr. Medalie always confirmed that I was doing fine) because I am a worrier by nature. lol But it was really tough at times, I cried sometimes because I was worrying so much. Thank God by the time I hit the 2 week mark everything was looking good enough that I didn't feel like I had to worry so much, but that's around the the time when the frustration of healing started to happen. I started feeling tired and wiped out emotionally not just physically. It takes a lot out of you to worry the way I do. lol And then I got in this funk from Saturday to Thursday when I just didn't want to do anything except lie in bed.

By the time Thursday rolled around I was going crazy. Luckily, Thursday I had a therapist appointment scheduled and I had no one to drive me to it so I drove for the first time. In hindsight I probably could have driven much sooner but I was so sluggish and didn't want to do anything so I didn't bother trying. But anyways, I went to the therapist and talked to her. She told me to get out there and make plans with people! So that's what I did. I posted a facebook status basically telling everyone that I'm able to drive again and I'm feeling well enough to go out or have people visit but that I just can't do anything that involves a ton of walking or sitting in an uncomfortable chair for a long period of time. And a lot of people contacted me asking to hang so Thurs until today, Tuesday, I've been doing LOTS of stuff! Hanging out with lots of friends. Some have come over and visited and we just sit outside in the gazebo talking and laughing. I've gone to friends houses to watch movies, play video games, hang out and go out for dinner. I also went to the picnic of my transgender support group which was super cool and definitely something I needed to lift my spirits. Oh and I went out and got a new facial piercing. lol I had been considering it for a long time and I figured it'd get my mind off of healing. So I got my septum done!

During my low period I was having lots of negative thoughts, like "what did I do to deserve this surgery?" and "what have I done for my community?" I talked about those feelings with my therapist, some friends, and a mentor I reconnected with. Everybody said the same thing, I've done a lot just by putting my story out there. By doing the fundraising page, by keeping this blog, and by giving resources to people who come to me with questions. I felt better talking about it and I really think it was just negative thoughts because I was feeling the lows of healing but it still inspired me. I want to do more for my community I just had no idea how I could go about doing that. And the universe must have been looking out for me, because that night when the negative feelings were at their worse, I received an e-mail from the Massachusetts Transgender Political Coalition (MTPC) stating that they would soon be starting a training program called the Community Advocates program which would train people on how to become a transgender advocate in their community. Basically, they teach you how to run workshops to facilities, schools, workplaces, etc. on how to be trans-friendly or more accommodating, as well as supplying these advocates with whatever other skills and tools they will need to improve the atmosphere for transgender people in their local community. Well I applied, I thought it sounded perfect! I've been wanting to volunteer my time to help the trans community. I have a psychology degree, and have years doing different social services work and volunteering with a variety of different populations as well as living the trans experience (that's got to count for something right?). They accepted me. Maybe they accept everyone. lol But I felt really special and happy that they accepted my application and allowed me into the program. It's going to begin in October and I'm really excited to be a part of this. My mother always tells me she believes I have so much potential and should be helping other trans people. My mentor always encouraged the same thing. I've always wanted to and I think this program is going to show me how.

So overall, yes, I had a bit of a rough patch, but now I feel like I have my 'mojo' back. Even though I'm not 100% physically able to do the things I want to do just yet, instead of laying in bed all day being all mopey, I'm going out with friends and doing fun things that I can handle. Oddly enough, I think when I started to do more stuff, it feels like my body took a big turn for the better int he physical healing department. As soon as I started moving around, I started feeling way better physically. I guess I thought laying in bed and resting a lot would help me heal faster, and I'm sure resting to an extent does help, but moving around more and just being out and about doing little things has made a tremendous difference. Also, I think the Community Advocate program thing really gave me hope for the future and just served to remind me, I'm capable, I'm smart, I have a ton of potential, and I rather than sit around sulking about not having done enough for my community I'm going to be able to do something that I can feel good about. I used to do a lot of volunteer work in college but after college I stopped and you know how it is, life happens, you get busy with this or that and say you want to do something but never get around to it. I'm excited to get back on the horse and I think it'll be especially awesome that I'll be doing the volunteer work specifically to help transgender people.

I don't want this blog to turn into a diary, but I felt it was important to share the things that have been going on in my head. I want to share the lows as well as the highs, because going into this I really underestimated the lows! So if you want my advice, don't let yourself fall into a post-op depression. Make plans to keep doing stuff you can handle doing, even if it just means having coffee with a friend. Don't give yourself too much time to just sit there and worry or lay there babying yourself and sulking. My go to pick me up for when I'm starting to feel down is to go for a long run but obviously I can't do that so I had to find other ways to make me feel happy. Keep that in mind if you're as active a guy as I am.

Anyways, right now, I'm feeling great and looking great, so I can't complain! :-]