Neo-Vagina Monologue 7
It hurts. Sex Reassignment Surgery. Jesus, it hurts.
I don’t remember anyone telling me about how much it hurts. Did I miss something? Am I talking out of school? Am I a wimp? Do I hurt more than everybody else? I don’t think so. The knowing grimaces I receive when I talk with my sisters—they felt the pain too. Most of all, we want to forget it, put it behind us. I write, that’s how I purge.
Let me try to tell you about the pain.
I awoke a new woman, so to speak, around 2 o’clock Monday afternoon. I don’t remember going to sleep. I never saw the operating theatre. I just woke up, and it was all over. All except the pain.
“Tris”—Tristan, a nurse was by my side, He smiled at me, and I smiled at him. And then I noticed that it hurt. I can’t recall specifically how that particular hurt was. Just bad things happening down there, and fear that it would get much worse. “It hurts,” I whined to Tris. He said, “Don’t worry, this will take away the pain.” He began fussing with some tubes and needles. “Hmmm, we have a few options here,” I heard him mumble. “Goddammit, hurry!” I screamed internally. Finally he added something to my IV, and the pain went down to a dull throb. But it still hurt. And I was so weak, so weak.
About 3 o’clock my friend Jamie Faye arrived to shuttle me up to the Surgical Hospital of Menlo Park, formerly known as the Recovery Inn, where I was scheduled to stay 3 nights. (This turned into 4, as you will see.) My actual surgery had been done in a modest OR called the Plastic Surgery Center of Palo Alto, saving almost $1,000 over having the same thing done in the OR at the Surgical Hospital of Menlo Park. In exchange, I had a delightful 2 mile car ride that afternoon. I had imagined this trip would be done in an ambulance, but apparently my condition was serious only to myself. They wheel-chaired me to Jamie’s SUV and helped me into the passenger seat, onto my rubber blow-up doughnut cushion. I tried to assume a Zen-like state as I tolerated the road bumps and hour-long stop lights along Middlefield Road.
The Surgical Hospital of Menlo Park is like a Holiday Inn with a 24 hour nursing staff. They wheel-chaired me to a lovely private room and bundled me into the bed I would not leave for 4 days and nights. They hooked me up to an IV with a morphine machine. They put a button in my right hand to activate the morphine, and another in my left hand to call the nurse. I immediately began thumbing the morphine button like I was playing Pac Man, but the machine only allowed a hit every 15 minutes. A little beep let me know when I scored. 15 minutes has never seemed like a longer interval, and I never got to the point where I could predict that the time had elapsed.
By late afternoon, the morphine was doing its job, and I became quite comfortable. Surprisingly, I remained clear-headed. Apparently the morphine was able to direct its effects at the pain specifically.
I felt so good, I started to think, “This is a piece of cake! No wonder the other girls never bitched about the pain.” I had some visitors and made some phone calls. All seemed to be peachy.
Every couple of hours a nurse came by to check on me. I was not allowed so much as a sip of water all that day, and my main discomfort was that my mouth and lips and throat were parched. Later I discovered they had some moist swabs that I could use to relive this condition, or I could rinse with water and spit it out, but that didn’t occur to me that afternoon. This parched mouth condition persisted all week.
The nurses checked my dressings. I was surprised to see that I wasn’t all bandaged up like my face had been after my rhinoplasty last summer. I just had an absorbent pad over my vulva, held in place with a medically-attractive pair of disposable mesh panties. As I looked down I could see there was no penis, sure enough! Just some flesh and and blood and stuff. I didn’t ask for a mirror to examine things closely at that point. On my left hip a clear plastic bandage covered the skin graft donor site, a 3” x 4” raw red patch. (Dr. Cholon used this skin graft to construct the extension of my vaginal canal. My scrotal skin was used only for the labia major and labia minora, which were all constructed in this one-step procedure.)
Tuesday morning I felt good, as I had on Monday evening. My “vet”,
Dr. Annette Cholon
visited me early in the morning to see my progress.
Dr. C is a cheerful, pixie-ish young blonde woman. She reminds me of the actress
Tea Leoni (but without the penchant for physical comedy!) She greeted me with a
big smile and a happy, "Good morning! How are you feeling today?" as she checked
under my dressing.
Everything looked great, except there was a little more blood seepage than she liked. But she couldn’t see anything in particular bleeding. She said she found this particularly annoying because everything else had gone just perfectly. I asked her about depth, and she said I had 13 cm. I quickly converted in my mind: 5 inches. That sounded pretty good, although I had heard 6 inches most often mentioned as a goal, and 8 inches as the Holy Grail. Perhaps I would gain a little more depth over time with proper dilation discipline.
Tuesday afternoon things started to go badly for me. I began having hallucinations from the morphine. They were very interesting because they seemed to be completely real, yet I could tell which was hallucination and which was reality when I tried. For example, I would tell a real visitor, “There are two hallucinations standing right beside you!” I often found myself reaching for things that weren’t there, usually stopping myself before I actually moved a muscle.
Then there was the itching. Not at the surgery site, but all over my body. It was not terrible, intolerable itching; just annoying. The doctor told me that was from the morphine, and then I noticed that every time I scored with the magic button, the itching would become pronounced. I squirmed and scratched a little, but not too much, since it didn’t really help.
As soon as I was put to bed Monday, they encased my legs in attractive white thigh-high compression stockings to prevent blood clots in my immobile legs. Really, they were quite attractive. I was going to keep them, except that by the time I left the blood stains grossed me out. In addition to the compression stockings, they wrapped each of my calves in something like a big blood pressure cuff. These were hooked to a machine that pumped air in and out of them, rhythmically on about a 20 second cycle, continuously massaging my calves. I kind of liked the feel of this, but the nurse told me some people hated it. I felt sorry for them. But after a few days, I got tired of it myself. Also the tubes from the cuffs to the pump would get tangled in my sheets and pillows when I tried to shift or roll over onto my right side. (There was no turning onto my left side, as the the skin graft donor site was there.)
Perhaps because of the calf-massage machine, or just because of the almost constant pressure on them, the backs of my heels hurt. Especially my left heel. This was a constant, sharp pain that got worse and worse as the days wore on. When a kind visitor massaged them it helped a little, but not much. I expected to develop a big blister or bruise, but there was no visible problem.
All of this was nothing compared to my overall misery from a constant state of chills and overheating, at the same time it seemed. I sweated profusely, continuously. The nurses monitored my vital signs, and I was never more than a half degree or a degree off 98.6, but it felt to me like a terrible fever. In fact I had suffered a fever of 101 degrees earlier in January, and that is what it felt like. Finally one of my visitors, Judy Van Maasdam of the Gender Dysphoria Program of Palo Alto, diagnosed what my problem was. I was having hot flashes! I had discontinued my hormones a couple of weeks earlier on the advice of my General Practitioner, who was worried about blood clotting during my period of immobility. So I had no estrogen coming in, and my testosterone producers were suddenly gone. I had no hormones, and I was going through menopause! I had my girlfriend pick up my patches and I went back on them on Thursday, but this extremely miserable condition persisted through the weekend.
Though I complain about the pain, through it all I kept in mind how small my pain was compared what many suffer. At least I knew I would be better in short days and weeks to come. How much harder it must be for those suffering with terminal illness, or, perhaps worse, those who know not what their outcomes may be or how long their suffering will last. How much more it must hurt to be the victim of terrible burns. How horrible it must be for those who suffer without good medical care, or pain relievers and anesthetics. (For example, how terribly the innocents of Iraq suffer under our decade of economic sanctions, not even allowing morphine into their country!)
Tuesday afternoon Dr. Cholon visited me again, and continued to worry about my seepage. My blood pressure was fine so there wasn’t a problem of excessive blood loss, but she was concerned that it didn’t seem to be stopping. Once again she examined the surgical site but couldn’t see anything wrong. She decided that maybe if she pumped up my stent a bit, it would pack the area more tightly and reduce the bleeding.
I guess I haven’t mentioned my stent yet. Dr. Cholon formed my neovagina using the inverted penile skin plus the skin graft around a surgical stent. The stent is about 6 inches long by an inch wide, a white flexible foam core surrounded by a clear plastic balloon somewhat thicker than a toy balloon. Two tubes come out of the stent. One passes completely through the center of the stent, for drainage. The other is a stem with a ball valve, to pump up the balloon, expanding the diameter of the stent. This stent was inside me continuously from the surgery until Monday a week later. (I still sleep with it in, 2 weeks later.) As I have about 5 inches of depth, about an inch of the stent sticks out. It is very uncomfortable, with a feeling like being constipated all the time. I remembered that a friend told me that she once was enjoying the feel of a butt plug so much that she decided to leave it in as she went about her day’s business. After several hours, she regretted her decision severely. Imagine leaving it in for a week!
Dr. Cholon produced a large hypodermic, and pulled it out to about 20 cc’s. She hooked it to the stent’s valve stem, and delivered. YEEEOOOOWWWWW!!!!!! Oh my god, it felt like she was splitting me in two. I grabbed for the morphine button and pumped. Got a beep, thank goodness. “Jesus, that hurts!” I yelped. Dr. Cholon smiled and said, “Now you know what it’s like to have a baby!” (Dr. C. had her first baby last April.) I don’t know if this was meant to comfort me, but it didn’t. At that moment, I hated Dr. Cholon as much as I have ever hated anyone on this green earth,
Then she did it again.
Tuesday afternoon and night were a haze of pain and hallucinations. I could not in the vaguest way remember why this had ever seen like a good idea to me. What was so bad about my penis, anyway? It never hurt me like this!
By Wednesday morning I was so sick and itchy from the morphine, it was tough decision whether to press the button each time. I actually rode out a few intervals without it. Dr. Cholon came in early as usual and checked me. I could not believe what I heard her say. “We’ll take her back into the OR today.” Back in? Under anesthetic again? Starting the whole deal over again? Oh my god. But that is exactly what we did. I went back under at 2 o’clock that afternoon. This time they used the OR in the Menlo Park Surgical Hospital, so at least there were no car rides involved. Dr. C unpacked me and took a good look all around. She was pleased with what she saw, which was basically nothing. No “bleeders” that needed to be cauterized or anything like that. It just seemed that the area around the urethra, where a bit of excess urethra was spit open and sewn in place to create moist pink mucosa in my vagina, was seeping some. Perhaps there was a little hemotoma under it, as it was quite swollen. So she just sewed it up as tight as she could, packed me extra tightly (it felt to me), and sent me back to my room. They also returned to me 2 units of blood which I had banked in advance of surgery, just to make good use of them.
It worked. Thursday the bleeding was way down, and I was permitted some solid food. Which of course I vomited up. They told me I could probably go home the next day, but that seemed impossible to me. Thursday afternoon the nurse made me get out of bed and walk over to a chair and sit a bit (like 2 minutes!). This was horrible torture and I objected mightily, but it got done. They also took away the morphine machine and put me on oral pain pills. I was glad to bid the blessed-turned-evil machine goodbye.
Friday morning I still felt as horrible has I had for the previous two days. But I was fed up with the bed, and the room, and the staff, and longed to get home. As my bleeding was stopped, and I was off the morphine and on unrestricted diet, there was no need for me to stay there. I decided that if I could keep some food down and perform the walk-around, I would try to go home. It all worked out, and although it seemed to take forever for my friends to pack all my stuff and get me checked out, I was home finally by 3 o’clock.
It still hurt like hell, down there, and I was totally weak, and having those chills and fever throughout the weekend. Three dear friends arranged amongst themselves for 24 hour coverage, and they took good care of me. Thank you sooooooo much! On Monday morning my body seemed to snap back into reality, more or less, at long last. For the first time in a week I didn’t feel shivery, and I had a slight runny bowel movement—which felt wonderful!!! I had a check-up with Dr. Cholon Monday afternoon, and she said everything was healing well. But she would leave in the stitches, stent, and catheter (ha, I never even mentioned the delightful catheter and urine bag!) for while longer.
That pretty much ends this part of the story. The worst was over and the healing was well underway. It still hurt—but in different ways. Maybe I’ll tell you about dilating, and about pissing myself, and other such unpleasantness later.
One thing I now understand, which always puzzled me before. Whenever somebody talks about whether or not they might be transsexual, the post-ops always nod sagely and tell them, “I dearly hope for you own sake that you are not.” Now I know why. SRS hurts. Jesus, it hurts!
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