SRS Diary - Mr. TR Terry, Leicester General Hospital, March 2003.
This is a forward written by beth after her Diary
SRS diaries are all well and good but they're often (my own included) pretty emotionally dry, being a chronology of rather icky events. So I thought I'd write this.
This is probably going to sound weird, but in terms of my emotional reaction of having SRS I have felt something I never really expected to feel at all. I don't think anyone really knows in advance how it's going to feel, but what has hit me over the last few days is how amazingly wonderful it feels to have done something... I don't know... permanent and irreversible at last. I mean, living pre-op there was always that risk, the small chance, that something could happen and my whole sense of who I was could be taken away from me simply by withholding pills. Or by someone seeing what I had in my knickers.
That fear, I guess, has been heightened by my experiences running up to the operation off hormones, which were without doubt truly the worst 6 weeks of my life for a long, long time. Especially when I had the disaster with the Laser (which had thankfully healed now, but I went into Hospital with scabs and spots covering all the visible skin on my upper lip, chin, and the majority of the right hand side of my face, and people STARED like they've never stared before).
But now... they can't take it away from me. It's done. Looking at myself in the mirror, thinking about my body as it is now and it really does feel "right" for the first time. I am extremely loathed to use the phrase "feel like a complete woman" but... being female physically (at least superficially) for the first time is surprisingly wonderful.
I've spent so long talking myself out of having SRS, and playing down what I could expect from it that I had completely forgotten why I wanted it in the first place. I wasn't 100% sure when I started hormones, but I was overjoyed when I finally did. I wasn't 100% sure that transition was the right thing to do, but it turned out to be the best thing I ever did... and ultimately I was very nervous about how I'd feel after SRS, but I am completely inexplicably wonderfully happy with it.
Well, except after dilating and walking around like I've just been rodgered vigerously by half of the England rugby team, then I'm not so happy. But hey :)
Now onto her Srs diary........
However, this is what happened...
I turned up in plenty of time and was shown to my pleasant side room, complete with television. I was yet to discover that the television didn't actually work properly, and required cunning usage of tape on the TV Ariel socket to get a viewable picture. I spent most of the day talking with the "trans woman" (she seemed very concerned about describing herself as such, rather than as a "transsexual person") who'd had her operation the previous week. I was reassured because she seemed to be doing so well, which was helpful, but then she started telling me about the discomfort and hunger that would make the next 5 days such a misery.
I had the infamous picolax drink at 2, which is for the uninitiated the laxative equivalent of a thermonuclear bomb, turning your insides inside out.
It's a nice way to get you slowly used to the idea that you're not there to have fun: You're stuck in the toilet pooing foul water (which is a bizarre experience in itself, having never had the runs myself) and you just want it to stop.
Otherwise, the only other things that happened were having my blood pressure and temperature taken (on the high side, not surprisingly) and at night, I had my first Heparin injection in my belly, which I found to be painless.
By the end of the day I was starving. I'd had a chicken curry the day before (just a microwavable one, nothing I actually enjoyed) and that was to be the last thing I ate for a LONG time. Hungry and thirsty I amazed myself (with hindsight) that I went straight to sleep.
Day 2 (Day of Operation):
Was woken by a nurse at 6 O'clock for my Obs (Blood Pressure, Temperature) and to be told that I was first on the list for surgery this afternoon, which came as quite a shock because it was almost unheard of. The surgeon apparently had to perform emergency surgery at another hospital in the morning. No one really seemed to know what was going on.
I was then faced with a morning of nil-by-mouth and steadily growing terror. I had another heparin shot and began the process of trying to make sure that the television would be working when I got back after the operation.
Felt very very hungry.
By around midday I had my final shower and was given a surgical gown and my suspension stockings to wear. All set up and ready to go, I waited in bed watching television until Andy, the nurse announced, "The waiting is over". I saw porters mulling around outside my room looking cool as you like. I, however, was now very very very nervous. I'd been informed that I wouldn't be able to have a pre-med, because I had to sign the consent form in front of Mr. Terry upstairs in the Theatre waiting area. As a result, once the porters started moving me I realized I could feel pins and needles in my hands - my adrenaline pumping so much preparing for what was to come.
Upstairs I saw Mr. Terry for the first time since I arrived (He doesn't look THAT much like Michael Portillo after all) and signed that I did indeed want "the works" - penectomy, bi-lateral orchidectomy, clitoroplasty with hood and labiaplasty. He then waved goodbye (he was still in a suit) and I was moved onto a theatre bed and was rapidly moved into a very small room, which was crammed with loads of people. I don't know how they all fit in. The anesthetist put a line into my right hand, which I barely felt. By now, I was extremely stressed out and terrified. My whole body was tingling and I felt I was going to start hyperventilating if I didn't try to calm down. They clamped a sort of blood pressure thing to my left arm, stuck ECG stickers on my chest and the anesthetist then told me he was going to put me to sleep. My last thought was "cool" as I realized how weird being put to sleep was ... it felt like a wave of yellow static, dissolving my consciousness.
I remember waking up in recovery. Someone pointed out the PCA (patient controlled analgesia) button and told me to press it if I felt any pain at all. Feeling completely knackered, I just went straight back to sleep and drifted in and out of consciousness. Didn't feel ill or sick or cold or anything, although I was aware of the super massive nappy like bandage I appeared to have acquired. I was amazed at not feeling any pain.
After about an hour my BP had stabilized so I was taken back to my room. I can't remember much else about that day. Remember the trans woman I'd met the day before popped in to say hello at some point. Didn't feel remotely uncomfortable but I was now thinking.. Jesus.. I've really done it, haven't I?
Day 3 (1 day post-op):
Woke up feeling rather elated about having survived the operation. I was pretty comfortable, and not feeling any pain, so I laid off the Morphine and asked to be able to use the phone. I rang a couple of my mates to let them know what was going on.
At this point, the "flat on your back for 5 days without food" bit began. At dinnertime, I could smell other peoples dinners and I ached for something to eat. I was grateful to be allowed to drink sips of water, but otherwise my dehydration was being taken care of by a saline and dextrose drip. The day was punctuated with a constant stream of nurses checking my Obs, carefully measuring my bladder output and draining the catheter. Mr. Terry popped his head round the door with the rather sleazy House Officer over his shoulder to tell me that it had all gone extremely well and that he'd managed to create a hood for the clitoris and that I could expect between 5 and 6 inches of depth, which was something of a shock because as I understood it, Mr. Terry is only prepared to create a cavity that is 5 inches deep maximum. I guess he's changed his mind over the last 10 months.
The massive dressing wasn't bothering me during the morning and early afternoon, but it did prevent any sort of movement. In addition, my Game boy felt extremely heavy and was a struggle to use. I monged out in front of the television which seemed to still be working. Because all the remote controls had been stolen, I ended up being stuck watching Channel 4 all day, because I felt too embarrassed about calling a nurse for something so trivial.
By the evening, my discomfort with the massive dressing was growing. I had backache, and the cramp in my legs was distressing me (would I ever walk again?). The plastic mattress on the bed meant I could feel sweat pooling around my arse.
By 9 O'clock I realized the discomfort was enough to stop me sleeping. I pushed the button on the PCA but it didn't seem to work, so I thought it had run out of Morphine. By 10 O'clock every 10 minutes felt like an hour. It really was unbearable, and at this point I started crying, I felt sorry for myself THAT much. Pathetic really. Then two things happened: First, a nurse drained the catheter, which brought instant relief to what I then realized was a full bladder, and I began really giving the PCA some welly. After about 10 minutes, I discovered I was again away with the fairies and drifted into sleep.
At this point I made the positive resolution that if I felt even modest discomfort I would use the button to basically avoid having to face up to the misery of what I was experiencing.
I didn't know it at the time, but I'd already faced up to the worst part of the whole operation and come out the other side smiling.... Morphine rocks.
Day 4 (2 days post-op):
Apart from the usual flurry of nurses checking up on me, a senior nurse with a student nurse arrived and told me they were removing the outer dressing and the drains. I was filled with dread at this point, having read other diaries that said this was going to be a painful bit. I whacked the PCA a couple of times, just in case. As they stripped away, the outer dressing I felt incredible relief - it felt wonderful to be rid of it. What was left was a mass of thick bandaging, positioned like a sanitary towel stitched to hold it in place. It sat on two thick plastic tubes that ran parallel to my new genitalia (I presume this stops the dressing crushing the surgery site), with some blue plastic stuff covering the surgery site itself. I could see the drains how, poking out of my abdomen and running off the side of my bed. The senior nurse then began to give instructions to the student on how to remove the stitches and pull them out. I nearly shrieked in terror, thinking, "Isn't it going to be bad enough without letting someone practice on me???"... but... she didn't cut me with the teeny suture cutter, and she didn't hurt me when she pulled out the drains. It was, however, one of the most unpleasant experiences ever. Very difficult to describe, but you can feel that what is happening is just... wrong... very very unpleasant. It squelches inside you, and you can feel skin and tissue jiggling around.
They left me feeling much liberated since the removal of the outer dressing. I could move my legs a little, and shift weight around a bit to relief my back pain.
Next I got a bed bath and was allowed to change into one of my own nighties and out of the hospital gown.
I was beginning to feel vaguely human again.
However, disaster was to strike when the cleaning lady moved the trolley my television was on, pulling out the Ariel cable I'd gone to great pains to secure. No more television.
Ended up asking various nurses to have a go at fixing it, but it seemed I was doomed to be able to watch for about 2 minutes before it broke again. I got embarrassed about asking the same nurse to keep fixing it over and over, so I had to wait until the next shift started before I had another go.
I'd also made the decision to stop using the PCA (on the grounds that if I kept using it after I'd stopped having any pain I'd have all sorts of other problems to deal with!). Especially as the outer dressing's removal meant I felt SO much more comfortable, I didn't think there would be a problem.
Spent most of the rest of the day dozing, playing Tetris and then discovering that if my bed was moved, and the trolley with the telly on was moved, I could sit myself up just enough to be able to reach over and change channel. This was real progress!
Day 5: (3 days post-op):
Outer dressing removed, now it was the turn of the inner dressing and the pack to make my life miserable. The stitches (4 of which were in my arse) were really beginning to irritate the hell out of me, and the plastic tube supports for it were digging in to my bum and driving me mad. This was to be a very boring day, again feeling extremely hungry constantly and trying desperately to sleep as much as possible to make the day go faster. I was being visited less and less by nurses (as I didn't need such close observation) and I was able to begin trying to lie on my side to alleviate the stress and discomfort.
Lots of television. Lots of Tetris. Made a start on "Wire in the Blood" by Val McDermid.
Otherwise just a crappy day feeling increasingly irritated and uncomfortable, if not in any particular pain.
Day 6: (4 days post-op):
Pack-out day. Of course, no one had any idea when Mr. Terry would turn up to do this, because it being a Saturday and we should all be extremely grateful if he turns up at all on a non-consulting day. I grew increasingly worried that he wouldn't turn up at all, until he turned up after the Wales/Scotland rugby match I'd been watching on the telly.
It was all over very quickly. He told me to stay very still, then he cut the stitches holding the outer pack in place and removed the dressing. I gave out a loud, "Ooooohhh..." from the relief of getting rid of it.
Then he removed the pack itself. He said it wasn't going to hurt me, and he was right. Feels exactly like removing a dilator (as I've now found out).
This is where the story deviates from the usual SRS diaries. Rather than inserting a dilator he turned to the nurse and said, "Catheter out Monday, Dilation starts Tuesday and Home Wednesday."
Terry has decided that it doesn't do any harm to leave it a couple of days before starting dilation. It has the advantage that it's slightly easier when you do begin because you're less swollen, apparently.
He said I'd be able to sit up and EAT from now on, and that I would be allowed out of bed tomorrow.
You should have seen my face.
Finally I was allowed food, and I could move about!!! I ordered a ham sandwich, some yogurt and some orange juice, and it was wonderful. Changed my nightie again, had another wash (was able to wash myself this time, which was great!) and sat up in bed to watch telly.
By now, my normal personality was starting to resurface and had begun gibbering my excitement to whoever would listen.
I should point out that I'd turned down the offer of a mirror to examine my new genitalia, on account of not really wanting to scare myself. I'd seen enough to know it wasn't pretty.
Day 7: (5 Days Post-op):
Woo... the end of flat-on-yer-back. Wonderful. First thing in the morning I decided to experiment with getting out of my bed and felt very pleased with myself for managing to clean my teeth and open the curtains. This left me rather tired so I went back to bed for another couple of hours. The catheter was beginning to irritate me, and was a pain to carry around so walking wasn't exactly big-fun, I have to say. The rush of blood to my groin when I stood up was a shock though... it really did feel incredibly sore and swollen, but I was pleased that there wasn't a massive torrent of blood all over the place, as I'd imagined. I also managed to change into some clean knickers and put in a fresh sanitary towel. They hadn't told me to bring them, but it's a good thing I did because the alternative would have been incontinence pants or jumbo massive whopper hemorrhaging blue whale towels. Still, I felt clean and happy, if rather delicate.
By about 11 I decided I wanted a shower, and managed to walk all the way, have the shower and get back again without dying or collapsing. A good sign. I was, however, completely exhausted and could barely speak as a result. I'd also noticed some disturbing swelling while I was in the shower, so I called the nurse and asked for help. It was as the piece of skin from my anus to my vagina had turned into a giant bubble or something. Very peculiar.
One of the doctors came and had a look and said it was perfectly normal, and that it would go down (it did).
Having a shower left me wiped out until tea time, when I risked another shuffle around my room to fiddle with the television again and get various things out of my cupboard that I though I might find useful, which included my beloved tweezers and my mirror.
This is when I got my first proper look at my new bits, and was rather shocked to see that they were remarkably realistic, despite being extremely swollen. I was really worried about getting a typical vaginoplasty where you don't seem to get any sort of labia, so you have this peculiar situation where you have a clitoris that just seems to be glued onto otherwise smooth skin with crinkles of skin that are supposed to represent inner labia.. this wasn't the case. There was a really obvious clitoris, outer and inner labia and urethra. I was SO relieved. The clitoris was also sensitive, which meant it had survived the operation and therefore there was a good chance I was going to be orgasmic.
All that remained was the removal of the catheter and finding out if, I was going to be able to wee. If that happened, I would have had a REALLY good result.
I was in a really good mood by this point. Very, very sore but otherwise beginning to get really chatty with the nurses and enjoying being free and mobile. I was reading more, too. I don't know if I'd say I was having a "good time" but it wasn't bad.
Well, until about 10pm, when the catheter had obviously been yanked about a bit too much, and the balloon was tugging on the neck of my bladder causing the muscle to spasm. Anyone who's had a urinary infection will know how bloody painful that is, and I felt like I was in agony. However there was nothing that could be done about it, so the nurse gave me some paracetamol and reminded me it would be removed the following morning.
Eventually I drifted off to sleep.
Day 8: (6 days Post-op):
6 O'clock in the morning and a nurse arrives and tells me she's taking out my catheter. Thank god, I think, until she actually does it. This is the first and only time I actually experience pain during my entire stay. Because my bladder was already in a pretty angry mood with me, it did NOT like the nurse just whipping it out, and I felt that familiar spasm of pain once again. I began drinking lots of water and eventually I staggered to the loo and squeezed out some wee. It went everywhere, but the fact remained I'd managed to wee, which meant that I wouldn't need re-catheterizing. A massive relief. This meant I was complication free and was still on track to go home on Wednesday.
By this point I was positively beaming with the joys of the world, having finally been liberated from all dressings, drips, catheters.. everything. I removed the canellas from my arm and hand myself (impatient, aren't I?), had a shower etc... and generally felt utterly wonderful (if still very, very sore).
By now, I was really into my book, and was quite happy to just sit and read (interspersed with the occasional blast of Tetris when I felt my concentration slipping).
Around 5 the trans woman who would be having her operation the following day came to see me and I gave her the nutshell version of what I'd just been through. She wasn't remotely interested -- believing, as probably most transsexuals do, that they already know everything -- more fool her!
A good day.
Day 9: (7 days Post-op)
Crikey a whole week! This day was marked by lack of a delivery of the betadine and sterilization tablets require to begin dilation, and a communication issue that meant the nurse who was to do the dilation training didn't actually know she was supposed to be doing it. Scary really. I ended up in tears, because I was so frightened about the consequences of NOT dilating, having already waited some time to begin as it was.
Relief came in the form of my first visitors. Being stealth, and being in a hospital so far away from my "friends who know" and my family meant that 2 virtual strangers traveling several hundred miles to see me (on the off chance that it would be fun) touched me unbelievably, and made this penultimate day go really quickly and took my mind of the lack of dilating. Having never met these two before (I knew them from the internet though) I was worried it would be awkward, but it bizarrely went extremely well and we had a good laugh.
As for dilating, which I managed to do at 8pm, I found it to be very easy, but it DID make me feel sore afterwards... found it very difficult walking around. But it was a relief to have been able to dilate without problems which meant I was again still on track to be discharged the following day.
Day 10: (8 days post-op)
Woke up and spent ages chatting with one of the Nurses, which had become something of a feature of my stay - getting nurses in trouble because I was stopping them doing other work, but hey, what can I say? They were all totally superb and wonderful people for whom I have boundless respect and admiration for.
The pharmacy STILL hadn't delivered the stuff I needed so I couldn't yet dilate on my own to prove I could do it when the doctors came on their rounds around 8am. When they came, I told them that I'd been able to dilate with no problems the previous night and that I didn't expect to have any problems. They said it was okay to go ahead and discharge me, but that I should let them know if I have problems. I was able to dilate about 30 minutes later perfectly okay, so it seemed that was it!
I packed up, moved myself and my stuff into the day room and spent a good few hours chatting with one of the other student nurses (who was incredibly cool) before my dad came to pick me up and take me home.
Day 11: (9 days post-op)
Still very sore. Increasingly sore, in fact, as dilation begins to stress my vagina in new and unusual ways. Sick of bleeding. Sick of dreading standing up, but otherwise my energy levels I think are pretty amazing. I've not had to nap during the day or anything, and have been able to sit at my computer and write all this in one session.
Had another good look at my new bits and pieces and they still look gruesomely swollen, and now have the added attraction of lots of visible clotting and icky bits around the entrance to the vagina. It's difficult to imagine how it's going to look when it's all settled down, but I have faith that it's all going to work out and that dilating will eventually stop causing such discomfort and pain. Actually doing it isn't the problem... it's the bleeding afterwards. Ugh.
So that's it. That's what having SRS is like. Fun eh?