Anna's Place

GRS Diary (page 2)

Friday 14th November - The big day at last!

6:05am

The last ever photo of me before surgery aside from those taken in the operating theatre by Suporn's staff - shortly afterwards I was on my way to theatre

Well, the big day has arrived at last! A nurse has just popped in to ask me to shower and wash my hair - I'm to use an antiseptic wash (Hibiscrub) I was given yesterday. I was also given a rather cute pink two piece number (top and trousers) to wear. It's a little baggy but very comfortable.

6:45am

That shower was probably the most important one of my life. The water temperature here is very hot and I've been sitting in my room naked for a while just cooling off. I even had to turn up the air conditioning a notch as the last thing I want to happen now is start sweating. I hope Kazzy doesn't get too cold!

The shower head is just a simple one and can't be directed up or down - only from side to side, and the spray from it proved to be nearly horizontal, which took some getting used to! Fortunately it could be lifted from its cradle to reach the bits it otherwise wouldn't.

After showering (but before dressing) I went and stood by the balcony door and said a short prayer. I'm very conscious that this is major surgery and that there is a very, very slim chance that I may not survive. While I have every confidence in Dr. Suporn and his team, I owe it to myself to be prepared for the worst. It was also an opportunity to give thanks for the help I've been given over these last two astonishing years. Without my Faith, I might not have made it.

This morning I've received quite a few text messages from friends wishing me luck on my big day. Thanks everyone. You're all in my heart, and I hope to see you soon.

7:40am

I'm just waiting to be taken to theatre now. I've a few butterflies in my stomach but nothing strong - and I'm still rather surprised they didn't come sooner. A nurse has just arrived to ask if I'm ready.

8:00am

Operation Room 2 in Aikchol hospital. This photo was taken from the clinic's website with their permission

I'm in the "Operating Room" lying on the operating table. A few minutes ago two nurses and an attendant arrived with the gurney and I climbed on for the trip down to the "Operating Room" (as it was named) on the 1st floor (confusingly numbered 2 - the ground floor is floor 1...).

I actually found the experience quite relaxing (the ever present smiles of the nurses certainly helped). It was rather amusing watching the lights go by on the ceiling...something I've only seen in movies and so on until now. Surreal.

When we arrived I was asked to climb onto the operating table and then to place my arms out by my sides in a "crucifixion" posture. Velcro straps were tied around my wrists (presumably to ensure that if they got knocked my body wouldn't move), an IV inserted into my left hand and an oxygen monitor placed on the nail of my left thumb. ECG probes were also placed on my chest.

The theatre itself is airy and bright and the air conditioning not nearly as vicious as I'd heard from others. I don't feel cold at all, and the warm smiles of the OR staff (and the fact that they've even put some music on for me) are all helping me to feel totally at ease.

We're just waiting for Dr. Suporn now. Once he arrives, my rebirth begins.

8:30am

He's here. As the anaesthetist prepared to put me out, another nurse (with a camera around her neck - I wonder what that could be for ) held and stroked my hand and smiled at me. A quick smile from the Doctor, and then nothing....

4pm

Kazzy took this photo after I fell asleep later in the evening, with a few friends to keep me company

I'm awake again, albeit very groggy of course! I'm not feeling any pain as such, more a strong aching sensation in the area where the T-bandage covers the wound. I also feel like I need to pee but can't - despite the fact that I am peeing - as the contents of the catheter bag can testify.

I've been given a morphine injection through the IV to ease the pain. That in itself is quite an experience - I felt the drug racing up my arm and when it reached my head I felt what can only be described as a "high". I felt a deep sense of relief and contentment and (presumably) fell asleep.

While I was in theatre a bag containing the medical supplies I will shortly need (including a 9" long 1 ¼" diameter stent, condoms, KY jelly, a small mirror, a ring doughnut to sit upon etc.) were delivered to my room.

One nice touch is that although I went down to theatre wearing a top and trousers, when I came back the trousers had been replaced with a matching sarong. A symbolic and sweet gesture.

Minda (the nurse who checked me into the hospital yesterday, who also works part time for the clinic) is staying with us tonight to look after me. That's typical of the care and concern I've been shown by the staff since I arrived - they are truly wonderful!

Saturday 15th November - 1 day post-op

I didn't sleep much at all last night, which I suppose isn't really surprising consideing I was out of it most of the day. Every time I stirred Minda was up and checking I was OK. She was just brilliant.

Dr. Suporn visited at 8am and told me everything went smoothly and there were no complications. The surgery itself took just 5 hours, which is unusually quick for him as he normally expects GRS to take 6 to 9 hours. Apparently the staff were all pleased because it meant they could go home early!

I didn't take much in the way of pain relief at all today - just one shot of morphine in the morning and a couple of paracetamol in the evening (the latter for a headache). I'm told I have to pass wind and I can feel the can feel the gas in my abdomen (it's pretty uncomfortable) but it took ages before it happened.

I've very little appetite and I've been told to drink more water as my urine is too concentrated. The drain however is virtually empty, which suggests that there is no significant bleeding.

I've had loads of text messages from friends (my favourite was "Congratulations - it's a girl!") and also phone calls from Jane, Susie and Toni (who's recovering from her own surgery just over two weeks ago). So many people care about me - more than I ever dreamed possible.

Kazzy's been wonderful. I really don't know how I could have managed without her. Whenever there was something I needed, it was never too much trouble for her to get it for me.

Postscript: When the T-bandage was eventually removed it revealed a haematoma (internal blood clot) under my mons pubis. Guess where all the blood that should be in the drain was? Although it caused me significant swelling of the labia minora, lots of pain (that area is sensitive!), and great discomfort when sitting, the effects proved to be short-term and didn't affect my long term healing.

Sunday 16th November - 2 days post-op

Although I was given a sleeping pill last night I couldn't sleep - I spent most of the night trying to ignore a rather persistent headache and watching the clock. Although I normally take Ibruprofen for headaches at home (I sometimes get some nasty ones), that's a bad idea prior to surgery as they're anti-inflammatories. The same goes for aspirin.

This is the first time I've worn a nappy in a while!

Despite that, I was feeling a lot chirpier this morning and actually managed to eat a light breakfast - an omelette and a couple of slices of bread.

Wannee and Dr. Suporn came to see me again at 8am and seemed very happy with my progress. Dr. Suporn told me that the T-bandage would be removed on Tuesday - and I can't wait to see my new pussy and have a well overdue shower!

The days seem to be passing faster now, which is a real blessing. Tuesday will be here before I know it, I'm sure.

One of the nurses cut away part of the T-bandage which was blistering my skin a little. I don't seem to be suffering with it as much as others have, so that's something to be thankful for.

The ache I've been feeling since I returned from theatre on Friday turned into pain today, and I've asked for morphine injections several times - at 9:30am, 12pm and 5:20pm. I'll probably ask for another at about 10pm, and a stronger sleeping pill as the one I was given last night didn't work.

At about 9:45pm (2:45pm UK time) I tried to ring my children for my weekly telephone contact. A man answered, and when I asked to speak to my children he hung up. I rang again but there was no answer.

10:35pm

I'm feeling very tired and the pain has subsided for now, so I may not even need that sleeping pill tonight. I haven't needed to ask for any more painkillers either.

Monday 17th November- 3 days post-op

2:45am

I've just woken up, and I'm finding it very difficult to get comfortable. I've taken the sleeping pill to see if it helps.

6:50am

The pain is excruciating and I'm feeling very cold - my teeth are chattering and I can't make them stop. Kazzy's woken up and gone to fetch a nurse.

They've obviously decided the benefits outweigh the risks, as I've just been give a shot of morphine. It stung so much going into the vein in my hand that I cried out in pain - but at least that pain passed quickly, and then the pain in my groin subsided into a dull ache. Kazzy and the nurse wrapped me up in towels to keep me warm. She told me that I'd been hyperventilating and that was what had convinced them to give me the injection early.

8am

Wannee and Dr. Suporn are here. He says the pain is probably due to swelling in the (rather sensate) tissue around the urethra. Wannee emphasised again the need for me to exercise my limbs in bed (which I've been doing) as it will make me stronger when I'm able to stand up and shower on Wednesday.

After they left breakfast arrived. My appetite is definitely improving, and I'm developing quite a taste for the omelettes they serve here! Breakfast was followed by the inevitable cocktail of pills. This time there were some new ones - painkillers I believe. After the agony I felt this morning they're certainly welcome.

8:55am

It's bed bath time! (twice a day, every day - I just haven't mentioned it until now). I'm beginning to feel rather pampered.

Seriously though, they do look after you very well here, but I'm still really looking forward to that shower.

9:20am

Kazzy has just helped me to shave the fuzz off my face, and I feel so much cleaner now! In the bag supplied to me by the clinic was a cute little pink framed mirror (intended for use when dilating) which proved to be ideal for the purpose.

10:10am

After shaving I read a little of one of the books I brought with me ("Sally" by Freya North) - the first time I've felt like reading since arriving here.

Like all her books it's very, very funny...but my personal favourite is still Fen^*, which I read a few months ago. Any book which manages to combine art and culture with astute observations about the connection between men with beards, tickling and fanny farts has certainly got something.

^* Fen McCabe, at 28, has only ever been in love with one man. To her sisters' exasperation, he's a 19th-century sculptor called Julius Fetherstone. Starting a new job at Trust Art, Fen dreams of her hero and his missing masterpiece. Her family and friends hope that she might just meet a living, breathing man instead.

After reading for a few minutes I dozed off, before being woken by the nurses a short time ago for another blood pressure, temperature and heart rate check - all normal. I'm feeling quite relaxed and  and rather tired at the moment, so I think I'll doze for a bit longer yet.

12:15pm

Lunch has arrived as punctually always, but as I'm not particularly hungry I just picked at it. I'll keep the fruit that came with it (grape, orange and love apple) for later though.

The meals here arrive very regularly (9am, 12:30pm and 5pm) which doesn't seem to fit too well with my body clock, so inevitably I'm eating less than maybe I should at the moment.

After all the pain I felt this morning I'm trying not to move about much. It's not hit again yet, but I am suffering a great deal of quite painful wind, which I suppose at least shows that my bowels are starting to work again. With the selection of pills I'm given after each meal I'm now getting Tramadol - a painkiller. It's not as fast acting or effective as the morphine, but it helps - and makes me feel a little woozy - probably because I'm so weak.

2:10pm

The painkillers aren't working so I asked for a morphine shot, which was injected into the IV in my hand as usual. Like this morning, it stung horribly as it passed through the IV into the vein, but immediately I started to feel a little "high" and relaxed and - most importantly - the pain in my groin subsided.

5:05pm

I've just had my second bed bath of the day. With the pain I've been feeling today I knew turning onto my side (which I have to do for them to wash my back) would hurt - and I was right. It's a stabbing pain somewhere near my clitoris or urethra. Ouch.

I'm now lying on my back waiting for the pain to subside. I do wonder if the pressure from the bandage is making it worse - at least it comes off tomorrow.

10:35pm

I've just had another morphine shot as the pain was starting to get much worse. Hopefully the injection will help me sleep.

Tuesday 18th November - 4 days post-op

5am

I haven't been able to sleep because of the pain I'm feeling - even with the sleeping pill I've been given - so I've asked for another morphine injection.

6:20am

I've just been given another anti-DVT injection to the abdomen. Surprisingly, it's not a painful part of the body to have an injection. They're so gentle with needles here.

8:05am

The bandage is off! You can click through for the unpixelated version if you like, but please be warned that it is not a sight for the squeamish

Dr. Suporn and Wannee have just removed the T-Bandage! The wound looks very swollen, but to me it's just so beautiful. The culmination of my dream is now very much in sight, and despite all the pain, discomfort and loss it's worth it for this moment.

I have a haematoma above the top of my labia minora (just over where Dr. Suporn routes the nerves - hence the intense pain) but it should fade in time. There is also some bleeding in my vagina which they mopped up with cotton wool balls (held by forceps), and told me that if I see bleeding I should hold a cotton wool ball over the site for 15 minutes.

I'm still in a lot of pain, but that's now balanced by the sight of my new pussy. Wow! Dr. Suporn also used forceps to show me where my new clitoris is - and boy is it sensitive!! When he mopped up some of the blood at the vaginal opening I could feel the cotton wool ball going inside me too. Amazing.

My IV has been moved to my right hand, which should make the morphine injections less painful for a while.

Time to rest now I think. Kazzy's given me one of her tranquilisers to help.

11.30am

I've just woken up. I really needed that sleep, and I'm trying not to move about much to avoid disturbing the wound.

5pm

We've just had a visit from Aey! She was really lovely and we spent ages talking about everything - friends I know who've come here or are coming here, my children, my past, all sorts of things.

Aey visiting me in Aikchol Hospital

When she looked at the wound she said she thought that in 6 months time it would be really pretty, and before she left she posed for photos with Kazzy and myself.

5.30pm

I've taken an oral painkiller (tramadol) as the pain is building up again, I can't lie on my side comfortably so I've been flat on my back (I know...no change there! ;P) all day.

The painkiller is helping, but I think I'll ask for a morphine shot at about 10pm to help me sleep.

6.45pm

Wannee has just paid us a visit. Apparently I can get out of bed and shower tomorrow!

When I told her about the pain I was feeling she told me that most of it was probably due to the haematoma, and that it should go down naturally. In the meantime I'll ask for occasional morphine shots to keep the pain at bay, as the tramadol just doesn't seem to be strong enough for that.

8.33pm

I've finally given in and asked for another morphine shot and the feeling of relief is immense. I was trying to wait until 10pm because of the tramadol I took at 5.20pm but the pain just got too much.

Wednesday 19th November - 5 days post-op

5.30am

I woke up in agony about half an hour ago and just had another morphine jab, the second since midnight, I managed to bear the pain for half an hour before I give in.

7.50am

I can feel the pain building again, and the worst bit is knowing I can't have another jab for at least 3 hours. To add to that, I've been having several involuntary contractions of the PC muscle which puts pressure on the nerves and made the pain even worse. I hope they can do something about this thing as quickly as possible as it's driving me nuts!

On a more positive note I now have no difficulty turning and the tenderness in the vaginal area is reducing. The vast majority of the pain now comes from the haematoma.

8.15am

Dr Suporn and Wanee have just visited me. Dr. Suporn says everything is normal and the haematoma will go down in a week or so. I didn't realise it at the time, but apparently it's related to the bleeding he stopped yesterday. Until then I guess I'll just have to bear the pain. Once I leave the hospital, I will have to rely on oral painkillers (paracetamol or tramadol) or tranqulisers (valium) rather than morphine.

Wannee told me I could shower today after breakfast, if I'm not feeling too dizzy. I lifted the head of the bed so I was in a sitting position, but I have to say I am feeling slightly woozy right now. I'm going to take my time.

10.15am

The rubber ring I had to sit on to take a shower

I've just got out of bed for the first time! One of the nurses and Kazzy held onto me as I lowered my feet to the floor (itself quite painful) and literally shuffled to the bathroom, where I sat on a chair with a rubber ring and the nurse showered me and washed my hair.

Sitting on the chair was very uncomfortable and I had to brace myself with my hands on the sides of the chair, to make it bearable. By the time I made it back to bed I was so exhausted it was unbelievable. I asked for a morphine shot and dozed for a while.

Postscript: Later on we figured out why I'd been so uncomfortable. The nurse had placed the rubber ring with the raised bump on my left instead of my rear, and as a result my genitals were under pressure from the ring. The following day she did the same - and I corrected it before sitting down. The difference was incredible.

5.40pm

I've been a bit lax at writing today but despite that quite a few things have happened. Minda and Aey have both visited for a chat, and they were both as lovely and charming as ever!

This afternoon after I had recovered from the shower ordeal, I tried to stand again and found I was much more steady on my feet. Sitting on the rubber ring is still uncomfortable as bringing my legs together to sit puts pressure on the swelling, but nevertheless I am consious that I only have 2 more nights before going back to the Mercure. I hope I'll be a little more comfortable walking and sitting by then.

I have also had a repeat of another painful contraction and have realised two things - firstly that they only seem to happen after a morphine jab and secondly that they almost certainly are symptoms of sexual arousal, as I can feel that my clitoris is engorged and pulsing! This is something I certainly hadn't bargained for, and I will talk to Dr. Suporn about it tomorrow. Maybe it's a side effect of the morphine.

I was offered another shower this afternoon but declined as I'd just had a morphine jab and was still wary after this morning's experience. I will have one tomorrow and see how I get on.

Thursday 20th November - 6 days post-op

6.40am

I've just had a visit from several nurses who reconnected my IV as well as doing the usual pulse rate, BP and temperature checks. I'm not sure why the IV is back on.

Last night I slept from about 12:30am to 2:30am (when a contraction woke me) but I must have managed to doze off again as I was asleep when the nurses came in.

8:00am

Dr. Suporn has just paid his daily visit. He says the PC muscle contractions often happen but to try to resist them if I can (which I've been doing anyway) and we also talked about my shower yesterday and dizziness. He seems happy with my progress, and asked if I'd had a bowel movement yet. I hope that will happen today as I'm feeling pretty bunged up now.

10am

Kazzy and I at the hospital this morning - 6 days after my surgery

I can barely believe how much progress I've made since yesterday. After breakfast Kazzy gave me the rubber ring (the one from the shower) and I managed to sit on it upright in bed for quite some time without any of the awful discomfort I felt yesterday. It turned out to be perfect timing too, as while I was sitting there two of the nurses arrived to give me a shower - and this time I thoroughly enjoyed the experience!

I used Hibiscrub to gently wash the outside of my genitals, and after I'd been dried off one of the nurses applied Betadine to the wound. I now feel so much more comfortable with the prospect of moving back to the Mercure Hotel tomorrow!

1:30pm

We've just had a long visit from an American called Sue who's having her surgery here tomorrow. We've both tried to give her a realistic idea of what to expect and a few tips for getting comfortable while bedridden. I hope her recovery proves to be as astonishing as mine has been so far.

I'm still feeling pain of course, but it's nowhere near as intense as yesterday - I haven't had a morphine shot since midnight last night, and hopefully won't need any more this trip.

The PC muscle contractions seem to have died down too. On the flip side, Minda tells me that my bowel will be blocked by the vaginal packing so until it comes out tomorrow I probably won't be able to have a bowel movement - and I'm feeling pretty bunged up already. I expect to have some abdominal pain soon as a result.

2pm

Yesterday Kazzy asked Aey where she might be able to have a dress made - something unique, and today Aey brought a friend of hers who is a dressmaker to visit us. They discussed designs and materials, and I was so impressed by how Kazzy knew exactly what she wanted - something I've never shared. I'm tempted to have something unique made too - but I don't know what I want!

6:55pm

Sunset over Chonburi on my last night in hospital

I had a rather painful episode this afternoon. All day I've been feeling more and more constipated (I'm ready for a bowel movement but remember the packing is blocking it). I was coping with that fairly well, but then my bladder started feeling full and I started worrying about whether the catheter was still working. It got very painful and even after checking the catheter (Kazzy monitored the levels for me) I started to panic.

Kazzy called the nurse and we tried to explain that I needed to have a bowel movement, but (for the only time since arriving) we had difficulty communicating with the nurse - when told I needed to go the nurse kept saying "no no no, she must do on balcony" - she thought I wanted to have a cigarette,^* but all I could think of was the Blackadder episode featuring "the latest in modern open air conveniences" - in other words "you shit out of the window"! Later we were in hysterics about this, which although not solving the problem was the best form of medicine - laughter.

^*Smoking is of course the one thing patients must not do - I've mentioned it to Wannee so the message should get through to any nurses who didn't realise.

Kazzy called Minda, who talked to one of the nurses looking after me and eventually they called Dr. Suporn. I was told not to worry and that it would all be sorted out tomorrow but by then I was extremely upset and burst into tears - the first time that has happened since we arrived in Thailand.

Kazzy comforted me, and shortly afterwards the nurse gave me a morphine jab - despite my hoping not to need another, but to be honest I needed it badly. For a while afterwards I dozed while Kazzy stood on the balcony and chatted to Chris in 804 - who's accompanying her friend Ulli (who's had FFS and is also moving to the Mercure tomorrow).

I hope I can sleep tonight.

9pm

Wannee has just visited to talk to me about what will happen on the big day tomorrow when the vaginal packing is removed. I have to drink a full bottle of water at 7am nd Dr. Suporn will arrive at 7:30am to remove the packing (and hopefully the catheter too) and show me how to dilate.

I'm to dilate by myself from 8am to 10am, and we leave for the Mercure Hotel shortly afterwards. It's quite a daunting prospect, and I hope the experience doesn't prove to be too painful or stressful.

Wannee also confirmed what I've suspected since the T-Bandage was removed on Tuesday - that I have some necrosis on my labia minora. I hope it's not too serious.