GRS Diary (page 5)
Wednesday 26th November - 12 days post-op
I've not written until now today as I've been resting basically all day. As a result of moving my morning dilation yesterday forward to 6am so I'd be able to see Toni off at midday, I started my evening dilation at 7pm - and this time it dragged terribly. I was very glad when it was over - especially as Kazzy went for dinner with the others and I couldn't join them in time.
While partway through cleaning myself afterwards I had my first encounter with something I've been warned by friends to expect to happen sooner or later - "post-op blues". Kazzy was at dinner and I tried frantically to reach her with no success - I cried hard for nearly an hour before she came back and helped to take the pain away. I still don't know why I cried - maybe a mixture of worries about the catheter (which I'm pig sick of now), the increased pain I had yesterday, things from my past that needed to come out...or maybe it's just hormonal imbalance from being off my hormones for 4 weeks now. Whatever the cause, it's past and I hope I'm stronger for the experience.
When she got back Kazzy ordered me a meal from room service (I'd been too upset to even do that), and after that I slept (although I forgot to turn off the TV, and woke to the sound of Queen playing "You're My Best Friend" on VH-1. Somebody's trying to tell me something...).
As a result I slept most of the day today, waking only to do a 1 hour dilation at 5pm so that I could move my evening dilation back to 10pm (which seems to be a comfortable time for me at the moment). Afterwards Brandy, Luke, Ulli and Oceana came to our room and we went to the Japanese restaurant on the ground floor together (a first for me - I've never tried Japanese cuisine and although I'm not sure it's really my taste I thoroughly enjoyed the experience. For obvious reasons I avoided the raw fish dishes of course!
After the wonderful meal we sat outside in the Terrace Bar for a while, before I came back to my room to check my email and dilate - which I actually started at 11pm. Before doing so I finally uploaded what I've written so far of this diary to my site. I've a lot of typing to do to catch up with my writing here, but I will!
Thursday 27th November - 13 days post-op
I'm just taking a breather before starting my first dilation of the day, having just returned from the clinic a very happy girl. Before I went there this morning I'd been told to drink lots of water, as Dr. Suporn may be able to remove the catheter today. If he did, they need to make sure I can urinate normally or it will have to be re-inserted - and I'm told that is very painful.
When Dr. Suporn examined me, I was very relieved when he did indeed tell me that the catheter could now be removed, and then proceeded to do so. It was an odd feeling, but not as bad as I'd feared and over very quickly. He also removed some more of the external stitches and told me that next week he may be able to drain the haematoma - which will reduce the swelling I still have. Even better!
Afterwards Aey brought me a large container of chilled water to drink, and each time I emptied it she kept refilling it and bringing it back. Have you ever had the feeling you were expected to do something...?
After I'd emptied the container about 4 or 5 times I finally felt the urge to pee, and after a quick "wish me luck!" I dashed to the loo. Once I sat down I tried my best to relax, and just waited. I knew the feeling would be very different, and I didn't want to try to force things in case I caused more inflammation and had to have the catheter re-inserted.
In the event I didn't have to worry or wait long, as just relaxing the muscles did the trick. As I sat there and felt it all happen I prayed and gave thanks to the Lord for getting me through yet another ordeal. Believe it or not, that small everyday act has already made a huge difference to my self-perception. I feel even more complete (if that's possible) than I did even after I saw my new anatomy. Incredible.
Afterwards I stayed at the clinic for a while chatting to everyone there, before Aey walked me back to the hotel, holding my hand all the way. She's shown so much care and consideration for me - a true friend.
I've been resting most of the day, but tonight we're all eating at the Chinese Restaurant again. It's Thanksgiving in the US today, and as the firkin turkey plucker is away we're improvising and therefore duck is on the menu.
I discovered today that Brandy (who I only really got to know last night) has a similar interest in history to mine - albeit a different period and continent, and she's very easy to talk to with a great sense of humour.
This afternoon both Aey and Wannee came to our room (I was dilating when Wannee arrived) and the four of us had a lovely heart to heart. They're so special. I showed both Wannee and Aey the pictures we've taken here and we talked of all the friends who've been here and are now back home in the UK - they send their greetings and Wannee says to tell Nikki that she still remembers "Bill"...
Friday 28th November - 14 days post-op
I'm two weeks old today!
I know I'm a bad girl - I haven't gone to bed yet (although it won't be long now). This evening we all ate Chinese again - and tonight although Ulli didn't come we were joined by a new girl - and her two friends who were accompanying her for her rebirth.
As usual, the meal was absolutely delicious, and far too much to finish.
Afterwards I joined Kazzy at the Terrace Bar, and coincidentally we were joined by Alison (who's not trans, but has become a friend while we were staying here at the Mercure).
After a quick Pepsi I was off to dilate again. While doing so I typed a little and then called Helen back in the UK - it was lovely to speak to her again, although it's only just over two weeks since she ferried Kazzy and I to Heathrow airport.
Luke is visiting us at the moment, and we're all chatting about Life, the Universe and Everything...and playing Populous on my laptop. I'm getting tired though, so I'm going to take a sleeping pill and crash.
Today has felt pretty uneventful - maybe that's a sign that I'm getting used to the routine here now. I do know it's an illusion - that a fair bit has happened, but I've not written it down so quickly!
>Kazzy wasn't hungry and skipped breakfast this morning, so I went down alone. When I got back at around 9am Wannee was here chatting to Kazzy and waiting for me.
As usual her visit was fun and friendly. She's so special, and I think she's rather pleased with my progress. I'm healing well, and I've not lost any depth since the packing was removed - for which I have a lot to thank my friends Melanie and Susie, who drummed it into me before I even booked my surgery how important dilation was and quickly you can lose depth if you don't do it properly.
After she left I dilated, then rested until Aey came to see us in the afternoon. She's always got a huge smile for everyone, and cares so much. We chatted for ages.
Afterwards I rested again, until Brandy came over to visit for an hour or so. By then I was really starting to flag, and when she left I crashed out - hard.
When Kazzy came back from a shopping trip (her and Ulli went to pick up a dress she'd had made at a local dressmaker) she knocked and got no response as I was out cold. When I eventually did wake up (from a very strange dream unusual in itself as I normally don't remember them!) I discovered that she'd hunted all over the hotel for me and was worried sick, bless her. She's truly my angel and soul-sister.
I was still feeling tired in the evening so I didn't go down for dinner tonight...I dozed for a while, then uploaded a diary update and posted a message to friends back in the UK via several online support groups. Right now I'm dilating again (surprise, surprise!).
Saturday 29th November - 15 days post-op
It's been a slow day that started off very fast. I was woken by Kazzy and Ulli at 7am, and we went for breakfast together with Luke shortly afterwards. His volume control was set on 11 this morning, and I felt distinctly uncomfortable, but I didn't say anything as I didn't want to cause discord.
I came back to my room to wait for Wannee (she normally arrives at 8:30am) but must have fallen sound asleep - she came, and said she'd return later. Once I woke up and found out, I delayed my 10am dilation a little in case she came back soon. When she didn't, I started (at 10:45am or 11am I think) only to have her turn up halfway through!
After finishing the first part of my cleaning routine (syringing out my vagina and washing the exterior with Hibiscrub) the cleaners arrived, preventing me from finishing the job (applying Betadine and Dermazin externally) until they left. Afterwards I pottered around for a while (posting some messages etc.) before trying to rest.
Today I've been feeling a little pain in my upper labia minora - an area that hasn't been painful recently. Although I've been given more tramadol, that's not proved to be as effective as usual, and I'm not sure why. I couldn't settle, so I took a 5mg diazapan (valium) tablet to help me relax. When it didn't seem to work I got up again - and totally forgot about the tranquiliser I'd taken. After a short while I was wondering why I was feeling light headed...
As I write this I'm lying in bed drinking a cup of tea and kicking myself. I'm going to doze now...5mg of diazapan didn't hit me at all in the hospital, but this time it's knocking me flat. Maybe I'm just run down after yesterday.
Wannee's very happy with my depth it seems. I haven't lost any! If I dilate on time (i.e. at 12 hour intervals -delaying even an hour makes it much harder at this stage) I can usually reach within 1" of full depth almost immediately without any difficulty, and the remaining 1" usually takes between 5 and 20 minutes. All the lectures by Melanie and Susie have really paid off.
Finally, my pussy's itching. I know that's another sign of healing, but it's an infuriating one!
When I went to the clinic on Thursday I was given a new supply of pills (antibiotics, anti-thrombosis, anti-inflammatories etc.).
When I restocked my pill-box this morning (Toni gave it to me, and it's very useful for organising all the pills you have to take once you've left the hospital) I noticed that I'd not been given a fresh supply of one of them - a painkiller (Idanae 200mg) which I've been taking 4 times daily, following the instruction on the packet. I didn't think anything of it, thinking I no longer needed it.
When I arrived at the hotel, I remember Wannee telling me that some of the pills were optional (certainly the tramadol, paracetamol and diazapan). I suspect that the Idanae was too - but the fact that I've been taking it so regularly has masked the continuing pain from the haematoma - and of course when they ran out that pain hit hard.
By early evening I was feeling much more pain than usual, and in areas I haven't had pain in since being discharged. I of course took painkillers - first 2 paracetamol (which didn't work), then an hour or so later two tramadol and a valium to help me relax and doze through the pain.
It didn't work. Kazzy heard me crying out as I tried to sleep and eventually persuaded me to let her call Wannee. She called Dr. Suporn, and then came at about 7pm and gave me a voltarol injection (although I thought it was morphine at the time) into the right buttock. I thought that would be a painful area to have a jab, but I barely felt it. It helped a lot, and I gave her a big hug when she reassured me before she left.
I dozed lightly. The voltarol injection affected me far less than morphine had in the hospital - whereas morphine usually put me out cold for at least 3 hours or so, I'm pretty sure I was semi-conscious most of the time.
My eyes felt heavy and I drifted back and forth between half sleep and half awake. I listened to songs on VH-1 and felt tears flow when ones that were special to me came on. I woke up at 8:30pm (almost wide awake, in fact!) but tried to rest for another hour or so before starting my dilation at 10pm.
I worked out some things about the effects of a drug like that on the body while I rested in that half conscious state. When fully awake the heart beats faster which probably flushes the drug from the bloodstream quicker. Taking deep breaths and relaxing (which also helps me to bear pain, and relax while dilating) helps to prevent that. That can be difficult for me at times, as my mind's often buzzing with ideas. Also, lying with the upper body and head in an elevated position helps direct the drug to the lower areas of the body (in this case the genital area) where it's needed. Believe me you don't appreciate the adjustable beds in the hospital until you don't have one!
Sunday 30th November - 16 days post-op
I'm scared witless right now. When I cleaned myself after my evening dilation (which I finished at midnight) I noticed something that just doesn't look right. When the T-Bandage was removed, there were some areas (particularly on my right labia minora which were blackened. I knew what this meant - necrosis (dead tissue) - and it's a scary prospect indeed. Dr. Suporn later reassured me that it looked like it was restricted to the surface, and indeed it did gradually turn white and come away.
However, tonight I noticed that what was pink new tissue on my right labia minor at my check up on Thursday (and indeed this morning) had turned white - which I interpreted as meaning that it was a failed skin graft with no blood supply and would come away like the black necrotic tissue which had covered it. Although if that happens I know it could be repaired in January when I return for my FFS, sensation is so important to me...and the most sensate tissue (that from the organ which has been the source of the discord in my life) has already been used.
With the sensation from and appearance of my reborn genitalia being so important to me (after all, I've waited so long and I'll always be without the ability to carry a child - one of my deepest wishes and something which isn't possible with current medical science for trans women - although it may be close, it'll be too late for me) I'm more scared of that prospect than of death (the fear of which haunted me as a teenager and which I vanquished long ago).
Lacking a magnifying mirror, I took a close-up picture with my camera and sent it to Susie in the UK as I thought she would know how to interpret what I'm seeing* - but when I rang her at home her friend Amanda told me she was in London and wouldn't be returning until around 8pm UK time (7 hours behind Thailand at this time of year).
She's a moderator on the Trans-Surgery support group, and a former Suporn patient (her surgery was on 23rd May 2003), while Amanda accompanied her on her journey and is a nurse. I trust their opinions and knowledge totally.
8pm UK time is 25 minutes away, and I'm guzzling coffee to keep awake until she calls. I'll stay up all night if necessary to wait for that call.
* Having a reasonable digital camera - mine's a 2.0 megapixel Canon Powershot A40 - and a laptop here has been a blessing in that respect, as I can not only keep a record of my progress, but see in detail on the screen what's changing in my genitalia as it heals.
Amanda persuaded me to call Wannee, which Kazzy did for me. When I talked to her she sounded exhausted and I felt so guilty for disturbing her. She advised me to rest tomorrow and I'll see Dr. Suporn first thing on Monday.
Sunday is the only day the clinic staff have a day off and therefore there's normally no support here on that day - which is actually far better than it sounds. Had I had surgery in the UK I believe I would have been discharged from hospital after 7 days or so, and if the same thing had happened after my discharge I suspect there would have been minimal medical support available - the local GP practices and surgeons just aren't trained to deal with this sort of eventuality, so in all probability the best help I'd be able to get would be from my friend Tessa, who's a nurse at my local hospital, and a very special friend.
To get specialist in-person support I'd have had to travel back to the hospital where I had my surgery - and the nearest are London (50 miles) and Brighton (60 miles). That's certainly more than I could bear in the state I'm in tonight - and I'd have to rely on friends for transport, as there's no way I could drive at the moment.
At least here there are others here to advise me. Kazzy called Ulli and Freeda and both came to our room to reassure me. I'm grateful to both, but especially to Freeda as she's just returned from the hospital for the second part of her FFS and to come to help me in those circumstances was a truly warm thing to do). She's a scientist with a great deal of medical knowledge, and looked closely at the tissue I'd noticed while Ulli held my hand and reassured me. Freeda thinks it is indeed necrosis - but a thin layer swollen with water, and advises me to gently blot it with lint and wipe it with Betadine to sterilise it.
I've just got off the phone to Susie (she called an hour ago and reassured both Kazzy and I). After looking at the picture I sent she said exactly the same as Freeda, and also gave me some extra advice on how to clean the affected area - to not only apply Betadine, but also dermazin, and do so about 4 times a day - not just after my twice daily dilation. Amanda concurred with that advice. I just can't thank them both enough.
I'm looking forward to introducing Susie and Kazzy to each other when we arrive back at Heathrow - albeit briefly as on my return I'm going to Ash (near Canterbury) with Susie and Kazzy is heading back to Weston with her friend Sammie. I expect it to be an emotional reunion on all fronts.
I awoke about 20 minutes ago as we fell asleep this morning leaving the TV on the movie channel. Being awoken to the sight of the top of someone's skull being sliced off to reveal their brain isn't my idea of fun (Kazzy tells me the movie was Bad Boys).
I took the last Idanae pill this morning to deal with the increased pain I've always felt in the morning since being discharged from hospital (not surprising, as while sleeping I obviously don't take any painkillers). When I turned on the light and check myself with the mirror the clinic gave me I could see part of the white tissue coming away.
Thankfully, it does now look like it's mainly surface tissue...some of it is beginning to come away on one side, but I can see some white areas underneath which are giving me cause for concern. All I can do now is wait now...but at least I've faced my deepest fear (with a lot of help from my friends both here and in the UK).
I've cleaned myself as recommended by Freeda and - more so - Susie and Amanda. Thank you girls - you've helped me through my worst nightmare.
I've just sent a thank you message to Susie and when I checked my e-mail afterwards, I saw an email from the Gender Trust saying the following:
The Queens Speech
You may well be aware that the Queen's Speech and the news around it has not mentioned the Gender Recognition Bill as we had anticipated. However there follows the text of an email from Judith Hayton at the Gender Recognition Division of the Department for Constitutional Affairs today.
There has been some concern following the Queen's Speech that the Gender Recognition Bill was not included and the implications of this. The Queen's Speech does not list all the new legislation that the Government intends to bring forward in the coming session. Rather, it is used to outline the main themes and largest Bills to be introduced.
Although it wasn't included in the speech, the Gender Recognition Bill is included in the Government's legislative programme and it is still the intention to introduce the Bill as soon as possible in the new session. A further update email will be sent out once the Bill is introduced to Parliament.
More information on the stages of legislation is available from the Parliament website at
Gender Recognition Division
Department for Constitutional Affairs
As soon as we have any sign of the Bill being introduced into the House of Lords we will let you know.
The Gender Trust
That's the news our community in the UK has been waiting for! The Government is introducing a Bill to give us back (most) of the legal rights taken from us by Judge Omrod in the April Ashley case in 1970 - a despicable decision by an ignorant judge based on wildly incorrect information from an expert witness who I'm reliably informed was Professor Richard Green - now the head of Charing Cross GIC. Is it any wonder I have no respect for this man and the patronising way he treats us?
A special message for the bigots of the Evangelical Alliance. Tough Luck - you're time is over. The Lord, and common sense and justice - will soon prevail over the bigotry you show in His name!
The cleaners pulled the same trick as yesterday again.
I haven't left our room today - and nor do I intend to as rest is most definitely on the menu. Speaking of which, I've not had much of an appetite over the last couple of days. One of the girls was good enough to bring me up breakfast though, which I happily munched on over the course of the next hour or two.
At 9:15 am I had a half hour call from Mel in the UK, and she and her wife Sue send their regards. For some reason we were cut off but by then my morning dilation was imminent. It went without a hitch and time passed quickly (so far my depth is still steady at 7" - which I'm more than happy with) aided by the fact that Susan (who visited us in hospital the day before the pack was removed) dropped in to see us. It turns out we have a fairly common past in Radio Frequency design (the job I did during my Industrial Training Year in University) so there was a lot of RF jargon flying back and forth. Our chat was cut short by the end of my dilation, and the need for her to start her own. She's one strong and smart girl, believe me.
Earlier today Kazzy rang Aey for a chat as she was feeling helpless (and angry at herself) for her inability to help me last night in the way she wanted. We were both stunned when she said that she was on her way to Bangkok tonight and to see her boyfriend (lucky girl!) but would drop in to see us. I didn't expect that - and neither did I expect the extra supply of tramadol painkillers she brought.
While she was here I gave her a surprise present that's I've been intending to give her for several days - one of my silver anklets, bearing a heart. I haven't had the opportunity to go shopping here, but my gifts come from the heart - and I'm giving them to very special people. Wannee and Fai don't know it yet, but I plan to give them the other two - the star for Wannee (because she is) and the dolphin (which I've been wearing for the past few days) for Fai.
Wannee had rung me earlier (a big surprise, but a welcome one) to check I was OK, which was a wonderful touch. As she was by then more awake I could explain to her why I'd been so upset. She then surprised me by turning up while Aey was here, bringing me some voltarol and cimetidene tablets in case I suffered again as I did last night.
I explained what I'd seen last night in more detail, how it had changed by this morning and how I'd been looking after the wound. She agreed I'd done the right thing. I also explained that I'm the sort of person who deals best with the unexpected if I understand as much as possible about what's happening and why. If I don't know, I try to work it out - and if it relates to my body and I draw the wrong or worst case conclusion (as I did last night) it can be very upsetting and panic can result.
She then explained more about my condition - apparently they discovered that my nerves and blood vessels are very close together so the haematoma was not altogether unexpected, and they've been monitoring my condition closely. She also explained that the whiteness is a by product of the action of the dermazin on dead tissue. My stitches look OK, and she believes that externally everything will be fine once the swelling has died down completely in 6 months or so. I hope so - I don't want another episode like last night.
I'm going for a check-up tomorrow so that Dr. Suporn can have a closer look and see whether the haematoma can be drained this week through the labia minora (it can't be done through the mons pubis because of the proximity of the nerve bundle). At the moment there's still too much swelling to see whether that's practical. It does get better each day though, so I'm hopeful - and reassured.
One final thing. Wannee told me that before I arrived she'd been shown my picture and told I was coming - as I've done for several close friends (Helen, Carolyn and Lisa) who are planning to come here next year.
Luke's just called in to check whether I'm OK, and while he was here Brandy called on the phone. I feel well and truly cared for here.
I've decided to rest and eat in my room again tonight. I'll order a steak (the peppered steak is rather yummy!) as I'm told the extra protein will help me to heal.
I started my dilation three quarters of an hour late (at 10:45pm) tonight to give me some flexibility for the check-up at the clinic tomorrow morning and it's much harder and less comfortable than usual - I was noticeably tighter. Hmmm....