This post is very much targeted at those who are planning to go through the sort of operations which I have undertaken. These operations are moments of amazing importance in our life so commitment to make them work is often not an issue. However, there are responsibilities which come with these operations, responsibilities which you should plan for when trying to plan your stay.
Please note that this post applies purely to Dr. Suporn… Each surgeon uses their own techniques and please don’t plan your stay with another surgeon based on this post.
I took the option of doing both GRS and breast augmentation (BA) at the same time, which puts some more strain on the body than one would think. Dr. Suporn’s GRS and BA are both very invasive, but invasive to ensure that you get the best results possible.
The first responsibility which you will face post op is to rest. This is so important and so easily overlooked, with some very serious consequences including bleeds, tears of the labia and increased swelling. Some people are lucky and can move around quickly after the operation, others have a great deal more difficulty. Plan for the latter rather than the former because if you have difficulties, you will not be able to keep up with commitments (especially remote work).
The second responsibility is pain management. I know that this sounds basic, but it is amazing how much pain affects the body and how much pain medication affects ones mind. I have been very lucky in that I have very little pain from my GRS but I have a great deal of pain from my BA which is also affecting any commitments I would have liked to make to be more active (be that remote work or even simple shopping trips here in Chonburi).
The simple summary of these two responsibilities is to plan for both a great deal of tiredness and to plan for pain management and to listen to the advice of the clinic and hospital staff, and to follow it. Both of these will improve over the weeks one is here, but it is important to be very aware of how these operations will affect one.
Beyond that, GRS and BA come with key post-op responsibilities which will take time and energy. At this point, I’m essentially committing a minimum of three hours a day to the procedures which are very necessary, alongside needing to sleep a great deal more. This takes planning if you want to maintain any commitments (even simple ones like remaining in contact with loved ones at home).
BA with Dr. Suporn comes with a bigger post-op commitment than with many other surgeons, but for a good reason: The post-op procedures associated with the operation are designed to increase the natural look of breast implants, having them move naturally and avoiding the classic breast implant look.
What one must do at least twice daily is a very vigorous massage of the implant to ensure that as the body heals around the implants, the cavity they are in remains free and avoids the contraction of scar tissue, which will result in a breast which moves a great deal more naturally. This massage is painful (especially in my case, but almost all complain about it) and the staff of the clinic will also invite you to massages there where they will put a great deal of work into ensuring the cavity remains free of contracted scar tissue. Their additional massages are very painful in the first two weeks, but very necessary.
When it comes to GRS, we all know that dilation is a necessity. What isn’t clear until one is actually doing this is just how much time and energy this takes. At the start, whilst the vaginal skin graft is healing, Dr. Suporn will require one to dilate for half an hour twice a day, using static dilation. By ‘dilate for half an hour’, he means reach full depth and then maintain that depth for half an hour. Before you do this, one needs to wash with Hibiscrcub and prepare the bed for dilation (5-10 minutes in total) and afterwards flush the vagina out with water three times and with a Betadine solution one time.
Some people get to depth very quickly, some people take more time. That means that each dilation can take from one to two hours quite easily, including preparation, getting to depth, the dilation itself and post-dilation cleansing.
Once the vaginal skin graft has healed, Dr. Suporn moves his patients to ‘dynamic dilation’, where one moves the head of the dilator in a circular motion to reduce the contraction of the skin graft due to scar tissue contraction. These dilations only last for fifteen minutes, but are much more tiring, and depending on maintenance of depth, Dr. Suporn will require up to three dilations a day for the first couple of months, reducing to two a day later on.
So, all in all, during the period of recovery in Thailand, one can expect to need to commit several hours a day to procedures and to rest, which is worth planning for.
Being here and having these operations is a truly magical experience and I am writing this post not to sound negative, but to be realistic. I want people who read my blog to get a realistic view of what this surgery means, especially for those planning to follow my steps. I want people to understand two key things:
- Having GRS and BA with Dr. Suporn is worth every single penny and every hour of recuperation and post-operative procedures one needs to follow. The results are more than worth the effort.
- Having GRS and BA with Dr. Suporn means being committed to putting the time in at the start to make sure you get the right results further down the road. If you’re coming here to do what I’ve done, please plan for that. Your recuperation and post-operative commitments are the most important things you will do here.
And on that note, I will now settle down for my afternoon dilation! 
Possibly Related Posts:
- The operation – Day 15: Dr. Suporn on my recovery
- Post-op trans woman cliché no. 82f
- The operation – Day 14: An adventure to the 7-11
- The neurological effects of hormones
- The operation – Day 12: Unpacked, dilated and back in the hotel
Tags: BA, Dr. Suporn, GRS, recuperation, Trans
Today I had my first consultation with Dr. Suporn after having left the hospital on Friday. The main reason was for the removal of the stitches in my armpits from the breast implants and some of the stitches in the genital area, but it was also an important opportunity for him to check my progress and for me to bring up the issue of my migraines.
The removal of the stitches went well, with very little pain, though the ones around the genital area were a little more uncomfortable than those in my arm pits. As for the consultation on my progress, Dr. Suporn is very happy and says that I am doing very well, with no skin necrosis (a common issue with GRS), remarkably little swelling and very advanced healing. What a relief!
As for the issue of my migraines, Dr. Suporn feels that with the level of my recovery, the best way of treating them is for me to go back onto my oestrogen pills. This is very early for him: He normally balks even at two weeks post op and aims for four weeks (with a lot starting somewhere in between) so I am very happy with this result.
When it comes to my breast implants, the recovery there is going well. They’re settling properly and looking very natural, but there’s the issue of the breast massages. I thought I’d been doing a good job but was quickly abused about that when Cin and a colleague (I didn’t yet catch her name) started my breast massage and it was sheer agony! Apparently, I need to do a great deal more there, which means some real pain… Oh, well… This is really a case of no pain no gain, I guess!
With regard to the rest of my recovery, I still need a lot of sleep and am still being admonished to not do too much and not walk too quickly as well as to avoid stress. My body needs an inordinate amount of sleep, still, which I guess is part of the payback for the quick wound recovery and I still have a sense of physical weakness, which I guess will be there for some weeks to come.
I think I’ve been very lucky with my recovery so far and I do hope that it continues this way. That would be just magical!
Possibly Related Posts:
- The operation – Day 17: Being clear on post-operative care responsibilities
- Post-op trans woman cliché no. 82f
- The operation – Day 14: An adventure to the 7-11
- The neurological effects of hormones
- The operation – Day 12: Unpacked, dilated and back in the hotel
Tags: Dr. Suporn, GRS, surgery, Trans
I’ve often heard post op women talk about how they can’t remember what it was like to have what they had down below before. It may seem like a crazy thing to claim: How can one forget a body part which one has lived with for decades?
Well, today, I looked in the mirror, 10 short days after my operation and I honestly cannot remember what it looked like down there before, nor how it felt. I can remember the inconveniences (the tucking, things not fitting), but more in a second-hand way, as if seeing someone else go through it. However, I cannot remember what it was like before… It all seems so right now.
Part of this is certainly due to the fact that I spent decades disliking and ignoring what I had and since coming to accept that I needed to transition, I became almost obsessed with hiding it from myself and others. Not looking at it for all this time certainly has its advantages!
Part of this is also certainly down to the way that the mind edits ones past. In the same way that I have memories of myself in childhood as a girl (I was in my head, but certainly not physically, so that’s quite some editing), I think that my mind has started editing away my past genitalia.
I think that a big part of this, however, is having the physical body which matches the mental body map I’ve had since childhood. It’s right now and my mind is reflecting this.
Whatever the cause, I like how things have turned out, mentally as well as physically.
Not that I like being a cliché, though, but this one I think I can handle!
Possibly Related Posts:
- The operation – Day 17: Being clear on post-operative care responsibilities
- The operation – Day 15: Dr. Suporn on my recovery
- The operation – Day 14: An adventure to the 7-11
- The neurological effects of hormones
- The operation – Day 12: Unpacked, dilated and back in the hotel
Today, I went on my first post op adventure: A walk to the 7-11 about 200m down the road to buy a few bits and bobs. It was nice to be out and about and it was fun to see what is in Thai shops (I love seeing those basic things when I travel!)
But now, I am dead!!! I am going to have to have a snooze before my afternoon dilation session, but before then I am going to eat the green custard sandwich I bought in the 7-11!
Another instalment in the exciting life of a post-op trans woman!
Possibly Related Posts:
- The operation – Day 17: Being clear on post-operative care responsibilities
- The operation – Day 15: Dr. Suporn on my recovery
- Post-op trans woman cliché no. 82f
- The neurological effects of hormones
- The operation – Day 12: Unpacked, dilated and back in the hotel
I am no neuroscientist (I’m glad enough I can spell the word properly alone), but my transition has taught me quite a lot about how my body works, especially how hormones affect ones brain. I had two neurological issues which I’d battled with for years disappear with my change in hormones and having stopped hormones for the operation, it’s been interesting waiting for them to return.
| Hormone basics | |
| Anti-androgens | |
| Anti-androgens are the hormone drugs which suppress testosterone (the male sex hormone). I was on 100mg of Androcur (cyproterone acetate) for four years and my German endocrinologist reduced that to 10mg since he believed that was more than enough to suppress the testosterone level I had. He was either right or all those years at 100mg had already properly chemically castrated me. | |
| Oestrogen | |
| Oestrogen is the female sex hormone (spelled estrogen in the US). I was on 4mg of oestradiol valerate orally and 2 squeezes of oestradiol hexahydrate gel pre-op. I will need to work with my endocrinologist on my new levels when I get back from Thailand. | |
| Progesterone | |
| Progesterone is a hormone which is an important part of preparing the uterus for pregnancy. Up until recently, this was believed to be its only function, but it is now being shown to be a neuro-protector (which is probably why male testes produce a small amount of it, too).
Androcur, the anti-androgen I was on, is also a progestogen, which is a drug which helps the body produce progesterone. When I get back home, I will have to work with my endocrinologist to understand if I need to take a small amount of progesterone for the neuro-protecting effects. Since this is quite new info, I don’t know if he will be aware of this, so this could end up being an interesting discussion. |
The first of these is migraines. Before, I used to get migraines very regularly. They ranged from light ones to horrible ones that would cripple me for a couple of days and I had all the classic symptoms, the visual auras and the intense sensitivity to light and smells, as well as scarily high peaks of blood pressure when I had the migraines (my doctor believed the migraines caused the blood pressure peaks, not the other way round, but it was never proven).
Very quickly after starting my oestrogen treatment, they practically disappeared to the point that instead of getting two or three a month at a minimum, I was getting one or two a year at a maximum, and much, much less intensely. Now, with having very low oestrogen levels again, the migraines are back, with the high blood pressure which had Jib from the clinic a bit shocked when she checked my pressure levels yesterday.
The second issue I had was a stutter. There were stress related aspects to it, but I’d worked with a couple of doctors and a speech therapist to get around it and they’d come to the conclusion that it was neurological in nature. It wasn’t a bad stutter and by concentrating hard, I even became quite a successful public speaker, though it was always a battle and it was a lovely surprise when starting anti-androgens to see it disappear.
I’m quite sure that the stutter is testosterone related since I was on anti-androgens alone for three months at the start of my transition (it’s a test done by the French doctors to make sure that there isn’t a testosterone-driven sexual nature to the wish to transition). About two weeks after taking anti-androgens, I found that ‘woolliness’ that I felt in my mouth when speaking start to disappear and my stutter vanished completely a few weeks later.
The stutter hasn’t come back, luckily, since my testosterone levels didn’t really seem to rise much when I stopped the Androcur (as I mentioned before, this was probably down to using too high a dose for too long), but since my body will from this point on have a small amount of testosterone from the adrenal gland (on Androcur, even that is completely suppressed) I will keep an eye out for that coming back.
It’s fascinating going through such huge changes in ones body. Some are traumatic, some are fabulous, but they’re all educational and I feel myself enriched learning more and more about myself through these experiences.
Possibly Related Posts:
- The operation – Day 17: Being clear on post-operative care responsibilities
- The operation – Day 15: Dr. Suporn on my recovery
- Post-op trans woman cliché no. 82f
- The operation – Day 14: An adventure to the 7-11
- The operation – Day 12: Unpacked, dilated and back in the hotel
Tags: hormones, neurology, Trans, transition
I open a lot of tabs when using Firefox, both at work and at home. Up until now, when a link was clicked which opened a tab, it would open at the end of the tab strip, but from Firefox 3.6 they open next to the tab where you clicked the link. I can understand why they do that, but this really messes me up!
Why? Well, I have six tabs which I have opened all the time:
- GMail
- Google Reader
- Transkitten.com’s configuration/dashboard
- Google Analytics
- Transkitten.com itself (so I can quickly see changes)
These are all opened in the first six tabs so I always know I can get at them by hitting Command+[1-6] on my Mac or Control+[1-6] on my work PC. Now, however, when I open a link in, say, GMail, that opens as tab number two, which means that the rest of my tabs are out of order and I can’t use the shortcuts to get to them.
Am I being anal? Probably, but I’ve become so used to being able to quickly access these tabs that this new behaviour of Firefox 3.6 is driving me insane.
Luckily, some hundreds of thousands of other people have already sent out cries of anguish about this and a quick bit of Googling found me the solution on Lifehacker, which also links to another page with some additional tips. It does require using the ‘about:config’ behind the scenes configuration, so do please be careful.
Peace has resettled upon my Firefox after this tip. I have to say that apart from that annoyance, Firefox 3.6 is really rather good. It’s much faster and seems a lot more stable on both my Mac and my work PC.
Possibly Related Posts:
Tags: Firefox, Firefox 3.6 tabs, tabs, tip
Today was a very bittersweet day. I got my freedom again, but I had to leave those lovely nurses at the hospital behind and I will miss them – they’re so caring and sweet!!!
This morning, the doctor did his bit of removing all the packing. I did seriously wonder if he’d come out with a rabbit or a rubber chicken, looking at how much he pulled out of me. It really was like one of those magicians pulling miles and miles of ribbon out of something tiny. Then, with the nurse, he did my first dilation, saying I have a depth of 7.5-8 inches. At that point, he showed me how to clean up and then he was off, ready for his next patient.
I then got to do something wonderful: Get dressed! First of all, just being able to put a pair of panties on was quite delightful, after a week on the bare side down there! Then, putting my own clothes on and doing a bit of make up… What a lovely experience and I felt so much more human after all that!
Then, I was left with the test of all tests for Supornistas graduating from the hospital: If you want to leave without having a catheter in your hand (not the greatest fashion accessory), you need to prove that you can pass water. Unfortunately, in removing the catheter to remove the packing, the Doc had emptied my bladder. After a slightly nervous 2 hours and six bottles of water, it finally happened and the nurses could call the clinic to pick me up, sans catheter!
Since then, I’ve done my first dilation, with the guidance of Jib just for this first time, and had a lovely dinner with three sweet girls I have met here. We had so much fun, but only for about an hour and a bit when I and one of the others ran completely out of energy and had to go back to the hotel before falling asleep at the table!
It’s lovely to be free and it really feels like my new life is starting… It’s going to be a fabulous one, too!
Possibly Related Posts:
- The operation – Day 17: Being clear on post-operative care responsibilities
- The operation – Day 15: Dr. Suporn on my recovery
- Post-op trans woman cliché no. 82f
- The operation – Day 14: An adventure to the 7-11
- The neurological effects of hormones
Tags: Dr. Suporn, surgery, Trans
Today’s an uneventful day. Yet another lovely shower and a little wander around to visit a new arrival who had her op yesterday (she’s still in the muzzy morphine stage), but apart from that, I’m just taking it easy and preparing for tomorrow when all the packing comes out and I start to live life as who I was always meant to be (but taking it rather easy at first).
My breast massages are getting easier (more like being beaten up by a boxer than mediæval torture, which is a big step up!!!) I’m still amazed that I have no pain elsewhere, considering the complexity of the operation.
The idea of leaving the hospital comes with mixed emotions. I can’t wait to be out, to be free, but I am going to miss the staff here hugely… I’ve never met such a lovely group of people, all so willing to help and be kind.
The nurses alone make surgery over here worthwhile: The care is absolutely second to none and the friendliness of the staff is just amazing!!!
Possibly Related Posts:
- The operation – Day 17: Being clear on post-operative care responsibilities
- The operation – Day 15: Dr. Suporn on my recovery
- Post-op trans woman cliché no. 82f
- The operation – Day 14: An adventure to the 7-11
- The neurological effects of hormones
Tags: Dr. Suporn, surgery, Trans
Today, I made great strides, literally! Well, little strides at first, to be honest!
Dr. Suporn came by whilst I was out for the count (I can still beat my cat in terms of hours slept per day) and did a quick check up, pronounced his happiness with my progress and told me I could go walking and could have my first shower. This may not seem like a lot, but for someone who’s been stuck in bed since the surgery, that news was worth a celebratory glass of champagne on its own (glass 1,873 on my list of glasses of champagne to catch up on when I’m allowed to drink again!)
Shortly after he visited, two sweet nurses came by and announced that it was walk and shower time. Considering that it feels like I’m three times taller than most of the nurses, this was slightly comical, both of them standing there to catch me as I got out of bed and stood shakily up. Luckily, I had no dizziness and didn’t go and squash any nurses by falling on top of them. Phew!
The shower I had sitting on a plastic chair with a rubber ring to protect the delicate areas and the nurse washed me whilst I just luxuriated in that stream of hot water. It was quite fabulous, probably the most astoundingly lovely shower I’ve ever had!
Then, I crawled back into bed, feeling clean and refreshed with my hair so nicely shampooed and conditioned and promptly fell asleep for another two hours. A 5m walk and shower will do that to you, I’ll have you know!
About an hour ago, feeling quite recovered, upon the advice of another nurse, I went on another walk, first of all around my room, and then as I felt more steady, did a whole two loops around the floor we’re on here. Oh, how liberating it was! I felt just fabulous and the nurse who was there to support me was a delight, all of her colleagues joking that she was half my height.
So, step by step, I’m getting better and in one huge step, a lot cleaner!!!!
Life is so good when one is who one really is!!!!
Possibly Related Posts:
- The operation – Day 17: Being clear on post-operative care responsibilities
- The operation – Day 15: Dr. Suporn on my recovery
- Post-op trans woman cliché no. 82f
- The operation – Day 14: An adventure to the 7-11
- The neurological effects of hormones
Tags: Dr. Suporn, surgery, Trans
Sorry for not writing yesterday. As Sarah Hélène mentioned in the comments yesterday, the third day after the op is often the ‘down’ day and it was a little like that for me. I slept almost the whole day and it seemed to do me a lot of good.
One good thing which I did discover yesterday is that the kitchen will cook you what you want. I wanted Thai food, but they only had meaty Thai food on the menu, so I asked a nurse why. She told me to just tell them what dish I want and I’d get it, and I have been (it’s really nice, too!)
Today started quite a lot better. After a 5am call with my boss in the US I had a lovely chat with my absolutely gorgeous girlfriend and as we disconnected, I heard a knock at the door and Jib from the clinic came in to start taking the outer dressings off ‘down there’ (which are actually stitched in place!) Half an hour later, Dr. Suporn came along to do the more intricate removal of the inner dressings and for the first time I got to see what I had down there.
A cliché it may be, but I started welling up and took Dr. Suporn by the hand and said a heartfelt ‘thank you’! I feel complete for the first time in my life and whilst I know it is just getting me physically as close as possible to what I should have been, it’s such a huge step that it is truly, deeply awe inspiring.
The Doc’s very happy with how things have gone. There’s very little swelling and the scarring is already showing signs of healing (so it seems I am a bit of a fast healer).
The rest of the day has been more of the usual. Bed rest and breast massage, and I think that whoever came up with this breast massage technique is a descendant of a mediæval torture genius!
Tomorrow, I start getting out of bed and start finding my feet again. Then, the packing inside will be removed and I will be introduced to the wonderful world of twice daily dilations!
I’m really happy, you know? And for the first time in my life, I am finally starting to find some peace with my body!
Just not with those breast massages!!!
Possibly Related Posts:
- The operation – Day 17: Being clear on post-operative care responsibilities
- The operation – Day 15: Dr. Suporn on my recovery
- Post-op trans woman cliché no. 82f
- The operation – Day 14: An adventure to the 7-11
- The neurological effects of hormones
Tags: Dr. Suporn, surgery, Trans