Monday, April 18, 2016

Post Op Day 6

Last night, I set my phone to wake me up just before the sunrise this morning.  Arizona doesn’t switch over to Day Light Savings time, so they are the eastern edge of the Pacific timezone.  That makes the sunrise fairly early.

Just over eleven years ago, I stared out the second floor balcony and caught the sunrise on my last day at Greenbaum.  Today, I did the same.  The sun is further north in April than it is in February, so instead of the sun coming up next to the hospital, it came up over the parking garage.  I guess that’s fitting.

I ordered breakfast by asking the person on the other end of the phone if I could just say, “same as yesterday?”  That seemed to work well.  I went back to sleep for another hour and a half before getting up to do some work and pick the place up.  My nurse came in, took vitals, and gave me my meds.  She said that Michelle would be in soon to remove the sutures and catheter, and then go over the dilation instructions.  My nurse asked if I would like anything for the visit…hinting that something to calm and help with pain would be nice.

“Sounds good,” I said, “except I’ll just take the ibuprofen instead of the hard stuff.”

“Michelle usually calls about 30-45 minutes before she comes in, so I’ll bring the meds by when I hear from her.”

“Awesome!”  The nurses here seriously rock.

I ate my breakfast and then my nurse was in with the meds.  I worked for a while; reading emails and responding when necessary.

Soon, Michelle was there with the suture removal kits, the catheter removal kit, and the set of straight dilators.

Since you have to open the package before you can see what is inside, the labial sutures had to be removed first.  It almost seems like cutting 50-pound wire holding up an 85-pound fish that you just caught.  Once those sutures are cut, you can feel the tension in the labia disappear.  Of course, the sutures still need to be pulled out of the labia, but that’s minor.

After that came probably the most difficult part of the morning: removing the packing.  It feels very uncomfortable having the gauze-like stuff slowly pulled from the vaginal cavity.  It’s kinda hard to describe, but it would sorta be like pulling gauze out of your stomach through your mouth.  It’s not painful, per se, but it’s definitely uncomfortable.

Next up, Michelle removed the catheter by connecting to the valve next to the outlet port and deflating the balloon in my bladder.  Boom…it was out faster than she could say it was out.

Finally, time for the dilators.  You could almost hear music from The Good, The Bad, and The ugly in the background.

She said that Dr. Meltzer was switching me to the straight dilators.  Maybe that will make it easier to hit the hole.

My board.
She lubed up dilator #1 for me and then I inserted it like the good ol’ days.  It slid in almost 4.5 inches before it bottomed out.  Michelle confirmed that we were all the way in.  I kept that in for about 20 minutes before pulling it out and cleaning up.  Michelle wrote my dilation schedule for the next few days on the patient board for the room.  Tonight, I have the dreaded 2am dilation.  I thought I’d never have to do that again.

As the day goes on, patients are starting to flow into the recovery rooms here at Greenbaum.  They said that Dr. Meltzer would likely be up mid-afternoon between cases, and sure enough, he showed up around 3pm with Dr. Tal in tow.  He took a look at the exterior and said things looked good, except for the blisters from the tape.  It will probably and hopefully be the last time I see Dr. Meltzer.  He’s helped me out big on two occasions…SRS and resolving this vaginal cyst discharge issue…and helped change my life for the better in more ways than most people can imagine.

My room from the hallway.
After I filled out the discharge paperwork and we headed to the elevator, I started to cry a little.  My wife saw and kinda laughed.

“You want to leave, don’t you?”

“Of course, but there is something special here that makes saying good-bye very difficult.”

She thought I was joking.  My wife is not trans, so I cannot expect her or any other cisgender people to grasp the vastness of these life changing surgeries and the loving care these nurses provide to us in recovery.

I turned my head from my wife as we drove to the hotel, mainly because I didn’t want to see her laugh or smile as I cried.  After I reached a point where I could talk, I tried conversing more with her on the topic.

My bed for nearly a week.
After we made it back to the hotel, we went back to the restaurant we went to the night before my surgery.  This time, I was able to eat.  I probably ate too much.

Tonight will be my first night not in a hospital bed.  I’ve piled up 3 large pillows so that I don’t have to lay flat and can take pressure off my stomach incision.  I’m planning to take half a pain pill around 11pm, get up at 2am to dilate, and then take a full pain pill to get back to sleep.

Sunday, April 17, 2016

Post Op Day 5

Just a note...NSFW below.

I walked over to Starbucks again this morning, and, like yesterday, I was exhausted when I got back.  If I go slow, I feel pretty decent.

Well, the recovery ward is empty.  I'm the only one here, but yet, when I went past the nurse's station, there are still two nurses here.  I figure it's facility rules to always have at least two here.  At least they have a light load today and tonight, but I'm sure that surgeries will start up again tomorrow morning.

Yum...Culinary Festival!
I took a picture of how things look so far (see below).  I have the usual catheter stuff coming out of the sewn up labia, but I think the labia is sewn up to keep the packing in.  Dr. Meltzer said he was going to slice along each side of the interior vagina and then use skin from the stomach to graft into the back portion of my vagina.  You can see that my skin is very sensitive and doesn't like tape.


Fortunately, though, I was able to avoid the booty blisters this time.  They put one of those large pads underneath me, but it has a plastic layer, as well.  I think the plastic layer retains or reflects the heat back at me.  I think it is what caused my booty blisters previously and started to warm me up this time, too.  I kinda push it to the side, especially when sleeping, in order to keep my booty blister-free.

This afternoon, the wife and I walked to the Scottsdale Culinary Festival here in downtown Scottsdale.  They had some food booths out, and this one rib joint smelled delicious.  I had a small plate of ribs and they totally hit the spot.  It made me wonder if the protein cravings will kick in after surgery.

Round 2 of the catheter.
It was hot out, but we walked slow.  I took along some water because of just how hot it was, but the festival gate people asked me to leave it behind.  When I showed them the hospital band around my wrist, that I just had surgery, and that it was water to keep me hydrated, they let me in with my water.  I'll take it as a small victory.

Saturday, April 16, 2016

Post Op Day 4

With my wife pregnant and a natural sleeper, she doesn't make it over to Greenbaum very early in the morning, but she does usually get me a morning tea.  This morning, though, I decided to walk over to the cafe on my own.

It took a while to get across the street and over to Starbucks, but I made it.  Doing laps around Greenbaum's second floor the past few days have definitely helped get me ready for my first big venture out again.  I was exhausted when I got back, though.

During my later laps today, the nurses have also informed me that I will be the only patient tomorrow as everyone is checking out.

It's interesting this time...I haven't really run into anyone in the recovery rooms and I only brought along my wife this trip.  My stay is also 2-3 days shorter than the average stay for SRS.  Previously, I had at least one friend here with me or chatted and hung out with some of the other people that were recovering.  This time, I haven't talked to anyone else.  It's kinda lonely since my wife only makes it over for a few hours during the day.  Surprisingly, though, the days seem to go by fast.

Friday, April 15, 2016

Post Op Day 3

I took the two pain pills right at 9pm last night and about 15 minutes later I could feel the warmth fill my body as the pain disappeared.  I figured I would sleep through the entire night with the two pain pills.  I woke up and it was still dark out, unfortunately, so I knew it was before 5:30am.  When I looked at my phone, it said 11:47pm.  Sheesh!  I barely made it 3 hours.  Luckily, I was able to get back to sleep without too much trouble, but slept intermittently until around 6.

The shift change happens between 7 and 7:30, I think, and my nurse usually comes in around 7:30am to do vitals and anything else that needs to happen.  In this case, my drains were to be removed.  I thought someone from Dr. Meltzer's office would remove the drains, but my nurse was able to snip the suture holding them in place and then gently slid them out.  It wasn't as bad as I thought it was going to be.

I also didn't realize how far down along the labia the drains ran under my skin, but I think one of the channels for the drains aggravated a nerve in my right leg.  Over the past few days, if I touch my right inner thigh in a certain way or stretch out my right leg so that the inner thigh has any sort of tension on it, it feels like it lights up on fire.  Like, seriously on fire.

Now that the drains were out and I was able to walk, it was time to shower.  It felt good to wash my hair and just sit under the warm water.  Greenbaum needs to fix their shower heads, though, as they pretty much suck…at least mine did.

Thursday, April 14, 2016

Post-Op Day 2

I slept OK last night, but still woke up a bunch of times.  The pain was manageable, but I probably should have requested more pain killers in the middle of the night.  Sometimes I just feel bad getting the nurses in the middle of the night.

My nurse was in early this morning and removed the IV port.  That was basically the first thing to go that was hooked into me.  I still have drains, the catheter, labial sutures, and the packing that will come out over the course of my stay.

After the IV port was out, my nurse showed me how to cap the catheter (the same as I did 11 years ago), and then I was mobile.  While I was up and walking about my room, I decided to wait until my wife was there before we did laps.

Meg also stopped by this morning and took a look at the surgical and graft sites.  She noticed that I had small blisters from the tape.  That seems to be my only thing right now.  Hell, I don't even have any bruising.

After breakfast, I started having gas and very slight pains in the stomach.  Is this a sign that I'm going to poo on day 2?  The first time that I was here it felt like forever until I went poo.  Sure, enough, though, I went poo four times today.  They were relatively small poos, but the stool softener did well and I just kinda let things happen on their own.  Gravity did well.

My wife made it in slightly before midday and we did a few laps throughout the time that she was here.  I only did one lap at a time before coming back to the room to rest.

Tonight, I told my evening nurse that I wasn't getting the sleep that I got with the pain pump.  She asked if I wanted two pain pills.  I said, "yes," of course.  The pain pills are down and I'm having one of my chocolate covered oreos before I jump into bed.  Hopefully it's a good night's sleep.

Wednesday, April 13, 2016

Post-Op Day 1

The PCA button enabled me to sleep about an hour at a time from about 9pm until around 5 or 6 this morning.  It's all kinda hazy.  I feel refreshed, but it wasn't like I slept a continual 8 hours.

Today, I'm on bed rest.  Remembering my first time at Greenbaum, I had booty blisters after less than 2 days.  I think it was due to the absorbent pad they put under you in combination with the coarse fabric of the hospital's disposable underwear.  My body would get hot in those areas and start to sweat, and with constant pressure on the skin, blisters would form.  I guess I just have sensitive skin.

I made sure to push the absorbent pad to the side with the catheter connection and hopped into the nicer disposable underwear in Dr. Meltzer's goody bag.

For breakfast, I ate a bunch of fruit, but I wasn't that hungry.  For lunch, I had a salad.  When I was here with Amber when she had her SRS in 2004, she started back on fruits and salads.  I think it's a good way to get the system going again, plus they also give me stool softener.  I was almost going to ask for prune juice today, but I realized that I didn't want to have to shit in my bed, so I'll hold off.

Dr. Meltzer came in to check on me and said that the surgery went well.  He was able to open up the hole and removed a cyst about 5cm size which I think he said unfolded into the skin that was originally up there.  He said he removed as much skin from beyond the hole, except for a patch that was attached to my bladder.  He said he hit that patch with the cauterizer instead of risking cutting my bladder.  After that, he used the skin graft to reline the reopened portion of my vagina.

I asked him what happened to cause this...did I not dilate deep enough or what...because I dilated like crazy the first 6 months and on schedule for the first 5 years.  He figured that it took years for the vaginal skin to take hold and that it probably gradually closed up.  While he has performed vaginal deepening on numerous people who had their original SRS in Thailand, he said he has had to perform very few vaginal deepening procedures on his own patients.  He said I was around the 4th.  Out of several thousand, that's pretty good.  I just happened to be one of the unlucky ones.

Remembering back to that early gynecologist visit where she dug out the excess surgilube, probably from the same cavity, I wonder if I just jumped up too early in dilator sizes and didn't get the dilator past that little constricted area.  Years later, I bet this is also what caused the half day of funky discharge from my vagina after dilating.  Eventually, I bet it closed off until the cyst started producing discharge that I noticed. 

Dr. Meltzer was off to San Francisco to perform surgeries for Kaiser on Thursday and Friday.  He said Meg would be in to check on me while he was away.

My wife is not an early riser, so she made it in around midday.  Around that same time, they took me off the PCA pump.  No more deliciousness.  Fortunately, they put me on oral pain pills, which I guess are better for the body.

Otherwise, today was kinda boring.  I haven't done much.  We watched a movie on the hospital TV system and that's been about it.  My wife got me a local paper to read and some chocolate covered oreos from Godiva.  They are the manifestation of decadence, and quite delicious, but not quite as delicious as the pain pump.

Well, I'm about to shut down again.  It's late and I need to get some rest.  I figure tonight will be more difficult than last night since the PCA is not there to keep me asleep.

Back in Greenbaum, about to sign off for the night.

Tuesday, April 12, 2016

Day 0 - Surgery Day

I woke up at 4:30am this morning, took my shower, and then packed everything up.  I was ready to leave a little after 5am in order to be at the surgery center at 5:30am.  My wife, who on a normal work day can wake up and leave in under 20 minutes, was having a hard time getting out of bed and into motion.  Let's just say that we go to Greenbaum before 6am.  Seriously, it doesn't take 2 hours to prep for surgery, but I'm sure they want us there early to go over all of it and not have to rush with everyone.

This was my third time at Greenbaum.  I checked in, paid the copay, filled out the paperwork, and then headed back.  We did the normal vital check, and then I took off my clothes and put on the hospital gown.

The nurse prepping me, though, asked, "I just want to be sure...you don't have a uterus, right?"

I smiled.

"No, I don't have a uterus."

After that, I was on the gurney where she inserted the IV port and completed the prep.  Numerous people came by including the transport nurse, a surgical nurse, and, of course, my anesthesiologist.

I just realized that everyone that has performed surgery on me has always been older than me.  At 45, I'm not a spring pup anymore, but it's interesting that my surgeons have all been older then me.  Realizing that I was well past 40 now, and the recovery time from surgery takes a lot longer than my 30's, I had actually spent the past year trying to get in really good shape.  I usually don't get out of shape, but I had a bout of plantar fasciitis hit me about a year and a half ago that stopped my running for several months.  Once I was able to run again, I pushed myself for more miles each month.  Hopefully getting my metabolism in good shape should help with recovery and the ability to ambulate.

My wife came into the OR prep area after a while.  She had already coordinated the delivery of my suitcase upstairs to the recovery floor.  I wanted to do it before surgery because I didn't want her lifting the big bag down from the vehicle while she is pregnant.

Dr. Meltzer stopped by one last time before surgery.  He had ridden in on his bicycle.  Soon, they were ready to take me into the OR.  I said good-bye to my wife and the anesthesiologist hit me with some calming juice.  I actually never felt anything as we drove through the lower hallways of Greenbaum.  Once in the OR, they had me hop over to the surgery table, and the anesthesiologist hit me with something stronger because I don't remember anything until waking up in the recovery area.

Waking up in the recovery area is a very unique experience.  I realized where I was almost immediately, but since I wear strong glasses, I couldn't make out anything in particular.  I tried keeping my eyes open and staying awake, but gravity and sleepiness kept pulling me back down.  Eventually, I was alert and awake enough that they moved me upstairs.  I want to say I made it up here by 2pm.  I had probably been in the recovery area for 2 hours, so it looks like Dr. Meltzer only took about 4 hours, quite a bit less than the 6 hours he said he would usually book.

My wife caught up with me in my room where she was able to put my glasses on me.  Surprisingly, I had stall 14 in the pre-op area and room 14 upstairs. 

The nice thing is that I was hooked up to a PCA pump which delivered a small amount of pain meds on a continual basis, and more pain meds when I pressed the button.  Delicious!  I'm not in that much pain with the low level dose, but when I press the button, it usually knocks me out.

I was actually alert enough to eat dinner tonight, but now I realize that I shouldn't have told them that I was lactose intolerant.  They have shut me down from ordering anything with dairy in it.  The thing is, I have my Lactaid pills with me which enable me to eat dairy without any consequences, but I guess they don't want to risk it.

Anyway, I am shutting down and pressing the button for some delicious sleep.

Monday, April 11, 2016

Pre-Op Visit

I had my pre-op appointment with Dr. Meltzer this morning.  I first met with Michelle, one of Dr. Meltzer's staff, to go over the bag of goodies. 

The bag included a mirror, airline neck cushion (for sitting on), white robe, feminine pads, bacitracin, douche kit, colace, arnica, 3x disposable underwear, and the dreaded prep bottle.

After we went over the bag, she started to talk about the time of the surgery.  Originally, I was scheduled for April 20th, then moved up to April 12 for some reason.  For the past few months, I was scheduled for the 7:30am surgery and had to be at Greenbaum by 5:30am.  Early!  Within the past week, I had been pushed to the 1:30pm surgery with a report time of 11:30.  Honestly, I wanted the early surgery because then I wouldn't have to sit around even longer without anything in my stomach.

When we were in Dr. Meltzer's reception area, though, we heard one patient telling Dr. Meltzer's staff that she was having concerns about her early surgery time.  We hoped she was currently before us, because I wanted the early spot.

Sure enough, Michelle says we've been moved back up to the 7:30am spot.  I told her that the early time was good and we'd heard the other patient had concerns.

After that, Dr. Meltzer came in, took a look at my vagina again, probed the hole a little, and then drew lines on my stomach where he would be taking the skin graft.  We chatted a little about the surgery and he described very basically what he would be doing which would hopefully resolve this constant discharge issue.

I was supposed to be on clear liquids the day before surgery, but they also said I could have one bottle of Ensure for each meal.  They said no dairy, but when I looked at the ingredients for Ensure, it says it has milk in it.  I love my morning English Breakfast tea latte, and since Starbucks is right next to Dr. Meltzer's office, I figured a little bit of dairy that morning wouldn't hurt since they were allowing Ensure throughout the day.  I told myself that I wouldn't have any more dairy or Ensure the rest of the day.  I also got a tall instead of a grande.

With midday rapidly approaching and the 5:30pm start time for the bowel prep, there wasn't much time to do anything major like drive to the Grand Canyon and look around.  Instead, we decided to chill, catch a movie, and then walk around before my wife ate dinner.

Finally, the time came to start the bowel prep.  I had already been drinking my fluids throughout the afternoon, so I downed the bowel prep right on time and then continued to drink fluids as listed in the notes.  Just like before, I started having bowel movements within an hour after drinking the prep solution.  By the time I was ready to insert the suppository at 9pm tonight, it felt like I was starting to wind down.  I inserted it, anyway, and waited for the last stuff to come out.  I was getting tired and my wife was ready for bed, so I did my last dump and now I'm heading to bed.  I'm setting the alarm for 4:30am.

ADDENDUM:
Rather than write about what happened between bedtime and surgery in another post, I figured I would add on here.

I woke up around 12:30am that night with a horrible stomach ache.  It was really bad.  I went to the toilet and basically sat there hoping the feeling would go away.  After about 5 minutes but what seemed like forever, a ton of fluids gushed from my bowels.  I felt better, but not great.  I wiped, then stood up, but I still felt bad.  I started to see stars, which seems like the prelude to passing out.  I made it back to the toilet and sat there again for what seemed like forever.  Finally, more fluids gushed from my bowels and I finally felt decent enough to go back to bed.

I woke up again around 2:30am to have more fluids gush from my bowels, but it was 100 times less extreme than the 12:30am adventure.  Still, that 12:30am episode was one of the worst feelings I have had my entire life.

Sunday, April 10, 2016

Back in Scottsdale

I honestly thought I would never be back in Scottsdale, Arizona to see Dr. Meltzer.  That's what I was thinking last year when I flew in for a consult and this year when I came in for surgery.

So, let me back up a little and start at the beginning...or at least some semblance of the beginning.  I had vaginoplasty (SRS) with Dr. Meltzer on February 22, 2005, and labiaplasty with Dr. Meltzer on July 6, 2005.  (I still haven't finished moving all of my old SRS blog entries over to blogspot, yet, but I need to.)

I started out with just over 5 inches (12.5cm) of depth and dilated like crazy the first six months (I think I only missed a handful of scheduled dilations).  This included hundreds of dilations, sometimes even four times a day.

I remember after my labiaplasty that I had a yeast infection and that it felt like I had lost some depth.  It felt like I was down to about 4" of depth.  I also remember going to a trans OB/GYN months after my labiaplasty for a checkup.  She said that I had a bunch of surgilube up in my vagina and proceeded to scoop it all out.

For the next nine years, every time I dilated, I also seemed to get a smelly discharge for about half a day to a full day.  In the summer of 2012, I pretty much stopped dilating altogether as I noticed I wasn't loosing any of my 3.5" of depth and I wasn't having penetrative sex...and when I had, it just didn't feel good.

I met my current partner in the spring of 2013.  We enjoyed doing a lot of things together, like hiking, playing sports, and riding bikes.  During the California drought of 2013-2015, the winter months had very little rain and the mountain biking trails remained open almost year round.  After one of those rides in early 2014, I noticed vaginal discharge...very similar to what I had seen (and smelled) in the half day following a typical dilation.

This discharge continued daily in small amounts.  After a few months, I called Dr. Melzter's office.  They said to douche.  They sent me a new douche kit and I douched.  The discharge continued.  They said to really get in there and use some force with the water.  I did, and on one douche, it hurt.  I put my finger up my vagina and felt where the pain had come from.  It was a hole.  Fuck!

Of course, I contacted Dr. Meltzer's office again and they said I should get it checked by one of my Kaiser gynecologists.  I did.  They didn't see anything.  They sent me to a trans-specialist gynecologist in Oakland.  They didn't really see anything, either, but upon probing for a bacterial infection, I noticed that she found the "hole".  Her swab came out bloody.

I contacted Dr. Meltzer's office again.  They suggested that I probably had some granular tissue and to have my gynecologist hit it with some silver nitrate.  They did, and it stung.  We did that for 3 sessions, with a couple weeks between sessions.  Nothing changed.

On my 4th visit, I asked her if she saw a hole or something...whatever she was putting the silver nitrate on.  I asked her if she could gently probe that area with a cotton swab.  She did.  She said it went in about 4cm.  She semi-freaked out in the office and called some trans-specialists in San Francisco.  They set up an appointment to see me.

So, I went to San Francisco to talk to them.  They didn't really check me out, but they said that Kaiser was partnered with Dr. Meltzer and they would send me for a consult.  In the meantime, they had me get a CT scan of my pelvic region.  The doctor who analyzed the scan said there was probably a cyst above the vaginal cavity.  Great.

All of that took about a year from first noticing the discharge in January 2012, to calling Dr. Meltzer in May/June 2012, to probing the hole in December 2012.

So, I had an appointment with Dr. Meltzer scheduled for February 2nd, 2015 in Scottsdale, Arizona.  I flew in that morning.  For those that don't follow football, Superbowl 49 was played in Phoenix on February 1, 2015, so I arrived in Phoenix the morning after the Superbowl.  Had the Packers not had their catastrophic collapse against the Seattle Seahawks in the NFC title game two weeks prior, I probably would have been there to see the Packers play AND see Dr. Meltzer, but, alas, I was only there for the evaluation.  My partner went, too.

When we flew in, I realized that I was 20 days shy of 10 years since my initial SRS.  We drove over to his office for the late morning appointment with me hoping that he could simply just close the hole and I could go home.

After he looked things over, the best way that I can describe what he said is that a portion of the initial cavity at the top had sorta closed in on itself and that there was a cyst up there producing the discharge.  He said he would need to open up the area, remove the cyst or whatever was causing the discharge, and then reline the vaginal cavity with a skin graft.  It wasn't a simple "close the hole" type of activity since the tissue up inside the hole would continue to produce the discharge.  I agreed to the procedure, especially since Kaiser would cover it, and met with his scheduler to set something up.  Remember, this is February 2, 2015 when I am there.

When the scheduler said "April,", I thought, that's not too bad...I'll have to wait 2 months to get this fixed.  When she said "April 2016", my mind said, "Fuck! I gotta wait another year to get this thing fixed?"  I booked it, because, really, I had no other options.  I'd already been dealing with the discharge for 13 months...and I'd have to wait another 14 more months, so basically, I was halfway.

While I knew that Dr. Meltzer was right, I wanted a second opinion, anyway, and with Dr. Marci Bowers in the Bay Area, I made an appointment with her.  That appointment also had a several month lead time associated with it.

Let me say that I went to Dr. Bowers with an open mind and without prejudice over any SRS surgeon.  I think they all do great work for the trans-community at large.

I showed up early for the appointment and sat in the waiting area.  She appeared to have two office personnel, with one of them wanting to take off early for some type of event.  I could hear Dr. Bowers having some sort of conversation with someone, via a translator, in Japan, I believe.  The conversation went on for quite a while, well beyond our scheduled time period.  I was finally called and put in a super tiny exam room.  It appeared that they were renovating the building that Dr. Bowers worked out of.

After a long wait, Dr. Bowers took a look and saw the small hole in my vagina.  Instead of asking for permission to do anything and then tell me what she was going to do, she basically started trimming out granular tissue.  I looked down at what she was doing and saw her discarding bloody skin in the waste.  She said, "Don't look at that!"

After she was done, she said the discharge would be better or non-existent, but that I would still have that hole.

She was wrong.  The discharge continued and was nearly the same as before.  (I'm going to include pictures of the discharge at the very bottom of this post.)

This reinforced what Meltzer was saying.  Perhaps a second "opinion" isn't always best.

So, I waited the extra 14 months from the consult in February 2015.  In that time, I had almost constant discharge.  It was usually the worst in the hours before a bowel movement.

Meltzer also had me increase my dilation schedule and had me douching on a more regular basis.  I had dilated with the #2 for many years, but I slowly worked back up to the #4 the past month.  I still only have about 3.5" of depth.  I can feel the hole at the top of my vaginal cavity.  When I probe it with my fingers, it will often start to bleed.

The initial discharge was a yellowish-greenish mess.  Sometimes it had more of a brownish color.  After I opened up the hole during douching, the discharge increased, probably because it could leave the hole easier.  Any time the hole was probed, I would bleed a little for at least a day.  After Dr. Bowers cut out some of the granulation tissue, I would basically have discharge all of the time.  Sometimes, after dilating or bowel movement exertions, the discharge would be bloody.  Other times, it would just be the greenish-yellow discharge...or a combo of the two.  (see below)

I tried using pads initially, but the pads would get wet from the constant discharge and aggravate my skin, so I switched to putting tissues there and changing them out when I could.  This seemed to save my skin from being aggravated.  I did this for two years.  In the hour before a bowel movement, sometimes I would also notice a very bad smell emanate from my vagina.  It had the same similar smell as the discharge.  Doing that for two years wore on me.  I had to be careful that "accidents" didn't happen.

When one of the old GenderPeace group made it to San Francisco a few weeks ago, we decided to have a little reunion and catch up with what everyone was doing.  Rachel has been all around the US with her partner, but was finally back in the area to visit.  Amber got married a few years ago and is doing well in her techie job.  Claire made it up from SoCal.  She's been working with a few startups.  Anne moved on to another company a few years ago and has been doing really well, too.  I see some of them once in a while; others more often.  I told them about my situation and what I was going to have done, and we all reminisced about our prior journeys some 10-12 years ago.  They were quite understanding.  They always have been.

But, just thinking back since this discharge stuff started, so many other things have happened in my life.  I got promoted to manager at work, proposed to my girlfriend (she said yes), moved in together (with her dog), bought a house together, remodeled a house together, got braces, ran a ton of miles, played a bunch of softball games, got my braces off, planned a wedding, got married, bought a new car, had to put our dog down, and, finally, after a lot of effort, my wife is pregnant.

But here I am, sitting in a hotel room in Scottsdale, waiting to see the wizard again and somehow hope to find another pair of ruby slippers that still fit.

Typical greenish-yellow discharge.
Bloody discharge.
Combo blood and blah.