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.

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