8 Days Post-op… Hospital Re-Cap

Hey folks, I’m still alive. Sorry I haven’t updated till now. My top priority has been resting and healing and although I want to be active in keeping up with updates, it’s of course more important that I focus on recovery. This surgery really takes it out of you. So much of the ways you are used to being mobile, caring for yourself, doing painfully simple things for yourself, peeing, really everything, changes at least initially after surgery. I have often felt like an infant during the early days because I’ve been completely at the mercy of those around me in order to get my needs met. I guess I’ll give a rundown of my experience at the hospital. The exact day-to-day occurrences really float out of the mind pretty quickly. So I’ll do my best to recall what I can.

Surgery Day – February 4th: I got to the hospital early, around 5:45 for check-in. It was very quick and easy. The registration process was incredibly streamlined, the nurse goes over the paperwork with you and you have a touch-computer screen facing you. Whenever you need to sign a document, you just sign the screen and the documents are all electronically saved. This took not much longer than 5 minutes and then my friend and I were brought down the hall, she waited in a family area while I was taken back to get changed, tagged, IV’ed and gurney-ed. They give you a Bear Paws gown that if you want while you are waiting, you can hook up to a tube that fills the gown with warm air. They are specially designed to keep your body at optimal temperatures during surgery. My friend was eventually called back to wait with me about 30-45 min later. I met with the anesthesiologist, Dr Crane, Dr Safa, and the micro team came in briefly to introduce themselves to me. When it was time to go I said goodbye and they wheeled me down the hall to the OR I was fully awake and not sedated at all when I was brought into the OR. I have had that experience many times before but I suppose it was a bit more intense this time because I was looking all the around the room at the multiple tables they have set up with hundreds of medical instruments of each one. If this surgery didn’t feel real up until that point, it absolutely did then. The anesthesiologist told me he was going to give me some medicine to feel relaxed and that was it. When I woke up the first thing I remember seeing was my donor arm. They had the wound vac on it but they hadn’t placed any sort of splint on it (grafted areas REQUIRE early immobilization). One of the micro team members came by to check on me in the immediate recovery room that they bring you to while you are first waking up. It’s the same area as pre-op. He seemed shocked that my arm wasn’t splinted and went and got materials to brace my arm and came back. He splinted me and then fairly soon after I was moved to the TICU unit. At some point in the hours after I was moved to the TICU unit they noticed that there were some issues going on with my scrotum. I had severe dark, dark bruising and swelling that engulfed my entire scrotum and then spread down to my butt cheeks and onto my thighs. I looked like someone beat me with a bat. The scrotum was black but the other areas were a deep purple. They started worrying that I had a hematoma. The ice chips they had been giving me occasionally stopped and they were assessing whether or not I needed to be brought back into the OR to fix a hematoma. At this time you are being checked with a doppler to assure healthy blood flow to your penis is occurring. You will also have a headed pad that forces warms water through tubes and into the pad to keep your penis nice and toasty. This helps to keep the blood vessels unrestricted and very open so they can do their job the best they can. You are also hooked up to about two dozen things. Probably 6 or more wires on your chest, an Oximeter on your finger, a blood pressure cuff that goes off randomly, nasal oxygen tubes, plus the other things I mentioned already. You also have at least one drainage tube coming out of you, usually the scrotum, but I also had a teeny tiny little tube at the end of the groin incision where they do your hook up. Plus a foley catheter coming out of the tip of your penis. It’s a lot!

Day 1 Post Op: Multiple doctors were watching me and eventually Dr Crane came in the next morning before surgery and said that he didn’t think it was a hematoma in my scrotum and he didn’t want to rush me back into the OR if it wasn’t absolutely necessary because there are added risks every time they put you under – and more risks of infection. He went and did another case and said he’d be back to reassess. When he came back a few  hours later he decided it wasn’t critical to bring me back to the OR and would be a better plan to just wait it out and watch the area and see if it healed on it’s own.

Day 2 Post Op: I believe I was brought to the 3rd floor on this day? It’s still very regular care by the nurses but it’s not as intense as the first couple days when they have you under very close observation in the TICU when things are the most critical and likely to go wrong. Most of my nurses were very attentive and kind and made sure to check on me and make sure my legs were comfortable and propped up on pillows and my donor arm was elevated and I had everything I needed. I believe my nurse Reza hit this one out of the park, she was an angel. The most attentive nurse I’ve ever met. Mimi and Raymond were also very kind. The time goes by slow, especially the nights when they are coming in to Doppler your penis and check vitals every single hour. It’s hard to get any normal sleep. Pain medication makes you a little drowsy, but when I started to have itching and they gave me benadryl, it was the benadryl morphine combo that I really began to look forward to because it allowed me to occasionally get more than 30 minutes of sleep. I think this was the day they came in and cut the ace bandage off my thigh where the split thickness graft was harvested from. Under the Ace bandage they had place a Xeroform dressing. This is the same stuff you dress your arm with starting the the day you leave the hospital. It’s yellow and greasy. When they cut the Ace off blood is pretty much everywhere. They bring a huge hot air blower over to your bedside and it stays aimed at your thigh for the next few days till the Xeroform turns black with beaded up dried blood on it. You leave this on your  leg till it falls off – trimming the edges as it naturally releases from your skin underneath.

Day 3 Post Op: I was a bit more awake and with it by now. I was able to call and order room service but often they would need to call and remind me that the meal window was closing and ask if I wanted anything. It was nice of them to do that. I’d think I wanted food and then when it came I usually didn’t eat much. The fruit bowls and juices were mainly what I lived off while I was there. Over the next few days the issue with my scrotum started to look better and better. Much of my sack was slowly turning from bruised black, back to pink again. However there remains a scab-like crusty spot on part of it that is still black. This is called an “eschar” sometimes they flake off on their own and other times they need to be removed surgically. We are still watching this. It’s not uncommon for them to take many weeks to resolve.

Day 4 Post Op: Time to stand up! Wow, so this is really intense. Aside from just feeling weak from being in bed for 4 days, everything is very very tender… ok painful. The female nurse that was in the room with a male nurse as well preparing me for this event kept telling me that I’m going to want to hold my penis when I stand up because I’m going to worry it would fall off. She wouldn’t stop talking about this. She kept telling me how unnecessary that is and that I shouldn’t hold it and that it’s on there securely and that it was essentially irrational to hold it while you walk. I was  tempted to say: “hey lady, don’t tell me what to do with my dick.” I felt like she was actually bothered by the fact that we want to support it. Honestly, I’ve seen far too many separations happen at the shaft and scrotal areas that I plan on supporting my new equipment till I am more than certain that it isn’t coming off. I don’t care how irrational anyone thinks that is. I waited my whole life for this package… I sat for about 10 maybe 15 minutes at the most and then asked for help back to the bed. Sitting was highly highly uncomfortable and I was really slouched back to take all the weight off of my perineal area. Not fun. Once I got back in bed I stayed there for the rest of the day. But I was able to get up late at night and use the toilet to have a bowel movement. This was quite an experience, being so weak, and still in so much pain, with two tubes coming out of your (bladder and scrotum) still attached to the wound vac, and trying to balance on the toilet while experiencing going to the bathroom for the first time with new anatomy down there. It was kind of mind blowing. I might not have related to the genitals that I had, but I had of course gotten very familiar with the sensations of voiding and even having a bowel movement is a very different sensation. Everything feels different and I was pretty obsessed about not wanting my new package to touch the toilet seat, so that will be an interesting new challenge. I finally made a toilet paper nest and was able to lay him across the seat.

Day 5 Post Op: The micro team came in quite early. I heard them coming down the hall and they said: “You know what day it is?!” and I said Yes I do!!! And they said: “It’s GRADUATION DAY!” There were 4 or 5 of them and all within about 3.5 minutes they had pulled out my scrotum drain, pulled out my doppler wire, pulled out the drain on my groin scar, ripped off my wound vac, and re-bandaged me with my first round of Xeroform and Kerlix wrap. It was not the most pleasant experience of my life but it was over fast. Deep breaths… Deep breaths… It was a Tuesday and I was scheduled for my first post-op appointment the next day, Wednesday, so Dr Crane just came up to my room before I left and met with me briefly there. He told me I didn’t need to come to the office the next day and that I could just come to the office next week. I was grateful because I was feeling overwhelmed just by the idea of getting back to the AirBnb house. Thinking about leaving the next day seemed absolutely dreadful. After I met with him I saw the hand therapist Olga (?) she’s VERY VERY nice and she made me a splint and talked with me for quite some time. She also gave me information about finding a hand therapist while I’m still in the area. Then I got all my scripts and paperwork together and they packed me up and wheeled me downstairs so my friend could drive me home.

That’s what I got for a re-cap from the hospital experience. I think most people are unsure of what all is going to go down for the actual surgery and the time until you are discharged. I hadn’t intended on writing so much but I hope it helps those who are curious.