3 Months Post-Op RFF Phallo

Yesterday, Thursday the 5th technically makes 13 weeks since surgery. I had surgery on February 4th, 2016, so I’m going to try my best to keep doing monthly updates around the 4th of the month rather than keeping track of weeks from now on. I can’t say how lengthy I will continue to make these posts, but I’ll do my best to keep them informative and detailed. At some point I’m likely to switch to posting every 3 months and then eventually only when something worth updating about occurs.

In the meantime:

Things are mostly going well. I’ve been back at work for a month and I’ve been managing, again, mostly well. Surprisingly what I thought would be the biggest challenge (my arm) is the least of my worries. My hand strength is getting better all the time and more than enough for all basic daily personal and work tasks. My wrist mobility is nearly 100% what it was prior to surgery – however it does FEEL stiff, but I can still get almost equal flexion compared to my other wrist. Heavy weight-bearing with my palm flat down and my wrist bent is the most uncomfortable position. So while push ups are certainly possible and have been for many weeks, it’s not something that I’m doing regularly. Weight-bearing in that position over flexes the joint and it’s uncomfortable. I’m still continuing to do O.T. on my own at home when I think to do exercises and stretches and I’ve been able to achieve satisfactory results this way.

FOREARM/DONOR SITE: The scar continues to look more and more blended in with the surrounding tissue color. The color actually looks even more blended and natural in person, the photo doesn’t do it justice. The light brown spots corresponds to areas where the graft had some minor slough. The graft just didn’t take quite as well as the pinker areas. I’m sure eventually it’ll all blend in quite evenly.

Forearm 01.JPG

I have noticed some progression in scar edges flattening, although the main ridge that runs radially where the two skin grafts were stitched together continues to remain more pronounced than the other edges. I wish I had pressed on this ridge line earlier to help flatten it but I did have some pieces of the healing graft that looked to be pulling away from where it was suppose to be and so I literally let the ridge dry up because it was mushy and too wet at one point from too frequently changing the xeroform. I figured at the time that if it dried up more that it would stay in place and not pull away from the wound bed. I massage this ridge pretty much daily now to aide in breaking up scar tissue and help with flattening the ridge – the issue though is with the sensitivity that I have radially near the wrist. If I take my index finger and firmly tap on this area, or god forbid accidentally bump it on something like I did the other day, the pain can be mildly uncomfortable to intensely painful depending on how hard it is struck. I honestly don’t even want to THINK about getting tattooed in that area. YIKES! Maybe in time this will calm down in the same way that the hypersensitivity along the back of my hand did. But I was warned by the hand therapist at CPMC, that Dr Safa advises against tattooing in this specific area because you can damage the nerve and cause a lot of issues.

Forearm 03.JPG

HAIR GROWTH: This is specific to the hair growth that I’ve experienced on the healthy non-grafted tissue on my donor arm. If you’ve ever had a cast or worn a compression sleeve on your arm you may be familiar with what can happen to the hairs underneath. I’ve been told that it’s friction that can cause it, but areas that are covered with a tight sleeve or cast for many weeks often sprout new coarse hairs that didn’t exist before. It’s a temporary phenomenon and it’s gone away in my previous experiences with it but I thought I would share a few photos showing the occurrence. The following photo is of course the bridge of my donor arm. The bridge is the area where I’m experiencing the excess hair growth since it’s the only area that’s covered with the sleeve that is still capable of growing hair:

Hair Growth.JPG

And this is my non-donor are in that same exact area. The hair is much finer and more sparse. Also keep in mind that I had almost completely cleared my donor arm in that area where all the hair is growing. This is a perfect example of how the body can trigger inactive or dormant hairs to start growing in certain circumstance. And if friction on the skin can cause this, it would stand to reason that that is the reason why even guys that clear the fine blonde hairs from the inside of their forearms can still have substantial hair growth show up in their urethra post-op.

Non Donor Arm.JPG

Here’s a side by side:

Comparison.JPG

DONOR ARM LEASH SITE: The leash that they harvest from the forearm above the flap site is doing better than ever. The scar is still pink and dark-ish at times, but adhesion was the big issue here initially. I am no longer having any issues relating to adhesion that bother me. Certainly there is still some existent adhesion that I notice when I am moisturizing and massaging the area, but I no longer feel pain or discomfort when extending my arm or reaching for things. It was probably at about the 6+ week mark that that sensation completely went away. It didn’t just happen on it’s own, I really worked at it to relieve the tension with massage, and stretches. Be proactive, push through the discomfort and eventually it will dissipate.

Forearm 04.JPG

SELF-CARE: I’ve been moisturizing my scars with shea butter for about a month and I’ve been happy with the outcome.My forearm graft feels softs and healthy. It does get dry easily and 2x daily moisturizing is most ideal, but it doesn’t always happen. At about the 2 month mark I did become a bit more lazy with upkeep on things such as my daily rituals of moisturizing all my scars, massaging, always wearing my silicone patch and sleeve. I started not being quite as vigilant and obsessive about all of it.

Shea Butter.png

THIGH: My thigh still gets really itchy at times. Interestingly enough weight-bearing activities can increase the itching sensation. It must have something to do with more blood flow happening in the area, but it’s odd none the less. I’m moisturizing that area at least 1-3 times per day. Since I switched to the shea butter it seems to lock in the moisture for longer than the Eucerin did.

Liquidy sperm shaped Eucerin from last month: (photo 04/08/16 – scar is darker)

IMG_2830.JPG

The Eucerin was nice though because it was a quicker and easier application – whereas the shea butter is a very firm/harder substance and it takes a bit longer to warm it up on the skin before it will rub in and absorb.

Shea Solid.JPG

So I tend to probably use it a bit less frequently since it takes longer to apply. Either way, the scar appears to be doing well and continues to fade. I have gotten some ingrown hairs a few times that resulted in a pimple forming. That’s been slightly annoying but seriously a non-event. I just pop it, free the trapped hair and move on.

This is a photo of my leg this evening immediately before the shea butter application:

Pre-lotion.jpg

And this is after 3 minutes of moisturizing and massage – there is quite a noticeable difference in the shade of the scar afterward:

Post Lotion.jpg

Here’s a side-by-side for easier comparison:

Side by side.png

 

HOOK-UP, GLANSPLASTY, SP SCAR: All three of these incisions are still continuing to heal well, with no issues or anything remarkable to report. Since last month I think I’ve noticed more progression in terms of scar fading with the hook-up scar:

Hook up.JPG

more so than the glansplasty scar. These incisions I admit to being WAY lax about tending to and I very rarely apply lotion to them or massage them – maybe just 1-2 times per week.

Glansplasty & SP.JPG

PAIN: I continue to experience mild, to fairly intense building pressure and pain in my groin when I stand for long periods of time. It’s most inconvenient and annoying when I’m at work and sitting and/or lying down wouldn’t be appropriate. This sensation feels like really extreme blue balls – like blood flow is just increasing and increasing and as though I am getting a rock hard erection but one that just throbs and aches. That’s the best way I can describe it. I also often refer to it as my balls having a migraine. It’s not a pleasant sensation. I’ve been experiencing this since the very first time I stood up at the hospital and it has been by far the most painful thing throughout all of this. Initially I couldn’t stand for more than 30 seconds without breaking out in a literal sweat because the pain was so intense. Gradually though, the time frame I could stand without pain increased and I could make it to the bathroom, to the kitchen to grab something then hobble back to the couch. Always once I am in a scooched way back sitting position where I’m able to lean mostly reclined, or fully laying down, then immediately the pressure/pain is relieved. I’m really hoping that in another month or two this experience will be gone. This pain and my v-nectomy site are the main things that feel like they are keeping me from being all that active right now.

PERINEUM: *sigh*… Ok, the hole is honestly doing WAY better than it was when I first got home from California,  and then a couple weeks after being instructed to pack it with gauze it really started doing much much better. It’s so shallow and small now that the gauze falls out immediately. I really wish Crane has instructed me to pack it when I saw him at my last post-op appointment and had him look at the site. As it stands, I didn’t end up making an appointment to have it looked at locally till a month after I got home because I just didn’t know any better. I figured I would have been told to pack it if the wound needed it. I would have really benefitted from packing it starting at just  a couple weeks post-op, it might have not even gotten to the size that it did, even though it was still fairly small and I would have been more comfortable in the meantime… Right now the tissue is 90% healed with light healthy pink tissue, but there is a noticeable divit where the skin dips into a crevice. The crevice has healed tissue on the inside, but to me it looks like a mini shallow vagina, which is just not ok with me. This divit is what I am seeking to revise. I want it closed up and brought back to the midline like a typical male perineum. I am currently trying to book surgery with Dr Nikolavsky in Syracuse, NY. I was going to have the procedure done locally in Boston, by a uro-gyn, but there is a secondary issue that I  am still having with my scrotum that the uro-gyn is not comfortable addressing.

SCROTUM: I continue to have an existing “pocket” of thin sebaceous tissue that previously functioned as the inner tissue of my labia majora. This specific tissue is sebaceous in nature, which means that it secretes oils and fluids. The inside of the labia majora is a thinner/wetter skin. It also can build up the same kind of “cheese” (sorry, I know it’s gross) that is especially produced in the foreskin of uncircumcised natal males. So no matter how much I keep this area clean and dry, it just produces more wetness and creates smegma over the course of the day. The pocket is just large enough to fit the head of a q-tip into and I honestly didn’t even know it existed till I got really up close and personal with my sack at around 4 weeks post-op and was horrified to find a pocket of smegma that had been growing there for weeks. There is another tiny missed piece of sebaceous tissue on the opposite side of my scrotum, however it’s  much smaller, about 5% of the size of the larger pocket… I had a follow-up with the uro-gyn in Boston about surgically closing the v-nectomy opening and also asked if he would be able to fix the pocket in my sack, although I was fairly sure he wouldn’t be able to. He looked at my scrotum and didn’t feel confident in messing with it since it was closer to my UL than he felt comfortable cutting into and he wasn’t sure about what was just under the skin in that area. I completely understand and truly appreciate him being honest about his comfort level. I’d rather know that a surgeon isn’t comfortable with doing a procedure rather than have him try to do something unfamiliar and then the outcome be that I wind up with another complication or an aesthetic result that would leave me disappointed. For those reasons I’m seeking out a revision of both my scrotal and perineal issues with Dr Nikolavsky in NY. I’m hoping for a date later this month or the middle/end of June… I have the option of returning to CA to have either Crane or Chen do the revision but it would cost me a pretty penny to fly out there, deal with local transport to and from the office, hospital, lodging, airport, and other expenses. My other option is that I could just wait until stage 2 to have the revisions done, but I really feel like I need to have it taken care of sooner than later, because I’m pretty uncomfortable.

ELECTROLYSIS: I just resumed electrolysis post-op for the first time on 04/28/16 (one week ago). I didn’t feel any pain associated with the hair removal, so I’ll be grateful for that. I had a 1 hour treatment and 100% of the hair was easily treated within that 1 hour session. The majority of the hair that is growing on my penis is on the UNDERside, on the lower right quadrant if I look down. There are a few stragglers here and there on the top and all over the shaft, but most is on the underside. I did about 11 months of hair removal pre-op (started with laser and then finished up with electrolysis). If I had it to do over I would have ideally had a solid 18 months of hair removal done prior to surgery. It’s not a big deal that I’m finishing up post-op, but it’s not all that ideal either. Also, I do have some hairs that I can see growing out of the tip of the UL. I debated about what to do with these hairs for a while. At first I was just trimming them VERY carefully, with very accurate small medical scissors. I also discussed the potential of using nair (in the UL, and peeing it out) with my electrolysis. I know a handful of guys who have gotten the go-ahead from their surgeon to do this and have tried it. The first time I heard this technique was being used inside the penis I’ll own up to being pretty shocked and horrified. But I guess with all things lower surgery I’ve just gotten used to the things that we sometimes have to deal with. So understandably when I mentioned the hairs sprouting out of the tip of my dick and the possibility of squirting Nair inside my penis, she had a similar reaction that I had when I heard about it initially too. She said that some people report burns just when using it on their legs or other body parts and that ingrown hairs are common too. She suggested that tweezers instead. My main worry is that tweezing might lead to ingrown hairs, which can lead to swelling at the site, which could potentially lead to a urine blockage… Alas, I eventually made the decision to tweeze them out. No issues thus far, although it’s of course early on and it’s only been a few days – but I’m relieved to look down at my dickhead and not seeing hairs sprouting out of my urethra.

SENSATION: I actually just noticed some sensation beginning only a few days ago and it was completely accidental. After my electrolysis appointment I was rubbing zinc ointment onto my shaft as directed to soothe and protect the skin post-treatment.

Zinc Ointment.jpg

I noticed an odd twinge of sensation and assumed I must have tugged at the base and that was what I was feeling. However, after more observation and experimentation I have been able to duplicate the sensation while mobilizing the base and not creating any tugging motion. I can firmly squeeze or pinch the head of my dick and when I do, a zap of sensation shoots down and is felt in my buried dick. I can also kind of roll my shaft in my fingers, pressing firmly into it and this creates a similar sensation, again, felt in the buried anatomy. I wouldn’t say the sensation I’m feeling is necessarily pleasurable. Although it’s certainly psychologically exciting to know that the nerves are steadily working their way through the highway sheathes, growing in, and making connections. Keep on networking, buddies! Keep on networking!!! I’m mostly shocked because I had imagined that the sensation would begin at the base and I would feel it there for a while and as time passed it would slowly make it’s way up the shaft. Currently though, I can trigger this sensation along all points of the length of my penis. It’s certainly not enough that I could orgasm from it, but still it’s a step in the right direction. There are multiple types of sensation (tactile, protective, erotic, hot/cold, wetness) so I still have a long while to wait as the nerves keep on doing their work! But as it stands, every day since discovering this I’m noticing it more and from less and less pressure. Even gently pulling him out to pee I feel it!

ORGASM: Orgasming has still been a fairly regular occurrence and was possible since right before week 5. I’m pretty sure I explained all that in detail in a past post, so I won’t really get into it here. But it’s primarily a tugging or pumping/bumping (into the anatomy at the base) that allows for orgasm to occur, at least for me. Currently the build up to the orgasm is much more psychological than it was pre-op, but the orgasm itself is easily just as strong. I keep telling myself that it only gets better from here on out, so that’s comforting to know. While I’m glad I haven’t lost my orgasmic ability, it’s certainly more work to achieve orgasm and the time during the build up to orgasm can actually be just as great if not equally amazing to climax. So that’s kind of frustrating to not have access to the intensely sensate buildup right now in the way that I could access pre-op. But this is a process, and time really does make a big difference. The odds are in my favor that I will eventually have pretty amazing sensation in my shaft and I believe that that will make all the difference for me once that occurs.

IMPLANTS: I still am on schedule to have implants in October of this year with Chen in San Fran. However, I am concerned about the current options available in the states for an erectile device. If I had access to any implant I really think I would go with the new Zephyr rod. My reasoning being low maintenance, few parts to fail, and I like that it would fill out my penis more 100% of the time rather than a rod that would only fill it out while inflated. I’m a skinny dude and my penis is certainly on the thinner side. I would like an overall thickening to my profile and I don’t think that the current options for rods available in the states would at all meet my needs. If given the choice between rod or pump, I’d choose pump. The overall shape and thickness of regular rods compared to the Zephyr looks wildly different. I like that the Zephyr model has the defined glans stopper at the tip and also that the overall girth of the implant seems to be thicker which I think would add to the density of my penis. I think it’s unlikely that the two Zephyr models will be available within the states anytime soon. So come October I’ll have to decide between getting the inflatable plus one testicle, or holding off on an erectile device for now and just getting my testicular implants. Immediately after surgery and for the first 6 weeks afterward I loved the thickness I had. It didn’t even look all that swollen, it just looked like a reasonably thick cock and I didn’t think I had any swelling there to go away. As the weeks progressed though I did notice that the girth decreased. It’s not a huge deal, but I would feel more confident with a bit more thickness happening all around, and not just during an erection.

PEEING: Urination is still going well. At one point last month I was worried I might have a UTI. I’ve never had one before so I only have a vague idea of what sensations to look out for. I was having a bit of discomfort close to the kidney area during the first pee of the day. This can be a common sensation if you have a UTI. So I made an appointment with my PCP to have a urine culture done. Everything came back with no issues. Then a couple weeks ago I started noticing a strong odor coming from my penis. Smelled like… ugh, ok, it smelled reminiscent of potent vagina that hadn’t been washed in a couple days. I reached out to Crane and asked if I could go on a course of Bactrim and described the odor. He suggested I go get a culture done because Bactrim doesn’t work on everything. I emailed back and said I had just had a culture done recently and it was normal and asked if I could just try the Bactrim anyway… Buuut, I never heard back from him. This was last Friday. In the meantime the odor has mostly dissipated. I haven’t felt the need to contact him or the office about it currently, but I was kind of annoyed and felt ignored that there was no follow-up after that.

PEEING HACKS: Otherwise my stream is strong and straight. If I’m at home or walk into a bathroom that is a single stall or that no one is it, I will tear off a small piece of paper towel and then after peeing use that to dab the tip of my penis and soak up a couple drops that would otherwise end up in my underwear. It’s not a big deal if they up in my underwear, but I feel drier and cleaner blotting the tip. I can’t tell you how often I see bio guys come out of the bathroom and they are leaking through their underwear and pants in a single circle drop at the head of their penis. I’d rather not be that guy if I can avoid it. If you choose to use this method, just be mindful to not drop the piece of tissue or paper towel in the urinal!!! Urinals can’t flush solid material or waste. I know, this might sound like a really obvious and basic concept, but I’ve accidentally done this a couple times because it’s habit for me to flush the single square of toilet paper that I use at home when standing to pee, in the toilet after I’m done. Muscle memory WILL make you drop it in the urinal! So be careful – you don’t want to be that guy either! Clogged or overflowing urinals are a pisser. Just discretely put your penis back in the stable and when you walk to the sinks to wash your hands you can toss it in the trash. No biggie. I’ve discretely observed men in restrooms for over a decade and plenty of guys do this. I tend to notice it more as a practice used by older gentlemen, but it still happens. No one will think or say anything about it.

WEIGHT: I probably lost like 10 lbs immediately following surgery. My appetite was terrible and I was nauseated just thinking about trying to get food down. The food issue alone was one of the BIG reasons I was so grateful that I had someone there to help with caretaking. Many days there was only one or two things I could even fathom being able to stomach and sometimes it was not a food I even had in the house. So having someone to walk down to a local store or make some food that was already in the house was a huge lifesaver. I honestly would have probably eaten 75% (and I was already eating so little) had I not had a caretaker. And adequate calories and protein are really important when you’re trying to heal. Currently I have the opposite problem now that I’ve long gotten my appetite back but still am not at the activity level that I was prior to surgery. I’ve probably put on 8 – 10lbs over my regular pre-surgery weight, which is a lot for me. Weight gain is common after major surgery. I’m trying not to let it get me down, but it does contribute to not really feeling like myself.

PSYCHOLOGICAL CHANGES: I really feeling like in a lot of ways I’ve been reborn. There is both deep joy and also some angst in that experience. I feel really grateful for having had only very minor hiccups along my recovery so far. But I also have worries at times that are not uncommon to most if not all men at some point in their developmental stages and throughout life. Like: is my penis big enough? There are times when I have asked myself if I chose the right donor site… I ask myself a lot of questions in life and so acknowledging that question and curiosity doesn’t mean that I have regret. Rather, I think it is important to bring up because if you were someone that is currently or was previously swaying between donor sites at some point in time, that thought or “what if” curiosity could still linger at times post-op. I’m not going to pretend it’s a thought that doesn’t exist because that only gives it more power. I freely admit that I would have and still do wish I could have known exactly what my penis outcome would have been like (functionally, aesthetically, sensate-wise) using every single donor site possible. Who wouldn’t, right?!?! Donor site is a big decision. I think it’s natural to want your penis to match as closely to the image you have in your mind as possible.

I love my penis, but I do also wish that I ended up with a bit more length and girth. And while I don’t get mad at myself to wondering what outcome I would have had with say, ALT, I try not to linger too long on these questions… In the same way that I feel I am on the more modest side of the scale of penis owners, there was potential for the complete opposite to be true for me and feeling uncomfortable with far too much girth for my preference. My body could have also reacted negatively with the use of a different donor site and I could have had major complications. So there’s really no way of knowing. I say all this because it’s a mental process that does feel in some ways that it’s landed me back in that adolescence phase that starting T does to us. Relearning a new body, feeling a bit awkward at times while we adjust to it, and relearning and experimenting with how to interact around and with others in both platonic and sexual exchanges.

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