2 Weeks Post-Op Stage 2 (Semi-Rigid Rod & Testicular Implants)

My stage 2 surgery was on October 11th, 2016 with Dr Chen at the Greenbrae Surgery Center in San Francisco. The surgery itself went fine and there were no major issues.

TESTICULAR IMPLANTS: The right side of my scrotum ended up being a tad bit smaller than my left side and so Dr Chen had to shave down silicone-carvings-1 that testicular implant so that it would fit into the sack. Had he not done this it’s likely I would have had issues with erosion if he tried to force the full-sized medium implant in. The nice thing about the Silicone Carving implants that Crane/Chen use is that they allow the surgeon to modify and shave it down to the exact size of the tissue that they are working with. That way you aren’t limited to just small, medium, or large which is the case with any of the gel or saline filled implants – rather, you can get the perfect sized ones for your body with the carvings if the space you can accommodate falls somewhere between the factory issued sm/md/lg. The other thing worth mentioning that Dr Chen noticed while placing the right implant was that the skin was fairly “thin” meaning I could be at a higher risk for erosion on this side which was a contributing factor in his decision to shave the implant down a bit to take some of the tension off the already thin skin and smaller space. I appreciate his conservative approach and efforts to not make a risky decision even though I expressed how much I really wanted the largest implants possible and to have two symmetrical testicles. These factors weighed heavily into my decision making process when choosing an erectile implant type, but I far and away prefer having slightly uneven testicles than risking erosion and ending up with only one testicle, or even none! Ultimately though, my hope is that over time the tissue will stretch with the weight of the implant, gravity,  and by manually stretching it myself. Down the road, be that many months or years from now I think it’s reasonable to assume I’d be able to fit a full-sized medium implant in the right side as a small revision add-on while I’m having an erectile implant replacement/switch.

ERECTILE DEVICE – SEMI RIGID/MALLEABLE ROD: The model of erectile device that I had placed is called the AMS Spectra, one rod, not two. Prior to1-ams-spectra_300 surgery we had discussed doubling up on the Gortex sheath that he wraps the rod in, in order to further aid in bulking up the penis. Upon getting inside though it became clear that I didn’t have enough space to accommodate a second layer of the wrapping. So my surgery was similar to the technique he has always used when placing the rod. He also told me that he was really happy with the positioning that he was able to get and the angle at which the rod was mounted.
Everyone’s pelvic bones are angled just a bit differently, so they don’t know exactly how things will end up being mounted until they get inside and look. He said that in the OR he was able to fully bring my penis straight up against my stomach and that I had a great range of motion. However, since I woke up from surgery I have not been able to bring my penis up higher than a right angle from my body. I can make it stick straight out but I can’t

dacron
Image on right is similar to the Gortex (Dacron) used to wrap the rod

can’t bring it fully up against my belly. In the O.R. there is no swelling so it could just be that all the edema is what’s preventing me from getting the same full range of motion. However, I’m also noticing a strong tugging/tension on the underside scar (from stage one) that the runs the length from tip to base on the penis. The lower portion of the scar when I try to bring my penis upwards feels like the point of tension that is making me feel like I shouldn’t raise my penis any further. It’s also worth noting that this portion of the scar is hypertrophic (thick and raised, but clear/white in color) so it’s my intuition that this scar is what’s causing the issue and that the reason he was able to bring my penis all the way up in the OR, was because my pain from over-stretching that scar didn’t stop him while I was under anesthesia. However, Dr Chen said upon physically assessing things at my post-op appointment, that he believed it was the swelling at the pubic mound where the incision to insert the prosthesis was made (photos below) that is likely causing the current lack of mobility/tension. He told me to continue to gently but firmly test my limits for how high I am able to angle it and that he thought I should see improvement as the swelling subsides. I’m trying to stay positive while also being realistic. I truly believe it’s the underside scar that’s holding it down and I’m not sure if or how this problem can ultimately be remedied if that is the case. I don’t think it’s an issue that would inhibit sex, but it could potentially limit sexual positions and definitely already does limit positioning options in my underwear since wearing it down is the only angle it is comfortable in, pointing up is not an option. Time will tell if this ends up improving or presenting as a problem that needs correcting. One option I am beginning to mull over is potentially getting Kenalog injections along the scar which might help flatten it, but I’m not sure that it would impact it’s flexibility/stretchability at all, which I believe to be the true issue. Pre-implants I had been sleeping with my penis in an upright position to stretch/flatten this scar because I had noticed that it was thicker and almost seemed to bunch a bit from wearing my penis down all day since it’s right in the underside crease. I will continue to update about this issue as I gather more information about corrective options or as things hopefully positively progress on their own!

ERECTILE IMPLANT INCISION: I’ll be curious to see how the pubic scar on my mons from erectile-implant-incisionthe erectile implant heals as it’s about 1.5 inches below the SP scar, about 1.5 inches long and located less than one inch above the connection point/scar of where my penis is attached to my mons. I’ve had quite a bit of swelling at this site over the last two weeks. If I’m up and being more mobile (ie: cooking, driving, walking) I notice that the swelling here increases. I’ve been addressing this by icing 20 min on, 20 min off and that has helped to decrease the swelling.

SUPRA PUBIC CATHETER SCAR REVISION: This was a super minor revision and unrelated to the erectile or testicular implants. At stage one in February I chose to keep my SP catheter in for an additional 2 weeks because I had a bit of a urine leak coming from my scrotum. I chose to do this to allow further healing of the UL without the added pressure of urine constantly flowing through the healing fistula every time I peed. In doing so, I added to the amount of scar tissue that builds up around the SP tube from belly to bladder, since the longer you leave an SP in, the more scar tissue that grows around it. What formed was a thick stalk of scar tissue inside my body that ended up healing with some adhesion so that the skin at the point of the external scar does not float and move normally over the structures below it – it remains stuck . I’ve tried manually breaking up this scar tissue with massage,  but the stalk of scar tissue under the skin is far too thick. So I asked Dr Chen to break the adhesion since he was going to be “in the area”. sp-scar-revisionThe first 1 or 2 days post-op I noticed that the skin was free-floating and mobile. But after a few days had passed I tried to move the skin and it had adhered to the stalk of scar tissue below it again. I had a conversation with Dr Chen prior to surgery about the SP adhesion and I asked whether or not he would be removing the “stalk” of scar tissue as well, to which he said: no, he wasn’t going to chase the stalk because that increased the risk of damaging surrounding structures, and he wanted to be as minimally invasive as possible. We discussed this re-adhesion at my post-op appointment and he was disappointed to find out it had re-adhered. He said it was good information to know though, so that if he ever did this procedure for someone in the future he would advise them to constantly be massaging the scar early on post-op to discourage any re-adhesion of the tissues. I will probably have this adhesion broken again at some point in the future but I would only do so if combining it with other procedures. Again, it’s not a big enough issue that it causes pain or distress. I would just prefer the skin float rather than stick as it does make the scar a bit more noticeable. But still, really minor issue and not something that would equate to even being a minor complication, rather just a common factor in healing from any surgery that produces a scar -adhesion is always a possibility.

PERINEAL DIVOT REVISION: My body took a long time to heal from the revision I had back in June to remove some granulation tissue that had formed at the point of vaginectomy closure at stage one. I had a fistula (not urinary related, just a hole or opening) that had a lot of difficulty healing. When I had the revision in June it opened back up and again had trouble healing. When I finally used an antiseptic powder on this site, it miraculously closed. However, it was open for so long that it did leave me with a small divot once it finally healed. This time around this area has healed well and when he did the revision there was no granulation tissue at the site which is great! I haven’t gotten too up close and personal in that area because I’m still pretty limited in how mobile/flexible I can be. Squatting is quite painful and I try no to do anything that increases pain, as those were a big part of my post-op instructions. If it hurts, STOP – or DON’T DO IT! I have used the Columbia Antiseptic Powder a few times just to make sure that area is healing over well, but I haven’t felt or noticed any issues with it. However, it does feel like there is minor tactile difference/dip between the perineal raphe and where it connects to this revised area which is about an inch from the anus. It’s subtle but it’s there. So I’m not quite sure yet if the revision actually improved the divot or not. I thought I would include a diagram of the male perineal area which labels all the different structures as a reference point. I thought folks might find comfort in knowing that many natal males have a visible raphe/ridge that runs from the underside tip of their penis to the anus. Their bodies closed this gap in utero, whereas transmen who have phallo and opt-in for a vaginectomy and achieve this closure via an incision line really aren’t all that different from the natal male anatomy in this sense.

raphe_on_male_geniitalia_with_labels
This is not a picture of my anatomy, this is an example of a natal male.

 

PEEING W/ THE ROD: Initially it was a bit harder to urinate the a couple of days following surgeryholding-a as I’m sure I had a good deal more swelling than I do now. I was also in SOOO much pain when I stood up that once I got to the bathroom I needed to sit down to relieve pain before I was able to relax enough to pee. Sitting to pee is more difficult for me and I think it’s something about the changed angle of the neourethra with the natal urethra ever since stage one that has made it a bit harder to pee in that position. I’ve noticed it takes longer to empty my bladder and my stream is weaker when my body is bent at that angle. The differences I’ve noticed with urinating since the rod has gone in is that I prefer to hold my penis differently now. I instead of holding it in the “A” position (pre-implants) I now hold it in the “B” position. The reason for this, is the rod is now filling up my penis as much as is safely possible without minimizing the needed space for the urethra to expand and fill with urine. If I hold it like photo “A” gravity is angling the rod down and adding pressure holding-bagainst the urethra where my hand wraps around the underside and creates further pressure. I can still pee that way if I really wanted to but I can feel the urethra being somewhat compressed and it’s just more comfortable to give it the full amount of space by holding the sides or top half of my penis so that the underside, where the urethra runs is unobstructed. I meant to mention this earlier, but if the last sentence didn’t explain it and you’re still wondering, the rod is placed on the topside of the urethra… This dick-handling adjustment hasn’t been all that big of a deal. Grip “B” is not quite as instinctual or natural as “A”, but it’s a small price to pay for being the proud owner of a hard dick. Also, if I really wanted, I can easily pee without holding my penis at all since the rod really keeps it at whatever angle I put it in. But it just feels more natural to hold him while I’m peeing. And since I’m not really holding him UP exactly when I’m peeing, I’m really kind of just mostly using my thumb to guide him in the direction I’m aiming, if that makes sense.

BENDING THE ROD/STIFFNESS: The rod is actually a fair amount stiffer than I had anticipated. I messed around with the model that was in the office, but I’m sure that one has seen plenty of handling and was likely much looser for that reason. I do think that even in the 2 weeks since I’ve had it, it’s already started to loosen a bit and I’m quite happy about that. There was a palpable clicking sensation when pointing my penis in different angles. I could also hear a very soft clicking noise as the “joints” flexed into different positions, and I can’t say I found that aspect all that sexy. It made me wonder what that sensation might feel for my partner when I was inside them. I’ll have to get back to you on that one as it continues to loosen up. The good news is that I’ve talked with some guys that have had the rod in for months or even years longer than me and they reported that is did indeed go away! Otherwise the rod is easily bent and positioned with one hand. I can move it up to a right angle and even a bit higher. If I am laying down and I point it to a right angle my penis will stay pretty much at whatever angle I put it in. If I am standing it will want to lower a bit, but generally will stay close to the angle that I put it in when I take my hand away.

(GIRTH) SIZE INCREASE: At this point and there is likely still a bit of swelling along the shaft but not much, but I’ve gained close to 3/4 of an inch in girth. This might not seem like a whole lot, but slight increases in girth are much more drastic than slight increases in length, in my opinion anyway. I feel much more comfortable with my girth now. Ideally I would have landed squarely on the 5 inch mark for a nice beefy thickness, but the 4.5ish range feels like a reasonable size to me as well. I can comfortably live with that and feel satisfied.

GUESSTIMATIONS ON EASE OF PENETRATION: I honestly can’t speak from experience about this for obvious reasons. Being only 2 weeks out I’m nowhere near being able to use my guy for play yet. However, I will say that going into this, I anticipated having far less rigidity than I do. Obviously I was getting an erectile implant for the purposes of topping. But a VERY close second on that list was choosing an option that enhanced my current package and really beefed things up. From obsessively reading phallo listservs over the past decade, participating in groups, and talking with numerous guys who have had different models of the rod, I’ve heard more than a couple guys say they wished their erections were firmer and heard some guys have issues with buckling, or the tip of the head drooping over the end of the rod which was possibly placed very conservatively far back behind the glans, etc. But I must say, I’m impressed. My rod goes all the way to within one cm from the tip of my penis, so I don’t anticipate any issues with the head not being firm enough and causing issues with initial penetration. There is zero droop at the tip of my penis. The rod itself bends easily, yet gentle exploration thus far seems to look like it will be plenty firm enough for sex, both vaginal and anal. Again, I’ll have to give factual, experienced-based updates on this at a later time… for the good of science of course!

SENSATION/ORGASM: This is a big one and I almost left it out. Since the rod was placed I completely lost all sensation in my penis. ALL of it. I had the most sensation at the tip which was incredibly sensitive and a few large spots around the shaft where sensation was coming in. Dr Chen assured me that it really should come back and that it’s fairly common but that it could take a few months up to a year to come back and that it’s likely that the nerves are just in shock. I’ll be totally honest and admit that I’m pretty scared. This fear provoked me into making sure I still retained the ability to orgasm even in spite of not having any shaft sensation. I’m happy to report that all is ok. Although I don’t recommend it, since you’re risking detaching the erectile device, we do what we have to do to manage and get through these really difficult surgeries where there are of course no guarantees and a level of uncertainty even though most guys will make out ok in the big picture. I personally don’t know any men that are not able to orgasm. I know guys that don’t have much or any shaft sensation but orgasm is still possible. I won’t get too much into the mechanics of all that and exactly how it’s possible, but I’ll say that the base where my penis was fixed to my pubic mound, is HIGHLY sensate and erogenous. Actually quite a bit more so now with the introduction of the testicular implants and i believe also the placement of the rod had something to do with it. I can actually “reach” (stimulate) my original smaller buried penis easier than I could pre-implants. Hopefully the nerves are just stunned though and they’ll wake up soon. I’ve spoken with some other rod-guys and they had a similar experience. So chances are everything is fine. I also noticed post fat grafting that my sensation decreased a fair amount for a while. It makes sense if you think about it because they are jamming things down into the penis where the nerves are growing for both the fat grafting and for any erectile device, rod or inflatable.

THE BATTLE OF THE BULGE!: Ok, so I’m pretty IMPRESSED! Again, there is certainly some getting used to this aspect of having a firm penis 100% of the time and never being flaccid. BUT, I must say, I really am enjoying it so far! I feel like it’s definitely had the impact on my self confidence that I had anticipated would result immediately following stage one. Had my forearm contained a more dense layer of subcutaneous fat, I think it’s likely that would have been my experience immediately following stage one. But this stage feels really fulfilling for me because it’s finally “scratched that itch” that I’ve been desperately waiting for since stage one and just never felt like I landed on. I experienced some pretty heavy depression in February after my first surgery, I believe in large part because this basic need I had just didn’t feel met. But now I really enjoy how effortlessly I fill out my underwear and I love reaching down and feeling my full package. I can’t speak from the experience of having had the pump (since I haven’t) and being able to compare this to that. But I do believe this experience is a better fit for me, at least at this point in my life given the current erectile device options that are on the market as well as current options for insanely expensive, “permanent” (lasting up to 2 yrs) fillers to add fullness and bulk to the penis. The pump is absolutely amazing in that it allows for the more natural experience of a flaccid AND and erect penis and all the stages in between of becoming erect and filling up. I do hope I get to be able to experience that some day as well. Clearly that’s the more “natural” option for many, if not most guys that are seeking an erectile device. But with my circumstances, I really do like that even though I’ve ended up with a more modest sized penis both in length and in girth, that I appear to be a show-er now, even if there’s no growing that will be happening later on, no passersby actually know that. That’s been really exciting for me – a definite confidence booster. Here are some quick photos I snapped just to show what my guy looks like in undies. The bulge is definitely MORE noticeable with just underwear – and much LESS dramatic/obvious with shorts or sweats on over the top. Also, keep in mind that I do have some swelling still going on (mostly scrotal)… Once I get back home and have more clothing options to play with I’ll probably snap some better photos in a few different kinds of underwear and types of pants, shorts, sweats etc. and model those for you.

 

SLEEPING: It’s still very EARLY DAYS and so I’m sleeping on my back to not cause any pressure on the pubic connection point. This is pretty miserable because I’m predominantly a belly sleeper, and an occasional but much less frequent side-sleeper. I’ve done a bit of side-napping using two very fluffy pillows propping my legs apart and then propping my penis up a bit so it’s not dangling at a drastic sideways angle. But I’m really paranoid that I’m going to fall asleep and then try to roll the rest of the way over onto my belly. It’s hard to know for sure yet, but I think I should be able to comfortably and safely belly sleep in another 4-6 weeks. I am doubtful that I’ll be able to do as many belly facing yoga poses as I was able to in the past though. I can indeed see this device potentially limiting me in that sense when it comes to lying on hard or even firm flat surfaces. Being a really lean guy means that I don’t have that extra belly or thigh fat to buffer the rod that’s sticking out when lying on my stomach. Hopefully I’m wrong about this though. If it ends up restricting my mobility enough it could be the deciding factor in eventually switching to an inflatable.

THE SHWING!!!: Alright, so I am noticing a bit more movement and jiggling while I walk as the days progress. I’m sure the decreased swelling and the loosening of the joints in the rod are probably equally responsible for that. Things of course don’t flop around nearly as much as they did pre-stage two, and it’s undoubtedly a big adjustment. I enjoyed my floppy dick, but not all the time, and not all that much. I didn’t like how it fell between my legs when I was sitting or driving – I felt like it got lost down there. Of course, the lack of testicles I’m sure played a large part in that too. But overall, I wasn’t all that happy with the size of my package. I had always imagined myself having a lot more going on, even though I’m really not a size queen. Anyway, things seem like they’re loosening up a bit. I notice that it is more likely to swing left to right a bit than it is to go in any other direction when I’m walking. There isn’t much downward motion/bounce since the shaft sits firmly against my scrotum and I kind of curve him around my nuts. I wouldn’t mind a bit more of a SHWING when I walk, but I may get that over time as swelling continues to go down, and the device continues to loosen up a bit with some *ahem*, “use”.

WRAP IT UP: I think that mostly covers things for now. My next post: which is already in draft, will be an explanation of Pump vs. Rod – How I Decided. I’ve been getting that question at least daily and I figured it’d be easier to have a post to direct people too with the long-winded reasons rather than typing the cliff-notes version over and over… As always, if you have any questions please feel free to ask or make requests for specific topics to be covered. I will update on all of these topics again at the 1 month mark. I can’t promise that it will be posted exactly one month post-op to the day, but I am still aiming to get all the correct content in for the listed timelines even if they are days or weeks late to go live. Thanks for reading!

Advertisements

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.