Preparing for stage-2 RFF Phalloplasty

Supplements / Diet

At the month-before-surgery mark, I cut out all alcohol and caffeine again. I also started to up my protein intake, and reduce the amount of rubbish that snuck its way back into my diet. I’m also having a glass of cranberry juice every day – anything to help avoid UTIs!

I started taking my multi-vitamins (but that’s really more of a backup than anything else; and this time around, I’ve started taking my silica tablets and something called Citruline prior to surgery too. The aim is to build up a base level prior to all the surgical bits and pieces happening. 

Citrulline basically works like Arginine, the main difference appears to be that you don’t need to increase the dosage to get the same benefits from it.

Physical

Now that I’m finally at a stage where I can actually work out, I’m smashing it wherever I can. The lack of exercise really put me behind weight-wise, and I’m trying to catch up where I can prior to surgery. 

In terms of what Hans has to work with – I don’t think I’m doing too badly. I just want to make sure everything is in the best condition it can be. 

Psychological

I’m more nervous about this surgery than the first stage. 

Stage 1 – while difficult mentally – is quite limited in its range of complications. You essentially end up with a pipe that goes nowhere, so as long as the graft takes – everything that goes wrong can easily be fixed. 

Stage 2 on the other hand, can have some MAJOR things go wrong with it. And because I’ve already had a small stricture at the base of my new urethra, I guess I’m worried I’ll develop another one …. and this time I won’t be able to pee and just ignore it (to a certain extent).

That being said! On the whole, I am not concerned about this surgery. Generally I heal quite well, and I don’t have the reservations about how long I’ll be bed-ridden – because I know it will only be for a few days, and I’ll still be more mobile than I was last time.

The idea of peeing standing up without the need for any aids is an exciting one, but I don’t think I’m quite ready to be fully excited by the prospect, until I know everything has gone well.

I guess we’ll see in just under a week!

7 Days Until Stage 1 RFF Phalloplasty

I decided not to do a post at 10 days out as there was more happening today.

So this morning I had my pre-surgical blood and urine tests done. I couldn’t really read the handwriting that well, but I’m fairly certain the bloods were a full blood count, coagulation and something else. The urine test was just a generic one. I had some concerns that I might end up having an argument with the nurse over which arm they were going to take bloods from, but I just shifted on the bed so she had to take it from the right side. A copy of those results will go to Dr Goossen and to my GP early next week.

In other news, I had a migraine today – which was unpleasant. Went to get some paracetamol and was given aspirin with codeine instead. The issue there is that aspirin is a blood-thinner and codeine can make you constipated – neither of which are good things prior to major surgery. I called Dr Goossen’s office to get confirmation if I could take them; he said yes but only until Tuesday. He also wants me to call Tuesday morning to see how my headaches are going. In the end I decided not to take the tablets. I’m not risking it – so I waited until I got home and took a paracetamol. Worked just fine.

I did my pre-admission form online last weekend. It was pretty straightforward – although I did have to take some time to go through all the surgeries I’ve had to date!

Random thought: phalloplasty – one surgery? Or three separate ones?

I also got in touch with a medical supply company about hiring a wheelchair. Only for the first few weeks post-op.. I can see walking around being difficult for a while,  and if I can lessen that – I will!

Physical

I’m continuing to moisturise my arm, and it gets exfoliated every night in the shower (to stop ingrown hairs). It’s looking pretty good – hopefully that will continue.

My diet is taking a bit of a swing this week to a much cleaner one. I’ve been eating quite well for the main part – but to aid in healing I’ll be moving to a much more protein-oriented diet. That and staying well-hydrated. Hopefully that’ll help get rid of a bit more weight before surgery too – my weight loss has plateaued slightly, which is irritating.

Mental

I’m feeling… Ok. I’m a little unnerved by the fact that I’m not unnerved (if that makes sense). I have the normal pre-surgical nerves that I get – but that’s really it…

I’m not freaking out about being in hospital for a week (although as a fidgety person it’ll be interesting to see how I go having to lie quite still for a couple days). I’m not having doubts about the surgery or worrying about pain/complications. Having the use of only one hand for an extended period of time doesn’t concern me (I’ve had two shoulder surgeries – I’ve done the one-arm thing before!).. To be honest the thing I’m most concerned about is having to be away from my wife for potentially 6 weeks.

I think that’s all for now! I fly to Brisbane next Thursday and have an appointment with the plastic surgeon that day – so my next update will probably be then.

17 Days Until Stage 1 RFF Phalloplasty

Fun, games and excitement. I can’t believe it’s less than three weeks until surgery. I think it actually hit me on Sunday morning – although I don’t know why specifically then (I wasn’t doing anything in particular).
I had my appointment with Dr Goossen yesterday morning (after an awful flight down, I might point out!). It went well, and I got to ask more questions – which is always good! For me at least, probably not for the people in asking (I can always think of more questions when I want to). Anyhoo! I was going to write about the appointment in a separate post – but things haven’t really changed all that much in my preparation, so I’ll do it here.Below are the questions and answers:

1. When do I need to stop shaving my pubic region? At least 1 week prior to surgery. This assists in the prevention of ingrown hairs and infections. Also – they shave you on the day of surgery anyway.
2. Is there a requirement for a bowel prep/liquid diet? No. Basically because the first stage is just moving skin and nerves around – there is no requirement for a bowel prep. The idea of being immobile for a couple of days and needing the bathroom is slightly unnerving though – so I’ll probably change my diet slightly before I go in. Anyone with tips on this side of things – please share!
3. Will the first testical be placed in the first stage? This wasn’t something I’d thought about until very recently. But apparently no – the testicle will be placed in the second stage; and the other testical will hold the pump for the implant and will be placed in the third stage.
4. How often will I need to come and see you (surgeons) in the first few weeks post surgery? Once discharged, I won’t see Dr Goossen much at all. At the three week mark everything is pretty much fine in terms of the phallus. The arm is what requires the most attention, and as such – I’ll be seeing the plastic surgeon on a much more frequent basis. Depending on dressings, it could be as frequently as every other day for at least 6 weeks. That all depends on how the arm heals though. I’m hoping that since I will be staying with my mum (who is a nurse on a post-op ward) that these visits could be less frequent – given I will be in the care of someone who knows what they’re doing! We’ll see.
5. Is my recovery time post-op entirely for gaining strength and recovering? Or at that stage is it more to prevent the risk of secondary infection? This might sound like an odd question – but hear me out! My work is mainly computer-based, and I have the opportunity to work a little from home – so long as the boss allows it. The proviso was that the surgeon needed to approve of it. And! (Ensuring that I don’t work a full day every day, that I keep my donor-site arm as immobile as possible and that I don’t wear myself out) he approved! Woot. This is good – means I won’t drive people up the wall as much!
6. Blood tests? Yes. To be taken a week out from surgery to ensure everything is good to go. I also need to do a basic urine test to make sure everything is good there, and also to establish a baseline pre-op. I would tell you what tests are being done – however the doctor’s handwriting is especially doctor-y.

Anyway that was it for questions. I didn’t have many to ask because I spend a heap of time researching everything… Something to keep in mind though – everytime I’ve seen Dr Goossen and asked him how long I need to stay in Brisbane post-surgery – the timeframe gets longer. First it was three weeks, now it could be upwards of six weeks. This (I believe) is because it depends on how the arm heals. However make sure (if travelling into town) you book fully flexible fares!

31 Days Until Surgery

Weight

So today I hit my minimum weight loss goal 🙂 very exciting. All up this means I’ve lost over 10kg and almost 6kg since I saw Dr Goossen in May. I see the good doctor in just under two weeks – so the possibility is there that I can lose another kilo and a bit before then.

Physical

I’m upping my arm care. Before chest surgery I started moisturising daily. It was a few years ago now, but I vaguely remember reading or hearing something about it making the area more supple and aiding in healing. Or maybe I just told myself that… I’ll look into it. Either way, I’m starting that up again. 

I’m quite pleased at how the hair regrowth is coming on the donor site. By that I mean I’m pleased at the distinct lack of ingrown hairs. I’ve been using Phisohex and an exfoliating glove daily – which seems to be doing the trick. Now all I need to do is stop the bloody cat scratching me!

Mental

I’m feeling a bit better about things from a worrying perspective. I think I was having a minor freak out from the lack of new researching information I’ve been able to find as of late. Then it became apparent that a number of the people whose blogs I follow all had surgery around about the same time of month; so none of them had anything to post about. I’m getting my monthly dose of research now though.

I haven’t hit the excited stage yet. I think I’m still waiting for something to go wrong and for the date to be postponed for some reason. Excited will probably come after I see Hans in a couple weeks.

38 Days Until Surgery

I keep trying to write posts very 10 days – but it’s just not happening.

Psychologically

How am I feeling? Well to be honest I haven’t had much time to think since I saw Dr Goossen back in May. Between work, trying to lose weight and buying a house it’s been pretty hectic. But as of last Friday – the house and work stuff are settling down; and now I have a bit more time to think. 

If I’m honest, I’m starting to get a bit nervous. It’s a byproduct of the anxiety I think – because I know it’s not regret. I guess I’m just a worrier.

I worry that I won’t be happy with the results, that I’ll have major complications, that my mental stability will suffer, that the graft won’t take. I worry that my wife won’t like the result, what people at work will think, what random people on the street will say; and every other worry that a person can have (whether rational or not). But at the same time, I know that this is just my brain trying to think through every possible scenario and how I’d react in each one. 

I know I want this surgery, know the helplessness and pain won’t last long in the grand scheme of things, know that at the end of the day – what I will be left with will be mine.

Weight

I have 1kg left to lose before I hit my minimum goal weight. I’m quite please with how things are going, but at the same time I wish I was a bit further along. If I keep going at this rate, I should lose another 3.5kg before surgery – which would be awesome. 

I don’t feel like I’ve lost a whole lot, but I’m total so far I’ve lost 9.5kg, and 4.5kg since May. Clothes are fitting better, and I’ve lost about 6cm around my stomach so far.

Arm

My arm is looking good. The weight loss has put the veins on show a bit more. I’m still working on my hand strength – which is helping in other aspects of life at the moment.

I’m pretty pleased with how my arm is looking post laser hair removal at the moment. Usually I start getting a heap of ingrown hairs around this long after treatment, and that doesn’t appear to be happening yet.

The plan is to take measurements pre and post surgery.

Hair Removal and Update

There hasn’t really been much to update on lately to be honest; I’ve just been working on losing weight before I see Dr Goossen in July.

Weight: So far, since I saw him on 16th May, I’ve lost 3.1kg. I know it’s not much, and to be honest I can’t really notice it yet – but it’s nice to see the numbers going down, and I can see a bit of a difference in the way I look in clothes. I have 2.6kg to go in 33 days… It feels so far away at the moment…

Hair Removal: I got called in to the laser clinic today to see the doctor. My usual clinician has taken an undetermined period of leave to take care of some health issues, and the girls wanted me to see the dermatologist to make sure I was still good to go.

He seemed really nice, and as planned originally – there will be no issues with continuing the hair removal post-op. The only real condition is that there are no open wounds. I’ll probably come and see them at about the 6-8 week mark just to see what their thoughts are on how everything is looking.

I have my last removal appointment pre-surgery on Thursday. Apparently I’m looking really good for only having had two treatments – but we’ll see. I’ll try to remember to put a picture up comparing the hair growth.

Little Update

Just a personal update this week.

The weight loss has started. I’ve lost about 700g this week. Given the only thing I’ve really changed so far is cutting out refined sugars – I’m quite impressed. And also surprised. I haven’t cut out any foods as such, I’ve gone back to full fat foods instead of taking to low fat options (because there’s more sugars in the low fat stuff) – and I’ve still lost a bit of weight. We’ll see if that continues.

The first couple of days were alright, but on the third day I started getting massive headaches and feeling sugar withdrawals. I’ve discovered sugar free cookies. Whilst it would be better not t have them at all – they help slow the cravings and for now my sanity and continued weight loss requires them.

In other news: I turned 27 on the weekend, which was nice. Didn’t do much, just took the dog for a walk on the beach.

700g down, 3.3kg left to go.

Doctor Consult

So today I went to see Dr Goossen for a catchup and hopefully to hear I have a date booked for surgery in July.

The catchup went well, and he said that there wasn’t really much else I could do in terms of preparation other than keep doing what I’m doing. He advised that I’d be fine to get another laser session done on my arm and that should do me until post-op (next appointment is in June).

As for a date – I’m tentatively booked in for August 6th. This depends on a couple things:

1. Whether the plastic surgeon is available on that date; and
2. Whether I can get into the normal BMI range by July 18th.

The second point annoyed me slightly. When I saw the doc in February I specifically asked whether that would be an issue – and he said no. Today though he advised that I needed to be within range. For me that’s only 4kg I have to lose; but had I known this in February – I’d already be way past that by now, and I’d be looking at early July. 

But! These things happen. Moving on…

I’m going back to see Hans on Iuly 18th, and should be able to meet the plastic surgeon then too. As for the weight loss – I’ll be hitting it hard from this point on. I’m cutting pretty much all refined sugars from my diet, and my workouts are going to be increased too. I’m annoyed that I hadn’t been working on this harder, earlier. I’ll keep you all informed on how that goes.

Sooo…

So because of the stuff around I was getting from my GP, surgery looks like it’s been pushed back until July/August. Grr. Dr X is going to get back to me as soon as he hears back from everyone involved and they agree on a date.

Initially I was quite annoyed – I was looking forward to just getting in and getting the first stage done. But to be honest – I’m happy to wait. I’m still years ahead of where I thought I’d be regarding this surgery, and I’d much prefer everything to fall into place rather than try to push things to happen.

So in the meantime I’m continuing with my bodyfat-loss and conditioning plan. I’ve also purchased a couple of hand-strength exercisers from Prohands. The one I have at the moment is a medium, but I have a couple lighter ones on the way too. I tend to lose muscle quickly after surgery, so if I can minimise that as much as possible before hand – I will.

I’ve had it about a week now and already I can tell the difference. I’ll be looking at selling them on once I’ve healed from stage one – so watch this space.

On that – I’m thinking of selling my packers. I don’t use them, and they’re going to be a moot point soon anyway. I’ll put a post up in a couple days with the information on them.

Life Update

I know it’s been a little while since I posted anything – there really hasn’t been much to update on.

I don’t have a date set for surgery yet. Initially that was because there was a miscommunication between my GP and Dr Goossen, however I managed to get that sorted. I was hoping for a date in May – but that’s looking like it won’t happen now. The surgeon’s going away unexpectedly in June and he doesn’t want to do the surgery within two weeks of leaving (which I completely understand!). There’s still a slight chance I’ll get in around mid-May, but given that’s just over a month away – I’m not holding my breath. There’s a lot to organise, and if he feels it’s better to wait – I’ll wait. I am a bit annoyed though. Not with the surgeon – with my GP. She stuffed around for three weeks, and that could’ve cost me a May surgery date… Ah well…

In other news I had my second round of laser hair removal. The woman at the clinic said I had a good result for the first round, but was glad I managed to get in again before surgery (I moved it forward a week because I thought I was having surgery in May). This time she turned the machine up to 26. I could definitely feel the difference – but it wasn’t too bad. I’m booked in again for late June, but we’ll see how we go. She did mention that at after 4-5 sessions you can get a random lot of regrowth. Apparently it’s just around the time everyone decides to stop going. She didn’t explain why it occurs – but I’m going to guess its the hair follicle’s last-ditch attempt at growing.*

That’s pretty much it for now. It’s 5 years on T for me on Thursday – so I’ll endeavour to make a post about it.
*I’ll check that and get back to you!