So I know a bunch of folks have been asking how I’m doing. I'm sorry I haven't responded or provided more info. So I wanted to catch everyone up from surgery day on. :)
Short summary:
1/27: Surgery Day
1/28: Recovery Day
1/29: Discharged
2/14: Major complication, ambulance ride, ER, hospitalized
2/16: Surgery Day II
2/17: Discharged
🧵 1/?
1/27/2026 - Surgery Day (Part 1)
Surgery was due to start at 1pm. @JMWinters and I arrived at the surgical center at around 11:30am. I accidentally left my phone in the Lyft on the way over, which was a pretty shit way to start the entire process.
The surgical center still had me listed as male on my forms and everything, which is disconcerting because all of that has been legally fixed for years. I have no clue where that might have come from because I know for sure I never listed myself as male anywhere on any forms. They fixed it, but also announced to the waiting room that they were fixing it. Could have done without that.
This kinda set the stage for what was, frankly, a very shitty experience there.
And @JMWinters and I are super, super close. I was with her during her bottom surgery last year, and one of the first shocks we got was that she wasn't even allowed past the door to pre-op. Which was different from what we were told would be allowed. Instead, she was told she could Facetime me or see me tomorrow at the recovery center. Which, honestly, is bullshit. There is no reason she should not have been allowed to at least see me at post-op. After such a major surgery, it is really unacceptable that your caregiver and family cannot see you.
So they took me back to pre-op ... and left me there mostly alone, with only someone occasionally checking in on me ... for two hours.
Finally around 2:30pm, my surgeon came in and chatted with me very briefly to insure we were on the same page: full depth vaginoplasty, asian technique. After that, I was quickly walked back to the OR.
My next memory is waking up in post-op. Again, @JMWinters wasn't there. No one was really there to talk to me; I had to find out how my surgery went by texting facetimedad a phone pressed into my hand to order food. The only things I could make out were "$20 max". I ended up ordering McDonalds because it was the only thing I could make out in a post-op haze. I remember guzzling as much water as I could, and eating a burger. I am pretty sure I ordered two, but only got one. I facetimed @JMWinters.
I passed out shortly after texting everyone that I was ok. The next thing I remember is waking up in what can best be described as a tent of curtains. It was around 1am, and the lights were off. My leg compressors weren't running and I had accidentally unplugged my wound vac pump. There was an air compressor that would kick on and off about every minute.
The call button I was supposed to be able to use to reach the nurse was out of my reach. Finally, I resorted to yelling for help. The nurse didn't hear me, but thankfully the other girl who was there that night did and pushed her call button to get me help.
The on call nurse just took my leg compressors off, and plugged the pump back in. Thankfully I had remembered my noise cancelling headphones but even they only did so much to cover the fucking air compressor noise. I added some white noise so I could finally try to get some sleep.
1/28/2026 - Recovery Day (Transport to Recovery Center)
I was awoken at around 5:30 to be transported to the recovery center. The only instructions that I got consisted of the on-call nurse reading the instructions from the surgical guide to me in a half-conscious state.
When the curtains were finally pulled back, I could see where I was: I was kept in a post-op bay all night, next to an air compressor that kicked on and off every minute that even my noise canceling headphones couldn't stop
The transport crew arrived and placed what can best be described as a small air mattress under me, which they rapidly inflated and used to place me on a gurney. I was then wheeled out to a van to be transported to the recovery center.
I did not have a super high impression of this process.
I was put on a stretcher in the back of an unfinished van, but no one was in the back of the van with me for the ride to monitor me. My belongings were placed unsecured on the floor of the van and were spilling all over the floor on the drive. At one point I leaned over to try to keep them from going everywhere.
Standard expectations for medical transport:
* A trained attendant in the back
* Patient secured
* Belongings secured
* Patient instructed not to move or lean
* None of this was done for me.
Also, bring a blanket and a pillow for this part. I was grateful that I did or it would have been even more miserable.
I finally got to see @JMWinters shortly after arriving at the recovery center. It's definitely an older facility that has seen better days. It seems like it is primarily a residential long-term care facility that has a few rooms that can be used for surgical recovery.
The entire time I was there I rarely saw nurses, except maybe every few hours. It's also surprisingly loud. Alarms constantly going off. Big piece of advice: close the door. Your recovery (and your ears) will thank you.
I will say the food there was definitely not the worst. And the random turkeys walking by the window were a welcome distraction from the boringness.
The recurring problem was meds. I was not getting my meds on anything close to the schedule my surgeon wanted or any real reasonable schedule at all. I finally got into it with the nurse that night...
... it turns out the morning nurse at the recovery center entered all the instructions wrong, which is apparently why we’ve been having to remind them of the med schedule all day. Thankfully once it was fixed things got better now but I get VERY easily frustrated when I feel like I’m not being listened to, especially about my own care.
Like why am I here? Observation? My girlfriend and I could manage the med schedule ourselves. At this point I’d rather go home with her.
I was discharged from the recovery center early Thursday morning. I was dreading the ride back to the AirBnb, but it ended up not being as bad as expected. Based on my girlfriend @JMWinters’s experience a year before, this is what we did:
* 3-inch gel pad under my bottom
* Small cylindrical pillow under my back
* 5mg Oxy 45 minutes before leaving
What I ended up doing was putting the wound vac pump and catheter bag on the floorboard of her car and sat in the front seat with the seat leaned most of the way back, and used my feet to rest most of the weight on my back and the back pillow. This ended up making the ride honest not bad. I would not want to have gone an hour or so, but for 20 minutes back to the AirBnb it was fine.
There are two steps to get down into the apartment. She used a block of styrofoam to shorten the steps to four so I could step down easier. From there, we put the would vac pump and catheter bag on a rolling cart and I laid down in bed.
Pain was honestly very manageable, and stayed around a 2 most of the day. I slept a lot.
LPT: rolling carts are such a massive saver when recovering. You can put your pump and catheter bag on it, along with your meds and supplies. It makes getting around - like going to the bathroom - so much easier because you just push the cart along with you.
2/1/2026 - 5 Days After Surgery (Peak Pain)
Around 5 days after surgery was the night my pain peaked. I think I missed a dose of medication, but that night as my pain approached a 5-6, I ended up taking two Oxy's to get it back under control.
At that point we went with something easy to follow: you take *something* every three hours, alternating between Tylenol and Ibuprophen, and Oxy every 6 hours. Note that this is more than the surgeon recommends, but still less than the daily safe limit on any of these meds.
I programmed this into my phone as a series of repeating alarms with labels that told me what to take and when so I didn't have to think about it.
Doing this cut the pain down to basically a 1. It was barely noticeable except for the fucking catheter irritation.
2/5/2026 - Post Op 1 (Part 1)
I was dreading my first post op because, honestly, so much of this experience had been so bad that I was legitimately not sure what to expect.
We drove to the surgeon's office that morning thinking about finding parking. And sure enough, when we arrived at the lot behind the building ... we found protesters. Apparently, the "teamsters" (and I have some doubt as to whether the 3 guys out there were actually teamsters or just bought some patches for their jackets) were protesting Kaiser at the lot and blocking us from getting in, telling us we needed to go park at a lot 3 blocks away.
To be clear, I am a huge supporter of organized labor. But, I am also a week from major surgery and my girlfriend is disabled. We don't have the choice of parking in another lot, we needed to be in *that lot* because it was close. Ableist assholes; no one wins when labor and disabled people fight. @JMWinters got into it with them, but did get into the lot.
My girlfriend was able to go get a wheelchair and get me up to the surgeon's office ... and basically right into the room. That was when I met one of the nursesI who went a long way to restoring my faith. She was so kind and, crucially, told me in detail exactly what was going to happen. As an autistic person, I welcomed this so much. I can deal with a lot if you just *talk to me first*.
They took the wrapping and catheter out, and finally, I got to see her. And she was *beautiful*! 🥰🩷🌮
I had to do the "pee test," where they inject a lot of (cold!) saline into my bladder before taking the catheter out, which thankfully was not a huge deal even though it took me a few minutes to remember how to pee and to adjust a bit to my new anatomy. I'm a shy bathroom user, so closing the curtain helped.
I had to do the "pee test," where they inject a lot of (cold!) saline into my bladder before taking the catheter out, which thankfully was not a huge deal even though it took me a few minutes to remember how to pee and to adjust a bit to my new anatomy. I'm a shy bathroom user, so closing the curtain helped.
The PA came in and did a quick exam, noting some red spots all over my legs and back. We had been treating this with bendryl and hydrocortisone cream, which was making a difference. She said to continue that but let her know if it didn't get better. Our theory is either contact dermatitis or a reaction to the surgical glue. It did fade over the next week or so.
Then ... I dilated for the first time on purple. Which was another thing I was dreading but ended up really being no big deal other than feeling weird. Purple went into me so easily.
And that was pretty much it! We were out of there in about an hour. And, on the way out, I got to meet a friend I had met on Discord, who was nice enough to gift me a box of lube! 🩷
After that, we went back home. I dilated another time that evening with no issues and, crucially, got to enjoy my first shower in more than a week.
2/11/2026 - Upsizing to Blue
Even from the beginning, dilating with purple was very easy. I could do that with virtually no effort. With this is mind, I decided to try going up to blue.
Purple I don't feel. Blue feels like it's splitting me in half. Warming up with purple for 5 minutes and doing the next 25 with blue made it easier, but the last 5 minutes or so of blue was miserable. It did start to get easier, but it still felt uncomfortable to the borderline of painful.
At this point I decided to do 1 dilaiton per day with blue, and the other two with purple.
2/13/2026 - Post Op 2 and the first warning sign
The morning of post op 2, I woke up with more blood in my pad than I had been seeing. It had soaked the pad and started to bleed into the underwear. I didn't think too much of it at the time. There had been some days where there had been more blood than others and I was told that some bleeding was notmal - this ended up being a mistake.
Post op 2 was mostly a non-event. We ended up taking Lyft this time instead of trying to drive. The PA did a pretty quick exam and recommended I start putting some 2x2 gauze rolls in the folds between the majora and minora to help dry things out. Other than that she seemed to be happy.
I went home and did my dilations like normal.
On the morning of 2/14, I woke up to go to the bathroom. I had been feeling wet and sweating like a pig all night. I was barely awake until I got into the bathroom and notice I was covered in blood from the waist to the mid thighs. It was everywhere. It had soaked through my underwear, all over the bedsheets. It had soaked down to the plastic barrier we had put on the bed.
I called for my girlfriend to come help. @JMWinters calmed me down and got me into the shower so I could clean myself up. While I was cleaning, I used my douche and shortly after this gross ... thing ... I think it was a clot ... came out of my canal. It was about 2 inches long and looked like a bloody slug. It had the consistency of cranberry sauce or grape jelly. It just came shooting out of my canal. There was no pain or anything, just a weird feeling as it came out. No more blood.
After a couple hours, we decided to call the nurse line at. The PA answered and, after explaining what happened, told me as follows:
"If there's more blood, put your legs up and put pressure on the canal. Then give me a call.”
I did 3 dilations on purple just to be safe, and everything was ok. There was no additional bleeding or anything on the dilator, so I figured things were normal and whatever that was was over. After my third dilation, I went to take a shower.
I used my douche a couple of times, and then everything went straight to hell.
After the second douche, I started bleeding. Profusely doesn't even begin to describe it - it was like a scene from a slasher movie. Blood fucking everywhere, pouring out of my vaginal canal. I was in shock. @JMWinters got me to lay down and put my legs up per the PA’s instructions while she held a washcloth to my vaginal opening.
We called the surgeon. After some back and forth, they wanted me to go to the hospital via ambulance. We called 911 and had an ambulance at the house in 20 minutes. By that point it had been an hour or so since the bleeding started and we had it under control, but I had spent the entire time with my legs up. My girlfriend quickly put together overnight bags and we got ready for a trip to the ER.
Achievement unlocked: my first ambulance ride.
I was walked gently out of the house and to a waiting gurney outside the door. It was raining and cold. I was wheeled into the ambulance and my girlfriend sat with me in the back as they drove me to the hospital. When we got there, the PA and head nurse from the surgeon's office were already there waiting.
More than anything, I had to go pee. I tried to use a bedpan but wasn't able to. They let me go to the bathroom and I peed, thankfully with no blood. They did an exam on me with the speculum and said that everything looked intact. They opted to re-pack my vaginal canal and put the catheter back in (boo!).
I was then admitted until they figured out what to do.
2/15/2026 - The Waiting Game
When I was admitted it was NPO, so no food or drink, in case they needed to do emergency surgery. So I awoke Sunday very, very thirsty and waiting for someone to make a decision. Around noon, they told me what they were planning.
The surgeon wanted to examine me under general anesthesia and, if necessary, fix anything he found. The surgery was scheduled for Monday morning early, around 8am, and was not expected to take more than an hour.
Mercifully, I was then allowed to eat. I can’t say the food was fantastic but I was so hungry and thirsty that I didn’t really care.
2/16/2026 - Surgery Day II: Electric Boogaloo
You don’t really sleep in a hospital.
It seems counterintuitive because you’re supposed to be resting and recovering, but in reality you’re constantly being woken up for people to take vitals, give meds, and do other things. So I don’t really feel like I woke up that morning so much as woke up when someone told me it was surgery time.
Thankfully, this time my girlfriend could accompany me to basically the door of the operating room. I was wheeled back in my bed, then put on the operating table and quickly put under.
My next memory is waking up in post op and being very, very hoarse. More than either of my other surgeries. And as usual very thirsty.
So what happened? From my operative report:
> Attention was the directed toward the intravaginal lumen, which was examined with a speculum and lighted retractor. A small intravaginal hematoma was evacuated and a small bleeding vessel was noted at the 5 o’clock position of the vaginal lumen. This was oversewed with figure of eight 0-vicryl sutures, and hemostasis was noted. The vaginal canal was copiously irrigated, with vaginal bleeding hemostasis again confirmed. Since the patient's systolic pressure remained high during the surgery with elevated MAPs, this was deemed a good test of hemostasis.
So … *one blood vessel* caused all this drama.
FML.
I was wheeled back to the room where my girlfriend was waiting and spent most of the rest of the day trying desperately to get some sleep.
2/23/2026 - Emergency Surgery Post Op
Mentally, the week between the 16th and 23rd was one of the hardest I've had in awhile. In 48 hours I had gone from being very confident in my recovery to hospitalized, and another 72 hours later I was back at home on bedrest with a catheter and packing in. I felt like I had been kicked back to step 1. Thankfully @JMWinters kept me sane.
At the post op, they removed the catheter and packing again and examined everything. Other than this issue, the PA seemed surprised at how well I am healing.
At that point, she told me to resume dilating on purple (the smallest one) for this week and see how things go, and she would see me back on Friday the 27th.
That first dilation was nearly panic inducing. My girlfriend had to hold me tightly while I did it, but I got through it. The PA also wanted me to douche while sitting rather than standing, and with lukewarm water. This was also anxiety inducing, but I got through it.
2/27/2026 - Post-Op 3
In just a few days I was back at the surgeon's office again. Thankfully this was another relatively short appointment. The PA took a look and again seemed surprised at how well I'm healing. It's hard for me to see it, but I am glad to be "winning" at surgery! 😂
I was cleared to go to the next size dilator, and also for some more movement as long as I pay attention to my body.
My first dilation at blue this time around was fucking astounding unpleasant, bordering on tears. I pushed through it with @JMWinters holding me but wow it sure did suck.
The next time we tried, I took a muscle relaxer, ibuprofen and Ativan (and some cannabis) before trying again. I also adjusted my posture with support under my legs and butt. This time it was easier. By this morning I was able to get blue in without too much pain.
3/4/2026 - Post Op 4
Post op 4 was like a lot of the others though this one included a speculum exam so that was really fun. In reality it wasn’t that bad.
But it was also saying a small goodbye to the clinical staff that had supported me through all this, since I was cleared to travel!
The next few days were a blur. We worked on packing - it’s astonishing how much you can accumulate when you stay almost two months in a place. We ended up shipping 11 boxes of stuff home.
And on the final day in San Francisco, @JMWinters and I rode a cable car. 🩷
3/11/2026 - Heading Home
@JMWinters and I intentionally kept the plan as limited as possible other than saying we wanted to be comfortable and take at least 4 days. It ended up being six.
We stopped in Reno, Elko, Park City (where we spent two nights) and Rawlins before arriving home.
The drive was not bad. She did all the driving and I had a variety of pillows and pads to make the trip less painful, but even with that it seems my travel limit is currently about 5 hours.
3/30/2026 - First Day Back at Work
Today was my first day back at work since surgery. It was interesting dilating in the dark this morning. But, I had my second done before I'd gotten to my first on some recovery days!
4/2/2026 - First Week Back
This week has been my first week back at work since January 16th, so getting back into the swing of things after having missed more than two months of work has been fun. In the meantime they split me team apart so I'm learning new faces and everything. It feels like my first week in some ways.
(For reference, I work as a remote software engineer)
One big thing for me was working a dilation routine into my work and life schedule. Right now it looks like this:
6:15am: Wake up, take tampon out, shower
7am: dilation 1
7:40am: get dressed, makeup
8am: work.
12pm: lunch, dilation 2
4pm: finish work, pick up kiddo from soccer
10pm: dilation 3 and get ready for bed.
Earlier this week I accidentally went two days with just two dilations. The third day started to get tight again, so I know I'm not there yet.
Other stuff that happened this week:
I had a followup with my PCP at the end of last week and she did my first post-op bloodwork. My estradiol was 145 and my testosterone was 5. I expected these to change after surgery but they're essentially unchanged from the last 18 months.
Had my first gynecologist appointment! 😬 Though it actually ended up being not a big deal at all, it was reassuring to have someone look down there and be sure the healing especially in the canal was doing ok. He said he didn't see any signs of bleeding or hypergranulation, and to continue following the betamethesone treatment.
I'm finally off all forms of pain management! I was still taking OTC ibuprophen twice a day (before my first and last dilations) but I stopped that yesterday with seemingly no issues in dilation pain.
AND .... I'm now to dilating using just green and orange, and I switched to sliquid lube and lube shooters. Squirt a bunch up the canal, some on the dilator itself. I've been warming up 5 minutes on green, then orange for the rest of the time.
Rebecca
