Content warning: graphic descriptions of surgical recovery, surgical care, biological processes, emotional distress
There is a wide variance in post-surgical experiences depending on things like the surgeon, surgical technique, general health of the patient, complications, etc. The below is my experience only, and should not be considered typical or expected.
The second and third weeks of recovery were a clambake of pain, itching, and depression. A choral symphony of misery hung in the air.
It was a miasma woven by moans and tears, electrified by static generated from expectations of the past, present, and future rubbing against each other. Bolts of physical and psychic pain coursed through my body as it sought to knit together flesh and spirit.
Painkillers dulled my senses, leaving me logy in a twilight of despair. I wanted this? Numb and sometimes bleeding flesh demanded and required my attention when all I wanted to do was hide from it. Thrice daily I was forced to confront this now bloated body’s painful needs by examining and care-taking its landscape of scarred tissue by dilating and applying antibiotic ointment to my incisions.
The itching, first manifested and localized to where surgical tape gripped me in the thighs with a red rash, grew to encompass my anterior torso in angry, red spots where I had been wiped down with antiseptic prior to surgery. Then the itching spread to my entire body as a flush. For days unending it was my primary torment. I popped Benadryl by the handful to try and knock it back but to no avail.
I noticed the itching increased after taking a Percocet for pain, so I gave up the opiate for ibuprofen supplemented with CBD-infused honey in chamomile tea. The itching receded enough to notch it down from mind-numbing wretchedness to misery, but it did not go away.
Skin flaked from my face like it had been burnt and my arms and lower legs were so dry it looked like I’d been rolled in powdered sugar. As much as I tried not to, I scratched. I scratched my scalp, my armpits, my back, anywhere where I couldn’t resist it’s insistent calling. Angry, red welts rose from my nails as I scratched and left me with as much lasting satisfaction as eating cotton candy for dinner.
I was a fucking mess. Then I got worse.
Dancing on every itchy tingle, skipping amongst the painful throbs and jolts, and mocking my island of numb, the brain weasels moved in. In my isolation, they told me I’d made a horrible mistake, that this disfigurement was permanent, and that all I had to look forward to was pain and suffering.
They pointed out discolored and swollen flesh, whispering in my ear it was going necrotic. They told me my rotting crotch would fall out when I sneezed hard, dropping with a painful, bloody sploosh into my underwear. They laughed at my itching and told me the rash was a bacterial skin infection, and that it had migrated to the inside of my vagina and was incubating a permanent colony for future attacks.
The weasels told me I didn’t have a clitoris and even if I did, it’d never work, and I’d never have an orgasm again. Besides, who’d want to have sex with someone who had a disfigured crotch, anyway?
They laughed at me and told me my hopes for surgery were delusional. While trying to block the discomfort and fall asleep they fished even darker thoughts from the recesses of my addled and rattled brain, sowing seeds of doom and gloom. Depression fell upon me like an over-weighted blanket, making it hard to breathe or move.
Were the brain weasels right? Would this never end? Was my disfigurement and numbness to be permanent?
In desperation, I asked the trans women of Twitter about their experiences. In private and public messages from those that have gone before, (thank you to everyone who replied, I am forever in your debt,) I was reassured things would get better in the coming weeks. Knowing the bad place was temporary helped me to keep the weasels at bay and focus on the future, but things were still touch and go for a couple of days and I shed many tears.
A post-surgical depressive freak-out sometime around the second week was startlingly common among the women I corresponded with as was a longer depressive streak. Post-surgical depression is a thing, and there are studies about it for cancer and heart patients, but of course none for trans patients.
I struggled with post-surgical chronic pain and the reduction in physical capability and stamina. I felt like an old woman who couldn’t move without pain and whose spirit and flesh had succumbed to the ravages of age, unable to do things I had previously been able to do with ease.
My doctor’s office had convinced me to schedule a checkup a week after I arrived home and I’m so glad they did. After consulting with my doctor, she suggested the itching was a reaction to both the oral antibiotics I had been prescribed and the topical over-the-counter antibiotic ointment I was slathering on my incision lines.
She instructed me to stop the topical and prescribed some industrial-strength antihistamines, which knocked me out so I could sleep. I’d already completed the oral antibiotic course. For good measure, I stopping using the chlorhexidine soap I was using to wash my dilators and shifted to liquid non-antibacterial soap. It took a week for the itching to subside to background noise and another for the welts I gave myself from scratching to fade.
The weeks detailed above were probably the worst physical experience of my life in duration and discomfort.
I’m a bit over six weeks post-op as a write this, and the depression is still here, but I can feel it starting to lift as I regain strength and stamina. I still have pain, but it’s manageable. Most of my incisions have healed, but I still have sutures working their way out. As others have told me, it will take weeks to months before I feel normal and for the swelling to go down.
As always, I look to the future.
I’m on Twitter @cistotrans
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