SRS 4: Walk Through Fire

Remember how I was adamant to avoid consuming and obsessing over the details about the recovery? I stand by that choice. The week following surgery was fraught with pain, fear, hardship–all of which would have been magnified had I anticipated their arrival. I recommend those like me skip this post.

Prior to the surgery, I had figured everything would be okay once I left the hospital. I imagined myself blissfully camping on the sofa while taking full advantage of Mama’s kitchen. We were going to braid hair and enjoy our time in Austin. It was to be a period of celebration and bonding; one of those was true.

The first couple of days at the house were how I wanted them to be. I was satisfying my palette with some real food, getting some good rest, and lounging with both my parents in the same room. I say it like that because my parents divorced shortly after I was born, and I never knew them together. Previously, the most intimate activity in which we all participated was a Christmas morning in the same house. Holidays and events are usually the only catalysts for getting us all together, and this would qualify. I will never forget how pleasant it was to have my mother and father sitting on the sofa with me–simply chatting and watching Parks and Recreation. My father went back home when I was still in a good state.

My biggest problem at the time was finding a way to rest comfortably while having the vaginal packing sewn into the creases of my thighs. I kept finding myself straining the muscles in my legs to relieve the pressure on my pelvic region. The catheter allowed me to remain in place for hours, but we were explicitly told to get up and move at least three times a day for ten minutes each. Standing up was a chore since it is nearly impossible to transition from a reclined state to a standing one without putting weight down there. Once vertical, my lower back assumed responsibility due to my inability to stand up straight.

Having a catheter stuck in me was not a sensation I enjoyed. The positioning of the collection bag was crucial to comfort. If the bag was ever lifted above my waist, I was assaulted with an incredible burning sensation as I watched the fluid slurk back into me. The only aspect of the device I enjoyed was the ability to drink water all the way up until bedtime, and still make it through to the morning without getting up. Even so, the convenience was not worth the sacrifice.

We bought a hefty supply of disposable incontinence underwear, which are basically lightweight diapers. I wore those along with long-thick-super pads which I changed every couple hours to absorb all the blood, puss, and miscellaneous dripping out of my crotch. They were super handy because we could rip them off to avoid the hassle of stepping out of them. Pants were more trouble than they were worth, so I was seen by my whole immediate family shuffling around in those underwear. They didn’t care. I love them.

I was told not to take a shower until the first post-op, which was fine, because the idea was rather terrifying in my fragile state. My brain was flooded with images of slipping in the shower and going back to the ER. Yeah, no thanks. My wonder-woman of a mother wiped me down with a washcloth a couple times throughout the week. We also did a fun hair-washing exercise over the sink, which consumed much of the energy I had. Stamina after surgery is a crazy thing. The most mundane of tasks would leave me searching for breath.

By the third day at the house, we had expected to have my bowels moving again. I have had surgery before, and resumed running a regular schedule within three days, even with a bowel prep. Much to my dismay, I started taking a stool softener. It was a difficult task for my mother to convince me it was to my benefit after the pre-op bowel prep nearly pushed me off the brink of consciousness–and that was when I was healthy. She succeeded, as she always does, and we started taking Miralax daily.

From this moment on, each day felt like three. It was a horrific countdown to the highly anticipated post-op appointment at the end of the week. My existence was rewritten with a story about endurance. The inability to vacate my bowels made it increasingly difficult to take down food, and eventually water. Each time I swallowed felt like I was fighting to squeeze a jagged potato chip down as it descended at a bad angle. We tried everything we could think of to help push things along, but the end result was always the same.

Have you ever tried a suppository? Silly little things. The concept is simple: when you get in a rut, put it up the butt to take a shortcut. Shove the little bastard up there and wait ten minutes, then it is “guaranteed” to produce a movement. All it did was make me feel cold and sick, followed by expelling bits of plastic over the next few hours.

Our first post-operative call to the nurse line was to inquire about the expected timeline for being able to have a movement. They told us a few days is normal, but some are unable to until the packing comes out. Given the failure of “guaranteed” results, I settled on the notion the packing was probably obstructing the rectum–making it impossible to triumph until we got that out. Lovely. There was some peace in accepting defeat.

The attrition from constipation contributed to my rapidly weakening body. I required assistance to stand up and lay back down without intense pain. My lower back was running marathons to keep me upright, and started to give out on me sometimes. At the end of the day my legs would tremble as they did their best to support my weight. The most painful experience I had was on the fifth night when I tried to get into bed. My exhausted body did its best to crane me flat onto to the bed, but gave up and left me to the mercy of gravity–of which it has none.

I let out a cry of pain, and proceeded to shake as if from a bitter cold. My mother entered crisis-response mode. She leaned over me, put her hands on my face, and told me to breathe. It’s amazing how breathing–really breathing, can help so much when we literally do it all the time. She brought me to a calmer place, and the shaking slowed. Then she moved to the end of the bed, uncovered my foot, and blessed me with a massage. She’s a saint.

Tears rushed to my eyes as positive sensations flashed throughout my body. I felt warm; safe. It was the first enjoyable physical feeling I had since before the surgery, and I sorely needed it. Even with my mother’s help, getting down to bed was the hardest and most excruciating part of every day. Just what I wanted before trying to sleep, right?

I did my best to remain positive, make jokes, and smile through the challenges. I could go from laughing to crying in a matter of minutes. However, my mind started to break in parallel with my body. I told my mom I felt terrible because regret was frequently on my mind, and this was supposed to be one of the most gleeful and monumental shifts in my life. I would tell her I regret making a choice that led me to feel this awful. I figured I would have a glorious moment at some unforeseen point in the future where I felt joy and accomplished.

The post-op appointment became our beacon of hope. It was to be our turning point–when we would step out from the darkness of recovery and feel warmth from what we had accomplished.

The day finally arrived. As we drove to the office I felt every abrasion in the road nudge the packing and pull on the stitches holding it in place. My mom and I both knew we wouldn’t be able to endure much longer. I am adamantly apposed to elevators, but there wasn’t even a moment of contemplation this time around. The waiting room was lined with chairs that were mocking my inability to sit.

As much as I wanted the catheter and packing out, I was equally terrified of the undoubtedly unpleasant sensations that would accompany the process. Again, breathing is key. The nurse would look me in the eye, tell me to breathe, and get to work. She started by snipping all the stitches binding the packing to my skin. It wasn’t horrible! I compare it to ripping out public hairs. The catheter was the part I really feared. I fathomed no graceful means to remove such a device from my urethra. A big breath in, a big release, and it was over. Don’t get me wrong, it burned like a bitch, but I appreciated the brevity. That was it! Done. All medical materials were removed from my body.

Next began the contract to maintain my recently vacated vaginal cavity. I would have to dilate for ten minutes, three times a day for the next three months. The nurse pulled out the dilation kit and I suddenly realized the time to start is now! She taught me the angles to transition between as the dilator is inserted further into the canal. It was a surreal feeling to have someone I barely knew insert a dilator into a body cavity I only recently obtained. There wasn’t much pain or struggle involved, which gave me an irrational amount of confidence for when I had to perform the deed on my own.

Our goals immediately refocused. With the catheter out, I needed to pee on my own using my brand new plumbing system. With the packing out, I desperately needed to get my bowels moving again so I could eat and fund my body’s efforts to heal. Lastly, I needed to clear a solo dilation. I listed those in descending order of anxiety.

In my mind, a ticking bladder bomb started the moment we left the office. All fluids I took in would have to exit, and now it had to be done on my own volition. The nurse and doctor we met with didn’t express any concerns, difficulty, or potential issues with urination or dilation after we left the office. In fact, we gave it a go on the way out of the office. The poop factory immediately started churning, and we were relieved to know that battle was over. However, no urine.

I grew more weary as the hours went by. Each time I sat on the toilet was met was drought and disappointment. We did what any rational people would do, and explored the internet for assistance. It started off with something so simple it is sometimes a means of pranking whomever falls asleep first: I put my hand in a bowl of warm water. We also read leaning forward can help, so I rested at an angle on the seat while dunking my hand in the water bowl. It looked as ridiculous as it sounds.

Next up on our lineup was walking and smelling jasmine. Fortunately, I had recently come into the possession of a collection of oils–jasmine included. We doused a cotton ball with the oil, and I then proceeded to waddle around the place while whiffing wildly. I got into a routine of switching between the sitting and the walking methods–neither of which seemed to get me any closer. It was unsettling to feel as if I forgot how to urinate. That is one of the few things newborns can do exceedingly well!

I thought back to a story I heard from another trans woman who was forced to frantically return to the emergency room due to her inability to urinate following the removal of the catheter. It was the only channel broadcasting as the clocks kept turning. This is why I shouldn’t read ahead…

As we passed the 6th hour since removal, we tried acupuncture. My mother is well versed in a multitude of Eastern medicinal techniques. She plopped some needles in my legs, and throughout my abdomen. We rested with the needles for half an hour, chatting our way to calmness in the face of a scary obstacle.

After some time to relax, and some acupuncture magic, I revisited the bathroom once more. With the joy of a toddler receiving commendation for potty training, I relieved myself; both in mind and body. The anticipation was over! I remember telling my mother, “now the only remaining milestone we have left to clear is dilating!” The nurse had already demonstrated the technique, and we were feeling pretty good about handling it ourselves.

The vaginal lips looked like two purple sausages at this point. It was nearly impossible to see through to find the opening we were supposed to fill with the dilator. I maintained a grip, and my mother did her best to try to guide me since I was weak and unable to see the area. We cautiously poked around… nope… try again… once more… and then room went silent.

Blood began spurting out of me like a geyser. I have never seen horror on my mother’s face the way I did that day. I’m lucky she is good under pressure. She reacted with haste to create a paper towel dam to try to stop the blood from spreading. I felt the warm, thick fluid pooling under me. Towels were cycling at an uncanny rate; the waste bin looked like we had killed someone.

We locked eyes–unsure what to do next. She held pressure on the area and I was paralyzed from the fear. I took over the pressure after a few minutes while she called the doctors. Due to an unfortunate mishap with their call tree, we didn’t get someone on the phone for 45 minutes. The doctor upheld an unexpected degree of tranquility while explaining how the site is not near any major arteries, and the bleeding shouldn’t be dangerous. He told us to cram a couple pads between the labia, and sit upright for half an hour to apply maximum pressure.

Sitting upright was not within my realm of acrobatic capability at the time, but I did my best to mimic the pose. It was incredibly uncomfortable, but the fear of continuing to bleed at that horrific rate fueled me through the pain. The minutes went by with a frighteningly serious tone in the room. By the end of that half hour, the tension was broken as the bleeding slowed down to the expected trickle.

The day we hailed as the turning point turned out to be much more of a violent shift than we imagined. From the moment we left the hospital, every action we took was about avoiding going back there. I got in the rhythm of feeling like any problem we ran into could ultimately send me to the emergency room. That habit persisted for almost two months after enduring the perils of the first week of recovery.

I had to walk through the fire to be reborn.