The Good
I can masturbate to orgasm. There, I said it. And it's true. It. Works!!!! At 5 weeks post-op I got an itch that I had to scratch and thank the sun and the moon and the stars that it still works. I can get off and I can get off by jerking on my dick. Let me write that again, I can get off by jerking ON MY DICK. Does anyone else hear the Morgan Freeman voiceover? Because I am in heaven. I got teary-eyed, too. What a beautiful, affirming relief to get pleasure from my very own penis. There is nothing in my life to compare this too. Nothing would do it justice, so trust me when I say that it is life-giving and magical.
Moving on. I am also starting to see some noticeable changes in my energy and healing. The last scab on the head of my dick fell off and it's almost all healed up. I went back to the gym at 6 weeks post-op to start walking on the treadmill. The first few days I was just walking, then I would walk two minutes, jog a minute. Now at more than 8 weeks post-op I'm going to the gym about 4-5 days a week and walking a minute, then jogging for two for about 25-30 minutes. For the first two weeks of returning to the gym a small walk/jog would sap my energy for the rest of the day. It's slightly better now, but I'm also pushing myself to go for longer period of time. I find this is a good marker of my energy level and a reminder that I'm not ready to be back at work yet. If a 30 min walk/jog wears me out, a 9-hour stressful day is gonna knock me on my ass. As of today, I plan on going back when I complete 10 weeks post-op and I may try to go back part-time at first.
The top layer of my arm graft is still an open wound (see below), but the good news is that it has been healing faster during the past few weeks. My local occupational therapist has experience with wound care and, after examining my arm, he suggested that I try a different approach to wound dressing. He switched me from Adaptic to Xeroform and he placed an ABD pad on top of the Xeroform to help pull the moisture up and away from the wound. He also switched me from changing my dressing everyday to every other day. Between the moisture and the dressing changes, the skin that was starting to heal kept getting ripped off, slowing down the healing process. This OT also confirmed my suspicion that this was a full thickness graft, not a split-thickness one. If I haven't described it before, the surgical team took three separate pieces of skin from my legs - two from my right thigh and one from my left - and these where placed on my left forearm to cover the open wound left from creating the phallus. I noticed early on that one section from my leg was cut deeper than the other two. It was and is slower to heal and hair was removed with it. While the other two are itchy and look varying shades of pink, this one is still producing blisters and scabs 8 wks post-op. Likewise, on my arm, that particular graft started off yellowish in color (not red) and you could see some hair follicles in it. I don't know why it happened and it could have easily been an accident. I'm not particularly bothered by it since the graft took and never became infected. It is irritating that it is healing so slowly (at least 4-6 weeks behind the other two graft sections) and it's impeding my ability to do more aggressive therapy to help loosen the grafts and increase my range of motion. BUT, this goes in the good section because I think I'm on the right track to having it heal up in the next 2-3 weeks thanks to this new wound care regimen. My OT also moved me back to a small compression glove (from my medium) which fits better now that so much swelling has gone down.
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| Top of arm - red area still healing |
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| Underside of arm - no open areas |
The Bad: Tender Nubs and My Underwear Adventure
At about the 5th week post-op a small black scab on the underside of my scrotum flaked off revealing some uncomfortable yet minor issues. It had been covering a still-healing drainage tube hole, which at close look still had a small black thread sticking out of it. :) Fun, right? Next to thread was a pink inflamed nub of skin that was tender to the touch. Let me just say that, in my mind, I'm mildly convinced at this point that this little black thread is like the loose thread of a sweater - once tugged on, the whole thing comes unraveled. And, I pulled on it a little to see if it would come off easily. Unfortunately, this little black thread seemed to be suffering from separation anxiety and wasn't budging. A small panic set in. I took a picture and sent it to Toni to ask what I should do. She encouraged me to go ahead and pull out the thread and she said that the pocket of tissue might be hyper-granulation. It could go down on its own or, if it doesn't, I can have my PCP remove it with a treatment of silver nitrate. Thank you, Toni, for anticipating my catastrophic thinking and texting me that there was no way the thread was connected to anything important! Still, I couldn't stomach it, so this became a job for my partner and his firm yank released the unwelcome guest. Success!
Sadly, the nub of tissue enlarged to about the size of a pencil eraser and was very tender to the touch, especially whenever it rubbed up against underwear. About a week later, I went to my PCP who called Toni to confirm what needed to be done. She gave him the option of doing straight up silver nitrate to burn it off or cutting it and then cauterizing the incision with silver nitrate. If you've never seen a silver nitrate treatment, the chemical is on what looks like a large matchstick and it basically burns the skin. This PCP is a very cautious person and from his perspective the stalk of the nub was not thin enough for him to feel comfortable cutting it. He used three different "matches" to get the whole nub and since I can't feel much in that area, I got to miss out on the burning sensation that usually accompanies a silver nitrate treatment. It did, however, turn my skin in that area a grey/silver color. The next day, the outer layer came off like a miniature swim cap, leaving a much smaller nub behind. It shrunk even more over the following week, but it's not completely gone and still tender so I got a referral from my PCP to see a local plastic surgeon to get it removed. It's a pain, but more annoying than anything. On the upside, my PCP had an assistant "health coach" that he was teaching, a guy in his 20s. I'm pretty sure my new dick blew his mind. I was impressed at how mindful he was to ask helpful and medical-related questions, like "what does your timeline for recovery look like right now?" rather than all of the potentially invasive ones that people tend to when they meet trans people.
Now, I'm switching gears and I may seem naive in saying this, but I really didn't think through how much dick would be present in my underwear. I was never like, "hmmmm...my flaccid dick will be the same size as an avg erect dick. That's normal and not a problem." Ugh. I wish I had. Not that it would've changed my mind on the size I wanted, but it might have prepared me for greater body acceptance. Here are the deets - my scrotum is empty and takes up a negligible amount of space...but, my dick. My dick is approximately 12.5 cubic inches or about 204 cc's in volume. That is a lot of flesh to wrangle into underwear and pants. Before going into surgery I wore medium-sized briefs and 34x30 pants that weren't "skinny" or "slim" fitting, but they weren't loose either. Post-op nothing fits, not even a little. I've been on an active search for pants with more room in the crotch (sometimes called a gusseted crotch) and for underwear that won't smash my lovely $170,000 dick. What I'm coming to discover (and accept, albeit slowly) is that most 34" waist pants do not have enough room for my hips, butt, and dick. Neither do medium underwear, even those with extra-roomy pouches. That has been a big mental adjustment for me and will be costly to have to likely switch out my entire wardrobe of pants. On top of that, the styles and brands that used to fit me now look frumpy on me in a size 36 waist. This is a bummer.
Update: I ended up finding a great style of chinos that are flexible and roomy enough in the crotch that nothing is getting squashed: Levi's 541 Athletic Fit Chinos. And, because they are stretchy my regular 34x30 size fits perfectly! Going up a size to 36x30 I found that the Levi's 502 Regular Taper Fit Jeans fit well, too, especially now that the post-op swelling has gone away completely.
My adventure for finding the "right pair" of underwear has been disappointing. I went off the suggestions of numerous guys who "swear by" a certain brand and none have been satisfactory yet. They are also wicked expensive. I'm doing a separate post all dedicated to underwear since this is the bane of my existence.
The Ugly - Depression
I am 3 months late on finishing and publishing this post because of THE UGLY. And, the ugly my dear friends is/was post-op depression. I went into the surgery knowing that this was a possibility and quite common given how many hours we are under anasthesia, the length of time we are on pain killers, and the length of time that our sleep is interrupted. For me, even the routine of Tylenol had me waking up every six hours, which was preventing me from getting a sound night's sleep. Additionally, phalloplasty surgery is a major life-changing event and whether this language resonates with you or not, it did feel like a trauma to my body. Add these together, especially with any history of depression, it was likely that I'd be feeling the blues. I just didn't expect it to settle in and last for so long. (For additional insight from another post-op phalloplasty guy: Reasons for Post-Op Depression and Post-Op Depression Resilience)
It caught me by surprise since I didn't experience post-op depression after any of my previous surgeries (chest, gusto, meta, or meta revision). I also haven't experienced symptoms like this in well over a decade: problems falling asleep and staying asleep, feeling like crying in the middle of the day for no apparent reason, infrequent suicidal ideation, the impulse to call in "sick" rather than go to work, missing bill payments, feeling irritable and overly sensitive, and spending evenings and weekends mostly in bed. All of this persisted even after trying lots of things that would normally help when I'm feeling down (exercise, eating better, etc.). I've never to this extent felt like saying "fuck it" to so many things in my life.
Luckily, I had a good friend hold up a mirror to me that this was very out of the ordinary and she encouraged me to see a Psychiatrist. I'm grateful that she did this as I had too many "explanations" that were keeping me from getting help. Fingers crossed.
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