The mysteries of dilation

Hmmm. Will i be ejected from the trans masonic lodge (or maybe “coven”) for exposing the secret stuff that goes on post-op.

Whatever: i shall not be silenced. All will be revealed. 🙂

Though there’s a high ickiness warning going down straight away: if blood and bodily fluids ick you out, just stop here.

One thing i have found alternately amusing and frustrating about transition is how one never quite has a full roadmap. At the start its all real-life experience. Then its about the hormones and feminising both physically and socially. Then we’re on to the op (which strikes me as much overblown in significance). And then we’re done?

The point to dilation

Not exactly. Next up is dilation – and, i suspect, even more stages beyond this. But one only gets to know about each stage as one is almost on top of them. Sensible? Allowing people to take on bits of this process only as they are ready? Or counter-productive? Probably a bit of both.

Anyway, the point to dilation is straightforward. The op – the grs – has created a cavity inside your body that goes straight thru the pelvic floor muscle.

The latter, like all good muscle, is presently trying very hard to heal itself and “close the gap”, which it will do if it isn’t trained otherwise – mostly by the use of a set of cutesy perspex dildos – sorry, “dilators”.

The pain of dilation

You start straight away. The pack comes out of your new vagina and a nurse or surgeon carries out the first dilation. Some, i’m sure, find it easy: others hurt. Mine hurt, though with probs around bowels, urethra and major haemotoma, i think if it hadn’t hurt i would have been amazed.

Its a bit like giving birth and a few hours after delivery, the gynecologist turning up and saying: if you ever want to have sex again, Mrs Jones, you’re going to have to take this fisting device and insert it three times a day.

There can be no allowance made for pain levels, or suturing, or anything else. Early days, post-op, the muscle is far more trainable than later, when it has begun to recover: you could wait, but that would almost certainly be storing up pain and difficulty for later.

A lot of the early days sutures go. You can tell they’re gone, because the sharp pulling pain you got of skin against stitching goes with them. The one that goes quickest seems to be the one at the top of you perineum (where an episiotomy stitch would have been placed post-delivery).

Its not, i am told, a prob when sutures go. Just that you end up with slightly flappy bits of skin that you should take extra care to avoid tearing, “granulation tissue” *(that i still don’t understand) and cosmetically slightly less optimal result that can be fixed later.

Perseverance, perseverance, perseverance

Dilation is three times a day (as it will be for much of the next six months) and right now is somewhere up there with falling off a horse status. Hurts every time, but i know i have to persevere, cause if i give up, it’ll be next to impossible to motivate myself to restart.

Oddly, the pain is not internal any more (in fact, internal seems to be going very smoothly). More that i am getting an intense prickling sensation on my outer skin (which has me at screaming point sometimes) and the prickling gets worse when i have a dilator inside. On a nought to 10 scald=e, it is never zero: varies, mostly from 2 to 5, very very occasionally 6.

Then, post-dilation, its a warm bath and douching with an iodine based solution. Yum: the douche comes in the form of the “streem master”, more usually a toy used for anal douching; and the process leaves me leaking a globby mess of lubricant (KY or aquagel), iodine and blood. Hard to say about the latter, cause the iodine is red-tinged and in andrea’s expert view, there is little blood, loads of iodine in the leakage.

Whatever, i am rapidly discovering the joys of sanitary towels, which i will be using as long as i am douching.

Support needed

Hard not to detach and think about how this all gets supported – which seems to me to be badly. We would benefit from a lot more thought about dilation, which currently is presented pretty much as one of those things that’s “painful, but has to happen”. A forum, a help group, a dvd, even: i’m sure some of these exist somewhere – but if they don’t, i’m up for helping bring some of them about.

Two purposes, really: a place to exchange knowledge on things that make dilation easier; and more important, a place for emotional support. I do feel that the psychology of the op is all wrong (and apologies if, by skipping ChX, i missed out on something i would have got there): its all about getting to that, with little preparation for the ugly painful physicality of what follows.

I’ll cope. Most of us cope. But whilst i was aware that this stage was coming, nothing really readied me for the reality of it.



2 Responses so far »

  1. 1

    Sarah Brown said,

    I may be incorrect in my medical understanding, but I believe the hole on the pelvic floor muscle was already there.

  2. 2

    Sarah Brown said,

    Re granulation tissue, it’s what the body uses to try and repair wound holes. For sone reason, it often goes a bit weird after vaginoplasty, and can be an irritant that lasts into the medium term. It appears bright red (like wound tissue, because it is), and may need cauterising with silver nitrate to deal with. It can take repeat applications – getting rid of mine took 3 attempts. Each one involved a speculum.

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