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What to Expect (MTF)Day One (Surgery - 2): Arrival in Trinidad, make yourself at home here. There is much to see and do in this Western Victorian town. A good place to start is the Colorado Visitor's Center, right off Exit 13B, where you can get information about lodging, dining, shopping, and things to see. It is open daily from 8 a.m. to 5 p.m. If you have only one meal here, have it at Rino's Italian Restaurant (with its singing waiters) located on Main Street across from the Post Office (Rino's is closed Mondays and Tuesdays). For history, visiting the Pioneer Museum (Bloom and Baca Houses) is a must (located just down from Rino's). Once you get into town, you need to connect with Dr. Bowers' office at (719) 846-6300 or via email. You should already have scheduled an appointment with Dr. Bowers today at her office - 328 Bonaventure St, Suite #2, (719) 846-6300, located right next door to the hospital - this should take about an hour. Day Two (Surgery -1): On the day prior to your surgery, you MUST restrict yourself to a clear liquids diet only; absolutely no solid foods. Have nothing to eat or drink after midnight prior to surgery. You will be given a bottle of bowel prep to drink the afternoon prior to surgery. We will tell you exactly when you should gulp this down (Yum!). Clear liquids include:
Please make sure that none of the clear liquids that you have are colored red, purple or caramel (example, Coke or Pepsi) If your surgery is on a Tuesday or a Friday, you will see Dr. Bowers today for your pre-surgery visit. (If your surgery is on a Thursday, you must come in to Dr. Bowers' office today and pick up paperwork. You will then go to the hospital for pre-admission, bloodwork, and bowel prep at the PACE clinic. You will see Dr. Bowers tomorrow morning in her office prior to your surgery.) After seeing Dr. Bowers, you will visit the admission desk at the hospital, located directly across from Dr. Bowers' office. There, you will have your blood drawn, pre-admit for the next morning, drop off paperwork, and go the PACE clinic to pick up bowel prep. We recommend you return to your hotel room within 30 minutes of drinking your bowel prep, where the effects of the bowel prep can be managed - plan on regular bathroom visits. Admission will be the next morning although the time will vary if you are an AM surgery (5 am check-in) or PM surgery (9 am check-in). (If you have a Thursday surgery, you will come to Dr. Bowers' office for your pre-surgery visit and then go to the hospital to be admitted for surgery. Your surgery will begin around 12pm.) If you are over 45, you should have already provided a copy of an EKG performed within 6 months of your scheduled surgery. If you do not have an EKG copy, you will need to have one performed at MSRH - an additional reading fee (about $45) will be billed separately. If you have not supplied the results of an HIV test, Ann can conduct a rapid test in the office. This takes about 20 minutes and costs $62 (Planned Parenthood). Day Three (Surgery): Day of Surgery - depending upon the time of your surgery, expect to arrive at the hospital early (5 a.m. for morning surgery, 9 a.m. for afternoon surgery). (If your surgery is on a Thursday, you will first have your pre-surgery visit with Dr. Bowers in her office, and then go to the hospital. You surgery will begin around 12pm.) Check in, get your bedside area set up for recovery. You will not be leaving the bed for 48 hours, so make sure things you want nearby are within reach. Valuables and cash can be locked up for you. You may meet with the anesthetist either in your room or in the OR prep area. Prior to surgery, you will be placed in compression stockings and given a tiny shot of heparin (to prevent blood clots). Once you have spoken with anesthesia, you may have medication for relaxation. Dr. Bowers will most likely say hello to you shortly before surgery. You may wake up in the OR recovery area, in your room, or somewhere in transit. After surgery, you might be sore, but many patients report little pain or discomfort. There will be a full sensation, like needing a bowel movement, due to packing in the vagina. In addition, you will feel like you have to pee (catheter in the bladder). Use the pain medication liberally if you need it - the first 2 days could be quite foggy with the pain lifting shortly thereafter. If you cannot sleep, ask for medication; same for nausea; which is common after using the pain meds. Throughout your recovery, you will want to drink plenty of water and be sure that your surgery site is well iced during the first 48 hours to reduce swelling. Any time a staff member comes through you should check your water and ice situation, as these constantly need replenishing. Advocate for yourself - and ask for these to be replenished when you notice they need it - the nursing staff has other duties and can not always notice. Day Four (Surgery + 1): Pain control and sleep are the main activities during the first 2 days following surgery. If there have been no complications and your nausea has gone down enough, try eating. This will give you something else to do! You may be switched over to oral pain medication today and your IV stopped. Also, start to exercise your legs in bed - they will be sore and you need to get the muscles moving. Keep drinking fluids! Day Five (Surgery + 2): If all goes well you will be out of bed today - perhaps not running a marathon but getting vertical with some assistance in any case. A shower is not out of the question, if you feel able. You can probably restart your hormones, but at a lower post-operative dose. You may request to use your own hormones or use the estradiol (2 mg per day) provided by MSRH. Day Six (Surgery + 3): The drain coming from your butt cheek is removed today. This is an odd sensation but normally not excruciating. You can take a pain pill ½ hour before they do this, if you need it. The retaining suture "Biber Button" (if needed) above your pubic bone is removed today. You will also be given a tube of triple antibiotic ointment which you should apply to your surgery site (labial incisions, clitoris, etc) to facilitate healing. You should be much more yourself today - starting to get bored. Moving from bed to chair or walking the halls is encouraged, but try to respect the other patients' need for rest, quiet, and privacy. If you need some time alone, shut your door. If you welcome visitors, leave it open. Day Seven (Surgery + 4): You should have had a bowel movement by now. This is normally a major problem - between the constipating pain medication, the packing in the vagina and your lack of activity. We try to keep up on this by giving you stool softeners, mineral oil, and oral laxatives, but this often is not enough. An enema is another option that may be offered. Let us know about this! Rarely, we must remove the packing in order for things to happen but try not to. Warm prune juice at bedtime may provide another time-tested remedy. Don't panic - everyone poops eventually! If everything goes as planned, you will be released today! You will be given a set of dilators at the hospital and then discharged and sent to the Morning After Guest House. You should go the pharmacy to fill prescriptions and then go to the Guest House. Rest and relax, and we'll see you on Day Nine! Day Eight (Surgery + 5): Today is for resting, relaxing and socializing with other guests. Day Nine (Surgery + 6): You will need to go to Dr. Bowers' office at about 11 am. (Be sure to bring your dilators.) Once in Dr. Bowers' office, the foley catheter is removed. There is often some bleeding (controlled by pressure) around the urethra or even a small clot passed, particularly when you first void. The vaginal packing will be removed and you will be taught about dilation of the vagina (see discharge instructions). Spend the night in a local hotel or continue your stay at the Morning After. Although you are released, we normally prefer that you spend another night or two in town, to make sure there are no minor problems that need addressing. Driving is possible although not while on pain medication. Taking advantage of friends or family for transportation is certainly preferred - and Dr. Bowers' staff, community friends in Trinidad, or other patients are usually available to ferry you from MSRH to the hotel, to pick up prescriptions, etc. Robin may be reached at (719) 846-6300 if you need transport to Dr. Bowers' office, your hotel, or the hospital. For those counting at home: If your surgery is on a Tuesday, you will most likely be discharged from the hospital the following Saturday. Unless you've made plans to stay additional days, you will leave the Morning After Guest House on Monday. Plan travel and accommodations, accordingly. Day Ten (Surgery + 7): Spend today resting and relaxing in your hotel room. If you want to get out into the 'real world' again, go to lunch or do some light shopping. You might take advantage of our local Social Security Administration Office today to get your official gender change, but plan on taking plenty of down time, also. Work on getting plenty of rest for your travel day tomorrow. Day Eleven (Surgery + 8): Dr. Bowers would like for you to continue your stay in Trinidad for a few more days. This is a good idea, just to help you heal a bit more before travel. You should contact our office or the after-hours numbers you will be given if you have any concerns. Day Twelve to Fourteen (Surgery + 9 to 11): On the 11th day after surgery, you are homeward bound! This will probably be a long travel day, so get plenty of rest the day before. Be sure to stay in touch with us with questions or concerns, and let us know how everything goes for you! We will call you about 2-3 weeks after your surgery to follow up, but again, stay in touch with us! We'll hopefully be able to send you home with your Surgical Declaration Letter. One per customer, but additional copies (in case yours gets lost, destroyed, or ensnarled in red tape) are available for a fee of $20 each. Billie and Jessica have suggested that you if you are spending a day or two in Trinidad after your surgery, you visit the Trinidad office of the Social Security Administration and get your official gender change. Some patients have reported problems with their local offices - but the folks in Trinidad know how to deal with this stuff. We've put a page together with guidelines, office information, and links to forms and stuff here Please visit our Patients Page for links to some of our patients who have documented their experiences online. There is also a Yahoogroup that some of Dr. Bowers' patients have set up to chat, trade notes, ask advice, etc. |
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