Update: 2/15/2015 - Wow, I can't believe that it has really been exactly a year since this happened. I still feel that it was the right decision for me and I'm incredibly happy with it. I feel it's improved my quality of life and made me feel better about myself. I won't sit here and say it would be the right choice for any given person; but for me it was and Dr. Arnkoff was a great choice.
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Update: 12/28/2014 - It's my understanding that Dr. Arnkoff - which is where I went, has raised his price from $2500 to $2800. Now, this is second hand information, but I do believe it to be accurate.
-M
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Update: 4/6/2014 - This post is far and away the most popular post on my blog. I hope that at least one person has found the information helpful in some way. I'm always more than happy to answer any questions about the procedure as it related to me, the trip itself, recovery, and so on. Feel free to leave a comment or drop me an email if you'd rather remain private.
Thanks,
-M
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My Orchiectomy has been a subject (at least partially) of various posts here recently; so I understand if it's getting to be a bit boring. However, the whole reason I started this blog was to share the things I experience during my transition with others who were interested. I've always appreciated that others have done that so I could research things as I hate the unknown very much. It's one thing to point out restaurants and retailers that I've had good/average/poor experiences with, but the things I really wanted to focus on were in depth things such as the legal process for my name/gender change and in this case the process for my orchiectomy. If you're tired of reading about it then by all means skip this post as it WILL be lengthy, no hard feelings; however, if you are curious or better yet considering one yourself then I urge you to read it if for nothing else to get an idea of what the process entailed (for me at least) - knowledge is power and the more you know before you do something like this the better.
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Update: 12/28/2014 - It's my understanding that Dr. Arnkoff - which is where I went, has raised his price from $2500 to $2800. Now, this is second hand information, but I do believe it to be accurate.
-M
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Update: 4/6/2014 - This post is far and away the most popular post on my blog. I hope that at least one person has found the information helpful in some way. I'm always more than happy to answer any questions about the procedure as it related to me, the trip itself, recovery, and so on. Feel free to leave a comment or drop me an email if you'd rather remain private.
Thanks,
-M
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My Orchiectomy has been a subject (at least partially) of various posts here recently; so I understand if it's getting to be a bit boring. However, the whole reason I started this blog was to share the things I experience during my transition with others who were interested. I've always appreciated that others have done that so I could research things as I hate the unknown very much. It's one thing to point out restaurants and retailers that I've had good/average/poor experiences with, but the things I really wanted to focus on were in depth things such as the legal process for my name/gender change and in this case the process for my orchiectomy. If you're tired of reading about it then by all means skip this post as it WILL be lengthy, no hard feelings; however, if you are curious or better yet considering one yourself then I urge you to read it if for nothing else to get an idea of what the process entailed (for me at least) - knowledge is power and the more you know before you do something like this the better.
Now if you want a "short version" that focuses on the actual procedure, please feel free to view my Reddit post on the subject.
That focused on the process itself and left out a lot of the details of the trip/etc that I plan on sharing here. There are also a few questions/comments there that you may or may not find interesting.
NOTE: Updated, added at the bottom as of 2/24/14, 9 days post-op...
NOTE: Updated again, added at the bottom as of 3/3/14, 16 days post-op...
NOTE: One final update at the bottom as of 3/12/14, nearly 1 month post-op...
NOTE: Okay, I fibbed, one last update at the bottom as of 4/7/14, nearing two months post-op..
- M
NOTE: Updated, added at the bottom as of 2/24/14, 9 days post-op...
NOTE: Updated again, added at the bottom as of 3/3/14, 16 days post-op...
NOTE: One final update at the bottom as of 3/12/14, nearly 1 month post-op...
NOTE: Okay, I fibbed, one last update at the bottom as of 4/7/14, nearing two months post-op..
- M
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Now that we have that out of the way, let's get into things. First off, what is an Orchiectomy? It's the removal of the testicles - there are multiple ways to accomplish this, mine was via an incision in the scrotal sack; but it can also be done other ways. Each way has it's pros/cons and it's important you consider that when/if making this choice as some GRS surgeons have issues if an Orchi has been done or has been done in the method I chose to use. The surgeons I'm looking at don't seem to have an issue with it, but as they say an ounce of prevention is worth a pound of cure, so do your homework on that.
Next, why did I choose an Orchiectomy especially if I'm interested in GRS/SRS at some point? Two main reasons:
1) Hopefully I can reduce the HRT medications I'm on - in many cases it seems like you can get off of the Spironolactone completely (or at least reduce it) and my Estrodial while it likely won't be reduced since it's still at the lower end hopefully will be more effective.
2) Straight up vanity. Even though for various reasons (HRT, blood pressure medicine, mental) "Mr. Happy" has become a non-issue; his two friends were still an issue in many of the clothes I own and/or wanted to wear. The whole "tucking" thing - well that didn't work well for me so I tended to wear clothes that didn't necessarily require that, but that gets old. Hopefully now once the swelling goes down it will no longer be an issue or at least as much of an issue.
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I chose to have my procedure done by Dr. Marc Arnkoff in Southfield, Michigan this past Saturday (2/15/14). Why did I choose Dr. Arnkoff? Several reasons;
1) The proximity to us. He is within driving distance, albeit a long drive. I wanted to drive for several reasons - cost is a factor since my wife was going. Hassle was a factor as while I have to fly for work on occasion, I really don't like it and the hassle(s) that come with it; plus a rental car/taxi hassle was avoided. But the two biggest reasons to drive were that we'd be on our own schedule (within reason) and to spend some quality time with my wife. We've never really been on vacation together and not that this was a vacation; but we got to spend hours alone with each other in the car and that time was everything I hoped it would be.
2) Cost was a factor although not a major one. Dr. Arnkoff currently charges $2500 which is on the lower end of what I researched. Now it is possible in some cases to get this covered by insurance - I believe "testicular atrophy" is a common ploy; but I had ethical issues with that and wasn't about to ask my Doctor to possibly compromise their own ethics. Now perhaps over time I might've qualified for that diagnosis, but I wasn't willing to wait. Now one of the reasons that Dr. Arnkoff is cheaper than some of the other "name" Doctors is that he does his via a local in his office in lieu of general anesthesia in a hospital. The procedure itself isn't all that much different from a vasectomy which is also often done under a local - mine (nearly 20 years ago now) was supposed to be done that way, but at the time the insurance company would only do it under general anesthesia so that's how it went; otherwise I probably would've been much more comfortable and confident with things this go around. :)
3) The fact that he does NOT require authorization letter(s) - although I do have one from my wonderful therapist Kelly that I've talked about elsewhere. The letter - well it wasn't a deal breaker as most of the doctors I looked at (Dr. McGinn being an apparent exception) only require a single letter for an Orchi which I have. While I technically did not need the letter for mine, I have attempted to adhere to the WPATH guidelines as best as I can throughout my transition and therefore I ensured that I did have a letter in hand prior to my actual procedure being done.
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How did I arrange the process?
I initially contacted him via his website and did not get a response after a couple of days so I called him. The number is his personal cell number as others have said and we discussed the date (this was about a month out) and once he said it would be available I told him I needed to confirm both my wife and I could get vacation. He told me once I did to just text him my name and date. A couple of days later I did and we eventually spoke by phone a day after that where he went over some specifics. Now the "delays" in his response were directly related to the fact that he was actually out of the state on a vacation so he was not as responsive to me as he has others, which *I* understand. Later on in the process when he was back working, the responses I got were much more timely.
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What were the "specifics" he went over during the process of scheduling the procedure?
1) Cost - $2500 (it has NOT gone up as of this weekend, although I've read that it may at some point). I'm not saying this is necessarily cheap - during my research I did find at least one cheaper option, but it was in Portland which with travel expenses it would've eliminated the cost advantage for me and he requires *TWO* letters which as of now I only have one. Most of your "name" doctors such as Meltzer, Bowers, and McGinn are more expensive as I touched on above.
2) Payment - cash or "bank check" (ie "cashier's check"). I've read elsewhere that he takes money orders and perhaps he does, but my bank doesn't charge me for a cashier's check so I went that route.
3) We also discussed that they preferred I had someone with me which I confirmed my wife would be. From some of the other accounts I've read this is not necessarily a deal breaker; but is at least strongly preferred and from my experience I can't imagine having to "go this alone".
4) We also discussed some basic needs such as Depends, Neosporin, jock strap, and so on. One note regarding the Depends, he said a 3pk should suffice and I'd disagree. I had enough drainage and such that I went through twice that. Now I could've been back in panties sooner than I chose to, but why ruin my nice panties? I would suggest at least 2 3pk's so you don't have to ruin panties and/or hotel sheets.
5) Lastly we discussed that I'd need to stay in the area at least overnight. Dr. Arnkoff mentioned one or two convenient hotels and I had read enough accounts to have a few others in mind as well. My wife and I went back and forth on this as if we'd stay overnight or a second night. What we finally settled on was staying overnight and then driving *halfway* back on Sunday and stopping there (in this case in the Indianapolis area) and then going the rest of the way home on Monday. That would keep me in the car far less at one time and as we suspected I might not feel too great - it would prevent me from getting too crabby.
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What were our final preparations?
I ended up booking us into the Holiday Inn Express in Novi, MI for Friday night and Saturday night. It's a few miles down 12 Mile Road (the road that Dr. Arnkoff's office is off of); and takes 10-20 minutes depending upon traffic. The reason I chose that hotel were that frankly I like HI Express and had enough points so that both nights would be "comped" from accumulated points. There was a Candlewood Suites closer to the Doctor that is also a IHG property and would've been less points even; but upon thinking about it we didn't think we'd actually use the "kitchenette" and the HI Express in Novi was close to a mall and another "plaza" with a Wal-Mart, and some other stores and several restaurants. Not to mention they have a reasonably decent breakfast included with the room.
The other hotel I chose was a Holiday Inn Express in Greenfield, IN. It was about 1/2 way and only a little out of the way; but it is literally a baseball toss from Interstate 70 which is what we'll take home and there were a ton of restaurants and a Wal-Mart, etc., nearby. The room here was also comped (and that factored in as I had just enough points to comp all three, if I had chosen another hotel we may have been paying for part of it).
Beyond that it was purchasing the few things that Dr. Arnkoff had mentioned and that was about it.
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The Trip itself - Friday:
Since we'd be spending Valentine's day on the road (and a long day at that), we had a nice pre-Valentine's day together on Thursday. We had the Valentine's special at Tucano's Brazilian Grill in St. Charles, did a little shopping, and then went home to pack and get some rest before the trip.
We left for Detroit around 3:45am CST on Friday 2/14/13 - we had intended on leaving at 3am, but were running late. A quick stop by the bank for some cash (just in case) and we were on our way by about 4am (so only a hour late). Our route took us via 70E to 270N until we got through Indianapolis at which point we'd veer NE towards Fort Wayne, then Toledo, and finally into Michigan. Actually Google Maps wanted us to go north more towards Chicago and then east - but I preferred going through Indianapolis and it was only about 5 miles longer and what's 5 miles on a 9-10 hour drive really?
The drive itself was nice, I love my wife more than anything and she feels the same about me and it was nice to have that much time alone together to just talk about this and that. We stopped a couple of times prior to Indianapolis, to get something to drink the first time and to get a light breakfast at McDonald's the second time. We stopped to get lunch at a Burger King in Defiance, Indiana (I think it was still in Indiana) and all was going well until we hit Michigan. About 30 minutes from our destination my wife noticed a chip in her windshield that wasn't there before the trip started - I assume it happened when it was dark out. That put a damper on things as her car is only a few months old and I felt guilty. Some quick research showed a Safelite Auto Glass shop not to far from our destination so we agreed that she'd drop me at Wal-Mart to pickup a few things and she'd head over there to see if they could squeeze her in that day. The next fiasco was some pot hole repair they were doing. They were literally just tossing stuff into the holes and I guess assuming that the cars driving over it would tamp it down. Turned traffic into a joke as well.
Once we arrived in Novi, we did as we discussed. They were able to fix her windshield (somewhere around $125-$150 I don't recall) and I got a few things at Wal-Mart. We then proceeded to head to the hotel and check in. Our room was reasonably nice, although no fridge or microwave - which I knew in advance - but which also meant that frozen peas would not be an "icing option" for me post-surgery. At this point I texted Dr. Arnkoff that I was in town and confirmed our appointment for 6am on Saturday 2/15/14. He replied that it was and made sure I knew where we were going which I did.
At this point, my wife and I drove down to his office to get an idea of drive time. It was further than I thought and took a good 20 minutes; although I suspected that at 5:30am it wouldn't take much over 10 or 15 instead. We then decided to have dinner - with it being both Friday and Valentine's day, most anything nice was packed so we settled on Denny's which was fairly slow. Food wasn't very good and their menu has been overhauled again and not for the better, but it was Denny's what do you expect there? From there we went back to the hotel and it was around 8pm local time. We figured a good 2 hours to get us both ready and presentable, including shaving the area around the testicles as per Dr. Arnkoff's instructions, so we set the alarms for 2:30am which would give us a hour cushion.
Well I had trouble sleeping and got up well before that and my wife finally did as well, so we started getting ready.
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The Big Day (Saturday):
The Big Day (Saturday):
As I said we had trouble sleeping, me for obvious reasons and I suspect my wife for the same as well as the fact that I kept getting up. We finally got out of bed around 1:30am and started getting ready. She showered and prepared while I killed time on my laptop and such. She took her time since we had lots of time so it was probably 2:30am before we started on me. We touched up some of my body hair first (arms and back), then I did my legs and chest - they probably didn't really need it, but I wanted to look my best as silly as that may sound. Once that was done we used a cream on my "parts" (Veet if anybody cares) to ensure they were as bare as possible per the instructions. Once we rinsed that off we shaved a few hairs that were missed and I took a long bath since I wouldn't be able to do anything other than a shower for at least several days and a hot bath is one of my guilty pleasures. It was probably 4:30 or so by now and it was time to get dressed.
I had intended on wearing a skirt but it was 5-10 degrees out so I settled on jeans, a pair of trouser socks, a nice pair of "shooties" that I recently got, a bra, and a loose blouse with a cami underneath it. We packed a loose fitting skirt and flats to wear afterwards since I wasn't sure how well the pants would work and with it being cold and icy I didn't want to slip in heels afterwards; although in hindsight wearing them there wasn't a great idea either. We took care of my hair - for anyone who doesn't know I'm relegated to wigs, but I have a couple I like and for this trip we had went with the shorter one since it's easier to deal with and in reality it's the one I wear most anyway. My makeup was a little hit and miss as I was nervous and truthfully didn't want to spend a whole lot of time on it at this point, but it was enough to get the job done. We had settled on leaving at 5:30am and we were actually ready a bit early so we headed down to warm up the car.
Suffice it to say even though I knew it was as cold as it was I wasn't expecting it to feel so cold - the wind was not kind either. Once we got the car thawed we headed over, as I had suspected with no traffic we got there about 10-15 minutes early and drove around to the "B Entrance" which is where Dr. Arnkoff's name was listed. We parked and waited and about two minutes later I got a text from him telling us "C Entrance" around back. Looking back over others accounts I should have known this, I simply overlooked it, but apparently he uses the "C Entrance". I guess it's because he took is in through his office and not the actual waiting area, but that's speculation on my part. We pulled up and parked and went inside with him.
I will say he is older than I expected; not that it matters, just an observation. He went over the process with my wife and I in some detail; he now does the incision from side to side instead of up and down as he says it's easier to get the testicles out (although as I mention below, I'm not sure on that). At that point he gave us paperwork to fill out and I guess left to prepare. His assistant Sarah came by with some aftercare paperwork and to ensure we filled out the backs of the forms as well. Standard stuff, contact information and the like. Upon his return I was still working on it and he wrote out my prescriptions. That surprised me a bit since I'm used to them being electronic these days but it worked out well for us as I'll get to later on. We once again confirmed that I'm allergic to Penicillin, so mine were for Cipro as an antibiotic and Norco for the pain which is I guess the same as Vicodin. He gave them to my wife and took my forms and my cashier's check and we headed back. He took my wife to the waiting room and left me to go with Sarah to take me back for the surgery.
Upon reaching the room (Room 3 if it matters), she asked if i needed to use the bathroom which I did not, and at that point told me I should undress from the waist down although I could leave on my socks, and get on the table and cover up. Before she left the room she did ask if I was okay - I'm sure I did look nervous - I mean here I was having my testicles removed while I was awake and paying $2500 for the privilege of doing so. Once I assured her I was okay she left me to take care of that and I removed my shoes, jeans (I normally hate jeans but it was about 10 degrees out and practicality ruled), and panties which left me in my socks, bra, and top. I then got up on the table and pulled up said top as she had instructed and covered myself up with the little "sheet".
As a side note, music was playing from one of their IPhones - it happened to be 70's which was fine - if they had asked I would've preferred 80's, but no biggie. In fact, my wife and I been laughing on the way over about me asking them to play something like the Nutcracker Suite from Tchaikovsky or something. Truthfully in hindsight I wish I would've asked if it was okay to bring in my own phone and headphones and I could have played a game or something.
Once Sarah came back she wiped down a large area (and Dr. Arnkoff had requested the area be shaved) with I think Betadine and then the actual area with Benzocaine (again I think) to "freeze/numb" the area. She told me that she and Doctor Arnkoff would be back in 10 minutes.
Now let me say I'm more than a bit squeamish so I didn't watch any of this even though I could have seen it, so most everything from here on out is what I felt and not necessarily what I saw. At about 10 minutes, they did come back and made the incision - I believe I felt the last part of it slightly. At this point he numbed the testicles, etc., I didn't pay attention to what he used; but he did say at one point that it was the same thing that dentists use (Lidocaine? Something else?). I did feel some of this - but it wasn't bad, a poke or two and a little bit of a burning sensation I suppose. Once he had done that they left me for another 10 minutes although I'd guess it at least 20 - for things to numb. I'm assuming the extra time was because I was a little jumpy from what I had felt while he was numbing things.
When they came back he started the procedure. He worked on the right testicle first and I hate to guess but maybe 10-15 minutes later Sarah said "one down". It was sort of anti-climatic - maybe I've watched too many episodes of M*A*S*H or something, but I sort of expected to hear him toss the testicle into the little pan or something. :) Now the left one was a little more difficult. Apparently it didn't want to come outside of the scrotal sack, in fact while I haven't seen it my wife says I have a thumb print looking bruise down there on that side. I guess I shouldn't have been surprised as I've read other accounts where there were similar issues as this and it was the less descended of the two I had. He finally got it out but it sure seemed like it took longer for him to do that one - long enough I was getting a little concerned. In hindsight I think part of it was that nobody said the second one was done so I had no frame of reference as to when he finished it and started "putting me back together". I didn't know until he was completely finished including inserting the drain tube.
I will say that I didn't feel much of anything during the whole process other than the following:
1) Part of the incision being done. It didn't really hurt, but I'm really squeamish about being cut and that part was more of a mental thing for me than it actually hurting.
2) The numbing process, as I said above I felt a couple of pokes and a small amount of burning, but neither was bad - I've felt worse at the Dentist and from the pain shots when I went into have my gall bladder removed years ago.
3) The actual worst pain was getting that second testicle outside of the scrotal sack. There was a lot of pressure and it did cause me to lift off of the table a bit and while she didn't say anything I noticed at one point that Sarah was actually putting some pressure on my left leg to keep me steady on the table. Once I relaxed back down she quit doing so; but I guess it was obvious enough that at one point he asked if I needed to be numbed more and she followed up with something along the lines of "don't be stoic, if it hurts too bad let us know we don't want you in pain". Not exact, but something to that effect. During the majority of the process I laid there staring at the ceiling so I wouldn't watch with my hands clasped below my breasts; but during this I actually had wrapped them beneath the table and was holding onto that tightly. I'm sure most people wouldn't have blinked an eye at that bit of pain, but I'm a bit of a baby and it did hurt enough that it helped me to do it.
I will say that I didn't feel much of anything during the whole process other than the following:
1) Part of the incision being done. It didn't really hurt, but I'm really squeamish about being cut and that part was more of a mental thing for me than it actually hurting.
2) The numbing process, as I said above I felt a couple of pokes and a small amount of burning, but neither was bad - I've felt worse at the Dentist and from the pain shots when I went into have my gall bladder removed years ago.
3) The actual worst pain was getting that second testicle outside of the scrotal sack. There was a lot of pressure and it did cause me to lift off of the table a bit and while she didn't say anything I noticed at one point that Sarah was actually putting some pressure on my left leg to keep me steady on the table. Once I relaxed back down she quit doing so; but I guess it was obvious enough that at one point he asked if I needed to be numbed more and she followed up with something along the lines of "don't be stoic, if it hurts too bad let us know we don't want you in pain". Not exact, but something to that effect. During the majority of the process I laid there staring at the ceiling so I wouldn't watch with my hands clasped below my breasts; but during this I actually had wrapped them beneath the table and was holding onto that tightly. I'm sure most people wouldn't have blinked an eye at that bit of pain, but I'm a bit of a baby and it did hurt enough that it helped me to do it.
Once the drain tube was in, Dr. Arnkoff had me lean forward so he could show it to me and go over it once again - he had discussed it beforehand, but better safe than sorry I suppose. I was to leave it in place until the next day, then shower and carefully remove it. If it fell out before then that was fine; but otherwise leave it until the next day. At that point, he asked if I wanted to see the testicles, get picture(s) of them, etc. I declined, but he still showed them to me. After he left with them Sarah explained why - apparently some people will feel the spermadic (sp?) cords and think a testicle was left in - by showing them it should confirm to the patient that they were both removed (which it did).
At this point Sarah went over the post op care and how important it was to eat prior to taking a pain pill, etc. Since my wife had my Depends, etc., she got her so I could get dressed. I had brought a skirt with me - one that I didn't care if I ruined, since I felt I would be tender and it would be easier to wear with a diaper, as well as a pair of ballet flats as I didn't want to slip on the ice. In hindsight I probably should have worn those on the way there as I could have just as easily slipped walking in and that may well have been bad too. We left via the way we came in and Dr. Arnkoff gave some parting advice including something to the effect that "the next couple of hours are the best you'll feel for the next couple of weeks." We did stop outside of his office as there was an atrium type of area with some fish and such - it's clearly visible from the waiting area (through a glass wall) and my wife wanted me to see it. It's actually a very nice touch as opposed to staring at plain white/beige/taupe/whatever color walls. The photo below is from the atrium area looking back into Dr. Arnkoff's waiting area.
From there we went back to the hotel. Most accounts that I've read discuss going to Walgreens to get the prescriptions filled, which is a 24 hour store and right next door. Our insurance is via Wal-Mart and as of this year, any non Wal-Mart pharmacy is out of network and costs more, so all things being equal we'd prefer to use them. We had talked about it in advance and had decided that we'd eat the expense so we didn't have to wait for the Wal-Mart pharmacy to open (9am). We figured that the medicines would be common ones (and I believe that they both were) so how much could it be - if we read the policy information correctly perhaps $12 each instead of $4 each so the $16 difference wasn't a big deal. However, as it turns out even though the Walgreens is 24 hours, the pharmacy doesn't open until 9am and it was about 7:40am. We decided that we'd instead go back to the hotel and have breakfast and get the prescriptions at Wal-Mart instead.
From there we went back to the hotel. Most accounts that I've read discuss going to Walgreens to get the prescriptions filled, which is a 24 hour store and right next door. Our insurance is via Wal-Mart and as of this year, any non Wal-Mart pharmacy is out of network and costs more, so all things being equal we'd prefer to use them. We had talked about it in advance and had decided that we'd eat the expense so we didn't have to wait for the Wal-Mart pharmacy to open (9am). We figured that the medicines would be common ones (and I believe that they both were) so how much could it be - if we read the policy information correctly perhaps $12 each instead of $4 each so the $16 difference wasn't a big deal. However, as it turns out even though the Walgreens is 24 hours, the pharmacy doesn't open until 9am and it was about 7:40am. We decided that we'd instead go back to the hotel and have breakfast and get the prescriptions at Wal-Mart instead.
That is one of the reasons I tend to stay at HI Express. I'm not saying the breakfast they have is anything to write home about, but for what it is - well it's not bad. I'm partial to their cinnamon rolls, and the little pancake machine makes decent enough pancakes. There's also generally biscuits, a sausage gravy, eggs (either scrambled or little mini omelet's with some cheese), sausage links or patties - in some cases both, four cereals (generally a "frosted flakes", a "cheerios", a "fruit loops", and something else such as a "raisin bran" or something) - I'm sure they're generics, but you get the idea. There's also yogurt, hard boiled eggs, bagels, toast, english muffins, fruit (almost always bananas, sometimes other things such as oranges or apples), and so on. There's coffee, a juice machine with orange juice, apple juice, and usually cranberry juice, and water to drink. Considering it's part of the room rate and their room rate is fairly reasonable it's not bad. Yes you can get a cheaper hotel, yes you can get a more expensive hotel, but for me at least HI Express is a sweet spot of cost versus features. Although I wish this one would've had fridges and microwaves in the room. As a side note, this one is a newer hotel if I understand correctly and had a nice enough flat screen TV, but had it connected up to analog programming which was a joke. The HI Express we stayed on outside of Indianapolis (which I'll get to later on) actually had DirecTV with HD service on it; frankly it was like being at home there.
Back to the pharmacy question, Dr. Arnkoff did say that Meijer doesn't charge anything for the antibiotics; but since we don't have Meijer's back home and there was a refill on each we decided to pay the $4 co-pay at Wal-Mart since I didn't want the hassle of transferring a prescription once we got home. We had a nice enough breakfast as I still felt pretty good from the local that had been used, and once we finished it was nearly 9am so she headed to Wal-Mart and I went up to the room.
Well she came back a little later with a few things we needed/wanted and with my pain medicine (Norco); and 2 days worth of my antibiotic (Cipro) - apparently Wal-Mart didn't have enough to fill it so they gave us enough to get home and get it filled. Mildly agitating since Cipro to my knowledge isn't some niche drug; but whatever. At this point I wasn't feeling "terrible", but was starting to hurt a bit. Finally at about 10:15am I gave in and took a pain pill. We napped off and on - maybe 1-2 hours at a time; my wife fetching ice for my ice pack when we did - this was one downside to the HI Express - since we didn't have a freezer we couldn't really do frozen peas like others have. Finally about 4pm we got up and I had another pain pill (instructions are 4-6 hours, and I was pushing for 6) and she ran and got dinner at Famous Dave's BBQ (very good - my "Yelp" review is here: My Yelp review of Famous Dave's BBQ - hopefully that's the correct link -- Edit: It wasn't, but it's fixed now). A little after 10pm I took another pain pill and we went to bed.
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The Day After (Sunday):
We got up off and on during the night and again my wife fetched ice. At 5:45am we got up and went down to breakfast right at 6am. I wasn't very hungry but had several cups of orange juice. We came back up and napped until 9:30am at which point we packed to leave which we did just prior to 11am. We had intended to remove the drain tube before we left, but as I was using the restroom before getting into the shower the tube came out on it's own, so I showered anyway but didn't have to worry about the tube.
Well Detroit got snow on Saturday night and it was a zoo leaving town - traffic barely moving, accidents, everywhere, and so on. The 4 hour or so trip to the new hotel (Greenfield, IN) took a good 5.5 hours with the traffic mess and stops for me and such factored in as well. I had not taken a pain pill since 10pm the night before and finally gave in when we got to the hotel.
Let me say this HI Express while probably not as new as the one in Novi was actually nicer in our minds. The room was about the same size and didn't have the annoying feature that your key card had to be in a slot by the door for the lights, it had a mini-fridge and microwave, the TV was larger and had a DirecTV box with HD service on it, and so on. It was so nice and the town seemed nice enough that with the forecast for home calling for freezing rain the following morning we elected to stay another night. At this point we had to pay for that one as I had used my points, but I think it was only $109 which isn't "cheap", but I thought was reasonable for the room/etc. So I cleared it with my boss since I had only taken Monday as a vacation day and not Tuesday and if we were to stay I'd need the extra day; and my wife arranged for us to keep the room.
Let me say this HI Express while probably not as new as the one in Novi was actually nicer in our minds. The room was about the same size and didn't have the annoying feature that your key card had to be in a slot by the door for the lights, it had a mini-fridge and microwave, the TV was larger and had a DirecTV box with HD service on it, and so on. It was so nice and the town seemed nice enough that with the forecast for home calling for freezing rain the following morning we elected to stay another night. At this point we had to pay for that one as I had used my points, but I think it was only $109 which isn't "cheap", but I thought was reasonable for the room/etc. So I cleared it with my boss since I had only taken Monday as a vacation day and not Tuesday and if we were to stay I'd need the extra day; and my wife arranged for us to keep the room.
After that, my wife ran to the Wal-Mart and got my prescription filled which wasn't a problem here and then she went and got Applebee's for dinner and then we crashed.
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The Day After The Day After (Monday):
I slept much better than the prior night and got up about 5:45am again and we had a nice breakfast. We then napped some more and actually went out for lunch. There was a Ponderosa in town and I like their wings. I had only intended on getting the buffet; but they had a Pork Tenderloin Sandwich lunch special that we both got. I'm used to those being a large sandwich but this one - well I've never seen one this big. It may not look that big at first glance, but look at the bun. That's a full size bun - perhaps a larger than average bun and it literally gets lost in the tenderloin itself.
The service was great, the food was great, in fact if I had a complaint it's because the service was too good. Our sandwiches came out hot and fresh, but so quickly we had barely touched our plates from the buffet - I think I had eaten two wings at that point. Suffice it to say that the majority of the sandwiches came back to the hotel with us and ended up being dinner.
I was sore, but not bad and didn't touch a pain pill until just before bed so I could sleep in preparation for the trip home. That afternoon I did fiddle with the Chromecast we had bought in Novi. It's design makes it difficult (at best) to get working on a hotel network since they have a login splash page. In Novi I was too sore/tired to screw with it, but here I felt better so I messed with it. There are multiple ways around this, what I did was set my wired NIC (this hotel has wireless and wired jacks in the room) to spoof the MAC Address of the Chromecast and logged in there first. Then I unplugged the laptop patch cable and configured the Chromecast from my phone. Worked great and we watched I think 4 episodes of the new season of House Of Cards (highly recommended watching). Beyond that we cuddled, talked, reheated our lunch for dinner and finally crashed.
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The Trip Home (Tuesday):
This is "new material" that wasn't in my Reddit post since I made that on Monday, so here goes.
I slept well but about 3am couldn't sleep anymore so I got up and played on the laptop while my wife slept - she needed it after all the wonderful care she had given me the past several days both physically and emotionally. Maybe for some people this would've been easy, but it was emotionally hard for me on several levels. I was scared that I wouldn't be able to handle the procedure from a pain perspective. I was scared that it is such a permanent step - don't get me wrong I wanted it, but up until now even though I say I never would - I could've reversed most everything - but not this. I was worried how she'd handle things. She's so loving and caring and seeing me at less than my best was a concern. But she as always was wonderful and was the difference between this going well as it did, and going horribly which it could have.
She got up at 5:45am as we had talked about and we had breakfast and got ready to leave. I actually ate reasonably well - I'm not a huge breakfast person, but I was feeling better and it was nice to eat a bit. By now I was feeling really good - I can't say there wasn't some hurt as there was; but compared to prior days, I felt great. We headed back about 10am Eastern time, with a pit stop in Terre Haute for a drink and a restroom break and then a stop in Chesterfield, MO at Bandana's (a local-ish BBQ chain) for a nice lunch. Even with our stops we got home about 2:30pm (we went from Eastern to Central time crossing from Indiana to Illinois so we got a hour back).
At this point things were great; but then my issue hit. Our house is two stories and all the bedrooms including our Master Bedroom are upstairs. She sent me in with only my purse, but trying to get up those stairs was the most pain I had felt in a couple of days. It was bad enough that I ended up taking a pain pill which helped a bit; but later on the pain came back. We looked and it appears that some stitches have come a bit loose. Dr. Arnkoff had warned us this could happen - but since everything looked fine we didn't worry too much about it and agreed to check on it in the morning and send him a photo if need be and let him determine if it was okay or if I needed to go to my GP or Urgent Care/etc. My wife reheated the balance of our lunches (I wasn't really hungry) and after she ate I took another pain pill and went to bed.
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The Day After The Trip Home (Wednesday):
I'm feeling better today, although still a touch sore. I haven't left the room - we have our own private bathroom and my wonderful wife has fetched anything I've needed/wanted. I haven't taken any more pain medicine yet and currently I feel good enough and things look good enough we're in a wait and see mode. If that turns we will track down Dr. Arnkoff and/or my GP; but for now I think we're good - I just plan to avoid the steps for the near future.
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The Day After The Day After (Monday):
I slept much better than the prior night and got up about 5:45am again and we had a nice breakfast. We then napped some more and actually went out for lunch. There was a Ponderosa in town and I like their wings. I had only intended on getting the buffet; but they had a Pork Tenderloin Sandwich lunch special that we both got. I'm used to those being a large sandwich but this one - well I've never seen one this big. It may not look that big at first glance, but look at the bun. That's a full size bun - perhaps a larger than average bun and it literally gets lost in the tenderloin itself.
The service was great, the food was great, in fact if I had a complaint it's because the service was too good. Our sandwiches came out hot and fresh, but so quickly we had barely touched our plates from the buffet - I think I had eaten two wings at that point. Suffice it to say that the majority of the sandwiches came back to the hotel with us and ended up being dinner.
I was sore, but not bad and didn't touch a pain pill until just before bed so I could sleep in preparation for the trip home. That afternoon I did fiddle with the Chromecast we had bought in Novi. It's design makes it difficult (at best) to get working on a hotel network since they have a login splash page. In Novi I was too sore/tired to screw with it, but here I felt better so I messed with it. There are multiple ways around this, what I did was set my wired NIC (this hotel has wireless and wired jacks in the room) to spoof the MAC Address of the Chromecast and logged in there first. Then I unplugged the laptop patch cable and configured the Chromecast from my phone. Worked great and we watched I think 4 episodes of the new season of House Of Cards (highly recommended watching). Beyond that we cuddled, talked, reheated our lunch for dinner and finally crashed.
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The Trip Home (Tuesday):
This is "new material" that wasn't in my Reddit post since I made that on Monday, so here goes.
I slept well but about 3am couldn't sleep anymore so I got up and played on the laptop while my wife slept - she needed it after all the wonderful care she had given me the past several days both physically and emotionally. Maybe for some people this would've been easy, but it was emotionally hard for me on several levels. I was scared that I wouldn't be able to handle the procedure from a pain perspective. I was scared that it is such a permanent step - don't get me wrong I wanted it, but up until now even though I say I never would - I could've reversed most everything - but not this. I was worried how she'd handle things. She's so loving and caring and seeing me at less than my best was a concern. But she as always was wonderful and was the difference between this going well as it did, and going horribly which it could have.
She got up at 5:45am as we had talked about and we had breakfast and got ready to leave. I actually ate reasonably well - I'm not a huge breakfast person, but I was feeling better and it was nice to eat a bit. By now I was feeling really good - I can't say there wasn't some hurt as there was; but compared to prior days, I felt great. We headed back about 10am Eastern time, with a pit stop in Terre Haute for a drink and a restroom break and then a stop in Chesterfield, MO at Bandana's (a local-ish BBQ chain) for a nice lunch. Even with our stops we got home about 2:30pm (we went from Eastern to Central time crossing from Indiana to Illinois so we got a hour back).
At this point things were great; but then my issue hit. Our house is two stories and all the bedrooms including our Master Bedroom are upstairs. She sent me in with only my purse, but trying to get up those stairs was the most pain I had felt in a couple of days. It was bad enough that I ended up taking a pain pill which helped a bit; but later on the pain came back. We looked and it appears that some stitches have come a bit loose. Dr. Arnkoff had warned us this could happen - but since everything looked fine we didn't worry too much about it and agreed to check on it in the morning and send him a photo if need be and let him determine if it was okay or if I needed to go to my GP or Urgent Care/etc. My wife reheated the balance of our lunches (I wasn't really hungry) and after she ate I took another pain pill and went to bed.
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The Day After The Trip Home (Wednesday):
I'm feeling better today, although still a touch sore. I haven't left the room - we have our own private bathroom and my wonderful wife has fetched anything I've needed/wanted. I haven't taken any more pain medicine yet and currently I feel good enough and things look good enough we're in a wait and see mode. If that turns we will track down Dr. Arnkoff and/or my GP; but for now I think we're good - I just plan to avoid the steps for the near future.
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Some general thoughts:
1) I couldn't recommend Dr. Arnkoff enough. He's to the point, but he is also very responsive and did good work from what I can tell so far. And per a question on Reddit - NO Dr. Arnkoff does not ask for people to post their accounts and speak highly of him. Frankly at his apparent age (he made reference to 40 years of experience, you do the math), I don't think he really needs the word of mouth. I posted this and on Reddit because I have found others experiences helpful to me in my transition and I want to do my part so to speak.
2) Ice is your friend.
3) If at all possible bring somebody to fetch ice, and/or run errands and such as once the local stuff wears off - well it's quite a system shock.
4) I'd recommend more than one jock strap as you're supposed to wear it at least two days and I had a lot of drainage especially the first day so I swapped out for a second one (the package I bought at home was a 2pk).
5) Extra diapers for the same reason as above - I didn't want to ruin panties and/or sheets so I've went through more than the three that the Doctor suggested.
6) To each their own; but in hindsight I would've stayed one more night in the Detroit/Novi area as leaving when I did I was still awfully sore and I think another day would've made the trip much more pleasant. I am glad I drove versus flew - I know for some that's not practical; but being on our own schedule was nice and being able to stop, etc., when we felt like it was a life saver.
7) Avoid stairs if possible.
8) As to why I did it. Well when I started transitioning, GRS was the "end game". At some point that changed and I realized I didn't need that to be a woman. Recently it has become important to me again - not as important as it once was, but important. I had never planned on an orchiectomy as to me it was throw away money since it's part of GRS and you don't exactly get a discount if it's already been done. But GRS is at least 2-3 years off and why shouldn't I be happier in the interim? Perhaps less medicine or lower dosages; hopefully my clothes will fit better, and so on. My wife and I made the decision that the (loosely) $3k it would cost was worth it. For many it may not be worth it, for many more it may not be financially feasible. But for some who can swing it, well it may well be worth it and I couldn't recommend Dr. Arnkoff enough. He is older and not exactly gregarious or bubbly, but he's to the point, does good work, and is cost effective compared to many. I'd recommend him to anyone looking into this.
If anybody has any questions, etc., feel free to ask and I'll answer as best as I can.
7) Avoid stairs if possible.
8) As to why I did it. Well when I started transitioning, GRS was the "end game". At some point that changed and I realized I didn't need that to be a woman. Recently it has become important to me again - not as important as it once was, but important. I had never planned on an orchiectomy as to me it was throw away money since it's part of GRS and you don't exactly get a discount if it's already been done. But GRS is at least 2-3 years off and why shouldn't I be happier in the interim? Perhaps less medicine or lower dosages; hopefully my clothes will fit better, and so on. My wife and I made the decision that the (loosely) $3k it would cost was worth it. For many it may not be worth it, for many more it may not be financially feasible. But for some who can swing it, well it may well be worth it and I couldn't recommend Dr. Arnkoff enough. He is older and not exactly gregarious or bubbly, but he's to the point, does good work, and is cost effective compared to many. I'd recommend him to anyone looking into this.
If anybody has any questions, etc., feel free to ask and I'll answer as best as I can.
Approximate costs:
Dr. Arnkoff: $2500
Hotel: $0 (comped)
Food: $140 - could have been much cheaper; but since we didn't pay for the room I made sure we ate a little nicer.
Prescriptions: $8 ($4 co-pay on each)
Misc: $200 - Depends, jock straps, Neosporin, windshield repair, etc
Now we did end up paying for a night in the hotel and another day+ worth of food; but that was simply because of the weather and for us to spend some time together and really had nothing to do with the surgery; but even factoring it that in, I think it was reasonable all told.
----------------------------------------------------
UPDATE: 9 Days Later:
I went back to work last Wednesday - four days post-op. Now I work as a software developer and from home at that. I will say that if I had a more physical job or did not work from home, I might have wanted to have taken the balance of the week off as I was very sore. In fact I was more sore on Wednesday/Thursday/Friday than I had been on Monday/Tuesday. I suspect part of that is that I was trying to avoid taking any pain medicine.
Let me say that in hindsight I think that was a *MISTAKE* on my part. I take a fair amount of medications already for HRT, blood pressure, etc., and that bothers me. Additionally, I've read so many horror stories about people getting dependent upon pain medication - granted I believe the dosage I'm on is a lower dosage - but that concerned me so I avoided taking it. Don't get me wrong, the pain was bearable, but it was enough to be a distraction at best and fairly painful at times. I'm not saying I needed to be taking one every 4 hours (the instructions are 4-6 hours); but maybe closer to 6 or even 8 would've kept me in a more functional state. By trying to only take one or two per day I would be in enough pain that the medicine would take time to work and extend my discomfort longer than it needed to be. Obviously this is something that will vary from person to person; but I would strongly suggest you gave it some thought before doing what I did.
As I said I did "go back to work" such as it is and I made it through the days. I had J at home the balance of the week and she made it so that I didn't have to leave the room hardly at all. As I think I mentioned earlier all of our bedrooms including the master bedroom are upstairs, and as well as I had felt the Tuesday we came home, the climb up the stairs was a real killer. So when I needed something to eat/drink or some ice she took good care of me. Unlike the actual trip itself where I'm not sure how I would've made it through without her help; not to mention the love, caring, and compassion she showed - I could have survived without her being at home, but it did make it SIGNIFICANTLY easier.
I am very swollen; more swollen that I expected; but truthfully I didn't really look at it for the first several days - I'm a squeamish little girl at heart I suppose - so I don't have a frame of reference. J says it really hasn't swollen any more than it was the first day so I'll go with what she says since she saw it. Again, maybe it's more from the fact that I'm not taking as much pain medicine; but it seemed more tender the last several days - up through yesterday (Sunday). It got to the point on Friday, Saturday and Sunday that if I was lying down I felt pretty good, if I were sitting it was a so-so experience, and standing/walking was painful very quickly.
As I said J was off the balance of last week, but had to go back on Saturday. I was sad to see that happen as despite the reason for us being together the last week; we had arguably the best week of our 8 years together. I would not trade that time for anything in the world and I think she feels the same way. On the other hand, part of me was glad she went back as I felt I needed to start being more self-sufficient again. However, that became an issue because of how sore I was as I mentioned above. Well Sunday morning, M offered to do my nails - they were showing some wear. She offered to do a gel manicure which while I've had done professionally, I'd never let her do one on me (J has). I agreed and she did a wonderful job, but towards the end I was getting crabby as I was starting to *really* hurt. Thankfully she was patient with me and finished up. When she did, I lied down and she refilled my ice bag, saving me a trip downstairs. When she came back we started discussing the fact of how active I have been. I felt I really hadn't been active since even though I have been working, etc., I sit at a desk. She pointed out that in comparison to the first few days at the hotel(s) I was being very active - maybe too active.
I had to admit she had a point. So I tried to rest a little more yesterday and partway through the day it occurred to me. The first few days I had on a jock strap and then a diaper. After a few days I got rid of the jock straps since we were still at the hotels and they had seen better days. However, instead of switching to panties - I decided to just continue to wear diapers. I didn't want to possibly ruin any of my panties and we had plenty of diapers. In hindsight this appears to have been a *HUGE MISTAKE*. While I did not ruin any panties; I also was providing *no support* for my scrotum.
With the swelling that meant that there was a lot of weight/pressure on things when I was standing; so how could I expect to be anything other than sore? I honestly think that in hindsight had if I had either worn some snug panties (and not cared about ruining them), or had continued to wear a jock strap I would've been in far less pain and far better off. I think that in conjunction with a more thought out plan on using the pain medicine would've made me *much* more comfortable and be extension happy.
Beyond that, I think things are going well - if I continue to feel better - which I have since I went to wearing panties again - I'll probably send Dr. Arnkoff a photo late Wednesday (I'm in training Mon/Tue/Wed this week) just to be safe. If he says all looks good, then great; if he thinks I need to have it looked at I'll see if I can get my regular GP to do it as I'm very comfortable with her. If not then perhaps Dr. Swenson in Columbia or Urgent Care as need be; but I suspect I won't need to as everything I've read seems to indicate that I'm progressing reasonably well.
Sorry for the lengthy update; the moral of this whole update is simply two things. First off, "take your pain medicine as needed" and don't be bullheaded about it. Secondly wear something that is supportive of the scrotum for a few days longer than suggested - be it a jock strap such as is recommended directly after surgery or even a snug pair of panties. Beyond that, all is good, thanks for reading.
----------------------------------------------------
UPDATE: 16 Days Later:
It's been another week since my last update. I'm now 16 days post-op and feeling pretty good. I still have swelling, more on the left side (the difficult one). That's also were the majority of the pain I'm feeling is. I'm almost completely weaned off of the pain medicine. It's been good enough that I never did bother Dr. Arnkoff, and instead I have an appointment with my GP next week - I have an ongoing rash on my legs that I need looked at. I will likely have her take a look and get her opinion, but I don't think there are any issues.
After reading the "post-op" care on Dr. Meltzer's website - which I ran across when searching for something else - we are moisturizing the area down there to keep the skin in good shape since I do want GRS/SRS at some point. I've also gotten back to almost normal activity. I actually used the treadmill last night a while without much incident. As I said above there is still some pain, but not a lot - I think I've had one pain pill in the last couple of days. I've also been to the grocery store and such and felt fine despite the amount of walking.
I will say I was a little concerned about the size of things down there - I realize there is going to be swelling, but I had hoped it would've gone by now and it hasn't. However, I did a little research and it seems that for at least a lot of others who have had the same procedure this is common. It's just frustrating as by now I had hoped that the "bulge" would be gone.
I do think that the spotting has finally stopped; as I mentioned above I should have been in panties all along - at least after the first couple of days using an athletic supporter - I think I caused myself a lot of extra pain with that poor decision. Panties and a pad would've done the job of the diaper and provided me with the needed support.
One other note, my hormones have not changed; I see Dr. Swenson in May and I'm assuming she'll want lab work then to check on things; although I may speak with my regular GP about that next week and see if she can order in advance. The reason this is relevant is that I've noticed since the surgery - really more the last week or so - that I'm more emotional that I was before. There's been tears just about every day and usually over trivial things. Now perhaps it's just my "cycle" as J puts in, or perhaps it's the lack of testosterone letting the estrogen really do it's thing. I'm fine if that's how it should be, but I think I'd feel better hearing from a Doctor that it is the case and that may need to wait until May. :(
I think that about covers it for now, as I said all is going well for now.
----------------------------------------------------
UPDATE: Almost 1 Month Later:
It's been nearly a month total since the surgery. The pain that I mentioned in the last update has been completely gone since perhaps a day after that update. Also within a day or two of that update the swelling started to significantly subside. The area is still larger than I would like, but it's now smaller than it was pre-op. I've been able to be much more active the last week or so, including being able to get back on the treadmill with no discomfort. At this point all appears to be going well, so I guess this will be the last update to this particular post. I hope somebody somewhere found the above useful in some regards. :)
- M
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UPDATE: Almost two months later:
All of the pain has went away, actually it did so weeks ago. I haven't seen quite as much "shrinkage" as I thought, but things have gotten smaller and seem to continue to do so, so perhaps I will end up with about what I expected. Regardless, I'm incredibly happy with the work Dr. Arnkoff did, I'm incredibly happy with my decision to have it done, and I'm incredibly happy with how much closer J and I are since that trip. It was a wonderful "bonding experience" for us and I wouldn't trade it for the world.
One other small note, I mentioned that Dr. Arnkoff had insisted on me seeing the testicles after they were removed, and that his assistant Sarah had explained that it was because sometimes people feel the cords afterwards and question if the testicles were actually removed. While at the time I really didn't want to see them, in hindsight I'm glad I did as there was a point where the swelling started to go down and the cords (especially the one on the left) did actually make it seem like the testicle was still there. So I do now understand why he showed them to me and I'm grateful he did.
- M
Hotel: $0 (comped)
Food: $140 - could have been much cheaper; but since we didn't pay for the room I made sure we ate a little nicer.
Prescriptions: $8 ($4 co-pay on each)
Misc: $200 - Depends, jock straps, Neosporin, windshield repair, etc
Now we did end up paying for a night in the hotel and another day+ worth of food; but that was simply because of the weather and for us to spend some time together and really had nothing to do with the surgery; but even factoring it that in, I think it was reasonable all told.
----------------------------------------------------
UPDATE: 9 Days Later:
I went back to work last Wednesday - four days post-op. Now I work as a software developer and from home at that. I will say that if I had a more physical job or did not work from home, I might have wanted to have taken the balance of the week off as I was very sore. In fact I was more sore on Wednesday/Thursday/Friday than I had been on Monday/Tuesday. I suspect part of that is that I was trying to avoid taking any pain medicine.
Let me say that in hindsight I think that was a *MISTAKE* on my part. I take a fair amount of medications already for HRT, blood pressure, etc., and that bothers me. Additionally, I've read so many horror stories about people getting dependent upon pain medication - granted I believe the dosage I'm on is a lower dosage - but that concerned me so I avoided taking it. Don't get me wrong, the pain was bearable, but it was enough to be a distraction at best and fairly painful at times. I'm not saying I needed to be taking one every 4 hours (the instructions are 4-6 hours); but maybe closer to 6 or even 8 would've kept me in a more functional state. By trying to only take one or two per day I would be in enough pain that the medicine would take time to work and extend my discomfort longer than it needed to be. Obviously this is something that will vary from person to person; but I would strongly suggest you gave it some thought before doing what I did.
As I said I did "go back to work" such as it is and I made it through the days. I had J at home the balance of the week and she made it so that I didn't have to leave the room hardly at all. As I think I mentioned earlier all of our bedrooms including the master bedroom are upstairs, and as well as I had felt the Tuesday we came home, the climb up the stairs was a real killer. So when I needed something to eat/drink or some ice she took good care of me. Unlike the actual trip itself where I'm not sure how I would've made it through without her help; not to mention the love, caring, and compassion she showed - I could have survived without her being at home, but it did make it SIGNIFICANTLY easier.
I am very swollen; more swollen that I expected; but truthfully I didn't really look at it for the first several days - I'm a squeamish little girl at heart I suppose - so I don't have a frame of reference. J says it really hasn't swollen any more than it was the first day so I'll go with what she says since she saw it. Again, maybe it's more from the fact that I'm not taking as much pain medicine; but it seemed more tender the last several days - up through yesterday (Sunday). It got to the point on Friday, Saturday and Sunday that if I was lying down I felt pretty good, if I were sitting it was a so-so experience, and standing/walking was painful very quickly.
As I said J was off the balance of last week, but had to go back on Saturday. I was sad to see that happen as despite the reason for us being together the last week; we had arguably the best week of our 8 years together. I would not trade that time for anything in the world and I think she feels the same way. On the other hand, part of me was glad she went back as I felt I needed to start being more self-sufficient again. However, that became an issue because of how sore I was as I mentioned above. Well Sunday morning, M offered to do my nails - they were showing some wear. She offered to do a gel manicure which while I've had done professionally, I'd never let her do one on me (J has). I agreed and she did a wonderful job, but towards the end I was getting crabby as I was starting to *really* hurt. Thankfully she was patient with me and finished up. When she did, I lied down and she refilled my ice bag, saving me a trip downstairs. When she came back we started discussing the fact of how active I have been. I felt I really hadn't been active since even though I have been working, etc., I sit at a desk. She pointed out that in comparison to the first few days at the hotel(s) I was being very active - maybe too active.
I had to admit she had a point. So I tried to rest a little more yesterday and partway through the day it occurred to me. The first few days I had on a jock strap and then a diaper. After a few days I got rid of the jock straps since we were still at the hotels and they had seen better days. However, instead of switching to panties - I decided to just continue to wear diapers. I didn't want to possibly ruin any of my panties and we had plenty of diapers. In hindsight this appears to have been a *HUGE MISTAKE*. While I did not ruin any panties; I also was providing *no support* for my scrotum.
With the swelling that meant that there was a lot of weight/pressure on things when I was standing; so how could I expect to be anything other than sore? I honestly think that in hindsight had if I had either worn some snug panties (and not cared about ruining them), or had continued to wear a jock strap I would've been in far less pain and far better off. I think that in conjunction with a more thought out plan on using the pain medicine would've made me *much* more comfortable and be extension happy.
Beyond that, I think things are going well - if I continue to feel better - which I have since I went to wearing panties again - I'll probably send Dr. Arnkoff a photo late Wednesday (I'm in training Mon/Tue/Wed this week) just to be safe. If he says all looks good, then great; if he thinks I need to have it looked at I'll see if I can get my regular GP to do it as I'm very comfortable with her. If not then perhaps Dr. Swenson in Columbia or Urgent Care as need be; but I suspect I won't need to as everything I've read seems to indicate that I'm progressing reasonably well.
Sorry for the lengthy update; the moral of this whole update is simply two things. First off, "take your pain medicine as needed" and don't be bullheaded about it. Secondly wear something that is supportive of the scrotum for a few days longer than suggested - be it a jock strap such as is recommended directly after surgery or even a snug pair of panties. Beyond that, all is good, thanks for reading.
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UPDATE: 16 Days Later:
It's been another week since my last update. I'm now 16 days post-op and feeling pretty good. I still have swelling, more on the left side (the difficult one). That's also were the majority of the pain I'm feeling is. I'm almost completely weaned off of the pain medicine. It's been good enough that I never did bother Dr. Arnkoff, and instead I have an appointment with my GP next week - I have an ongoing rash on my legs that I need looked at. I will likely have her take a look and get her opinion, but I don't think there are any issues.
After reading the "post-op" care on Dr. Meltzer's website - which I ran across when searching for something else - we are moisturizing the area down there to keep the skin in good shape since I do want GRS/SRS at some point. I've also gotten back to almost normal activity. I actually used the treadmill last night a while without much incident. As I said above there is still some pain, but not a lot - I think I've had one pain pill in the last couple of days. I've also been to the grocery store and such and felt fine despite the amount of walking.
I will say I was a little concerned about the size of things down there - I realize there is going to be swelling, but I had hoped it would've gone by now and it hasn't. However, I did a little research and it seems that for at least a lot of others who have had the same procedure this is common. It's just frustrating as by now I had hoped that the "bulge" would be gone.
I do think that the spotting has finally stopped; as I mentioned above I should have been in panties all along - at least after the first couple of days using an athletic supporter - I think I caused myself a lot of extra pain with that poor decision. Panties and a pad would've done the job of the diaper and provided me with the needed support.
One other note, my hormones have not changed; I see Dr. Swenson in May and I'm assuming she'll want lab work then to check on things; although I may speak with my regular GP about that next week and see if she can order in advance. The reason this is relevant is that I've noticed since the surgery - really more the last week or so - that I'm more emotional that I was before. There's been tears just about every day and usually over trivial things. Now perhaps it's just my "cycle" as J puts in, or perhaps it's the lack of testosterone letting the estrogen really do it's thing. I'm fine if that's how it should be, but I think I'd feel better hearing from a Doctor that it is the case and that may need to wait until May. :(
I think that about covers it for now, as I said all is going well for now.
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UPDATE: Almost 1 Month Later:
It's been nearly a month total since the surgery. The pain that I mentioned in the last update has been completely gone since perhaps a day after that update. Also within a day or two of that update the swelling started to significantly subside. The area is still larger than I would like, but it's now smaller than it was pre-op. I've been able to be much more active the last week or so, including being able to get back on the treadmill with no discomfort. At this point all appears to be going well, so I guess this will be the last update to this particular post. I hope somebody somewhere found the above useful in some regards. :)
- M
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UPDATE: Almost two months later:
All of the pain has went away, actually it did so weeks ago. I haven't seen quite as much "shrinkage" as I thought, but things have gotten smaller and seem to continue to do so, so perhaps I will end up with about what I expected. Regardless, I'm incredibly happy with the work Dr. Arnkoff did, I'm incredibly happy with my decision to have it done, and I'm incredibly happy with how much closer J and I are since that trip. It was a wonderful "bonding experience" for us and I wouldn't trade it for the world.
One other small note, I mentioned that Dr. Arnkoff had insisted on me seeing the testicles after they were removed, and that his assistant Sarah had explained that it was because sometimes people feel the cords afterwards and question if the testicles were actually removed. While at the time I really didn't want to see them, in hindsight I'm glad I did as there was a point where the swelling started to go down and the cords (especially the one on the left) did actually make it seem like the testicle was still there. So I do now understand why he showed them to me and I'm grateful he did.
- M
