CW: gross medical/bathroom stuff

TL;DR

My friend and I had vaginoplasties with Dr. McGinn two weeks apart. Tragically, she had complications with a rectal-vaginal fistula (a 0.6% chance of occurrance). My results are good so far. I also talk about the experience of the Gaia House vs a hotel near the hospital in the context of the coronavirus pandemic.

Background

I'm a 40yo software engineer from Chicago who started seriously questioning my gender/sexuality in 2017, started HRT Jan 2019, FFS with Dr. Deschamps Jan 2020.

My friend, "Steph," (an alias) is three years younger. We met through a mutual friend when that friend learned I was going to have FFS with Dr. Deschamps and introduced me to Steph who just had hers. We've casually kept in touch and hung out since then. Her timeline is similar to mine but FFS was a literal life saver for her. Transition has been rough too as she's experienced problems related to FFS (botched bandaging/broken nose by BF) and electrolysis (3rd degree burns during a large volume session).

Prologue

By the time I finished FFS, I had decided I wanted bottom surgery. I was a bit overwhelmed with all the options but I was to the point where I just wanted something done, and given I was entering my 40s, I didn't think I needed a porn star-quality vagina, just something "good enough" and was going to settle on Dr. Schechter, even though I was getting a lot of "hmmmm OK"'s from everyone I mentioned it to. The big advantage of Schechter was the hospital was literally walking distance from my apartment, which is a big plus considering I don't have family support, just chosen family in Chicago.

While I was waiting for a Schechter consult, Steph mentioned to me she was looking into Dr. McGinn. I had passed over her previously because of distance from home and no real support in the Philly area. But her results looked fantastic and her waiting list was much shorter than Schechter's. I had a consult with McGinn in July 2020 and got scheduled for surgery Dec 1, 2020, depending on how bad the pandemic would be by then. I decided I'd figure something out in terms of local support, like hire an in-home nursing service or something. Plus I knew one person who lives in Philly who might be able to provide some small support.

I told Steph my date and she said, "great, that's just two weeks after mine!" So we planned that I would take care of her for two weeks, then she would take care of me.

One of the most important pieces of planning this was that McGinn's office wants to be sure that you will be in the New Hope, PA area and have a designated person who can pick you up from the hospital (since you'll be on narcotics and could in theory be taken advantage of if some taxi driver drives off with you). So they heavily suggest you stay at the Gaia House because at the very least they know a driver who you can hire to take you to the B&B. The first week is also difficult to do alone.

Another weird thing is, while Dr. Deschamps gave me all my drugs the day before surgery, Dr. McGinn gives out the prescription at discharge, so it's up to your helper to pick up your meds at a CVS on payday Friday while you writhe in agony in the passenger's seat. So there's a hard dependency on having someone with you.

Chaotic Countdown

As the day drew near, my plans all got thrown out the window. My immediate family were definitely not going to take care of me, or even let me stay with them after my initial recovery. That completely ended my relationship with them. Steph wasn't sure whether she'd be able to go through with surgery as she had complications with electrolysis. My one friend in Philly told me she actually doesn't know how to drive and wasn't sure if she could get way out to New Hope. The Gaia House did offer to connect me with a driver, which was great. But I was also worried about finding personal help, which was hard in the remote town of New Hope.

I was determined to make this work, so I found there's an Element Hotel (a bougie Residence Inn) only a mile from the Capital Health hospital just outside of Trenton, NJ. Hopefully my friend in Philly could at least get there to drive me. Worst case scenario, I could walk to the hospital for surgery and hire an in-home nurse to get me back to the hotel and take care of me.

On top of all these wrenches thrown into my plans, there was the pandemic, which worsened each day as Dec 1 approached.

But finally good news came that Steph could go ahead with surgery and I could drive out with her. We'd stay at the Gaia House for her recovery, then move to the Element next to the hospital for my surgery.

All I had to do was survive COVID, survive the election, and hope the hospitals didn't shut down from the pandemic!

Steph's Surgery, The Gaia House

The town of New Hope is super cute, it's like a little, queer Stars Hollow near where George Washington crossed the Delaware. There's a system of trails along old canal towpaths you can walk/bike for miles and visit other cute towns. There's a historic railroad with a functioning steam engine for all the train nerds like me. There's also a good collection of restaurants, all withing walking distance of the Gaia House. However, during a pandemic and not wanting to risk any exposure, I found my options extremely limited to just a few restaurants via Doordash/etc.

The Gaia House itself is equally lovely and would be perfect for a week-long vacation. We stayed in the largest suite, which included what was basically a closet with a cushioned bench that could be a "bed" or a cramped work area. Again, in a non-pandemic world, I could have found great coffee shops in town to work from, or even the Gaia House's cozy shared spaces, but it was frustrating to be trapped in a closet doing conference calls.

Bill and Rob, the hosts, are super nice and helpful. However, with me worried about minimizing exposure before my surgery, I was a bit annoyed by the frequent, close, indoor interactions with the hosts and other guests. Additionally, all we had was a tiny dorm fridge to store all the food we needed (liquid diet items, etc.) so getting groceries and having room-made meals wasn't really an option. The doors were also not great at blocking sound, so any other guest/host noises carried directly into our room.

I really appreciated getting to visit Steph in the hospital and see everything that would be happening to me so I could know what to expect. Definitely a welcome comfort when no family support is there.

Initially, it seemed as though Steph's surgery went great, but not long after coming back to the B&B she noticed a lot of yellow/brown liquid soaking into the packing. At her first post-op she found that she had a rectal-vaginal fistula. She was only the 6th person to have this happen out of the long list of patients Dr. McGinn had. Dr. McGinn had tried to repair it as soon as it happened but it seemed the flap that was sewn on wasn't holding. This was devastating to Steph, she was so looking forward to having a vagina but this now means she needs a colostomy bag for 6 months and a vaginal revision. She won't be able to dilate so the neovagina will shrink and have to be replaced somehow with either a new graft or a peritoneal pull-through.

This definitely put a huge damper on what was supposed to be an amazing transformational journey of two trans sisters. Joy and solidarity were replaced by sadness, awkwardness, and shame. We went from planning beach vacations together to Steph telling me how she had to stick a gloved finger in her vagina every time she pooped to block the fistula.

My Surgery, The Element Hotel

We moved to the Element, which is really nice. My previous job involved a lot of travel and hotel rewards so I got all kinds of bonuses to get the executive king suite, which is basically a 1BR apartment with its own kitchen and full fridge, super nice for two trans girls with liquid diets. The accessible bathroom also nice for those dizzying catheter pees.

The hospital/Element Hotel are on the outskirts of Trenton, which puts you in the delivery radius of a ton more grocery and restaurant options, which was great during the pandemic. The pizza/Italian here is really good (yes, I'm a Chicagoan who thinks Chicago's pizza landscape is only so-so).

I had to drop Steph off at the ER for her colostomy procedure the day before my surgery, which brought my plans back to square one. Steph would need her car to be at the hotel when she got discharged, so I would need to find my own way to the hospital for my 4:45AM srugery time. I tried doing an Uber Reserve for $55 to take me one mile to the hospital but I wanted to make sure I had something definitively scheduled (and yes, Uber is evil).

The liquid diet/bowel prep day SUCKED. Magnesium citrate is the devil's bile. Enemas also suck (I never really did enjoy full anal stuff anyway). I also got a pre-checkup and a COVID test that came back negative. (my first COVID test of the pandemic!)

But! I was just one day away from surgery! It was finally here!

On the morning of surgery, my Uber Reserve was never confirmed and never showed up. There was no Lyft or Uber available at 4:30AM on the outskirts of Trenton. So, I decided to just walk the mile there. It wasn't that bad crossing a freeway overpass when there was virtually no traffic. I just cranked "Take me to the Hospital" by The Prodigy as I power walked.

After all the prep, Dr. McGinn came in and chatted over what we were going to do. She was super reassuring and I was excited to get it done. I knew Steph's complication was rare, but I was now aware that just because I make it out of the OR doesn't mean everything is hunky dory.

They hooked me up to the IV and an initial sedative as I was wheeled into the OR. It was a sort of party atmosphere as happy music was playing while everyone was getting set up. The last thing I remember is being strapped to a cross-like gurney.

The next thing I remember is waking up in the most excruciating pain of my life. I was in a staging room of some sort where a curtain separated my bed from others. As I moaned in pain, the nurse gave me some pills and told me the meds were kicking in soon. I started to feel OK again as they wheeled me into my room. I was fully concious by the evening and Krystal, the PA, told me "nothing out of the ordinary happened." Great...!

The next few days started with me anxious to click the morphine button every chance I got, but by the end the pain was minimal. Lots of boredom, watching the clock tick, just didn't feel much like TV or games, but did get some DS9 time in. Some phone calls with friends. I was worried about being alone for this portion, but honestly with all the nurses around it was fine.

I couldn't really see any of the results other than a bandaged mons. I felt happy to have this done but still uneasy about what the final results might be.

Steph had recovered from her colostomy operation so she was able to drive me back to the hotel on discharge day as planned. She stayed to take care of me the first couple days but we agreed she should go home to her family and that I would be OK for the rest of recovery. She got me a reacher/claw grabber thing, which has been a godsend.

Once I had my first post-op, I felt much better. Having stitches, catheter, and packing out make a huge difference. They had me hold a mirror up while they poked around and I finally witnessed the bloody mess that is my vagina-still-in-progress. It looks like I might want to get a small cosmetic revision later since my penile skin was inadequate/not malleable enough. I still can't dilate until second post-op.

In the end, everything worked out OK, but was definitely full of surprises, disappointments, and challenges. Every day, I'm feeling better and happier with how things are turning out.

And now my life begins again!

A special shout out to Dr. McGinn and her team and the nurses at Capital Health, they are all wonderful people and were super helpful. They have definitely been helpful given Steph and my tough situations going solo together.