98 lines
3.7 KiB
Markdown
98 lines
3.7 KiB
Markdown
---
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type: post
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title: Notes from Surgery Consult with Dr. Dugi
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slug: notes-from-dugi
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date: 2016-12-20
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---
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*This is mostly a scratchpad of notes right now; I will likely clean it up when I have more spoons, but getting my raw notes out felt like a good idea.*
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Schedule
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Next fall, probably september or october
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big effort to emphasize hair removal, usually the blocker
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Staying in the area
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: plan on staying nearby for about a month
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Surgery timeline
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learn dilation during first visit (3xday 30min each) - pelvic floor pt for dilation within week before surgery
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Surgery 7-8hrs
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5-6 days inpatient after surgery, total bedrest
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2wk, 4wk, 3mo visits
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visit a 3-4 days before
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Healing
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wound healing shows up ~ten days
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two layers of dressing after surgery: a pack, catheter, drain, plus sew outer labia together, plus dressing on top of that (off day two)
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no wound infection with any grs patients (really rare with surgeries in the area due to good blood flow)
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shower twice a day, rinse, press dry, pads
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uti risk: higher after, because distance between bladder and world is shorter, less protective layers, etc. Always urinate after dilating/intercourse
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History
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Started six months ago, booked out a year
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normally booked out of state through kaiser, weird for me to not be kaiser
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Begin of practice started in 2011, opened for surgery in 2016
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About thirty surgeries to date, waiting list 10-11mo.
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After
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most common revision: remove extra labial skin (added to give room for swelling during post op)
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some choice on how much of the clitoris is hooded
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also inner labia some choice on how big
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### Questions from the form:
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How many patients end up regretting their GRS? Are there concerns about post-surgery depression?
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: Might experience a letdown in terms of "what do I do now?" Day after Christmas sort of feeling. No reported regrets for Dugi, less than 4% instance of regret in general. Greater incidence of regret when the results are unsatisfactory
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I'm uncircumcised and have fairly severe phimosis, leading to a very sensitive glans. Can I expect it to remain too-sensitive after, or will it calm down over time?
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: Some people have hypersensitivity. Using more tissue for clitoral hood so shouldn't be a problem
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How much does insurance usually cover?
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: Ask surgery schedulers
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How much out of pocket medical costs should I expect related to my stay in Portland?
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: pads, surgilube, roll gauze
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How does neovaginal wetness work? My understanding is it basically doesn't, so you still need lube
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: Moist but not enough for sexual intercourse, but some were wearing pads to deal with excess moisture. Definitely need lube for penetration to prevent pulling on grafts
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On average, how long after surgery do your patients return to (physically light) work?
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: Definitely limit walking, no real lifting requirements, 1k steps per day within house for four weeks as a guideline. 6 wks back to work/light exercise, but let your body be your guide
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How hard is it for nonbinary, dmab, prefer to stay primarily testosterone-based people to get this surgery?
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: Dugi would be very open to nonbinary folks, but a lot of that's on WPATH (which suggests a year of hrt) and insurance (both patient's and the practice's). Two letters for all genital surgery
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How much say does the patient have in the appearance of the neovagina?
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: A little bit:
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hood of clitoris depending on skin behind glans - more or less hidden clitoris
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how much skin used for inner labia using similar skin
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Depth: depends what your body will allow through peritoneal reflection 4.5-6.75" (any more is unsafe), then lined with skin (two factors)
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mostly dependent on individual anatomy, and different folks will look different.
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