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99 lines
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<title>Zk | 2016-12-20-notes-from-dugi</title>
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<h1>Zk | 2016-12-20-notes-from-dugi</h1>
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<p>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</p>
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<p><em>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.</em></p>
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<dt>Schedule</dt>
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<dd>
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<p>Next fall, probably september or october</p>
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<p>big effort to emphasize hair removal, usually the blocker</p>
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</dd>
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<dt>Staying in the area</dt>
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<dd>plan on staying nearby for about a month</dd>
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<dt>Surgery timeline</dt>
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<dd>
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<p>learn dilation during first visit (3xday 30min each) - pelvic floor pt for dilation within week before surgery</p>
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<p>Surgery 7-8hrs</p>
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<p>5-6 days inpatient after surgery, total bedrest</p>
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<p>2wk, 4wk, 3mo visits</p>
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<p>visit a 3-4 days before</p>
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</dd>
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<dt>Healing</dt>
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<dd>
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<p>wound healing shows up ~ten days</p>
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<p>two layers of dressing after surgery: a pack, catheter, drain, plus sew outer labia together, plus dressing on top of that (off day two)</p>
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<p>no wound infection with any grs patients (really rare with surgeries in the area due to good blood flow)</p>
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<p>shower twice a day, rinse, press dry, pads</p>
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<p>uti risk: higher after, because distance between bladder and world is shorter, less protective layers, etc. Always urinate after dilating/intercourse</p>
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</dd>
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<dt>History</dt>
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<dd>
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<p>Started six months ago, booked out a year</p>
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<p>normally booked out of state through kaiser, weird for me to not be kaiser</p>
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<p>Begin of practice started in 2011, opened for surgery in 2016</p>
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<p>About thirty surgeries to date, waiting list 10-11mo.</p>
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</dd>
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<dt>After</dt>
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<dd>
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<p>most common revision: remove extra labial skin (added to give room for swelling during post op)</p>
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<p>some choice on how much of the clitoris is hooded</p>
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<p>also inner labia some choice on how big</p>
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</dd>
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</dl>
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<h3 id="questions-from-the-form">Questions from the form:</h3>
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<dl>
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<dt>How many patients end up regretting their GRS? Are there concerns about post-surgery depression?</dt>
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<dd>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</dd>
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<dt>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?</dt>
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<dd>Some people have hypersensitivity. Using more tissue for clitoral hood so shouldn’t be a problem</dd>
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<dt>How much does insurance usually cover?</dt>
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<dd>Ask surgery schedulers</dd>
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<dt>How much out of pocket medical costs should I expect related to my stay in Portland?</dt>
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<dd>pads, surgilube, roll gauze</dd>
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<dt>How does neovaginal wetness work? My understanding is it basically doesn’t, so you still need lube</dt>
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<dd>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</dd>
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<dt>On average, how long after surgery do your patients return to (physically light) work?</dt>
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<dd>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</dd>
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<dt>How hard is it for nonbinary, dmab, prefer to stay primarily testosterone-based people to get this surgery?</dt>
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<dd>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</dd>
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<dt>How much say does the patient have in the appearance of the neovagina?</dt>
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<dd>
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<p>A little bit:
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hood of clitoris depending on skin behind glans - more or less hidden clitoris</p>
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<p>how much skin used for inner labia using similar skin</p>
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<p>Depth: depends what your body will allow through peritoneal reflection 4.5-6.75” (any more is unsafe), then lined with skin (two factors)</p>
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<p>mostly dependent on individual anatomy, and different folks will look different.</p>
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</dd>
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</dl>
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<p>Page generated on 2020-06-24</p>
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