Archive for the ‘ Blood ’ Category

2 Months Post-op (Detailed Summary)

My progress at 2
months:

General Healing
In general I am pretty comfortable most of the time. I am, however, aware of occasional discomfort. I don’t know if this is from the tissue around my penis pressing on it, or from swelling issues I’ve had with my scrotum. I have been working on losing some weight (a few pounds already) and will get back in
the gym next week. I hope that (a) weight loss will help; and (b) there won’t be any more infection issues in my scrotum.

  • The swelling in the left side of my scrotum is either gone or very little. The left side still feels as if there is scar tissue or something semi-solid in there (I can feel the implant as well as other matter). That side is still larger than the right but it is not painful to touch. I can’t tell whether the left side is swollen or just larger because the implant is closer to the surface of the skin (which it is – the right implant is certainly deeper).
  • Over the last week or so I have had no more discharge (neither pus nor blood) from the hole left from the vaginal closure (see posts here and here
    for more about past discharge issues).
  • I finished the antibiotics three days ago. I hope I will not have a
    recurrence of the infections I’ve had in my scrotum.
  • The midline of my scrotum appears to be healing nicely. There haven’t been visible stitches along the midline since my primary care physician removed some stragglers 19 days ago.
  • I can no longer see stitches where the
    testicular implants were inserted though the suture lines are still a little lumpy. These lines are also slightly tender when pressed firmly.
  • The spot where the suprapubic
    catheter was inserted continues to heal well. I have a slight depression at the site which is purple
    in color and about .25 inches across. It is not sensitive.
  • The inside of my
    cheek feels pretty normal and I don’t even think about that donor site unless I touch it with my
    tongue.

Positioning and Movement

  • At this point I’m more comfortable if I walk normally (when my scrotum is swollen, however, all bets are off). I am still careful while sitting or
    driving but that’s mostly about the crotch of my pants. When they pull tight I am uncomfortable. Long hours sitting (while driving in particular) can be uncomfortable so I wear jeans which are as loose-fitting as possible.

  • I’m able to sleep on my side with little trouble. I place pillow(s) beside me so I can place one knee/leg on them but I did this even before surgery. Now it’s as much about
    comfort in my back as keeping pressure off my genitals. In some
    positions I do feel slight pressure but it is no longer really uncomfortable and I’m able to fall asleep – I just have to take care not to “pinch” my penis between my legs.

Pain

  • I started back to work on the 18th (9 days ago) and I drive a truck for a living. Most days, near the end of a long day driving, I have taken a couple of RRET Tylenol. I don’t have pain, really, just quite a bit of discomfort. The discomfort is due to my jeans and underwear rubbing my crotch but I haven’t decided whether my scrotum or my penis is what’s really bugging me. Regardless, by the end of the day I’m ready to get my pants off!

Voiding

  • I still sit to pee. I have too much extra flesh around my penis (fat mons)
    to allow me to grip it to urinate. Also, the urine sometimes comes out in a fan or some other weird formation. Maybe in time I’ll be able to drop trou and urinate standing. Urinating through my fly won’t happen before the mons resection.
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Doctors, Infections, and Stitches

If you’ve been following my recovery you know that I have had some yellow-colored discharge from the hole left at the end of the vaginal closure. I also had some stitches along that line which were relatively loose and knotted. I suspect those knots were causing some irritation and even a very tiny amount of bleeding.

E-mail exchange with Miro
I emailed Miro, my surgeon, and specifically mentioned the stitches and some swelling and discomfort I had a couple of days ago. I asked if it would be alright have the visible portion of the stitches along the closure cut away. He said that was fine. He also mentioned that while six weeks is enough time for capsules to form around the testicular implants, it is not enough time for complete healing of the scrotum. He thought the new swelling was caused by my activities a few days ago and wants me to continue to be careful while sitting, walking, and driving. I assured him I am doing so.

My Local Doctor
Yesterday I saw my general doctor about the stitches and the yellow-colored discharge. He cut away those loose stitches and the tugging made me pretty sore. He also took a close look at everything else and was happy with my healing progress (he last saw me 9 days previously). He told me that I needed to do a better job of cleaning the folds on and around my penis and to take care to keep them dry. I thought I’d been keeping everything clean but apparently not clean enough. And, frankly, there are folds and crevices I didn’t know about (I’m not a contortionist and it’s difficult to find and see everything while holding a mirror with one hand. I have, however, worked it out – I think – and am keeping things more clean and dry).

NOTE: There are a lot of details about post-op care that are left out by the surgical team. Typically we are very well-informed about the surgical procedures and risks – and I think they expect us to be just as well-informed about aftercare. The team also seems to have a general outlook of, “Don’t worry, it’ll be alright…” and they don’t worry about crossing a bridge until they actually get to a bridge. Sometimes getting information, especially speculative information, is challenging.

My doctor did not see any discharge until he dabbed a bit of gauze at the small hole at the end of the stitch line. It came away with a tiny amount of yellow fluid. While I was in the doctor’s office they also checked my urine for signs of infection (which has been a concern since the catheter came out). The urine test showed that I have a slight infection. Considering that and the yellow discharge from the vaginal closure my doctor prescribed more antibiotics (generic for Augmentin to take twice per day for seven days. I have been taking only one per day for the last several weeks). He also gave me a prescription to help avoid yeast infection (Diflucan). He asked if I liked yogurt and I told him I’ve been taking a probiotic on a daily basis. He was glad to hear it and recommended I continue (oh, and I bought more yogurt).

Soreness and Discomfort
Before my appointment with the doctor yesterday, which was at 1310, I stopped at the bank and a couple of stores. After the appointment I stopped for lunch and at a couple of other stores. All of the stops were relatively brief and didn’t really involve a lot of walking. But by the time I got to the last store it was about 1600 and I decided to skip it and go home. I’d become fairly uncomfortable by then and there wasn’t anything on my grocery list that couldn’t wait a couple of days. So I went home and about a half hour after I got there I took a Norco. I guess between the walking and driving, as well as the doctor pushing skin and tugging stitches, my scrotum was just over it. My pain level was at a 4, pushing a 5.

This morning I was alright and my discomfort was closer to a 1 on the scale. Naturally, I had high hopes of a good day and taking it easy. I left home about 1100 to drive 40 minutes to my grandmother’s house (she has an early appointment tomorrow and I’m driving her). I stopped on the way and picked up a couple of grocery items for her as well as my antibiotic prescriptions. By the time I got to her house I was becoming sore again. My mom joined us shortly after my arrival and we all had lunch and played dominoes. We were probably an hour into the game, about 1400, when I gave up and took a Norco. The pain had crept back up to what it was yesterday evening and I decided against ignoring it.

By the way, sitting at the dining room table wasn’t the problem. I was no more comfortable sitting in the recliner than on the dining room chair. It’s just the same old story of paying the price for activity the day after I’ve been moving around.

That’s it for the last couple of days. I’ll be out and about tomorrow until early afternoon. I have a feeling I’ll spend the remainder of tomorrow and all of Saturday on the couch. We’ll see.

6 Weeks Post-op (Detailed Summary)

My progress at 6 weeks:

 

General Healing

  • I don’t often use the strip of gauze I had been wrapping around my penis to protect that sensitive flesh. I used a strip of gauze for a couple of hours one day this week (until I urinated, which necessitates replacement). I didn’t bother to replace it.
  • The flesh of my penis is still sensitive but it’s better than it was a week ago. My underwear rubbing on the head doesn’t bother me the way it did previously.
  • I have had swelling in the left side of my scrotum for a few days and yesterday it was a bit painful. I’m pretty sure it was due to the activity level of the previous day.
  • No itch attacks this week.
  • All visible stitches on and around my penis are gone. There are still visible stitches where the testicular implants were inserted though there are fewer than last week. Occasionally I will notice a long end of a suture and I will cut it off.
  • I can still easily see the stitches along the lower part (back toward the anus) of the mid-line of my scrotum (this is also the vaginal closure). There is still a tiny hole at the back/dorsal end and I still have a very small amount of yellow-colored fluid coming out. This began 5 days ago. I no longer get blood draining from that hole but I do occasionally pick up a small dot of fresh blood from the area. I believe this is from those loose stitches and their knots. Miro (my surgeon) said it’s alright to cut those visible stitches. (I’ve made an appointment with my doctor. I’ll post an update about that when I have one.)
  • The inside of my cheek is feeling almost normal and I don’t even think about that donor site unless I’m brushing my teeth. It is still slightly sensitive (but not painful) to being brushed or bumped.

 

Positioning and Movement

  • I am still being careful while walking, sitting, and driving and have actually been limiting my activity to some degree just to be cautious.
       

    • I am able to sit upright, especially on firm chairs, as long as I am careful. A few days ago I spent a few hours playing cards while sitting on a wooden chair and I was perfectly comfortable. (I don’t think this would be the case if the swelling in my scrotum were greater).
    • I still walk with my legs apart slightly though I am able to walk with them together. I feel pressure if I try to walk normally but no pain.
    • So far I have been limiting my driving and only drive my personal vehicle a couple of times per week.
  • The last couple of nights I have been able to sleep on my side part of the night. Last night was even better. I stack pillows beside me so I can place one knee/leg on them and keep pressure off my genitals. I do feel slight pressure but it is no longer uncomfortable and I’m able to fall asleep. (I wake to move into and out of this position).
  • I am not back at work and won’t go back until 18 December. If I worked at a desk I could have gone back already.
  • Again, I am able to do more and for longer than I could a week ago. Having said that, I’m still taking it easy.

 

Pain

  • My overall pain level has continued to decrease and I have not used any pain medicine this week (neither prescription nor over the counter medication).
  • Yesterday I had some twinges of pain and an increase in discomfort in the evening. I did not take any pain medicine.

 

Voiding

  • I still get a little bit of burning at the tip of my penis when I urinate but it’s very little.
  • The last couple of days before the supra-pubic catheter was removed I began to get a bit of an infection around the entry point. I continued to take antibiotics after the removal and will take my last pill tomorrow. I am going to see my general doctor later today to have some stitches removed and to have this fluid checked.

Discharge update

The discharge I talked about yesterday has decreased as today has progressed. I still get a little bit of reddish yellow-colored fluid come out of the hole left at the dorsal end of the vaginal closure along the mid-line of the scrotum. Obviously there is still a bit of blood coming out there along with the yellow-colored fluid that started coming out yesterday. I’ll keep you posted as things move along.

One thing I did notice is that the initial discharge yesterday coincided with the swelling in my right testicle really dropping. That has certainly helped with my comfort level.

Not much else is going on. I have been a little achy today but not enough for medication. I’m also more tired/sleepy than normal. I’m finding it difficult to get to sleep at night and I’m sick of sleeping on my back. Sometimes it’s really difficult for me to get comfortable. A couple of nights ago I was able to position some pillows to prop one leg so I could lie on my side. Unfortunately, while it was a great change I was not able to sleep soundly in that position.

5 Weeks, 2 Days: Yellow Discharge

If you’ve been reading this blog you know I had my catheter removed on Monday (4 days ago). I had a bit of infection at the entry, including a very small amount of pus discharge, so I have continued antibiotics with the approval of my doctor. I still have 5 more antibiotic pills remaining. The catheter entry point is healing well and does not seem to be unnaturally inflamed.

Now for the yellow-colored discharge.

This morning I had quite a lot of yellow-colored fluid come out of the hole left at the rear end of the vaginal closure along the mid-line of my scrotum. I have had a very tiny amount of blood coming out there for a couple of weeks (which I believe is normal) but today is the first time I have had this yellow discharge. I used baby wipes and saline-soaked cotton sticks (aka Q-tips) to clean the area. This morning it was perhaps 4 or 5 ml of fluid total and it was enough to get on my underwear.

Throughout today I have still had a bit of yellow fluid coming from that hole but not in the amount I had this morning. I only see it now if I touch the spot with a saline-soaked cotton stick, a baby wipe, or toilet paper.

I suspect it may be a yeast (or similar) infection due to the antibiotics. I do take a probiotic daily but that may not be enough to completely counter the effects of the antibiotics. Other suggestions are pus or lymphatic fluid. I have my doubts about this (I think it’s too yellow for lymphatic fluid… but then again, I’m not a doctor, lol). I do wonder if the fluid came from around the testicular implant on the right side. The fluid release seemed to coincide with the disappearance of the swelling on the right side of my scrotum.

I emailed my surgeon and he said the most important thing is that the fluid is not urine (it is not). As long as it is not urine and it is yeast infection or some other type of fluid it is a minor problem. He is not terribly concerned and we agreed to wait to see what happens as we both expect the discharge to stop. I can always go to my doctor for cream or whatever.

EDIT to add:
Another guy had a similar experience at about 5 weeks post-op. He said a round of antibiotics cleared it up.

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