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location:  Transition  >  Bottom Surgery  >  Timeline This timeline contains notable events in my bottom surgery pre- and post-operative period. August 2005 I began to have my psychological evaluation by a psycologist at my graduate school in order to obtain a letter recommending me for bottom surgery. October 3, 2005 I received my first letter from the Acting Director of my graduate collage's Counseling Services Center. June 2006 I was supposed to have a consultation with Dr. Djordjevic in Maryland (he works in Belgrade, Serbia). Unfortuntely, I had to cancel at the last minute due to travel complications. December 2006 I began seeing a licensed social worker in order to obtain a second letter recommending surgery. January 13, 2007 I had a consultation with Dr. Miro Djordjevic (Belgrade team) in Baltimore, MD. January 20, 2007 I had a consultation with Dr. Meltzer in Burlington, MA at the First Event 2007 conference. January 27, 2007 I scheduled surgery via email with the Belgrade team for June 2007. March 15, 2007 I received my second letter from a private-practicing licensed social worker. March 21, 2007 I had a consultation appointment with a local pediatric urologist who agreed to manage my case post-surgically. May 23, 2007 I had my pre-operative physical exam, bloodwork, and chest x-ray. May 24, 2007 I had my pre-operative EKG. May 25, 2007 I paid the remaining 9000 Euros to the Belgrade team. June 16, 2007 3 Days Pre-op Left for Serbia on Air France flights via Paris. Exchanged USD for Euros at the Boston airport. June 17, 2007 2 Days Pre-op Arrived in Serbia. Exchanged USD for Serbian Dinars at the Belgrade airport. We were picked up from the airport by Marko. Registered with the Police Station. Unpacked at the apartment. Got basic groceries at the store across from apartment. June 18, 2007 1 Day Pre-op Went to the clini to meet with anesthesiologist and have blood drawn. June 19, 2007 Surgery Day Took a taxi to the clinic. Was shown to my room. Shaved my genital area. Met with all of the doctors right before surgery. Had metoidioplasty, urethroplasty, vaginectomy, scrotoplasty, and testicular implants by the Belgrade Team. Doctors checked on me in the middle of the night after surgery. June 20, 2007 1 Day Post-op A small hematoma on the tip of my penis was drained. I was allowed to drink water and have soup. Took a couple "penguin steps" while they changed the bed. Bandages were changed. Got one (of the three) IVs taken out. June 21, 2007 2 Days Post-op Woke up with migraine. I was allowed to eat a chicken sandwich, soup, and mashed potatoes. Walked across the hall to visit the other guy having the same surgery. Got another (of the three) IVs taken out at midnight. June 22, 2007 3 Days Post-op Bandages were changed. I was allowed to eat pastries, a chicken sandwich, and pizza. June 23, 2007 4 Days Post-op Bandages were changed. Last of the three IVs was taken out. Switched to a clamp at the end of the suprapubic catheter and empying it myself (instead of being connected to a bag all the time). Spasming in my bladder began. Went back to the apartment. Showered for the first time since surgery. Brushed my teeth for the first time since surgery. Began oral antibiotics. June 24, 2007 5 Days Post-op One of the doctors checked on me at the apartment. Spasming in my bladder became worse. June 25, 2007 6 Days Post-op Showered (did not get penis or balls wet). Marko checked on me at the apartment. Began periodically flushing the stint in my penis with saline to remove collected blood. Cleaned around my penis with cotton swabs and saline (hadn't been getting it wet in the shower). Spasming in my bladder become even more worse. June 26, 2007 7 Days Post-op No one came to the apartment to check on us. Began taking Miralax for constipation. June 27, 2007 8 Days Post-op Showered (got penis and balls wet, no soap). Marko checked on me at the apartment. Swelling around my mouth stitches had finally gone down enough to fully brush my teeth on that side. June 28, 2007 9 Days Post-op Took a taxi to the clinic. Had an ultrasound to see if any hematomas had formed from the vaginectomy. Stint in my penis was removed. Miro also ultrasounded my bladder to see if the catheter was in the bladder neck, but it was not. Decided not to have suprapubic catheter readjusted, hoping it was the stint that was causing the spasming. Miro tested my urethra for leaks and did not find any. Went out to lunch with the entire Belgrade team of doctors. June 29, 2007 10 Days Post-op Miroslav the taxi driver took us on a car tour of Belgrade and we walked around Kalmegden fortress. Bladder spasming continued, but it wasn't as painful as before the stint came out. Finally showered normally, using liquid dial soap on my penis and balls. June 30, 2007 11 Days Post-op Had breakfast with Miroslav the taxi driver. Began different oral antibiotic regimen. Marta came to the apartment to get our passports to sign us out at the Police Station. Marta examined me, removed crusted blood on the tip of my penis, and tested it for leaks and didn't find any. Showered normally. July 1, 2007 12 Days Post-op Marta and Vladimir picked us up from the apartment and brought us to the airport. Marta helped us check in, exchange our left over Dinars to USD, and showed us to the security checkpoint. Flew home on Air France flights via Paris. July 8, 2007 19 Days Post-op I had been bleeding for a few days from my stitches so I emailed Marta. July 12, 2007 23 Days Post-op Bleeding from my stitches had stopped (had lasted about a week total). July 14, 2007 25 Days Post-op We had a Penis Party to celebrate! July 15, 2007 26 Days Post-op Voided for the first time through my new urethra. Suprapubic catheter remained in place. July 18, 2007 29 Days Post-op Went to see a pediatric urologist (scheduled before surgery). Had a voiding cystourethrogram (VCUG) to check for fistulas, strictures, diverticula, or other complications. Had an ultrasound to check for any pooling fluid. Learned I had a fistula in the posterior 1/3rd of the neo-urethra. Urologist decided to leave suprapubic catheter in (will have another VCUG in four weeks). July 21, 2007 32 Days Post-op Began being treated for an infection around the insertion site of the suprapubic catheter. July 25, 2007 36 Days Post-op Stitches in my mouth were completely gone. July 29, 2007 40 Days Post-op Heard back from my local urologist, and he answered my questions. August 8, 2007 50 Days Post-op Stitches around penis and between balls have completely dissolved. Foreskin swelling beginning to go down. Walking normally. "Overactive bladder" symptoms present, but getting better since taking Ditropan (oxybutynin) regularly. August 24, 2007 66 Days Post-op Went to see my pediatric urologist again. Had another voiding cystourethrogram (VCUG). Found the fistula had not closed, but amount of fluid leaking through was much less than five weeks ago. Decided to leave suprapubic catheter in and have another VCUG in four weeks. Increased Ditropan dose to help with frequency and urgency urination issues. September 19, 2007 3 Months Post-op Began urinating through the new urethra, in preparation for the VCUG the following day. Noticed that when I urinated, a couple drops of fluid dripped out from where the vaginectomy was. September 20, 2007 3 Months Post-op Went to see my pediatric urologist again. Had another voiding cystourethrogram (VCUG). Found the fistula was still there and no noticeable change from the VCUG four weeks ago. Suprapubic catheter was removed. Instructed to wean myself off of the Ditropan over the next seven days. Told to return in three months and to call if urine leakage became significantly more. December 20, 2007 6 Months Post-op Went to see my pediatric urologist again. Had a Retrograde Urethrogram and (attempted) Fistulogram. Got no appreciable images from the imaging studies, but they clearly saw the fistula was still present. My urologist decided to move forward with the revision surgery to fix the fistula and remove the “pocket." He also drew me a picture of what the revision surgery will entail. December 26, 2007 6 Months, 1 Week Post-op Was treated for a bladder infection with Ciprofloxacin for 7 days. January 17-21, 2008 7 Months Post-op Had a culture and sensitivity urine test to re-check for the bladder infection. Began being treated for the bladder infection with Nitrofurantoin, but later changed antibiotics to Bactrim since the sensitivity showed it was more sensitive to Bactrim. Scheduled my revision surgery with simultaneous pubic liposuction and chest revision for mid-March. March 4-7, 2008 8.5 Months Post-op Went to my pre-op appointment at the hospital. Had a follow-up urine culture that came back negative. Received a letter from my health insurance approving me for “urethroplasty.” March 10, 2008 8.5 Months Post-op Day of Revision Had bottom surgery revision, specifically excision of perineal urethrocutaneous fistula repair using gracilis muscle graft, cystoscopy, and excision of penile shaft skin tags (defects from the last suture healing). Woke up with 2 drains (one in my leg and one in the perineum), a Foley (indwelling) catheter, and pressure bandages on my leg and right side of my chest (from simultaneous chest surgery revision). Stayed in the hospital overnight. March 11, 2008 8.5 Months Post-op 1 Day Post-revision Spent the day in bed (was not allowed to get up and walk). Stayed in the hospital overnight. March 12, 2008 8.75 Months Post-op 2 Days Post-revision Got up and walked around the hospital floor. Both drains where removed. Went home from the hospital. Aas given Tylenol with Codeine (pain medication) and Cephalexin (antibiotic). March 13, 2008 8.75 Months Post-op 3 Days Post-revision Switched pain medications from Tylenol with Codeine to Hydrocodone, because the former was making me very nauseous. March 16, 2008 9 Months Post-op 6 Days Post-revision Woke up with a very swollen left foot/ankle that eventually went down with elevation. March 19, 2008 9 Months Post-op 9 Days Post-revision Had first post-revision (fifth total) VCUG. Foley catheter was pulled. No leak was shown on the VCUG. Told to return to urologist in 6 months. March 22, 2008 9 Months Post-op 12 Days Post-revision Began to have the leaky/“peeing in my pants” feeling again. March 26, 2008 9 Months Post-op 16 Days Post-revision Began Bactrim treatment for another bladder infection. March 30, 2008 9 Months Post-op 20 Days Post-revision Still have leaky feeling with some fluid around suture lines after urinating. Decide to give it a chance to heal on its own and wait to contact my doctor at it until suture lines are completely healed up. April 1, 2008 9 Months Post-op 22 Days Post-revision Called my urologist because my bladder irritation was becoming worse. Had a urine culture and sensitivity done. Switched from Bactrim to Ciprofloxacin antibiotic. Mentioned to my urologist that I was still leaking. April 2, 2008 9.5 Months Post-op 23 Days Post-revision Scheduled a Retrograde Urethrogram for later that week. April 4, 2008 9.5 Months Post-op 25 Days Post-revision Had second and third post-revision urethrograms (sixth and seventh total urethrogram) – one RUG, one VCUG. Saw no evidence of a stricture or urethral narrowing. Noted a small diverticulum that may or may not be a small fistula causing leakage from the perineum. Bladder culture and sensitivity came back negative. Started on oxybutynin (Ditropan) to help with the bladder pain. April 10, 2008 9.5 Months Post-op 31 Days Post-revision Increased dose of Ditropan to further help with the bladder spasms. April 17, 2008 10 Months Post-op 31 Days Post-revision Reduced dose of Ditropan due to side effects. Leakage amount has reduced significantly, though still a pin-head of red, mucous material is consistently present. Noticed a bizarre red/pink “skin tag” of sorts around the perineal region that is not associated with the suture lines.