I've apparently overcome the sleeping pill I took last night, and the pain medication doesn't seem to be doing its full potency job this morning. Then again, I should get another around of medication to take after breakfast
that includes pain meds, which should help.

My groin, already still somewhat sore from the first two surgeries, hurts the worst. My side is a hot ache, but not so intolerable. However, the cumulative effects, along with my sore rump from being bedridden and the chill in the air have all fused into one grand hurt that refuses to go away regardless of what pills arrive to make the pain more manageable.

I'm also concerned about the amount of pain medication I'm taking. I don't want to become reliant on the stuff to get through the day, but at the same time I have trouble focusing well if I don't take it because everything simply hurts too much. I'd go back to sleep as it is, but, of course, my back hurts on top of everything else and there's just no finding a comfortable spot in this bed.

It really is the home stretch now, assuming everything goes according to plan, but it's hard to see it that way sometimes. This is, at least in memory, the worst—and the most different places at once—that I've hurt since
getting into the hospital, and so it's difficult for me to say now that from here it all gets easier, since it's really only gotten more painful the longer I've stayed. However, there shouldn't be any more surgeries, they do keep me
doped up when I request it, and I've got someone here to help me make sure I don't request it too often.

Pain aside, my biggest issue is the whole bedridden thing. I've done this before while being here, and it's just not easy for my head to accomodate. Despite my fantasies and my desires, the reality of being medically incapable
of taking care of myself is painful to accept, and it's frustrating in the extreme. I had to awaken Jessie to ask zim to get me something out of the refrigerator with which I could take some medication; I couldn't go get it myself. I'm under strict orders not to get out of bed for three days, not even to use the bathroom.

Jessie assures me that zie understands and doesn't mind helping me, but that doesn't make it any easier, even though I believe zim. The block is in my own mind, and I have to learn to overcome it. I just hope that I'm not in bed long enough for me to have to learn to overcome too much of it. I really could not face another round of this, not for a long time.


At 14h15 this afternoon, the gurney arrived to take me down to surgery. This time, Jessie came with me, as well as Praxis, and they both helped pass the forty minutes that I spent on the operating table waiting for Dr. Sanguan to arrive and get started. There is little so daunting, in my mind, as the time spent in anticipation of something one doesn't want but must have, like sitting in the waiting room at the dentist's office in anticipation of a root canal, or in the boss's office waiting to be fired.

The first time I went into surgery, I had a general anaesthetic. The second was supposed to be under an epidural but ended up being general when something went wrong with the spinal block. This time, I had the option of going totally under again—an idea no-one particularly liked—or having everything done solely under a local where needed. Now, in the past I've made my share of jokes about watching the procedure as it was happening. I even wanted Jessie there to take pictures or get a video or something. However, faced with the idea of being awake while the surgeon cut on me, I began to quietly panic. Unfortunately, the epidural wasn't an option this time, and nobody was happy with the idea of me having to go under general anaesthetic three times in such a short span, and so I agreed to have it done with just the locals.

Lying on the bed, Dr. Sanguan testing areas on my side to find out if I was numb enough for him to remove a hunk of flesh to act as the graft donor site, I about fainted, I think. Jessie kept me mostly coherent, telling me I was doing well and reminding me to let zim know about any pains or twitches, letting me squeeze zir paw when I felt something unpleasant or just needed to release tension. I think if Jessie hadn't been there, I'd have had a
full-blown panic attack.

In hindsight, the whole experience feels like having been in-scene to an unsafe master, Dr. Sanguan. Let me state right now that the man has brilliant hands and that I can't think of anyone I'd recommend more highly for the procedure than him, but because of how my head is wired, about half an hour into the two-hour process, I began to get very nervous and twitchy. I'm in very poor shape, and so limbs that lie still too long begin to lose
circulation. My arm started to tingle after about half an hour, and I had to ask one of the nurses for permission to move it because it had been tied down to the bed to keep me from flailing around with it. Shortly thereafter, my
butt started to get sore from lack of motion, and I tried to shift it but Dr. Sanguan told me to stop moving, and of course there was no option for me but to comply and wait.

I told him what the problem was, and he said when he was done with my side he'd let me adjust myself while he worked with the graft tissue. I did get the chance to move around on the table when he'd finished sewing up my side, but not very much, and by the time he was ready to numb up my groin to do the graft itself, I was still sore and not looking forward to another bout of enforced stillness.

He removed my catheter, something that hurt very briefly, then put in a new, shorter tube, which hurt a little more, but neither pain lasted very long. Then came fresh packing into my vagina, to keep me nice and stretched for the
three days I'll be stuck in bed, which he inserted with a speculum and nowhere near enough lubricant, or maybe it was just a larger size than to which I was accustomed. Either way, the insertion was stressful, even painful at points, and then he had to pull it out and do it again because he'd made it too long, which was another round of pain ending in discomfort at having something just slightly too big stuffed between my legs. On top of the catheter change it felt very much like I had to go to the bathroom, though I couldn't have done so even if I'd really wanted it. 

After all these steps, the nurses put my legs up in stirrups, effectively cutting off their range of motion and the circulation below my knees, which meant that inside of fifteen minutes of Dr. Sanguan stitching on the grafts, my legs went numb and I had to get Jessie to explain to the nurses what needed to be massaged. Then my butt followed suit and what followed really was little more than forty-five minutes of extreme discomfort, but no way to safeword, no way to say "stop" and have it mean anything, no way to pause while I got my bearings, my breath, my sense of safety. All I could do was lie there, let Jessie stroke my hair and endure the sensations.

Nothing ever hurt, except for the pinpricks of the syringes and a few misplaced jabs with the suture needles. That was, I think, the worst part. If it had hurt, I could've said something it all would've stopped right there. Nothing ever did, but they were as annoying and discomfiting as possible without passing the line at which I could've legitimately complained and been heard and had something done about the problems.

As I said before, I'm back to enforced bedrest. Dr. Sanguan's said I can't stand, can't walk, can't do anything that would put the graft or my side at risk for three days. After that, he'll remove the packing, check all the stitchwork and let me know how things have gone. I hope like hell that the grafts take this time. If they don't, I'm going to have to do this again, and I'm really not looking forward to that.

If I do have to have surgery again, I'm requesting the general.


Last night, I woke up at about midnight, and then again at two in the morning, in pain. I have no idea what caused it; it had happened a few times prior but it had always gone away fairly quickly. This time it wouldn't stop, and after about ten minutes I asked Jessie to go ask the nurse for a painkiller and a sleeping pill. Whatever it was, it went away and it hasn't come back since.

Dilation is basically routine now, but it's frustrating. It feels a little dehumanizing with the nurse helping me do it, though at least she doesn't stand and watch me now. I get about half an hour between when she leaves me with one of the stints inside and the next prepared, and when she gets back to clean the area and change my bandage. That half-hour is one of the most boring imaginable, because I can't really do anything more than watch TV or participate in any activity that takes more than one hand, I'm stuck on my back with my legs in the air during it, and I've got something probing uncomfortably up inside me at the same time. If it weren't a chore, it might be enjoyable, but then, usually when something becomes a job for me, it stops being fun.

Dr. Sanguan came by the room while I was trying to work on this entry, and he just confirmed that I did indeed have a bacterial infection, which is probably what cost me the penile graft. He's assured me that the scrotal graft is safe, and he's switched me onto a specific antibiotic to fight the infection that I have, and so I should be set to go under the knife again on the first. He was cheerful about the whole thing, and so it was kind of hard for me not to be as well, at least then.

Realistically, though, right now I'm just very upset, or at least I was when I first heard about this. Originally, I thought I'd be in the hospital for five weeks, and I was grimly determined to survive it. Then suddenly it looked like we'd be out in three, and Jessie and I were ecstatic. Now it looks like we're back on our original schedule, and for some reason we're both just incredibly bothered by that. Ennui has settled, and I'm still catheterized and tied to the hospital as a result. Jessie is going stir-crazy, and I'm having to fight to keep from getting incredibly frustrated at my inability to go out and do things away from this room.

At least hopefully we won't have to extend our stay.


Dr. Sanguan just took a look at my wound areas, and he's said that before he can perform the surface skin graft, he's got to wait for the culture test on my vaginal swab to find out if I've picked up any bacteria that could damage the graft, and that'll take another two days, so it won't be until Thursday at least that I have what I hope will be my last surgery. Once that's done, it should be reasonably fast that I heal enough to remove the urine catheter, and then from there things should start to take on a reasonably normal tone.

Also, today I had my first experience with dilation. The surgically-sculpted vaginal canal has to be kept stretchy and pliant, or else over time it shrinks and penetration becomes painful and difficult, something I certainly want to
avoid. Thus, the vaginal canal must be slowly dilated through the insertion and gentle movement of increasingly larger stents to ensure that the skin is kept flexible and ready to accept penetration. This also ensures that the
opening itself doesn't shrink over time, so that I'll be ready to accomodate whomever or whatever, within reason.

Lying flat on my back, a mirror between my legs, I watched in fascination and a small amount of arousal as Dr. Sanguan pressed the first stent up inside me. Again, it's an experience for which I lack the vocabulary. I didn't feel this one against the sides of the canal, only the pressure at the tip when it bumped into the back wall of the tunnel. With that, he removed it and went up to a two.

I made it up to a five today, whatever that means. Five inches' worth, in fact, for what good that does me. Supposedly with practice, pressure, diligence and a bit of luck, I can gain an inch or so of depth by pressing back. Five, however, has left me sore; it actually stretched a bit, which is necessary to add diameter, but in so doing, it did hurt somewhat. 

Unfortunately, the nurses are going to have to do this for me at least for a while, because I still have open wounds in the area where the skin grafts aren't, and those are what really hurt right now. The nerve endings at the edges of the good healthy skin are raw, and the stretching and tugging against them caused more than a little irritation.

This is the sort of experience to which I'm going to have to grow accustomed over time. Unfortunately, right now, time is something I have in abundance.


Today has been an adventure in more ways than one.

First, this morning, around 09h00 give or take, Dr. Sanguan arrived to change the dressing on my surgical site and remove the packing and such from my vaginal canal. The moment of truth, as it were. The nerve endings around my groin are, at the moment, generally irritable both from hair regrowth—the nurses shaved me there for surgery—and just the amount of surgical abuse that's been done to the area, and so I clutched rather tightly to Jessie's paw during the tape removal. Dr. Sanguan commented as he looked that around the outside, some of the external grafts didn't appear to have taken very well, which meant that I'd need a skin graft from probably my hip to cover the open areas. However, this is, he assures us both, a very simple procedure and one that can be done under an epidural, hopefully this time a properly administered one.

Removing the packing itself from the vagina was odd to say the least. When I had a cystectomy performed at the base of my spine, my mother had to pack the wound with fresh gauze every night and then remove it the following evening so I could shower and wash out the wound. That hurt, in no uncertain terms, and so I was exceptionally tense as Dr. Sanguan positioned his surgical tweezers. However, when he began pulling, I only really felt a sense of pressure, a bit of friction, and a strange release as the amount of gauze stuffed into me slowly subsided. Jessie quipped at the time that any minute now zie expected the doctor to pull a hat out of this bunny. Then the "solid" core came out with a wet slither, and everyone present, Dr. Sanguan included, made a slight gagging noise at the smell.

The nurse pointed a flashlight at my groin, and Dr. Sanguan peered and probed inside of me for a few moments while I sweatily clamped onto Jessie's paw in a death-grip, until Dr. Sanguan announced very pleasantly that my internal skin graft appeared to have taken without a hitch. My mate and I breathed sighs of relief, and then the nurse gave me a mirror and Dr. Sanguan let me look at my new arrangement.

I almost started crying right there.

Right now, four long rows of stitches run the length of the genitalia, holding everything in place, which make me look like Frankensnatch. However, Dr. Sanguan gently pulled apart the labia minora, still somewhat swollen beause of the surgery, and pointed out my clitoris. In so doing, he poked it with the end of the tweezers, maybe an accident or maybe to confirm that it was sensitive, but either way I jumped, rather startled by the sensation, which made him smile. Then he moved his fihgers down and showed me my new vaginal opening, and then without any foreplay he proceeded to push almost all of his middle finger into me.

I quite literally cannot describe the sensation now. Physically, there was pain, pressure, pleasure, a blend of signals that seemed totally irrelevant compared to the mental sensation of having someone's finger inside me that
way, of having the capacity to be fingered in that way. I just sort of went into autopilot for a few seconds, staring up into Jessie's face who was smiling at me, watching my response. Both Sanguan and the nurse seemed quite

After that, he changed the dressing on the remaining open areas and said he'd schedule a fresh skin graft from my hip for a few days from now to give everything the chance to heal a bit more, and then he said I could get out of bed, walk if I felt capable, even get a shower if I thought I could handle it. More enticing words I had never heard, and as soon as the dressing was finished and everyone save Jessie and I were out of the room, I got up and hobbled to the bathroom.

Now, not two days ago I had spoken with someone else about experiences just coming out of surgery, and she warned me that her stamina was next to nil and that taking a shower required her to sit down regularly and recuperate. I, however, felt myself invincible on having received such wonderful news, and proceeded to get into a tile shower, still attached to the wall by a urethral catheter, absent of any safety bars whatsoever, and cranked the heat up to just shy of scalding, after three days of enforced bedrest following a bad run-in with mixed anaesthestics.

As one might predict, hijinks did indeed ensue.

Inside of about five minutes, I started to feel light-headed, and I commented as much to Jessie. Zie said I should sit down, but by the time zir statement had registered in my mind, I realized that I was too unsafe on my feet to risk moving or else I'd fall over, and I was too far from anything useful to grab to sit down. I suggested to Jessie to grab the wheelchair in the bedroom that had been doubling as our adult bedpan, and so of course as my body went into power-save mode, I dutifully sent away my only possible point of stability to fetch an awkward implement too large to fit into the bathroom. 

It is a small miracle that I did not die falling face-first into the tile. 

I did, however, suffer a short-term blackout and when I awoke, I was on my butt, the urine catheter having been pulled loose, thankfully not from me but from the rubber tube to which it was attached, the one leading to the bag
hanging on the wall. None of my stitches were damaged, and I don't think I suffered any concussion, but whatever dignity to which I may still lay claim will likely be laid up in traction for a while.

Ultimately, I ended up sitting in the shower on the inner tube that Jessie bought for me to serve as the donut cushion that Dr. Sanguan advised we bring with us on the trip that I had forgotten to get before leaving for Thailand, head down, letting warm water run over my body. I washed my hair twice and had Jessie scrub the last of the medical tape remnants from my back. I think that's the most glorious shower I've ever experienced.

The rest of the day from there is kind of a blur. After that harrowing experience, I've just been on a sort of glaze, not really focusing on anything. Jessie and I spent the better part of the afternoon talking about video games and my simultaneous inability to get along with the majority and desparate desire to be part of it while zie sat on IRC, and then we experienced the wonders of homemade peanut-butter-and-jelly sandwiches with Milo while I again sampled something "exotic" off of the hospital menu: spaghetti.

My meals are part of the package deal for which I'm here, so there's no reason for me not to order something at every meal for Jessie and I to experience, even if we've ordered out for pizza or zie's gone for KFC or something, but most of the menu items, I won't eat, and of the ones I won't that Jessie will, zie won't enjoy eating that much. Every morning now is scrambled eggs and bacon for me, pancakes or eggs and bacon for Jessie. Lunch for me is chicken fried rice if I think I can face it again, maybe chicken with baby corn and steamed rice otherwise. Dinner is whichever I didn't have at lunch, usually, but I'm going to start ordering breakfast for dinner if I can't find something on the menu I can enjoy that isn't something I've already grown sick of eating. Jessie has taken to buying things at the local shopping center and putting food together on the fly, which is why the PB&J was such a treat for me.

The trip appears to have been extended for a few days, but nowhere near as long as we'd originally planned.


Two days have passed, roughly, since I last updated my diary, and I'm of mixed feelings on that. On the one hand, I did promise that I'd generate a thorough recording of the trip here, and on the other nothing "unusual" has
really happened. We did identify that the bedsores on my rump have been standard pressure sores that have gone away over time, and last night I was able to lie in bed comfortably for the first time in several days which I have
to say has been a blessing unto itself.

Last night, we ordered Thai pizza online, which I must say was far more of an experience than it needed to be,
but well worth the effort in the end. One of the local pizzarias had left a laminated menu at the nurses' station, and at the bottom they'd listed their website, amusingly hosted by the same company providing our dialup access. So, we decided that rather than try to go through the nurses, ordering through the staff and then dealing with cash hassles and such, we'd just take care of the entire transaction online and pay with a credit card, as they said we
could, which would make things nice and convenient.

Of course, nowhere on their site could I find a place to enter my credit card information, and then it said that it would email the details of the transaction to my listed mailing address, which I had marked as nobody@menagerie.tf to prevent any unwanted advertizing. So, I went through the entire ordering process again to get the details of the order, only to fail to have the email materialize at all. Right after that, I managed to
knock my catheter bag into the floor, and shortly thereafter I had a crying fit all over Jessie's arm.

The pizza itself was quite good, once it did arrive, though. I was so shocked when the delivery man arrived at the room—ahead of schedule, no less—that it tasted far better than I expected it would, even given that the sausages on my "meat deluxe" were curried. The cocktail sauce that came with our breadsticks tasted sufficiently of peanuts to give me pause, but Jessie adored it, saying that zie lacked any equivalent in Western cuisine and that for that alone it was brilliantly weird. 

This morning, I got myself out of bed and did my own cleaning in the bathroom. I still can't shower because of the epidural needle, so my hair is a horrendous mat on the top of my head, but I could take a washcloth to my own
skin, brush my teeth without having someone hand me the spit-tray, et cetera. There's something heavily empowering in being able to do one's own toiletries after so many days in bed. I could have gotten up any time along the way and done this, but until now sitting up hasn't been an option because of the bedsores, and before that I couldn't get out of bed at all.

Of course, now I'm getting out of bed and able to really walk around and such just in time for another few days of enforced bedrest. Dr. Sanguan came to the room just after I'd finished cleaning myself and inspected things, and he said everything looks set for the skin graft either tomorrow afternoon or Friday morning, so either I can have breakfast and not lunch, or lunch and dinner but not breakfast the next day. However, it also means that I'll be three procedures down, and only one to go before I should start being able to look at return flights to England to see Chloe again.

In a way, this whole trip has been an incredible vacation, despite the painful medical procedures under which I've gone while I've been here. I've gotten to see one of my extended family, I've gone through the last major stage in my transition, I've gotten to see two foreign countries I'd never visited before, and I've actually met a number of people here that, in one way or another, I'm glad to have gotten to know.

In a very small way, I'm going to miss Thailand. Not much, and not often, but it'll probably happen.


I have once again hit the point at which no matter in which position I put myself, something's going to hurt, so I might as well hurt sitting up at the computer. Getting sleep consists of putting my arms under my buttocks to try to relieve some of the pressure sores and then getting between fifteen and thirty minutes of nap until my arms go numb from the weight on them. Then I remove my arms, shift onto my side and crush the packing between my thighs for a few minutes, shift to the other side to do the same, then lie back again on my back, return my arms to beneath my rump and start the whole process over again. This worked remarkably well for the first day. It hasn't
worked since.

Tomorrow, hopefully, Dr. Sanguan will clear me for short walks out of bed, and at that point I can stand up and move around some and take the pressure off of my rump so that when I do lie down it isn't an instant muscle cramp with numb soreness along my buttocks. I haven't had weight on my feet in the last three days, give or take, I think. I was still walking around on Thursday. Today is Sunday morning, so it hasn't been that long on
recollection, but it feels like it has been.

The packing is, in and of itself, a minor demon sent from some level not quite hell to torment me. It's wedged up into the neovaginal canal, which isn't lined yet with anything, to ensure that the opening heals properly while the
skin which is to line the neovagina is in the skin graft bank, being carefully stretched and measured. Every time I shift positions, I can feel the thing rubbing painfully against the exposed nerves within, and it's needless to say
an unpleasant sensation. 

In the interest of completeness, I'm doing my best to keep these diary entries as genuine as possible, but if I keep typing on this one, it's going to degenerate into unpleasantries. I know when all is said and done that I'll have considered this whole experience worthwhile, but as it stands now I can't help but wish in some small part that I'd never started down this road. I know that's the pain talking, not my true feelings, but at the moment, there's a
lot of pain and it wants to have a say.

I've been out of bed three times now since Dr. Sanguan came around to check on my recovery. I'd managed to pop the covering to the packing, and he came in on his day off to check on my packing, tape it closed again and then clear me for short bouts of standing on my feet and walking around the room. I still have to be exceptionally careful, and my balance isn't too good because I still have the packing in place, but it has been wonderful just getting out of bed again, even if only for short bursts.

Tomorrow morning I go back to the OR for Dr. Sanguan to change my packing, which should be only under an epidural. The anaesthesiologist put in a special tube for that when I had the vaginoplasty performed, so with any luck I won't ever be totally unconscious again for the rest of the time I'm here, except when I'm sleeping, and that should become easier as well as I continue to heal. I'm really not in that much pain any more, despite what I was saying earlier today. A lot of that, I think, has just been from the ability to get off of my butt for short stretches, something I've been doing a lot lately. 

As I type this, we've had yet another brown-out. I say yet another because it's been the fourth since our arrival. Jessie was asleep for the first one, so when the second happened during dinner a few nights ago and zie noticed,
being able to say "You missed the first one" generated the most beautiful expression on zir face. I didn't say it to be mean, though; at the time I was pretty doped up on painkillers and in the middle of enjoying the first meal I'd had in several days that actually tasted good.

I said at one point that the worst thing about this place was the food. I lied. The worst thing about this place has been the company. Dr. Sanguan has his own ward in the hospital where all of his patients stay, and the general
attitude of everyone within the wing seems to be "We're a little family here," which I'm sure most of my extended family will realize doesn't sit well with me even under the best of circumstances. One of the girls in the group looks like she's had one too many facial reconstructions, her breasts are too large for her body in my opinion, and she claims to be an expert on the process because she came out as female at age nine and has been in treatment for twenty years. I managed to put up with her coming into my room for a brief visit while she detailed her experiences, but it was only by supreme force of will that I didn't ask her to kindly shut up and leave.

I'm probably going to have to speak with Pim about getting our return tickets changed. We're almost certainly not going to be here the full five weeks at this rate. I probably won't be able to extend the trip to England by much since I have to be under a doctor's care at all times or else I'm no longer on medical leave, but I can justify some amount of travel time based on the fact that my hospital stay took less time than expected.

I just hope when I get back to work that it hasn't all blown up in my face and that I'm not out of a job.


I've just met again with Dr. Sanguan, and he says that he thinks he can get me five inches of depth with my scrotal tissue, which means that even a second-stage colon graft is less advisable. This time, I agreed. Part of me feels like I've accepted a lesser solution, but at the same time I remember everything that he said could go wrong with a colon graft, even though those were one-stage surgical complications.

Am I giving up on my goal? Am I accepting a more sensible surgical result? Jessie and I have talked about it, and zie pointed out that Dr. Sanguan probably wouldn't be advising against the colon graft procedure if it were positively indicated by my medical conditions. The fact that I have as much scrotal tissue as I do means that there's no medical "need" for the colon graft to extend depth, and the desirable effects of the colon graft are for
the most part outweighed by the invasiveness of the surgery to get it.

Also, there's the fact that I've got at least one more surgery while I'm here, the scrotal skin graft into the cavity that's been carved out of my abdomen and packed. I've had a tube in the packing to drain out any bleeding, and I've been cathetered to keep me from needing to go to the bathroom since I left the OR on Friday afternoon. I've got no interest in extending my stay or putting myself into any more undue pain.

I think, of everything that's happened here, the worst honestly has been trying to find something on the menu that I can eat and enjoy. Jessie's the true neophile in the family, and even zie's had trouble keeping up with the spices, heat and flavorings in the food. I finally discovered the generic chicken fried rice, and the roo tried the chicken with baby corn, which I found I liked quite a bit. Everything else I've had has either failed to satisfy or tasted unpleasant.

The nurses will change my packing on Monday, and Thursday I'll have the second-stage skin graft. I have no idea how long I'll be here after that, but I've scheduled for five weeks if I need it. I hope I won't at this rate, but if that's what it takes, I'll do it. 


Phuket International Hospital is an exercise in surreality. A nurse delivering hot water woke us up this morning an hour ago, and we asked her to bring us more towels. When she came back with those, she informed me that Dr. Sanguan—what the staff call him and what I suspect is his actual family name—would be meeting with me this morning but that she didn't know when. I mumbled an affirmative and she left, at which point I commented to Jessie how strange it felt to be undergoing an intense and invasive procedure in a country where nobody spoke my language natively. Jessie's only comment in response was to consider the reverse, where any knowledge of foreign language would be near-accidental. I had to concede that point.

The shower in the bathroom here isn't a recessed stall, or a raised tub with a curtain around it. The whole bathroom floor is sunken about two inches, and the shower area is little more than a waterproof curtain isolating about a third of the floor space. We got a shower, and while I was toweling off, it occured to me that, if I didn't know better, I could easily see the bathroom as being located in a moderately priced hotel. Only upon stepping out into the rest of the room and seeing the single-occupancy white-sheeted gurney with attendant cot beside to remind me of precisely where I was and why. That only added to the disconnected feeling. It's not upsetting or bothersome, just... noteworthy.

The bed arrangement led last night to the first real recognition of what was happening. As I said last night, we met several people all here for the same reason. "Hotel Phuket," Kimberly called it, which brought to mind thoughts of "Hotel Saigon" and branching outwards from there. When Jessie and I finally went to bed, neither of us could sleep at first, despite the sleeping pill a nurse had given me an hour prior. I had to sit up and hold Jessie's paw for a while, just talking, and suddenly it struck me just how much I really was scared. The procedure itself doesn't bother me, but the idea of spending the next five weeks in a bed without my mate upset me heavily. Jessie and I both began crying, something I never expected to happen, and as zie curled zir arms around me, sobbing into my shoulder, zie called me something I'd never heard zim say before.


I've faced surgery before. I've had my gallbladder removed, two cysts removed from the base of my spine, and an ingrown toenail fixed, as well as a number of minor procedures only requiring local anaesthetic like wisdom teeth and stitches. I know how much what I'm going to be doing will hurt, and that I can deal with the pain. I don't think I ever really quite understood just how frightened Jessie was, of being with me, next to me, here to hold my paw and yet totally unable to help or do more than offer reassurances that the pain would go away. I don't think zie did either.

Zie said the only thing that could've been harder than watching me suffer, even for something we both knew I needed to do, would have been not being here. Zie said zie finally understood and had learned to respect zir father for what he had to face with all of his own wife's medical problems. Zie said zie'd be with me, until the end, and that zie never wanted me to let go until I wished to do so. I don't think I ever will.

Surgery at this point is going to feel almost anti-climactic.

I've just finished the consultation with Dr. Sanguan—which is his first name, the equivalent of "Dr. Harry" in the US—and I'm not too pleased with the outcome, but at the same time I find it hard to argue with his analysis. He said I have ample scrotal tissue but negligible penile skin, and that I wasn't a good candidate for one-step colon vaginoplasty. We talked briefly about possibly doing the colon graft later this trip, or perhaps coming back in six months to a year if I decide I'm not happy with the lack of depth or the lack of self-lubrication, but he said full-stop that tomorrow would be the normal vaginoplasty and that we'd discuss later in the trip further options.

After spending six months or more psyching myself up for the pain and suffering of the one-step colon graft, to be told "you don't qualify" is a let-down. At best, I'm looking at having two surgeries while I'm here, something I'm certainly not happy considering. At worst, I'm looking at having to schedule a second trip to Thailand, which means getting more time off from work, more money into the flights, et cetera. It's... disappointing.

At the same time, I'm relieved that Dr. Sanguan was honest with me. It would have been far worse to come away with some of the complications mentioned for people who weren't a good fit for the procedure. Jessie and I have been doing our best to downplay the fact that my results won't be what I expected and talk up all of the positives that result from this. I won't be in the hospital as long, I won't be in pain as long. I may have more time in England. I'll be able to use it more quickly after we get back. Best of all, sayeth my mate, it won't cost as much, so once again I'm saving money.

At times, I feel like I'm constantly fighting this battle. I never quite get what I want, only what will suffice. This is probably the biggest instance of this happening to date. I feel cheated, but nobody's to blame. If anything, it's my genetics at fault, but then that road leads to the "I should've been born female" path, and going that way just degenerates into nailing my paw to my forehead. I'm disappointed, and yet there's no way to argue with it. I can either accept what I'm offered, or I can live with what I have now. I can't have what I desire, but I can learn to make do with what I can get.

I wonder if everyone faces this, or if I'm the only one, or if everyone else does but nobody else thinks it's unusual.

This afternoon at 15h, a nurse came to the room and left me a shotglass of what I can only describe as lemon battery acid. I forget exactly what it is, but anyone who's had any kind of intestinal surgery knows precisely to what I'm referring when I mention it. Essentially, it induces a good case of diarrhea, forcing everything in the intestinal tract out of the body. I then got another dose of it at 17h, ensuring that my system's been totally flushed.

The only hitch, of course, is that I'm not having the colon graft procedure, thus I can't see the need for cleaning out the colon. I suppose that it's always a good safety procedure to make sure that there's nothing that could cause contamination of the surgical site, and I know it's normal protocol to stop all food and water intake at midnight the previous day, but this somehow seems a bit ridiculous. I've had two bowls of chicken broth, three glasses of tea, one can of Diet Pepsi, and close to two liters of water with this reverse purgative to ensure that I'm clean from one end to the other.

At 20h, a pair of nurses shaved the surgical site in preparation for tomorrow morning's operation. They pulled the curtain around and blocked Jessie's view of the proceedings, which seems a bit silly to me. It's not like zie hasn't
seen it all before. Then again, I was mildly irked at being asked to change into a hospital gown in front of strangers, and even though I did it with a minimum of complaint I was a bit flustered over it. For as many claims to lack of body conscience as I've made in the last few months, it was a bit surprising for me to discover this last remnant of what some might call dignity. By now, I'd figured I'd gotten over that sort of thing.

It's now twelve hours to surgery, give or take fifteen minutes, and I'm about to go to sleep. Last night, I crashed out at 22h00, and I was up this morning at 06h30 when the nurses came to clean the room. Hopefully tomorrow morning I won't have three hours between when I wake up and when I go under the anaesthetic. Jessie's asked me to make sure zie's awake before I go under the knife. It feels a bit unreal, even now. This was always something that would happen "someday," and now even if it's not precisely what I'd hoped, someday is tomorrow, and there's the possibility of getting the rest of it before I leave, or once I'm fully recovered from this and have a bit more money in the bank.

I don't know if I'll write a diary entry tomorrow. Dr. Sanguan estimates that the surgery will be about five hours, and after that I'll be in the ICU for most of the afternoon and possibly overnight. Hopefully on Saturday I'll be able to get back to the computer and detail how I feel. I won't have any details of the surgery itself, seeing as I'll be unconscious for it. At least, I'd damn well better be unconscious for it. I've awoken once in the middle of surgery already; I've got no desire to do it again.

I really don't have anything more I need to say about it. I've been asked for a detailed report on the process, and this is really it. Most of the time, we've been alone in the room, aside from the visits from nurses and Dr. Sanguan to take blood pressure, clean the room, deliver fresh towels and sheets, and generally keep the place clean. I've had one surgical consultation, and tomorrow is the operation. From here, the rest of the time in the hospital is recovery, and now probably much less of that than planned. I'll keep up notes of what happens and how things proceed, but there's really nothing more about the preparation for the surgery itself.

I need to update my site design, too. As of tomorrow, I'll have burned the bridge.


The jet lag is taking its toll, but I want to put this down somewhere before I forget to do so. Anji asked me to keep a detailed account of the experience, and I've agreed.

The flight from Heathrow to Bangkok was uneventful, though nine hours in any plane is enough to drive me crazy. There was no power adapter for the computer, so after working for an hour on some commissions, I got the warning light telling me that the battery was low. It was fully charged when we left Chloe's, but it doesn't last long.

I'm worried about her, honestly. Seeing her again was wonderful, and going to Brigg to visit her mother's house felt a bit like coming home, but I know she doesn't get much contact with other people, certainly not people with whom she can really be herself. I wish I could spend more time around her, and I know I'll be seeing her again in a few weeks, but after that I have no idea when next I'll have the chance to visit the siscoonie, and that's upsetting, even now. Leaving yesterday evening—twelve hours ago, give or take—was painful. I almost started crying twice in the airport as we entered the secure area.

Bangkok's a sauna compared to our normal environment, and Phuket, being an island, feels even worse. When we got to our room at the hospital, it was raining, but not normal rain. The air holds so much water during the day
that, when the temperature starts to drop after sundown, less moisture can be held in the atmosphere and the excess condenses out and falls to the ground. I remember seeing this effect in Singapore, but that was only two days. This will be five weeks.

One of the other patients in Kunaporn's wing came over to our room as soon as we were situated and semi-insisted on taking us around to meet everyone else in our wing, the others here for the same procedure or related surgeries. I mentioned my desire to have the one-stage colon graft because of the quality of the result, and Kimberly, our guide, began trying to dissuade me from it. I was rather annoyed, and a little unnerved. I got to meet someone else that had had it done, and she's now on her fourth day in bed, cathetered to within an inch of her life and still in pain from the operation. I tell myself I'm a tough chick, that I've had my gallbladder, two cysts and an ingrown toenail removed, but I'm still a bit spooked.

I'll have to consult with Dr. Kunaporn tomorrow about surgical options specifically. Apparently he doesn't like doing the one-step colon graft unless the patient insists or he can see no other way of doing the surgery. I intend on insisting, even granting the increased recovery time and the risk of infection. I'm here for the results, and I'm willing to do what it takes to have the body I want. I can't help but feel that, were I to go back with a less-than-ideal result, I'd end up resenting and regretting the whole trip, instead of planning on coming back for a repeat visit to have my depth extended. Plus, the idea of the procedure I want is to get me away from relying on artificial lubricants; skin grafts from the thighs and tummy won't give me that.

I know what I want. Now I just have to get the surgeon to give it to me, and then deal with the consequences of my decision. I just hope I'm healed enough to go home by the departure date.


We arrived in England last night or this morning or something, and then shortly thereafter Chloe brought us the three hours give or take out to Brigg. We stopped somewhere on the M25 for a traditional breakfast—eggs, bacon, sausage, fried tomatoes, and tea—on the way home. Shortly after arriving, of course, Jessie and I crashed heavily since we'd been up since 10h00 the day prior, and by the time we got to the raccoon's house we'd been awake for close to twenty-seven hours.

So far, everything here is going well, though last night I did have a bit of a hormonal breakdown. Before I left home, I had put on a few pounds saying I'd been good and that it was going to be a while before I had any of those things again. Then last night, I was being something of a hormonal bitch and Jessie was eating cookies, so I grabbed one and noshed it. Then I went for a second and zie said zie'd have no sympathy when Kunaporn told me I was too fat for the operation. Needless to say I put down the second cookie.

Later, though, when I was curled up in bed next to Jessie, I couldn't get the thought out of my mind. What if he did refuse, for whatever reason? I almost started hyperventilating over it. To get this close and then be denied... I
don't know if I could handle that. It took much coaxing and petting from Jessie to get me to relax enough to sleep, and I spent a while sobbing into zie shoulder anyway.

I'm too close to success to fail now. Things could still go wrong, but I can't allow myself to think about them. We leave for Thailand on the twelfth, and three days later I go into surgery. I can't consider things happening any
other way.


I've been off of my hormones now for four days, and while I'm not doing nearly as bad as I feared I might, I'm certainly not doing as well as I'd hoped. I won't say it's hubris; I didn't walk around saying I wouldn't notice being off my pills. I will say that it's a lot worse now that I'm aware that I'm not taking my usual dosage. Before, when I had the pharmacy screw-up, I didn't know I was supposed to be having this many problems, and so it didn't feel
like I had them. At least, I don't remember having them. Jessie says I was a living terror, but I honestly don't remember.

At any rate, I've been all over the map emotionally. Mostly I've been going from intensely frustrated to miserably depressed at my loss of control, and then irritated at my own hormonal swinging and then frustrated at my inability
to control my emotional state, and so on and so forth. It's a weird road to walk, knowing that I'm irrational and unstable and being unable to stop it, only to watch as it happens. It's a bit like a roller coaster, unto which I have likened my mood swings before.

Tomorrow—later today, really—I'll be boarding the flight to England, the first leg of the trip. Hopefully I'll have bottomed out by then, or at least this bloody headache will have resided. Maybe.


I think this is actually the longest that I've managed to put off updating my diary. Six weeks seems like a long time, but to me it feels like no time at all. In the next few weeks, I'll probably be adding a lot to it in a very short time, since I'm about to leave for my trip to Thailand. Today's been a bit hectic, since it's my last day at work, but after today, things will start happening that require notation here.

One thing of note did happen today, or rather didn't. I didn't take my hormones this morning, nor will I tonight. I've started the two-week countdown to the surgery itself, and for the next fourteen days I'm off of my pills. This is one of the big reasons why I'm not too worried about the insurance people covering these first few days; I turn into an unlivable bitch when I'm not taking them regularly.

I just hope Jessie survives to see the end-results of the surgery. The last time I ended up not taking my prescribed dosage, zie called an exorcist.

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