Goodbye, Boobies Week Two: Wound Care Tips

My healing continues swimmingly.  Honestly, I don’t think I could ask for an easier recovery course. I’ve had no swelling, no oozing, no wound separation, no pain, no infection.  Which is really very fortunate because, as happy as I am with Dr. Steinwald, and as much as I think he does excellent work and would recommend him to anyone, his actual postop instructions have been maddeningly vague (I read a similar complaint on someone else’s blog about him, so not just me).

I realize it’s tricky; everyone’s results and rates of healing are different (I feel like a veritable Wolverine with how fast things seem to be proceeding).  Still, it would be nice to have some more specific rules to follow.

For instance, activity.  I asked at my 1-week visit when I could resume biking, and he said by the next weekend (so two weeks out), but “gently.”  Mind you, the packet says at two weeks you can start light exercise such as walking, but I’ve been walking since day two, so obviously that might not be applicable.  (I’ve actually gone out on the bike twice at this point, going half the distance I’m used to at half the speed (my interpretation of “gently”).  It’s strange because my legs are still twin powerhouses of muscle, while my lungs feel like they’ve shriveled to the size of well-cooked hamburger patties.  My legs want to go, go, go while my lungs are holding up one finger begging, “hang on…<pant, pant>…just give me a second…<pant, pant>.”  So my first bit of advice is do yourself a favor and get in as good a shape as you can before surgery, because it’s very disheartening how quickly that conditioning vanishes when you’re resting up for a week or more.)

(I guess I’m not completely pain-free.  The nipples have started healing in earnest, and every so often I’ll get a little twinge in one of them.  Or, at worst, a feeling like someone is twisting one really hard.  Both feelings go away after a few seconds thankfully.)

So with a dearth of helpful tips provided by the surgeon, I decided to write about my process, which has been trial and error, to maybe help give someone ideas for their own.  Please note, I’m not getting paid to talk about any of these products, and none of this has been endorsed by a medical professional.

It will also most likely be enormously boring to anyone not looking for this kind of advice, so I’ll get the good stuff out of the way first.

Life without boobies.  Let me tell you, it’s even better than I expected. To walk to the mailbox, or go to the grocery store after just throwing a shirt on, not worrying about which bra will make my chest look the least grotesquely oversized; the feeling of jogging down stairs without feeling excess fat jiggling with every step. It’s how I feel the week after my period, when I can stop wearing bulky maxipads and two layers of underwear, can go back to being free and easy in just boxer shorts.  And this is the feeling I get to experience every day from now on.

Bad news, ladies:  T-shirts really do fit better with a flat chest (to be fair, I only buy men’s shirts, but only because I can’t stand clingy little “baby doll” styles).  I thought I’d be like a kid in a candy store in the T-shirt section, but truthfully I’m still riding the high of trying on clothes I’ve had for years but gave up wearing because they were hopeless with breasts, but I loved them too much to get rid of them.  Old favorites have become new favorites, even moreso, because everything looks (and fits) better without boobs.

My partner Tery loves the new me almost more than I do.  She said, “I really think you weren’t meant to have breasts.  You look so much more natural without them.”  My sentiments exactly.

Alright, onto the wound care.

Let me preface this by saying I’ve never had a “regimen.”  I only use shampoo/conditioner all-in-one solutions because washing my hair twice is too much work.  And don’t get me started on hair dryers — I comb and leave the house with it still wet. Deodorant (no perfume/lotion/body oil/whatever), clothes, shoes, done.  “Low maintenance” is my middle name.  So to suddenly have this elaborate, necessary wound dressing routine is a stone drag, but unavoidable.

Step one:  Showering.  From what I understand (hopefully correctly interpreting Steinwald’s rapid-fire orders), showering is okay from 48 hours after surgery, as long as you keep the incisions/nipples dry.  Easier said than done, especially if you try washing your hair, when all manner of unauthorized dripping happens.  In the second week I believe moisture is permissible, just no direct spray on the nipples.  Needless to say, showering isn’t especially fun having to put this much thought into it.

(On a side note, if Tery wasn’t around to protest I’d seriously consider shaving my head during this period, or at least trying a Charlize Theron/Furiosa buzz cut.  You don’t notice how much your hair falls out until it starts getting caught and fossilized in all the ointments and goop you have to put on your incisions.  Highly, highly annoying.)

Step Two:  Incision.  Like I said, whether through Steinwald’s excellent work or my own miraculous recuperative powers, I’ve never had any oozing, wound separation or big areas that I needed to wait to close up; the wound has looked basically healed from the beginning.  With the exception of the drain exit sites (which continue to be the worst part), and on these I use Brave Soldier Antiseptic Healing Ointment because it has performed miracles for me on past open wounds.

Brave Soldier

During the first week, moisture was everything.  Whenever the incision dried out, it felt like a huge crack in my skin.  I had started out putting the Brave Soldier on the whole thing, but it’s not really meant to be a moisturizer.  So I switched to something I had lying around, Tree Hut Shea Body Butter.  Shea Butter

Note:  Apparently the amount of shea butter (that supposedly helps in healing) in this product is negligible, and fragrance-free options are preferable, but like I said, I already had it and it felt fantastic on the wound and kept it feeling moist enough (applying it twice a day).  Also, it’s about 30% cheaper at my local grocery store (shame, Amazon).

Something else that’s supposed to be great for wound healing and locking in moisture is silicone.  The problem is, anything with silicone that’s marketed specifically for medical use is outrageously expensive.  So one of the first bloggers I discovered on this journey recommended anal lube.  Don’t laugh!  It’s a lot cheaper, and so far seems to be working great.  I got Wet Platinum Premium Lubricant which, for the amount you get and the grade of silicone, is a steal (and good for sexy funtimes as well, should the need arise).

Lube

That was my routine for the first week.  Now on week two the wound feels a lot less tight and less dry, so I replaced the body butter with Vitamin E Natural Ointment.  E ointment

I ordered this before Googling and realizing that medical professionals caution against vitamin E for wounds based on clinical studies, however, the reviews are full of customers who swear by how great it is for minimizing scars, etc.  It also contains wheat germ oil, aloe, and petroleum, which I suspect might have a lot more to do with its alleged miraculous properties.  It goes on like Vaseline, which is also recommended for wounds, then I add a layer of lube on top.

Later on, after the first month when the focus will be less on healing and more on massage and minimizing scarring, I plan to switch to Bio Oil, which comes highly recommended by everyone and Amazon has by far the best prices.  Bio oil

Step Three:  The Nips.  This is the area that I’m the most nervous about since it feels the most shaky. The nipples looked pretty horrific the first few days after removing the bandage (and to this day Tery can’t look at them at all, they make her lady bits hurt sympathetically), but I’ve seen slight but noticeable improvement every day.

I started off cheap (because as you can see, I’ve already spent quite a bit on other wound care and I’m not Donald Trump), with generic antibiotic ointment and non-stick pads to cover the whole mess.  After the first week though, I started to worry that Steinwald would be able to tell at my next appointment that I had cut corners and not followed his instructions (which were to use Adaptic, or oil emulsion pads, that were crazy expensive and only available online).  I get the feeling that successful nipple grafts are of utmost importance to him, and I didn’t want to sabotage his efforts.

So back to Amazon, where I found Curad Oil Emulsion Gauze Dressing, which is the most economical for the quantity you get.  These look like a fine mesh that is infused with petroleum (and they’re meant to go under another outer dressing, so more non-stick pads for me).  They’re also big enough to cover the bottom arm of my anchor incisions, which hadn’t been healing as quickly missing out on most of my ointment applications under the big dressing.

I also upgraded my antibiotic ointment to the name brand Neosporin, because as much as the generic claims to be comparable, there’s always a nagging doubt, isn’t there?

3M tape

I don’t know who that last nurse hold-out is, but they clearly have no idea what they’re talking about

I got new dressing tape, which was the best decision I ever made.  I had been having a pervasive itchiness this whole time, not my incision but my entire chest above it.  I attributed it to perhaps a sensation radiating from the wounds, which I know itch while healing, except I’d never heard of itchiness spreading to other areas like pain can.  Antihistamines only worked a little, so I took a chance and got Nexcare Sensitive Skin Tape.

Holy HELL, what a difference.  Costs twice as much as the regular stuff (and again, cheaper at my grocery store), but worth every penny–nearly instant relief.  I didn’t think I had sensitive skin, but now Tery calls me her “delicate little flower.”

(Pro tip:  When putting tape over the outer dressing, try hunching your shoulders forward a little.  It will keep the tape tight in more positions, whereas if you put it on tight with your chest upright, it will pucker and loosen up when you bend forward.)

Step Four:  Bandage.  I left the surgery center with a standard ACE wrap with velcro ends that I had been using ever since (Steinwald mentioned a compression vest a few times, adding that it didn’t provide very good compression so he didn’t endorse it very strongly.  After two weeks with this foolish wrap I would have liked to give it a try, however).  I imagine this is probably used by FTMs to bind, and if so, you have my sympathies. Near impossible to wrangle around myself without Tery’s constant help, even without enormous bags of fat to negotiate.  And uncomfortable: every time I felt a prickly pain or itching that made me panic about infection, it turned out to be a miniscule bit of exposed velcro rubbing my skin.  And soaks up a lot of sweat even when running short errands.  Just not enjoyable at all.

As of yesterday I was totally fed up with it.  Tery suggested one of my sports bras, and I remembered the packet did approve of them if they’re more comfortable.  I thought they’d be too stretched out to do much good; boy, was I wrong.

It fits me like I'm an 11-year-old who can't wait to need a bra, a phase I seem to have missed completely

It fits me like I’m an 11-year-old who can’t wait to need a bra, a phase I seem to have missed completely

So, word to the wise: Don’t burn your bras right away!  They’ll still come in handy as a compression dressing.

I’m mostly eager to be done with this recovery because, ironically, this is the most I’ve kept my chest covered in years, and I hate it.  This too shall pass.

I think that about does it.  I hope someone finds any of these suggestions helpful.  Now, for some pics (note: some graphic close-ups.  Look away now if you want):

I think they actually look pretty damn good

I think they actually look pretty damn good

Okay, the next two are extreme nip closeups.  You really, really, really might want to look away.

wpid-20150907_135936.jpg

They have an imprint from the mesh of the oil pads

wpid-20150907_135921.jpg

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