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USEFUL INFORMATION

Here is a copy of the letter Dr. Biber sends home explaining post-op care:

DISCHARGE INSTRUCTIONS:

Dilate five times a day, 15 to 20 minutes each time, utilizing the pair of rubber dilators provided and as instructed. Space the dilations over the 24 hour period as much as can possibly be done. it is very important to keep the depth in the vagina, especially the first two or three days after discharge. it is very important to utilize plenty of jelly and place the dilator in such a fashion down toward the rectum primarily for a small distance then directly inside into the vagina, without using a screwing motion, because when you use a screwing motion, the ribs on the dilator might harm the new baby skin that is healing in the vaginal cavity. Graduate to a longer dilator between the fourth and fifth week. The easiest place to get a firm dilator is to go down to any adult bookstore and get a plastic dildo, get it the same diameter as the large dilator provided. Approximately 4.5 to 5cm in diameter and get it two inches longer, which will make it about 8 inches in length. Utilize this in a similar fashion as the original dilators and continue the dilation for a period of six months, however when you get to the fifth, sixth month, and everything is staying wide open, you may, with common sense, decrease the number of dilations too. May begin intercourse about the sixth week period. You will be somewhat moist inside, however not moist enough for penetration so it is important in the pre-sexplay period to insert some K-Y jelly and be prepared for penetration. If you do not use the K-Y jelly, you are going to tear yourself up. When beginning intercourse for the first time, take it slow and easy to avoid any damage that difficult and forceful penetration may cause.

We will send you home on Estinyl and Provera. Take the Estinyl one a day and cycle the Provera so that you can take it one a day for one week, perhaps the last week of the month, along with the Estinyl. It will place you essentially in the feminine cycle. We will send you home on urinary and tissue antibiotics and utilize them for a period of ten days. But even more important than the antibiotics is to drink copious amounts of fluids, 10 to 12 glasses a day. You may also drink a couple glasses of cranberry juice a day, which will acidify the urine and take away some of the smell. You may also douche, even once or twice a day because the vagina will present some obnoxious material while healing. You may douche twice a day if you wish with a tablespoon of white vinegar to a quart of warm water, not dark vinegar, but white vinegar.

Do not do any heavy lifting for a period of six weeks. If you have any specific problems, call my office, the office personnel or myself will handle your telephone calls and should be able to answer all your pertinent question. If you have to see a doctor at home for any reason and he doesn't understand what is going on, please have him call me.

Also, remember that you are specifically female now. You are subject to all female diseases. You can get Trichomonas infections, you can get Yeast infections, and these have to be treated just like any other natural female. It is conceivably possible now that you have a cervix, that you may develop cancer of that cervix, even though we have never seen this happen. However, it is probably very wise once every six months or once every year to get yourself a Pap Smear, to rule out this possibility. Remember you are subject to other diseases as well. Be very careful with your exposes, you can still pick up gonorrhea, you can pick up syphilis, and all the other exotic diseases that females are subject to.

Keep in touch with me, fill out the six month questionnaire in six months, and please send it back, so I can add to our statistical volume and utilize it in our presentations.

Any time you feel like writing, let me know your general status, i.e. financially, socially, what you think about your body image, and what adaption you are making to your new role. I'd be more than happy to hear from you. In other words, keep in touch. Do not let us lose your address. We want to follow you for a considerable period of time. For any other complications that may arise, please call and let us share them with you.

Stanley H. Biber, M.D.

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