r/Transgender_Surgeries
•Posted by
u/Ancientalienaardvark
Here is the story of my Orchiectomy with Dr. Arnkoff
Background: I am MtF/NB and like to present as a girl. I don't see that changing any time soon so I wanted my testicles removed. I am about a year on estrogen and I took blockers for about 2 years before that. I am really squeamish about being cut. I tend to faint. I picked Dr. Arnkoff because he was within a days drive of where I live and he does not require any letters/psyc evaluation.
++++++ THE TRIP +++++++
I contacted Dr. Arnkoff on October 1st. We briefly discussed my history (age, hormone use) and he told me he would check his schedule and get back to me. The next day at 8am he called me back and discussed his schedule. We decided to schedule the surgery for October 11th which was only 10 days away! I had no idea it would be possible to get such a close date but evidently he has good availability. October 11th worked well for me because my wife was scheduled to be on vacation at that time so she could drive and help me recover. We booked a hotel room at "The Baronette Renaissance" in Novi. This hotel is about 15 minutes away from Arnkoff's office. It cost about $150 a night which I thought was worth it. The room was very nice and the hotel is in an affluent area. I have had my share of crappy hotel stays and I am completely over it at this point. I highly recommend paying for a nice hotel stay.
On the 6th we went to the bank and got a cashier’s check for $3600. We also got our car ready for the drive to Michigan which included me replacing some emissions control solenoid valve to fix an issue with hard starting.
We made the 8 hour drive to Michigan on Wednesday the 7th which would give us a few days to vacation before the surgery. The drive was uneventful and actually less boring than I thought it would be. I think I would like to do more road trips in the future. We arrived on the evening of the 7th and checked into our hotel. During our drive Dr. Arnkoff called me and informed me he had a cancelation for Saturday the 10th and that Sunday would not work well for him anymore. I agreed with this new schedule and the surgery was moved to Saturday October 10th. I was now 3 days out and starting to get anxious.
Background: I am MtF/NB and like to present as a girl. I don't see that changing any time soon so I wanted my testicles removed. I am about a year on estrogen and I took blockers for about 2 years before that. I am really squeamish about being cut. I tend to faint. I picked Dr. Arnkoff because he was within a days drive of where I live and he does not require any letters/psyc evaluation.
++++++ THE TRIP +++++++
I contacted Dr. Arnkoff on October 1st. We briefly discussed my history (age, hormone use) and he told me he would check his schedule and get back to me. The next day at 8am he called me back and discussed his schedule. We decided to schedule the surgery for October 11th which was only 10 days away! I had no idea it would be possible to get such a close date but evidently he has good availability. October 11th worked well for me because my wife was scheduled to be on vacation at that time so she could drive and help me recover. We booked a hotel room at "The Baronette Renaissance" in Novi. This hotel is about 15 minutes away from Arnkoff's office. It cost about $150 a night which I thought was worth it. The room was very nice and the hotel is in an affluent area. I have had my share of crappy hotel stays and I am completely over it at this point. I highly recommend paying for a nice hotel stay.
On the 6th we went to the bank and got a cashier’s check for $3600. We also got our car ready for the drive to Michigan which included me replacing some emissions control solenoid valve to fix an issue with hard starting.
We made the 8 hour drive to Michigan on Wednesday the 7th which would give us a few days to vacation before the surgery. The drive was uneventful and actually less boring than I thought it would be. I think I would like to do more road trips in the future. We arrived on the evening of the 7th and checked into our hotel. During our drive Dr. Arnkoff called me and informed me he had a cancelation for Saturday the 10th and that Sunday would not work well for him anymore. I agreed with this new schedule and the surgery was moved to Saturday October 10th. I was now 3 days out and starting to get anxious.
On the 8th we went to the Ford museum and saw a bunch of classic cars and old planes. We also visited Belle Island. On the 9th we drove to Toledo and went to the Zoo and botanical garden there. The botanical garden was nicer. I thought I was about to get covid at the Zoo due to the number of idiots not wearing masks. I can see why Ohio has so many covid cases now.
On the night of the 9th Arnkoff called me to confirm I still wanted surgery. I told him yes. He instructed me to meet him at his office at 6:15am the next day. The surgery was scheduled for 6:30am. I didn't sleep too well that night.
About Dr. Arnkoff: I found him to be nice but very direct. He will quickly communicate via call/text and is good about answering all your questions. The answers you receive from him are short and to the point. He is a nice guy – he just always seems like he is in a hurry. I did not get a paper with after care instructions (which would have been nice) but he did verbally give me instructions and he is available to answer all your questions via call/text. There is no gate keeping with him. I signed my balls away that that was all.
++++++ THE SURGERY +++++++
I woke up early at about 4:30am on the 10th and took a shower. We arrived at his office right on time at 6:15am. The office is a huge glass medical/office building. I was worried that the office might be a little sketchy but this was not the case. It is a nice newish urology office on the first floor. At about 6:25 we met with Dr. Arnkoff in the lobby of the office. He was nicer and more personable face to face than on the phone/text. He brought out an informed consent form which I read and signed. He discussed possible complications of the surgery with me as well and gave me some tips on how to prevent a blood clot from forming in my leg after surgery. I asked him some questions as well and he explained that he now makes two incisions rather than one in order to limit bleeding. I was unsure about having two incisions rather than one but I trusted his judgment and agreed. After signing the form he left us in the lobby and went back into the office to setup for surgery. We were also waiting on his assistant to show up which took a few minutes. I would guess that at around 6:45am I was called back to the operating room.
The OR was fairly simple I thought. It contained some equipment that we would not be using as well as what looked similar to a dental chair with a bright surgical light overhead. There was also a tray of surgical instruments off to the side. I did not look at the time at them but I did take a picture. The assistant (who I think is Arnkoff's daughter) asked me to undress and lay down in the surgical chair. She gave me a cloth cover to put over myself as well. She left the room and I took off my underwear and pants and laid down as she said. A few minutes later she returned and cleaned me with iodine (I guess) and then added some additional covers over me.
This was around the time I started to get very nervous. I had previously told Dr. Arnkoff that I am pretty squeamish especially about being cut and so I might faint. I told this to the assistant as well. She made some small talk with me and mentioned how she used to be squeamish when she first go into the medical field. She told a story about watching a C-section preformed for the first time which did not help me to feel any better (lol).
After I was prepped for surgery Dr. Arnkoff entered the room and started working on me. I told him I was feeling faint and he gave me some smelling salts to hold in my hand. I took a whiff and realized why they work. That smell is crazy strong! At some point the assistant stuck a pulse oximeter on my finger which she evidently checked throughout the procedure.
Dr. Arnkoff started by numbing the incision sites (one on each side). I closed my eyes at this point and did not open them much at all during the procedure. He played oldies music on his phone and I concentrated on that rather than what I was feeling. He explained that numbing was the worst part of he procedure and I think I agree. He also numbed the spermatic cords and possibly some other areas as well. I would describe the numbing process as uncomfortable but only slightly painful. It felt like he was squeezing my testicles and spermatic cords but not that hard. There was some stinging and burning depending on the injection site. I managed to get through the numbing without fainting. After he was done injecting me both Dr. Arnkoff and his assistant left the room for about 15 minutes. I laid there with my eyes closed and waited. I actually felt very relaxed during this time and nearly dozed off.
After the wait both returned to the room and started working on me. My right side was done first. Dr. Arnkoff stood on my right and his assistant was on my left. I imagined what was going on but I never looked. There was some tugging and discomfort but I would not say it was more than very mildly painful. After what I imagine was 15 minutes they announced that the right side was done. I opened my eyes for a minute and watched them switch sides. Arnkoff was now on my left and his assistant on the right. The left side took about 20 minutes I would guess and was slightly more uncomfortable than the right. Stubbing your toe is worse. There was a point where I felt a little poke sensation which I guess was from being stitched up in an area that was not totally numb. I told him and he immediately gave me more numbing in that area.
During the procedure I did have a sense of what was doing on. I could kind of feel what I guess was a testicle on my leg when each was out but maybe that was just Arnkoff's hand resting there? With the cloth coverings they put on you there is less sensation than I imagined there might me. I was also worried about hearing the snipping of scissors, etc. but this was largely drowned out by the oldies music. I did occasionally ask him questions about the procedure (like "are my testicles big or small?" They were small lol) which he quickly answered. I kept thinking I might soon faint during the procedure but I never did.
After what I would guess as 30-40 minutes of work I was told I had only a stitch of two left and then it was all over. I sat up to take a look and snapped a quick picture. I felt a huge sense of relief after they were done. I had made it and I was ok! I didn't even freak out and have a panic attack or faint. The assistant helped me put on a women's diaper catch any bleeding what would happen. They left the room and I put my clothes back on. A minute later I wondered out of the OR and found Arnkoff and the assistant talking in what I guess was his office. He politely walked me to the door. I left with a prescription for 5mg hydrocodone + 325 mg acetaminophen as well as a prescription for cephalexin.
++++++ THE RECOVERY +++++++
At around 8 am we left the office. We went straight a Rite-aid and tried to fill the prescription but they did not have the hydrocodone he prescribed me. We tried a CVS next and they said they could fill it but It would not be ready until 11am. We decided to wait. My wife drove and we got some breakfast at a BurgerKing nearby. After that we sat in the CVS parking lot for about two hours while they dicked around filling the script. At 11am I got the prescription and I immediately took a pain pill. We went back to the hotel and I was not in much pain during the short walk to the room. I laid down and my wife propped my legs up with pillows as the doctor recommended. The hydrocodone made me a little silly and loopy as expected but it was very manageable. I am not sure that the pain pills really do much for my pain. I think they just make your brain wonder more so you tend to care less about the pain and are better able to ignore it.
Day 0:
Pain level: Mild provided I kept up with the pain meds. My wife says I am wimpy lol. I Iced constantly and maybe even more than I should have. I did like 40 minutes on and maybe 15 minutes off. This helped with the pain and I think minimized the swelling.
Bleeding: About 30 drops would be my guess. I took off the diaper they provided me in the after noon and replaced it with a piece of gauze plus some tight fitting underwear. I did not have very much bleeding.
Appearance: A little swelling at the incisions. My scrotum looked empty which made me happy. No bruising yet.
Sleep: Not too good. Maybe 6 hours. I woke up every 2-3 hours to change the ice.
Mood: Bored and tired.
Day 1:
Pain level: Like day 0. Not too bad. Some pain while sitting/walking but very little while laying down. I iced all day as well.
Bleeding: About 20 drops. I changed the bandage a time or two and applied antibiotic ointment to the incisions as Arnkoff directed me to.
Appearance: Swelling starting at the incision sites. Some swelling of the scrotum due to the spermatic cords swelling (I guess).
Sleep: Not too good. Maybe 6 hours. I woke up a lot to change the ice as well.
Mood: Bored and tired.
Day 2:
We drove back on day 2. It was an 8 hour drive and it sucked. I was trying to wean off the pain meds and had not taken one for maybe 6 hours when we started to drive. I sat in the back seat of our SUV with my legs propped up to try to avoid a DVT. My crotch, back, and butt hurt bad. I took two hydrocodone over the course of the drive and it still sucked. If I had to do it again I would clean out the entire back of the SUV, put the seats down, stick a small bed in there and lay down the entire way home.
Pain level: I have had a kidney stone before. I would consider that a 10/10. The worst pain on the drive was a 7.5/10. With the pain meds kicked in to their maximum the pain was like a 4/10. If I had layed down the pain would have nearly gone away I believe. If you have a long drive do something other than sitting with your legs propped up for 8 hours. I got out and walked around a few times during the drive which helped some. Once I got home I laid down immediately which made the pain nearly go away.
Bleeding: A few drops at most.
Appearance: More swelling but still no bruising.
Sleep: Better than before. >7 hours.
Mood: This sucks. Also look what I see out the window! Can we stop soon for food? I'm bored! lol
Day 3:
Pain level: Sore when moving around. I stopped taking hydrocodone at the end of day 2. I started taking one extra strength Tylenol every 6 hours. The pain was mild.
Bleeding: None
Appearance: Getting more swollen each day now. The ends of the spermatic cords are about the size of small grapes.
Sleep: nearly normal
Mood: Less bored. I wish I could do more. I built a computer for a friend with the help of my wife to lift things.
Day 4 - 5:
Pain level: About the same as day 3. Sometimes I would forget to take Tylenol and I was still ok. Incisions are getting a little itchy.
Bleeding: None
Appearance: incisions swollen and ends of cords are grapes in size.
Sleep: nearly normal
Mood: Enjoying time with my wife. Less bored.
Day 6:
Pain level: I only needed a little Tylenol. Still sore and a bit achy but easy to ignore.
Appearance: Maximum swelling. Ends of cords are like large grapes. Probably a little bigger than my testicles where to begin with. Incision swelling is starting to go down. One of the incisions has some bruising above it. No other bruising.
Sleep: good normal sleep.
Mood: Normal/bored.
Day 7:
Pain level: I stopped taking Tylenol entirely. The incisions are itchy and my junk is generally sore.
Appearance: About like day 6.
Sleep: good normal sleep.
Mood: Normal. We watched a bunch of movies which was fun.
Day 8:
Pain level: Same as day 7. My back is more sore from sitting in a chair all day with my legs propped up than my junk is lol.
Appearance: The bruising is starting to reduce. The incision swelling is going down as well.
Sleep: good normal sleep.
Mood: Normal.
++++++ HORMONAL EFFECTS ++++++
I have no scientific reason to believe this but I think since my orchie my skin/hair is a little less oily and and my breasts are a little sorer. I never stopped taking estrogen before or after surgery but I did stop taking progesterone on the 7th due to concerns it might increase my clotting risk. I take 2.4mg of estradiol valerate every 3 days. My estrogen level stays around 400 pg/ml. My testosterone last tested at 19 ng/dl which means I was probably already at castrate T levels due to my aggressive estradiol monotherapy routine.
Mentally I have noticed no changes except that I am happy to not have testicles anymore.
++++++ OTHER ++++++
The pain killers made me constipated. I took two stool softener pills which helped. If I had to use the pain meds for more than 3 days it probably would have sucked. I am not looking forward to FFS for this reason among others. I was worried about side effects from the cephalexin but I never had any. I took it all as the doctor ordered.
The double incision method proved to work really well for me. I have had very minimal bleeding and swelling and I don’t think I developed a hemotoma either. I will end up with two scars rather than one however. I think my recovery was easy as far as they go.
