Salute to Misfile (and all my favorite comic strips)

Tags

Andy Capp, anti-coagulant, B.C., Batson D. Belfry, Bill Watterson, blood clot, Calvin & Hobbes, Canada, cartoons, Charles Schulz, Charlie Brown, Chris Hazelton, classic comic, comic strips, David Willis, Dilbert, Dumbing of Age, estrogen, fallen angel, father, For Better or Worse, FoxTrot, Garfield, Greg Evans, GRS, heart attack, heaven, Hell High, Indiana University, Johnny Hart, JumpStart, Luann, Lynn Johnston, Misfile, MTF, Murder, One Big Happy, Peanuts, risk, Robb Armstrong, Rose is Rose, Scott Adams, Shoe, Snoopy, TDOR, Transgender, Transition, transphobia, Transsexual, Wizard of Id

Lois Lane – my cartoon alter ego

Sometimes people ask me what I do for fun. One of the things I do is read comic strips. My selection of comic strips provides me with everything from a good belly laugh to insight about life, to a look at today’s world with a healthy degree of separation from the news media and today’s divisive rhetoric, to enable me to find a way to laugh at myself when needed. And in today’s world, laughter is needed more than ever.

There are a handful of strips that I read daily. Some are the same as will be found in the daily newspaper (as long as newspapers will continue to exist). One is a comic that used to appear in newspapers daily but now only on Sunday. A few of them are classic comic reprints.

I also read two web-based comic strips. Since they require going to separate websites and they are based on ongoing arcs, I prefer to read those once a week.

Chris Hazelton

One of those web comics, Misfile, ended its run recently. The author of the strip is Chris Hazelton. The basic story line is that an angel in heaven’s filing room screws up (as is his tendency), but really big time this time. His error causes one teen girl at a high school in NW Massachusetts to lose two years of her life and go from a senior on the brink of graduation to sophomore. The error also causes another sophomore to suddenly be physically transformed overnight from male to female. They are the only ones aware of the changes. Everyone else in their life has had their memories transformed so they only know this new reality. Somehow these two teens find each other and are joined by the screw up angel and a cast of other heavenly host characters and unwitting earthbound characters in the attempt to restore the original history and all the conflicts that brings.

Chris has started a new web comic called “Hell High” that seems to be based on the same universe, perhaps the result of what appeared to be the solution to the dilemma faced by the key characters in Misfile. I have just started reading it and will give it a month or two to see if it holds my interest.

Ash (Misfile)

Misfile premiered online on February 23, 2004 (I had a lot of catching up to do when I found it). On November 20, 2014, Chris revealed part of the inspiration for the main character who is transformed from male to female and frequently struggles with being in the wrong body. Chris’s father, one of his earliest fans of the comic, was a male to female transsexual who transitioned prior to the inception of Misfile. (I am identifying her the way that Chris does.)

http://www.misfile.com/?date=2014-11-20

In 2007, Chris’s father died. She developed a blood clot that led to a fatal heart attack. It is believed that the cause was the estrogen that she was taking as part of her transition. It was the worth the risk to her.

Doppler ultrasound to detect blood clot

It is also worth the risk to me. I suffered from a blood clot around the time that I had my GRS. I believe that it was a result of the combination of a trauma to my ankle and the changes in medication that were necessitated by surgery (removing anti-coagulants from my normal dosage, although also removing estrogen, except for a shot of Heparin while in post-op). I was taken off of estrogen and put on a strong anti-coagulant (Xarelto) for about 4 months. I began to suffer from curling fingers and loss of shoulder mobility and the symptoms were getting worse. To restore quality of life, I stopped the Xarelto and resumed estrogen. To minimize the risks I switched from sublingual to topical estrogen, take only half the dose that was originally prescribed (blood tests are showing high enough estrogen levels to justify the change) and faithfully take a baby aspirin a day (or more if I have a headache or body aches that day).

The date in which Chris made the reveal is significant. He did so on the official day to observe the Transgender Day of Remembrance (TDOR). It is the day when we remember those who died in the past year because of their transgender identity (real or perceived) or alliance, whether through murder or lack of medical care. When my health allows, I participate in TDOR ceremonies locally and spoke at one a few years ago.

The TDOR ceremonies are quite moving. Even one person who dies this way is too many. In the United States, some twenty to thirty people die in this way. Around the world the number is approaching four hundred that are reported. The number is likely higher than that. Some are not reported because the family of the victim hides the facts.  In other cases, the police or the government hides the information. Russia and the People’s Republic of China are two of the larger countries that do not report this information.

Some deaths are caused by hatred towards gender variance even when the victim does not identify as transgender. In some especially heart-wrenching cases, the person doesn’t get a chance to identify. The saddest (and they are all sad) murder I have read about happened nine years ago. A sixteen month old toddler was playing with his mother’s clothes. The mother’s boyfriend (not the baby’s father) told police that he struck the child several times with his closed fist, “trying to make him act like a boy instead of a little girl.”

To end on a lighter note, here are the other comics I read regularly:

Andy Capp – The title character is a lovable layabout who is a perpetual beneficiary of the British social welfare system, his long-suffering wife and any friend he can sponge off of. I get my dose of British humor and slang. Andy is either cadging beer or ale at a local pub (and getting drunk), cheating at cards, darts or snooker (presumably to get some money as well as massaging his pride).

B.C. – One of two Johnny Hart originated comics I read, it delightfully morphs modern times and the stone age, but without the Honeymooners parallel that The Flintstones had. Some strips feature early homo sapiens, some feature critters (both extant and extinct), some strips combine the two.

Calvin & Hobbes (classic) – One of the most brilliant of all comic strips, Calvin’s adventures and insights stem from him being super-intelligent and very bored. At the same time we often see his vulnerability. His best friend relationship with his toy stuffed tiger, Hobbes, reveals a lot about Calvin. Hobbes only becomes animated when alone with Calvin. Calvin has a vivid imagination, but sometimes it seems like something more must be going on.

Dilbert (w/ Dogbert)

Dilbert – The inanity of the modern world as seen through the everyday life of a dysfunctional, fictional tech company. The title character exhibits the highest degree of job skill competence while dealing with the frustrations of being inept at climbing the corporate ladder and being socially clueless (sometimes because of his own intelligence combined with lack of tact).

Dumbing of Age (web comic) – Indiana University is the locale for this look at modern college life using characters brought forward from earlier strips in the same universe in shuffled roles. Many, but not all, characters are LGBT, including at least one T in the closet. One of the main characters, Joyce, finds her rigidly fundamentalist and legalistic Christian beliefs challenged on a regular basis. Her challenge is to continue to love her new friends (and one close friend from high school) even though some worship differently, some are atheist, some are in same sex relationships, some have vastly different scientific beliefs and some simply aren’t very lovable. Joyce’s world often gets turned upside down but she manages to bounce back up and hold onto her belief that through faith and her good works, she can help the people she cares about live happily ever after.

cartoon self-portrait of the author of “For Better or Worse”

For Better or Worse (classic) – Family life north of the border, it is loosely autobiographical. Over time the characters age and the family grows. Although these strips are reruns, here and there the author updates them. On gocomics.com, the comments section will include the author’s remarks about how something similar happened to her in real life. Canada isn’t that different from the U.S., especially since hockey is becoming more common here, and it can be just as funny.

FoxTrot (Sunday only) – Family trials and tribulations with mom, dad, two painfully average teens and a preteen brother who is a genius. Of course, this means the youngest is also a nerd. The strip ran seven days a week from its inception in April 1988 until the end of 2006 and classic versions of those strips are available online, but I am only reading current strips.

Garfield

Garfield – With apologies to Heathcliff fans, Garfield is the only comic strip cat for me (with occasional cameos by Arlene and Nermal). Supporting characters including a lovable pet dog (Odie) who barks but otherwise has only spoken once in a thought bubble (other animals in the strip speak regularly that way), a nerdy owner (Jon) of Garfield and Odie, and a veterinarian (Liz) who eventually became romantically involved with Jon despite his clumsiness (physically and socially) and lack of fashion sense.

JumpStart – The life of Joe the Philadelphia police officer, his wife Marcy, a nurse with a rising career, and their four adorable children: daughter Sunny an ecology maven, son Jo-Jo a budding politician and martial artist wannabe, and adorable infant twins Tammi and Tommy whose thought bubbles alone are worth the read. While the characters are diverse, the cartoonist and the family are one of the few successful ones in the industry that are black.

Luann

Luann – The life of an awkward young girl who is slowly growing into a young woman (aging, but in cartoon time).  Many story arcs focus on her family (but rarely her parents) and friends rather than Luann. Some of her public school friends have departed and were replaced by new friends now that she is in college. This is the most popular current strip that I read. It is as close as I have come to having insight into the life of a teenage girl.

One Big Happy (new comics but on time delay in gocomics.com) – An extended family who live next door to each other (grandparents, parents and children), they are Italian except for the mother. While all are featured, as well as some friends and neighbors of all ages, the central character of the strip is Ruthie, the youngest child, six going on fifty, who is super-smart, super-confident, and doesn’t let her lack of experience knowledge gaps get in the way of her mouth. In short, she is a pip! (I identify with the confidence Ruthie has, which I had before gender issues kicked in.)

Peanuts (classic) – Perhaps the best known comic strip of all time, all kids all the time, and a few anthropomorphic animals with starring or supporting roles. Charles Schulz stipulated that no one else would ever do the strip after his death (unlike other strips that have had successors). In Snoopy, he may have created the most lovable cartoon character of all time.

Rose is Rose – The strips about the nuclear family of romantic couple Rose and Jimbo and their adorable son Pasquale are great. The ones about the other characters and the anthropomorphic animals, not so much. I think the difference with the animals is that most of them are drawn realistically (unlike Schulz whose animals were caricatures) but are doing things that are not what an animal would do and not believable. This is the comic strip that I debate dropping from time to time, but the nuclear family brings me back.

Sen. Batson D. Belfry

Shoe – All anthropomorphic birds all the time, the title character is a sarcastic, given to anger, newspaper editor. Similar to Pogo, the strip often brings up the current state of politics (especially with Sen. Batson D. Belfry) with humor making it more palatable. The strip started in 1977 and after Watergate and the onset of economic malaise, it helped me think of politics and still be able to smile again. It is needed more than ever now.

Wizard of Id – The other Johnny Hart originated strip I read, this one conflates modern society with medieval times. In addition to the Wizard, the strip features a little king who is not at all benevolent. a troop of incompetent knights and a host of rabble citizenry (plus constantly attacking Huns who should have overrun Id by now).

And the seventy returned again with joy, saying, Lord, even the devils are subject unto us through thy name. And he said unto them, I beheld Satan as lightning fall from heaven. Behold, I give unto you power to tread on serpents and scorpions, and over all the power of the enemy: and nothing shall by any means hurt you. Notwithstanding in this rejoice not, that the spirits are subject unto you; but rather rejoice, because your names are written in heaven. In that hour Jesus rejoiced in spirit, and said, I thank thee, O Father, Lord of heaven and earth, that thou hast hid these things from the wise and prudent, and hast revealed them unto babes: even so, Father; for so it seemed good in thy sight. – Luke 10:17-21

God bless,

Lois

And Now For Something Completely Different … – Part VII

Tags

ABD pad, ankle trauma, Bala Cynwyd, bleeding, blood clot, blood thinner, bottom surgery, breast augmentation, caregivers, catheter, Combine Pad, comfortable position, compression stocking, contraction, CT scan, depth, dilation, dilator, disposable panties, Doppler ultrasound, douching, Dr. Carolyn Wolf-Gould, Dr. Sherman Leis, dressings, DVT, edema, Estrace, estrogen, facial feminization surgery, feces, First Event, Fluconazole, follow up visits, gel, Gender Reassignment Surgery, genital tract infection, genitalia, granulation tissue, GRS, gynecologist, hand mirror, healing, hygiene, immune system, infection, logisitics, lubricant, narrowing, non-woven sponge, oral surgery, Philadelphia Trans Wellness Conference, physical condition, planning, plastic surgeon, post thrombotic syndrome, primary doctor, psoriasis, speculum, spray bottle, spritzer, stirrups, sublingual, supplies, swelling, tissues, toilet paper, tracheal shave, trans women, trans-friendly, Transgender, travel costs, urethra, urine, vagina, wings (knit pants), wiping, workplace accommodation, Xarelto, yeast infection

I had said that I would have one more blog post in this series.  But it was longer than I anticipated, so I divided it into two posts.  The new final one should follow after this one in a couple of days.

Aftermath

My guess is that no two GRS experiences are identical.  Some people have additional gender transition operations to recover from.  My post-operative recovery was complicated by having extensive oral surgery 15 days after my GRS, and apparently having gone into the surgery with a blood clot caused by ankle trauma a week prior to the surgery.

Thus my recovery has been slowed and I have felt overwhelmed at times.  But I will state one thing categorically: in no way do I regret having had GRS.  The oral surgery so soon after bottom surgery was forced by insurance issues, but the decision was justifiable.  And the blood clot was an unknown at the time, but I am dealing with blood thinners and recovery from edema or perhaps a mild form of post thrombotic syndrome (swelling of a lower extremity, in this case, my left foot, ankle and calf).

The biggest problem being on a blood thinner is that it had been increasing the amount of bleeding that occurs when I dilate (although that problem has abated somewhat now).  And having to revert back to four dilations per day, this increases the bleeding even more.

The dilation kit provided by Dr. Leis as part of the surgery package included five dilators of different sizes.  Based on my petite size, Dr. Leis felt that I would be able to reach the #3 dilator, with an outside possibility of making it to #4.  I started dilating when he showed me how, shortly after my catheter was removed.  I quickly moved up from #1 to #2 based on when he said I should be able to.  I then advanced to #3 during my recovery at home.  Returning to Bala Cynwyd for a follow up exam on November 6, he told me that I was doing well.  I took with me a prescription for Estrace, an estrogen cream to put into my new vagina to help with the healing of the granulation (raw) tissue that remained after the surgery.  Consulting with my primary doctor, I reduced my sublingual estradiol intake from 2 tablets a day to one as long as I was on the Estrace (2 grams a day for two weeks and then 1 gram a day for two weeks).  I did this for two tubes of Estrace.

Things continued to progress nicely as told to me by Dr. Leis during follow-ups on November 20 and December 12.  I noticed some decreased depth in the dilations shortly after my November 20 visit, but he reassured me that things looked fine on December 12 and I had a fine depth of 4½”.  He also told me that while there was a bit of granulation tissue remaining, there wasn’t enough to cauterize (as he needed to do on the previous two visits).  He noticed a bit of an odor during the December visit which he suspected might be a yeast infection.  I took a single dose of Fluconazole as a precaution and made a connection and appointment with a local gynecologist as a follow up.  A GYN is strongly recommended for a trans woman after GRS and I wanted to establish a relationship with one locally to cut down on travel once I reached a certain level of healing and Dr. Leis was in agreement that I didn’t need visits to him as frequently.

So I put my feet in the stirrups for the first time, a position familiar to most women.  My GYN took a swab of my vaginal lining and the test results came back negative.  She suspected they might as the Fluconazole taken five days earlier would have knocked out the yeast infection by then.  But it was good to have the test done as a precaution.

Of greater concern was that she didn’t feel she could put a speculum in me because the opening was too narrow.  This was only 8 days after Dr. Leis had no problem doing so (and I had expressed my concerns to him).  Even so, he had a lot more experience dealing with trans women than my new GYN did.  Yet in the back of my mind there was concern.  But it took a back seat to Christmas and last minute activity for my tax practice.  Not only did I have to get out my annual letter on a rushed and delayed basis because of the timing of the new tax law being signed, I needed to evaluate which clients had a possibility of benefiting by prepaying property taxes (and a few with quarterly estimated tax payments, making sure they paid their fourth quarter by the end of 2017).  And I needed to contact them, both those who would actually benefit and those who wouldn’t.  Making it more difficult, depending upon which town they lived in, some had an easy time prepaying and some had to go back multiple times.  And I had handholding to do during this process.

A set of dilators similar to the ones I am using.

My scheduled follow-up with Dr. Leis on January 4 got pushed back to the 9^th due to snow and ice conditions all along the route between my house and Philadelphia.  On the 9^th I received the bad news: my vaginal opening had shrunk dramatically.  He opened me up as much as he could manually.  I had dropped down to dilating every other day based on his schedule and was using the #3 dilator (but with increasing difficulty and decreasing depth).  Now I would have to return to the #1 dilator, try to increase it to #2 as quickly as possible (using #1 to open it up for #2 for a while) and then the same from #2 to #3 when possible.  I would also need to return to four dilations a day, maybe five when possible.

Now that I am on a blood thinner (Xarelto) in response to my blood clot, at times I am getting more blood on my dressings immediately after I dilate and even a few hours later sometimes.  So I am trying to find a proper balance with the help of Dr. Leis and my primary physician, Dr. Carolyn Wolf-Gould.  Dr. Carolyn examined me on January 26 and pronounced the surgery to have been done very well and that my vagina is a bit narrow but perfectly functional if I don’t plan to have intercourse.  (At this point, I have no one in my life that I would want to have sex with.  But for now would like to keep my options open in the event I meet someone in the future.)

It took some discussion with Dr. Leis to reconstruct what went wrong.  Apparently there was an omission in his dilation instructions, perhaps something that was expected to be communicated orally.  I have been told that it will be added to a revised instruction sheet.  The decrease in dilation frequency should not have begun until the granulation tissue has been completely healed.  Until that time, the body is sending even more resources to heal what it is interpreting as an open wound.  And with my body having an extremely active immune system, I will have even more healing resources sent there than most people.  Suffering from a massive mouth infection following my oral surgery, those immune system resources were temporarily diverted, so much so that even my psoriasis retreated for a time (one area is completely healed still).  But the psoriasis has returned and the vagina started to shrink by some time in December.

Doppler ultrasound

To combat feeling overwhelmed, I have been actively taking ownership of my medical situation, doing a lot of research on estrogen effects on trans women, blood clots, blood thinners and post-thrombotic syndrome.  Meanwhile, use of knee-high compression stockings on my left leg and keeping my leg elevated as much as possible have almost completely eliminated the swelling in my leg.  A Doppler ultrasound of my leg on January 19 revealed that the blood clot (or possibly scarring caused by the clot which has by now dissolved) moved up to the popliteal vein, which is on the back side of the upper leg.  As far as I could tell, the only swelling occurred below the knee.

On January 29, I had a CT scan to check for any pulmonary blood clots.  And the good news is that none were found. But Dr. Carolyn has me off of estrogen for three months and she never wants me to take it sublingual again. So I will use a gel.

I saw Dr. Leis again on January 30.  Once again I learned something new.  The majority of my shrinkage is at the opening to the vagina.  I still have good depth (~4”) and it is wider inside.  But the dilator has to get past that opening and it is with frequent dilations that I will hopefully be able to gradually open it up.  Fortunately the skin there is supple and after using the #2 dilator, I am able to successfully use the #3 again during the same dilation session.

On February 5, Dr. Carolyn told me to continue wearing a knee-high compression stocking for another 4-6 weeks, but that I could try sitting and lying down normally, without elevating my leg.  If the swelling returns, I will resume elevating the leg again for a time.  So far, so good.

Recommendations to Prospective MTF GRS Patients:

          Selecting a surgeon – I had an excellent primary doctor who is also a specialist in transgender medicine.  She did this ground work for me, although I most certainly interviewed her suggestion before I committed to him.  Many of you will not have a primary doctor who is as knowledgeable about transgender medicine as Dr. Carolyn is.  Therefore, you will need to do your homework.  Check out websites, but remember that some of the reviews are bogus or by people with an agenda.  Dr. Leis received many excellent reviews, but also some low marks with complaints that simply didn’t match who he is.  Go to transgender events like the Philadelphia Trans Wellness Conference (note the new name) or First Event or similar events close to you.  Attend the seminars offered by surgeons at those conferences who do the type of surgeries you are looking to have.  I only had bottom surgery.  Some of you will also want breast augmentation, facial feminization surgery or a tracheal shave.  Talk to other trans women who have had surgeries to find out about their experiences.

          Physical condition – I suggest that prior to bottom surgery, you especially work on four areas of your body: strengthening your legs, your core and back, and your arms and shoulders.  At the same time, increase your flexibility as much as possible in your legs and hips.  It’s amazing how quickly you lose your muscle tone in your legs if you are in bed for a few days, let alone two weeks.  The sequential compression devices work your calves, but not your thighs.  My thighs felt like lead climbing from the ground floor up two flights of stairs three days after surgery.  Working your core and back will also help deal with being horizontal for a couple of weeks.  The flexibility and arm and shoulder strength will help when you do your dilating.

          Dilation – Your surgeon should be the one to instruct you on how to dilate and what frequency schedule to follow. What I need to impress on you is the need to dilate often in the immediate weeks and months following bottom surgery.  You need to dilate frequently at the beginning when your body is sending healing messages to the skin and tissues of your new vagina.  It’s natural that your body wants to close it back up.  What I learned is that it will close it at the entrance to the vagina as much as anywhere else (from the outside in as much as from the inside out, if not more).  It is not necessarily a pleasurable experience, but it need not be painful, either, if it is done right.  It is helpful to find a comfortable position where you can dilate properly.  For example, I prefer to dilate with my dominant arm bare or with the sleeve rolled up so fabric doesn’t interfere with the groove.  And remember: dilate so your new vagina won’t die early!

          Caregivers – It is not mandatory to have one while you are in the hospital, although it would be good to have one bring you anything you need while there, as well as having a visitor. You will certainly need them immediately after your release from the hospital.  For those of you who don’t have good, willing and available caregivers in your immediate circle of family and friends, this is something you need to work on early.  Once you get specific dates from your surgeon, then you need to firm this up with your list of potentials.  I had to work to get a group of caregivers and it worked out that I divided the duties among three different friends who worked out a schedule among them.  But I wound up with the first two days, the neediest days, uncovered.  That first day was very scary and very lonely.  My only triumph was figuring out how to work the remote.  I was the happiest girl on the planet when my first caregiver walked in the door a day earlier than originally scheduled.

          Budget – Remember to include in your budget the trips you will need for follow up visits with your surgeon and post-operative supplies.  Many of you live in parts of the country where there are no GRS surgeons nearby.  My surgeon is a 2-3 hour drive, depending upon traffic and weather conditions.  I know of some trans women who have a minimum of either an 8 hour drive or a flight to their surgeons.  And while you may save money having the GRS done overseas, the follow ups are part of your consideration.  Since going home on October 19, I have had five follow ups with my surgeon, plus one follow up with my primary and one with my new gynecologist.  A local GYN who is trans-friendly and transgender knowledgeable helps with the budget and is a long-term necessity.

          Supplies – Find out in advance of your release date what your surgeon will be sending you home with.  Presumably a set of dilators and a tube of water-based lubricant (the only kind you want to use) will be part of the package.  Lubricant is cheap.  I can get a 3 oz. tube of Dr. Sheffield’s Lubrigel for 88¢ if I buy it in Wal-mart (online they charge nearly double, which is still a pretty good price).  It was a little more cohesive (i.e. stickier) than the medical supply brand I went home with so it is a little harder to control.  But at the price, even using a little extra you are still ahead of the game.  Body heat quickly warms it so it lubricates as just as well.  A tube lasts pretty long so you don’t need to buy it in bulk.  The other thing you don’t need to buy in bulk is douching supplies.  As long as you clean them thoroughly after use, they can be refilled and reused.  But as far as dressings (I use 4×4 4-ply non-woven sponges and ABD, aka combine, pads), disposable panties (aka Wings) and bed pads, you can buy them in bulk and save money.  Forget the drug store chains.  I found it much easier and cheaper to buy in bulk from Wal-mart.  Their search engine for health supplies is a bit clunky and frustrating, but it is worth the savings.  Target and the club stores might also have this available, but Wal-mart is the closest store to me, so that is what I chose as sometimes it is cheaper to do delivery to store.  Other times it is shipped directly to you.  Another thing you might want to have is a spritzer bottle.  At the beginning, the pad inserted into my vagina needed to be damp, not wet.  You can do this by running it under the faucet and squeezing out the excess, but a spritzer bottle of water is ideal.  If you don’t already have one, you should get a hand mirror that you can use with ease so you can see where you are putting your dilator.  You also might want to have an extra supply of facial tissues and toilet paper on hand when you get home to wipe off excess lubricant and for extra bathroom trips as you get used to new plumbing and learn new muscle control.  Have as much of what you need on hand before you leave for surgery.  You want to keep your life a simple as possible for a while when you get home.

          Logistics – Have a place set up where you will do your dilating comfortably, where your supplies can be in easy reach and where you can store them nearby (out of sight, if necessary). I like my digital clock nearby so I have an idea of how long I have dilated.  If you go to work at a job site, you may need to arrange a place where you can dilate on your lunch hour, if at all possible.  I always dilate in a horizontal position so I have no idea if it is possible to dilate while seated on a toilet or standing up in a bathroom stall of the women’s bathroom.  But if you work an 8-hour day and have any kind of commute, and figuring that you won’t want to be dilating right before you leave for work (i.e. after you have done your hair, makeup and put on your clothes nice and wrinkle free), that is going to be a lot of time between dilations when you are still at a point where you are dilating four or five times a day at the beginning.  Once you are down to three times a day, and especially once you are down to two a day, this won’t be a problem any further.  So hopefully, if your dilating goes well, this will be a temporary problem and the powers at be on your job (who hopefully are accommodating) can be told this.

          Hygiene – A simple fact to remember: urine is sterile; feces is not sterile. If you do wipe towards it for some reason, keep your stroke short and away from your genitalia: especially your urethra.  You don’t need a urinary tract infection.  Learn as much about hygiene as you can.  And although urine is sterile, it is an acid so it will burn in time.  But you should have learned this long ago.

And moreover, because the preacher was wise, he still taught the people knowledge; yea, he gave good heed, and sought out, and set in order many proverbs. – Ecclesiastes 12:9

God bless,

Lois