Follow-up: Remote Work While Recovering from Vaginoplasty

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Now that I've been back to work for ~2 weeks and am roughly ~5 weeks out from my surgery date, I figured this would be a good time to share how my initial recovery has gone thus far.

With the exception of a minor complication (one that I discussed briefly here), I'm happy to say that I've generally had a very smooth and manageable recovery!

First Week The first week was mainly defined by pain management and doing my best to get back on my feet. I have great cardiovascular health on account of the long walks my husband and I take regularly (we don't own a car), so I was able to move about relatively comfortably immediately following surgery. While these walks helped a lot with my pain, I was still very dependent on my prescribed painkillers and the transition to over-the-counter painkillers shortly after discharge from the hospital was a very difficult adjustment.

Second Week The second week was all about dilation. After getting the packing and catheter removed from my first post-op follow-up appointment, I was happy to find that dilation was decently easy for me, and my surgeon (Dr. Min Suk Jun) encouraged me to upsize quickly if I could manage it. Unfortunately, this is where my high pain tolerance definitely came back to bite me, as I managed the upsizing to blue and green just fine over the course of second week, but my first attempt at orange was a step too far and ended up causing significant (~3cm up each side from the bottom of the introitus) wound separation of my labia minora. The labia majora, canal, and main incisions are completely fine, thankfully, so the complication is entirely aesthetic, but it obviously still sucks to likely need a revision surgery down the line to correct it.

Third and Fourth Weeks We flew home immediately after the third week post-op appointment and I resumed working remotely the next day. I had worried that this would be too much for me to handle, but I found it manageable. My passive pain levels had gone down sharply at this point, and dilation had remained relatively easy even with the complication, and my coworkers were sympathetic (more importantly they didn't greet me with a huge backlog of work lol). The fourth week was largely the same; my pain levels continued to fall and my workload remained relatively light.

Fifth Week I'm still very early into my recovery at the five week mark, but I find that I no longer need painkillers most days and sitting at my desk most of the day is perfectly fine as long as I use my donut pillow. Dilation has gotten more difficult recently as I've started gaining sensation inside the canal, but I haven't had any issues beyond that. There's still plenty of time for more issues to arise, of course, but I suspect that the main topic of my follow-up next week will just be the complication and timeline for scheduling the revision surgery.

Summary I agreed with the perspective of several commenters under my original post that the ~3-4 week mark is the earliest you should consider returning to remote work. I was able to manage my return to work after three weeks, but there were three important caveats:

• I have a documented history of recovering well from injury and have a high pain tolerance. I'm also in my mid-twenties, have strong cardiovascular health, and no chronic illnesses. I have no doubt that my recovery could have been much rougher if I had any chronic illnesses like my husband or had gotten my surgery at a much older age.
• I got pelvic floor physical therapy prior to surgery and, thanks to it, have been able to manage dilation quite well. If dilation had been an exhausting struggle, as I know it can be for many trans women, then it would have been much harder to balance it and work at the same time. You could also argue that, if I hadn't had the time pressure of returning to work so soon over my head, then I might not have upsized so aggressively and could have avoided injuring myself.
• I am incredibly lucky to have my wonderful husband as my caretaker, and he has been a bulwark of emotional support during the lows of post-op depression and was of tremendous help during my early dilation sessions and general recovery struggles. I could not have managed any of this with caretaker who didn't thoroughly understand and support me (such as my parents), let alone trying to manage it all on my own.

I wouldn't advise anyone who differs significantly from me in these respects to consider returning to work so soon. It's impossible to predict exactly how well you'll recover, or what complications you might face, but I'd say that you should plan to wait longer before returning to remote work if you have any noteworthy health issues, limited or no post-op live-in support, or reason to believe that you might struggle with dilation (pelvic floor dysfunction, no pelvic floor physical therapy prior to surgery, etc.)

I hope that this recap is of help to anyone else who works a remote position and has the same questions and concerns as I did a few months ago!