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  1. #1
    Gold Poster SarahG's Avatar
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    Default Tucking Risks/Complications

    This could easily be the most graphic posting I'll make on HA, if you have a weak stomach you'll not want to read it. Tucking can cause medical complications, believe it or not. I am learning this the hard way right now.

    When you're tucked for prolonged periods of time (like 12 hrs a day or so) you've got these tight panties, gaffs, or whatever else holding everything up against your natal cleft (that's the area of skin between your butt cheeks). In this environment, you have so many hours per day of continual sweat, dead skin (your skin all over your body sheds dead cells constantly), and if you're on HRT on top of that your penis will discharge a fair amount of clear would-be vaginal fluid whenever you get turned on. This part of the body does not normally get a lot of air flow to begin with (the more butt cleavage you have, the more covered your natal cleft will be). The process of tucking restricts how much airflow the skin can get on top of that. Anywhere else on the exterior of the body, when dead skin, sweat, or oils from the body get into a pore or a hair follicle, they form a pimple. The amount of foreign compounds required to cause a pimple is invisible to the naked eye, that's why people with good hygiene can still get pimples, all it takes is for a microscopic amount of dead skin cells to fall into a large pore. But in the natal cleft region, since there is no airflow, it's moist, and warm, instead of forming into a normal pimple a pore that get something inside it forms into an abscess.

    This abscess then, since it's in your ass (one of the parts of the body that stores the most amount of fatty tissue) starts feeding off of your fat tissue. As this process goes on the abscess slowly increases in size, the infection fills the void with infected fluid, and then that fluid needs to find a way out. The body then reacts to the under the surface pocket of infected fluid by forming a tunnel that then goes to the surface of your skin somewhere. At the surface, it forms a vent, and starts discharging the infected fluid out. The fluid then starts infecting the surface of the skin where it is discharging, irritating the skin, forming a sore, and itching. For abscesses in the natal cleft region the "vents" are almost always somewhere in that divet of skin between your ass cheeks. The abscess itself usually takes form somewhere off to the side, in either of the ass cheeks. You can have multiple tunnels or vents per abscess. You can have multiple abscesses themselves. If not treated fast enough the abscesses each can become the size of a golf ball or greater. In the early stages, everything mentioned is invisible to the naked eye. You might not know it's brewing inside you.

    This is called Pilonidal Disease. Trans people are one of the highest at-risk groups for this condition, because of tucking. Other common at-risk groups seem to be GG's in their late teens to late 20's, and middle aged guys. For reasons not known, pregnancy and menstrual cycles seems to influence the occurrence of this in GG's. Years ago in the past, medical science used to think that this was caused by hair getting into pores, and thus it was thought of as a "hairy old man's disease." Since then that notion has been thoroughly debunked, anything getting into pores- however tiny- can cause this. Body oils, dead skin cells, and of course hair (any kind of hair, they have found pet hair inside abscesses from pet owners allowing their pets to sleep on their bed).

    Except for in extreme cases, the vents can only be seen under good lighting while pulling the ass cheeks apart to make the natal cleft taunt. They will appear as pinprick pores (see this picture). In early phases the abscess will not always be visible from the surface, nor will it always be easily felt by touch. As it grows in size it usually starts to look like a wart or pimple, it will feel like a soft lump, and discoloration of the skin may start to appear on the surface (redness similar to a pimple). You'll notice in the above example there is a red dot in the skin in the upper left corner of the picture- that is the abscess. The tunnels would connect it with the vents shown in the natal cleft itself.

    This cannot be treated except through surgery. There are two ways they treat this, the bad way, and the really bad way. Both are invasive, and when I say invasive I mean invasive. The not-as-bad way involves draining the abscess (example picture), they will cut it open so the inside of the abscess is exposed to the air to dry out (see picture). This is similar in technique to how they treat compartment syndrome involving legs. Scarring will be a problem, there will be an inch or two long scar in your ass at the site they cut open. This will be repeated for every abscess you have (some people have more than 1 at once).

    But even that isn't always going to do the job. If this is not caught early, or if the first surgery attempt fails to clear the problem up, they have to do the really invasive surgery. They cut the abscess & surrounding area out of your ass. They cut out the swath of fatty tissue between the abscess and the vents (where the tunnels are). They then cut out the sore/vents on the natal cleft itself along with some surrounding tissue. Depending on the size of the abscess you will lose a significant chunk of your ass. Since this means removing most of the natal cleft (the skin between your ass cheeks) they will then need to make a flap using the "good" ass cheek.

    To do this they will make a long cut down the length of your intact ass, and stretch the skin over what was the natal cleft originally. This will do two things, it will replace the tissue that had the sore/vents, and it will make the natal cleft shallower (or in some cases nearly gone). This is a very disfiguring scenario and the worst case scenario. Major reconstructive surgery will be required to try to get things shaped normal again and will not be able to hide all the scarring, which will be in some cases extensive. Example case. An extreme case would probably be a career killer for someone who makes their living from their appearance, because the scarring can be that bad.

    My tucking process has consisted of simply tight thongs. From birth my suspensionary ligament (the muscle they cut in penis enlargement surgeries to make it appear longer) is very tight, consquently my penis never "hangs" even when soft- it sticks straight out parallel against the floor, which presents some unique problems for tucking, and the only thing that has worked for me has been using tight thongs. Anything else just doesn't seem to do the trick. About two years ago I started feeling pain between my ass cheeks, but assumed it was chaffing from the tight thongs since that was the only symptom I had at the time.

    This month however, I started feeling pain in my natal cleft all the time, even when sleeping/naked. This was accompanied with a very severe itch. Curious I used a mirror to investigate and found a sore that runs my entire length of my natal cleft. It looks like someone took a razor blade, ran it 7-8 inches from my anal opening almost to my tramp stamp. It does not bleed. This condition is the only thing that describes my symptoms and the sore, so I pulled my ass cheeks apart and sure enough I found at least two vents. It took me a few days later to find the abscess. For me it is totally invisible to the naked eye, and on my left ass cheek (3-4 inches or so up and to the left from the top of the sore). My abscess, which I thankfully caught early, is about the size of a dime in size and spherical in shape. It is just below the surface of my skin, enough that it does not yet show. I could only find it by touch, and only when sitting down.

    Hopefully the cut & air out process will work for me, because if they have to start cutting out all this tissue I am looking at loosing anywhere from 1/8 to 1/4 of my left ass cheek going by my measurements of the affected area. That's assuming they don't have to make a flap using the right to replace my natal cleft. This is not something to ignore, if you show symptoms, if you get a sore in your natal cleft do not assume it is chaffing. Get it looked at, before they end up having to go cutting chunks of your body off. You can not put this off, it will not go away and can only get worse.

    I am going in next week to have them figure out how to proceed surgically and to see if they can put it off long enough for me to finish the semester so I can take my finals (the downtime from this can be weeks depending on severity, you will not be able to sit for more than a hour or two at a time until it is healed up). They'll probably have to do some MRI's to try to see what is going on down there, or if there are additional spots I don't know about.

    I have not heard of this on any trans site anywhere, despite trans people being at very high risk for the disease. I have been asking around to see if any other MtF ts people have run into this problem and I have found a few others who have had to go through this and a few others who are facing the surgery in the near future. That's not counting the stories google turned up. I don't know if people are just afraid to be associated with what used to be called "a hairy old man's syndrome," or why this never seems to have come up on any of the popular trans sites. I don't care what people think of me, so I am putting this out there as bluntly as I can so people know to watch for it.
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    And maybe its easier to withdraw from life
    With all of its misery and wretched lies
    If we're dead when tomorrow's gone
    The Big Machine will just move on
    Still we cling afraid we'll fall
    Clinging like the memory which haunts us all

  2. #2
    Gold Poster phobun's Avatar
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    Default Re: Tucking Risks/Complications

    I hope you are better soon!

    Quote Originally Posted by SarahG
    This cannot be treated except through surgery.
    I think you hit the nail on the head here. SRS solves the tucking problem.



  3. #3
    mmmmm beefy Platinum Poster rockabilly's Avatar
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    Sarah , I hope things go well when you visit the doctor. My heart is w/ you and i ... just want you to know that.
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  4. #4
    Gold Poster SarahG's Avatar
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    Default Re: Tucking Risks/Complications

    Quote Originally Posted by phobun
    I hope you are better soon!

    Quote Originally Posted by SarahG
    This cannot be treated except through surgery.
    I think you hit the nail on the head here. SRS solves the tucking problem.
    An orchi probably wouldn't hurt either, the less the panties have to pull into position the looser they can be and the less of a risk this would be.

    But an orchi would in the long run be a good idea for anyone who plans on being on hrt for a while (like, for life). Staying at preop dosages for decades presents a wide range of problems like risk for kidney & liver damage/failure. Potassium level problems from spiro can lead to heart problems or death, the dehydration side effects of spiro can be very uncomfortable (foot cramps for me is the most amount of discomfort spiro usually gives me).

    Have I mentioned on this board that long term spiro use is what gave me an irregular heart beat problem? Now it will intermittently skip beats, which feels kind of like having your heart race when under adrenaline, only its scary because it also can have nausea and light headedness. First time it acted up on me I thought I was going to die. So now I have to be careful and limit my caffeine intake, stay away from amusement part rides, not do any strainious exercise (not that the later two were ever something I cared for). If I can get rid of the testes (from an orchi or srs) I'd be able to drop or drastically cut back the spiro and the heart problems should go away after a while. My bloodwork hasn't ever shown my potassium or salt levels to be the cause of my heart problems, so it's a side effect of the spiro itself, not a side effect of the side effect.


    And maybe its easier to withdraw from life
    With all of its misery and wretched lies
    If we're dead when tomorrow's gone
    The Big Machine will just move on
    Still we cling afraid we'll fall
    Clinging like the memory which haunts us all

  5. #5
    Platinum Poster BeardedOne's Avatar
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    So...

    What you're saying is that you could end up half-assed?



    Just kidding, making lite of a serious issue. I hope that you are doing better and kudos for keeping an eye on your overall health/transition as you do.

    I read your post with great interest as the symptoms/ailment are very similar to acne rosacia. Unpleasant, though surprisingly common, affliction of the face.

    Anyone from these forums that has either met me or seen color images of me has noticed that I have a 'rosy' complexion. It ain't from being out in the sunshine, Sunshine. There are combinations of factors, similar to your own tale, that include things like diet (Mine sux, but I'm resistant to change), alcohol (I consume mass quantities), and stress (My middle-fucking-name). The only positive thing that I can point to is that it is an ailment that I share with the late John Pierpont Morgan and that I may be doomed to inheriting his famous, and ginormous nose.

    Motherfucker! Why couldn't I have shared his ginormous =WEALTH= instead?!? Grrrr.

    That said...

    It's nasty. I bathe regularly (None of the gurls have yet to complain), wash my face vigorously, and spend more time than I care to in policing the errant zit, yet the occasional abscess presents itself and a new battle ensues. At least I have the dubious pleasure of engaging the enemy in a mirror. I can't begin to imagine what you might be going through.

    My best to you, dear. Keep us apprised.


    "In times of universal deceit, telling the truth will be a revolutionary act." - George Orwell

  6. #6
    5 Star Poster elo's Avatar
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    Default Re: Tucking Risks/Complications

    Quote Originally Posted by phobun
    ...

    Quote Originally Posted by SarahG
    This cannot be treated except through surgery.
    I think you hit the nail on the head here. SRS solves the tucking problem.



  7. #7
    Silver Poster fred41's Avatar
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    Hope it works out well for you in the end (no pun intended..well maybe a little bit).

    Seriously though Sarah..wish you a pain free recovery..and the best of health in the future.



  8. #8
    Gold Poster SarahG's Avatar
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    Quote Originally Posted by BeardedOne
    So...

    What you're saying is that you could end up half-assed?
    lol, cumulatively it would probably be a hair over half assed.

    The initial shock was bad because my ass & hips were where the bulk of my natural curves developed. I've had a 1:1.5 waist to hips ratio without any implants, pumping, or injections so it's kind of a "two steps forward... three steps back" moment. I'm actually more worried about the visible scarring than any risk for tissue loss. It's relatively easy to add tissue (fat injections, implants, etc.) but there is far less medical science can do about bad scarring.

    It's oh so tempting to go grab a razor blade or a needle and drain the abscess myself while I am waiting to get in to have it looked at. I trust myself around sharp objects, but I don't think anyone else would. But with my luck that would end up forcing them to take more out than they would need to in the long run.

    I am hoping I can use this to argue that an orchi is medically necessary. That would allow my insurance to pay for it and I'd have less to worry about in tucking after everything heals. If they do it all at the same time then I'd only have to go under once before any reconstruction, which is good because i am at high risk for anesthesia complications.

    I read your post with great interest as the symptoms/ailment are very similar to acne rosacia. Unpleasant, though surprisingly common, affliction of the face.
    I have Eczema & Seborrheic Dermatitis of the face so I know all about how stuff like that goes. The only way I can keep it under control is to practically bath in moisturizer (figuratively speaking). I can't use any cleansers or makeup removers because it seems to irritate both, so to clean off makeup I use tissues covered in moisturizer to take everything off, and the put moisturizer on my face afterwords.


    And maybe its easier to withdraw from life
    With all of its misery and wretched lies
    If we're dead when tomorrow's gone
    The Big Machine will just move on
    Still we cling afraid we'll fall
    Clinging like the memory which haunts us all

  9. #9
    Gold Poster phobun's Avatar
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    Quote Originally Posted by SarahG
    I am hoping I can use this to argue that an orchi is medically necessary. That would allow my insurance to pay for it and I'd have less to worry about in tucking after everything heals. If they do it all at the same time then I'd only have to go under once before any reconstruction, which is good because i am at high risk for anesthesia complications.
    Best wishes for you



  10. #10
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    Wow. Never heard of that before but its truly terrifying. I have always wondered if there was any negative side effect of girls tucking. I assumed it was just excess body odor in that area especially on hot days.

    Best wishes on a full and speedy recovery.


    I have the personality and people skills of a retarded home-schooled kid.


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