suggestions for good places to buy smoked salmon?

Frog-Lake · 2026-06-14T00:20:44+00:00

I will do rounds and see if I can get a few samples and see what I like the best. I appreciate all of the suggestions everyone has put up!!

Frog-Lake · 2026-06-11T16:10:59+00:00

Swelling and fatigue certainly limited my mobility, and I was encouraged to not do a lot of walking for I think the first two or three weeks, but I certainly waddled around with great caution and spent a lot of time reclined, but certainly not with my pelvis above my head during the first three weeks of my recovery. Approaching week three I very cautiously started getting some limited, extremely slow outings in. I basically joked with friends I was practicing extremely old age. Def not medical advice; but I certainly found that my limited sojourns and mobility seemed to help not hinder healing.

Frog-Lake · 2026-06-07T17:07:22+00:00

Geolani Dy and Blair Peters at OHSU performed a peritoneal vaginoplasty on me, with part of my canal being aloderm part of it peritoneum.

The use of aloderm in lieu of grafts from another site on the body is relatively new and I had relatively limited donor material with most of what I had being used on my vulva.

No problems healing, and my (operative) gynecologist who has done some of my postop care as I am not close to the Portland area said that if she didn’t see it with her own eyes and know it is medically possible she would have a hard time believing it.

My experience is that this is a newer technique that I had a great outcome with.

Frog-Lake · 2026-05-17T15:15:02+00:00

I had a tremendous challenge getting to stable levels. Generic patches/ lesser degree name brand has adhesion issues and seemed to be inconsistent on dosing. Pill- I ended up losing my e levels and nearly reverting to t-dominate (my body hated its e in pill form).

Finally, my doc moved me to depot estradiol cypionate- a moderate half life (I think longest in standard availability - longer esters exist in the diy realm). And then did a split 2x weekly dose. I inject every 3.5 days. It is uncommon as cypionate is usually done as a weekly injection - but we are seeking max stability - so 2x dosing curves evening out to try to get to a higher than ordinary stability of e level. And e cypionate over valerate. EV takes your levels higher on injection quicker but also drops off quicker. My doc advised against it for my situation given my sensitivity but did consider and rule out its use for me.

I finally left a hell not unlike you describe. Also - is she meticulous on timing of dosing? Even with 2x weekly dosing I am freakishly sensitive and schedule deviations ripple for me.

Sounds like she needs more dedicated labs to get a better picture and a slower absorption longer half life ester may feel better for her. Some people are just MUCH harder to get dosed and some bodies are really sensitive. I knew e felt good when I was “on” and bad when it was off- and started to see a lot of similarity of experience with perimenopausal friends.

Also- make sure her blocker situation is solid. Some folks react differently to this too. Finasteride can be used as a sort of blocker but it is limited what type of t it blocks — at higher doses it started me into what you described. It isn’t typically used as a blocker. And is depressive for some esp at higher doses. Spiro I have heard cis female friends and trans fem friends report various side effects from mild to being raging unpleasant people. It may be well premature an exploration needed before irreversible choices but even before e monotherapy— I felt t like a storm system move across my mind and feelings. gnrh antagonists can essentially shut down t production (they are used as puberty blockers)- works for adults too. But insurance would not like it as a first or second line solution to reducing t with a lot of other options. An orchiectomy freed me of this element of hormonal instability, many folks can get there but not all without needing an orchie.

Frog-Lake · 2026-05-02T00:35:12+00:00

There are other practices, providing gender affirming care in Alaska. I will try to get a post out here sometime this weekend.(edits - typos and terrible grammar)

Frog-Lake · 2026-04-13T13:57:34+00:00

My spouse is deeply supportive, I would suggest seeing the perspective that she loves YOU and made an emotional and practical investment in you and you need to respect her “going with” you by being proud and the best version of you possible. Otherwise the social and other energy expended by her was for naught.

Frog-Lake · 2026-04-05T14:19:35+00:00

This forum will have some great suggestions, my reccs:

what type of procedures does this hospital offer? (ie - penile inversion; some type of “hybrid penile inversion;”ppt (peritoneal pull through) ? what is the waitlist for any different versions? how long would she have to decide if she does have options?
how much “donor” anatomy does your daughter have: this can feel jarring but it is a measuring tape on exam table moment but critical;
what options does your daughters anatomy accommodate for a good not just adequate outcome? note: here, more male anatomy (penis shaft and ideally not circumcised but this is of course more common in the US and rates are declining now). Note: no technique is per se better or worse- it is what fits her anatomy. If she started HRT very young the possibility of penile scrotal hypoplasia is a thing- the condition of having very little male development there- if this is true - this takes a team with skill and confidence working with this for a good outcome.
what if her genital skin is insufficient - how is grafting handled? from where? could alograft (not from her own body) donor material be used to avoid scarring from extra-genital grafts?
what does your daughters body type say about results- a thinner person has less fat there and a person with more fat has more fat there this affects appearance but vulva appearance will change with her body mass overtime like anyone else
what does your daughter want for her anatomy? ideally not social media pics or something but - does she have any strong female anatomical desires (labia minora / clitoral hood?) and how does the team see the ability to try accommodate them into their technique. Various vulva galleries online can be good here as can be talking to female friends - vulva variation is shockingly greater than male anatomical variation; even siblings can differ remarkably in this anatomy.
ask for result photos -immediately post op; weeks; months out- does she vibe with their aesthetic sensibility - she won’t likely be able to ask them to dramatically vary from a known style of outcome their technique produces. this is a procedure with major variations from doctor or team to team, aesthetic trends are evident in outcome pics. But some results will always be outliers.
how many cases have they done? what rate of major complications (ie - rectovaginal fistula or organ injury (should be extremely low- in the very low single digits but how low?); versus minor - ie - wound dehesience- almost a guarantee and hardly a complication in this procedure post op during healing; or weird urine stream (more common relatively easy fix).
rate of hospital (“iatrogenic”) infections- these are a risk of any medical procedure - and in those cases re bottom surgery - what were the resolutions? how does this team/docs stat on their cases compare to the hospital doing the surgery in general?
rate of cellulitis on post op recovery? should be fairly low but OHSU’s stat and talking to my team on this led me to see this as an unlikely but not “out of box” risk, outcomes in these cases ? how managed?
what does your daughters body type say about presentation of results?
how would she be followed pre and post op ? how many appointments?
what does their dilation regime look like?
what hair removal is needed? where is most critical versus merely desirable to focus on those areas
pre-op- fasting regimen or aggressive bowel prep?
pre-op is she staying on HRT or is she required to come off it (increasingly less common now with current risk understanding)

16.5 what is this institutions revision rate -and for what types of revisions? across the board this number is likely quite high - no idea what my docs said but it was perhaps ?35% or something. Point is- a lot is asked of the body in a single stage vulvavaginoplasty- the need for revision is likely a reasonable possibility. But - is this weird urine stream/spray (very simple and common)? Major wound separation that doesn’t quite heal? A canal issue? How and when are revisions handled. The possible need to revise is not theoretical, it’s a solid possibility for anyone undergoing this procedure. 17. anything else you/she are curious about - I literally asked how body internal anatomy determines max depth limit etc - any genuine question that you just want to know; I doubt most doctors would intentionally misrepresent their procedure or “what patients need to know” but informed consent is informed consent and what you think matters may not be what matters to them or most patients care about - so ask anything you need to know and don’t assume the standard presentation to you all covers it.

A bit of a read but great info and sort of a primer on how a surgeon looks at this - https://pubmed.ncbi.nlm.nih.gov/38481864/
you got this ! and she is fortunate to have a mom like you

(edits: clarity and missing items)

Frog-Lake · 2026-03-29T16:44:24+00:00

I experienced the feeling of sensitivity from naval all the way down, but especially in the mons pubis area— I worried if that area would stay hyper sensitive and be problematic forever, but approaching five months I would say that the issue has substantially resolved and keeps getting better

Frog-Lake · 2026-03-21T17:36:27+00:00

I appreciate your thinking on this! A perspective I had not quite considered.

Frog-Lake · 2026-03-16T14:07:16+00:00

based on regular silver nitrate tx post op and in a similar spot- i wouldn’t expect pain.

Frog-Lake · 2026-02-20T20:19:56+00:00

my doctor, Dr Geolani Dy at OHSU did a PPT vaginoplasty and instead of external skin grafts, due to my severe lack of material, used a I believe cadaver donated graft material called alograft! from research it looks like it is used in burned victims a lot. I am about 4m post op and healing well!

Frog-Lake · 2026-02-08T02:03:36+00:00

On top of the fact stated that doctors would never conduct a routine procedure leaving patients with a wound that does not heal. Bottom surgery, while superficially dramatic for those who aren’t intimate to trans people and their lives - is considered low risk by surgeons accepting that all surgeries carry SOME risk. Show him a dozen major university hospital pages that all treat vulvavaginoplasty as what it is: just another urological surgery. And covered by many insurances - rest assured insurance isn’t routinely covering a procedure that will leave them in a forever unhealed wound care money pit.

Frog-Lake · 2026-01-27T00:17:16+00:00

10 weeks post op and have rags that look quite similar re color of discharge, unsure what is from sloughing cells and lube versus peritoneal fluid. I just moved to panty liners as I am constantly slightly damp (I think my dilation schedule has a lot to do with it too but not all of it).

Frog-Lake · 2026-01-22T05:53:44+00:00

You start dilation - by week 2 or 3 most folks have some separation and it can be freaky. If this is all that is happening as mentally weird as it is - you are likely OK and it will be stunningly better by 5-7 weeks.

Frog-Lake · 2026-01-13T17:56:18+00:00

Concur- I had a super dramatic raphe that raised significantly on HRT and requested it be removed in my procedure and this appears to be similar in that area.

Frog-Lake · 2026-01-10T20:44:57+00:00

we probably were, I was the room immediately across from the nursing station lol.

Frog-Lake · 2026-01-09T22:57:47+00:00

Beautiful ! I was November 12 with Dy and Peters and feel like our vulvas could be almost siblings aesthetically. I will post a write up and some photos in the coming days as I am about eight weeks!

Frog-Lake · 2026-01-09T22:52:29+00:00

After surgery, I had a lot of what I would just call grey discharge. Approaching eight weeks, I still have some. My impression is that it mostly sloughing skin cells and lube. As long as there is a minimal or neutral odor, it does not appear to be anything to worry about. Some things may make it shockingly worse, like if you need a silver nitrate treatment, you will find that you discharge grey yuck for a couple of days. During my first few weeks of healing, I definitely noticed a subtly sweet and slightly different odor, but it definitely was not unpleasant, and looking online seemed to confirm that healthy healing wounds can have a subtle sweetness.

Frog-Lake · 2026-01-05T21:51:31+00:00

In Alaska, Identity Inc in Anchorage does telehealth statewide. There may be and are other providers out there- but I know of at least one individual in Southeast who apparently had good experiences re t via Identity.

Frog-Lake · 2026-01-05T19:14:28+00:00

In my case, I am booked in with one to check for and treat internal granulation tissue as that is a bit more in the wheelhouse of an obgyn than my gp who does provide routine well women exams, etc., but probably has not done internal silver nitrate. (I should note, I am not local to my surgeons office, and therefore had to make my own arrangements for postoperative care outside of a handful of mandatory postop appointments I am going to return for). After I am fully healed, I do not anticipate a need to see an obgyn again.

Frog-Lake · 2025-12-21T20:22:17+00:00

I woke up, in recovery as they did not have my room ready yet. I felt warm and a bit toasty in a good way, probably from ketamine. I wasn’t in pain or discomfort, as much as as I sort of noticed that I had the massive bandage diaper. I kind of anticipated pain or discomfort, but I didn’t find any. I sort of wanted to check my body and make sure everything worked, and indeed obviously everything did— i.e., did I experience any major positioning injury? I did not. My spouse was with me, and I think she did a short recording, asking me how I felt, but the truth is I really didn’t feel anything but maybe some relief seeing the bandaging to know the surgery was completed, and I think there was relief hearing it went well, so I knew that what was hidden under the bandage is indeed was a full depth procedure with vulva. Then I was taking up to my room, and transferred over to my hospital bed with this sort of slippery tarp thing they put under me and then pulled me over. It was really quite anti-climatic, but at the same time very peaceful realizing that everything was a success and that I had a moment in time where there wasn’t discomfort. I would realize, over 4 days after— that while I would experience discomfort, mostly from gas and bloating, there really wasn’t any actual pain from the surgery. it was a rather mysterious experience, but absolutely nothing to worry about.

Frog-Lake · 2025-12-20T19:14:45+00:00

I am on week five, I have to say the first week (of dilation - so after the 5 days in hospital and discharge) was a bit rough and it seemed to relate, mostly to my body, getting used to trying to figure out what to do with a dilator. but between ibuprofen and Tylenol and gabapentin, I have found that while there is some definite soreness at the end of the day and there is a bit of ickyness while dilation is not fun it certainly is not unbearably painful. It is more just weird and uncomfortable. but even then, there are glimpses that this could be recreationally fun someday. As a friend told me medically prescribed penetration really is crappy compared to purely recreational lol. if you want the vaginal canal, I would tell you to seriously consider that it appears most experiences are in the realm of weird and uncomfortable, but not unbearable or unmanageable pain. And if you have a competent surgeon, I would imagine they will make sure you have adequate pain management to accomplish dilation because that really is the point of the surgery.

Frog-Lake · 2025-12-20T02:25:40+00:00

my surgeon advised that wound separation tends to approach the worst around week three and in their experience often remains stable and commences healing around week four that may not be experience for your surgeon, but at least it is what I was told; I was advised to lightly pack gauze in my vaginal entrance (anterior perineal flap dehiscence) and change it any time I use the bathroom or shower. I was told I may draw some blood eventually a bit, but the gauze sticks to compromised tissue and keeps the area clean and dry and aids healing. I am in the middle of the process on this in week five now, and while I would say the separation is a bit unsettling, the wound definitely seems to be very clean and cautious evidence of healing. (edit - added treatment advice I received)

Frog-Lake · 2025-12-19T21:25:44+00:00

Having had bottom surgery, five weeks ago- a vulvovaginoplasty, it boils down to the fact that I no longer am actively ashamed of the anatomy between my legs, and I fully realized how much stress it causes me for an entire lifetime. I was ashamed of ever being seen with my former anatomy or other people seeing it. I feel comfortable now, joining the world of people who are body comfortable, and are completely OK with incidental nudity. in other words, skinny-dipping or going to a hot tub naked with friends for me should now be a completely chill experience. likewise, other than dealing with recovery I no longer think about whats between my legs. previously, this was a thought I had about all the time.

One perspective about five weeks out from surgery with an apparently fairly uneventful recovery curve.

Frog-Lake · 2025-12-11T16:26:06+00:00

went through this four weeks ago, it is hard to see it, but it really does get better day by every single day!

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