Orchiectomy with Dr. Murray Kimmel, November 2002

By Jennifer Bentley

Original Discussions with Dr. Spector

I first ran across Dr. Spector on the Web in a desperate search for information on castration. When I found his site, it was very rudimentary; and his picture in combination with his name was somewhat disquieting. I also had found a reference to Dr. Spector on Anne Lawrence’s site, and it was in no way reassuring.

Only someone who was extremely desperate would resort to such an avenue for help. So you will understand how desperate I was when I resolved to contact him to arrange an appointment. I first copied the registration forms from his website and filled them in. He later called me, since he seemed to prefer the telephone as the primary mode of communication. According to his instructions, I provided the first $750 of the $2,000 total, and sent it along with a copy of the application. He mailed me back the information about what to do before hand and what medications to defer until after the procedure, a prescription for the antibiotic to be taken before and after the procedure, the necessary shaving instructions, and some other details. I was relieved to know that everything was in motion even though I had concerns about Dr. Spector's capabilities. But shortly before my time to go, I got a letter stating that instead of Dr. Spector, a Dr. Kimmel would handle my case.

The Mysterious Dr. Kimmel

In some ways I was relieved that someone else would be doing the procedure, and in other ways the same anxieties remained. I looked for any information on the Web about Dr. Kimmel, but there was nothing that I could find. I knew absolutely nothing and the time for my appointment was approaching. As it turned out, I had to postpone my appointment because of other obligations, so I called Dr. Kimmel directly to ask for an extension until August. That was my first exposure to a very nice lady named Mary. I even spoke with Dr. Kimmel; he took the time to talk to me, even though the office seemed busy. They were very helpful and professional, and arranged for the postponement. As it turns out, my obligations were still pressing in August, so once again I called Dr. Kimmel’s office to postpone the operation until the week just before Thanksgiving. Mary was always polite and helpful through all of this.

Final Preparations

Talking directly to Dr. Kimmel and Mary was probably one of the better things I had decided upon, because one day, out of the blue, I received an email from Dr. Spector. The email stated that at one time I had inquired about help from him, and he was asking whether I was still interested. What? I began to panic at this point because I had given him $750, and he did not seem to have even the slightest knowledge of all the previous arrangements I had made with him. I quickly responded, including all the emails that we had exchanged to date and a scanned color copy of the check I had sent to him some time before. I received a note back saying not to worry, that everything was fine. Then about two months later I got a similar letter, seeming to have no knowledge of anything up to that point. Therefore I resolved from that point to stay in contact with Dr. Kimmel’s office alone.

When the time arrived for me to make the trip, I confirmed all my arrangements, including the plane flight, car, and especially the appointment. It turns out that this was very important to have done, because that same week there was communication between Drs. Spector and Kimmel, wherein Spector told Kimmel that someone with a name entirely different than mine was on record to show up. Since I had already verified the information with Mary and confirmed that everything was a go, Dr. Kimmel was certain of my arrangements and reassured Dr. Spector that it was me who was scheduled. My advice is, don’t assume anything and check and recheck to confirm the details of your arrangements.

The Walk to the Office

In my last discussions with Mary, she told me that I should not drive to the office, but instead should stay at the Best Western, which is just a very short walk away. She said it was likely that I might still be kind of groggy from the medication when it came time to leave. The morning of appointment, I called the doctor’s office first thing for information on what direction I should be traveling down Pennsylvania Avenue. Mary told me to head in the direction of the museum. It turns out that the hotel is at the very south end of Pennsylvania Avenue and that the museum is to the north. After making a few wrong turns, I finally figured out how Pennsylvania Avenue ran. Once I got on the right road, it was very easy to find the office, which was exactly one small block away on the east side of the street.

Mary

I got there early, I guess, because the doors were locked. Although there was a sign on the window saying to knock, there was no response. Fortunately I brought my cell phone and was able to reach Mary to come let me in. Dr. Kimmel had been slightly delayed at the hospital and was due in any time, so I waited for a little while looking at magazines. Mary was medium height, thin, blonde and had a very pleasant smile. I waited for a while, and after Dr. Kimmel arrived, she brought me back to get some information for the doctor. Since she was asking some questions, I inquired whether I could ask a few myself, for I had written out a few things that I wanted to be sure of before I left. My questions concerned follow-up visits, emergency telephone numbers, etc. It turns out that it was good that I had asked before the surgery. Mary said they go over the information, but usually after the procedure, when people are still a little groggy. The question came up whether I had in fact made the first deposit to Dr. Spector. Fortunately I had a copy of the cashiers check that I used to pay him. Mary seemed very impressed that I had taken the time to prepare for this, because sometimes the documentation and payment information between Dr. Spector and patients that he has sent to Dr. Kimmel has not always been clear.

Dr. Kimmel

While waiting for the doctor to come in, I had a chance to look around his office. It was kind of cluttered, with a good number of records and things that had been acquired over the years. I noticed numerous documents on the walls: his licenses to practice in New York, Pennsylvania, and other places, his degrees, and awards for his work in urology in the armed services. Clearly he was a very capable and active doctor in his field.

Finally Dr. Kimmel came in. He was an older gentleman, but was obviously sharp, aware and perceptive. He went over the data that Mary had collected, and then went into a more personal line of questioning to understand my long-term goals and why I wanted the surgery. He went through a litany of things related to gender issues, and it was complete and thorough. He explained that in my case, since I was eventually seeking sex reassignment, it was important to leave all the scrotal tissue intact for later use. He discussed how he would perform the surgery. We then talked a little about my family, so that he could get a sense of my resolution. He explained once again the irreversible nature of the procedure. Finally he was satisfied that he had explained everything, and he moved toward getting things going.

The Procedure

He gave me a Valium to take with some water, and a couple of shots. We then went back to the room where the procedure was to be done. It was an older building, yet everything seemed to be clean. I stripped down to my socks, leaving my shirt on, and lay down on a table. The surgical area was carefully treated with iodine solution, the drapes were arranged, and Dr. Kimmel began his work.

I don’t remember much of the operation, but I knew he was making steady progress because he let me know how things were going. I remember Dr. Kimmel telling me that he was half way finished, and then the Valium and the anesthetic seemed to take over and I fell asleep. I later found out that the whole procedure took about 30-35 minutes. I awoke right at the end, to see Dr. Kimmel finishing up and cleaning up the area a little. There was no real evidence of bleeding, or of any difficulties. He went over how the procedure went, including the placement of the incisions and the provisions for drainage. He was very clear and precise. We finished up the bandaging with some help from one of his assistants. After I dressed, we went back to the office we were in earlier.

Post-Procedure

Dr. Kimmel sent me back to the hotel with an entire package of things, including pain medication, bandages, large cloths to avoid soiling my bedding, extra 4X4 bandages, and an extra scrotal support. I also had brought spare bandages, peroxide, and antibiotic cream, so I was well equipped. Dr. Kimmel provided another prescription for an antibiotic that I could use if needed. When it came time to go, I gave Mary a hug and shook Dr. Kimmel’s hand. I made my way back toward the hotel in a much less groggy state than I had expected, but still very carefully and slowly.

Back at the hotel I got some ice for ice packs and immediately put myself to bed. I lay down and slept until about 6 PM. After I woke there was definitely a dull ache from the procedure, and since I had already caught up on my sleep, any more rest was fruitless. I decided to get dinner in the restaurant downstairs. Afterward I went back up the room and watched TV, wrote a little, and watched some DVDs I had brought with me.

The most memorable part of the evening was a call from Dr. Kimmel. He called at about 9 PM, and was just as nice as in the office. We went back over almost everything he had told me earlier about what I should be doing to care for myself. Before we hung up I was almost crying, because of how thankful I was that everything had turned out to so well, and because he was so obviously concerned about me. He said he appreciated how well I was dealing with everything.

The next day, I discovered that the Best Western had been the right hotel choice. It was a little more expensive, but it was the closest to Dr. Kimmel’s office. Also, it was right next door to a number of restaurants and a drug store. I made a short trip to the drug store and picked up some soft foods like fruits and pickle spears, I and scoped out a Chinese place that I wanted to go to for dinner. Actually I never went out for dinner, thinking it best to stay down with ice as prescribed, and because even the short trip earlier seemed to have increased the ache. I even broke down and took one of the pain pills Dr. Kimmel had provided for me.

Just before I went out, Dr. Kimmel called me again. He took the time to go over most everything once more. I told him about how I had cleaned the whole area in the morning, that the amount of drainage that was moderate, and that as a result of his preparations there had been no surprises. He was very kind, and once again he told me how well I was doing. I had my surgery on Friday, and he called Friday night, twice Saturday, and Sunday, too.

Home and the First Week Post-Procedure

I strictly adhered to Dr. Kimmel’s instructions to stay off my feet for the first couple of days, to keep the bandages clean, and to keep ice on the area. This really paid off, because the trip back went very well, with minimal discomfort. Of course it still hurt having to pull my heavy suitcase, but taking it slowly and utilizing whatever help was offered, I got through with no mishaps.

I am not a good patient when it comes to staying away from my work. I was supposed to stay in bed for most of the coming week, but of course I had to go to my office and check on things. I was planning to go in for an hour, but spent five. The second day was a little better; I stayed in bed most of the morning, but got up and was on a conference call with my work for a couple of hours. I tried calling Dr. Kimmel on Tuesday like he suggested (Tuesdays and Thursdays are the best days to call his office for routine contacts), but the line was busy. I spent the rest of the day relaxing until the afternoon, when I went over to my ex's house; but I was home and in bed before 11 PM. Thursday was bad: I traveled to my sister’s for the Thanksgiving holiday, and I was hurting by the time I finally got home at 10 PM. Friday was little better; I spent it cleaning up and preparing for my kids to come over. But by the time I had finished this run of active days, I had done too much. Although the swelling had continued to go down and there was no significant drainage, I was hurting and I had managed to loosen one of the stitches. One week has passed, and the lesson I learned is that instead of the four days I spent in Philadelphia, I should have stayed all week. One solid week of uninterrupted rest off my feet would have been the best thing for me. At least I have been very conscientious about taking sitz baths twice a day. Going into my second week, there were no infections or serious problems, but I needed to be extra careful not to aggravate the healing process.

Second Week Post-Procedure

My second week I was almost as bad as my first. I was good over the weekend, in that I did not do much at all, though I went out for a walk around my neighborhood once or twice. The first couple of days back at work were the most hectic I had experienced in a couple of years, lasting until 8 or 9 at night. Each night I got home and, after getting a bite to eat, got in a sitz bath. The first two nights were kind of alarming, because the arrea continued to look like it was staying open in spite of the fact that I was taping it very securely and keeping it very clean. I wanted to try to call Dr. Kimmel, but I didn't get a chance. Wednesday I was up very early to pack for a trip. I went into the office and then got on an airplane to meet with one of my customers. I had to hurry through the airport to catch a connecting flight. Once I got into my hotel room it was evident that there had been a significant improvement, with the incisions closing a good deal. Thursday and Friday were again all day events. Friday I crashed as soon as I came home. Again it was obvious that everything was beginning to heal very well, with noticeable improvement each day.

Third Week Post-Procedure

By the end of the third week everything had healed very well. There was still a slight opening of about 3/16", and after talking with Dr. Kimmel I learned that there were a number of internal stitches that would take a couple of weeks more to dissolve. I was not prepared for the swelling that took place in the spermatic tubes--there were large swellings on either side of the scrotal area. If you also experience this, don't panic, nothing is wrong. Just give everything time to heal.

Elements of Success

What were the reasons I made it through so well? Well, I have to attribute my success to four things.

First, I followed instructions. I stayed at the Best Western, which it is very close and has stores and restaurants a short walk away. I stayed long enough to let my body get over the initial shock. At least two nights is Dr. Kimmel's general rule; more is better. I wrote down the instructions given to me before surgery and followed them.

Second, the surgery was done well; it was very neat and there was no infection.

Third, I followed the detailed aftercare instructions that Mary and Dr. Kimmel provided.

Fourth, my efforts to keep the area very clean and to tape the area very carefully allowed me to make up for the lost stitches and kept me from stressing the area again during my activities at work.

I did one thing differently than I was told to. The instructions specified the use of a incontinence-type diaper and an athletic supporter for the first two weeks. I decided to swap these for a girdle with some firm support through the crotch. After the first two days of ice and my trip home, there was no effective support from the garment provided, and I didn't like the idea of wearing a garment that was so specifically masculine to begin with. In the end my substitute worked out well for me.

Summary

My experience was extremely good. Thank you, Dr. Kimmel!

The contact information for Dr. Kimmel's office is as follows:

Murray H. Kimmel, M.D.
2301 Pennsylvania Avenue (Parkway at 23rd Street)
Philadelphia, PA 19130
Phone: 215-563-0847

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