Saturday, April 19, 2014

Eat, Rest and Carry On.

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Ugh, I'm tired. Not sure why, I suppose it's related to being 12 days out from surgery. I'll open with a pic from my first trip to the gym post-surgery this past Wednesday.

The first thing I did was walk on the treadmill. I set the speed to my normal walk pace, 3.0mph. Whoa, horsie! WAY too fast. So I slowed it down to somewhere around 2.0, maybe even slower, and just walked. I had a book and read and walked for 10-20 minutes (didn't pay attention). After I got tired of that I went to lift some weights. I did some really easy stuff with only 5 pound weights, bicep curls, tricep stuff, the basics.

Thursday was my follow-up with Dr. Canales, "I read your blog and about spit out my coffee when I saw you went to the gym." That followed with an explanation of why even the easiest of weight training is NOT ok at this early point. I'll spare you the details but it involved internal friction and bleeding. Ok, got it. So here's the general answer to my "When can I exercise?" question.

Weeks 0 - 2: NO EXERCISE
Week 2: Can start walking. No increased heart rate, no sweating.
Week 4: Can start running. Emphasis on taking it easy, listen to my body, etc.
Week 6: Can start engaging core (weight lifting). Again, listen to my body.

Admittedly, I'm not the best at listening to my body. But given the gravity of my situation, I will do my absolute best. I don't want any bleeding or other such problems to take me backwards in my recovery. Speaking of blood, he also gave me a NSFW picture of me mid-surgery. It's not for the faint of heart. I'm warning you, only click here if you don't mind blood and gore. The black line is where they cut. The 11cm spot on the ruler is where my belly button used to be.

He said they cut off about 3lbs of skin, 1 lb of fat and removed about 1lb of fat from my love handles via liposuction. So, about 5lbs altogether. Not that I did this to lose weight, had nothing to do with that. I'm still fairly swollen so I haven't seen that change on the scale, I'm still about 144 and can barely zip a size 10 (I was mostly wearing a size 6 before). Not that it matters, I'm all about the elastic waistbands these days. None of this matters for now.

Other than my eating. Trying to put my energy into focusing on that, since I can't exercise. Speaking of food, here's what I made for dinner Wednesday evening. These are zucchini, red bell pepper and pineapple kabobs I grilled. I also did chicken thighs marinated in a bottled orange ginger sauce on the kabobs but didn't take a pic of those. It was a yummy dinner. Too bad the kids only wanted the chicken, I thought they'd at least go for the pineapple.

Anyway, back to my follow-up appointment. When I was done with that they told me the MedSpa downstairs was doing free demonstrations of Obagi Blue facial peels and asked if I wanted one. Why not? BTW, taking a selfie while laying down makes your skin look perfect?!

And here I am with the medical aesthetician, Danielle Anglen. Does my skin look all glowy and perfect?

I think it's supposed to induce a bit of peeling but it's been two days and I haven't noticed anything.

Anyway, about this time I was feeling really good, no pain meds, had a good amount of energy. I did a bit of shopping, got Easter outfits for the kids and picked up a couple Spanx tanks for myself, since I can now switch to those from the abdominal wrap. Friday evening I had plans to visit one of my oldest besties...wait, not one of my oldest bestie, my only oldest bestie...Joy. She's been in this blog before, way back in 2008 when we joined her crew on a rafting trip. I was preggo with Marek at the time.

Joy and I have been friends since we were 14 years old and live a mere hour apart but you know, life gets busy and we just don't see each other enough. So I made the drive out to see her for dinner and stayed the night at her place. It was SO fun to catch up. We started with sushi for dinner. Joy got out her reading glasses and...oh dear, we are aging aren't we?

I love this woman!
But at least we're healthy! Joy is a serious mountain biker and hits the gym on the regular. We caught up on all things - work, friends, relationships, kids, etc, etc. Takes a while when you wait years to see one another. Anyway, after a few sushi rolls and a lot of chatter we decided to drive to Davis and see The Budapest Hotel movie, which was solidly ok. Walking back to the car in this university town and we spotted people eating ice cream sandwiches. Even after movie theater popcorn that still sounded good. After a quick Google search we found our way to Cream.

We went with an oatmeal raisin cookie on one side, chocolate chip on the other, and soy mint ice cream in the middle. And split it. So good.

The cookies were still warm!
The only problem with the visit was all the laughter. I was in agony and begged her to stop but with her being both funny and sadistic, that wasn't happening. Back home today and errands, a family lunch outing with Miguel and the kids, getting ready for our big family Easter party rest for the weary. No wonder I'm feeling drained.

Speaking of drained, today I put a practically whole gallon of vanilla ice cream down the disposal. I knew I was feeling too mentally drained to have it around. Sure, I could have lied and told myself I'd save it for the family Easter party tomorrow and then go on to eat half of it tonight. No, that's not happening There are times when this weight loss/maintenance thing feels like war and I have to fight. So fight I did. The money's been spent, eating that ice cream won't bring it back.

Well, that's the latest. Monday I'm allowed to start walking so I plan to go to the gym after work for another leisurely stroll on the treadmill. You might wonder why I'm not just walking outside. It's the air at the gym, I need to breathe it, be in that environment, remind myself that the gym is part of my routine. So I'll stroll, and talk up the positives and wait out my body continuing to heal.

Wednesday, April 16, 2014

The Tell-All Tummy Tuck Post (Part 2)

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In case you missed it, here's the link to Part 1.

I woke up several hours later in recovery. Moments after opening my eyes my mom was there and it seemed like moments after that I was walking out to the car. We'd planned to stay one or two nights at the hotel and then go home. Since I didn't end up needing drains (which is a good thing), I didn't have a post-op appointment the next day, which was nice. All rest, all day.

We got back to the room and I took two pain pills, Percocet 5-325. They did absolutely nothing. Or at least it didn't feel like it. I was dying in pain. We called the doctor's office and a nurse said to put ice on my tummy and to make sure I'm sitting up with pillows under my knees. Two hours later, still dying. None of this was helped by the fact that I still had a cough. Every time I coughed I thought I'd pass out from the pain.

I have a mom friend who's also had a tummy tuck. She was checking in on me via text and when I told her about the pain she suggested I switch to Vicoden, that it had worked better for her despite being a weaker drug overall. I called the doc's office back, eventually spoke with Dr Canales and he made the switch. In the end what worked was to alternate the drugs every few hours, take Percocet, then Vicoden, then Percocet.

Dr Canales also told me that my abdominal muscles were entirely separated (also knows as Diastasis recti, read all about it here) and had to be stitched together from the top to the bottom.

This, and they didn't use drains, which meant additional suturing (which meant more pain), "but trust me, in a couple days you'll be happy about not having drains." - he was right, so thankful for not having to deal with that.

So, in the end, a solid couple days of too much pain and, yes, even regret, another few days of pain but at least it was manageable, and then a few more days of discomfort entirely managed by the pain meds. Oh, with the coughing, my nurse friend Catherine told me to hold a pillow against my stomach and put as much pressure as I can when I cough, "that's what heart transplant patients have to do, use the pillow like a stint." That made a world of difference.

You might be wondering how my tummy looked after the surgery. Well, I wasn't. I could have cared less. In fact, I was thinking what an idiot I was for putting myself through such torture just to look better. When it came to the first couple of overnights there was good and bad news. Good news, I was sleeping pretty well (with the help of an Ambien). Bad news, I'd sleep through the time for meds and wake up in serious pain. I never said I bore pain well.

Being the good blogger that I am, I took a picture from my reclined position. This was taken Monday evening around 7:45pm. Can't tell much, I know, but there you have it.

So after the first couple nights I learned to set an overnight alarm to take pain meds at least every three hours while I was sleeping. Oh, and I extended my hotel stay by a couple more nights. I was not ready for a car ride. And the fun doesn't end there. All those opiates led to constipation. Skip the rest of this paragraph if it's TMI for you but I want to include it for anyone getting a tummy tuck. So yes, constipation. And it was bad. Despite my being very careful about taking Senna and stool softeners and despite eating mostly fruit, drinking a good amount of water, and even drinking a few glasses of prune juice, my system came to a serious halt. Fortunately I have my nurse/runner/mom friend Catherine on speed dial. I'll spare you the gory details but just know that by Day 3 I had to action I typically associate with people in convalescent care.

I finally came home on Thursday. More TMI so feel free to skip this paragraph too. It took a day of constipation-related interventions for my system to start working again and then when it did, things took a turn for the opposite. I go from laxatives to Imodium AD but at least things settled down to almost normal before the kids got home.

Regarding the kids, Miguel and the pre-school teachers had been prepping them on how I'd be delicate for a while, "gentle hugs and kisses, no jumping on mommy, no sitting in her lap, she has an owie that needs to heal." So that night Miguel and I took the kids out to Chevy's to make things easier. They were so happy to see me and did their best to be gentle with me. It wasn't easy for them to refrain from the usual bear hugs, and we had a few bumps here and there but all in all they were great. I ate the Santa Fe Chopped Salad and a few chips. I was still uneasy about putting food in my body but I was hungry.

Mesquite-grilled chicken breast, crispy bacon (which automatically makes it delicious), fresh Hass avocado, fire-roasted red peppers, crumbled bleu cheese on chilled hearts of romaine.
I'd planned to spend the weekend away from home, I didn't yet have the energy or fortitude for being around the kids full time. Friday, Saturday and Sunday were all about rest. Each day I felt a bit better and needed less pain meds. A week after surgery, Monday, I was almost feeling like my normal self. I'd hoped to get through the day with no pain meds but about 4pm I decided I needed one. So yesterday, Tuesday, was my first day with zero pain meds - extra-strength Tylenol a couple times and that did it. Thus far today I haven't had anything, not even Tylenol, and I feel fine. Just very mild discomfort. Barely even discomfort really, except when I cough and then it hurts a bit but it's fleeting and manageable.

Ok...enough of all this. I know it's time for a picture. On the left, my "before". On the right, a pic taken Monday (one week post-op). Ah, the beauty of corrective surgery.

It kind of makes all the pain seem not-so-dreadful now, right? Right. At least for me. Of course, if I had it to do over again I'd do a better job of managing the pain from the start.

I just snapped this bikini pic in my backyard. And to give you an idea of how much movement occurred... I highlighted a couple moles on the left side and the same ones on the right to show you how my skin moved. Which is why my belly-button had to be removed and re-installed.

So I'm a week-and-a-half out and feeling very happy so far. I'm still swollen, they say it takes 8 weeks for the swelling to go down entirely! And I still have stitches (that you can't see because they're at my bikini line and hidden by my clothes). The black line under my belly in the pic at the left is where the stitches were placed. I think they'll be removed at my follow-up appointment on Thursday. Oh, and I have to wear this abdominal binder for a total of six weeks. Thank goodness for elastic waistbands.

As far as exercise, I plan to ask when I can start exercising and using my core muscles again. I'm already feeling antsy about sitting around so much. So today I'm taking my own advice (This isn't a slump but #9 still applies here) and heading to the gym. Hold on, don't freak out. I plan to walk slowly on the treadmill for 5-10 minutes while reading a magazine. And then I'll leave. The last couple days I've been eating a bunch of crap. I had vanilla ice cream for lunch yesterday and so-called "veggie" sticks were essentially my dinner. I know, I want to stop, hence the gym visit. Just being there will remind me of my goals, remind me of what I want - to maintain my weight during this recovery time and to formulate and implement a fitness come-back as soon as my body is ready - and how to get it.

Another good thing is I'll be meeting with Janine, my Pharmaca herbalist soon to go over my goals. I know that will help keep me on track too. In fact, I'll email her right now. Alright, that's it! I'm looking forward to sharing my comeback journey.

Monday, April 14, 2014

The Tell-All Tummy Tuck Post (Part 1)

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Where to begin? I've lost over 90 pounds and I've had two babies. That didn't bode well for my belly. I've been dreaming of a tummy tuck even before I hit my goal weight. Most people who'd see me (dressed) balked when I said I wanted a tummy tuck, "What?! You're so skinny, you don't need one!" Sometimes, if they were a close friend (or my hairdresser) I'd show them my belly, to which they'd always say, "Oh yeah, I see, you should get one!" Want to see what I mean? Here are my official "before" pictures taken by the plastic surgery folks.

Before (tummy tucks) pics
Those pictures make it look even better than it is was in my opinion. They were taken when I went for my pre-op appointment in November of 2012 (the surgery had been scheduled for December but ended up getting canceled because of my cough. The docs were worried I'd get pneumonia).

So it got canceled and I randomly chose April for a new date. At the time April sounded so far off in the future but it was here in the blink of an eye! I got so nervous leading up to the date. I'd really wanted to lose those re-gained 5-7 pounds before the surgery but it didn't happen. Oh well, maybe that's a good thing. But what wasn't good is that I caught a cold (with a cough) about a week before the surgery. Ugh. I just hoped it would go away before Monday.

It didn't, but the docs still gave me the go-ahead for the procedure. I was so nervous! My final pre-surgery workout I felt so strong, and I was dreading the downtime to come. Anyway, the night before surgery I stayed in a local hotel so I wouldn't have to get up at the crack of dawn. I followed instructions - no shaving for two days, wash with surgical soap the night before and morning of, and ingest nothing after midnight.

I arrived to the surgery suite exactly at 7:30am and they took me straight in. Eek! No mom to hold my hand. I took some pictures to keep me busy and called Miguel and the kids for one last chat. I said some very heartfelt "I love you's" just in case I d.i.e'd, which I wasn't seriously worried about but still.

And then Dr. Canales came in for a pre-surgery pep talk. And to do some body-art on my tummy. I'd asked most of my questions long before but this morning he answered my last minute ones, some of which were repeats because I was nervous and couldn't remember anything.
  1. Will you be cutting through my abs? No. If they are separated we'll sew them back together but I won't know if I need to do that until we get in there. But no, I won't be cutting into them.
  2. Will I still have the same shape and definition I have now? Hard to say exactly but you will look better. (he said more but I'm paraphrasing here)
  3. How long will the surgery take? About 2 hours, recovery will be 1-2 hours, depending on how you do.
  4. Will you take a selfie with me? Sure!
I'm sure there were more questions but that's all I can recall for now. So, here I am, all marked up and ready for the knife.

Before (tummy tuck) pics
It's not easy sharing these pictures. Just had to say that.

And, the selfie! (if it's two people should it be called a welfie?)

Dr Francisco Canales and yours truly.
No, I didn't select him because he was the cutest doc I saw, though that didn't hurt. I chose him for a few reasons. First, he came recommended by someone for whom he'd done a breast augmentation and she was very pleased with the work. Nothing like a first-hand recommendation. Second, I felt he was very honest about what to expect from the tummy tuck. And finally, I didn't feel he was selling me. He didn't dazzle me with the magic of plastic surgery or how fabulous I'd feel or look afterward. Some of the docs I saw gave me the feeling I was buying a new car. No sales job please, not when it comes to my body.

And he told me not to touch my arms. I'd asked about surgery to remove the fat hanging from my arms and he practically told me he wouldn't be willing to do it, "they aren't that bad." I asked him if I was being neurotic and needed to get over it, "Maybe I wouldn't put it that way, but yes." There you go, honesty goes a long way.
Then I had a chat with the anesthesiologist (holy cow I spelled that correctly on my own!). He reviewed my history of pneumonia and coughing and listened to my lungs. All clear.

The nurse came and got me, washed me up some more, laid me down and then the sleep doc gave me a pre-anasthesia cocktail...and with that...I went under the knife. Link to Part 2.