For as long as I can remember, I have been...
I have been focused on losing weight my entire adult life. Some might call me a success story; my highest known weight is 264 lbs and today at 5'6" I weigh 150 pounds. I've gone from a size 26/28 to an 8/10. It has taken me the better part of a decade to lose more than 100 lbs through a series of experiments with exercise and then nutrition. I've been stable at my current weight (give or take 5 lbs) for about a year. I'm 35 years old and in the best shape of my life. I eat clean and healthy, weight train twice a week and I'm an avid runner, having just completed a half-marathon in April. I still struggle with food as a crutch but my lifestyle is a complete 180 to where it was when I was in my early 20's.
As I've gotten smaller over the years and my natural figure has started to emerge, the idea of plastic surgery has been something I've had in the back of my mind. My body definitely shows signs that I was once morbidly obese; I am covered in stretch marks, the skin on my stomach is loose and I have abdominal fat that clings to me tooth and nail regardless of any diet or exercise.
I started doing research on plastic surgeons here in Denver and ultimately found one that I scheduled a consult with. After an initial conversation where I shared my weight loss story with the surgeon, followed by an examination, it became clear that the best option for me would be either an extended tummy tuck or a body lift. Both procedures would address the excess fat and loose skin on my stomach and I decided to go for the extended tummy tuck.
The really interesting part about this process so far has been the emotional response I've had since committing to the surgery. Right after I officially scheduled my tummy tuck, I found myself binging on food like I hadn't in a very long time. It was almost as if I was trying to fatten myself up as much as I could in a single night. There is something about having this procedure that signifies the end of a long chapter in my life (or the beginning of a new one, depending on how you look at it) and the thought of shifting my focus away from consistently losing weight was jarring. There is so much of my identity wrapped up in my weight loss that, as crazy as it sounds, I don't know any other way to live my life at this point. I won't consider myself "done" with losing weight completely after my surgery but I really only have another 15 or so pounds to lose; self-sabotage is definitely my biggest hurdle right now.
1) How am I going to manage to get in and out of my ex-boyfriend's SUV after surgery? (He'll be taking care of me for a few days post-op and he drives a Nissan Xterra!)
2) What can I do to avoid getting constipated? I am seriously obsessed with this. I have never had surgery before so I have no idea what to expect in terms of how my body will handle the anesthesia, pain meds, etc. I get blocked up pretty easily as it is (TMI, I know) so I'm terrified of having a traumatic BM post-surgery. I'm getting sweaty just thinking about it.
So regarding #2 (see what I did there?) I am actually going to see a nutritionist on Monday who has a specific surgery recovery regimen to help keep things moving. I'll report back after I meet with her. Otherwise I plan to sip on MoM with a bendy straw and pop stool softeners. Any advice on this topic is greatly appreciated!
A few pictures and things to look forward to
Two of the many things I'm most looking forward to as a result of this surgery:
1) Being able to sit down without my belly spilling out all over the place. I've always been so self-conscious about that and more often than not I will opt to remain standing just to avoid the embarrassment.
2) I have a t-shirt that doesn't fit very well around my tummy and I cannot wait until I can wear it! It's a silly thing but I am so looking forward to looking and feeling good in my clothes.
Logistics and a story about love
After five years together, Matt and I separated last September. The separation was by far the most difficult thing I've ever gone through in my life. Matt is an amazing man, brilliant and loving. Early on our relationship was everything out of a fairy tale. We used to gaze lovingly into one another's eyes and I'll never forget the first time he told me that he loved me -- my heart literally skipped a beat. We were so deeply in love.
As the years went on things started slowly coming apart at the seams. We grew co-dependent in many ways and our communication completely broke down. By our fourth year together we were to the point where we become entirely averse to conflict and more and more resentful of one another. We stopped bringing out the best in each other and life became a routine of coming home after work, walking the dogs, eating dinner, watching a little TV and pretending everything was okay. We lived this way for years, just going through the motions.
Ultimately we tried couples counseling and saw some small successes, but after a year we both recognized that the damage had been done. We both felt a sense of peace knowing that we did everything we could to try to save what we had, but sometimes love just isn't enough and some people simply aren't meant to be together as life partners.
Our split was amicable; we each took one dog (that was hard) and since my apartment is so small, Matt has the majority of the furniture from our home together (which means recovery should be somewhat comfortable since the couch and bed are both familiar to me.) We've had some time to heal and while some people find it strange, we have a very healthy relationship now. We see each other at least once a week and I consider him my best friend and my family. I think it's fair to say we get along better now than we did while we were together. Funny how that happens but to me it's a sign that we chose well; it was five years well spent.
Matt and I initially met in 2005, so he has witnessed a good portion of my weight loss journey and he knows what a life-altering impact this next step will have. He has been an incredible support system and I will love him forever for loving me at every size. He calls me "pretty lady" even still and has always made me feel beautiful, even when I was at my biggest. My eyes are tearing up just thinking about all of this.
Matt has taught me so many things in this life: the value of companionship, how to cook and the meaning of perseverance, among other things. I am so incredibly grateful for his love and support and honestly there isn't anyone else I'd rather have by my side as I recover. To be on the safe side I have already apologized to him in advance in case I'm emotional (I will be) and for the variety of bodily fluids/functions he's about to become intimately familiar with.
Although things didn't work out for us romantically, we are definitely about to take our relationship to the next level.
Yesterday I met with a nutritionist; the intent was twofold: 1) I needed some structure to cut a few pounds before surgery. I'm about 7-10 pounds heavier than I want to be before my TT. 2) I've been looking for a post-surgery nutrition regimen so that I can heal as quickly as possible and so that I can make sure my digestive functions keeps doing their thing while I'm taking pain medication, etc.
Her regimen was pretty much in line with a lot of the research I've done so that was reassuring. Here's an overview:
Bone stock: she suggested I make my own ahead of time, freeze it and then sip on it 3x per day right after surgery (promotes healing)
Protein with every meal (promotes healing)
Pineapple (for inflammation)
Arnica (for inflammation)
Nuts (for inflammation)
Fish oil (for inflammation)
Fermented foods (digestion)
My surgery packet says I can't take fish oil two weeks before and after my surgery so I'll check with the nurse at my pre-op on that one. As of now I'm on a hardcore dose of probiotics to get my good gut bugs built up before my TT so that I can avoid the dreaded traumatic BM during recovery (seriously having nightmares about this.) She also mentioned Smooth Moves tea (I've seen it at Whole Foods) would help with that. Between the tea, probiotics, stool softeners and MoM I'm starting to think I might err too far in the other direction!
The red pill or the blue pill
When I initially met with Dr. Vath he thought the best options for me would be an extended TT or a body lift because my skin redundancy starts just passed each hip. He mentioned that one thing he often hears from his weight-loss patients is that after a TT they’re sometimes disappointed with their sides, or “love handles” when they just have the stomach addressed.
Frankly I have no idea how I’d feel about love handles considering I’ve been so focused on how abnormal my stomach looks the smaller I get. There are other parts of my body that are far from perfect and truly, I’m not seeking perfection…I just want to look and feel normal. The body lift is a much longer and more involved surgery and honestly I just had more of a visceral response to going the TT route.
Of course the thought of how I will view the other imperfect parts of my body after surgery is lingering. Once I don’t have my stomach to obsess over I hope I won’t end up feeling consumed by some other flaw.
Fear and Surrender
If you put it all on paper, I have done all the right things to get to this point. I have lost weight slowly and in a healthy way. My BMI is in a healthy range, I’m active and I know how to eat right. I cherish my body as my temple and I’m grateful for its strength. I have researched exhaustively and have found a surgeon I trust. I have asked for support from friends and loved ones to see me through this. Most of the time all of this brings me comfort, but I find I am having moments of panic the closer I get to surgery. The most difficult thing I continue to grapple with now is the fear that I haven’t lost enough weight and I’m so afraid my results won’t be ideal because of that.
I shared some of these worries with Kari down at Dr. Vath’s office and she assured me it truly is a skin problem, not a fat problem, and that the transformation for me would be immediate and obvious because of my shape. Honestly none of that made me feel any better but she then went on to say this:
“Surrender to the path you have chosen.”
That statement has been my anchor throughout this process so far, and if you ask me it’s just damn good advice for life. I keep repeating these words to myself when I have my “oh shit” moments, like today.
There’s so much wrapped up in this surgery for me that goes beyond just my physical appearance and I can’t think of anything that would stop me from doing it at this point. I am doing everything I can to surrender and trust in the decision I have made.
Part of me is secretly hoping the TT will help ease some of my back pain once my muscles are tightened and the loose skin and fat are removed from my lower abdomen. Here's hoping!
To spanx or not to spanx, that is the question
This morning I went for a run down to the park as I often do on the weekends. Running makes me feel better physically and emotionally but because of the shame I have about my body, even after all the weight I've lost, I will wear my running hat low to cover my eyes so I don't make eye contact with anyone while I'm out there. I highly doubt the other people running are scrutinizing my belly bulge the same way I am, but even still I can't wait until the day comes that I can get out there and run for the joy of it and let go of the shame forever.
I was nervous going into my appointment this morning but ultimately it was a really positive experience for me. I wish that I could enumerate all the things Nurse Jen (loved her...she was very patient with me as I asked all of my poop questions) and I talked about but I think the mental and emotional state I was in prevented me from retaining the specifics. What I do know is I feel about as calm as I've felt in weeks about doing this and I'm so much more at ease with the amount of weight I've lost being enough. I had an emotional moment when that acceptance finally set in.
I'm grateful for the experience I had today and I definitely feel like I'm in good hands. Let's do this.
An investment in a life well lived
The few people in my life that know I'm doing this have been supportive...they've seen me hustle, struggle, emerge victorious and save my own life in losing a tremendous amount of weight over the years. I did have one friend however, when I was in the early stages of this process, challenge me. He said I should consider taking the money I'd saved up for the procedure and travel the world. It's something I certainly thought about, knowing that ultimately this life is about experiences and not physical things, and that our bodies naturally decline over time.
But here's the thing: while I have had some life experiences that I am abundantly grateful for, *every single one of them* has been overshadowed by my weight or body shame. I cannot live this way any longer. I cannot.
I don't expect this surgery to be a magic bullet that is going to fix everything about my life, but I truly believe it is the gateway to being able to live my life more fully and vibrantly. And to me, that is money well spent.
Wax on, wax off
And while I'm on the topic of lady parts I *think* I am getting period (it has been really irregular lately) which will be a huge relief to get that over with right before surgery.
Reality sets in...
Although my surgery is on Tuesday, for better or worse I decided to take Monday off work to "get my head in the game" so to speak. I made a spa appointment for myself and I'm going to go for a run and just try to make peace with how far I've come on this journey so that I can move forward to the next phase. Life as I've known it for the bulk of my adult life is about to shift. I can't help but feel a bit afraid of the unknown that is to come.
3 more days.
Dreams and Gratitude
So a new form of neurosis I've developed is that I'm going to forget I can't eat or drink anything the day of my surgery. I've been thinking on it so much I've actually started having dreams about it! Last night I dreamt that I drank some water and took a bite of chocolate zucchini bread right before my surgery and then immediately spit it out once I realized what I was doing. LOL...and to think, I'm not even on pain medication yet!
I also wanted to thank my RealSelf buddies for the love and support you've given me up to this point; I'm so grateful to have an empathetic community to link arms with in going through this process. Thank you for being a part of this with me...I couldn't do this without you.
On the other side
Progress so far
I didn't have much of an appetite at all. I could really only stomach a few crackers so that the Percocet wouldn't hit an empty stomach. I was definitely in a fair bit of pain and discomfort yesterday but Matt has been a wonderful nurse and support system.
Last night I managed to sleep a bit here and there probably largely in part to the Percocet. I'm still really uncomfortable but I was able to get myself to the bathroom on my own a few times through the night with the help of a walker. I am feeling much better today and may try to shower later this afternoon. I will post pics when I can.
Right now just doing my best to stay on top of the meds, alternating the Valium and Percocet. I haven't had the binder off yet so I have no idea how things are looking, but I definitely feel much more compact and I have noticed where my pants are sagging now because the apron is gone! They took 4 pounds of skin off of me!
Starting to get a little of my appetite back. I'm still a little hunched over but have started to stand a bit straighter with each little walk around the house. Dr. Vath called to check on me today which warmed my heart.
The thing I was most afraid of
Any of you have any other tricks up your sleeves? I left a message with the nurses at Dr. Vath's office to see what advice they have.
All in all I've been asleep for the better part of the week. I'm off the Percocet now and just alternating Tylenol and Valium. Not quite walking upright yet.
Pro-tip: during early stages of recovery don't even bother with underwear; it's just one more thing to hassle with when you have to go to the bathroom.
Attached is a picture of the same kind of underwear on before and after. Can't wait for this swelling to subside a bit.
The first several days after surgery I pretty much just slept around the clock with a few walks around the house to avoid blood clotting. Yesterday I managed to walk a few blocks and even went to the grocery store. I was pretty wiped out after all that. Even though I feel like a wide load right now my figure is so dramatically different and I know there will be a day in the coming weeks/months where I'll look back on this and say I'd do it again in a heartbeat. But right now I am just trying to get through one day at a time. The good news is things are going A OK in the pooping department (just doing a probiotic at this point) and I don't mind the compression garment too much.
Still not walking fully upright yet but I'm managing to get around without the walker; I really only needed the walker the first few days but boy was I sure glad I had it when I needed it. I am definitely experiencing some back pain, though. In general my stomach feels like concrete. Otherwise I've just had some pockets of pinching or hardness along the incision line. My first post-op is on Thursday.
I'm going to attempt to shower and fix my hair today to see if I can feel a little more human. I have yet to get bored (probably because I've been asleep most of the time) but I have had a few mini emotional meltdowns...last night I cried asking myself why it even matters what our bodies look like and why I've given my flaws so much power over my entire life. I haven't had a moment of regret in doing this so far but it has absolutely tested every bit of my physical and emotional resolve.
A shower bench and removeable shower head will make this process much easier if you're still pre TT.
Pro-tip: spray the shower bench with a little warm water before you park your naked butt on it. Just trust me on this one.
Today is my birthday
No major changes physically over yesterday but I did get on the scale and take measurements today. I'm down 8.4lbs since surgery and 3.5" around my hips where the apron was. I don't have much of an appetite still; all I'm craving are big green salads.
It has started to rain out. I think it's a good time for a nap.
Feet on the ground
The other night I tried sleeping without any Valium and that was a mistake. When it comes to the pain and discomfort during this process, don't try to be a hero...seriously. I hate taking even OTC medication of any kind under normal circumstances but insofar as this surgery is concerned, I learned my lesson. As far as drugs go I'm taking the occasional Tylenol (usually just for back pain at this point) and a Valium just before bed to help me sleep.
Speaking of sleep, I'd fight a bear to be able to lay down on my side but it's still too uncomfortable, so for now I'm continuing to sleep on my back in a nest of pillows.
And ladies, right after this surgery...maxi-skirts and yoga pants are your friend.
Another before/after shot
Other milestones for me this week are I get to start taking my fish oil and Ibuprofen again and I can wash the steri-strips off in a few days. They haven't bothered me much but I'm curious to see how my incision is looking. I have one suture near my lady parts that is poking the crap out of me when I'm in certain positions. I'll post pictures when they're washed off.
Still not much of an appetite (not complaining) and of course waiting for the swelling to go down but as we all know, that's one of the biggest factors of recovery.
Thing is, I knew I could not get through this alone.
So once I made the decision to move forward with the surgery I put out an APB to my nearest and dearest friends and asked them to link arms with me knowing what an emotional toll this would take on me. One of my best girlfriends came with me to pre-op and sat with me while I cried in acceptance that the amount of weight I had lost was enough and that I was enough. Matt lovingly hovered over me for an entire week while I slept, cried, dry heaved and bitched about not being able to poop. My mom gave me, her adult child, a shower and has checked in on me every single day. One of my best friends brought me magazines and meals, did my dishes and just sat with me for hours. Others have sent texts to see how I'm doing and to offer encouragement and support.
In my heart I know my support system is helping me to heal physically, emotionally and spiritually. These people are among the very best human beings in the world and I am blessed to call them my friends. I am more grateful than I can adequately express and because of them I am a better person.
So that's my unsolicited advice for the day: ask for help. Don't try to be a hero and do this on your own. Be grateful and gracious, but rest and let others care for you.
And look both ways before crossing the street. And don't do drugs. I mean, except for right after your TT....then, definitely do drugs.
Two weeks PO
I went in to the office today but left around 3 p.m. to try to decompress and rest a bit. I also had to get home in time for my first lymphatic massage. It's supposed to help the swelling and accelerate the healing process; I got a referral for the same local gal from my doctor's office and my RS pal 62andnew so I called her yesterday and she was able to fit me in today which was pretty awesome...she even came to my house. She specializes in lymphatic therapy right after TT and was definitely knowledgeable about the whole process. The massage is really light and focused and believe it or not helped me start breathing better almost immediately. I have been finding it hard to get those really full, satisfying belly breaths since my surgery. Overall I feel about 10x better than I did this morning.
The gal's name is Pam so if anyone in the Denver area is interested in contacting her send me a message and I can share her details.
Patience and unexpected side effects of surgery
As of this morning my measurements and weight are exactly the same as 2 weeks PO so it looks like I'm stuck in the maxi skirts and yoga pants a while longer. The hardest part for me is that my pre-op clothes don't fit and since we are all so different in shape/size and how we heal, there's no definitive answer as to when the swelling is going to go down enough for me to feel like I look "normal" and can get back into some of my clothes. I guess this is where I will need to learn and practice patience.
So a couple of unexpected side effects I experienced as a result of surgery are kind of random but worth sharing. I have a MAJOR sweet tooth and also cannot function with coffee/caffeine each morning. Right after surgery I pretty much slept through an entire week and during that time apparently I went through sugar and caffeine withdrawals because I have not been craving either ever since my surgery. I'm loving it! I'm sure I'll be back on the sauce eventually but I am going to try to ride this out as long as I can. :)
This afternoon I'm going to research some different compression garment options online to see if I can find something a little less bulky than the binder I have now. I don't mind wearing the binder...in fact I'm comforted by it...it's just really hard to hide underneath clothes. If anyone has any strong opinions on this topic, I'm all ears.
Tonight Pam put some olive oil on them and loosened the tops and bottoms of the strips to the incision line (for like 15 minutes) and then I managed to wiggle them off under warm water in the shower after she left which took another 30 minutes. They weren't bothering me but I am so glad to have them off. I'm no expert but the incision looks pretty good to me. I'll post pictures soon.
In other news I'm feeling super disgusting and bloated over the last two days. Then I realized my period is due later this week. I'm really not looking forward to that. On the bright side I'm 100% off the drugs and just taking the occasional Ibuprofen for soreness at this point. Not too shabby for only being 3 weeks out if you ask me.
Week 3 pictures
Yesterday I got back to tracking my food intake, not to make sure I wasn't eating too much but to make sure I'm eating enough. Turns out I've been eating maybe 800 calories a day so I forced more down my gullet today. If only this was my problem under normal circumstances!
I've been taking two short walks each day; still a bit hunched but not too bad.
Since the traumatic experience of taking the steri-strips off yesterday I have had a few little unpleasant pokes from scabs getting knocked off when I maneuver around but it's tolerable. For anyone who hasn't had their surgery yet make sure to keep some old underwear and comfy clothes you don't care too much about handy. I've ruined several shirts and underwear between the ointments and oils I've been using.
Pictures from this morning attached. Excuse my cookie box but it's easier to see the incision. Nice and low. Thanks Dr. V!
CGs, binders and Spanx, oh my!
I also have a pair of high waisted Spanx shorts that I still can't even figure out how to get onto my body.
In other news I've lost another 2 pounds (probably due to reduced appetite) but the swelling is the same and that's definitely giving me the blues.
On the topic of the blues, I've really been struggling emotionally this week. I get really run down by the end of the workday and have had to leave early most days. I've had some things going on in the evenings here and there so I've probably been pushing myself too hard. It's just so humbling feeling like I'm only 50-60% as functional as I usually am. I know this is all part of the process and this too shall pass but the last few days have proven some of the more difficult in my mental and emotional recovery.
Dem bones, dem bones
Other notable updates: I have successfully survived my first post-op period. It was unpleasant but I'm glad to know things are still functioning well enough in the hormone department. My swelling has gone down somewhat and I've managed to get into a little more of my pre-op clothes but I've still got a long way to go. I've been taking measurements every week and I have lost a half inch off my stomach since week 1 post-op. My appetite still ain't what it used to be (not complaining!) I literally can only graze...I eat a few bites of food and I'm done. I think with the muscle repair my stomach just doesn't have the ability to expand to the size that it once did. Same goes for my bladder...I have to pee constantly. I'm still sleeping on my back for the most part but I can manage a little bit of side sleeping every now and again. My incision is healing really nicely; I've been going back and forth between applying vitamin E oil and Bacitracin ointment. I'll try to post some updated pictures over the weekend.
I found a compression tanktop that I've been wearing this week during the day instead of the binder and it has made all the difference in the world in how my clothes fit. I usually switch to the binder when I get home from work. As far as working out goes, I have started some light weight lifting with my trainer once a week and I'm trying to go for two decent walks each day...that's about all I can handle right now. But speaking of marathons, I am actually signed up to run a full marathon in April 2015 so my goal is to spend September increasing my walking and then in October begin a 5k training program. Hopefully my body will have muscle memory and running will feel like an old hat. Here's hoping because if I intend to run a full marathon next spring I have to start training in December. Wish me luck.
I'll wrap up with a funny story. Last week Pam came over to give me another lymphatic massage and start some scar work. During the massage I told her I kept feeling this hard thing poking out on my hip and I asked her what it was. She answered with a little surprise in her voice, "okay, Sara....that's your hip bone." I've been so overweight my entire life and then I carried so much excess skin I never even knew there were bones underneath all that. :) Pam went ahead and pointed out my rib cage and pubic bone too so I won't be alarmed by those as my swelling goes down. LOL.
Hip bone connected to the thigh bone. Thigh bone connected to the knee bone...
A few pictures
In other news I survived my first sneeze since surgery today. Luckily I've managed to suppress my sneezing for over a month so it wasn't quite as traumatic as I'd expected it to be.
Itchy and Scratchy
I had a 7-week followup with Dr. Vath today. It's the first time I've seen him since my surgery. He's a very sweet man and I was glad for the chance to see him today. I told him my recovery has been largely uneventful; we took a peek at my before pictures (insert horrified emoticon here) and he said everything looked good and sent me on my merry way. I'm officially cleared to do whatever I want at this point, I just need to listen to my body.
No movement on the swelling I'm sad to say. This has been the biggest ongoing bummer as I know many of you can relate. I'm trying to be patient but I just keep hoping I'll wake up and my pre-op clothes will fit again. I'm massaging my belly, taking Arnica, drinking tons of water and eating well so I'm not really sure what else I can do. Have any of you TT veterans out there gotten to the 2-month mark and still couldn't fit into your pre-op clothes? I'd love to hear from you.
I've had a very positive experience with Dr. Vath and his entire staff. Prior to my surgery I was fortunate enough to have Kari (patient counselor) as a resource when she was still with the practice and I've always had supportive and encouraging interactions with everyone including the gals at the front desk and the nurses. The day after my surgery Dr. Vath personally called to check in on me which was very comforting; he is an incredibly skilled surgeon, confident and honest. I'm pleased with my tummy tuck results and would definitely recommend him.