Loving my Body by Dr. Peter Fisher! - San Antonio, TX

I estimate that I was at 400 pounds at my highest weight. I had multiple health conditions. I tried multiple options for weight loss, but when my health became critical, I had the VSG surgery in February 2014. I always had a flat butt, but after the VSG my breasts deflated. I weighed 271 at the time of that surgery.

As I hit 170, I started to do my research on plastic surgery. I wasn't sure if I would be a candidate. My loose skin looked like fat to me, and I was 35 pounds away from the ideal weight for my BMI. As I worked out with a personal trainer, my stamina increased, as did my bat wings and the thigh rub. Continually scratching off my irritated skin was the last straw.

I consulted with three US surgeons and two Mexican surgeons. Living in Alberta, Canada, I would only have been covered for a panni, but with my diabetes I wanted to have the minimal amount of surgeries. I definitely needed more than a panni.

I narrowed down my choice of surgeons based on who had the experience and skill in calf reduction. That brought it down to two. The one I connected with was Dr. Peter Fisher. His brother also practices at the same clinic, so it's important to specify which surgeon you wish to speak to.

I contacted him initially through RealSelf, and he got back to me that night while on vacation. Every time we chatted on the phone, he was warm, patient, honest and informative. He was focused on my health and always made me feel so comfortable. I couldn't wait to get to San Antonio to meet him in person.

We agreed that I would probably need two procedures. The first would include the Lower Body Lift (with the hip flap), an Arm Lift and a Breast Lift (no implants). The second surgery would be a thigh lift, calf reduction, a neck lift and a possible bra line lift (if needed).

I paid my deposit, sent him recent lab work, and took a month off of work. I flew to Texas three days before my pre-op appointment to get settled in the hotel, buy groceries, rent a recliner, etc. I booked my flight home for three weeks plus a day, to allow for my drains to come out, post op check ups and recovery.

On June 29th, after getting lost initially, I made my way to his office. It's warm, and not sterile. He met me with a hug, and began his assessment. He weighed me (168 pounds), and commented on how empty my skin was as he took my photos from different angles. Empty is a good thing BTW. He took his time with the markup, carefully measuring, and reworking his lines. He strives for perfection.

I had a number of questions for him. I asked about his signature procedure, the hip flap. I struggled with the decision to get this, as I couldn't picture it on my body. I trusted him and went with it, desiring the curvy figure it creates. I also wanted to know about my tramp stamp (the tattoo on my tail bone). I have always hated it, and it only got worse as I lost weight. I even won a contest for laser removal for the worst tattoo. I hoped that Dr. Fisher would be able to remove it entirely. He never does more than is necessary, so only a third of it was removed. The tattoo on my hip was completely removed. Another question was about my calves. My calves were disfigured from a previous injury. He circled them and said he would lipo them. That was unexpected and was a huge added bonus for me.

I was self conscious about the mark up lines when I was in public, and they smudged a bit as I slept, but Dr. Fisher wasn't worried. At the end of the appointment we hugged again and he assured me that he would see me when I woke up from the surgery. I had no concerns leaving the appointment. I got my prescriptions filled and went shopping with my friend.

I had researched the procedures I was going to have, and though worried about the pain of recovery, I thought I would be back at work early. I definitely underestimated that part of the recovery.

Pre Surgery: Before going to the hospital I put my jewellery and pain meds in the hotel safe. I packed one change of clothes, my phone, a charger and my garments (girdle and bra). My friend brought a change of clothes, a tablet for me, a laptop, reading material and a phone. He brought too much. There is internet access at the Forest Park Medical Centre.

Surgery Day: I showered with the special soap and cabbed it over to the hospital for 5am. My friend and I were the only ones in the lobby. We quickly went through the admitting process and met a friendly Canadian nurse who took me to a pre op area. I had to change into a gown, and they put the tad hose on me. I don't remember much after that. An IV was put in, and they drew blood for testing. The anaesthesiologist came to see me. They wheeled me out and gave my friend a pager to receive updates on the surgery. With the pager, he could have left the building, but he chose to stay. There were digital signage boards in the hospital that stated patient status as well.

The surgery took 11 hours. It went longer than expected as Dr. Fisher found that I had some unusual stomach anatomy. This won't affect the outcome, but he needed to take more time to deal with it. About 8 pounds of skin was removed. I woke up and did see Dr. Fisher before falling back to sleep. I wasn't in pain.

I never used my tablet or my phone. The room was nice, but I spent most of my time sleeping, or in a daze. It was a private room with a bathroom. A guest suite was included, but my friend slept on the couch, close to me. The staff were fabulous. They were always there when I needed them, very attentive and gentle. Dr. Fisher was available by text, but was out of the state. His partner checked in on me regularly. I was encouraged to cough, and at one point oxygen was put on me. I was turned frequently, and the nurses changed the sheets. My friend found it hard to look at me because of the blood. It was not something he was prepared for. The binder which I am still wearing has a lot of blood on it. I had morphine for the pain. The first night basically consisted of falling asleep and being awoken every hour or 2 when the nurses came in to check on me and turn me to both sides to prevent deep vein thrombosis.

Day 2: I continued to sleep, but the nurses had me turning myself occasionally. I wasn't interested in food, but I enjoyed the ice chips. Respiratory therapists came in to see how deeply I could breathe. I was definitely in pain.

Day 3: The catheter was removed in the afternoon. I was able to transfer to a recliner. A nurse showed my friend how to shower me. I walked the hallways and hoped to go home. I was supposed to pee, but couldn't. I was so panicked that I would have to pay for another night in the hospital just because I couldn't pee. Finally, it happened and I was released to go home. I never did use my tablet, or watched TV. I was given my discharge papers and wheeled down to a cab.

After the hospital: The recliner that I had ordered was set up in the hotel room when I got back. Getting in and out of the cab and up to the hotel room completely drained me. I started my pain medication and slept. Dr. Fisher came to see me at the hotel as soon as he got back into town.

I started walking the hallways of the hotel that week with my walker, gradually increasing my distance. My friend washed my incisions daily, and I watched endless episodes of Law and Order. I took the pain meds, but felt quite ill. I threw up once and realized that I never wanted to do that again. So much pain! I wasn't able to eat or drink very much and Dr. Fisher gave me a prescription for the nausea. I was losing weight. He came again to see me in the hotel before I saw him in his office.

The drains were horrible. He puts them in the LBL incision as opposed to making a new hole for them. Where do you put them when you are wearing a dress? My friend was responsible for measuring the output and stripping them. Two out of the four had a pinching/burning sensation when he stripped them. It was very uncomfortable to sleep with them, and I continued to stay in the recliner.

Dr. Fisher took them out earlier than I was expecting. I had hoped and feared the day that they came out. I had read that it would feel like fire. I compare it to getting my yellow fever vaccine. It was fast, painful and gross, but I felt great afterwards. I started to sleep in a bed after that. I hoped to be able to go home soon. I love Dr. Fisher and his staff, but I was missing home.

Recovery: I needed to get out of the hotel room. Dr. Fisher cautioned me about the sites I wanted to see, concerned about the heat, humidity and the risk of dehydration. I went to the RiverWalk once, and really overdid it. I walked too much, I had forgot my binder, I was dehydrated, nauseous and so very tired. My top of groin incision that had started to open up grew in size after that outing.

I was self conscious about my compression garments and my tad hose showing, but I'm almost done wearing them full time. Dresses, especially t-shirt maxis, helped to hide that.

Pain: My arms and breasts rarely hurt. My LBL would feel tight and sore after walking, as did my hips. I didn't like the pain medication and tried not to take it. I preferred Tylenol instead.

Dr. Fisher and I discussed when I could go home. We decided that I could fly out 17 days post op. The take off and landing was painful, and because my friend had the luggage, I occasionally wheeled the wheelchair. That was not a good idea. My arms started to hurt after that.

Complications: When I flew out I still had the opening at the top of my groin. Other than that, my incisions were healing well. Since then, I have had small openings at my armpit, underneath my left breast, at the back of my right hip and on my right armpit. I saw my family doctor who referred me to the infection clinic at the hospital, who referred me to a wound care clinic. They are concerned about the top of groin one and the one underneath my breast. I send Dr. Fisher pictures of the openings, and he assures me that this is normal. The rest of the incisions are healing well. I wasn't sleeping well after the surgery, and that is still a problem now, but Tylenol PM has helped. My appetite is returning, though I still struggle with my water intake.

Today (August 8th): Pain has not been bad through this journey. It's present when I sit, walk or lay down for long periods of time, so I am back at work on a half time basis. I started to have muscle or nerve pain over the last couple of days, around my left breast/chest area, but that is subsiding. I take the occasional Tylenol. I miss my gym routine.

I wear my compression garment all the time. It is getting looser now, and it can be a bit uncomfortable in heat or under jeans. I definitely feel better when I wear it.

There have been days when I question why I couldn't live with the extra skin. Why I chose to go through this and why should I have the second surgery. Then I look at the results. Dr. Fisher is pleased with the outcome. My calves are symmetrical, my breasts are fantastic (he was most pleased about that), my arms are so small that the regular blood pressure cuff was almost too big. I can't wait to get them toned. My stomach is not flat like I had hoped. It is still swollen. However, the shirts and dresses that I wore sized extra small are too big. My pants size has gone back up to a size 8, but that's ok. When the swelling goes down, I'll be smaller than I was before the surgery. I weighed 152 on his scale. I weigh 155 on mine. My A1C has gone down (I'm still diabetic).

My friends notice a dramatic difference. I have a curvy figure now, I'm tiny(er). For the first time in my life someone said I was hot, and I notice men noticing me. My body by Fisher is beautiful, for the first time ever.

Dr. Fisher and I check in with each other by text frequently. He is quick to answer my questions and provide guidance and support. I am worried about the recovery from the next surgery, but can't wait to go back to see him and his staff.

What I brought:
- Maxi dresses of different sizes. I didn't know what size I would swell to. I ended up wearing the same size I wore in pre surgery (XS).
- Pads. I had my period during my markup. This was not a problem for Dr. Fisher. I was glad it ended before my surgery.
- Baggy shorts and harem pants. They were comfy, but did not look good with my tad hose. I preferred to wear dresses and didn't bother with underwear.
- Hoodies. I get cold easily and hoodies were the answer to excessive air conditioning.
- Vitamins and medication I normally take.
- DVDs and a laptop. This helped with the boredom, somewhat.
- My best friend. I needed a lot more help than I expected. My friend communicated on my behalf with Dr. Fisher when I was unable to. He washed me and my garments, fed me and helped me get into my garment. I was very lucky to have him with me. He stills helps me at home, as I am not fully independent.

What I needed:
- An accessible hotel room. My last night in Texas, I was at a different hotel. The room wasn't accessible and getting in and out the tub to shower caused my wound to open.
- A car, at least initially, to get supplies pre-surgery.
- Wound care supplies; i.e. bandages, gauze pads and tape. I bought them at Walmart. I found blue tape for sensitive skin. This was awesome. It's a shame I can't find it here.
- A walker. Interesting fact: Unlike here, you cannot rent walkers, bath stools or raised toilet seats for health reasons. I bought a walker, used the bath stool the hotel provided and was comfortable with the height of the toilet in the accessible room.
- Laundry detergent. You can do laundry in the hotel, so pack lightly.
- Gentle liquid laundry detergent to wash your compression garments in the room.
- A second compression garment. Dr. Fisher provides one, but it's good to have a second one. I found a girdle and bra that he approved of from Marena. I ordered it, and had it delivered to the hotel. BTW, it's important to be accurately measured for the garment. I couldn't believe it when I measured at an XL. How is that possible when I wear a size small/extra small?
- Protein powder. I used Unjury chicken broth for the liquid diet before my VSG. For my two day liquid pre-surgery diet, I ordered it and had it delivered to the hotel. I used less than needed, and it was easy to return the unused portions.
- Soup. The first day of the liquid diet, I could have any soup. I had Tomato Basil from La Madeline, and Broccoli Cheese from Panera Bread.
- Prescriptions. I made sure to fill the prescriptions he gave me, immediately. They included a pain med, and an antibiotic. FYI: I could not fill a prescription from a US doctor in Canada.
- I had protein powder, but no blender to make a shake with. I went to GNC and bought some protein bars and snacks.
- Lens wipes or alcohol wipes to assist with stripping the drains
- Milk of Magnesia. I didn't have a lot of constipation. This worked quickly, very quickly.

What I would do next time:
- Don't wear light coloured undergarments or clothing to the markup. Some of it will rub off on your clothes.
- I will bring Gavison and Gravol from home. I wasn't always able to take my heartburn medication, and I couldn't find something in the US that worked as well. I also experienced nausea, and I couldn't find anything in the US that worked for me.
- I would not spend as much money on groceries initially. I assumed that soon after the surgery, that I would be fine to eat. I wasn't (due to swelling). Thankfully I was able to return or donate most of it.
- I would have a plan for my friend while at the hospital. We had forgot to pack snacks for him, and the cafeteria closed very early. He brought a laptop which helped pass the time while he waited for me while in surgery.
- Plan for the heat. July was terribly humid. It was hard on my friend and I, coming from a dry climate. We used the air conditioning in the hotel, and couldn't spend much time at the outdoor malls (pre surgery) or the RiverWalk (post surgery). We needed to focus on hydration.
- I would try harder to follow the rest and recovery orders. I get bored easily and pushed myself a bit too much. Protein and water were a struggle and I should have tried harder to be consistent about my intake.
- I would make more of a concentrated effort to not use my arms to lift anything. It can be hard to be so dependent on someone else, and I can be stubborn.

These are the photos I took when I was consulting with plastic surgeons.

These are the pictures that Dr. Fisher took of me at my first appointment.