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My journey to this point had been somewhat...

My journey to this point had been somewhat different that what I originally envisioned (isn't that usually how life goes though?), but I am excited and ready for this surgery. After consulting with another PS in town who found that I had an incisional hernia (you can find my related posts here on Real Self about all that) I felt that it was important to find a surgeon who was current and board certified in both plastics and general surgery.

I met with Dr. B on 1/23/12 and could not have been more pleased. After checking in, updating paperwork, and watching a short video that outlined the surgery and recovery from my procedure, Dr. B came in and met with me in the consultation "lounge." It is wonderful (and less intimidating) to speak with your surgeon as a person who is fully clothed- it truly is a conversation rather than the typical consult and exam where you're half naked in some paper getup. Kudos to him and the office staff for adding that extra step in!

Of course across the hall is where I got undressed and put on the wonderful surgical the nurse put it, "one size fits none." and Dr. B came back in to examine my abdomen and thoroughly checked out the herniated area. I do have a diastasis (after two big baby boys that's not all that surprising) so he will perform muscle repair with the TT- and best part is that the hernia is almost exactly along the midline of my abdomen, so the MR will majorly reinforce that repaired area and he won't use mesh or anything on the hernia site. Another plus to having him as my surgeon...he only performs surgery in a hospital based-OR setting and makes all his patients stay overnight.

As an RN this is important to me because 1) working in the ER and ICU I have seen a lot of cases of patients that got into trouble in "outpatient" surgery settings where only limited life saving resources were available, and 2) the first 24 hours post-surgery are rough for a lot of people as far as nausea, pain management, mobility, etc. Definitely something that factors big with me...just because you "can" send someone home as an outpatient doesn't always mean that you "should." And, for the record, even with the overnight stay factored into my total cost, this procedure is less expensive than the first surgeon I saw. But really...if you're pinching pennies when it comes to your health and safety....maybe it's time to ask if you're really ready for plastic surgery.

Anyway, I was so relieved and excited after meeting with him (even after posing for those terrible "before" photos, haha) that I booked my surgery before leaving the office! Bright and early on March 6th I am going to be having the biggest surgery of my life, and while I am mentally and physically preparing for a slow and easy recovery, I can't help but be excited for the major changes that will be taking place! I have worked really hard with diet and exercise to get my body where it needs to be for me to be healthy and strong, and so for me, having the TT is like putting a period on the end of that sentence. The next six weeks are going to be more intensive core and cardio training at the gym, and meticulous diet at home with lots of lean protein, iron, and vitamin supplements to help get my body ready for the major stress that surgery and recovery will create. I meet with Dr. B again on February 6th so will update then with more details. In the meantime I am posting a list of pre- and post-surgery items (I know there are a few out there, but I spent most of last night looking and didn't find one that had EVERYTHING in one place) that hopefully will be helpful to y'all. So glad I found RealSelf and this wonderful community of support, laughter, and information:)

Planning for your tummy tuck As a surgical nurse...

Planning for your tummy tuck
As a surgical nurse myself who has taken care of a lot of patients during their immediate and extended recoveries, I thought it might be helpful to reproduce my list of things to do/get to help prepare for this surgery. There are a few on this site and others out there but I didn't find one that seemed like it included all aspects of the pre and post-op process:

Your protein intake is crucial to a good recovery. If you are following a healthy diet and exercise regularly then a daily lean protein intake of about 45-50 gm per day is good before surgery. Because protein is so important in your recovery phase, your daily protein intake should be more like 1 gram per lb of body weight following surgery (so, if you weigh 150 lbs, that's 75 grams of protein each day!). Besides lean meats and eggs, protein shakes (usually containing whey or soy protein) are a really good way to bump up your intake. I have personally used Muscle Milk and Vega One and they both taste good, blend easily, and can be mixed with just about any liquid. Vega One is considered nutritionally "complete" meaning that it also has fiber, greens, and probiotics, and so it's vegan friendly, if that's your thing:). Just get into the habit of reading labels and make sure that the shake doesn't contain anything you DON'T want...fillers, lots of sugar, high fructose corn syrup solids, or other junk that your body doesn't need. Protein shakes are awesome post-op because you can drink them through a straw and they taste pretty darn good...and are easy on your digestion as it gets back to normal after anesthesia and the stress of surgery.
There are a LOT of vitamins and herbal supplements that can adversely interfere with anesthesia, clotting (aka your body's natural ability to STOP bleeding), and recovery. Always make sure you discuss your complete medication list with your surgeon well before your surgery date...even the occasional aspirin or advil that yout take for a headache can make a difference in how your body responds to surgery. Three items, two supplements and a vitamin- Bromelain, Arnica Montana, and Vitamin C- have been shown to help with post-op bruising, swelling, and general inflammatory response. So much in fact that many PS practices will recommend that their patients take these three items starting a week or two before surgery and for about two weeks afterwards. Remember to always consult with your PS (and your regular doc) before starting any new meds. Most likely they will be aware of these three items and will tell you how much to take of each and when to start/stop them.

Home Care-
If you don't have an awesome network of family and friends who will swoop in and cook, clean, drive your kids and basically take over as chief, cook, and bottle washer for a few days, you might consider checking into some short-term home care assistance. Most agencies have a lot of experience helping surgery patients and rates are usually in the $15 to $20/hr range. Besides being there to help you to/from the bathroom, empty your drains, and stay comfy, most provide light housekeeping and meal prep. The less stressed you are the better outcome you will even if it's for a few hours during the day (or overnight so your hubby can sleep) it's totally worth it. Same goes for childcare and/or housecleaning.
Other good home care items:
Elevated toilet seat
Shower chair/seat
A walker
Walmart and Amazon carry all of these items, if you don't already own them. They are kind of like that pair of crutches in your basement- you never know when you'll need them again, so for a total of maybe $80 to $100, it's a good investment.
Lift chair or hospital bed rental- or medical grade wedge pillows to elevate legs and support back/neck for sleeping upright.
You can't lie flat, you can't strain your incision or MR internal sutures, so anything that makes your daily activities easier and rest time more restful is never a bad idea. Lift chair rental (less bulky than a hospital bed) is pretty economical, and there are lots of companies online who will deliver, set up, and pick up the chair for you whenever you need it- sometimes with less than a day's notice.

Medication and JP drainage charts- You'll be taking pain meds around the clock, emptying (and measuring output of) at least two drains twice a day, and you may even be taking something for sleep and/or a muscle relaxant. There's a good reason we do a lot of chart paperwork in hospitals- and most of it has to do with tracking these types of activities for our patients. You will be tired, uncomfortable, and a little out of sorts from the anesthesia, and this stuff can get overwhelming pretty quickly. If you don't get a JP (Jackson-Pratt) drain care chart when you are sent home, the Internet has tons to download and print- as well as customizable medication charts.

Wound Care- your PS's office will probably supply you with some of this stuff, but it's a good idea to have some on hand anyway...
Sterile Gauze
Gloves (I prefer sterile gloves, and yes you can buy them online or in a medical supply store)
Triple antibacterial ointment
TransPore or paper tape (or other medical tape)
Cup for measuring JP drain output
Exercise band to attach drains in the shower (IF you are allowed to shower with drains still in. Confirm this with your PS), and safety pins or clothes pins to secure drain tubing

Comfort Care
Insulated cup/"big gulp" style jug with lid and straw...and a bag/box of bendy straws. You can't bend, so your beverages have to:)
Reusable ice packs
Wedge pillows for back and knees
Shirts that unbutton in the front and soft waistband pants
An extra surgical garment- for your first stage of recovery, try to find one with the gusset (soft crotch slit-style opening) as opposed to the hook and eye closure. Nothing is worse than sitting on a crotch with metal hooks...or having your spouse have to close the crotch of your surgical garment while you stand there hunched over when you can't shower or take the darn thing off anyway. Sorry for the visual, but I know a lot of people don't consider that when buying their post-op compression garments.

Last, but certainly not least...
Watch the "coupon" sites like LivingSocial and Groupon for deals on laser hair removal packages. I can't tell you how many reviews I have read where people were upset after their TT that their bikini line was radically different than before surgery. Remember that your PS is not only pulling your upper abdominal skin down...but also the skin from your pubic bone on down will be elevated somewhat, so the bikini hairline will be higher than it used to be. Plan accordingly, and invest in four to six sessions of laser hair removal for your, ahem, land down under.

I hope this is helpful to y'all. So excited to hear of everyone's progress towards and following their own TT procedures. Happy healing...see you all on the "flat side" soon!

So I saw my PS for a follow-up consult on the 6th....

So I saw my PS for a follow-up consult on the 6th...I am now less than a month out from my surgery date and reading everyone's updates and seeing their after photos has me so excited! A little nervous, but mostly excited! At Wednesday's visit we reviewed specifically where he thinks my scar and belly button will end up being (my BB is apparently somewhat high anatomically right now, lol) and went over my little list of questions I had for him. I will be staying overnight in the hospital after my surgery (this is routine and he requires it for all his major PS patients), so I'll have an IV pain pump and anything else I need to be comfy post op.
My PS still teaches, writes, and participates in research/clinical trials, so it was interesting to get his perspective on pain control, scar care, and vitamin supplements. He also mentioned that I probably won't have a whole lot of lipo on my hips or flanks (if any) because there just isn't that much fat there. Apparently all these years in the gym trying to flatten my sad belly are finally paying off, hahaha! Also reminded me to call him on his cell immediately if my hernia starts to hurt or gets bigger in the meantime. So nice to know that I have that kind of access and availability, and really validates for me that I picked the right surgeon! Anyway, next time I see him will be the afternoon before my surgery to get marked and get prescriptions so I can fill everything prior to surgery the next morning- he reminded me to wear undies or a swimsuit bottom that realistically represents what I'd ultimately want to routinely wear. That way when he does marking I will know what to expect with scar placement. It's crazy how quickly this is all happening...and yet it feels so far away at the same time!

Less than three weeks to go, and I am in full...

Less than three weeks to go, and I am in full nesting mode. Is that normal or just me? Have been cleaning, organizing, making to-do and to-buy lists and generally driving my hubby nuts. My pre-op testing and anesthesia visit is next week at the hospital. I think it's basic bloodwork and an EKG, nothing too exotic. Also, thanks to the awesome ladies on this site, we are headed to Rent-a-Center to look at power lift chairs after hubby gets done with work today. It's less than half the cost to rent a recliner/lift chair from there than any of the medical supply places I called, which is awesome! much for the Rent-a-Center theory. They... much for the Rent-a-Center theory. They didn't have one power lift chair in the store or in the area and the recliner they had was so low to the ground that I think it would be harder to get in and out of than my bed! I did some calling around and finally found ONE place that rents electric lift/recliners. Sheesh. You'd think in a town this size that something like that wouldn't be so hard to find. On a positive note, it still wasn't very expensive ($150 for the month) but I am glad that I didn't wait until the week of my surgery to go look into the rental stuff! I guess all this "nesting" and planning is a good thing:)

Busy day today! Ran errands, hit the gym, had a...

Busy day today! Ran errands, hit the gym, had a playdate with my youngest little guy and realized that two weeks from today I won't be doing any of that stuff. It's happening! I am nervous and excited all at once...and counting the days! No cold feet but it's finally starting to feel real. Then I got a call from my PS's nurse just to check in with me since I am TWO WEEKS OUT today (squeeeeel!) from surgery. Reminded me of the no-no's- no aspirin, ibuprofen, fish oil, herbal supplements, or vitamin E from here on out- and also to check and make sure I had called to schedule my pre-op testing at the hospital. Other than that... I've bought my supplies, rented a power lift/recliner chair, and my BFF will be coming to stay with us the first week to help with the kids and generally taking over while I am out of commission. So blessed to have her- we have no family here and none who are able to fly or drive in to help out otherwise. I am hoping that her being here will get me through the first/roughest stage of recovery. I had my gallbladder out almost two years ago and I remember that the first few days really sucked...hurt so much to cough, move around suddenly, etc. so I am hopeful that the TT with MR and hernia repair won't be too much worse than that was. Why do I have this crazy feeling like I'm forgetting something important??!? Also, the nesting has gotten a little cray-cray. Cleaned out my closet last night and made a drawer for post-surgery comfy clothes- all my favorite soft yoga pants, tank tops, jammie pants and granny-style undies- where I won't have to bend or squat to get them. I randomly started to put together shelves last night (by myself, because my husband didn't understand why it needed to be done right THEN, lol) to organize supplies in the basement. See, I told you the nesting around here's gotten a bit out of hand!

Went for my pre-op testing and pre-admission...

Went for my pre-op testing and pre-admission paperwork today. No big deal, basically vital signs and two tubes of blood, then answering medical history questions with one of the nurses. Who, by the way, was a year out from her OWN TT with hernia and muscle repair, and was excited to share her story. I wasn't expecting her to be so supportive and reassuring and open about her own experience- and she was so excited for me on top of all that! I had been having kind of a crummy morning and felt rushed and stressed by the time I got to the hospital, and sitting and chatting with her really made a huge difference. It's funny how God puts people like that in your life just when you need them.
Have a few more things to pick up before surgery including Hibiclens to clean my belly with starting this Wednesday.

Any recommendations for a good brand of dry shampoo?? My surgeon uses drains and I can't shower until they are pulled, eeeeeyew, lol.

Got some bad news today. They found something on...

Got some bad news today. They found something on my mammogram. My gyn has already seen the films and is very concerned based on where the mass is. He has scheduled a sonogram and an MRI to get a better look at it and figure out next steps. I have a lot of mixed emotions at this point, mostly scared about what the outcome of all this could be. My TT surgery has obviously been postponed for the time being. I've decided that this is going to be my last post here- my priorities and focus have changed so I want to say thank you, good luck and happy healing to all of you wonderful ladies.
Birmingham Plastic Surgeon

Recommended to me by another surgeon, and he has taken care of another family member and a friend's mother.

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