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Pre appointment. This is the first appointment I...
Pre appointment.
This is the first appointment I have with my surgeon Winston McEwan to see if he thinks I am a good candidate for surgery. I want to have multiple surgeries at once so that the recovery time is shorter and the expense is less. I ask about brachioplasty (arm lift), medial thigh lift, tummy tuck with liposuction and a breast lift with fat graft from the liposuction. I have lost just over 70kg (154lbs) after having a gastric sleeve so have a fair bit of loose skin.
I am asked to get into a gown so that he can see the areas that concern me. Once into the gown his practice nurse Anna is also in the room to assess me. He decides that I am a great candidate for the surgery but can’t guarantee that I will have much in the breast department as I do not have much fat on my body.
I have a follow up appointment to get measured for compression garments that I have to wear for 6 weeks during my recovery.
An estimate of the surgery is given to me – broken down as follows:
Surgeon Fee - $9000
Garments - $300
Anesthetist - $2000 - $3000 (this is based on a 3.5 hour surgery)
Hospital Fee - $9000 - $11, 000 (this is based on a 3.5 hour surgery, equipment used, theatre hire, medications and a maximum of two nights in hospital)
A grand total of $23,300 at the most – I have $22,800 saved at this point and can put the extra on the credit card if I have to, although would rather not do that.
This will be sent to me as three separate bills, I will pay the surgeon and garment fee prior to the surgery then the anesthetist and hospital fee after the surgery as these are dependent on equipment used, length of stay in hospital and length of surgery.
For the garments I decide on one black and one skin coloured pair of pants that go from calf to just under my breasts. These both have hooks and zips and are crotch less so that they don’t need to be removed to go to the toilet. I decided to have the zips on alternative sides so that when I am wearing them I am not putting more pressure on one side than the other, also for comfort reasons. I also get two sleeves that hook up behind the shoulders.
Once my garments are made I receive the invoice for the surgeon and garments. Surgeon’s fee remains $9000 and the garments are more than I was expecting at $399.05.
I hope everything else is within budget as I really don’t want to have to use my credit card for any of this.
9 Dec 2016
Today is the day of surgery. I’m feeling good, not nervous or anxious at all. I’ve had many surgeries before so have some idea of what to expect. My brother’s girlfriend also had the same surgeries all at once and she managed quite well with everything so I’m hoping I will be the same. I check into Braemar hospital (Hamilton, New Zealand) at 12:30 and fill out all of the routine paperwork that is require. Anesthetist Alan Crowther checks in with me and explains what will happen. I had spoken to him a few days earlier on the phone where he wanted to check if I had any concerns or medical issues that he should be aware of. Really nice and personable guy. I feel safe in his more than capable hands. For me personally if I were to worry about anything going wrong in surgery it would be the anesthetic.
Winston McEwan my amazing surgeon also checks in with me and marks me up for surgery explaining what he will do and how much he will take. He also mentions he may need to do a vertical incision along with my tummy tuck to pull everything in tight but won’t know for sure until he is in there. I explain to him that I’m not concerned about scars and would rather have longer or more scars with a better result than shorter scars with an average result. I trust his judgement. Another thing I notice is that whenever I have been naked or near naked with Winston he ensures there is another person in the room at all times. This is in my opinion very professional and discrete. I imagine many others wouldn’t even notice he does this. He also makes sure that I am comfortable and wearing underwear so I don’t feel so exposed. His bedside manner is outstanding.
From here it’s all pretty quick. I get wheeled into theatre and drift comfortably off to sleep after joking with the anesthetist about how health and safety is ruining the fun stuff in life after trying to slide onto the operating table without waiting for the wheels on the other bed to be locked first. Winston completes his magic in theatre and I wake up safely and perky in the recovery room. He comes in to see me briefly and explains the surgery went much longer than expected because of the tummy tuck and I had quite a few blood vessels exposed so they took longer to deal with than he had anticipated. Instead of being a 3.5 hour surgery it became a 5 hour surgery. I’d lost a bit of blood but nothing to be too concerned about. I notice that I have one drain in my tummy, which was disappointing as I was hoping to not have to deal with drains but he placed a drain because of the bleeding – better to be safe than sorry.
I feel pretty good. Arms and legs feel tight and tender, boobs I don’t notice any pain, but boy do I notice the difference – I think I am in love with my need boobs. Tummy tuck again not much of a concern although others had said that would be the worst of the pain. Later that evening I get up to go to the toilet and have a bit of leaking from my nipples and other spots, these are all covered up, then I discover I can’t go to the toilet so go back to bed. I try to go to the toilet again about 2 hours later. There were three nurses in the bathroom with me and I struggled to go again. I asked them to please leave and shut the door as I felt I had stage fright. As soon as the door shut – success!!! I’m using a female urine device (sheewee) and would recommend this to anyone having either a tummy tuck or a thigh lift as you do not need to take your garment off and nothing gets wet when you go to the toilet.
10 December 2016
I have a pretty uneventful night and manage to get the normal amount of sleep for me which isn’t much, I’ve never been a good sleeper.
In the morning Winston comes around and checks up on me and decides that I look well enough to go home and that the drain can be removed as I have not drained much fluid at all. I’m super happy about this, not just because I get to go home but that I don’t have to lug around a drain for a few days/weeks. I’m also concerned that my surgery took so long and at this point any saving of money will be needed to cover the cost of the extra time in surgery. Feeling a bit anxious about the hospital and anesthetist bills that are yet to arrive.
He also mentioned he took off about 1.8kg of skin from my stomach area and managed to graft about 80-100 mls of fat into my breasts. I’m surprised at the amount of skin from my stomach area as I didn’t think it would be that much at all. This definitely doesn’t show on the scales – well not yet anyway, I’m currently 2.5kg heavier than I was when I went in for surgery.
I head off home to stay a couple of weeks with my parents, my son and cat have come with me for a sleepover. Haha, my cat is a real mummy’s boy so there really is no other option. He seems pleased to see me and comes in for a bit of a snuggle.
A friend is about 10 days ahead of me with her surgery healing process (She had a breast reduction and tummy tuck with the same surgeon) and had been recommending that I get a bed wedge as she believes it’s the best thing she has spent in preparation for her surgery. I am so pleased I listened to her advice and have found that the wedge and the sheewee are a must for this type of surgery. She also mentioned she had quite a bit of back pain from crunching over when she was walking around after the tummy tuck. I am able to stand up pretty straight without feeling any pain or strain. Perhaps it’s because I used to be fat and my skin is more flexible? I’m not sure. I can say though, that a tummy tuck is a breeze compared to a c-section. I really haven’t had any concerns with the tummy area at all.
I’m still bleeding/weeping quite a bit, mostly from my legs and arms so have a towel on the couch and in bed to make sure I don’t ruin the furniture. I am able to manage my pain well and have been sleeping okay. I usually sleep on my stomach but haven’t found sleeping on my back to be much of a problem. I am sure this is because of the bed wedge and pillows, that and it’s near impossible to flip over without waking yourself up in some form of pain.. haha.
14 December 2016
First check up with Anna the nurse and Winston also pops his head in to check that everything is looking okay and that I am feeling okay.
I change into a gown and Anna has me sit on a recliner chair so that she can see all of my wounds. I’m not looking forward to the tape coming off but I am pleasantly surprised that she uses this wipe called Remove that unsticks the glue so all of the tape comes off painlessly. Anna makes me feel so comfortable that I don’t even notice that I am naked and not exactly sitting like a lady! My dressings are quite soiled so she makes the decision to remove all of the dressings and replace them with fresh dressings, also adding a bit of extra padding here and there where things are weeping. Once all of the dressings are removed Winston comes in for a look and is more than happy with how things are looking. I notice that I have stitches in my breasts and tummy area but staples in my arms and legs. He mentions it is because the surgery was going too long and he wanted to close me up as quickly as possible. I’m not concerned about this as I have had staples before and can’t really notice the difference in scaring from staples or stitches.
After quite a long process of changing dressings, Anna then helps me into my compression garments. It’s at this point that my leg starts to shake uncontrollably. I’m not sure what’s causing this and I’m not too concerned about it. Probably just sitting for so long without the garment on and dealing with pain then releasing that pain when standing up. It goes away fairly quickly but Anna walks me out of the offices and makes sure that I am able to get into the car.
After this I go back to my parents and enjoy a rather long afternoon nap. Apparently that wee outing wore me out more than I thought it would.
15th December 2016
I wake up feeling very swollen and tender in places and ring the offices to see if I can get some medication for fluid retention as I feel I am retaining quite a bit of fluid. Winston is off doing hospital rounds but I am assured by Anna that she will call me when he gets back to see what they can do for me. True to her word she calls me back within a very short amount of time and has booked me to come in and see them both at 11.30am.
When there I talk to Anna about my concerns about my arms being quite sore, in particular my armpits. It feels like I’ve split something and the tape is grabbing me in all the wrong ways when I try to move. Anna assess my arms and redresses them, while doing this she notices there is a small split in one armpit but doesn’t seem concerned about it.
Winston also checks the spit and isn’t worried – thankfully I’ve seen a few splits on here and they have all come right so I’m also not too concerned. Rather than giving me something for the fluid retention Winston suggests that I stop taking the ibuprofen as this can sometimes make things difficult for some people. He also prescribes me a course of antibiotics to be on the safe side.
18th December 2016
Progress! Not only are the scales moving in the right direction I am finding that I am able to urinate more. The last couple of nights I have taken stool softeners as I have not had a bowel movement since before my operation – I’m not that regular in that department anyway so wasn’t worried that I hadn’t been but wanted to make sure that I didn’t strain when I did manage to go.
Took my garment off completely to go to the bathroom for #2’s, success in that department too, while it was difficult to sit on the toilet seat and mildly uncomfortable it was completely manageable. After going to the bathroom I put my compression garment on again then go to wash my hands. It’s while washing my hands I realise I haven’t quite finished, so back to the toilet I go, remove my garment again and manage to finish things off. Getting the garment on and off is okay by myself but doing it can be quite tiring at this stage. So after this round I ask my mother to help me hook and zip the garment for me. While she is doing this, that weird leg shaking thing happens again so I go and lay down for a while and promptly fall asleep for half the day.
The final cost:
The bill from Braemar hospital is broken down as follows:
1 day hospital stay $582.61
Theatre charge $4473.90
Medical gases $404.60
Sutures $346.36
Drapes and Linen $257.45
Irrigation/IV fluids $67.87
Medical Supplies $1079.95
Pharmacy supplies $ 171.81
Staples/Stapler $221.50
Theatre equipment hire $60.87
Recovery fees $173.91
GST $1176.12
Total hospital bill $9016.95
(sigh of relief – well within the $9000 - $11,000 quote I was given for the hospital bill)
Still concerned about the anesthetist bill though not for long as that arrived the same day as the hospital bill.
Alan Crowther Anesthetist
26 time units (5 hours of anesthetic time) plus 6 procedural units $2080
GST $312
Total: $2392.00
Also well within budget, I even have left over money for a shopping spree when I have healed and the swelling has gone down.
This is the first appointment I have with my surgeon Winston McEwan to see if he thinks I am a good candidate for surgery. I want to have multiple surgeries at once so that the recovery time is shorter and the expense is less. I ask about brachioplasty (arm lift), medial thigh lift, tummy tuck with liposuction and a breast lift with fat graft from the liposuction. I have lost just over 70kg (154lbs) after having a gastric sleeve so have a fair bit of loose skin.
I am asked to get into a gown so that he can see the areas that concern me. Once into the gown his practice nurse Anna is also in the room to assess me. He decides that I am a great candidate for the surgery but can’t guarantee that I will have much in the breast department as I do not have much fat on my body.
I have a follow up appointment to get measured for compression garments that I have to wear for 6 weeks during my recovery.
An estimate of the surgery is given to me – broken down as follows:
Surgeon Fee - $9000
Garments - $300
Anesthetist - $2000 - $3000 (this is based on a 3.5 hour surgery)
Hospital Fee - $9000 - $11, 000 (this is based on a 3.5 hour surgery, equipment used, theatre hire, medications and a maximum of two nights in hospital)
A grand total of $23,300 at the most – I have $22,800 saved at this point and can put the extra on the credit card if I have to, although would rather not do that.
This will be sent to me as three separate bills, I will pay the surgeon and garment fee prior to the surgery then the anesthetist and hospital fee after the surgery as these are dependent on equipment used, length of stay in hospital and length of surgery.
For the garments I decide on one black and one skin coloured pair of pants that go from calf to just under my breasts. These both have hooks and zips and are crotch less so that they don’t need to be removed to go to the toilet. I decided to have the zips on alternative sides so that when I am wearing them I am not putting more pressure on one side than the other, also for comfort reasons. I also get two sleeves that hook up behind the shoulders.
Once my garments are made I receive the invoice for the surgeon and garments. Surgeon’s fee remains $9000 and the garments are more than I was expecting at $399.05.
I hope everything else is within budget as I really don’t want to have to use my credit card for any of this.
9 Dec 2016
Today is the day of surgery. I’m feeling good, not nervous or anxious at all. I’ve had many surgeries before so have some idea of what to expect. My brother’s girlfriend also had the same surgeries all at once and she managed quite well with everything so I’m hoping I will be the same. I check into Braemar hospital (Hamilton, New Zealand) at 12:30 and fill out all of the routine paperwork that is require. Anesthetist Alan Crowther checks in with me and explains what will happen. I had spoken to him a few days earlier on the phone where he wanted to check if I had any concerns or medical issues that he should be aware of. Really nice and personable guy. I feel safe in his more than capable hands. For me personally if I were to worry about anything going wrong in surgery it would be the anesthetic.
Winston McEwan my amazing surgeon also checks in with me and marks me up for surgery explaining what he will do and how much he will take. He also mentions he may need to do a vertical incision along with my tummy tuck to pull everything in tight but won’t know for sure until he is in there. I explain to him that I’m not concerned about scars and would rather have longer or more scars with a better result than shorter scars with an average result. I trust his judgement. Another thing I notice is that whenever I have been naked or near naked with Winston he ensures there is another person in the room at all times. This is in my opinion very professional and discrete. I imagine many others wouldn’t even notice he does this. He also makes sure that I am comfortable and wearing underwear so I don’t feel so exposed. His bedside manner is outstanding.
From here it’s all pretty quick. I get wheeled into theatre and drift comfortably off to sleep after joking with the anesthetist about how health and safety is ruining the fun stuff in life after trying to slide onto the operating table without waiting for the wheels on the other bed to be locked first. Winston completes his magic in theatre and I wake up safely and perky in the recovery room. He comes in to see me briefly and explains the surgery went much longer than expected because of the tummy tuck and I had quite a few blood vessels exposed so they took longer to deal with than he had anticipated. Instead of being a 3.5 hour surgery it became a 5 hour surgery. I’d lost a bit of blood but nothing to be too concerned about. I notice that I have one drain in my tummy, which was disappointing as I was hoping to not have to deal with drains but he placed a drain because of the bleeding – better to be safe than sorry.
I feel pretty good. Arms and legs feel tight and tender, boobs I don’t notice any pain, but boy do I notice the difference – I think I am in love with my need boobs. Tummy tuck again not much of a concern although others had said that would be the worst of the pain. Later that evening I get up to go to the toilet and have a bit of leaking from my nipples and other spots, these are all covered up, then I discover I can’t go to the toilet so go back to bed. I try to go to the toilet again about 2 hours later. There were three nurses in the bathroom with me and I struggled to go again. I asked them to please leave and shut the door as I felt I had stage fright. As soon as the door shut – success!!! I’m using a female urine device (sheewee) and would recommend this to anyone having either a tummy tuck or a thigh lift as you do not need to take your garment off and nothing gets wet when you go to the toilet.
10 December 2016
I have a pretty uneventful night and manage to get the normal amount of sleep for me which isn’t much, I’ve never been a good sleeper.
In the morning Winston comes around and checks up on me and decides that I look well enough to go home and that the drain can be removed as I have not drained much fluid at all. I’m super happy about this, not just because I get to go home but that I don’t have to lug around a drain for a few days/weeks. I’m also concerned that my surgery took so long and at this point any saving of money will be needed to cover the cost of the extra time in surgery. Feeling a bit anxious about the hospital and anesthetist bills that are yet to arrive.
He also mentioned he took off about 1.8kg of skin from my stomach area and managed to graft about 80-100 mls of fat into my breasts. I’m surprised at the amount of skin from my stomach area as I didn’t think it would be that much at all. This definitely doesn’t show on the scales – well not yet anyway, I’m currently 2.5kg heavier than I was when I went in for surgery.
I head off home to stay a couple of weeks with my parents, my son and cat have come with me for a sleepover. Haha, my cat is a real mummy’s boy so there really is no other option. He seems pleased to see me and comes in for a bit of a snuggle.
A friend is about 10 days ahead of me with her surgery healing process (She had a breast reduction and tummy tuck with the same surgeon) and had been recommending that I get a bed wedge as she believes it’s the best thing she has spent in preparation for her surgery. I am so pleased I listened to her advice and have found that the wedge and the sheewee are a must for this type of surgery. She also mentioned she had quite a bit of back pain from crunching over when she was walking around after the tummy tuck. I am able to stand up pretty straight without feeling any pain or strain. Perhaps it’s because I used to be fat and my skin is more flexible? I’m not sure. I can say though, that a tummy tuck is a breeze compared to a c-section. I really haven’t had any concerns with the tummy area at all.
I’m still bleeding/weeping quite a bit, mostly from my legs and arms so have a towel on the couch and in bed to make sure I don’t ruin the furniture. I am able to manage my pain well and have been sleeping okay. I usually sleep on my stomach but haven’t found sleeping on my back to be much of a problem. I am sure this is because of the bed wedge and pillows, that and it’s near impossible to flip over without waking yourself up in some form of pain.. haha.
14 December 2016
First check up with Anna the nurse and Winston also pops his head in to check that everything is looking okay and that I am feeling okay.
I change into a gown and Anna has me sit on a recliner chair so that she can see all of my wounds. I’m not looking forward to the tape coming off but I am pleasantly surprised that she uses this wipe called Remove that unsticks the glue so all of the tape comes off painlessly. Anna makes me feel so comfortable that I don’t even notice that I am naked and not exactly sitting like a lady! My dressings are quite soiled so she makes the decision to remove all of the dressings and replace them with fresh dressings, also adding a bit of extra padding here and there where things are weeping. Once all of the dressings are removed Winston comes in for a look and is more than happy with how things are looking. I notice that I have stitches in my breasts and tummy area but staples in my arms and legs. He mentions it is because the surgery was going too long and he wanted to close me up as quickly as possible. I’m not concerned about this as I have had staples before and can’t really notice the difference in scaring from staples or stitches.
After quite a long process of changing dressings, Anna then helps me into my compression garments. It’s at this point that my leg starts to shake uncontrollably. I’m not sure what’s causing this and I’m not too concerned about it. Probably just sitting for so long without the garment on and dealing with pain then releasing that pain when standing up. It goes away fairly quickly but Anna walks me out of the offices and makes sure that I am able to get into the car.
After this I go back to my parents and enjoy a rather long afternoon nap. Apparently that wee outing wore me out more than I thought it would.
15th December 2016
I wake up feeling very swollen and tender in places and ring the offices to see if I can get some medication for fluid retention as I feel I am retaining quite a bit of fluid. Winston is off doing hospital rounds but I am assured by Anna that she will call me when he gets back to see what they can do for me. True to her word she calls me back within a very short amount of time and has booked me to come in and see them both at 11.30am.
When there I talk to Anna about my concerns about my arms being quite sore, in particular my armpits. It feels like I’ve split something and the tape is grabbing me in all the wrong ways when I try to move. Anna assess my arms and redresses them, while doing this she notices there is a small split in one armpit but doesn’t seem concerned about it.
Winston also checks the spit and isn’t worried – thankfully I’ve seen a few splits on here and they have all come right so I’m also not too concerned. Rather than giving me something for the fluid retention Winston suggests that I stop taking the ibuprofen as this can sometimes make things difficult for some people. He also prescribes me a course of antibiotics to be on the safe side.
18th December 2016
Progress! Not only are the scales moving in the right direction I am finding that I am able to urinate more. The last couple of nights I have taken stool softeners as I have not had a bowel movement since before my operation – I’m not that regular in that department anyway so wasn’t worried that I hadn’t been but wanted to make sure that I didn’t strain when I did manage to go.
Took my garment off completely to go to the bathroom for #2’s, success in that department too, while it was difficult to sit on the toilet seat and mildly uncomfortable it was completely manageable. After going to the bathroom I put my compression garment on again then go to wash my hands. It’s while washing my hands I realise I haven’t quite finished, so back to the toilet I go, remove my garment again and manage to finish things off. Getting the garment on and off is okay by myself but doing it can be quite tiring at this stage. So after this round I ask my mother to help me hook and zip the garment for me. While she is doing this, that weird leg shaking thing happens again so I go and lay down for a while and promptly fall asleep for half the day.
The final cost:
The bill from Braemar hospital is broken down as follows:
1 day hospital stay $582.61
Theatre charge $4473.90
Medical gases $404.60
Sutures $346.36
Drapes and Linen $257.45
Irrigation/IV fluids $67.87
Medical Supplies $1079.95
Pharmacy supplies $ 171.81
Staples/Stapler $221.50
Theatre equipment hire $60.87
Recovery fees $173.91
GST $1176.12
Total hospital bill $9016.95
(sigh of relief – well within the $9000 - $11,000 quote I was given for the hospital bill)
Still concerned about the anesthetist bill though not for long as that arrived the same day as the hospital bill.
Alan Crowther Anesthetist
26 time units (5 hours of anesthetic time) plus 6 procedural units $2080
GST $312
Total: $2392.00
Also well within budget, I even have left over money for a shopping spree when I have healed and the swelling has gone down.
Updating with pictures
A few pics for comparison.
2 weeks post op, removal of staples
Well I can not say enough about Anna the nurse. This woman is truly amazing. She makes you feel so relaxed and comfortable and cleans up as she goes so you don't have to see all the yucky stuff. Today I had 167 staples removed from my arms and legs which took two hours to remove. There were about 3 that were up there on the discomfort scale, but all in all it went pretty well and pain was kept to a minimum. One staple had somehow managed to turn itself completely around and Anna managed to flip it back over and remove it without causing too much discomfort. She is amazing.
So far I am healing really well and have no gaps or holes showing yet - long may this last!! I do have one spot at the back of one leg where the garment has been irritating the staples, although Anna tells me this is not a big deal and will settle down quickly now that the staples have been removed. Winston (the surgeon) says I was healing beautifully and is very happy with how things currently look.
I'm a little red in the pictures as the tape is not entirely agreeing with me at the moment but that too will settle. I have more white tape to help things stay in place and next week at my next appointment I will go to brown paper tape which is supposed to be more comfortable if I continue healing the way I am.
I bought some silicone tape to use once the wounds are completely healed from Amazon.com. So probably will start using that at about 4-5 weeks.
So far I am healing really well and have no gaps or holes showing yet - long may this last!! I do have one spot at the back of one leg where the garment has been irritating the staples, although Anna tells me this is not a big deal and will settle down quickly now that the staples have been removed. Winston (the surgeon) says I was healing beautifully and is very happy with how things currently look.
I'm a little red in the pictures as the tape is not entirely agreeing with me at the moment but that too will settle. I have more white tape to help things stay in place and next week at my next appointment I will go to brown paper tape which is supposed to be more comfortable if I continue healing the way I am.
I bought some silicone tape to use once the wounds are completely healed from Amazon.com. So probably will start using that at about 4-5 weeks.
Provider Review
Winston McEwan
Winston and his practice nurse Anna are both outstanding people. Both make you feel comfortable and relaxed at all times. They work very well as a team and in my view are magicians. The follow up so far has been amazing and I would recommend this team to anyone in New Zealand or even overseas. The cost is more than reasonable - in fact it would have cost me more to go to Thailand to get this all done than it did here.