Tummy Tuck Part 1: PO day 21 - new pics AND new review started!

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Hi girls. I have been lurking for a few weeks now,...

Hi girls. I have been lurking for a few weeks now, and have learned so much from these reviews. I am so grateful to you for all the advice, thoughts, fears, joys, and tips you have given. I am certain I have learned more here than by researching or speaking to my doctor! I have many posts and lots to say, so this one will just be an introduction. I was an obese teenager, having a 44 inch waist and weighing 252 lbs at 5'6" by the time I was 16. Between the ages of 19-21 I lost 115 lbs, and have kept it off (mostly...babies don't count, right?) for the last 12 years. I am 32 years old, have 2 children who are 7 and 5, and am done having babies. My pregnancies did not add any new stretch marks or loose skin to my frame that wasn't already there. I developed a minor diastasis after my second pregnancy that I closed through proper exercise, though there is still a 2 finger gap at my belly button, and a 1.5 finger gap below my navel. I am an ultramarathon runner (races longer than 26.2 miles - up to 100 miles or more), backpacker, mountaineer, and yogi. I lift weights, speed walk and bike occasionally. I am very strong and healthy. I am 5'7" tall and weigh 137 lbs. Any of my extra weight is concentrated in the torso area, and always has been.

I began gaining weight at 8 years old, and by that time already had an overhanging stomach. I literally cannot ever remember a time when i could see my belly button. I have always been embarrassed of the extra flesh on my stomach, but more so the effects on my lifestyle are what hurt. I cannot sit down without pulling my shirt out of my skin rolls. I cannot wear certain fabrics. I have to shop for pants at 10 different stores to find something I can tuck my skin into. When I run, my belly skin chafes, blisters or bleeds. When I roll over in bed a pile of flesh is lying beside me. Though my husband has never complained, seeing my own body is a turnoff during intimacy. This surgery for me is not really about the appearance, as much as it is about the functionality of my abdomen, and the way it has hindered or touched every aspect of my life. I have wanted this for so long, and now is the time because fate intervened and I developed a nasty little hernia. It is inguinal, which is rare for women. It is located in the groin, close to my thigh. This cannot be repaired laproscopically, and I must have an incision and anesthesia.

What has held me back all these years is the same thing that holds you back - a sense of selfishness, wasting the money on something "frivolous", being put under anesthesia and cut in half. But now that I need the hernia repair, I have decided to do this once and for all. My first consult was yesterday, Dec 5th, and my surgery is scheduled for December 27th. I have so much more to say including specifics about my surgery, why I am refusing muscle repair, what this means for me as an athlete, and more, but I'll let you chew on this and post more again in the coming days. Thanks for listening.

I thought I'd tell you a bit about my expected...

I thought I'd tell you a bit about my expected procedure. Unfortunately it is impossible for me to locate a doctor in my area who is able to repair my hernia and give me abdominoplasty. Inguinal hernias have a high recurrence rate because the surrounding tissue is so weak. I was recommended to a general surgeon who's recurrence rate for this hernia is one half of one percent. After visiting with him I learned that his bedside manner is pretty poor (what women doesn't have the experience of a doctor avoiding eye contact and talking down to you? I suppose it has happened in more doctor offices than I care to think about.). But the reality is - he doesn't have to be nice to me if he is going to do a good job. The surgery usually takes about 45 minutes and the hernia is fixed with a small piece of mesh. He does not happen to be in the same healthcare network as my PS, but there is one hospital that they both work out of in common, so it was determined I would go there. He isn't "thrilled" about doing the procedures together - mainly due to the increased risk of infection and the thought of having drains placed anywhere near a new piece of mesh, but agrees that it makes logical sense from a recovery standpoint to do the surgeries together. As long as I understand the increased risks, he is fine with working with Dr. Langstein.

I have known I wanted Dr. Langstein for years, and already knew that I wouldn't be bothering with multiple consults. Dr. L has 27 years experience as a PS, is the head of the cosmetic surgery department at one of the best teaching hospitals in the country, and is world recognized for his skills as a microvascular surgeon. I have watched him on a few episodes of the PBS series, Second Opinion, and was specifically blown away by his skills recreating a breast from virtually thin air with donor tissue - it had symmetry, realism and balance. The doctors on the show pointed out that he was an incredible engineer and artist, and I have to agree. If he could make a natural looking breast out of belly and labia skin with stitching so fine it could barely be seen, that looks nearly identical to it's neighboring untouched breast - then he can certainly pull my stomach tighter.

I went to see him for the first time on Dec. 5th. He was very kind and pleasant, but as expected in a busy practice - busy. He didn't spend much time chit chatting, but I already knew what I wanted and have educated myself thoroughly, so have no major questions. He looked at my belly and declared that I could get a "great result" and that this would be "easy", not in an arrogant way at all - he just seemed to be confident and comfortable. He questioned me regarding my reasons for wanting no muscle repair and was satisfied with my answers and happily obliged. He did not say I would need liposuction or anything else to get a nice appearance. Because of all this he said the surgery would only take 1.5 hours on his part. In his 27 years he has NEVER done these 2 surgeries at the same time, but felt okay if Dr. W was okay too. Due to the hernia repair - I need an overnight in the hospital, and much of the facility fees and anesthesiology fees will be billed to the insurance company. My total out of pocket price for everything came back as $5182, and without hesitation I booked the surgery.

Nothing left now but the crying! In less than three weeks, my "barnacle" will be gone. So blessed.

On my way to pay my bills! Woohoo...feeling real!

On my way to pay my bills! Woohoo...feeling real!

So I am farting around at the store today,...

So I am farting around at the store today, deciding what to do with a gift card and coupon, and I remember my PS saying I should bring in a 2 piece (yeah right!) or a pair of panties to be marked in. But I am so cheap that I have no underwear that I really like, nor that are representative of the scar I want. I definitely do not want a straight scar, but one that curves up to follow the contour of my hips. But because I have a saggy ass, I always wear hipsters....which are usually very straight across the top. Anyhow, I am in the store staring at the wall of panties and totally paralyzed by the choices and the overwhelming task of choosing a garment that will dictate the shape of a scar I will have for the rest of my life. What sort of macabre game is this? The other women must have thought I was nuts, I am sure I had a look of fright and hopelessness on my face.

After 20 minutes, I finally uncover 2 pairs of hipsters that have a seam in the center waist and angle slightly upward toward the hip, like a shallow V. I grab them after agonizing over color..why ? Who will see them but you, my PS and my husband? Crazy! Then I make the unfortunate mistake of wandering over to the body shapers...omg...what? What do I need? How big should it be? One that goes over my butt and hips, one with a crotch or no, one that is like a tank top? What about this silly looking tube slip, can I jam that down over my torso? What brand? Boning or no boning? No doubt about it..these are first world problems! Luckily when I tried my new panties, they were exactly right...and I can wait to figure out the binder....I still have 3 weeks. Omg, 3 weeks!

When I got serious about having a TT, I began...

When I got serious about having a TT, I began doing research. Realself has factored very highly into it - first person experiences are so much more valuable than clinical description. Since I am having a hernia repaired as well, I set out to determine what all the aspects of TT are and make sure I only got what was necessary for me, for safety and health's sake.

In the beginning I watched Becky's tummy tuck journey on YouTube, and read countless reviews and first hand accounts here and elsewhere. It seemed to me that there was a litany of short term and potentially long term side effects to MR...some of them that seemed risky to me. Of course there is the pain, pressure, tightness, muscle spasms and slow healing time initially. But then there was the popped stitches, bulges, tingling, muscle weakness and lingering soreness that can prevent one from working the core, lying on her stomach etc. Of course, this was not everybody by any means...but there were enough of these stories that it gave me pause. Do I really need it? Define need.

I asked the question to the realself doctors, as well as went back through the archives. The responses were pretty militant, even bordering on insulting. They said things like - it is essential! It is a rare woman who doesn't need it! Your TT will look unfinished! You will have a sloppy or dumpy appearance! The surgery is not all it could be! This one size fits all model didn't sit right with me. Certainly I have seen photos of ladies who's Timmy's stilled bulged as if they were pregnant, who had hernias, who complained of weakness and who's appearance led them to be asked when the baby was due on a regular basis. Still there are other women who at one time had a lovely narrow waist and they lost it during pregnancy. For these women, muscle repair may be just as important cosmetically or mechanically. But to say that for ALL women it is necessary is unfair.

For me, I had to examine why I want a TT. Is it for a certain look or dress size? Is it to relieve pain and bring back strength? Is it just to remove extra skin and fat? Personally, my TT is about self esteem and function. My primary concern is for good health and mobility. For me, though I have a minor diastasis, it is not worth risking my agility and strength to take an inch of my waist, or make my tummy flatter. For you, maybe it is worth it. But I have been aghast at the assertion by many doctors that it is a must for a good job. In fact I was afraid to even ask for it. Once I explained to my doctor that my core muscles were strong and 'if it ain't broke it shouldn't be fixed', he was very happy to do a skin only TT for me. If you happen to be reading this and are unsure whether muscle plication is for you, I encourage you to research and weigh the pros and cons. Also, to watch tutorials on YouTube that explain how to locate and measure your own diastasis, and not just trust your doctor to make the call once he has you opened up. This is MY TT and I am getting what suits me. I hope you have advocated for exactly what you want as well, and get nothing but the best!

In 16 days, I will shed my skin suit. Hallelujah!

Oh, and I just want to add, in case it wasn't...

Oh, and I just want to add, in case it wasn't implied - I respect every gal's decision on this subject of muscle repair and whatever your reason for tummy tuck, you get NO judgement from me!

I was on the treadmill yesterday, when I realized...

I was on the treadmill yesterday, when I realized that I was doing something that I often do unconsciously - putting my hands along my sides and grasping my torso. I don't know why, but I have done this for ten years in the mirror, when I'm standing around cooking, working out, speaking to someone. It is like I am reassuring myself that my muscles are in there, that somewhere underneath all that heaving loose skin there is strength and firmness, reminding myself that it doesn't have to be like this. Reassuring myself that I am strong, even if I can't see it.

When I run, my stomach skin twists and bounces as if it were a bra-less boob. Sometimes it hurts. Always I am embarrassed that other runners will look at me and think I am undisciplined, or new, or "just a jogger" because of my physique. For years I thought about what it would be like to take 2 months off, and lose fitness and start all over from zero - a heavy proposition since I have been running ultramarathons non-stop for five years. Starting over is a mental difficulty. I never take time off. I don't sleep when I can't run or hike or climb. But when I think about tightening the hip belt on my backpack and not having a roll flopping over the top of it, or wearing shirts that are a size too big to camouflage my bulge, or praying the wind doesn't change direction and plaster the shirt against my pouch, or shopping for special high waisted exercise bottoms to tuck my skin into, or doing down dog without living in total fear that my shirt will flip up and people will see what I am hiding, or doing plow pose and not having the roll flop down and crush my lungs and make it impossible to get my feet on the floor....or putting my hands on my hips and feeling something firm where I used to feel nothing but droopy softness - it is worth whatever amount of time I have to take off, whatever amount of pain I have to endure, whatever kind of judgement from others I am offered to finally feel what I really am, for once - STRONG.

Since surgery is 2 weeks and one day away, and I...

Since surgery is 2 weeks and one day away, and I booked my presurgical screening today, I figured it was time to start building the war chest of supplies. Of course there will be a run or twenty to the grocery store for foods and drugs and baby wipes and all of that nonsense in the coming days. But for now I wanted to be sure to get some other essentials out of the way that could not be bought on the fly. So, off to Wally world I went...

Some genius suggested that purchasing and wearing an "old lady housecoat" that zips up the front is the perfect post surgical solution. No need to bend over and fight with pants or stretch your arms over your head tugging a shirt off...you just unzip and go! This is a brilliant idea, and one that also manages to be acutely humiliating for a 32 yr old woman. In my cart goes 2 pastel colored mumus. I also bought a Hanes brand Torset compression braless tank and a Cupid brand Waist, hip and thigh shaper if I need to attack the belly from the other direction. Since the 2 items cost less than 1 pair of spanx, I figured it was worth it. I also bought Medihoney alginate dressings. They come in rolls that are 12 inches long and you can cut to fit them. I read a lot about manuka honey, perused the various products and feel good about purchasing and using these for my wound care.

I have to say that It was a singular experience to plop the house dresses and body shapers up on the belt in the check out line. You have to laugh at yourself, cause you'd cry your eyes out if you didn't!

Just home from my pre-surgical appointment. The...

Just home from my pre-surgical appointment. The hospital staff was awesome. A medical secretary walked me through the fees and options and had me sign papers. Then a nurse took my vitals and a whole mess of blood. (yuck) Another nurse came in and quizzed me, she also spoke with me at length about my fears. She looked at my chart and said that I had an excellent surgical team between the 2 doctors, and that since I was healthy I will be fantastic. She told me that ti was their job to worry, not mine. She also answered questions about where my mama can wait for me, when she'll see me again, how it all goes down before the surgery etc. Really calmed my fears. Then a PA came in and listened to my chest, asked more questions and I was free to go.

The overwhelming thought I had when I walked into the surgical center was just one of disbelief. I cannot believe I am finally doing this, and that I am going to be cut open and sewn back together. This is one of the biggest decisions I have ever made in my life...as I'm sure it's been for everyone else too. I am so very busy right now getting ready for surgery, the holidays and to sell our house after Christmas that I don't have too much time to dwell on it all, thank God. 13 days now.....

When I first found out that my hernia would need...

When I first found out that my hernia would need to be repaired, I had my fingers crossed I could go on a TT journey as well. I didn't fully understand what it entailed, but after some initial searching, wound up at realself. I have quite a few inspirations and I want to thank them, because without you I wouldn't have the knowledge I need, the courage to do this, or anyone to share it with...so, away we go:

- Wildorchids: our similar stomach drape and body shape give me immense hope. And her incision and BB have been the best I've seen in my opinion, hands down. If my doctor can make my belly look half as good, I'll be stoked.
- Kimmers25: for being an awesome den mother, encouragement, and for being willing to share her story and then keep helping others on their journeys.
- All the ladies who have a major split to their muscles. What you have endured, with having people ask when your baby is due, the embarrassment of having a pot belly etc - if anyone deserves a TT it is you! I thank God for doctors who can restore those muscles and for your bravery
- All the massive weight loss ladies. You have been to the darkest places a woman can go physically, survived it, and you DESERVE to look as strong as you are. When you began your weight loss journey, perhaps you thought the body embarrassment was over, but it was only beginning because of the hanging skin you were left with. Now is your time to have what everyone else has and feel NORMAL. Way to go - all of us!
- The mamas - who sacrificed their figures, their skin and their self esteem to bring forth children. You give so much of yourself as a mother, and it is time to get back something for you. Go on hot mamas!

And finally, Metalmomma, for posting a pic of her "new favorite pose". It inspired me to do the same, since it is my least favorite pose. On all fours, I measured from the edge of my skin hang to my belly button: 3.5 inches. In 1.5 weeks I will never look down and in that position and see that mess again. Thank you baby Jesus, Merry Christmas to MEEE!

For the last 12 years I have been obsessed with my...

For the last 12 years I have been obsessed with my stomach. I probably lift my shirt up and look at it in the mirror 3 times a day, every single day. I put my hands on it, grab a handful and squeeze or pull it off my muscles, I dig my fingers in searching for the muscle underneath. It has been an anchor...in everything I wear, every time I leave the house, when I meet someone new, when I exercise, when I sit down in public and my stomach drapes across my lap like a fleshy skirt....
and in 10 days it's over.
I can't believe it's going to be over. What will I do with all the extra brain space that I will have when I am not obsessing about and constantly tortured by my stomach? I anticipate that December 27, 2012 is going to be one of the greatest days of my life.

Tomorrow I have to begin "no supplements". This...

Tomorrow I have to begin "no supplements". This scares the snot out of me, as I have 2 school aged wee ones and I am a germaphobe. Does any other pre-ops feel like pulling a Michael Jackson and wearing a surgical mask in public or not letting anyone touch them?! Strep and stomach flu, as well as regular flu are going around the community and school and I am terrified of being rescheduled. My mother is a snowbird and is planning on being here for exactly 10 days after the surgery to take care of me, then she flies south for the rest of the winter. I cannot blow this opportunity to have her help with my care and the kids, so I CANNOT GET SICK!!

My instinct is to diet myself down as "thin" as possible before the surgery and not eat very much. My common sense is telling me to eat enough to stay warm and healthy and eat the highest nutrient content food possible. Sense wins. I generally eat very healthfully, but not every meal is a win. Sometimes a "meal" is a christmas cookie or a granola bar...that's not cutting it right now. So, I am eating as usual, but making every meal and snack count instead of just one or two. These are items I am emphasizing:

Chia seeds (protein, fat, intestinal health)
coconut milk (fat, electrolytes, minerals)
greek yogurt (intestinal health, protein)
raw honey (general antibiotic capabilities, trace minerals)
fresh pressed vegetable/ fruit juice combos with an emphasis on dark colored greens, citrus fruits, and ginger (vitamins/ minerals)
modest quantities of meat and eggs (protein)
coconut oil (fat is essential for cell repair)
organic nut butters
fresh berries and fruit
green salads with oil and vinegar
steamed vegetables

I am avoiding high sodium foods and processed food, eating very few grains (and gluten free when I do)

PRAYING that this brings me to the surgery as healthy as I can be, and keeps me illness free so I can even have it.

Did a big shop today...bought groceries enough to...

Did a big shop today...bought groceries enough to last through 3 weeks if needed! The to-do list is still a mile long but I am growing weary of it all - whatever doesn't get done will get done after the surgery when I am better or by someone else. Is this how I want to remember my holiday - running around like a maniac getting my house ready to sell, fitting in work around the mayhem (I am a writer), over-scheduling parties and gift exchanges? The kids are only 5 and 7 once and I do want to enjoy my holiday and not have all these irons in the fire. Whatever happens it'll all be okay - I don't have to do it all and be everything to everybody right now.

One week from today, and the skin I have always dreamed would go - will.

I have to admit - though I've heard great things...

I have to admit - though I've heard great things from nurses and other doctors, seen a bit of my PS's work on TV, I really haven't seen any before and afters for him. I know it's nuts, but I think he is that good and has such a high reputation that he doesn't need to show off a before and after book. This morning I was googling around his name (for like the 100th time) and I found the Top 10 PS of New York website, and he was listed for 2011-2012, nominated and selected by his peers. The site says " Dr. Langstein has received numerous awards such as the 2009 Patients’ Choice Awards, Best Doctors Award 2008-2010, America’s Top Surgeons and Top10ofNewYork – Top New York Plastic Surgeon 2011-2012 to name a few."

There is still this part of me that says "I want to see the book of photos!", but I have to trust that he is an expert and will not do me wrong. I am typically a control freak, so to just trust this man is strange, but that is how confident I feel about him. In my gut, I just know he is going to create a great result for me. I absolutely cannot wait for my pre-op appointment next Wednesday where I can see him again and get all my surgery questions answered. Wow, so little time left to wait...

I am so happy to report that my to-do list, the...

I am so happy to report that my to-do list, the one associated with getting our house ready to sell in 3 weeks is COMPLETE! After scrubbing 800 sq feet of limestone tile on my hands and knees and washing all the baseboards and woodwork on the first floor, I finally crossed off my last item and can relax! I have also gotten all of my regular "job" work done for the next 2 weeks (though it's no big deal, because I work from home). Now all I have left to deal with is 4 straight days of parties, cooking an enormous amount of food, laundry, general cleaning, packing for surgery, packing kids to stay with friends, that whole pretending-to-be-santa-claus business, and then I am DONE, and ready to be surgerized. Oy.
SO freaking ready for 2 weeks off my feet and waving bye bye to jiggly belly for GOOD!

Merry Christmas realselfers! It has been a...

Merry Christmas realselfers! It has been a whirlwind of presents and food around here...as expected. Tonight after the kids are in bed I will take down the tree and all the decorations. My pre op with the PS is tomorrow...the rest of the dy will be getting prescriptions filled, running errands, packing ec blah blah. The busyness has made it so I haven't had time to worry. I am sneezing right now and praying it is not the start of something terrible. Can't believe I'm almost there....Thursday!!

Just back from my pre-op. Got all my questions...

Just back from my pre-op. Got all my questions answered. So interesting how the different doctors handle TT. Mine is not super concerned about leg compression to prevent DVT, and waist compression isn't a huge deal for him either, though I will get a garment. I can shower as early as 1 day PO, he won't need to see me until late next week, but they do want me to spend the night in the hospital. The standard less than 30cc drain output for 2 consecutive days rule applies, and may have the drains for up to 2 weeks. He came in with the camera and when I took off my robe he said again, "You are going to have a really great result. You will be so happy!" And I believe him!

I think the best tool one can have in their toolbox for undergoing something like this is the right attitude. You have to be prepared for a bad outcome, a bad recovery, complications and such. You also have to really be willing to accept the swelling, physical limitations, immobility, and lack of independence. There have been many times in the past 12 years when I would get close to booking a consult and then think of the time off from running and living and being normal, and decide it was not worth it. Now, I finally feel like I am ready to face whatever I have to to remove this burden from my life. To not be or feel more attractive...just to feel normal. I don't feel normal since I lost the weight over a decade ago. I still feel like a fat girl or an out of shape person, though that is so far from reality. My dream is that in 3 months I will get dressed without trying on 5 outfits, that I will not be ashamed to get undressed, that I will look as fit as I am, and that I will finally....just feel normal.

Best of luck to everyone going in tomorrow - momoftwinks, yvette29, svalentine, and petite. See you on the flat side!

Lying in my hospital bed. Not wearing compression...

Lying in my hospital bed. Not wearing compression so I've already been able to peek! Incision is super duper low. My doc does internal dissolvable stitches..so no ugly black sutures or staples. I, for the first time since the age of 10 have a belly button, somewhere under the white tape. Doctor told my mom that I could maybe leave tonight, but I suspect they won't be stopping by since it is already 6 pm. Pain level was a 4, knocked down to 2 by Vicodin. Slightly nauseous. Had a half of a little ice crem cup. Throat hurts from tube. Pain is localized to incision line and hernia repair. Was scared going in to surgery, but now don't remember anything other than being wheeled down the hallway.... So grateful. Minor pleating at the edges it looks like, but doc warned me I would. Praying for all my 27th sisters!

When my folks got to my room, they told me that...

When my folks got to my room, they told me that the PS said I could leave tonight if I wanted. Hell to the yes! Be woken up every 2 hrs to have my vitals done, and share a Room with a lady who was having a friggin high school reunion or something or go home? Home for sure!

The first time I stood up to go pee I was very dizzy and lightheaded..and nauseous. When they discharged me, without a CG, I knew it was gonna be bad...especially cause my mom is a crazy driver. So I noticed where the plastic bags were in advance. We were only 3 blocks away when I puked all the water I had drank and the 1/2 cup of ice cream! But seriously felt so much better...no dizzies and belly was settled. It did hurt the incision to puke though.

Was sent home with Rx for keflex and norco. I am going to be good and take the pain pills for a day or two, then try to step down to Tylenol. Pain on the drugs is about a 2 out of 10. Pain is localized to drain sites and the hernia repair. Again, as a reminder, I chose not to have muscle repair and that is probably why the pain is minimal. The lack of compression is probably going to equal a big tree trunk of a torso, but I have some garments at home I can rock when I leave mom's in a few days. I am so happy, and can't wait to post pics Sunday or Monday! Even with the immediate swelling I can see my ab muscles. Woohoo!

Rock on 27th sisters!

- I am not surprised that male doctors place...

- I am not surprised that male doctors place drains in the mons, since they have never possessed a vagina. This is a terribly inconvenient place to locate the darn things. They are in the way when I pee or walk around. I have to tug them up to wipe myself. Really? What is the wisdom of this?
- the dulcolax, prune juice and antibiotics are hosting a rave in my intestines right now. It's going to be interesting later...very hopeful this helps
- sleeping sitting up is BS and quite uncomfortable. I'll try the bed with a wedge pillow tonight instead.
- get the old lady mumus....it works awesome for dealing with the drains!
- drain output is very high...and needed without any compression, as much as I hate them they are doing their job.
- GMA had a segment this morning about eyebrow transplants. Really? REALLY?
- honestly, it is hard to b excited or relieved or proud or happy at first because you are so wrapped up in your pain. It hasn't registered with me that my body is so different...all I can think of is being careful and healing, not all those fantasies I had about tight shirts and running without all that cadaverous skin hanging off me.
- I am very very grateful for everything and though it will be weeks and months until I finally see my new mid section, I can already say I would do this again and again and again.

Be blessed gals!

What is worse than being in constant pain,...

What is worse than being in constant pain, juggling drainage tubes, and being a hunchback? A : the utter boredom of recovery. Really? How many days do I have to sit here and watch talk shows with my mother? When my only real labor involves eating, drinking, and pill taking and my only chore to TRY and find a comfortable position...when there isn't one.

Slept in bed last night with 2 wedge pillows, but woke up in my side, curled in a ball with my legs scissored...just how I normally sleep. Alas, I had to get up for pills and peeing and never found the sweet spot again. I went to bed extremely swollen and misshapen, and am looking much better today. I hope to shower and see my belly button today. I stopped vicodin yesterday afternoon and switched to Tylenol. Had my first poop this AM... All came out fine thanks to prune juice, tons of water, and twice daily doses of stool softener. I think the freakiest thing is the drains and total lack of sensation below the belly. The painful thing is the hernia repair, and the actions of coughing, throat clearing and nose blowing. And the back...oh lord the back. It's only day 2 and I am already dying to stand up!

But overall I do feel ok, energetic, and focused on one day at a time. Really grateful....this isn't too bad. Don't get me wrong...it really freakin sucks, but it's still not too bad.
Happy healing girlies!

I know this question has been asked before, but...

I know this question has been asked before, but the reviews get updated so fast, I can't keep up. My ps didn't give me info bout this one. When is it time to straighten up? Is it natural, or something to work towards. If so, when do I start working towards it? Thanks for your help....this is by far the worst part. Other than that, it is minor annoyances and discomforts.

So interesting to me that when I was Pre-op I...

So interesting to me that when I was Pre-op I stalked the reviews for those first few days post op pictures, and now that I am here and could return the favor, I couldn't care less what my stomach looks like or showing it to anyone. Pics tomorrow AM for posterity though...promise.

Yesterday was my first shower, which I took with no help in my parents corner cubicle shower. I figured there were 3 walls to catch me if I keeled over. I did as the doc said, kept my back to the water and didn't linger. My incision is dissolvable sutures and the top layer is glue, so I only have a bandage over my BB. I did take the tape off and found the button filled w gauze. I pulled some out, and it was like a magicians trick, it kept coming and coming! So I cut the 5 inches I'd removed off, put my Medihoney dressing on and left it alone.

I had 2 poops yesterday, and one already this morning with the aid of stool softener. I am managing my pain w extra strength Tylenol before bed, and small doses throughout the day, though I feel I've crossed from pain to discomfort...with minor stabbing pains coming from my right drain. The left drain continues to have high output, that has decreased everyday, the right has less than 40 now, that has also decreased daily. I can only hope that they come out Wednesday! Again, by far the worst part of this is not standing or lying straight. I did get some relief yesterday when I got on all fours and flattened my back for a moment.

Other oddities - mega gas, no appetite (though I am eating plenty), and when I sit up (in the car, at the dinner table), I get sweaty, my heart pounds, head is buzzy and get slightly queasy. Dunno why, because it doesn't hurt to sit up....maybe just takes too much energy.

My swelling is minimal in the AM, but by the evening I have a ring of fluid all the way around my body at the incision line and I look 4 months pregnant. My mom just brought me home...yes, my kids will probably make me nuts, but I just was not comfortable anymore...I was longing for home. So here I am. This was a long post, but I want to make sure I cover everything for all you hungry Pre-ops. I do want to mention how inspired I am by the women who underwent muscle repair....I can imagine that pain only, and I give you so much credit. No wonder there is a period of buyers remorse and depression. As for me, my recovery was just as expected - not fun, but really not too bad. Godspeed Pre-ops, and speedy healing wishes for the post ops, especially team 27th!

Well, I finally got around to taking some photos...

Well, I finally got around to taking some photos this morning. It was the most upright I've been so far, but it will be short lived because the swelling has already begun. Swelling right from minute one is a way of life for us gals who's docs to use CGs I suppose. After these silly drains are out, I will add some form of compression in on my own.

Ah, the drains. Repulsive to look at, painful to have, nasty to change. Specifically my right one has had very low output from day one. Now it is causing stabbing and shooting pains. My first post op isn't until Wednesday, day 6, but I am going to call in this AM and beg to be seen, and at least have the right one removed. Hoping.....

Weighed myself this AM. Down 3 lbs since surgery, despite the unusually large quantities of food I've had to eat while healing. I suspect that 2-3 lbs of that was the actual skin and fat removal. Still exhausts me to sit up without back support, still having bouts of nausea (probably due to the medicine), pain is still minor and localized around the drains and hernia repair. Only now the pain I feel w no painkillers in my system is the pain I was feeling 2 days ago with Tylenol...so, big improvement.

As you can see in my photos, the doctor made me a nice little bloody mess of a BB, but I think it is going to be adorable when it heals. The fact that I even own a visible BB is still a point of disbelief for me, since its been about 22 years that I've been able to see it. When I first saw my incision I couldn't believe how low it was, but I was lying down and had no clue how compressed my torso was. As I become more erect that scar floats higher and higher, and I suspect will be visible in all my hipster underpants. And yes, I did have a MAJOR thigh and pubic lift out of he deal. Holy cow! But ya know, I am all crisscrossed with stretch marks anyhow...what difference does a little old scar make?

This mornings pictures were definitely the first time I've felt thrilled. AND it only gets better from here!

Woohoo, PS can see me today to have the right...

Woohoo, PS can see me today to have the right drain removed. Progress!

So I went to see the PA for an emergency...

So I went to see the PA for an emergency get-this-god dang-drain-outta-me appointment. I had to wait 45 minutes, but it was worth it when righty got yanked! Thank ya Jesus! Now to kick his twin out on Wednesday. Shoo! She did say that my belly button looks healthy, incision looks great and that I'm doing well. So, yay! It was a lot of work today so now I m back in my bed nest chillin for the rest of the day.

Happy New Years realselfers!

Happy new year realselfers! I am happy to report...

Happy new year realselfers! I am happy to report that I feel like I have turned a corner in my recovery. The first 2-3 days of recovery were unlike anything I've ever experienced. If you have had a healthy life and no c sections, I guess you don't really know what that sort of weakness and helplessness is like. But things are I really looking up.

Each day I stand a bit straighter in the morning. Each day I am a bit less swollen, exhausted, etc. weirdness still persists with the hunching, the one drain, the side effects from meds and all that, but each day is a few more baby steps towards normal. Tomorrow the hubby goes back to work and kids go back to school, so for at least a few hours each day I cannot schlep around like an invalid. Truly, I can do more than I have been doing, but won't. I didn't pay all this money and go through this pain to mess up my results, so I've allowed people to baby me. I recommend everyone does the same!

So happy that today is my last day of antibiotics, and I will finally get to sleep through the night. My drain output is pretty low, and looking forward to removal tomorrow. My PA said yesterday that I couldn't run Until THREE weeks. I thought it would be SIX! I told her I was in no hurry, and that my goal was to be walking in 3 weeks, not running. I do run several thousand miles a year, but I am beyond the point where it defines who I am as a person, and have no issues with time off. A few years ago....I'd have been climbing the walls though. I think I waited until the right time to go to flatsville!

Hope 2013 is the best year of your lives gals!

Well, you know what they say, about nothing being...

Well, you know what they say, about nothing being perfect? That includes plastic surgery...it can't fix your love life, make you wealthy, or make you look like a super model. I had pretty low expectations for TT. Can I please not have 1/2 a foot of flesh hanging off me when I bend over? Maybe I could get dressed without trying on 20 outfits? Thanks. So it is funny that I am having moments of missed expectation. Somewhere along the way I must've allowed an image of my results into my head, without even knowing it.

I was surprised immediately by how much laxity I still have on my sides. The truth is, that I was probably a good candidate for fleur de lis, a circumferential body lift, or at least an extended scar. I didn't speak to my doctor at all about those concerns, I just opted to trust him. I also expected that he'd release my skin up to my breasts, but I realize now that he barely went higher than my BB, so when I sit or lean over, there is already a gathering and sagging of flesh above my BB. There must be a reason for it, but I didn't expect it. I should have asked more questions. My bad. Plastic surgery can undo some of the sins in the past, but not all of them, and for me this is the honest truth. It is a vast improvement. I'd take this any dang day of the week over what I had....but I won't lie and say I am perfectly happy with the outcome. Who ever is?

Slept all night on my side last night! Hooray! Took the last of my antibiotics, and only one Tylenol all day yesterday. Still taking stool softener, because pushing freaks me out. Do not want to blow out my hernia repair! Going to see PS today for first real post op. hoping to get the left drain out, but I have a stinky suspicion it's going to be with me another few days.

Children at school, husband at work. Allowing myself to do light housework and one errand only. Not going to tackle any of my other jobs until next week. The rest of the time I am reclining with my feet up. Everyday I stand up a bit straighter, though its still a couple weeks I think before I am fully erect all the time. Happy healing ladies, stay positive!

I am one week post op today. Yesterday I got to...

I am one week post op today. Yesterday I got to meet with my PS. The great part was that he pulled my last drain, yay! He told me that I did have a one and a quarter inch muscle separation at my belly button, but that it was not a huge deal, and he honored my request to leave it alone. He said my wounds looked very healthy. His PA reiterated that I am cleared to exercise at week 3, To let the glue over my incisions fall off alone, and to take it easy during the next 72 hrs while my body sorts out what to do w any fluid buildup, now that I have no tubes under my skin to whisk it away. For the record, having this drain pulled did not hurt like the other one. I did ask my PS about using a marble or plug on my BB and he chuckled...said that a BB has never healed closed up for him. I have a nice round BB, not to worry.

Other things I discovered yesterday:
- When you apply compression after the drain is freshly pulled, expect Niagara Falls out of that open wound
- Compression makes you stand straighter. My doc is not a believer, but after I got home I did put on my Hanes Torset top just to help with any extra fluid collection. I am standing up nicer, but have weird sensations under my incision...,not sure if that is good or bad.
- Peeing is very interesting now. There was another realselfer recently who spoke about this problem too, but I cannot recall who she was. When I pee, I have to lean way forward, or else the pee goes all over the seat and my thighs. This is clearly due to the pubic lift as well. Only a minor annoyance in the ladies room. A very large problem it will be in the woods. As a hiker and mountaineer, I am a regular yogi bear, but this definitely throws a wrench in the works. How will I manage to pee outdoors without hitting my clothes. Perhaps I will teach myself to go standing up!
- the fatigue I have experienced is humbling, and my body's cues, powerful. My sport, ultra marathon running ( 31 - 100) mile races, revolves around ignoring your body's pain and fatigue signals. You cannot run for 24 straight hours and honor every cry your body gives to sleep or stop or eat half a large pizza. But my body's insistence that I get off my feet NOW is so loud that I haven't dared ignore it. At first, I could make it for 2 or 3 minutes,now I am up to 10 - 15. Yes, I COULD keep going...but that call to lie down immediately is intense, and oddly, I have been good about honoring it. I have literally thrown whatever item I have in hand on the floor, walked away in the middle of a chore or conversation so I could get horizontal. When my doc mentioned exercise yesterday, I nearly laughed out loud. It is a feat to take a shower or put some clothes in a drawer or make a sandwich for the kids. Exercise is a long way off!

Question! What is the deal with everyone talking...

Question! What is the deal with everyone talking about eating pineapple or drinking its juice? What does that have to do with swelling? Is this old wives' tale stuff or real deal?!

Yesterday saw two major milestones. The first is a...

Yesterday saw two major milestones. The first is a great one - my agility has come back. These changes are so small day to day that you hardly notice they are happening. But sometime around lunch I suddenly realized that I was moving around the house with my normal speed, not using furniture to prop myself up while standing, and standing much much straighter. Felt more like me, which was great news.

The second milestone was experiencing my first full day drain less, and working through the inevitable fluid buildup. My doctor was a little aggressive with my drain pulls, because the output never went below 30, it was between 30 and 40 for several days straight. But he felt okay about it, and of course I was anxious to get rid of them. So by the end of the day yesterday, one side of me, below the incision was filled. I am now wearing a body squeezer that goes from mid thigh to rib cage. This morning it looked better, but I think it will be a daily cycle. Will try some pineapple as everyone suggests.

Other than that nothing is new in tummy tuck land. Read a few books. Watched every goddang episode of Say Yes to the Dress on my iPad in the last couple of days. I don't know why. I kind of hate the girly stuff. I bought my wedding dress for $200 in a department store. But I do love reality TV for various reasons. It's a way to console yourself....'I may not have taken a shower in three days, have pee splatters on my underpants, and be wearing a housecoat.....but at least I'm not as messed up as these people!"

It figures. If there is a ten percent chance that...

It figures. If there is a ten percent chance that someone will develop seroma, who gets it and why? Better question - who's got two thumbs and is really unlucky? THIS GIRL!

So my left drain was pulled after three days of output hovering between 30 & 40, and I ain't even going to try to lie and say I was going to object if the doctor offered to pull it. It's only 10% of the gals! It won't be me! I am super good and totally not going out of the house or doing any housework. I spend all day on my back! And I will wear my power panties! But to no avail. The left side below the scar got heavier and bulgier and I watched it grow all yesterday and all morning, and finally at my lunch time potty break I sat to go and tapped it. And girls, my pubic hairs did "the wave". Frick.

As it's Friday, sort of panicked knowing it had nothing to do but grow all weekend. So disturbing, the left side of my mons was three times as big as her sister and drooping like a rubber sheet off my body when I leaned down. I called the PA and she told me to come right in. She tapped me and watched it dance. After that was the pleasant experience of a huge needle in my tender, recently scabbed drain hole, and the dam breaking. She got out about 35 cc, not a whole terrible lot....but enough..and with a promise that this probably wasn't it and she'd probably see me on Monday. Double frick.

So another order to do nothing. Again, if I did less, I'd be dead. And wear my special unders. Yup! And find that bromelain stuff. Okay! And pray this is somehow it, because Monday my helper (mama) gets on a plane and flies away.

Who said the road would be smooth?! That's right - no one! The odds are that my body still needed that drain and I should have fought to keep it. Paying for it now. Que sera sera....

Oh, and I promise if it develops again, I'll give...

Oh, and I promise if it develops again, I'll give ya a picture. It is really ghastly :)

Not much to report today. My seroma returned...

Not much to report today. My seroma returned almost immediately yesterday. I lay in bed crying and scared that this would drag on for weeks last night. It really interferes with healing, ya know? So long as that pocket of water is there, my skin can't reattach to the muscles. I just want to get the ball rolling. Feeling discouraged. And my helpers struck out looking for bromelain yesterday. Eating pineapple and lots of green tea w lemon.

Standing almost straight now, sleeping through the night in my preferred position - on my side. Ready to do more than lie on my back.

When my 6 year old underwent tonsillectomy and...

When my 6 year old underwent tonsillectomy and adenoidectomy last year we suffered through two weeks of night terrors. She had never gone through anything like that before...it was deeply disturbing to go into her room at night while she moaned and screamed and thrashed in the bed. I would scream in her face, shake her shoulders and she wouldn't come out of it, focus her eyes on me. It was exhausting and terrifying. After 5 days I finally did some searching, and found quite a pile of anecdotal evidence about the correlation between general anesthesia and night terrors in children. Gratefully they went away after two weeks, but I was chastened to learn that the doctors don't tell you everything, nor report on every potential side effect...particularly psychological ones.

I knew that post surgical depression is expected with plastic surgery, but I assumed it was caused by a combination of unmet expectation, frustration with physical progress, anxiety about results etc. I was not prepared for what happened to me the last couple of days. Yes, I have all of the issues stated in the last sentence, but what I've been experiencing is much more complex than that. Yesterday I spent most of the day crying uncontrollably. Even crying in front of my children, and I am very conscious to never bring adult problems to little eyes and ears...but I was weeping as I told these poor confused kids all of my fears. I couldn't pull myself together. I had a blinding headache most of the day, was medicating myself with unhealthy food and felt utter irrational despair. As I wake this morning, my prevailing thought is "what the hell was that?!"

So I did a bit of research, and found a fair amount of evidence about the psychological side effects of general anesthesia. I wish I understood this, or that doctors acknowledged these potential post op problems and discussed them with patients. In thinking that we are simply dealing with feelings and processing the reality of the suddenly changed bodies we have, I think we may be done a disservice. What I felt yesterday is not something that I could have gone away simply by manning up or thinking positive. I am generally a positive person, and this madness I began feeling on Thursday, that reached Its crescendo yesterday was far from the normal post op blues. While today I feel so much better and view my water belly and need for continued rest as temporary setbacks, yesterday I was beyond irrational. I wonder if that was the last hurrah...if the drugs were finally exiting my system completely....

I wonder have other realselfers felt paralyzing grief like that?

As for things physically, my pain lessens everyday. My scars look great. I am standing all the way straight now and moving normally. I do have a growing seroma, that I'll have aspirated tomorrow, and every couple days until it is gone. At some point next week I'll begin working again. And emotionally I feel normal again.

Well, I survived the weekend drama and was ready...

Well, I survived the weekend drama and was ready to get back to a bit of normalcy until my smallest came downstairs this morning with a fever. FABULOUS! So let's see what plans are out the window today. Nap? Gone. Groceries? Gone. Relaxing and trying not to move? Gone. Trip to PS to get the kiddie pool, previously known as my stomach, aspirated? I must. Even though I have hidden my scars from them and want to spare her the trauma of seeing someone stick a 4 inch hollow needle into mommy's stomach, I cannot bear another day of this sloshing. Thinking of strategies to divert her attention while they do it.

Seriously, when I lay on my side it's like a waterfall as it all wooshes to follow gravity. When I look at my lower belly I think "cistern", and the appearance sort of reminds me of a soup ladle. So lucky!

In general I am also swollen and now know what the swell hell is. By the end of the day yesterday I was like an overstuffed sausage, practically bursting the seams of my power panties. If I could just wave a magic wand and sleep through the next 2 weeks of aspirations and swelling and scabbiness, I'd be ever so happy, but alas - there is no magic pill for this one. Repeat after me - it will pass, it will pass, it will pass.

Happy healing, ladies! (sidebar, I am so tired I first typed out "Happy swelling ladies!". Hmmm, perhaps that's more accurate.)

Another day passes in the pursuit of flatness. -...

Another day passes in the pursuit of flatness.
- Went to PS to be aspirated yesterday. They pulled 70 cc off of me, which is 3 days accumulation. My poor drain site is sore and bloodied from the repeated sticks. By nightfall, the wave was back though. At the PA's suggestion I am wearing multiple compression garments, and feel the way one of those quick change artists must. Currently I have on a pair of tight granny panties, 2 pairs of thigh and torso shapers, and my Torset top over it all. Can't get a deep breath, takes 5 minutes to get it all off to go potty, but the worst part is that it doesn't seem to be making much difference. My seroma will burn out, hopefully sooner than later.

- Both kids are sick now. Doin everything I can to not contract it.

- Still lots of general swelling

- Now the good news: I made a real dinner last night, took care of the sick kid, picked up the house a bit and felt much more energetic and mobile. Slept awesome.

I have realized that my posts are becoming a...

I have realized that my posts are becoming a litany of negatives, but I want to show those pre-ops that even if there are setbacks and complications there is still always something positive too!

- My scars. First of all - they look lovely. Already the glue is peeling off and they are a light pink. I absolutely love my PS technique of doing layers oF internal sutures and nothing on the very top except glue. There was nothing to remove, no Frankenstein black stitches to look at, no bandages to mess with. And now that the glue is peeling off and I can see my new belly button and the future of my scarring I am very very pleased and not worried in the least about the final appearance.

- I am standing about 90% straight. I can reach my arms over my head. Do an arm bind behind my back to crack my upper vertebrae.

- I sleep on my side, rest comfortably and sleep through the night with no pain meds.

- Am in relatively no pain or discomfort. (Um...sneezing is still off limits though)

- I have read 4 books, hand sewed the binding to a queen size quilt, and learned to let things go and ask for help. Also, I am having more "patience training", which is always good.

- My energy is returning somewhat and I am able to get through a short trip to the store all by myself or make dinner etc. (Wish I could take a small walk, but the seroma keeps me sitting through those non-essential tasks. Again - more patience training.)

- I am learning to accept kindness. Someone once said that it is harder to accept kindness than it is to give it, and they are right. I am amazed by the lengths people are going to, to care for me. My mother stayed in the snowy north for an extra week after Christmas to help me. My husband has worked his full time demanding job and been an excellent house husband and mommy stand in. My children have made me pictures and cards and projects and brought them to me as small offerings, and pressed into my palm special rocks, shells or pieces of jewelry as healing talismen... they are generous, empathetic, caring little girls. My best friend brought over a lovely basket of fancy cheeses, bread and fruit and we took it up to my bedroom for a picnic...just like when we were teenagers. (She also watched my kids during surgery, and brought me smutty magazines when my brain was too hammered to read Tolstoy.) My realself friends have been generous with their support and in sharing their journeys with me.

- There is an end to this. This process is finite. One day I will feel my stomach skin, and pull my chest through upward dog, get dressed without trying on 10 outfits, pull on a 35 lb pack and climb a mountain, leave compression wear behind (for GOOD!), have visible abdominal muscles and run 50 mile races again. There is an end. Though right now it is hard to see, it is there, and it's just waiting for me to make it.

* addendum to todays daily post about "what's...

* addendum to todays daily post about "what's good": all of the 4, 6, and 12 month post op ladies who have posted recently. Thank you for showing us the light a the end of the tunnel!

Went to the doctor yesterday for another...

Went to the doctor yesterday for another aspiration. They pulled 50 cc out, which is 2 days accumulation. So far the rate at which it is collecting hasn't really slowed down. But given that there are many ladies who have their drains for longer than 2 weeks, I am not really abnormal. Would I have rather had a drain this long, or go back for repeated aspirations? Well, that drain really got me down, so I guess I'd rather have it this way, even though it hurts to be stuck and I have to make a 40 minute round trip to the PS every other day. The PA drained me, but then the PS chased me out to the lobby, assuring me it will stop and that this is rare for him. I really believe it is due to the hernia repair, as the collection forms right over top of my new piece of mesh. I am cleared to exercise at week three, provided the seroma is gone. Please oh please...

My back hurts this morning, right in the middle. I think it is from the fatigue of just not standing quite straight. My ribs hurt as well from where the second binder scooches down in my sleep. I took pain killers for the first time in days this AM.

Managed to prevent myself from getting the kids' cold for now. I am going to go on a disinfecting rampage this morning and hope it stays that way. It is a pretty nasty one and I am not interested in getting it.

Today I start back at work. I am a writer. My current major project is as a ghostwriter for a self-help book. I will spend time speaking to my "author" this afternoon and taking notes for the next chapter. Hoping to sit at my desk for a few hours tomorrow and write. I am putting off my other job, as race director for an ultramarathon, until next Monday. Neither of these things are physically labor intensive but they can be extremely stressful and mentally taxing so I have provided adequate space until I was psychically ready to handle them. I hope it was enough time. If i have a nervous breakdown next week, I will get my answer.

Posted 2 week pictures. Skin looks healthy and everything is healing well. Of course there is a great deal of swelling, as is typical between days 9 and 28. Can't stress enough how much reading a million reviews has helped me. I know exactly what to expect by taking surveys from a wide variety of patients. I don't think I have had the "OMG, what is THAT?!" moment, and it is all due to post ops who generously and meticulously share their stories. Thank you ladies!

I had the thought a few days ago that I really...

I had the thought a few days ago that I really have a seroma because God stepped in, knowing that if I didn't have some limitation I'd do too much. I do feel better and stronger each day and have been tempted to get on the treadmill or do a push up, but the water belly has kept my butt on the couch. The seroma does seem to be abating a little bit. I will see when I go for aspiration this morning. But my new concern, though I tried my very hardest to avoid it, is the cold the kids gave me. It is a really bad one with fevers, headaches, and tons of green mucus. Oh, I am so not looking forward to this. But it will serve to keep me on my back and sleeping for another week. Maybe it's a sign.

Yesterday I got fed up with the compression - my ribs were hurting, I felt like I couldn't breathe well and I knew that it just wasn't going to happen for much longer, seroma be damned. So I took my garments off and slept in normal clothes. I was so much more comfortable and slept like a baby. When I woke this morning I was lying on my stomach! That was scary, but it didn't hurt. And I don't feel that my seroma got worse through the night because I was uncompressed. Time will tell.

I think for the first time yesterday it hit me. I was sitting on he couch, with no drains or compression or odd clothing layers, just reading a book and realized with a startle that there was nothing there. I had no roll to rest my book on. Before my TT I thought I would have this moment of tears and joy when my new belly was revealed to me, but that couldn't have been farther from reality. So far I haven't really cared about my stomach or looking better, my main concern was getting well. But now I am beginning to process the reality of my changed body...changed life. This WILL be a process, one that I am excited to undergo.

Many new pre and post ops on realself...welcome gals! Take courage and happy healing!

To read part 2 of my Tummy Tuck journey, please click here.

Dr. Langstein is a world renowned micro vascular surgeon who specializes in breast reconstruction after mastectomy. He has appeared as a specialist on the PBS series "Second Opinion" and is a true artist. I am very excited to be working with him!

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
4 out of 5 stars After care follow-up
3 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
4 out of 5 stars Wait times
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