Thigh Lift and Arm Lift--stage II Lipedema - San Antonio, TX

I’ve been chubby most of my adult life and worked hard to lose the weight I gained with my pregnancies. Despite nursing my babies, it was no easy task to get the weight off and I left a good 15 pounds on with the last baby. A divorce and early menopause sent me into a bit of a tailspin and I began gaining weight mostly in my upper arms and upper legs. I concluded that it was me eating too much and not exercising enough, and taking after my mom’s side of the family—all the women had huge upper arms and upper legs. But after increasing my exercise and reducing my calories to un-healthy lows for months only to lose minor amounts of weight, I felt something else must be wrong. After much research, I traveled to LA to meet with Dr. Amron—an expert in the field of lipidema. Dr. Amron diagnosed me with stage II lipidema and felt that it was likely triggered by early menopause. Dr. Amron performed a debulking procedure on my upper arms, calves and ankles and made some progress debulking my thighs. (My mom’s legs were large tree trunks and her upper arms were huge. Sad to say, we had no idea that this was due to a disease and she battled constantly to try and get weight off.) I met with one of Dr. Amron's associates about having the long scar vertical thigh lift done there, but after much more research decided that Dr. Fisher was the best choice for me. Dr. Fisher specializes in this procedure and his reviews stellar.

12/27—Met with Dr. Fisher and Joann. Pictures and markups completed. I had hoped for a minor brachioplasty revision along with the thigh lift, but Dr. Fisher felt that he would achieve the best result by redoing the brachioplasty entirely. I cannot find the pictures I took after the first brachioplasty that show significant laxity at my elbows and armpits--sorry about that. Not too keen on having both arms and legs done at the same time—not sure how I’ll navigate, but in some ways getting it all over with at once will be good. The first brachioplasty was done 4 years ago and I’ve been hiding under ¾ sleeve and long sleeve shirts ever since.

Back at the hotel, I ordered a lift chair, a walker, and a raised toilet seat from Primo medical supply. They delivered these around 4:30 the same evening.

12/28—Arrived at the hospital at 5:30 a.m. Extremely nervous. Dr. Fisher did some more markings. Woke up in recovery feeling loopy and nauseous. Stayed a bit longer than they had planned then I was taken up to my hospital room. Got there about 3 p.m. Surgery ended a bit after 1 p.m. In a strange position in the bed---legs higher than chest but head above chest? Feels weird but apparently helps with swelling. Not feeling great—nauseous. Had hoped this wouldn’t happen as I discussed my sensitivity to anesthesia with all the doctors. Nurse Tony immediately got me Zofran and also got approval for the stronger anti-nausea medication in case I needed it. I was provided a liquid dinner, of sorts, but did not have any… too worried about being sick. I slept a lot for the next 8 hours or so. Used the stronger anti-nausea medication during the night as I needed some pain medicine—my incisions were burning—strangest feeling—like they were one fire--and I was very swollen. This was the only dose of pain medicine stronger than Tylenol #3 (Tylenol with codeine) that I took the whole time. Thankfully it was just for a few hours during the night that I had the burning and I haven’t had it since, but it was a long few hours and I found myself feeling very alone and wondering if I’d done the right thing. Too late to turn back now!

12/29---woke up at 7:30 a.m. to find Dr. Fisher sitting next to my bed. We talked and he checked me out a bit. He said the nurses would get me out of bed around noon and into the chair (couldn’t imagine that at the time) and that if I felt up to it they’d get my compression garments on and I could think about going to the hotel instead of staying a second night. Honestly, at that moment I could not imagine leaving the hospital, although it’s not the easiest place to sleep in.

Day nurse got me up, I sat in the chair for a few hours and then she took the catheter out (at that point we agreed that I felt well enough to head to the hotel with my loved one) and she helped me get the compression garments on. She gave me Tylenol with Codeine about ½ hour before as she said it was going to be painful. I only took Tylenol with Codeine from that point forward at night as it helped knock me out a bit and to sleep better. No other pain medications were taken. A few hours after that I walked to the bathroom and peed on my own.

Check with Dr. Fisher on when you can shower. My release instructions did not note this and I wasn’t sure what to do. I should have texted him to ask.

The hospital folks were wonderful. Tony—the nurse I had when I came out of surgery, stopped by the this afternoon—even though he was working on another floor. He peeked around the curtain and saw that the bed was empty (the nurse pulled off all the sheets and stuff when we got me in the chair) and he had a look of sheer panic and then realized I was sitting in the chair on the other side of the room. He gave me a hug and wished me luck. So thoughtful!

Navigating getting in and out of the car was hard for sure. With the passenger seat pushed all the way back and the back of the seat lowered as well, I sat on the edge of the seat and kind of swung my legs into the car--trying not to bend them too much. We drove to the hotel with me almost in a laying down position, with my butt on the edge of the seat. I did the opposite when I got out at the hotel. I arrived at the hotel at about 6 p.m. It was exhausting walking into the hotel and down the hall. I collapsed in the lift chair and fell asleep.

12/30-1/1-- Feeling a bit better each day, but it’s rough. This recovery is not for sissy’s. Dr. Fisher suggested Advil 3 times per day for the anti-inflammatory properties. I was taking that, Bromelain, and Arnica for swelling. Seemed to help a lot. The night in the hospital my hands were like balloons, but after a few days of this cocktail the swelling went down. That, and a low/no sodium, low carb diet---THIS IS CRITICAL. You need to watch all of your sodium and you need to eat protein, non-starchy vegetables and low sugar fruits like berries. I was eating scrambled eggs, raspberries and blackberries, pecans, greek yogurt, ground turkey with lo sugar ketchup, broccoli, cauliflower and for a treat—1 rice cake with a couple of teaspoons of peanut butter. Boring, right? Yes, but I can’t tell you how important it is and how much better I felt not swelling and feeling like my incisions were going to split open. It wasn't too hard because I didn't have much appetite at all.

The lift chair is a must—make sure you get one with multiple adjusting options and the option for the head to be lower than the feet (slightly)--I think they call it zero gravity. I think one of the keys to my recovery going so well is that I spent much of the first 2 weeks in the lift chair, with my feet and legs higher than my heart—not too fun and boring as heck. And the walker made me feel more secure, especially when I was getting up on my own in the night to navigate the bathroom.

The hardest thing to navigate was bathroom needs. The female urinal device was good but I didn’t practice before the surgery and managed to pee all over myself during the first night at the hotel after surgery. Since you are trying to keep things very dry, you can imagine what cleaning up that mess was like. You’ve got to get it snug against your skin and even though it’s pliable, if it hits the incisions it hurts and probably isn't a good thing. I finally got the hang of it but used it to pee into a paper coffee cup, not in the toilet—way too difficult trying to go in the toilet. Pooping is a whole other story—very cumbersome, even with the raised seat. Those first days it feels like things will tear open if you move the wrong way, so doing anything that strains the incisions is a bit scary. I ended up hovering over the toilet and hanging onto the handicap grab bars in the bathroom…. Not great—I was weak and that took everything out of me. Sorry to be so graphic, but if anyone is going to have this procedure it's good to know and plan ahead. Since there are sanitation issues with a toilet seat, Primo medical supplies does not rent them--they have to sell you one. For me, it was a waste of money. I did not feel comfortable sitting in any position.