How my Hysterectomy Will End with a Tummy Tuck - Thibodaux, LA

I'm 45 with three children, two born C-section....

I'm 45 with three children, two born C-section. The skin of my belly and pons pubis (the area of fatty tissue above my vagina) were stretched badly during the C-section. For the last 15+ years I've hated my belly, it hangs over and makes me self conscious, but even worse was the pons pubis. It is a badge of honor my ex-husband said, it doesn't bother me. I learned to live with it. The last few years I started getting rashes under the Mommy Apron, as I call it. Everytime I work out, cut the grass, walk a fair or festival, it gets red, inflamed and irritated. Just another thing I have to live with I decided. I also started to have stress incontinence, another lovely thing to live with. If my friends made me laugh, I pee my pants a little, or a lot, sometimes...super embarrassing. Coughing or sneezing made it happen too. I was told by my Mom it was just something that happens after having babies, nothing to worry about. I started bleeding heavier and between periods. Yuck...Then pain during intercourse...this was the last straw...I just remarried and can't enjoy sex? Time to see a doctor. My Gynecologist was amazing and listened to all my concerns. He ordered blood tests, ultrasound, referred me to a uro-gynecologist. I didn't have one of my dreaded rashes when I went to see him so I didn't mention it, seemed to me there was enough to deal with already.
The ultrasound showed that I had a cystoocele (prolapsed bladder) and prolapsed uterus which was causing the stress incontinence. Then I had a DNC to check for uterine cancer since the bleeding had gotten so heavy. Not a fun procedure, had to go under general and the anesthesiologist nicked my esophogus, causing my throat to hurt for two weeks afterward. The doctor didn't find cancer so said we would go ahead with a hysterectomy to deal with the bleeding and hopefully resolve the painful intercourse, as the position of my uterus could mean he's hitting it resulting in pain.
At the same time, I'm visiting the uro-gynecologist who has given me meds to try to control the incontinence. Helpful, but makes me super-constipated and I already have IBS. When I let him know about the hysterectomy, he gave me questions to ask my GYN about the procedure and when I did, he suggested the uro-gynecologist do the hysterectomy since he will be able to surgically correct the bladder and urethra issues, which my regular GYN isn't comfortable doing. At one of my visits, I had the dreaded rash, from trying to work out again, to lose some weight. I'm 5'8" and weigh 250 pounds. I carry the weight well, but it would be nice to be a bit smaller. As usual, my belly gets inflamed. My uro-gynecologist sees the rash and prescribes me nystatin powder. The next time, I went to see my primary care for the rash, and they say the same, use the powder and put gauze over the sores. When I discussed having my uro-gynecologist do my Hysterectomy, I jokingly said can you cut off my mommy apron at the same time? He said no, but if you have a plastic surgeon in mind, I'll work with him to do that. Wow, just the idea that I could have a future without that apron of skin and rashes when I walk too much or sit outside in the heat, its just wow...
That's how I found RealSelf...researching Mommy Apron Excision, aka Panniculectomy. Under my circumstances, it might be covered by insurance. I looked up surgeons that had the same hospital affiliations as my uro-gynecologist and came up with Dr. David Jansen. After asking my PCP for a consult request, the insurance company called and asked if I had someone in mind, I gave them his name and they got him credentialed and made the appointment. Not that it was hard to get the Plastic Surgeon approved, since he's the chief of plastic surgery at Tulane. I had my consult with him yesterday.
Dr. Jansen was very kind, listened to my story and took a look at my Apron and said he could fix it. He's submitting a letter to my insurance to try to get the panniculectomy approved. He also quoted what it would cost for him to tighten the muscles and raise the pons pubis, that nasty stretched skin above my vagina. Coming up with the money in a short time frame is hard, but I'm so excited by the prospect of having a smaller flatter belly that I'm going to try my damnedest to get it. If the panni gets approved, I'll at least not have to worry about rashes or incontinence anymore. The Tummy tuck would just be a bonus. I told my Mom and she is happy for me. My Mom told my sister however and she asked why I want to do this to myself...to which I promptly said mind your business, then explained that I'm going to be in pain from surgery anyway, may as well get it all done and out the way. She told me about horror stories her friends experienced about not healing. I guessed that her friend didn't stop smoking. Right on the money, she didn't. Smoking is the number one way to ensure complications in any surgery. It restricts oxygen flow to tissues and slows healing. If you smoke and have to have any surgery, quit...I quit three weeks ago when I was told I needed the hysterectomy, and I'm so glad since I may now be having an even more heal intensive procedure. It is totally worth giving up to gain so much. Plus I'll save money. Now I wait to see if the insurance will cover the procedure...and for my rash to heal, which means no walking long distances for a bit.

Getting Ready

Both Doctors are looking at dates that work for them and the hospital. Will post exact dates as I get them. In the mean time, working on making meals, getting supplies, researching what to expect. And...taking before photos...
Dr. David Jansen

Dr. Jansen was my first choice and thankfully my insurance approved him. He's one of the top plastic surgeons in Louisiana and he's earned my trust. My issues are a little different than those who just want to look better. I get horrible rashes when I exercise or just sweat for too long in the Louisiana heat. I have to have a hysterectomy with urology repairs, and my surgeon advised me to contact a PS when he saw the rash under my Pannus (mommy apron of fat). Dr. Jansen evaluated me and submitted a letter to my insurance to get the panniculectomy approved. He also quoted how much it would be to have the muscles tightened and skin manipulated to create a flatter waistline. Thankfully the other surgeries cover most of the expense, so I was happy to come up with the difference. Can't wait, never thought I'did be excited to have surgery...

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