Whining

So it can’t be all sunshine and roses, right?

Yesterday, even though physically I am doing incredibly well for 9 days post op (well now, 10 days), I had the toughest day mentally. I knew that I would experience a rollercoaster of emotions after surgery, but knowing that it was coming didn’t make it any easier to deal with.

I took my first shower without the shower stool and was feeling great. Then, I looked down and noticed that some of the steristrips were coming off part of the incision. I was told this was fine, that some of them would start coming off naturally over the next several days, and then come Monday I’ll have to make them come off if they haven’t already. So after getting out of the shower, I snipped part of the tape that was loose away and got a look at about 2” of my incision over the hip. I started crying immediately.

I mean, logically, I KNOW that I had my body practically cut in half, but seeing that incision is really something else. Until yesterday, the whole thing was covered so I couldn’t actually see the cut mark itself, and while it is beautifully done, it was still very disturbing and strange to see it on my own body. That set me into an emotional whirlwind, and for the rest of the day I was on the verge of tears. I think I cried 9 or 10 different times yesterday, and I am so not a crier.

I think at this point in the journey, my mind is totally there and my body, is just, well, not. I am so frustrated to be so helpless and I just want to be back to my normal life.

My top complaints at the moment are:

    1. The damn compression garment. I have to wear the compression garment 24/7 for 6 weeks. So, 4.5 more weeks. It goes from just above my knees to over my shoulders with a v-neck covering my chest. It doesn’t go well under any other clothes, and the side has eyelet hooks underneath and then is zipped up over them. It’s really hard to get on by myself, and I am just sick of it.
    2. The foam pads under the compression garment. I am wearing medical grade foam sheets – 3 of them – around my midsection under the compression garment. I’ve been wearing them since right after surgery, so parts of them are covered in dried blood and disgusting. They make me feel even more stuffed into the compression garment than I already do, and are really difficult to put in the compression garment without assistance, though it’s getting easier. Luckily I can say goodbye to these on Monday.
    3. Waking up very sore and stiff every single morning and having to take Tylenol before I can get out of bed. Not much more to say here, but I feel like a 90 year old woman first thing every day. I usually wake up the first time and pop a few tylenol and stay laying down for a little longer before getting up, and then it’s not so bad.
    4. Getting exhausted from things like putting on the compression garment. Or taking a shower. The compression garment is pretty hard to put on without assistance, but I did so yesterday after taking a shower and it took me a really long time. I had to pull it up over my hips, put in the three foam sheets, make sure they stayed in place while I pulled it the rest of the way up, and then close the eyelet hooks on the side and zipper it up. It felt like what I’d imagine it’d feel like if I had just run a marathon.
    5. My lower back aching when I’m on my feet for too long. That’s been one of the surprising things about this surgery. My back is what hurts more than anything else! I was expecting my abs/stomach to hurt (which they did for several days), but now, it’s my back that aches like crazy. If I’m up and walking for any amount of time (which ranges from 15 minutes to an hour depending on the time of day) I have to sit down immediately and can’t finish what I was doing.
    6. Feeling scared to be alone because of the “what if’s”. Not really much to say here, but I live alone and being there by myself makes me extremely nervous. I’m staying at my boyfriends this week but it makes me feel like such a burden because I can’t do much and I am just always here. Ugh!

I wanted this to be as honest an account of what going through this procedure is like as possible, so you are welcome. Smile

The Procedures, The Concerns and The Photos

So here we are about a week and a half past surgery, and I am feeling amazing. If you didn’t know I just had major surgery, you probably wouldn’t guess it because I am getting around well, albeit a little slower than normal, and standing mostly upright at this point. I still have a lot of soreness and stiffness when I first wake up in the morning, but it’s getting less each and every day. I am still quite tired and things that seem like they shouldn’t require much energy completely wipe me out, like taking a shower. I did that on Monday (my first unassisted one!) and passed out for almost 3 hours afterwards. But besides the fatigue and soreness, plus some random itchiness and twinges from nerve regeneration, I am feeling pretty amazing and thankful that my body is healing so well.

The Procedures:

I’ve gotten a few questions about exactly what I had done, so I thought I’d spell it out here. I had my surgery with Dr. Paul Ruff of Ruff Plastic Surgery on July 29, 2013. Here is a breakdown of the procedures:

1.) Extended Abdominoplasty – it was “extended” because the incision starts right in the middle of my hip on either side, basically straight down from the center of my armpit. The reason is because I had a lot of excess skin to get rid of, and they have to cut longer than the skin they are removing. I had full muscle repair as part of the procedure as well, which feels like you did two million sit-ups in one sitting at first, but has gotten less sore with time.

2.) Flank Liposuction – this was actually something I wasn’t expecting before my consultation, but apparently it goes along with many tummy tucks. Dr. Ruff explained that when they remove the skin/fat on the front of you, the flank liposuction helps contour your body and slim your waist so that you have a more hourglass shaped figure.

The Concerns:

When I wrote the post the night before surgery, I had some big concerns going in. They were:

  • That something will go wrong during the procedure. it didn’t.
  • That coming out of anesthesia will be rough. it wasn’t.
  • The pain during recovery. that proved true and was not fun, but thankfully I’m over the hump.
  • The scar I’ll be left with from hip to hip. I still haven’t seen the incision itself because it’s covered in steristrips (clear tape), but that comes off Monday and then I’ll get a good look. It’s pretty enormous, but I would take the scar (I think) over what I had going on before any day.
  • Having to deal with the surgical drains during recovery. these were not nearly as bad as I expected. Annoying, yes. Painful, no. I actually liked seeing the progress in the drainage as it went down over the days after surgery and turned from red to lighter in color. I also liked that the fluid came out of me instead of staying in there. I got one drain removed at 5 days post op (PO) and the second one at 7 PO.
  • Not being able to do things for myself. This is something I struggled with a lot, and still do to some degree. It’s hard to be slower than I normally am and I have to make a conscious effort to remind myself that I am recovering. I need rest so my body can keep working on healing me. Having to be given a shower was probably the hardest part for me.
  • The fatigue and run down feeling I know I’ll be dealing with for weeks. Yup. Dealing with it. But it’s manageable. It’ll be a lot harder when I go back into the office full time.
  • Swelling. I am about 10 lbs swollen right now. I know this because my weight is still the same as it was pre-op, and they removed 10 lbs of skin/fat from me during surgery. I am definitely feeling a little swelling/bloated, but it hasn’t hit me yet. I’m told it gets worse in the coming weeks, so stay tuned.
  • Not recognizing myself in the mirror. Sort of, but this is actually a good thing. I still can’t believe how slim my waist is. And this is with medical foam padding under my compression garment AND 10 lbs of swell.
  • That I’ll be unhappy with the results. So far, I am ecstatic with the results of the surgery. I still have a long ways to go as far as healing goes, but the progress I’ve made in the first week is amazing. Our bodies are incredible.

The Photos

So what you’ve all been waiting for! The pics. Just a few things of note. First, I am healing VERY well. My doctors have been impressed with how great I look for this soon after surgery. Also, I am dealing with about 10 pounds of swell right now, so my stomach is going to be even flatter over the next several months as my body fully heals. Also, I still have a lot of stretch marks. If all the stretch marks are below the belly button, they will all generally get removed in surgery, but mine were all over the place, so they did not. The stretch marks will be come less prominent as the swelling goes down, though, and most of them are now below my new belly button. I also have not seen the actual incision yet since it’s covered in steristrips. Those come off on Monday, so I will show you guys the scar itself once I see it for myself and how it progresses with scar treatment therapy. Ok, enough with the disclaimers.

I literally get sick to my stomach with the thought of posting these “before” photos of my stomach. Ironic, isn’t it? I hid it quite well in clothes and always felt like I was hiding something because, well, I was. But, this is not my body anymore and I know a lot of people who undergo massive weight loss deal with issues of loose skin and flab around their midsection, too. So I’m going to take one for the team here and show you what I looked like until last Monday. For comparative purposes, my stats are: 5’8”, ~175lbs, size 10 pants/medium top. Here we go. Gulp.

Before Tummy Tuck Surgery

Before TT

The one on the far left is with everything “tucked in” and the one on the far right is with it… not. The scar above my belly button is from the time I decided piercing my own belly button with a sewing needle would be a good idea at age 16 (and shockingly it got infected) and the rest is just from being obese for so many years.

And here are some photos from the after; the now.

Post Op, Day 3

PO Day 3

Post Op, Day 5

PO Day 5

Post Op, Day 6

PO Day 6

Post Op, Day 7

PO Day 7

This was the day they removed the gauze/tape from my belly button, as well as my last drain.

Day 3 – Day 5 – Day 7 Comparison

Day 357

Before and One Week PO

before after

I am terrified to press publish. Please be kind.

The Flat Side: The Next Few Days

So let’s see, I left off with me being in extreme pain in the middle of the night within the first 24 hours of surgery. I didn’t intend to leave such a cliffhanger, it just felt like a good stopping point at the time until I re-read it and realized why so many people said ending there was torture. Sorry ‘bout that!

I ended up taking 3 more Vicodin and a Xanax and drifting back to sleep for a few hours. I woke up and took more pain meds, and then my mom drove me back to Ruff Plastic Surgery. I was greeted at the car by a nurse, Sharonda, and she helped me walk into the building. I had actually called and requested a wheelchair, but when Sharonda came down to the car (without a wheelchair), she said Dr. Ruff really wanted me to walk on my own because the more I did, the quicker I’d heal. The visit there was a blur – literally. I was brought into an exam room immediately and there were three people there – Sharonda, Lori, and Michelle – and they all helped remove my garment (which was still unhooked from the night before, but I was still busting out of it).

I remember standing there and feeling like I was either going to pass out or throw up because the feeling was so intense when the garment came off and I’m pretty sure I did pass out a bit. They were putting those smelling salts under my nose and the three of them were holding me up while they put another (larger) compression garment on me. I remember being told to keep my eyes open and just being in SO MUCH PAIN I couldn’t even get my head around it. They put medical foam pads into the garment which help keep things smooth and contoured post surgery, and then I was sent on my way back home. I was bummed because that day was also when I was supposed to get to get a first glimpse at the results of my surgery, but because I was in such a haze during the whole switching the compression garment ordeal, I didn’t even get to see what I looked like underneath the compression garment.

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Clipping the drains to that chain ended up being clutch.

That said, I was given scripts for much stronger pain meds (OxyContin and Percoset), and was told to take the Oxy every 12 hours, and then the Percoset for breakthrough pain every 4-6 hours as needed. The new pain meds were like night and day. I basically slept on and off the entire day and only really woke up to take my antibiotics, more pain meds, and to use the bathroom (only to pee – more on that later). I also got lots of gorgeous flowers delivered, which was definitely the highlight of the day (from my close girlfriends, my office, and my old boss).

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And a balloon!

I was still in a good amount of pain even though it was much better managed, and I remember telling my mother more than once that if I knew how painful it would be, I wouldn’t have had the surgery. She told me it was too late. Ha. Truth.

So that was the first day post surgery. Not one of my better days.

The next day was Wednesday, and that was the day I was told that if I hadn’t had a bowel movement (BM), I had to start doing something to change that. When I woke up that day, the pain was much more manageable, but my stomach was in KNOTS. I felt bloated, uncomfortable, crampy – you name it. I barely even felt any pain from the surgery itself – all I could think about was how to empty my system. Warning – TMI ahead – so if you don’t like poop talk, I’ll see you tomorrow.

I had actually started taking Colace (a stool softener) on Saturday before surgery, because the anesthesia and the pain meds can really back you up. I was taking that once or twice a day, but come Wednesday, that proved not to be enough. Natalie (the OR nurse) called me in the morning to see how I was doing, and was relieved to hear the pain was much more under control. She asked about whether I’d had a BM, and told me that she would text me the recipe for a cocktail that there was a 95% chance would get things moving in 2 – 6 hours.

This is what I had to drink, I kid you not:

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4 oz. of a mineral oil enema (ie. one that is intended to go in the other end, but it was just mineral oil), 4 oz. of apple juice (for flavor?), and 1 shot of vodka (to help me forget I was drinking an enema?)

It.was.horrific.

I drank it like a champ, choking down the cocktail while promising myself it would be worth it when it got my system moving. Well, guess who was part of that 5% that it didn’t work for? Awesome. So, not only did I drink an enema, but I also did not have a BM as a result.

I called the nurse back after the 6 hour window had passed because I was getting more uncomfortable by the minute, and I was told to try taking a laxative. That was at least intended for oral consumption, so it went down easier. I popped 2 Senokot and hoped for the best. Matt had come back that night (and was the lucky one to get to purchase said laxative), along with a few of my closest girlfriends, so it was nice to have the distraction and the cheer squad each time I got up to try to use the bathroom. Everyone left around 10 that evening, and I coaxed myself back to sleep with more pain meds and Xanax. I woke up once in the night for more pain meds, but overall it was pretty uneventful.

When I woke up Thursday, I literally felt like I was going to explode. My stomach was going crazy and I couldn’t think about anything else besides the gastrointestinal issues. I was doubled over in pain and switched myself from the narcotics to Tylenol so I had a chance at getting things moving (plus the surgery pain was feeling a lot more manageable that day). I spoke with Lori from RPS, the nurse practitioner, and she said that she had a lot of issues with constipation during her pregnancy and that I should try suppositories. So, my mom went out and bought me some from CVS, and after several hours of concerted effort (I will spare you the details here), FINALLY, finally, finally, I had a BM. And then probably 10 more in the next several hours because everything I was doing to get my system moving kicked in at once. But I’d take that over the previous situation any day.

PS: I’m really glad I just shared that story with the world.

I also took my first post-op shower that day (thank God I bought this shower stool – best purchase ever). And by “I took”, I mean “I was given” my first shower. By mom and good friend Kate, and to say it was a humbling experience would be an understatement. It actually wasn’t as painful as I was expecting (I’d read horror stories), but being a 29 year old female unable to bathe herself was a tough pill to swallow, even if it was temporary.

So then came Friday, 4 days post op, and it was the first day I woke up feeling pretty good. I was very sore and quite stiff when I first woke up, but after taking a few Tylenol and walking around a little bit, I loosened up, and actually ventured outside for the first time post-surgery, besides that fun compression garment switcheroo earlier in the week. My mom and I went out to lunch, and even though the restaurant was just 1.5 blocks from my apartment, it took me a good 20 minutes to get there because I was walking so slow (and so hunched over).

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That’s probably how I look while dancing, too.

I was pretty uncomfortable at the restaurant so it was a fairly quick lunch, and I couldn’t really eat much because my appetite was still all messed up from the meds.

But! I was walking. And I was outside my apartment. And I was feeling a bazillion times better than I was the days before.

Better place to end this one, eh?

The Flat Side: The Day of Surgery

What a week it has been! I honestly barely even know where to start, so I think I’ll just start with one week ago today.

As I alluded to in my last post, I was feeling reaaaaally anxious and nervous on the day before my surgery, so when my alarm went off at 5:45am last Monday, I wasn’t quite sure what state I’d be in. But somehow, I was much more calm than expected and I woke up pretty easily. I took a quick shower with antibacterial soap, brushed my teeth, and sipped just enough water to take a Zofran (an anti nausea medication) before gathering up my things to head out the door. I was instructed to wear comfy pants and a top that zipped or buttoned up (nothing that went over my head), as well as my glasses rather than contacts.

Since my parents had stayed in town for the weekend, I got in the car and drove to their hotel for 6:15am, so we could head to Ruff Plastic Surgery. We got there a few minutes before 6:30am and since the building wasn’t quite open yet, we putzed around outside for a few minutes while I tried to teach my parents the wonders of the iPhone camera.

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Before too long, we were met by my OR nurse, Natalie, and taken into the office to get ready for surgery. I honestly could not believe how calm I felt! I was expecting to need to take a Xanax, but I felt calmer than I do on a normal day – weird. After going through the basic questions and a review of the medications, I changed into my hospital gown and compression stockings, took some pre-surgery meds, and then just hung out in the room where I’d be recovering.

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I am cool, I swear.

Before too long, Dr. Ruff came in to check on me and see how I was doing, before marking me up all over with three different colored markers. He said that they mark your natural anatomy/curves while standing because things shift when you lay down (for the surgery) which I hadn’t really thought about before. After he was done with the markings, he said he’d see me soon and left the room, and then the anesthesiologist came in. He went over my medical history with me, asked about any prior complications or family history of complications with anesthesia, and then hooked me up to an IV to start me on fluids.

At just a few minutes after 7:30am, I said goodbye to my parents, and then Natalie escorted me into the OR. Right away, they had me remove my gown, and my entire body was painted down with this betadine solution by two medical assistants with these rollers – almost like what you paint walls with. The solution smelled TERRIBLE and was so cold on my skin, but I needed to be completely sterilized prior to surgery (obviously). After that was done, I was walked over to the operating table where I laid down with my arms stretched out on either side, and then the anesthesiologist came back into the room. I remember him asking me some questions about my job, and making some small talk. I thought I would have a “here we go” moment where I would be aware that I was fading and come to terms with the fact that I was going under the knife, but it was not like that at all. I don’t remember even starting to drift off, I just remember waking up in recovery fully clothed.

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Totally doped up and happy post surgery.

The procedure itself took about 5 hours (just slightly longer than the 4.5 anticipated) and I came out of anesthesia quite well. I wasn’t nauseous at all, which I was really thankful for, and I just remember being way more “with it” than I was expecting. I have flashes of people (Dr. Ruff, the nurses, my friend Susy who works at Ruff Plastic Surgery) coming in and out of the room, and also of the machines they had me hooked up to beeping and my mom telling me to keep breathing. I also got my hands on my phone and texted a bunch of people back (with totally coherent, non-anesthesia sounding responses) and even updated my facebook page.

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Priorities, right?

It was kind of surreal.

The other time I had anesthesia was for my emergency back surgery was in 2006, and when I came out from being under that time I supposedly was swearing pretty loudly and persistently. This time, I was a bit paranoid about having the same reaction, because I asked the doctors three separate times if I came out swearing, though I only recall asking the third time, and don’t even remember the answer. I was asking very coherent questions, but don’t remember most of the answers. One question I did ask was “how much did you remove from me?” and I do remember the answer (though I’m told it wasn’t a one-time question) – 10 pounds! Holy crap.

After the fading in and out stopped and I was stabilized and mostly with it, I was wheeled out of recovery and the building, and got into my parents car. I got home, up to my apartment, and was totally alert. It was wild! I was expecting to be sleeping for the entire first few days post surgery, but I was totally awake. My boyfriend (good of a time as ever to make that “announcement”, eh?) came over and brought flowers and a get well package with magazines, an eye mask, smoothies and protein snacks. My mom made some chicken gyoza from Trader Joe’s and we all watched the season 6 finale of Dexter (I’m still catching up).

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In my compression garment, with the sexy drain tubes and compression socks. And lots of beverages.

I wasn’t in much pain at all and was getting up on my own to use the bathroom. It was wild!

But then around 8:30pm, my body woke up and realized what had just happened to it. I hit the wall, and hit it hard, and was overcome with pain, fatigue, and tears. Dr. Ruff called me to check in around that time from his cell phone and I had my mom talk to him because I couldn’t. He said I could take 3 Vicodin every 6 hours if the 2 every 4 wasn’t working, so I did that and coaxed myself to sleep with some Xanax. That worked for a couple hours, but then I was up in tears again around 2am, paralyzed from the pain. We called Dr. Ruff on his cell phone in the middle of the night and he recommended my mom try to open my compression garment to release some of the pressure, which she did and that helped a tiny bit. He said our options were to either go to the ER right then or wait until 6:45am to go back to the office to figure out next steps and how to get the pain under control. We went with the latter option because the last thing I wanted was to go to the ER at 3am…

To be continued…

Today is the Day

By the time you read this, I’m already under way with my plastic surgery since the procedure started at 7:30am today. The surgery is supposed to last for about 4.5 hours, so I should be out of surgery around noon. I’ll stay at the surgical center just until I am stabilized, so will hopefully be getting back to my apartment around 2pm or so.

To be honest, yesterday was a much more emotional day than I was anticipating. I’ve been so incredibly busy in the time leading up to the surgery that I haven’t had too much time to focus on just how big of a deal this surgery is. I’ve stayed pretty calm, cool and collected and had been feeling more impatient and ready than anything, until yesterday. I had a brief breakdown in the late afternoon and realized just how much my nerves were built up.

I am changing the biggest thing that has plagued me and put a huge blanket of insecurity over the person I have become.

The things that are causing me the most anxiety surround the procedure are:

  • That something will go wrong during the procedure
  • That coming out of anesthesia will be rough.
  • The pain during recovery
  • The scar I’ll be left with from hip to hip
  • Having to deal with the surgical drains during recovery
  • Not being able to do things for myself
  • The fatigue and run down feeling I know I’ll be dealing with for weeks
  • The swelling
  • Not recognizing myself in the mirror
  • That I’ll be unhappy with the results

But then I have to remember why I’m doing this. I’ve worked so hard to get myself from where I was to where I am now, and I know that I deserve to feel comfortable in my own skin. The things I’m most looking forward to in the after:

  • not feeling like I’m hiding something under my clothes
  • buying lingerie and not have to pick it out based solely on how well it will keep everything contained
  • actually FEELING sexy
  • not being scared to change in a room of my girlfriends
  • feeling more confident with my shirt off
  • not having to wear spanx to suck it all in under dresses and other clothes
  • being less afraid of form fitting clothes
  • not having to pull up my underwear constantly
  • having less anxiety if i move in a way that makes my shirt accidentally come up
  • having less stretch marks on my stomach
  • feeling like working out will actually produce results, instead of having them hidden under extra skin and fat
  • feeling like my body finally matches how i feel on the inside
  • feeling more confident in myself and my body

And I think those afters will definitely outweigh the inevitably shitty recovery I am going to have to go through to get there. I’ll check back in as soon as I can to let you know how everything went during the procedure and how recovery is going. Feel free to check out my facebook page and twitter because I’ll probably say something quick there before writing a full post here. Thank you so much for all the well wishes.

See you on the flat side!

Things I’ll Miss (And Won’t) About Peru

Peru was such an eye-opening trip for me. There were so many things I loved, including:

1.) The jungle. Heh.

The people, especially.

Group

2.) The gorgeous sites.

Machu Picchu was seriously the most magnificent thing I’ve ever seen.

MP1

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And the Sacred Valley wasn’t so bad, either.

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Washing my hands in aphrodisiac water, according to the Incas.

 

3.) The Markets!

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These markets were packed with vendors selling tons of handmade items for SO cheap. I had to buy an extra bag when I was there so I could carry home everything I bought. Seriously.

4.) The simplicity of people’s lives.

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Everything is just so much simpler there. No fancy phones, no constant checking of email, no being unhappy over trivial things.

5.) Feeling appreciative of all we take for granted in the states.

It’s so much easier to realize when you’re away from it all.

6.) Meeting random people from the states on tourist trips and at hostels.

There’s some instant connection you automatically feel when you connect with someone from your home when you’re not there.

7.) Everything being new and familiar.

I have been in DC for almost 11 years, so I feel like I know it like the back of my hand. I LOVE that about DC, but it’s incredible what simple things can strike you as you travel to a new place.

And now, for the things I won’t miss.

1.) Not being able to drink tap water.

Using bottled water to even brush my teeth took some getting used to!

2.) Being (quite aggressively) bombarded to buy things all the time when you walk down the streets, are in stores or markets, or even when you’re eating at a restaurant.

3.) Not being able to use a credit card anywhere.

I think in a lot of ways it was good for me to have to use real money, but NO WHERE took credit cards in Peru. Even places that had Visa and MasterCard signs plastered to their windows couldn’t get the machines to work! And I am cheap, so I hated paying $10 ($5 from my bank, and $5 for the ATM fee) anytime I wanted to take out money. And I also was mindful that a lot of people get robbed, so I didn’t want to take out a lot of cash every time.

4.) Having to take malaria pills every day. Yuck.

5.) Not being able to dry my clothes after washing them.

A luxury I always took for granted! Even at the apartment we had just a washer, not a dryer, which wasn’t the end of the world but I do appreciate drying my clothes!

6.) Drastic temperature changes from day to night.

During our 6 nights in Cusco, it would be almost 70 degrees during the day, and then drop to the low 30s overnight!

7.) Being fearful that everything I eat would make me sick.

And, unfortunately, this ended up being the case.

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Despite using bottled water for EVERYTHING including brushing our teeth, peeling every piece of fruit or vegetable we ate, holding my breath in the shower, and doing everything I could think of to avoid it, Stacy and I both left Peru with parasites! Stacy got a lot sicker than I did, so I got tested just to be safe and it turned out I had something, too! We both were able to take care of them with just taking antibiotics (both Cipro and Flagyl), but trying to get medical attention in a foreign country can be quite challenging. Luckily I am off the drugs now (and OK to proceed with my surgery!), but it was still not fun.

Moral of the story? Peru was amazing, but I sure do love America!

Pre-Op Appointment

All the posts on this topic are compiled here for easy reference in case you missed any.

So somehow, my surgery is just two weeks from today! I knew when I scheduled it that the time was going to fly by, but I honestly didn’t expect it to go as fast as it has! I’m already into the two week pre-operative time frame, where I have to start taking certain precautions, stop taking certain medications, and focus on a high-protein diet. I can’t believe it’s so close!

Last Thursday, I had my pre-operative appointment at Ruff Plastic Surgery, which was my last appointment at the office before the surgery itself. The appointment was supposed to be about an hour, but it ended up being almost two because I had so many questions and everyone that I met with was so thorough.

The basic purpose of this appointment was to:

  1. Go over all my (many, many) questions
  2. Meet with the nurse and the doctor one more time before surgery day to go over the procedure
  3. Review my current medications (and over the counter supplements) to make sure they were OK to keep taking
  4. Get my pre-op photos taken
  5. Get all my prescriptions for post-surgery
  6. Get my blood work done
  7. Make final payment for the surgery

I got there a few minutes early, and waited in the waiting room with my nerves in full effect with my completed almost-60 page pre-op packet on my lap.

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After a few minutes, I was called back to meet with the nurse, Sharonda, who is amazing. She was the same nurse who was there for my consultation, and will be assisting in the surgery as well as my main point of contact for post-operative care (besides the surgeon himself). I found out during my appointment that she actually had the same procedure done, and that made me feel even more comfortable and confident than I already did.

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She was SO patient with me and didn’t mind addressing each and every one of my million questions, since it had been quite a while since my initial consultation and also because I’d seen two other plastic surgeons between. She went through all my paperwork with me, my list of current medications, and then everything I wanted to talk about. She also told me she will check in with me the Friday before my surgery and provide me with her cell phone number, so I can reach her at any time for questions.

Some of the main questions she addressed for me were:

  • What follow up appointments will I have after surgery? I’ll have an appointment the day after surgery with Dr. Ruff to check for any signs of complication/make sure everything looks good, then 1 week after the surgery I’ll return to the office to get the drains removed, then 2-3 weeks after the surgery I’ll have an appointment with Sharonda to go over scar treatment therapy and check on progress. I’ll have appointments with Dr. Ruff at the 6 week, 3 month, 6 month, and 1 year mark to check on progress and healing. The doctor and nurse will also be on call between those appointments for any questions or concerns that may come up.
  • How long do I have to wait to shower after surgery? Dr. Ruff will give me clearance, but it’s usually after the day-after surgery check in.
  • What type of activity restrictions will I have post surgery? She said it’s expected I’ll be walking outside as soon as day 2 post op, but not for exercise just to move around more than I would in my apartment. She returned to work one week post surgery, and said she was definitely moving a little slower and sitting down more, but she was ok. She said at the 3-4 week mark I should be able to return to some cardio (power walking/jogging), and at the 6 week mark I should be completely cleared for normal activity. This was actually less time than I was expecting to need to take off from these things, so I took it as good news.
  • What type of compression garment will I have and how long do I wear it for? I will wake up in a compression garment and they will also order a second one for me included in the price of surgery. It will be high-waisted all the way up to just under my chest, and then go all the way down to mid-thigh level. I’ll have to wear it 24 hours/day for the first 4 weeks after surgery, and then 12 hours on/12 hours off for the next 2 weeks to get my body ready to not need it. She said she recommends not wearing it during the day, and sleeping in it at night for the 12 hours on/12 hours off part.
  • What should I wear the day of surgery? Yoga pants or sweat pants with a button up or zip up top (nothing that goes over your head). I will wake up from surgery in my compression garment with these clothes back on over it.
  • What should I wear while I’m recovering? This surgery is obviously very traumatic to the body, so I should expect a good amount of swelling after the surgery. She said for the first week or so after surgery, it’s normal not to fit into your fitted clothes from pre-surgery. She recommended wearing a lot of loose fitting dresses (good thing I love these anyway and have several) once I’m heading out into public.

She also went over all my pre-op instructions. The main things I have to do are:

  • Stop taking birth control 2 weeks prior to surgery, as it can effect blood clotting.
  • Stop taking aspirin or ibuprofen 2 weeks before surgery, and only use Tylenol if needed.
  • Wash with an antibacterial soap (they recommend Dial) for one week prior to surgery to reduce the amount of bacteria on the skin as much as possible.
  • Take Arnica tablets (a homeopathic medicine) for one week prior to surgery to help minimize post operative swelling, pain and bruising.
  • No drinking alcohol for one week prior to surgery.
  • Start taking Colace (stool softener) for 2 days prior to surgery, to hopefully combat the side effects of the post-op pain killers.
  • Fill all my prescriptions (antibiotics, anti-nausea, and pain killers) and get my house ready (cleaned, fridge stocked, supplies, etc).

After we went through all the paperwork, my questions, and her instructions, she left the room and I got undressed and back into a gown to get ready for the final exam.

photo 2

Dr. Ruff came back in with Sharonda once I was changed and asked me if I had any other questions for him, which of course I did. The main things I asked were:

  • Where exactly will my incision be located? He said it will be hip to hip, and lay very low just above the pubic area. He said if I have a string bikini or low cut underwear I’d like to bring in (which I don’t), I can bring it in on the day of surgery and they can mark me up to have the incisions hidden by that piece of clothing.
  • Where will the drains be located? I’ll have two drains, and they will be located just under the incision line in the pubic area towards either side.
  • What will the incision closure be like? Very precise (I loved that that was his first answer). There will be several layers of dissolvable sutures which will heal from the surface down over time. The surface stitches on the incision will be covered with steri strips (basically clear/white surgical tape) that should stay on for about 2 weeks or until they fall off on their own. After those come off is when I’ll meet with Sharonda again (at the 2-3 week post-op mark) to discuss scar treatment therapy.
  • How much skin/fat does he expect to remove? He won’t know until he gets in there, but if he had to guess he would estimate around 10 pounds (!!).

After going over all the questions, he did an exam and talked about his exact approach with the procedure and the results I should expect. He showed me on my body where I should expect the incision to be and how things will look after surgery. His mannerisms, professionalism, and caring personality made me so sure in my decision to go with Dr. Ruff. He was very thorough and patient, and made me feel SO good about the surgery, his ability and the results I should expect.

After I was done with the Dr. Ruff portion of the program, we got to the super scary part – the pre-op photos.

photo 5

I was completely naked for these, and they were taken from every angle – straight on, from the back, from each side, and at an angle facing each direction. They were taken with the machine pictured above that apparently produces 3D photos that will be up on the big screen (oh joy) during surgery. I was assured these photos would only be shared with the doctor, my nurse, and the surgical team. Phew!

After that, I was taken back into the room where I asked all the questions to get some pre-operative blood work done by Sharonda. Then I asked to see the room where the surgery will be performed, since it’s done onsite at the doctors surgical center rather than in a hospital. The surgical room is very nice, clean, and high-tech, and I was also shown the recovery area where I will be waking up from anesthesia. It was kind of crazy to see the room and know that the next time I’m in there, I will be on the operating table with all my stats up on the patient board (and those glamorous full body shots on display).

After the surgical center tour, I met with Michelle, the surgical coordinator. She and I went over a few final things, and then I made the payment for the surgery and the anesthesia. The anesthesia is a separate fee, and it may actually be higher than what I paid if the surgery needs to go longer than initially anticipated (4.5 hours) but we’ll cross that bridge after surgery. I paid for the bulk of the surgery itself using Care Credit (but the anesthesiologist does not take it), which is a credit service reserved for medical/dental procedures, where certain doctors offices have low or no-rate interest agreements. Dr. Ruff’s office has a 12 month 0% APR agreement, so if I pay off what I charged in 12 months (which is my goal), there will be 0 interest. Basically it’s like a free loan so I can get the surgery done sooner and not have to dip into my savings more than I already am.

After all that, I left the office feeling SO excited and like the surgery is really happening (because, well, it is). It’s crazy to think that the next time I go back there will be at 6:30am on July 29, the day of the surgery itself! I know I’ll experience a rollercoaster of emotions between now and then, but for right now I’m going to enjoy riding high and the excitement and anticipation I feel.

Some other random things of note:

  • I am planning to take 2 weeks off from work, but may return to working from home during the second week if I feel up for it. I’ve shared with my work the truth about what I am doing, and they are very supportive and flexible, which is amazing. I am obviously prioritizing my health here, so if it turns out I need more than 2 weeks I will make that work/possibly work from home for longer.
  • My mom and dad are coming next weekend (two days before surgery) and staying Saturday/Sunday night to help me get ready and spend some QT with me before I go under the knife. My dad is going to stay until I’m out of surgery and back in my apartment, and then my mom is staying with me for the entire week to help take care of me post-surgery. It’s such a blessing she is able to do that for me because I can’t think of anyone I’d rather have with me as I recover (slash anyone else who will put up with me). After my mom leaves, my good friend Kate (who happens to be an ER nurse) is going to step in to help for a couple days and assist me with getting back to Dr. Ruff’s office to get my drains removed, anything else I need help with, and also just to keep me company. And then of course my girlfriends and boyfriend will stop by to check in and help as needed, but that’s the main post-op care situation I have set up.
  • A lot of people recommend getting a recliner or hospital bed to use during recovery from surgery, but I am just going to use my regular bed. I live in a super small apartment so it would be tough to have one of those things added, and the doctor also told me I absolutely don’t need one. I have to sleep with my upper body and legs elevated, so I am getting a reading/husband pillow for my upper body and borrowing a wedge pillow from my mom for under my legs, and will just use lots of pillows around me in bed to make sure I stay in the right position for the first couple days after surgery.
  • The only supplies I need to get for recovery are the reading pillow mentioned above, a shower chair (because apparently taking a shower post surgery feels like running a marathon in terms of exhaustion), Arnica, Tylenol, Colace, and bendy straws (to help with drinking lots of fluids). I plan to thoroughly clean my apartment, have a well stocked fridge with easy protein-heavy snacks and meals, and get lots of magazines/reading material to keep me occupied post surgery outside of the TV.

50 Things I Learned in the Jungle

I’m baaaack! Peru was amazing and an incredible, eye-opening trip, but I am so happy to be home! Our 16 day trip started with a flight from DC to Miami, and then a (long) flight to Lima, Peru. We spent one quick night by the airport in a hostel, flew to Cusco the next morning, and then left the following day for a 6 night, 7 day jungle tour.

Before

Me and Stacy

At the beginning, the jungle trip was a little touch and go. Keep in mind I’d never been camping before (except when I was in middle school, according to my mother) so this was quite a way to start. For the first couple of days, Stacy and I both had a hard time adjusting to life in the jungle. Being so hot all the time, having a daily regimen of Deet only, and always feeling dirty were a little hard to get used to, but I think we reached the point of acceptance around day three or four. We were in a group of 10 people and got pretty close with the whole group over the course of that week.

Group

By the end of the trip, we had totally embraced it, learned so much, and were sad to be done! I shared this list with the group on our last night during dinner (pictured above), so I wanted to share it with you all, too.

50 Things I learned in the Jungle

1. I am not as adventurous as I thought I was.

2. Waking up at 6:30 am is considered “sleeping in” in the jungle.

3. How to pee the right way outside – squat low, lean forward and choose a downhill, if possible.

4. You can in fact live without Internet, but only for one week in my world.

5. Nothing dries in the jungle, so I really should have stopped expecting it to.

6. Peace and quiet is often underrated.

Sunset

Watching the sunset over the Manu River.

7. Animals in their natural habitat are even more intriguing than I expected.

jaguar

The jaguar we saw chilling by the river.

8. Biodegradable toilet paper is a must have at all times.

9. The “lasts 10 hours” claim on deet does not apply in the jungle.

10. Compared to some people on the trip, I am not as tasty to bugs as I would have expected.

11. Cold showers can actually be refreshing.

12. How to brush my teeth with bottled water without skipping a beat.

13. Some people can live without electricity, but I am not one of those people.

photo%205

Sun kissed on the last night.

14. Going to bed before 9pm is completely acceptable in the jungle.

15. Waking up to the sounds of the jungle is the best way to do it.

16. Stacy is actually quiet when I’m not around.

17. Instant coffee can be delicious, especially with powdered milk and sugar.

18. It’s ok to eat soup when it’s really hot out, even for every meal.

19. It doesn’t take a lot for people to truly be happy.

Boat Tour

20. I will never get tired of watching monkeys.

21. Ice is often a luxury that is often taken for granted.

22. I can fall asleep anywhere when sleep deprived enough, even with my head banging repeatedly against a bus window.

23. I really should have studied more Spanish before my trip, as I’m not very good at hand charades.

24. Birds are actually pretty cool.

Binoculars

25. Mosquito nets may cause weird dreams and/or hallucinations in the night.

26. It’s possible to gain weight from being sedentary and eating three large meals, two sugary snacks, and dessert each day, even in the jungle…

27. Wearing the same thing repeatedly, even under conditions causing extreme, prolonged sweating, is perfectly acceptable, except for with your underwear.

28. Drinking a hot beverage during the peak heat during the afternoon is not a good decision for me.

29. No one appreciates cows alongside the river in the jungle.

cows

30. Always check the water jug for bugs before you fill your bottle.

31. Instead of watching out for deer, you have to watch out for cows, lambs, and pigs in the streets.

32. I’m not good at holding my tongue, even in Peru.

33. It’s very common to crave cookies and candy by 10 or 10:30am in the jungle.

34. I would become comfortable peeing in front of a group of 10 people I met just days before.

35. In certain tribes when a man loves a woman, the father gets to “try him out” first. Despite where your mind may have gone, this involves giving him an axe so he can attempt to cut down an iron tree.

36. You cannot extinguish a candle on the nightstand from inside your mosquito net.
Mosquito Net

37. My only useful survival skill is comic relief.

38. The jungle is full of natural medicine.

39. Tough and strong are two different things.

strong

40. One benefit of cold showers is that your mirror doesn’t steam up.

41. Jungle viagra, which ironically comes from a very small tree, goes into a drink which is named “69”.

42. For some reason, people from the USA are perceived as loud.

43. Despite their intention, it is possible to fall asleep with a cheek full of coca leaves.

44. The proper way to tell someone they have a booger in their nose is to say “hey, you have a bat in the cave”.

gator

45. Unfortunately, cockroaches can fly.

46. Cock of the rock is not what you think it is – its the national bird of Peru.

47. Turns out potatoes go with everything.

48. The reserve zone of the jungle is really far away from Cusco. I’m talking 12 hours in a bus, followed by many, many hours in a boat.

Mo (2)

49. Bathrooms along the river are never where you expect them to be.

50. Laughter is one thing that crosses all language barriers.

That Weight Thing

I’m currently in the Amazon Jungle, but wanted to write a post I’ve been meaning to write for a long time!

So, you may have noticed I haven’t mentioned or talked about my weight in a loooong time on here. Fortunately, that’s not because I’ve gone off the deep end and gained everything back.

My goal weight with Weight Watchers was 164, but I found that SO HARD to maintain at my height of 5’8 and I was only able to stay there for a few weeks. I met with my primary care doctor to talk to her about my weight, and she said I should try to maintain between 175-180 to be healthy for my height and with my build, so I reset my goal weight to 177 with Weight Watchers. I know that probably sounds like a lot to some people, but I am not looking to be skinny – I just want to be average and healthy, and not obese. I love food way too much to restrict myself in the way that I would have to to get down to my original goal weight or below.

I almost don’t want to put this in writing for fear of jinxing myself, but for the last several months, I haven’t been counting points and have just been eating intuitively. And you know what? I’ve actually been maintaining in the range my doctor suggested I go for. Though I’ve had to keep trying and being mindful of what I’m eating, I’ve found that my body finally isn’t fighting me anymore.

I’ve had my fair share of pizza, french fries, and chicken wings, but have been very aware of portion sizes and not overdoing it when I’m eating those heavier things. I’ve also focused on eating healthy staples most of the time – fruit, veggies, English muffins, cottage cheese, greek yogurt, eggs, and smoothies. For the first time in what feels like ever, I’ve actually been able to keep nut butter in my house and not have the jar disappear in a day or two. It’s been sort of eye opening trying and learning to trust myself with food again.

So, for a while now, I’d been thinking I should try to get back to 164 before the surgery to get as ideal of results as possible. But, I’ve been looking through a lot of forums and they say you should go into the surgery at your goal weight – and a lot of times its higher than you think it might be. They say you want to pick a weight you can maintain and go into surgery at that weight because then you will get ideal results for a weight you know you can maintain, and where you won’t have to fight against it.

I’ve decided that because of that, I want to focus on working out and getting strong going into the surgery, but NOT losing any more weight because I know where I am right now is something I can maintain for the long-haul. I feel like my body will be best contoured with ideal results at the place I am at now, and I really don’t want to spend the rest of my life trying to get my weight to an arbitrary number that clearly goes against where it wants to be.

Getting Ready for Peru

Getting ready for my very quickly approaching 17 day trip to Peru has been WAY more stressful than I expected. I’ve never in my life taken a trip like this, so didn’t know exactly what would go into it. The only other places I’ve been on vacation are to the beach, and I basically just showed up with myself, a bathing suit, and a few other things and relaxed away. This time, I booked my ticket from DCA to Lima, Peru because flights were cheap ($650 round trip) without doing TOO much research into exactly where things were in Peru or what went into preparing for the trip. Not necessarily the best way to plan a big trip like this, but it forced me to make it happen.

Before getting ready for the trip, I had to:

  • Schedule an appointment with a travel medicine clinic. Here I got a Hepatitis A vaccine as well as a yellow fever vacine, and a prescription for Cipro (an antibiotic) in case I develop typhoid symptoms (fever, diarrhea, fun).
  • Schedule an appoint with my PCP. She prescribed me malaria medication, altitude sickness medication, and some medicine for my anxiety around traveling on sketchy buses. In retrospect, I could have gone to the travel medicine clinic for all of these things, but I had to see my primary care doctor anyway, so it wasn’t a huge deal.
  • Renew my passport. It expired in January, and I took care of getting a new one in March so I had plenty of time.
  • Book a domestic flight. Flying in and out of Lima was great and cheap, but I realized that most of where we wanted to go was located much closer to Cusco, so we had to book an additional flight from Lima to Cusco, which ended up costing about $350, so airfare is around $1000 total.
  • Plan the itinerary. When looking to book tour groups, they were asking for close to $3,000 for as few as 8 days of travel. This did NOT include flights, and when I was looking at the prices, I knew that wasn’t the way I wanted to go. So, instead, we did a lot of research and booked things ourselves.

What we came up with:

  • June 21: Fly from DCA to Lima and stay overnight at a hostel near the airport
  • June 22: Fly from Lima to Cusco and stay in a hostel in the city
  • June 23 – June 29: Get picked up at our hostel, and take a 7 day, 6 night guided tour of the amazon jungle. I negotiated the price and we were able to get the trip (which includes the tour, all accommodations, and all our food) for $750 USD each.
  • June 29 – July 5: 5 nights in an apartment in downtown Cusco through airbnb.com. We were able to find a nice apartment with a kitchen, wifi, laundry, and everything we could need for $56 USD per night right in the center of the city.
  • July 1 – day trip to Machu Picchu. This cost about $250 USD per person, and includes transport to and from, entrance fees, and the tour itself.
  • July 5: Fly from Cusco back to Lima, stay overnight in a hostel in the city center, spend 2 full days in Lima
  • July 7: Fly from Lima back to DCA (just after midnight, so no need for a second night in a hostel)

It seems like a LOT of traveling when I look at it put down like this, so I am really glad we have those 5 nights at the same place in Cusco. Hopefully we will take a few days just to relax and explore.

Packing

I am bringing a large hiking backpack that I am borrowing from my sis, and plan to bring just that, so wanted to pack really light. We made sure to have laundry in our apartment in Cusco, so will be able to do it on day 8/9 of the trip – just about half way through. June is winter in Peru, and it seems like the temperatures vary a lot – from in the upper 60s during the day, to the low 30s overnight. This means one thing – dress in layers! Since I am trying to pack light, I wanted to make sure not to bring anything more than I needed, so I did a ton of research on what to bring during that time of year. I was able to bring the list down to a reasonable amount which all fits in the backpack. For the jungle tour portion, the company is giving us a duffle bag that we will fill with what we need just for the jungle (mostly hiking stuff and toiletries), and then we will leave the rest of our items at our hostel in Cusco.

backpack1

Here’s the full list:

Documents:

  • Passport
  • Yellow fever vaccine confirmation
  • Itinerary with hotel/hostel names/addresses/phone numbers + flight info
  • Peruvian Currency

Gear:

Clothes:

  • Socks
  • Bathing suit
  • 2 maxi dresses
  • 1 convertible skirt/dress
  • Black jeggings
  • 2 pairs hiking pants
  • 4 long sleeve shirts
  • 4 tanks for layering
  • 4 short sleeve shirts
  • Rain Jacket / Windbreaker
  • 10 pairs underwear
  • 2 Sports bras
  • 2 regular bras
  • Sarong
  • Pashmina
  • Scarf
  • Hiking sandals
  • Flip flops
  • Flats

Medical Kit:

  • Chapstick
  • Pepto
  • Immodium
  • Advil
  • After Bite
  • Bandaids
  • Blister Pads
  • Tissues
  • Benadryl
  • Malaria Meds
  • Altitude Sickness meds

Toiletries:

  • Toilet paper
  • Toothbrush
  • Hair tyes
  • Hair gel
  • Deodorant
  • Shampoo (bringing a few hotel sized ones and will throw out as I go)
  • Conditioner (bringing a few hotel sized ones and will throw out as I go)
  • Body Wash (bringing a few hotel sized ones and will throw out as I go)
  • Face wash wipes
  • Wet Naps
  • Makeup

Miscellaneous

Not so bad for 17 days! It actually doesn’t even look like a lot when it’s all laid out.

gear1

Now, just to figure out how to get it all in the backpack…

What’s the best vacation you’ve ever taken?

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