Random Thoughts of a Disordered Mind


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I Can See Clearly Now, the Drains are Gone

The title of this post makes no sense, since drains are not connected to eyes, but the song has been running through my head since my last doctor’s appointment.

My drains were finally removed last week, five weeks and one day after my surgery.  I knew that one would come out but the other still was collecting fluid and I was pretty sure the doctor would keep it in another week.  Turns out, thought, that five weeks is long enough and way longer than most people have them in, so out they came.  Freedom!

No drains meant I could finally take a shower for the first time since surgery morning, and it was the best shower of my life.  How fabulous to be able to really wash everything in one place without dripping all over the floor and everywhere else!  I felt so clean and normal afterwards, and I know my work colleagues were happy 🙂

Over the next week, though, fluid was building up inside the belly near the incision.  The doctor had told me this was very common after drain removal, and that I would know it was too much if I could push in one spot and see waves in other parts of the belly area.  That sounded so weird I couldn’t conceive of it.  But I did, and it was weird.  it was also uncomfortable and felt very “full”, especially with the compression binder still on.  As though I’d overeaten even when I hadn’t had anything at all.

So I called and got a same-day appointment to have the fluid aspirated out.  Think of having blood drawn, when they change the little vials to get more blood for different tests.  That’s what they did to me, but instead of vials they used what looked like turkey basters (without the bulbs), and pulled out almost a cup of fluid.  The incision area is still numb so it didn’t hurt, it just felt odd.  But it’s definitely better now.

I still have a lot of swelling, especially in my upper thighs, and from the front I look a lot like Jane Curtain in the old SNL sketch of The Widettes, who have ginormous thighs and butts.  Well, okay, it’s not that bad, but it’s a lot lumpier than it was before.  I know it’s from surgical swelling and from the abdominal binder (when you compress something, bits squeeze out both ends – it has to go somewhere).  It will go away.

In the meantime, my tummy is still very flat and I’m enjoying the concept of having a lap.  Did you know that laptops actually work better when they are, um, on top of a lap?  Instead of a pillow carefully positioned to slant the device over the belly rolls.  It’s a novel concept in my house.

Work has been crazy busy.  We’ve been interviewing for a brand new professional position and as a member of the search committee, at least half of every interview day was taken up with something, sprinkled through the day.  Multiply that times four and you can see that not much was going on.  I contemplated going in on the weekend for a few hours just to get some projects in place for my staff, but decided “nah” and will enjoy the weekend in peace at home.  After errands and, um, writing a “welcome to the conference” piece for the annual meeting’s final program booklet.  I seem to work best against a deadline.

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Yes, I Still Have Drains

My surgery was four weeks ago today and in many ways, I’ve come a very long way in four short weeks.  It’s already hard to remember how much it hurt that first week (we do block that stuff out of our heads as soon as possible so we don’t go crazy).

But I still have my drains.  I knew this was coming and it sucks, to put it bluntly.  It was clear to me by the weekend that there was no way that the fluid collection was going to drop to 30 cc (1 oz) per day per drain.  Not when I was still getting 40 cc from one of the three measuring times.  So I tried to just tell myself that I’d have them for another two weeks, just so I wouldn’t be completely discouraged.  Doesn’t mean I have to like them, though.

I went back to work last Thursday, actually managing full time, much to my surprise.  My doctor wanted me not to start on a Monday and it was really smart.  Having two days of work followed by two days of weekend R&R gave me a chance to get more sleep, visit the hair place, and buy little clothes for a baby shower.   They are all so CUTE, it was hard not to buy out the store.

So to summarize:

  • I have drains.
  • I want a shower.
  • I’m feeling much better and have a waist and everything.
  • I’m back to work.
  • My energy levels aren’t all the way back so I’m trying to get extra sleep.
  • Baby clothes are cute.
  • I love my cat.


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Three Weeks Post-Op

I saw the doctor again today, and there was good news and bad news.

The good news (and it IS good news) is that the “under the armpit and over the shoulder” dressing is history, as are the ace bandage wraps on the arms.  The incisions are healing nicely and I can use soap and water everywhere except where the drains are.  And deodorant, which my colleagues at work will be very happy about, because I’m going back to work tomorrow.

The bad news is that I still have my drains.  Much as I despise them, they are doing their job of drawing out fluid which helps me heal.  I was close to crying when I asked the doctor if I was doing something wrong, or was there something wrong with me, that I have them so long.  He was very kind and took my hand and said, “There is nothing wrong and there is nothing to change.  People heal at different times and different ways, and no one way is better than another.”  It did help.


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Whining Ahead

Last week (how time flies!) I went back to the surgeon for my 2-week update.  My hope was that the nasty surgical drains would be removed, but I knew going in that it wasn’t likely.  In fact, when he asked me how I was feeling, I said “Physically much better. Emotionally, pretty crabby since I know I will leave with drains.”

My surgical drains

He ended up removing two and leaving me with the ones that have been draining the most.  The normal rule is that you keep the drains until the total daily output is no more than 30cc of fluid for two consecutive days.  Unfortunately I have one that generates almost 90cc in the course of a day which makes me annoyed, plus it’s literally a pain in the butt.

One reason for the annoyance are the limited clothing options (hello, red moleskin shirt!).  I know that when the drains are gone, I will finally start to really see the results of the surgery.  I’m trying to figure out if there’s anything I should be eating (or not eating), or increasing or decreasing kinds of movement and even sleep to speed things along.  At the same time, I also know that having the fluid removed from my insides is good for my healing and I should just shut up about it and let things go at their own speed.

My boss and I talked last week about coming back to work.  After she heard about what the surgical drains actually involved, she said I should stay home until they’re gone.  But what if I go back on Wednesday and still have one?  I can’t stay here forever.  Maybe I need a note from the doctor saying it’s okay for me to deal with them at work without increased risk of infection.

Because that’s another possible complication:  the longer you have the things in, the greater the risk of infection.  It’s hard to change the dressings when they’re on your butt and you can’t actually see what you’re doing.

Now let’s whine about the arms.  I hate the ace bandages that are the compression gear for the upper arms.  I’m using the self-stick kind with the ends taped together to try and make it stay put.  I’m not so good at wrapping, though I’m getting lots of practice.  I would really like to graduate to “wear 12 hours, leave off 12 hours” but don’t know if my doctor is likely to go for it.  He’s pretty conservative.

The upper arm incision still has stitches that need to be removed, hopefully this week (I know, I’m terribly optimistic about this week’s visit).  It runs from my elbow along the bottom of the arm up across the armpit and wrapping slightly under the arm to my back.  I wear dressings on the “around the armpit” stitches and the only way to hold them in place (at least with my Wikipedia medical degree) is to wrap the whole thing across the shoulder with 2″ medical paper tape.  I have lots of sticky residue in some complicated to reach places.

And I want a shower.  I really really want a shower, which I can’t have until the drains are out.  So I’m back to them again.  Blech.

Flat tummy in fleece pajamas

On the plus side, I’m completely off of pain meds (and have been for about 10 days) and cleared to drive.  I’ve been out in the car twice and it felt so good to not have to depend on neighbors, friends, and cabs to get places.  The big incision seems to be healing nicely and I can actually lift both legs up on the bed without using my scarf as a sling.  This is huge.  My abs are not totally happy about it but I feel very accomplished.  And my ankles and calves are no longer swollen with edema.

So that’s where I am at almost 3 weeks post-op.  I don’t regret doing this but wish I’d had better idea of how much it would take out of me and how long certain things were going to go (think drains).  Much of it, though, can’t be just set in stone.  It depends on the body and how it wants to heal.  And it IS healing.

Thanks so much, everyone, for your kind thoughts.


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More Than You Wanted to Know About My Plastic Surgery

This is going to be a bit long but I wanted to get this down for myself and for anyone else who may be considering doing this particular combination of plastic surgery options. After a 130lb weight loss, from a combo of WeightWatchers and lapband, I maintained my weight for 5 months within a 3 lb range. My insurance paid for an abdominoplasty (tummy tuck) and bilateral brachioplasty (upper arm lifts) – I was extremely fortunate to have both covered, as that rarely happens. Here’s how it went:

My procedure took 5 hours, for which I was intubated and catheterized (fortunately not while I was awake to know about either one). Between belly and arms, the surgeon removed ten pounds of skin and fat, but mostly skin. There was no liposuction. However, post-op, the doctor told me that they had done a bit of muscle contouring in the lower belly to achieve the goals we wanted. Which meant more pain and a slightly harder recovery but a better ultimate result.

The tummy tuck incision is along the bikini line (not that I’ve ever worn one, but you get the idea), and it went completely across my front and wrapped slightly around the sides, ending on the side of my butt. Surgical drains (4) were inserted on both ends beyond that point to drain out fluids, help reduce swelling and improve healing. They are emptied and contents measured 3 times a day. I’m hoping hoping hoping that the drains will be removed on Tuesday’s post-op visit coz they are a pain in the butt – literally.

The very long incision is covered by Tegaderm, a clear acrylic dressing that helps hold the skin together for a more narrow scar, protect the incision from bacteria, and serves as a barrier to water. Supposedly I can keep it on for up to 2 weeks at a time, even through showers. (Not that I’ve had one yet; those stupid drains have to go first.)

My belly button is original but it was reattached when the skin was tightened so I have a dressing over that, too. And on top of everything I have a giant abdominal compression binder that feels like a corset. It actually does feel good to have the extra support, especially if I start to cough, and my drains are clipped to the top, which fits just under the bra line. Not exactly attractive but it works.

Now on to the arms: incisions are on the bottom of the arms (think holding your arms out to the side, palm forward; what’s on the bottom got trimmed up) and run from the elbow into the armpit. These incisions are also covered with Tegaderm and I have dressings that run from my back to front inside the armpit. It is next to impossible to make them stay in place. I also have ace bandages wrapped on both arms.

Believe it or not, this 5-hour procedure was day surgery. My insurance (and university) allowed me to transfer in a wheelchair van from the surgical center to the university health inpatient facility for 4 nights, and it made a HUGE difference. Just having two people at a time help me get out of bed was huge (just try getting up when your belly feels sliced open and you can’t put any weight on your arms). There is simply no way I could have managed home-care on my own, or even if I had someone there to help me.

My first week post-op was spent in the infirmary and at home, loopy on percoset, wrapped up like a mummy and dressed in my fleece pajamas. Because getting in and out of bed is so hard, I haven’t napped in bed since I got home. I get into bed by sitting on the side and looping a scarf around one foot at a time to pull the legs up without pulling on the abs.  I sleep with bed wedge pillow to elevate my head and a big pillow under my knees to keep the body in a folded position, also to reduce stress on the abs.

As of now, I feel physically a lot better than I did even yesterday; every day is an improvement. But I can’t for the life of me figure out how the surgeon’s office thinks I can change the dressings on my own. The ones for the drains are on my BUTT and the ones on my armpit run front to back – how the heck do I change the dressings when my arm movement is restricted by stitches? I’m also apparently incapable of correctly wrapping ace bandages on my arms – again, having each one hampered by incisions is not making it easier. I saw my primary care doctor on Friday for a quick checkin and the nurses changed the dressings for me – and asked me how anyone thought I should be able to do them myself. No idea coz I have the same question.

I go back to the surgeon’s office on Tuesday – Day 14 from surgery. I am really hoping the drains come out and I get permission to drive plus a signed note to return to work. I need to find out what the long term plans are for those awful “under the armpit” dressings and when the stitches come out (the ones in the arms; the lower big incision are absorbable). I am still swollen and will be for a while, but every day that gets better and the more I return to normal life activities, the better that will get. No workouts at the gym, certainly, but even the usual ups and downs of standing, sitting, walking here, stairs, etc. will make me feel more normal.

And I can’t wait to get rid of the red moleskin shirt I’m currently wearing. I look pregnant because of the drains clipped in the front on the binder, and this is the only thing (other than my fleece pajamas with polar bears wearing pink scarves) that can cover the drains. Do you think burning it would be too excessive? Only after I’m fitting back into other things again, of course 🙂