Rick Genter's blog

My chronicle of my experiences, starting with my upcoming plastic surgery.

Saturday, February 11, 2006

Conclusion

This is my last entry in this blog.

On Thursday I had my 5-month follow-up with my surgeon, Dr. Gee. The incision is healing nicely; there's still some "inflammatory" appearance (i.e., the scar is still red in most spots), but that will fade over the next year or so, similar to how the scar where my pacemaker was implanted faded.

There is also still some numbness, but that, too, is to be expected and that, too, shall fade over time.

All in all, I'm pleased with the outcome. There is more that I would like to do; I still have significant loose skin on my thighs, but I'm going to wait at least another year before I try to tackle that.

If anyone had any specific questions about my experience, leave a comment here with an e-mail address where I may reach you, and I'll be happy to follow up.

Monday, October 03, 2005

Back to reality

Today was my first day back to work. I told myself I would try to take it easy, but of course I ended up putting in nearly a 10-hour day.

One thing that was interesting: I find that I sit at work a lot more than I realized. At one point I went to stand up and felt very stiff and uncomfortable. It turned out I had been sitting for a solid two hours. While I was recuperating at home I never sat that long. I think I'm also subconsciously trying not to move while I'm sitting, which contributes to my growing stiff. Tomorrow I'm going to make a conscious effort to move around more.

I did see Dr. Gee today. He said that he felt my incision was healing very well. I have to wear the binder for three more weeks - which I expected - but I don't have to go back to see him for another four months. At that time I'll go back and have my "after" pictures taken. He did remove about five stitches; the stitches were all the dissolving kind, but these just hadn't dissolved yet and they were aggravating my skin, so it was time for them to go.

The other part of coming back to reality came with my credit card bill today: $13,600. Ah well; I knew it was coming. Also, I get 13,600 airline miles :-). That trip to the Caribbean this winter is looking better and better.

My walking continues to increase. Yesterday I walked eleven-and-a-half miles, from Arlington to Wakefield. It was exhausting, but it was a good exhaustion, the kind you feel after a good workout. The walk took me four hours, which means I am continuing to walk about twenty percent slower than prior to the surgery. The speed will come back as I continue to heal, and once I no longer have to wear the binder I'm sure I'll regain the rest of my speed.

Thursday, September 29, 2005

Tape-free

Today I was able to remove the bandage/tape that covered the incisions. Since the tape was clear plastic, there was no surprise, except for the smell. I was surprised that there was a - stale - smell that came from the incision. I guess I shouldn't be surprised - this was skin that hadn't been washed in 3 weeks :-). I removed the tape just before I took my shower, and it felt good to wash the incision, and now I can start treating it with aloe to further reduce the scar, although it's pretty small as it is.

I've been steadily increasing my walking distance. Monday I did 3.9 miles. Tuesday I did 5.4 miles. Yesterday I did 6.7 miles. I'll probably hold at about that level for the rest of the week, mainly because of the time it requires. Even after 6.7 miles I feel good; in fact, I feel better after walking than I do after sitting around most of the day. Sunday I plan to attempt an 11 mile walk, but I have a ride on call should it turn out to be too much.

Sensation continues to return to the area around the incision. The area just below my navel is still numb, and Dr. Gee indicated that it may be numb for up to a year. The rest of the incision is starting to regain feeling, however, mostly in the form of itching.

Last night I made a surprise appearance at my weight management class. I had decided earlier in the week to go if I felt I could walk the distance (it's a 5.3-mile round trip), and given how good I felt after my walks Monday and Tuesday, there was no doubt in my mind that I would go. It was great to return and see both the staff at the clinic and my classmates. It also was an opportunity to be in a seated position for a little over an hour. I've started sitting more and more this week to prepare for returning to work. Being in a seated position isn't really so much of a problem, but I feel like I need to be careful during the acts of sitting down and standing up, as I can feel tugging and pulling when I do. This process has taught me a lot about how the body is interconnected. For example, the simple act of crossing my legs involves pulling on skin around my waist in ways that I never thought about before.

Monday I return to work. I've been working from home pretty much from the first day after surgery, but it gets a little lonely working from home. I enjoy working from home some of the time, but when you're working on a group project, it's good to have face-to-face interaction with those you're working with. On the other hand, it's so much easier now with instant messaging, e-mail, etc., than it was fourteen years ago, the last time I was working alone at home, that it almost feels like working in the office. Almost.

Monday is also my next doctor's appointment. The surgeon will examine the incisions and see how they're healing (looks good to me :-). Also, I'm hoping he'll remove the remaining stitches. Once I took the tape off I was able to examine the incision much more closely; I do have about a couple dozen stitches - a couple here, a couple there - placed strategically around to help "sculpt" the shape of my body. Dr. Gee really did do a fantastic job.

I plan on writing another entry on Monday after I return from Dr. Gee's, but then I'm not sure when my next entry on this log will be. The next major event (I believe) will be to stop wearing my binder, which I think happens in another three weeks. After that I can start exercising vigorously, doing things like sit-ups and the like. At three months (early December) Dr. Gee wants to take my "after" pictures, since by then the primary healing process should be complete. Since the point of this log was to chronicle my experiences through the surgery and my recovery, and my recovery will be mostly complete at that point, I'll probably stop updating the log at that point.

Monday, September 26, 2005

Psychological Healing

My recovery continues on track. Physically, everything is going well; I continue to gain more flexibility and sensation every day. Yesterday I walked 3.2 miles: 1.5 miles in the morning, and 1.7 miles in the evening. I felt great after both walks.

I have found that some of the process of recovering from any kind of illness or injury is psychological. For me it is important to get back to as normal a routine as possible as soon as possible. To that end, I made a symbolic change yesterday in that I stopped wearing the baggy sweatpants I'd been wearing since the surgery and have gone back to wearing my jeans.

I started wearing my jeans on my walks a week ago, but would change back into the sweatpants when I got back home. Part of the reason for wearing the sweatpants was to put as little pressure on the incision as possible; when I sit propped up in bed, I was afraid that my jeans' waistband would apply undue pressure on the wound. It turns out, though, that my fear was unfounded; I've lost enough skin off my waist that my jeans are baggy now, too, even while I'm wearing my binder.

Getting back to my normal routine also means showering every day instead of every other day. I'd been nervous about showering, not wanting to have the water hitting the incision, even though it's sealed under waterproof plastic tape. As I continue to heal, though, I've become more comfortable with allowing the skin around the incision to be touched, to the point where having water hit the incision directly does not bother me.

So between showering, wearing my contact lenses every day instead of my glasses, and wearing more normal clothes, I'm rapidly getting back into a wellness mindframe. And that, in turn, is helping me to continue to improve physically.

On Thursday I get to remove my tape. I have to call Dr. Gee's office that day and find out how long I should be wearing the binder. It still provides a measure of psychological support as well as physical support, but not wearing it will be one more step along the path back to a normal routine.

Friday, September 23, 2005

Steady progress

I continue to make steady progress in my recovery. Each day I feel a little less tight. Each day I regain a little more sensation (usually denoted by a healthy itch :-(). Each day I seem to be able to do more and feel less tired.

Yesterday was particularly interesting because I made some sort of quantum improvement. I felt significantly more flexible, regained significantly more sensation, and went for a 1.4 mile walk without feeling very tired at all. This morning when I showered I looked carefully at the incision; it's healing nicely, and there's no noticeable bruising and swelling.

Wednesday Yoryos, Brian and Sean from work visited at lunch. It was great to see them; I've been working from home over the Internet pretty much the whole time I've been out, so between the phone, e-mail and instant messaging I've been in fairly constant contact with them, but that still isn't the same as interacting with them face-to-face.

Yoryos brought me the Camelbak I talked about in my previous post. It's very cool; he also gave me a spare bladder so that one can be cleaned or chilling while the other is in use. He also gave me a cleaning kit; I had wondered if there would be an issue keeping the bladder clean. Having it be removable makes that much less of an issue, but water bottles still need to be cleaned every so often to prevent algae or bacterial build-up; Camelbak offers a cleaning kit with disinfectant tablets and a wire brush, much like you would use for an aquarium.

Sean also brought me a bunch of books to read. I had set aside a bunch of books to read on the theory that I would be too wiped out during my recovery to do any heavy thinking for work, but I'd be able to read off and on, especially during the first week. Wrong! The surgery was on the 9th; I came home on the 10th. I was doing e-mail on the 11th and was back to working on the 12th. So much for taking it easy :-).

It's now been two weeks since the surgery. I certainly have more of an appreciation for what people who've gone through surgery have to do to recover. I also have had my belief reinforced that you should try to be in the best shape possible if you're going to undergo an elective procedure like this. I'm sure it's made my recovery easier than it otherwise would have been. Though it's published by a company promoting its own medications, this web site has a good summary of all the things you can do to improve the post-surgical healing process.

Tuesday, September 20, 2005

Healing Frustration

My recovery continues on track, but not fast enough for me.

I knew this would be an issue; basically, I don't have a lot of patience, especially with myself. It has now been 10 days since my surgery. The incision is healing nicely, and now that the drains are out, I have more mobility than I've had since this adventure began. Last night I was even able to sleep on my side for several hours.

Still, I want to be healed now. This evening I went for another walk, this time stretching it to 1.4 miles. Before the surgery I could do 1.4 miles holding my breath. Now, instead of taking 25 minutes, it took 37 minutes, and by the end I was tired. Not overextended, but tired. Actually, I felt good; I think some of the tiredness is coming from not having done any significant walking for over a week, and as I walk I can feel my muscles warming up and getting more limber.

Today I started noticing a bruising-type pain in both hips. There's no actual bruising - I think my use of Arnica Montana, an herbal treatment for bruising and swelling recommended by Dr. Gee - has helped immensely. I've also heard from various friends that Arnica is used by women immediately after childbirth to prevent bruising and swelling. It seems to work great.

The feeling I have in my hips is as if I'd been repeatedly punched there. I suspect that, as the sensation comes back to my midsection, I'm going to start feeling the pulling and stretching that was performed during the operation.

Tomorrow I'm going to have visitors from work. My boss was kind enough to get me a CamelBak hydration pack. He's coming by tomorrow with a couple of my friends and colleagues to deliver it and to bring lunch. He's bringing a satay noodle soup from the Vietnamese restaurant across the street, Viet's Cafe. It's one of their tastiest meals; nice and spicy, with a seafood base and with thin noodles.

Well, it's been an hour since I came back from my walk and I feel good. I plan to do the same walk the next two days; if that goes well, I'll extended it again on Friday.

Monday, September 19, 2005

Unplugged!

(with more apologies to Eric Clapton)

This morning I had my other drain removed. Finally! My mobility greatly improved when I had the first one removed on Thursday, and having this one removed makes me feel free. And the best part is: I can go back to wearing regular clothes! :-)

Yesterday I went for a one mile walk. It felt so good. The sun was out and the temperature was in the mid-70s. I mentioned this to Dr. Gee and he said that that was good, and I verified with him that I can keep walking like this, so I will. I'll continue to do a mile per walk for now, but I want to start increasing it as soon as possible.

Next Thursday (the 29th) I get to remove the plastic tape that's covering the incision. When he looked at it today he said that it looks like its healing extremely well; there was one spot where some fluid had accumulated, which he drained, but other than that he said it looks great. He also said that it looks like my shape is coming out the way it should, and I have to agree. No more rolls of skin on my butt, and no more roll around my waist that I can grab on to. I actually feel like a "normal" thin person. It's amazing, and what I was hoping for when I decided to have this surgery.

My next appointment is two weeks from today, and that's the day when I can resume driving. I may cheat and drive a day earlier; my car is at my friend Gail's house and she has my parking pass so that she can come and go to my apartment building while I convalesce. She's been a godsend, shopping for me and even making dinner for me a few times, especially the first few days after the surgery. She walked with me when I took my walk yesterday - she insisted, and it was a good idea to have someone with me on my first "big" walk outside - so I made her a low-calorie pumpkin custard. The custard is basically a crustless pumpkin pie, using fat free condensed milk and sweetener instead of sugar. The calorie content is about four-fifths less than regular pumpkin pie (72 per slice vs. ~350-400 per slice) and just as tasty.

I talked with Nancy, my health educator at the weight management program. She said that I shouldn't change my calorie budget, even though I've dropped eight pounds, since skin really doesn't affect my metabolism. I argued that my calorie budget was probably wrong before, in that case, since I had budgeted for my pre-surgery weight. She pointed out that my pre-surgery budget was working, so there's no reason to change it. We compromised, though; I've altered my calorie budget to maintain a weight five pounds lower than before, and I'm being particularly careful until I can resume my normal high levels of physical activity. With my metabolism, five pounds is only 41 calories, so it's not a huge difference in any case.

Metabolism is interesting. There is a rule-of-thumb that says that an adult male requires 12 calories of food intake per pound of weight to maintain that weight. This reflects the energy used by the body's organs during the day; it takes energy for your heart to beat 24 hours a day, for your liver to process fats, and for your brain to operate. In fact, unless you do a lot of exercise, keeping your body's organs going burns more calories than anything else you do. Exercise is critical to maintaining health, but it's misguided to think that an hour at the gym will make up for eating pizza and a hot fudge sundae. An hour at the gym just doesn't burn as many calories as you'd think.

Anyway, about a year ago I took a test to measure my metabolism. The device used is called a MedGem; it measures your body's at-rest oxygen consumption to determine your resting metabolic rate. Just from the detailed record keeping I do on calorie intake and physical activity I knew that my number had to be lower than 12; at 12 calories per pound, to maintain a weight of 185 pounds I should be able to eat a little over 2,200 calories a day. There was no way I could eat that much without exercising and maintain my weight. So I took the test.

My number is 8.26.

I didn't want to believe it, so I took the test twice. The results came out almost exactly the same both times. While it made sense, I also found it depressing. It means that, to mantain a weight of 185, instead of eating a little over 2,200 calories per day, I get to eat a little over 1,500 calories per day. And the calorie equation is grossly unfair; if I eat nothing, the largest deficit I can have in a day is 1,500 calories, but there's effectively no limit to how much above my budget I can go in a day. I mean, there is a limit as to how much you can eat in a day, but it's so easy to eat 3,000 or even 4,000 calories in a single sitting! A large hot fudge sundae at a gourmet ice cream shop like J.P. Licks is 1,600 to 1,800 calories.

I had been operating on a budget for maintaining 185 pounds (and I've been consistently weighing in at about 190 to 192, which, considering that my clothes weigh about 6 pounds, worked out about right). I've resumed weighing myself daily and I'm consistently running about 8 to 9 pounds lower than I was before the surgery, so I figure that retargeting for 180 is probably about right; yes, the 8 pounds that was removed was skin, but it must take something to maintain skin, right?