Rick Genter's blog

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

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?

Thursday, September 15, 2005

Let it drain

(With apologies to Eric Clapton)

Well, I went to see Dr. Gee this afternoon to have my drains inspected. One was ready to come out (yay!), but one wasn't (boo!). The right-hand drain had basically stopped draining; I was only getting about ten milliliters of fluid every twelve hours. The left-hand drain, on the other hand, still had some fluid - 25 milliliters over twelve hours - so he decided it should stay in. I go back on Monday morning to get it removed.

While I was there he also "cleaned up" my incision. This involved removing all of the clear plastic tape all the way around - which surprisingly wasn't bad. The tape's adhesive, while adhering well, didn't stick to what hair I have left (he shaved off a fair amount for the surgery), so it came right off. He wiped off the dried blood that was underneath; what's left is a very thin scar which is healing nicely and is going to be much less visible than I thought it was (and that I had seen in pictures of other people who've had this surgery). The material he used to close the incision is called something like "Tagabond" (I looked for it on the Web but couldn't find anything about it); he said he likes it better than Dermabond, and I have to admit it does an awesome job.

Anyway, after cleaning the incision and removing a few stitches which he said he used to "help contour my shape to match what it would have been if it had never been so out of shape", he re-taped it with more clear tape. Then he dealt with my belly button.

As I mentioned in an earlier post, part of this procedure involved the relocation of my belly button. For that part of my body he removed the skin around the belly button and pulled the skin from my lower chest down, cutting a hole in it to attach my belly button. It was taped and there was a cotton "plug" that was pretty much soaked with dried blood from immediately after the surgery. He removed that and threw it away, then cleaned out my belly button and re-taped it with the clear plastic tape. No plug this time, which was good; I didn't realize that I had a plug there and had explored it mostly by feel, and I thought he'd turned me from an "innie" to an "outie" :-).

There's been virtually no pain throughout this entire experience, but I think a lot of that is because a lot of the area - about four to six inches on either side of the incision - is almost totally numb. I am getting some feeling back, and I noticed even more today while he was working on me, but I think the human body is pretty smart, realizing that the stress of pain would retard healing, so why not just shut down the nerves while I heal and let the feeling come back slowly?

Removing the drain was interesting. As I had noticed, it was stitched in, and the first thing he did was cut those stitches. Then, without warning, he just pulled it out. The tubing went for several inches, and then there was about six inches of flange tubing that was about twice as wide as the tube coming out of me to help prevent the tube from coming out. All told he pulled what looked to be about eight to ten inches of tube out of me! I wasn't expecting that. On the other hand, it was good that he didn't warn me; he just pulled it out, so it was uncomfortable, but I didn't have an opportunity to tense up or suck wind before he did it, so it was done before I had much of a chance to react. The resulting hole bled for a bit, but after soaking one kleenex and replacing it with a pad to absorb the blood, it stopped bleeding after a couple of minutes. I removed the pad as soon as I got home.

And that was it. As I said above, I go back on Monday to get the other drain removed. When he replaced the binder he tightened it another notch beyond how I had it, and that wasn't uncomfortable, so the swelling is definitely going down and I continue to improve, so I'm happy.

On the way home I asked my friend Joyce (who was my ride) if we could stop by the Winchester Hospital Weight Management Program so I could say hi. Unfortunately, neither Nancy, my weight management educator, nor Kathy, the program administrator and the person who initially referred me to Dr. Gee, were there :-(, but I got to see both Holly and Emily (hi guys!), the other two health educators in the program, both of whose classes I've enjoyed in the past. It was good to see them and good to get outside; today was the first time I'd been outside since I came home from the hospital on Saturday, so even though today is a cloudy, rainy, muggy day thanks to the leading edge of Hurricane Ophelia, it felt good to be out. This weekend is supposed to be "iffy" as far as the weather goes, but I'm going to try and get out for an extended walk (fifteen to twenty minutes) at least once before going back to Dr. Gee on Monday. Then, when I see him, I'm going to press him to see when I can start becoming more active.

Tuesday, September 13, 2005

More than a feeling

Recovery from this operation involves a myriad of sensations.

The primary sensation, as I've mentioned before, is tightness. It's hard to describe, other than the skin on my butt is so tight that it literally feels like it's too tight for my body. Ironically, I end up walking slightly hunched over because I also don't want to strain the incision in the front.

The second most felt - or rather, unfelt - sensation is numbness. Currently I have no feeling most of the way around my waist. It's not an unpleasant sensation, but it's odd.

New sensations are starting to come forward now, though. Occasionally I'll get a very targeted, brief itch. I think it's coming from the incision itself; I expected such as part of the healing process. (Don't cuts always itch as they heal?) Obviously I can't scratch them, partly because I'd be afraid of damaging the incision, and partly because it's underneath both the binder that I wear and the clear plastic tape that covers the entire incision.

The binder is interesting. It's basically the same material as you would find in a flexible knee brace with Velcro strips placed at strategic intervals so that its size is adjustable. I wear it as tight as is comfortable. So far I've only taken it off once since leaving the hospital, and that was when I took my shower. I'm going to take another shower today, so it'll come off again today (and I'll get another look at how the incision is doing).

Other sensations I experience are brief flushes of warmth. Often when that happens I think "Oh crap! I've overdone it and ruptured the incision and am bleeding all over the place!" but it's not true. I think it's just another by-product of the healing process.

The most disturbing sensation is the tugging and pressure sensations when I deal with my drains. When I empty them I'm also supposed to "strip" them, which involves "milking" the tubes, trying to force any liquid in them down into the bulbs so that it can be emptied as well. The purpose of this is to clear out any clots that may be obstructing the tubes. The clots are normal - after all, the liquid is partially blood - and the stripping and draining is supposed to be performed at least a couple of times a day. I do it once in the morning, right after breakfast, and once in the evening, right after dinner. In the hospital they did it every 8 hours, but I'm not getting up in the middle of the night to do it :-).

Anyway, when I strip the drains, I either feel a tugging, which I try to minimize, or an internal pressure if any of the fluid gets pressed back into me, which I really try to avoid.

The other sensation is soreness in my shoulders, elbows, back and legs. This has nothing to do with the operation, but rather with how I'm compensating for my limited mobility during my convalescence. Last night my shoulders were bothering me enough that I ended up taking a Percocet so that I could sleep. That stuff knocks me out cold, which is good, because then I get a good night's sleep.

By the way, shoulder and back problems are normal for people who are or have been chronically overweight. I experience shoulder pain any time I walk for more than a couple of hours at a time, even without a backpack. I talked with my doctor about it, and she said that people who are overweight for a prolonged period (i.e., decades), can develop arthritis in their joints from the abuse they take. One more reason to get and keep the weight under control. I just wish I had "gotten it" sooner.

Monday, September 12, 2005

Look ma, no stitches!

Yesterday I took my first shower since the operation, which gave me my first opportunity to look at the results. Dr. Gee did a great job. There's very little swelling, but most amazing at all, there are no stitches! Apparently he used something that the hospital nurses referred to as dermabond. Whether he used actual Dermabond or a dermabond-like substance, the end result is that I have no stitches; just a line where the incision was, covered by a wide swatch of clear plastic tape.

Actually, I think I do have a few stitches. The holes where the drains emerge appear to be sutured closed. It's hard to tell; the areas are tender (not painful, but it's a funky, pressure feeling) and, frankly, the drains still creep me out. Though much less so than they did when I first dealt with them.

I made the appointment to have my drains inspected and hopefully removed for Thursday at 1:00 PM. I'm really hoping that they get removed; they have become the biggest annoyance for me at this point.

I also had my first non-standing trip to the bathroom today, if you know what I mean. Thanks goodness for Phillip's Milk of Magnesia. I'd never tried it before - I have a pretty high-fiber diet, so I usually don't need anything like it - but I had read several web sites of people who'd been through this surgery who recommended it, so I started taking it two days ago. It made the bathroom session much easier, though it was still a long, time consuming process: from walking into the bathroom to walking out was nearly 30 minutes. I'm sure it could have been shorter, but I really didn't want to do anything to risk my recovery. By the way, I can personally recommend the Wild Cherry flavor; it isn't chalky at all, nor does it have that sickly sweet taste like cough syrup. In fact, it's quite pleasant.

Today I actually started doing some work from home. Our office needs better throughput on its Internet access; usually when I download from a web site I can get anywhere from 300K to 600K bytes per second, but from our office I can only get maybe 150K, if I'm lucky.

Just for fun, I weighed myself today. I did this right after eating breakfast, wearing my recovery clothes (oversized T-shirt and baggy sweatpants), wearing my binder, and with my drains. Even with all that, plus the swelling I have, I'm 3 pounds lighter than I was the morning I went into surgery. I have a feeling Dr. Gee removed more than the estimated 6 pounds of skin. Time to recalculate my calorie budget - after I'm more fully recovered, of course :-).

Sunday, September 11, 2005

Wow

Well, it's done. What an amazing experience.

Friday morning my friend Gail picked me up at my apartment at 5:30 AM to drive to the hospital. I packed some clothes and the like, but it turns out that I didn't need them. The day surgery department (where this operation is performed, even though people usually stay overnight) opened at 6:00 AM; we got there a little early, so we just hung out and chatted until the department opened.

I was allowed no food or water past midnight, so I couldn't have any coffee :-(. I went through the usual question and answer session, makng sure I was who I was and that I had no allergies, etc. They weighed me and took my vitals, then had me slip into a johnny and on to the portable bed. Then they wheeled me into the room where I met with the anesthesiologist. One funny thing: while I was getting prepped and weighed and all that they enter all the information into a laptop, and suddenly the laptop dimmed and said the battery needed charging. The nurse said that they have this problem all the time and I pointed out that the plug had come loose in the back. Sure enough, that was the problem.

The anesthesiologist and his assistant came by, again checking for information about allergies, did I have anything to eat or drink, etc. In a way it's good that they cross check and double-check as much as they do, but it does get tedious after a while. Finally, at about 7:00 AM, they put in my IV. This was so they could give me fluid during the operation, plus the anesthesia.

At about 7:20 AM the surgeon came by. His name is Dr. Peter Gee; he's a very nice guy, very laid back yet focused, which is what *I* want in my surgeon :-). Anyway, we chatted for a minute, then he went off to scrub. Right at 7:30 AM they wheeled me into the operating room, where it was FREEZING. I asked about why they kept it so cold in the OR, and there are two reasons. One is that the low temperature retards the growth of bacteria. Two is that the lights they turn on during the operation are extremely hot and it helps keep the surgical staff cooler. Both are important reasons.

Anyway, after a couple of minutes of prep the anesthesiologist said "OK, I'm going to give you a little medicine now."

If anyone has ever read any of Larry Niven's science fiction books, one of the technologies he describes is the Slaver Stasis Field. This is a field that, while it is on, no time passes inside for the occupants, while time proceeds normally on the outside. So, if you're inside the field, one minute it could be 8 in the morning on a Tuesday, and then a blink of an eye later it could be 3 in the afternoon on Thursday, or it could be a thousand years later; you can't tell the difference.

That's what happened to me. The anesthesiologist said "OK, I'm going to give you a little medicine now" and then I opened my eyes as I heard someone say "It's 1:40" and I was staring at the ceiling of the recovery room and I felt very very tight across my abdomen and butt. No pain, just tight. Nurses kept coming by and asking how I was feeling - they use a scale of 0 to 10 for pain, where 0 is no pain and 10 is the worst pain you've ever felt. I told them a 3, which was "There's discomfort, but if you get into a conversation or are watching TV or listening to music you can forget that it's there."

I've never felt beyond a 3. Well, except once, which I'll get into later.

After a couple of hours they wheeled me into my room. I got into my room just before 4 PM. By then I was pretty much fully conscious and still feeling no pain; they kept telling me "We'll be happy to get you any pain medications," but I never needed it. At around 6 PM my boss, Yoryos, came by to visit, which I really appreciated. We chatted about how work was (there was a big event scheduled for this weekend, which also seems to have gone well), and then he left after about 30 minutes. Then I had dinner.

This whole time I was completely flat on my back. For dinner they wanted me to stand up - I'm not supposed to bend much at the waist, as that puts too much strain on the wound. So I stood up. Bad idea. It took me a minute or two get into a standing position (try getting out of bed some time without bending at the waist and you'll see what I mean), which went OK, but then the blood rushed out of my head and I broke out in a cold sweat and had to lay back down. Gail says I paled about 12 shades. I ended up eating dinner (a chef's salad - no dressing) laying down.

After dinner I watched the Red Sox play the Yankees (David Wells did not have a good outing - they lost 8-4). Gail left about 9:00 PM, and I went to sleep shortly thereafter.

During the night I woke up either by myself or was awakened by the nursing staff about every hour. This was all fine, and the night nurse, Mary Beth, was really nice and very apologetic and gentle, so that wasn't really a problem. The only negative experience I had was with the clinical assistant who came into my room at 5:00 AM to do my vitals. She had no bedside manner whatsoever, and was not gentle in the least. I had to wear a catheter the whole time I was in the hospital - probably the worst part of the experience - and she was bumping it around while draining it, which was not pleasant. This was the only time my discomfort got above a 3. I told her twice to be careful and only the second time I got a terse "sorry". Then, when she left my room, she left my light on full intensity. The cord to turn it off was above my head, which was quite an effort to reach, but there was no way I was going to get back to sleep with that hundred watt flourescent blasting me in the face. Finally I did reach the pull cord and turned it off and went back to sleep.

The day nurse was great - her name was Leigh, and her clinical assistant, Erynn, was also great. I had a good breakfast (cream of wheat and a banana), then settled to watch Saturday morning TV. Which sucks. If you're over the age of 6. Finally, though, TNT started showing "Jaws", which is a good classic, so we watched that (Gail returned at about 9 AM to join me), then when that ended we switched to the Red Sox pre-game show. Curt Schilling had a great outing - I only got to watch him pitch through the seventh inning, though, because I got discharged! Dr. Gee came in in the morning and looked at the incision and was very pleased with how it looked (as were all the nurses - they said he did a fabulous job, and when Gail talked to him while I was in the recovery room she said that he was particularly proud of the job he did, which is something else I like to hear from my surgeon :-). In the afternoon Leigh talked to Dr. Gee and, after I walked up and down the hospital corridor a few times - no light-headedness or pain - and after they removed the catheter and I could pee without it, I was free to go!

Removing the catheter was the worst part of the experience. What they don't tell you but they should is that when the catheter comes out you feel a burning sensation from heat. This is because the tube is full of urine which is at body temperature - 98.6 degrees. Since it comes out rather suddenly, and it's not being driven out by your body, your body isn't expecting it and when the sudden rush of heat comes through, it's very uncomfortable. I think it was the surprise that got me more than anything else though. Though, having never had a catheter, could they really have warned me what it would feel like?

Anyway, I left the hospital at about 3:00 PM and my friend Joyce drove me home with Gail following. Joyce drives a Cadillac where the front seat can recline almost flat, so once I got into the car I could be relatively comfortable and not bend much at the waist while she drove me home. She did an excellent job avoiding manhole covers and other bumps in the road (really important!) and I got home about 3:30PM. I walked into the elevator and to my apartment without incident, and the only issue was getting into bed. In the hospital I kept getting into and out of the right side of the bed; at home I normally sleep on the left side of the bed. It turns out that I feel more discomfort trying to roll on my left side than on my right, so I ended up getting into the right side of the bed for the night. Although I did get out of bed several times during the evening to hit the bathroom and do my drains.

The drains are disgusting; I have about 3 feet of clear plastic tubing coming out of me in two places, ending in squeeze bulbs. The bulbs fill with a bloody fluid - kind of pinkish - and need to be drained about every 8 hours. Each time I drain them there should be less fluid, and so far there has been. Of course, I slept better in my own bed than I ever would in the hospital, so I slept a total of more than 8 hours last night - more like 11 - but the drains were less than half full even after all that time. I'll drain them again after the game this afternoon, but looking at them this morning there isn't much liquid in there at all, so that's going well too.

Today I took a shower for the first time, which felt great. I also got to see Dr. Gee's work in the mirror for the first time; even with the swelling (which there isn't much of) it looks fabulous - all of the loose skin around my waist and on my butt is gone! It was exactly what I had hoped for. I am very glad I did this.

I'm going to watch/listen to the Red Sox this afternoon and catch up on my work e-mail, then read a bit. I'm also going to go for a brief walk outside this evening around dusk - it looks like a beautiful day outside, in the low 80s with lots of sun, and I want to get some of that while I can.

Tomorrow I have to call Dr. Gee' s office to make an appointment for either Thursday or Friday to have him look at and hopefully remove my drains. I'll probably have another appointment a week or so after that to see how I'm doing, and then he'll tell me when I can drive and when I can start walking again - my normal walks, that is, of 8 to 10 miles a day.

Thursday, September 08, 2005

Drawn and quartered

I had my "marking" appointment this morning. Basically this involved stripping down to my briefs and having the surgeon draw on me where he is going to cut. I'd stand in one position while he gathered up the loose skin, tightening as much as he reasonably could, then using an indelible felt tip pen draw where the cut goes. Then I'd turn about thirty degrees and he'd gather and mark again. The whole procedure took about ten minutes.

He's going to remove even more than I originally thought. It's a swatch about nine inches wide in the front, and even wider (close to twelve inches) in the back.

There's still a ton to do: I still have to pick up my prescriptions (Percocet and Oxycontin), I have to do my final cooking, cleaning and laundry, and I'm picking up a barstool as an alternative to a kneeling chair. I was unable to find a kneeling chair that had independently adjustable seat and knee pads, and the chairs I tried had the knee pads too close to the seat; I was still bending too much at the waist.

Even though I'm only eighteen hours from my surgery, I'm not nervous; I'm more excited than anything else. I look on this as a big adventure, and definitely a learning experience. The most exciting aspect to me is that I have next week off from work :-).

Final Preparations

After five months of seeming like the day would never come, suddenly my surgery is tomorrow. And just as suddenly it seems that there isn't enough time to do everything that needs to be done.

This morning I have my "marking" appointment with the surgeon. This is where he draws on me where he's going to cut. I'm most interested to see where he's going to cut around my navel, especially since he told me he's going to "relocate" it (meaning that, in order to keep it where it is, he'll have to make a hole somewhere else).

Massachusetts has a law that allows for a health care proxy. This is a person that I can designate to make medical decisions on my behalf should they be needed and should I be in a state where I can't make those decisions for myself. Normally I would designate my sister to be my proxy, but since she's going to be 500 miles away tomorrow I'm designating my friend Joyce to be my proxy. Of course, that means more paperwork that has to be filled out. The other paperwork that I had been putting off for a long time but finally got my act together about was my will. I don't have a lot of assets, but it's important to make sure that the assets I do have get to the right people should the unthinkable happen.

There's a lot of other mundane stuff I still have to do, too, like clean, cook and do laundry. The surgery is scheduled for 7:30 AM tomorrow, so I have to be at the hospital by 6:00 AM, which means I have to get up at 4:30 AM. I have a feeling I'm not going to get a lot of sleep tonight.

Friday, September 02, 2005

Oops

So this morning I get a call from my surgeon's office. In all of the interaction I had with them getting the finances straightened out, they forgot to tell me that I had a pre-op testing appointment at the hospital at 8:00 AM this morning. Oops.

They've rescheduled the appointment for Tuesday at 9:30 AM, but I may "have to wait", since they are "squeezing me in". This will be interesting, since I also have an appointment with my cardiologist Tuesday at 2:00 PM as a follow-up to my stress test that I'm having this afternoon.

In order to make sure everything was a go for this operation, I made sure I had my various annual checkups before going forward. I had my annual physical in July, and my annual checkup with my cardiologist a few weeks ago. When I went for that appointment, he told me that I was doing great, but that he wanted me to take a stress test since I had never taken one.

I wonder how high a score I can get on the test? :-)

Thursday, September 01, 2005

Finances are done

Yesterday I finished arranging payment for all of the major phases of the operation. $6,000 to the surgeon, $5,100 to the hopsital, and $1,918 to the anesthesiologist. $13,000, and that doesn't even cover the incidentals, like the toilet seat extender.

I didn't mention the toilet seat extender? During the recovery, I'm supposed to minimize the amount of bending I do at the waist, to prevent risking opening the wound. That means things like arranging my apartment so that everything is roughly at waist-height so I don't have to reach high or low to get things in cupboards. It also means having a toilet seat extender so that I don't have to bend so much to sit.

Yes, no sitting for as long as 3 weeks. I'm looking into those "kneeling" chairs to see if I can find one I like. I've looked at Relax the Back here in the Boston area, but the model they sell has a fixed distance between the seat and the knee pads which is way to short for my legs.