Toni literally called me and said can you be here in 1 hour (maybe less). I was so anxious to get there and have the consult that I said yes and basically hopped into the car with Harlan (my 5 yr old son) and raced the 30 minutes to the north end of town to get there! About half way there I had a sudden horrific realization..... I was on my period and wearing the most unattractive period panties I own. LOL I know you girls out there totally understand my horror. (and if this part of my story makes you uncomfortable you should close your browser and delete this blog from your list because things get more real and graphic from here forward...maybe not in THIS post but in the posts to come).
So here I am..... last minute appointment that she is squeezing me into.... me in my period panties... no time to go home and change. Do I call and cancel? Or just press ahead and hope that the Dr. has a sense of humor? Humor prevailed! I decided I would just apologize for my panties and go anyway. I kept reassuring myself that if I choose him as my surgeon he would be seeing more of me than just my period panties.... besides, he's married right? He has a wife that probably has similar panties that he has seen. And he, being a Dr should know all about a women's cycle and know I can't make it stop, right....RIGHT?!?!?!
I get to the office door. It is a big wooden door. I could still change my mind, they haven't seen me yet. Oh... what to do? All I could do was hope that he was very clinical in which case he would never mention my horrid panties or stupid period or he would have a sense of humor and just laugh it off! Thankfully Humor prevailed AGAIN and I pushed open the heavy door.
Toni was there to greet me warmly and made me feel welcome. I signed in and then sat down, trying to wrap my head around sitting in this office about to embark on my first step in the skin removal surgery journey. I barely had time to feel centered and the wonderful nurse was there to call me back. The nurse (whose name I forget) was again so welcoming not only to me but to Harlan. She gave him a nice chair to it in. I gave him my phone to play on. She closes the door and asks what we are seeing me for. I take a deep breath and say "skin removal after Gastric Bypass surgery weight loss". She smiles and asks how much I have lost. I tell her 160 pounds. She grins from ear to ear and says how awesome that is! She then tells me that Dr will want me to get all the way undressed and put the big fluffy white robe on. White fluffy... did she say WHITE? Undressed ALL the way? I smile and say.... "ummm I'm on my period, heavy day.... I think it is best I leave my panties on". She says "Oh yes that makes sense". She points to the robe hanging on the back of the door and leaves.
I quickly grab the robe and undress down to my hideous period panties. I notice a full length mirror on the back of the door under where the robe was hanging. I stare at my hanging skin and my panties....They are cheap Walmart ones that celebrate St. Patrick's day. I have rainbows and Shamrocks and a pot of gold on my ass. Sigh. Why does it have to be Thanksgiving next week? I mean, at least if it were March or hell even springtime my panties would make more sense! I am still hoping for an unattractive very clinical serious Dr that will not mention said panties. I wrap the very nice fluffy white robe around myself and tie the belt just in time to hear a knock at the door. I tell them they can enter (nurse and Dr,) and I take a seat on the exam chair/table.
I look up and make eye contact with Dr. Buchanan. He is a nice looking Dr. with a nice smile and a trusting face. He is dressed in scrubs. He introduces himself and says "I'm sorry I'm in scrubs but I was in surgery this morning. I'm embarrassed because I usually like to meet new clients in a suit" Oh Holy Crap!!!! I have an opening given to me by fate itself. I respond "Oh Dr. I won't worry about your scrubs if you don't worry about my ugly period panties." he looks up at me again, gives me a genuine smile, laughs and says "Ok. Don't worry, we see everything in here, much worse than period panties" Relief washes over me! A nice Dr with a sense of humor and the ability to make people feel at ease! He is wracking up points in my book.
He asks me some questions about why I am there today. I tell him about 4 pregnancies with HUGE babies, and my major weight loss of 160 pounds following a successful Gastric Bypass Surgery. He smiles and tells me congratulations and commends me on how hard I have worked and how not everyone that has WLS succeeds at keeping the weight off. We talk more about my weight loss, how long I have been at my current weight etc.
We had a nice chat about my health, my battles with anemia, and he makes a polite attempt to talk to Harlan who is too engrossed in his phone playing to respond. So far so good. I ask him some questions about his experience and how long he has been doing these type of surgeries. Well, come to find out, he has personally been trained to do and has preformed 100s of gastric Bypass surgeries he has done 100s of skin removal after major weight loss surgeries.
It is important to note at this point that in Spokane, WA there is not very many Drs that will preform such surgeries for post WLS patients. Apparently doing these surgeries require more training and skill than the average tummy tuck due to the very large amounts of skin that gets removed. I am sure there are other reasons that I am not aware of, but my WLS Dr. V basically told me when she referred me to Dr. Buchanan that he was the only Dr she knew of locally that did these surgeries. Her own WLS surgeons in the Rockwood Weight Loss Surgery Center no longer did them. She did know of one other Dr in Idaho that did post WLS plastics and a handful of Drs in other cities like Seattle. So finding Dr. Buchanan in Spokane that not only understood my gastric bypass surgery, had preformed them himself, and had the training and experience to do post WLS plastic surgeries was as lucky as the shamrocks and pot of gold on my ass!
Next came the exam part. I had to stand up untie my belt take off my robe and let the first man other than my husband in 20 years see my full naked body in all it's saggy glory, I was waiting to see the same grimace of disgust on his face that was on mine. But no. He told me my skin looked pretty good for how much weight I have lost. He was completely professionally and courteous. He did his exam and then asked me if he could take some pictures to submit for insurance purposes. Big sigh. Great. Not only will Dr. Buchanan see my hideous period panties but now we are going to photo document them for his files and my Insurance company. Kill.Me.Now.
While he is taking his pictures I am totally sucking it in and not breathing. Typical girl..... camera comes out and suddenly my spine straightens, abs pull in and boobs get pushed up a little. That last part was extra hard because my bra with all it's gravity defying effects lay crumbled on the floor by Harlan's chair. Then Dr. Buchanan says.... "Ummmm these are for the insurance company to get your surgery approved. Don't suck it in. Let it all hang out." OH EM GEE. He's kidding right? Period panties.... no bra... saggy boobs.... and I can't even attempt to pull my abs in?!?!?!?! Give me strength! Then he says "Ok lets try the pictures again. let it hang." And so I did. And I turned to multiple angles and sides and even showed him my butt covered in shamrocks, rainbows and pot of gold! Oh and he had me lift my apron of skin to document the rashes under the flap. KMN.
Then I gladly wrapped my robe back around myself and sat back down. We discussed the 3 options I had for surgery.
Option 1: panniculectomy - Panniculus is a medical term describing a dense layer of fatty tissue growth, consisting of subcutaneous fat in the lower abdominal area.[1] It can be a result of obesity and can be mistaken for a tumor or hernia. Abdominal panniculus can be removed during abdominal panniculectomy, a type of abdominoplasty. A panniculus can also be the result of loose tissues after pregnancy or massive weight loss.
This option would only remove the layer of skin that hangs down. It is most often covered by medical insurance. the surgery would involve a low bikini line cut and removal of skin. It would not address my muscle separation, any liposuction, or re positioning of my Belly Button. Dr. Buchanan said that he almost never agrees to do only the Panniculectomy because patients are often not happy with the results and the other problems that need to be addressed are not. he said to prepare myself that this is probably all my Insurance company would cover and that the additional work that would need to be preformed would be out of my pocket expense.
Option 2: Full Abdominoplasty- (Click the link for some coll drawings of how it's done) In general, a complete (or full) abdominoplasty follows these steps: An incision is made from hip to hip just above the pubic area.Another incision is made to free the navel from the surrounding skin. The skin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures. Liposuction is often used to refine the transition zones of the abdominal sculpture. A dressing and sometimes a compression garment are applied and any excess fluid from the site is drained.
This option is what I want. It addresses the hanging skin, extra tissue, moves my belly button, tightens my ab wall etc. Dr. Buchanan said that most people are very happy with the results of this surgery and it is what he recommends for me to do. However, he highly doubts my insurance will cover it. But we can contact the hospital and get a price quote once we figure out what my Insurance will pay then we can calculate what my portion would be. the whole time I am thinking about an appeals process through my Insurance Company and how I will be the squeaky wheel because THIS is what they should cover.
Option 3 : The Fleur De Lis Tummy Tuck - For the most redundant abdominal skin, the Fleur De Lis Tummy Tuck incorporates removal of skin and fat from the lower abdomen, and tightening of the abdominal muscles. In addition, the Fleur De Lis Tummy Tuck allows for removal of excess skin from the center of the abdominal wall from the ribs to the pubic region. Basically in addition to all that is included in Option 2 you would also get a vertical incision so they would take skin from the sides as well.
Dr. Buchanan felt that this level was unnecessary for me since I did not have alot of skin hanging around above my belly button. He felt that Option 2 would be most beneficial since I was concerned about the vertical scar. Option 2 would have a lower bikini scar only. This option would include a vertical scar as well. And my shape right now is still hour glass-ish so I did not need this level. besides the fact that he doubted even more that my Insurance would cover it. But that didn't matter to me because I wanted option 2 and that was what I would get my insurance to cover.
He said he would get the paperwork sent into the Insurance company after he received the documents we had requested from my Primary Dr W., My WLS Dr. V, and his consultation report and request. I asked if there as any chance we could get it done before the end of the year. Dr. B said that he had slots available and he was sure the hospital would too, he just wasn't sure the money end/insurance would get figured out in time. But he would have his office staff get on it right away!
Challenge Accepted! I was going to get this done. This Year. :)
(here are some of my "before pictures" not in my period panties! )
If you don't want to see them.... close this window of your browser!
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I do not offer eye bleach and you can't "unsee" this!
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Still here? ok...... Consider yourself warned!!!!
Side view (box to cover identifying tattoo)
4 babies and losing 160+ pounds have not been easy on this body!
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