Processing the decision

After I left Spokane Plastic Surgery's office I sat in my car for a minute to process the series of blessings that had just been given to me.  Amazing Health Care Insurance through my husband's hard work at a job he loves.  The right stars aligned to get me to Dr. Buchanan.  Remember I had tried to get a referral back in August, before my WLS Dr. V had even met Dr. Buchanan.  She was going to send me to the Dr in Idaho.  By having to wait for the referral until November it allowed these two drs to meet and build a relationship.  And then the right people work at SPS.  Alicia and Toni and Pauline went to bat for me with my Insurance company.   Dr. B was willing to try to get the surgery scheduled before the end of the year.  He motivated his awesome staff who obviously respect and admire him and worked hard to get it all to happen!  I have worked really hard to keep up on my supplements and iron and take care of myself in order to be healthy enough for surgery.  How many missteps could have happened?!?!?  Even 1 piece of the puzzle out of place could have ruined the whole thing.  All of it is such an overwhelming blessing I had to take a moment and feel it.  Tears were shed.

Then I activated my phone tree!  LOL I called my husband who was in total shock.   I got my sisters (by choice not blood) motivated and informed.  We made a plan of who was going with me, who was staying with my kids.  I called my Mom and my Aunt Kathy to give them all the news. Surgery was a go!!!!

WOW!!!  It is really gonna happen!!!

More planning.... Amber is gonna take my kids to and from school the week after next.  Tim let his boss know he really was gonna be gone for a week.  I stocked up our fridge and pantry.  I made menus for Tim.  I tried to make chore lists for the kids but in the end figured I would be too drugged to care and once  I did care I could tell them what I wanted done.

I packed a bag and gathered all my paperwork I needed to take with me to the hospital.  I posted my news on facebook.  Here is what it said:

I have debated putting this on FB. Part of me wants to keep it a secret. But the bigger part of me wants to share my journey. Wanting to keep it a secret is linked to shame. But I realize that I have nothing to be ashamed of! I started at 340pounds. I had gastric bypass surgery. I worked my ass off and lost 165pounds. And that my friends leaves a bunch of extra skin and complications that come with it. So I consulted a surgeon. We submitted to my insurance company. The Insurance company approved an abdominoplasty (removal of extra skin on tummy, tightening of muscles, and some contouring) on Christmas Eve! My surgeon pulled some strings and got it scheduled for the 30th. Tomorrow morning I am taking the next step in my journey to health! My hubby will be updating this thread tomorrow as I go under the knife! Wish me luck! Much love to all of my fb family and friends!!!

The responses I received from my family and friends was OVERWHELMING!!!!   So much love and encouragement.  Over 100 people liked and commented on my status.  The whole thread was full of love.  Just pure love and well wishes.  One person's comment that really stands out is my Cousin in law Steve Bell that told me:

You are answering a prayer, that I said for you when you told me you were having the [weight loss] surgery!  Thank you for not being ashamed, you brought a smile to my face.

I love you Steve.  Not only because you loved me through my weight loss journey but also because you loved and respected me before it.  You accepted me into your family with open arms and most importantly an open heart.  And the fact that you prayed for me and my health when I was starting my journey means so much to me.  And you ALWAYS bring a smile to my face.

There is just so much love in that comment thread that I can't even take it all in at once.  I go back and process more and more of it every time I read it.  I feel loved BEYOND MEASURE!

So the night before my surgery, when I was expecting anxiety and sleeplessness,  I feel asleep feeling the love and prayers of all those loved ones surrounding me.  <3

A picture of Steve and I and his lovely wife Ladeena

Clear Liquids & Test Results Day

As most everyone know the day before a surgery you usually have to only have clear liquids.  Especially if it is an abdominal surgery.  So the 29th the day of my sons actual 12th birthday turns out to be clear liquids day for me.  My kids get to choose what they eat on their birthday.  He wants pancakes, eggs and bacon for breakfast.  My mouth was already watering for some eggs and bacon when he requested it the day before.  I tried to talk him out of it and say do just pancakes (which I never eat anyway).  Nope.  He wants the whole spread.  It as torture of me, but I did it!  He got his favorite breakfast and  I drank herbal tea.

Yes that's right.  I was still feeling dehydrated from bowel prep day so I figured I should avoid caffeinated beverages since they tend to dehydrate you.  So no coffee for me either.  Kill.Me.Now!  And wish my children luck to get through this day alive.

I drank tea and apple juice and ate jello.  I tried several kinds of flavored broths.  All of which were vile and horrible. I made myself some lemonade (powdered as no pulp allowed) and drank Sobee free water.  I tried to lay low and stay away from the children because I had a caffeine withdrawal and hunger headache.  Oh My... I was a bear to be around!

But today is the day I get the blood test results.  My appointment was at 1:30pm.  I was so nervous.  And tired and hungry and dealing with some residual bowel prep day issues.  LOL

I check into Spokane Plastic Surgery Office.  Toni and the rest of the staff greet me warmly!  I am starting to get excited.  Everyone seems happy and that things are going well.  Maybe my surgery will be a go!  I sit down and hold my breath.  I stare at my phone wishing that I would have brought someone with me to hold my hand.   Very soon after that the nurse calls me back.  It's Pauline.  She is my Angel.  And she's smiling too.  My heart skips a beat.

She takes me back into the room and tells me to undress all the way and put on the white fluffy robe.  This time I smile and say Ok.  No period to contend with and I took extra time in the shower to trim the hedges and shave my legs.  This time I am photo ready! I quickly get undressed put the robe on and sit on the exam chair and wait.  It seems to take longer this time for them to come back in.  I remember staring at the poster on the wall but I could not tell you right now what the poster actually depicts.  But at that moment it was all I could stare at.  And all I could think about.

Knock knock.  I say to come in and Pauline my angel face nurse and Dr. Buchanan enter.  They are smiling and start asking me how my bowel prep went.  I know I made a few jokes about it, but I can't remember what I said.  I told them I was starving and had a headache from clear liquids day.  All I could focus on was the file in his hands.  It holds my blood test results.  Dr. B sits down and opens the file.  I ask as nonchalantly as possible, "so how does my blood work look?"  In my head it felt nonchalant, however I probably wasn't masking my true fear very well.  I could tell by how quickly Dr. B. looked at me and then back at the file and answered, "they look fine.  You're a little anemic but most post WLS patients are.  It isn't anything to worry about as long as you are taking your supplements.  You are taking your vitamins and iron, right?"  I answer, "yes I am."  And then I try again to be nonchalant and ask "So surgery is a go?"  Dr. B looks up, gives me a warm smile and says "Of course".  I look at Pauline and she is smiling too and nodding in agreement.  A wave of relief and fear and shock rolls over me.  I start to tear up a little bit.  I told them that I didn't let myself believe it was really gonna happen until I got the blood test results back.  I told them in short choppy sentences that probably only made sense to me about unmade freezer meals, and unplanned recovery time, and fear of being disappointed.  I told them how they were making my dreams of being beautiful and healthy and fixing my body images all come true.  I'm not sure that they understood the gravity of what I was saying or how deeply I was feeling my emotions in that moment.  But they nodded along and smiled and reassured me that all was well.  Surgery was gonna happen. Tomorrow.

Dr. B wanted more pictures.  Hopefully he will burn the period panties pictures from our first encounter and replace them with the lovely clean shaven version! We discussed some specific questions I had about my scar, went over recovery instructions and some other stuff that seems unimportant right now.  They gave me some very simple instructions on what to wear (loose fitting comfy clothes), to shower but not wear perfumes or lotions, to leave jewelry at home.  They told me where to check in and at what time.  9:30 am.   And before I could even think twice I was headed back out the office door to my car.

Bowel Prep Day

Even though I didn't know for sure what my test results were gonna be I was required to do the bowel prep just in case the surgery was a go.  Bowel prep was required because while he was doing my tummy tuck, if Dr. Buchanan saw any existing hernias he would repair them at same time. So my bowel had to be clear in order to do any potential repairs.

Pauline, the lovely nurse from Spokane Plastic Surgery had given me the bowel prep sheet.  2 days prior to surgery take a "gentle" laxative such as Women's Correctol.  Pauline says to buy the small box, as I will only need 1 dose.

I think.... well it can't be too bad.  Since I take iron every day I also take Benefiber to keep things moving.  I wasn't afraid.  I'm actually more afraid of not being able to go.  That has happened to me.  That is horrible.  So the day before when I saw the little pink box of Women's Correctol Laxitives I thought.... this is not a big deal at all.   I threw it into my cart and moved on.

The next day I get up and make my coffee.  Routine kicks in at that hour of the morning.  On autopilot I add 2 scoops of Benefiber to my coffee along with my creamer and Protein powder.  I shake it up and start drinking it.  It is delightful.  I stare out the back door wrapped up all cozy in my robe, at the cold ground covered in frost.  I take big gulps of my coffee. I watch the dog sniff around the back yard and then quickly beg to come back in,  My cup is soon empty and I pour my next cup.  Creamer only this time.  My morning routine in tact I sit down at my computer to check on my Facebook Peeps.  Then I see the Bowel Prep sheet taped to the computer cabinet door.  Oh shit.  I mean, literally, I think of  all the shit!  Bowel prep day is TODAY!?!?!?!

What to do?  I can't skip the bowel prep, can I?  I mean if I do I may get my surgery canceled.  And if I lie about not doing it and I have a hernia....oh my.  Well I guess I have no choice.    But maybe I will wait a few hours to take the laxative.  Its all good.  I have all day.

I finally decide I should just do it.  It's my Sons birthday party day and I would really like to get this over with before we fill my house up with 3 extra people when we only have 1 bathroom.  That's right....11 people... 1 bathroom.  Awesome.  I am already feeling sorry for everyone in the house!  Thankfully some of them are leaving for a few hours to play Laserquest.

I look at the Women's Correctol dosing instructions.  It says take 1 to 3 pills.  1 to 3?  Well which is it 1 or 3?  Is 2 an option?  Well if I am gonna do something, anything.... I am going do it 100%.  I pop 3 little pills into my mouth, wash them down with a big gulp of water and wish myself luck,

I am sure you can all imagine what happened next!  Lots of candles were lit (and not for my sons's B-day cake).  Lots of toilet paper was used.  Lots of cramping and swearing and oh my, lots of shit!  I swear I pooped out a piece of gum that I accidentally swallowed in the 3rd grade!

But as fate would have it the worst of the episodes happened while the boys were gone to Laserquest! :)

More waiting and obsessing

Over the summer I went into my Drs office for a routine check up that included blood work.  At that appointment they discovered I was severely anemic and would need 2 blood transfusions.  I have since that day been very scared of getting bad blood test results.

When the nurse handed me my lab slip I was terrified that if my blood work came back low/bad that my surgery would be canceled.  I was obsessed.  I looked over my copies of the good blood test results from  November.  How bad could they be in less than 6 weeks?  I had been taking my supplements almost perfectly. Except for that one day that I left them on the counter.  Was that 1 day of forgetfulness going to sabotage my surgery?  Oh My how I stressed and obsessed.

I refused to even plan for my surgery with the exception of my 2 best friends and my husband. We figured that between the 3 of them they could cover the day of surgery (2 with me, 1 with kids) and that Tim would take a week off of work to take care of me.  He submitted his time through FMLA, but told his boss it might get canceled if my blood work came back low.  His time off was approved, and his boss was fine if he had to cancel it.  All was ready.... well at least the kids were covered.

Friends tried to make plans with me for the week of the 30th and I made lame excuses.  It wasn't that I cared if they knew I was having an abdominoplasty it was the fear of it getting canceled and me having to live that disappointment with an audience. I told my Mom and my kids. And I did tell 2 other close friends.  But swore them to secrecy. And I explained that the surgery could still get canceled if my blood work was low/bad.  My friend Amber told me I should be making freezer meals and planning for a long recovery.  She even said she would help me.  I couldn't commit to doing it.  How could I face a freezer full of meals if the surgery got cancelled?

So instead I took down Christmas decorations and planned Kaleb's 12th Birthday party.  A sleep over with 3 friends and Lazerquest with Dad.  A fun chocolate cake to bake and decorate.  Pizza, presents, Fun.

Tim, Kaleb & Jen

The whole crew!!!!

My Birthday Boy!

But inside... I was obsessed with blood tests that I had no control over.  :(

The Call

Christmas Eve morning,  I'm laying in bed snuggling with my Harlan my 5 year old.  I can hear my other 3 kids eating breakfast and watching TV.  It was supposed to be a restful morning as my Mom and my niece and nephew were coming that afternoon to spend the holidays with us.  I had a few things still to do to prepare for our Christmas feast and some presents to wrap.  I was not even thinking about surgery.   My phone rings on the night stand next to me.  I look at the number.  It's a call from Spokane Plastic Surgery.  My heart skips a beat.  I take a deep breath and answer.  It's an angel nurse named  Pauline.  She asked me if I still wanted to have my surgery this year?  YES of COURSE I DO!!!!  Apparently I am the first patient SPS has had that received  Insurance approval for the whole tummy tuck procedure.  My insurance company had agreed to pay for the skin removal, muscle wall tightening, belly button re positioning, and liposuction on my hips and buttocks area to help contour the fat under the scar.

Wow!

Holy SHIT!!!  No Fucking Way!  (oops sorry for my potty mouth, Pauline).

What happens next?

Pauline, the angel face Nurse, goes on to tell me I need to come in for blood work and bowel prep instructions.  And Alicia lets me know I have to pay a deposit by 11 am to secure my surgery date which was December 30th.

DECEMBER 30, 2014!!!!!!!!!!!!!!!!!!!!!!!!

This Year!!!!!!!!!!!!!!!!!!!!

Pauline explained that once Dr. Buchanan had received the news from his office staff that my surgery (the whole thing) was approved he had asked Pauline to pull some strings with the hospital scheduler to get it done this year.  So while I was completely unaware of my approval, and Dr. Buchanan was sitting on a beach in Hawaii (it's true, he was), this spunky sweet little angel of a nurse, Pauline worked really hard to get my surgery scheduled before the end of the year.  Bless her perfect little heart,  I am just overwhelmed with gratitude to her!

So I jump out of bed, grab my credit card, scream at my kid to get dressed and put their shoes on, throw on my Mom uniform (jeans, T-shirt, baseball cap,  black dansko clogs, Oberlin Sweatshirt).  We leave the house in less than 15 minutes.  We arrive at the SPS office just in the nick of time.  10:45am.  I pay the deposit.  Pauline goes over the Bowel Prep instructions.  She hands me the lab test slip.  There is alot of blood work required.  She makes me an appointment for the following Monday to see Dr. Buchanan and to go over my test results and do the final prep appointment before surgery.  She tells me where to go to get my blood drawn and I head that direction.

I'm still basically in shock.  Could this really be happening?

I get to the lab and due to a guy passing out in front of us there is a VERY long wait.  With 4 kids,  The day before Christmas. And the youngest tells me he didn't eat breakfast even though it got made for him.  Oh no, please have mercy on us!!  The hospital receptionist tells me I could try another location an offers to call the one up the street.  It's 12:01.  All other locations except the one we are at close at Noon on Christmas Eve.  We are stuck.  We have to wait it out!  So after a 2 hour wait and chasing my son around the potted plants in the waiting room, trying to stop him from picking the leaves off or throwing the decorative moss around, they finally draw my blood and we are on our way home.

Christmas is tomorrow.  But I know my anticipation will not end until the 29th when I see the Dr and he gives me my blood results.

The waiting

Anyone that knows me knows that I hate waiting.  I have little to no patience.  And it is only exacerbated when I have no control over the situation.  So waiting for office staff and my Insurance company to get the paper submitted and make a decision was so HARD for me!  The office staff at Spokane Plastic Surgery did a great job getting the information submitted.  However my insurance company did not necessarily do a good job receiving the information or being consistent on what they wanted submitted to consider the surgery.  This made me crazy.  I would call the Insurance Company to be told that my Drs. office did not send pictures or start a file properly.  And then hear from SPS office staff that the Insurance company did not request pictures or start a file for them properly.  All I can say is that Alicia at SPS is a saint!  She worked so hard to make sure the Insurance company had what they needed and in a timely fashion.  She dealt with my weekly sometimes daily (ok 3 times daily) phone calls for updates with complete courtesy and professionalism as did Toni!  Even when I was losing patience with them and maybe not being my sweetest self  (I'm sorry Alicia and Toni).

Additionally Toni and Alicia gave me clear ad reasonable expectations that it usually takes 30 BUSINESS day so about 45 calendar days to get an answer from an Insurance company.  They tried to gently set me up to not freak if we still were waiting in January.  Oh man did they try.  But I REFUSED to accept that answer.

I knew that with my original Gastric Bypass Surgery approval that the squeaky wheel gets oiled with my Insurance company.  I called for updates, spoke to the nurse that actually makes the decision and made sure she had all the documents that were required for my WLS.  I  believe it was because of my diligence that I received approval for gastric Bypass Surgery in such a short amount of time.  The difference there was that I had tests that had to be preformed and sent back to them before they would approve it.  But once they had all tests and all the information my approval was made within days, not weeks.

I approached my Abdominoplasty with the same attitude.  If you speak nicely, follow up with the decision makers and make sure they have everything they need then the process will move more quickly. Additionally, in making my follow up calls I got to actually speak to the Nurse Manager that makes the decision on my surgery.  I got to plead my case to her and explain all my health issues related to the extra skin.

I don't want to share too much, mostly because it is embarrassing and most people don't really care.  However if you are reading this blog to find a way to get your surgery covered by your insurance company it may be helpful to hear how I got mine approved.  The primary issue was the extra skin kept getting infected.  No matter how clean and dry I kept my skin I had recurrent nasty itchy skin infections under the apron of skin and in my belly button. I had gone to both my primary Dr. W and my WLS Dr. V over the past 2 years and been treated for these infections.  I refilled prescriptions multiple times over the years.  In the summertime was the worse.   This is what all of my Drs sighted for my primary complaints in their letters of support to the Insurance company.

What I also got to tell the nurse at the insurance company was that I suspected I had a separation of my abdominal muscle which makes me at higher risk for a hernia.  This separation happens from being morbidly obese as well as carrying 4 babies to full term.  And my babies where big squishy 9 pounders.  :)  Also you can get hernias or increase your risk of them developing anytime you have abdominal surgery, of which I have had my bypass but also in 2004 I had my gall bladder removed. By pulling that muscle separation back together, it could help prevent hernias.   I also got to tell her how the extra skin was effecting my ability to exercise.  I told her stories of how I had to strap the skin down to run, or do any cardio with spanx or other binders.  And lastly I bared my soul to her and told her the extra skin was negatively effecting my marriage.  I felt unattractive due to my extra hanging skin and it was effecting my sex life and thus my marriage.  (Please note:  these were MY hang ups.  Tim never once complained or probably even noticed the extra skin.).

The nurse told me she had everything she needed to review the surgery and she would be making her decision soon but gave me the standard "it can take 30 days to make a decision".

Again with the waiting.  By this time we were past the middle of December.  I actually told my husband that despite all my efforts it would probably not happen before the end of year (and thus in time for us to use our already paid deductible since my transfusions over the summer were so expensive).  I was doubtful we as a family could come up with the deductible plus our co-insurance for this surgery until the end of 2015 if we couldn't take advantage of what we had already paid in 2014.  So even if I got approval after January 1st I could not have the surgery for another year.  I was sad.  But with my 15 year wedding anniversary on the 18th of December, Christmas fast approaching and my oldest sons 12th birthday coming up on the 29th I just put my disappointment aside and focused on my family and the holidays.

My Consultation

As soon as I got the go ahead from my WLS Dr.V that I was cleared to look into skin removal surgery I did!!!!  I immediately called Spokane Plastic Surgeon's office and requested a consult with Dr. Dallas Buchanan.  As luck would have it after playing phone tag a few times with the awesome receptionist Toni, they had a cancellation and got me in the following week.  I don't remember the actual date but it was the week before thanksgiving.

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! )

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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)

Front view:

4 babies and losing 160+ pounds have not been easy on this body!