Monday, September 12, 2016

Cut and Sewn


On August 22nd, nearly 7 years after my gastric bypass surgery, I had my first cosmetic surgery. I had  an abdominoplasty, also known as a tummy tuck. In talking/writing about it I don't like referring to it as a tummy tuck, because I'm afraid it makes it sound like I did this for vanity, which I did not. The thing is, 6 years ago, in the very beginning of my new life as an averaged sized person, the skin didn't bother me. After I had maintained my nearly 140 pound weight loss for a few months I saw where my abdominal skin sat and though "ok, I can live with this". Weight loss surgery (WLS) patients are recommended to undergo cosmetic procedures after maintaining a healthy weight range for 6 months to a year. That time period came and went for me and I decided not to pursue cosmetics. At the time, the extra skin wasn't very bothersome, and the thought of cosmetic surgery terrified me. Yes, I was scared to do it. It looked painful, and I was scared of the sedentary lifestyle that is needed for recovery.

Fast forward 6 years, my life has been the opposite of sedentary. in the span of 6 years I finished 3 ironmans and 7 half ironmans, plus more smaller triathlons and running races than I can count. I am 35 credits away from my bachelor's degree. I have been go go go for the past 6 years. In February I went to see my new primary care doctor for my yearly checkup and labs pertaining to my gastric bypass surgery. When it came time for the routine check for hernias, she asked right away why I hadn't had the excess abdominal skin removed yet, because there was so much of it. I was honest with her and told her I couldn't afford it. She held up the large flap of skin and told me a surgeon at the army hospital could do it and asked me if I had lower back pain. I told her yes, it just recently started developing and I didn't know why, but I assumed it was from riding my bicycle. After 6 years I had recently noticed my abdominal skin had started protruding instead of hanging. The now protruding, heavy skin made sense as the cause of my lower back pain. I knew it was time. The skin made it look like I had a gut, it stuck out more than my chest, and I was putting biofreeze on my lower back twice daily because of the pain. I couldn't hide behind the fear anymore. I had to go through with this.

A week before surgery, abdominal skin protrudes after losing 140 pounds and keeping it off for 6 years

When I was finished racing for the year I went to see the surgeon at the army hospital. She insisted I go to a plastic surgeon and assured me everything would be approved by my insurance as this looked more reconstructive than cosmetic. Sure enough, after I met with the plastic surgeon for the first time, my insurance approved the procedure quickly, and 10 days later I had a surgery date.

Originally I wasn't going to share much about this. I learned there are huge misconceptions out there about this procedure, and many still believe that diet and exercise will tighten skin. As a former personal trainer who can tell you that there is no such thing as toning, many still believe that toning exists, when it doesn't. You can only build and strengthen what is under the skin, building a larger muscle will cause it to press up against the skin, but the skin itself does not tighten. I knew this before WLS. In the days leading up to my surgery I watched YouTube videos of the procedure because I wanted to know what was being done to me. The comments section floored me by the sheer number of people who commented "why go through all this, just diet and exercise" or "if they would have just done some sit-ups" and similar comments.

As a WLSer who waited 6 years to have the first cosmetic procedure done, and has held a strict exercise/training regiment for 6+ years, I felt I owed it to the WLS community to share my story. I could not find any WLSers who have waited as long as I have, nor could I find any who had been as terrified as I had been.

I have quite a few WLSers who follow me on Instagram. Last week I posted my 2 week post op picture, along with a before picture. Even though the post surgery pic is fairly rough, as I still have a drain in my hip because of a draining hematoma, and as my kids say my incision line looks like I was sawed in half, I found it harder to reveal the pre surgery pic. Up until I posted that pic, I can count on one hand the people who I have allowed to see my extra skin in all its glory. For some reason it has always been a source of shame, and I'm not sure why. I was 300 pounds, the skin stretched, I lost 140, the skin stayed. Such a simple anatomical concept but one that brought me shame and embarrassment. I can admit that the protruding skin brought down my self esteem. I sit at 20% bodyfat with a resting heart rate of 65, yet I looked like I had a big gut and I had to buy pants a size larger in order to tuck in my extra skin. 

With all that being said I'm talking (well writing) about it now, in hopes that it will help others. There are so many "before and afters" out there that make this seem so wonderful, but the recovery has been pure hell. Today I am 3 weeks post op, and I am so sore and tired. I have been dealing with draining a large hematoma since day 3 post op, and because of it I still have a drain coming out of my right hip, which has been the bain of my currant existence. The swelling is unreal, hitting its peak in the evenings. I have to wear an abdominal binder 24/7. I have a high pain tolerance, and I'm trying to be a "tough girl" and not complain at all since I chose to do this, but it hurts, it just plain hurts. Hematomas are not common when "regular" people get tummy tucks, but they are a common complication in massive weight loss people. Through all this I still realize how fortunate I am, I got a tummy tuck from a board certified plastic surgeon and didn't pay a dime. I am grateful

Not a long of training and racing will be going on in the next few months, so I'll keep progress updates here. Its been years since I have written anything WLS related, and I consider this to fall into that category. Through the pain I have to keep faith that the hematoma will resolve, I will recover, and this will all be worth it, I just have to be patient.

The Instagram pic, revealing to the world the reality of what it looks like to lose 140 pounds. The right is 16 days post op