Surgical Drains, What Are They?

Even though my surgical drains have been out for over a month post-tummy tuck, I've been meaning to blog about them. Going into the surgery, I only had a vague idea about what the drains looked like or felt like.

When you take your first trip to the powder room post-surgery, you'll notice two tubes coming right out of your flesh in the upper pubic area. A woman I met who underwent a lower body lift mentioned that she had four drains after her surgery. Good Lord. Anyway, your 1/4" diameter tubes will be stitched in. Mine had about 18" of tubing that led to the drain, a large, clear soft plastic bulb (water balloon size). The bulbs have a valve at the top for emptying, and they will be safety-pinned to your binder. The safety pins prevent the heavy bulbs from pulling downward and yanking on your stitches.

With the tubes and bulbs, you will look like something out of Dr. Frankenstein's lab. Not surprisingly, the tubing hurts. After the first few days, when my painkiller started to wear off, it was the tubing sites that gave a nagging pain. Every time you move or shift, your body says, "Hey, there are a couple of holes that aren't supposed to be here and I don't like it!"

Draining the bulbs is easy, once you get over the initial shock of seeing bright red fluid in there. I emptied both bulbs into a plastic cup, and then dumped the contents in the toilet. When the bulbs are empty, you squeeze any air out of them and cap them off. This puts a little suction on the surgical site to help pull fluid out of you. The marks on the bulb read 100 mL, 75 mL, 50 mL, 25 mL. The first night, over 100 mL drained into the two bulbs. A week later, I was draining about 40 mL for a whole day.

At my one week appointment, the surgeon looked at my 'drain log', and said the fluid level was low enough that the drains could come out. Oh, Happy Day! She got her equipment ready, and I grabbed my husband's hand. The doc snipped the sutures holding in the tubes (OW), and then pulled out a good six inches of tubing from inside my body cavity (what a weird feeling). Then she did the second one. By all means, have someone's hand to hold during this procedure.

I was on top of the world after the drains came out. I kept saying that I couldn't believe it. The pain went down a whole bunch, and I was able to stop the pain medication the next day. The little holes leaked fluid for 24 hours. I was tempted to try a Depends, but I opted to stick a maxi pad horizontally at the top of my underwear. By the next morning, the leaking had stopped.

My surgeon recommended no shower until 24 hours after the drains were removed. I was scared to death, but I sure needed a shower. My hubby helped me get out of my clothes--it was the first time we had both seen my entire body after the surgery, and we were a little shocked. I feared passing out or falling. At the end of it though, I have to admit it was one of the five best showers of my life. Clean, and in fresh clothes, I plopped on that recliner and napped for hours. Ahh, you always remember your first shower.

All in all, the drains are awful but necessary. They do come out pretty soon. And it's absolutely glorious when they do.

Take care!

One Month After Surgery

It's been four weeks since the surgery. These days I can walk around the block three times, or do a quarter of a yoga class. I'm not in any pain. There is some tightness in my middle when I lie down on my back, and I can't yet lie down flat with legs straight. I still wear the binder all day, but I take it off for sleeping. My stamina is nowhere near where it used to be, but I can cook and serve dinner, and put the little ones to bed. My daughter thinks it's cool that she can climb onto a folding chair and hoist herself into the crib. Oddly, my two-year-old saw my scar in the bathroom, so my three-year-old insisted that he get to see it too. Now they routinely ask Mommy if they can see the owie. They now understand why they can't elbow Mommy in the tummy.

If I focus on what I can do, I feel pretty good about where I am in the recovery. I think I could work now, especially if I sat more than usual on the job. I still have a few more weeks off, and I'm really grateful for that. I'm still a bit hunched and swollen. I could potentially squeeze into my pants using Spanx and pliers. I think I'll stick with the stretchy pants for awhile.

Finally, here's the million dollar question: Was it worth it? I answer with a qualified yes. I'm glad my muscles were repaired. I'm glad that my skin fits now. But I'll be really happy when I can be something other than a couch potato for most of the day. Life goes on.

Good luck to you!

Tummy Tuck Pills

My plastic surgeon sent home an information packet when I scheduled my surgery. She recommended that I reduce vitamin E supplements (though the amount in a multivitamin is okay), and increase vitamin C and B complex. I started taking extra C in addition to the usual supplements I take. The surgeon was especially concerned about plant extracts and Chinese medicine supplements, because those can contain all kinds of unknown compounds.

Two weeks before the surgery, I picked up my prescriptions: Erythromycin for fighting infection, Darvocet for pain, Ambien for sleeping, and Phenergan for nausea. I also picked up a bottle of Dulcolax stool softener. When I got home from the surgery, I took an Erythromycin and a Darvocet right away. I was warned not to take the Phenergan on an empty stomach, so I waited to take that one. I tolerated all the pills well, except for the nausea drug. And I didn't take vitamins for a few days post-surgery, until I started eating again.

From what I understand, Darvocet is a relatively mild narcotic. The doc said that it's less potent than Vicodin, but it also has fewer side effects. I had some Vicodin left over from my c-section, so I felt like I had a backup plan in case the Darvocet wasn't strong enough. There were only a couple of times I wished I has something stronger than the Darvocet, but it wasn't bad enough for me to break into my bottle of Vicodin. For the first five days, I took a Darvocet every four hours around the clock. I worried that I wasn't able to let more time pass between doses, but I just felt like I needed it. By day 5, I was able to go an extra half hour or hour between doses, and around day 8, I was off the sauce entirely. The biggest impetus to get off the pills was that I wanted to drive. I'm amazed that my body was pretty much pain-free such a short time after major surgery. Way to go, bod!

I tried the Ambien a couple of nights before the surgery, and it seemed gentle and effective. I continued to take the sleeping pills for two weeks after surgery. They seemed to work best while I was taking the narcotics! At the two week mark, I hit a night where it took me three hours to fall asleep after taking an Ambien. I realized I would have to either up the dosage or give it up, so I gave it up that night. As it warned on the package insert, I had a fierce case of insomnia on the next night, but after that I slept more or less okay. I still woke up three or four times a night to roll over for awhile, but that eased as the days progressed.

I mentioned in a previous post that I had a horrible (and apparently rare) reaction to the nausea drug Phenergan--extreme vertigo. I wish I had taken a sample dose before the surgery so that the doc could have given me a different prescription. Thankfully, I only had a little nausea in my recovery.

Now let's talk about my pal, the stool softener. I started taking one per night on the second night. Things are rather sluggish in that department for the first few days. On the morning of day 4 post-surgery, the Dulcolax kicked in. It was a glorious moment, indeed! As the anesthesiologist told me, you can't start taking a stool softener too early. After a week, I felt like I could go without it. No pun intended.

Before surgery, ask you doctor if you can give some of your prescriptions a test run (not the antibiotics, but the others). After surgery, be sure to write down the times you take your meds. You'll be in the twilight zone for a few days, and it will comfort you to know when you can take your next dose. And give yourself at least a week before you start obsessing about addiction. Most people can take these drugs for a couple of weeks without a problem. But if you suspect a problem, talk to the doctor right away.

Happy Healing!

Lining Up Help

Your first few days after surgery, you're going to be completely dependent on others. Since you probably can't afford round-the-clock nursing staff, you'd better be really nice to your family and friends!

I have two adorable and needy children, and one wonderful husband. Luckily, my parents offered to fly across the country and help us for the first week post-surgery. My folks and my hubby took turns watching the kids or watching me. That was amazing, and it helped everyone keep their sanity. Let's just say that, at times, I was a teensy bit stressed.

Let me just tell you an anecdote from day 2. I was installed in my recliner, full of darvocet but none too comfortable. That was the day I felt panicky, probably from low blood sugar (but at the time I thought I was losing my marbles). My parents arrived for their 'shift', and I overheard my husband ask my folks if they would keep my two-year-old daughter at home with me while he took out my three-year-old son. My radar mommy-hearing was particularly acute that day. So I yelled for my husband to please take both kids. I needed peace and quiet more than anything else. He yelled back that he had agreed to watch three nephews at the same time, and he couldn't watch all five kids at once. Ultimately I pulled the surgery trump card, and he left with the kids. The house was quiet. I started to relax. My Mom came in and spoke softly to me until I drifted off to sleep, and I felt a whole lot better when I woke up.

Don't get me wrong, I love my kids fiercely. It ate me up that I couldn't run around and play with them. But I had to have peace, quiet, and special attention to heal at the beginning. We mommies find it particularly difficult to accept help. Whatever you do, make sure you line up a whole bunch of assistance. In a few weeks, you'll be giving those baths and dishing up those Cheerios again.

I have a big shout out for my Mom and Dad--I can't begin to thank you for everything you did for us. Thank you to my favorite Aunt and my Cousin for coming over. And hubby, you are amazing. Thank you for being so supportive. Thank you for holding my hand at the doctor's, and for being there in every way. Finally, extra thanks and kisses to my babies. Thank you for helping Mommy, for giving lots of hugs, and for understanding that Mommy has an 'owie'.

Compare & Contrast: The Lady in the Waiting Room

I had a little setback yesterday. It turns out that going to yoga class 3 weeks after surgery made my tummy unhappy. After feeling great Wednesday, I noticed a huge bulge above my belly button on Thursday afternoon. I spent all day drinking water and watching reality TV, and the swelling went down today. Whew!

I want to tell you about the eye-opening appointment I had 9 days post surgery. We had planned for my hubby to take the kids to the park all morning, then they'd all come with me to the doctor's office for my afternoon appointment. After lots of whining, delays, and unexpected dirty diapers, I decided to just drive myself. I was feeling pretty spiffy once I arrived and settled into the waiting room, and there I met another patient. She had the 'tummy tuck hunch' like I did, so we started comparing notes right away.

Maria had her surgery the day before I had mine. She had barely slept since the surgery because she didn't have a recliner. And her drains were still in, and hurting her like mad. Mine had been taken out 2 days before. Let me tell ya, the drains really suck. The tubes are about 1/4" diameter, and they come right out of your body. And your body is kind of annoyed that some plastic has been stitched in. The day they're removed is a glorious day indeed. It's also a day you might want to wear Depends--you leak out of those holes for hours.

I was feeling pretty advanced after talking with her, but it still cracks me up to think of how we looked. Here's what Maria was wearing: A matching warm-up suit, sneakers (with laces tied!), and a bra. She also had styled hair and makeup. Here's how I looked (I call it "Institutional Chic"): $5 WalMart sweats with mismatched tee-shirt, fuzzy purple slippers, unwashed hair, no makeup, and no bra (my DDs seemed just fine perched on top of the abdominal binder at the time).

I guess the bottom line is that your body knows how fast to heal, so don't obsess about what other people are doing. And your excellent doctor has seen the likes of you many times, and will tell you when things aren't going well. So let your body do its thing! Chances are that the chick who is bounding around two weeks after surgery is probably ten years younger than you are, and the lady who is far behind you in healing is also ten years older than you are. But you'll all get to the same destination.

Heal well!

No, Really, It Was a Hernia

OK, today is the day I officially come out of the closet. I've been telling everyone the truth, but not the whole truth. The truth is, I had a hernia and I got it fixed. The whole truth is that I went and had a tummy tuck. Yes, I had plastic surgery! I paid out-of-pocket! I'm so shallow!

Before I even had my second baby, I had a consultation with a general surgeon at Kaiser. He described the long vertical incision that I'd need to fix my umbilical hernia and diastasis recti (stomach muscle separation). So it came down to this--I could have the general surgeon do the surgery on my HMO's tab, but it would leave me with a vertical scar to go with the horizontal c-section scar, and it wouldn't fix the hanging fold-over tummy. Or I could fork over seven grand and have a plastic surgeon fix it all up and make it look aok. I went the latter route, but I still don't tell people. It's no wonder that I couldn't find anyone who admitted to having cosmetic surgery. For months, I'd been eye-balling likely ladies at Curves, but I just couldn't bring myself to ask, "Excuse me, but have you had work done? (wink, wink)"

If it makes me feel any better, I showed my wonderful Aunt Sylvia the 'problem area' last year. She told me that she's only seen that kind of stomach on women in their eighties. Then she sent an unsolicited check for $20 in the mail two days later for my 'surgery fund'.

So, plastic surgery! Time for it to come out of the closet. Gulp.

Three Weeks of Recovery

Yesterday I saw my plastic surgeon. She glanced at my scar, said it was fine, and told me to come back in another 3 weeks. She also okayed my sleeping without the binder, reminded me that the binder should be pulled down to cover the scar area, and said that I could start getting a little more exercise. "Like yoga?!" I asked excitedly. "Exactly." WooHoo!

When I hit week 2, I decided to start walking outside (instead of just shuffling inside). I was still pretty hunched over, but I put on my sneakers and looked down the block. I started in the direction that has a slight incline, then quickly changed my mind and went the shorter, flatter way. To the corner and back, and I was winded. Since then, I've about doubled the distance every day.

Well, last night I noticed my faaaaavorite yoga teacher's class was starting today. She is incredible and inspiring, and I've been going to her for 7 years (with time off to give birth a couple of times). Today alone, she was teaching 5 yoga classes. The woman is in her mid-seventies and in dynamite shape! I put myself in her beginners class, cinched on my binder, and off I went.

My best piece of advice on recovery is that you should focus on what you can do, not what you can't do. Though I spent half the class sitting in a chair, I was amazed at what my body can accomplish already. It was especially weird laying on my back. Even with knees bent, I felt like I had spandex on the inside! I know this tightness will ease, just as my hunchback is lessening every day. It felt amazing just to be able to do anything other than sit on the sofa. I've seen on other websites that some people go back to work just 2 weeks after surgery. Though my body is healing well, there's just no way I would have been able to do that.

Be sure to relax, let your body do it's thing, and breathe. Namaste.

Surgery Day

On surgery day, my Dad, husband, and I drove out to the medical suite while happily chatting. We met the anesthesiologist, I changed into a gown, and then we chatted some more. After what felt like hours, I started to get jumpy--I'm all for being polite to the medical personnel, but why the heck were we talking about Lord of the Rings when I just wanted to get the surgery over with? Turns out we were waiting for the surgeon. I went to cry in the bathroom for ten minutes, and came out to wait some more. I was terrified.

OK, the doc showed up, drew some lines on me, and took me to the surgery suite. Her prep materials assured me that the surgery suite was state-of-the-art despite being outside the hospital, and it looked high tech. Amazingly, the operating table was heated. Nice touch! Then I was out.

It was four hours later when I opened my eyes. I felt icky from the anesthesia and bound up in the middle, but there was no pain. After just an hour, they brought my husband in, sat me up, and shuttled my shaky body to a wheelchair. I was absolutely stunned that someone in my condition would be sent home. But there I was, being wheeled to the curb, asked to stand up (!), and strapped into the passenger side of our minivan. I was on the edge of nausea and my guts felt so tight! No one said a word all the way home.

Back in the house, I plopped in the recliner and kept a trash can nearby in case I hurled. I was so scared of throwing up because that could lengthen the recovery time. But they told me I had to eat at least four crackers before I could take the nausea meds (phenargen). I simply couldn't get one cracker down. Little did I know that delaying the phenargen was a blessing in disguise. I kept sipping water and eating ice chips, and I had to pee every hour. Oy, every hour my husband helped me go. We emptied my drains. Eww. I took the Darvocet and Ambien, and actually slept a little in the recliner. I'll post more on the meds and drains soon.

On day two, I started juice, jello, and soup. It still mostly hurt when I got up to walk (now every two hours). I became jumpy and anxious, I think because my blood sugar was pretty low. When I began to eat regular meals, the jittery feelings passed. I felt well enough to have my son and daughter come in to hold my hand, but mostly I wanted to stare out the window or sleep. I believe this was the point everyone goes through where you say, "Why, oh why did I do this to myself?" My hubby kept asking me if I wanted to move the recliner into the living room. No way! When I was that far out of it, I just needed the quiet. Note, on day 2, I started taking a Dulcolax stool softener before bed. Don't fear the stool softener! It gives you a gentle boost, and you're going to need it.

By day three, I noticed that my guts didn't hurt quite so much. It was the external incision that would start to feel sore as I approached the four-hours-past the last pain pill. But day 3 was actually my worst day. I felt a little nauseous, and popped my first phenargen. Within 10 minutes, the room was spinning violently. It just so happens that my body can't take that particular medication. I slept all day until I got that stuff out of my system. I'm so glad I didn't take it on day one! Please don't avoid taking nausea meds if your doctor prescribes them, but get your prescriptions a week ahead of time, and try each pill on a separate evening. You will be so glad you did, and you'll have time to get a different prescription if you have a bad reaction. By the way, on my horrible day 3, my in-laws decided to pop in and visit me. My father-in-law made jokes, my mother-in-law asked repeatedly if I needed anything, and I sat in the recliner wanting to die. They filed out of the bedroom pretty quickly!

In short, the first three days weren't pretty. But things progress quickly after that. By 9 days post-surgery, I was off the pain meds and driving myself. By 2 weeks, I was off all medicine. When it's your turn, just remember that the first few yucky days will pass and everything will work the way it used to.

Choosing a Plastic Surgeon for your Tummy Tuck

When I got serious about finding a plastic surgeon, I first surfed the web for reviews. I didn't find any! My next task was to find local doctors. It turns out that plastic surgery offices spring up around major hospitals. Okay, I don't have movie star income, so I chose a hospital near me in a city that wasn't too pricey. I wasn't looking for bargain-basement surgery, but I'm not ready to take a second mortgage on the house.

Through more surfing, I found two plastic surgery offices in my target area. I made appointments at both. The first office was owned by one doctor. She's been in the business for years, and got her MD at Stanford. Did I mention Stanford? I visited the office with a list of questions, and she knocked them all out of the park. The office looked tidy, the staff looked happy, and there were plenty of clients coming in and out of the waiting room. Okay, so far, so good.

My second visit was an office that had three surgeons sharing. One of the surgeons is over 70, and the other two are quite young. When I called to make my appointment, it seemed as though 90% of the available slots were for the older surgeon. I booked with one of the younger ones. While I was in the waiting room, a patient was looking distressed at the front desk. Apparently she thought her appointment was with a younger surgeon, but it had been made for her with the older gentleman.

I was shown to the examination room, and in walks the man my mother wished I had married. The man that every mother wishes her daughter married. He was young, gorgeous, and funny. This is the doctor that you put on full makeup for before an appointment. Alright, Amy, get a grip! He seemed like a great contender until I asked one final question. I asked him how many tummy tucks he'd done before. He'd been working there a year-and-a-half (!), and he'd done 12 tucks. Game over, Dr. Handsome.

I went with the first doctor (Stanford! I sound like such a snob!). Except for a couple of times before the surgery when the office didn't answer my questions (when they realized their mistake, they deluged me with correspondence), I've been super happy with my choice. Here's what I learned:

• Like Aunt Sylvia says, you have to ask how many times they've performed the procedure. That one question made all the difference to me.
• Look for a decent website with plenty of before-and-after photos. Pray that the photos are of their actual clients.
  
• Look for impressive credentials. They can't hurt!
• Ask for an appointment around the same time that previous patients are coming in for a check-up. Ideally, you want to talk to the clients that are about a month out. For heavens sake, don't talk to the ones who had their surgery two days ago. It will scare the hell out of you.
• I choose competence and skill over hand-holding. Yes, I'd like my surgeon to be more mothering during our appointments. That's just not her. But I make sure to write my questions down, and follow every last piece of advice. And she is so so good at what she does.
• Ask about the timing of appointments post-op. So far, I've had appointments at surgery plus 2 days, 7 days, 9 days, and 3 weeks. I feel extraordinarily well taken care of. From some other websites, it seems like the doctors don't have patients come in quite so often. More is better!

Good luck!

Top Tummy Tuck Tips

Hello out there! I'm a wife and working mom of two (ages two and three). I blew out my abs with the first pregnancy and c-section, and the second pregnancy didn't help things much down there. I was left with a diastasis recti and umbilical hernia, such that I have never been able to hold my daughter, while standing, for more than two minutes. I've also been going to the same wonderful yoga teacher for the last seven years, and lately I've had to sit out all the abdominal moves and twists. My middle was just mush--I practically had to tuck my stomach into my jeans. Well, I decided to fix my tummy before my daughter gets too old to be carried.

It's been two-and-a-half weeks since my tummy tuck. I got so much great information from other bloggers about their abdominoplasties (my favorite was Erica's Abdominoplasty Blog), so I thought I'd step up and hopefully help someone else out there. Also, I have another five weeks of vacation in my empty house! I'm going to start with a few of my favorite tips, and cover more topics in more detail as the days roll by.

• Get a recliner. Thank you Erica, for writing about your 'recliner nest'. We bought a used leather (reduces the ick factor) LazyBoy from Craig's List the day before the surgery. Thank God! In a recliner, you can sit up a bit more if you feel queasy, or lay down a bit more to sleep. You can't do that with a bed full of pillows and a husband trying to sleep next to you. I'm not a back-sleeper and I normally can't fall asleep in a recliner. But add some narcotics and sleeping pills and I slept soundly from one potty break to the next. Now that I'm off the pills, the recliner makes a nice napping place when I'm tired of scrunching my incision as I sleep on my side. By the way, I met a woman in the waiting room who had her surgery the day before I had mine. She said that she could barely sleep, and sure enough, she had no recliner.
  

• Wear a tank top. My doc recommended that I wear a tank top under the abdominal binder. What a great tip (and I've never seen it online anywhere else). You won't be peeking under the binder for the first few days (for fear that your guts will fall out). Once you have your drains removed and start taking showers, the tank top will help you feel fresh and clean every time you change, and you won't have as much chafing.

• Cinch the binder at an angle. I can't believe it took me two weeks to figure this out, but the binder is much more comfortable if you make it a little smaller on the top and larger on the bottom (cone-shaped). This way, it doesn't move around and bunch up as much.
  

• Don't get the surgery over the summer if you can avoid it. I read this piece of advice, and like other people who teach, I thought it was silly to avoid summer. Now that I've had the surgery, I can see why. If you got itchy and sweaty under your binder (which you have to wear for two months), you would be a basket case. If you can crank up the AC and stay indoors, you might be okay.
  

• Give yourself a break. I cried so much the first few weeks. And I'm no wuss--I've traveled around the world alone, earned a Ph.D. in chemistry, had a c-section and a vaginal birth...but this experience knocked me flat. I'm so used to being the one who makes this house run. It was hard to ask for everything, and to have my little one want me to run with her. Now it's hard to walk with a hunchback and get those pitying looks. It sucks, it's hard, but it's going to be okay in a very short time. It's my surgery and I'll cry if I want to! You should cry too, if it happens to you.

Those are my first few tips! Cheers!