Merry Christmas... Let the countdown begin!

MERRY CHRISTMAS!

Spent some of this week jotting down the items I'll need to haul down to Monterrey with me.  It's basically a modification of the list posted on the Dr. S group over at ObesityHelp.com - modified for a man.  :)  The list was extremely helpful BUT some items just don't apply to me. 

I can't say I'm nervous yet but I'm feeling a little anxious.  It's in the back of mind now.  I never had surgery before and the unknown is always a bit scary.  I wonder if I'll start having butterflies as the time gets closer.  I'll focus on getting ready for the trip and preparing as best I can.

Part of the prep has been keeping at my exercise routine, hard!  On the days that I work, I'm at the gym by 6am for my cardio routine and then 3 days a week I'm back at lunch for some heavy weight training.  I'm doing the Stronglifts 5x5 program which focuses on full body workouts.  Squats are at the core and I've increased mine up to 215 pounds.  I want my legs to be strong and this program is good for that.  I should be squating 225 before the surgery.  That's my goal at least.

Mark

I don't need no stinking badges... but I do need a passport.

If you're getting a passport for the first time pay close attention to the rules.

1) Get the form - http://travel.state.gov/passport/forms/ds11/ds11_842.html
2) Get proof of your citizenship - If you're a native US citizen a certified birth certificate does the trick.  Make sure you understand what certified means.  Here is the definition they use:

A certified birth certificate has a registrar's raised, embossed, impressed or multicolored seal, registrars signature, and the date the certificate was filed with the registrar's office, which must be within 1 year of your birth.

Mine was easy as I just went by my county's courthouse and got a copy for 10 bucks.

3) Have an acceptable ID when you apply - Here are the primary types they accept

• Previously issued, undamaged U.S. passport 
• Naturalization Certificate
• Valid Driver's License
• Current Government ID (city, state or federal)
• Current Military ID (military and dependents

4) If you don't have one of the primary types of IDs you can present multiple secondary pieces together.  Here is the example from the website - Social Security Card + Credit Card + Employee ID + Library Card

5) Make sure they photocopy your ID to send in with the form.

6) You'll need two photos of yourself.  Unless you're VERY familar with the requirements save yourself the trouble and just have them made when you apply.

7) Schedule an appointment and bring the completed form and all documents.  Make sure you are aware of the fees as you'll need to pay when you apply.  Here's a link to prices - http://travel.state.gov/passport/get/fees/fees_837.html

Note:  Allow 4 - 6 weeks for the passport to be delivered to you unless you pay extra.  Then you can get it within 3 weeks.

Plans... they are a-changin!

MAJOR UPDATE: My plans have changed. I’m now taking advantage of medical tourism to have my plastic surgery done. Don’t freak out or anything but I’m going to Monterrey, Mexico to have my procedures done. How did this drastic change come about? It’s actually kind of ironic. Dr. Eaves from CPS suggested that I start reading the plastic surgery forums at obesityhelp.com. I immediately noticed many of the folks having their operations in Mexico. I was shocked.

We have a lot of bad perceptions about Mexico here in the USA. So, my initial reaction of shock shouldn’t be surprising. I was intrigued so I started reading the various posts, profiles and blogs of the members who had their plastic surgery done in Mexico. One doctor’s name keep coming up – Dr. Sauceda. He’s referred to by most as Dr. S. I can see why as I can’t often remember how to spell his name either! Most of the “chatter” about medical tourism in Mexico was about Dr. S. I started looking into him.

Firstly, the price absolutely floored me. The estimates on his website were less than half of what I was going to pay locally. Those estimates included the stay and the up to 600 dollars of flight expenses. I’ll admit that the price got me to consider changing my plans but I wouldn’t risk my health on price alone. You cannot put a price tag on something as life changing as this surgery or your own well being. So, I really ramped up my research.

I scoured the forums reading all the posts about Dr. S for the past several months. I looked at before and after pictures of his work. It was just as impressive as the pictures I’d seen of Dr. Eaves work. It couldn’t hurt to contact Dr. S and see what he would say about my loose skin. I sent him an email briefly explaining my weight loss and situation. He asked for a set of four pictures (back, front and both sides in underwear). He responded to the pictures with the exact same procedures that Dr. Eaves at CPS suggested. His response gave me the assurance that he had good experience with massive weight loss patients. How good, I was about to find out.

I was a little impressed by how he was able to come to the same conclusions as Dr. Eaves from just four photos. I asked Dr. S how many body contourings he’d done after massive weight loss. When he wrote back than he’d already done 26 just this year, I was floored again. I may have found one the most experienced plastic surgeons for weight loss reconstruction in world. Now, Dr. Eaves is a pioneer in his own right and I believe he’s the best in the south-eastern US. I was very happy to have found him so close and have him as my initial consult. Even with the same expertise and huge cost saving, I wasn’t yet convinced to make the switch. The “last straw”, so to speak, was the care I was going to receive in Mexico.

With my original plans, I was going to be in the hospital for one day and then be at home. I was to be fending for myself, basically. Not entirely true, as I have lots of nurse friends to help me out. My main concern was the doctor was 50+ miles away from where I live. I wasn’t looking forward to the drives for checkups during those next 2 weeks after the surgery. Not to mention, if I had any problems. With Dr. S, I’m in a clinic for the surgery and my first few days afterwards. In my opinion, a clinic devoted solely to plastic surgery is MUCH better than a hospital where a variety of illnesses are treated.

After I’m ready to leave the clinic, I’m moved to a hotel room just minutes away from the clinic and Dr. S. I’ll have nurse visits to help me out with showers and such. Plus Dr. S visits frequently too. Did I mention his level of service even extends to picking me up at the airport personally? Amazing. The care level I’m going to get in the clinic and hotel sealed the deal for me. I cancelled my appointment with CPS and scheduled my trip to Monterrey for Jan 15th through 27th. There’s even an extra added bonus. Several members of the plastic surgery forums will be down there at the same time. I’ll have “friends” down there, friends that instantly have a lot in common with me.

There you have it, my logic on changing doctors (as well as countries). I’ll be posting about my preparations for my trip from now on.

Thanks for reading
Mark

Friday Q and A

I went for my second consult on Friday.  The first consult was done as part of a mini monthly seminar.  It's not that the first one felt rushed but I didn't feel I had time to "take it all in" before asking questions.  I also didn't have the advice/questions of all my different nurse friends.  They suggested questions that I NEVER would have thought about.  I was also lucky that one of my best friends, Chris, tagged along for the consult.  As an extra added bonus, he's one of the nurses and will helping me out on the day I have the surgery.

Dr. Eaves from Charlotte Plastic Surgery (CPS) will be performing my extended abdominoplasty, thighplasty, and brachioplasty.  That's a tummy tuck, thigh lift and arm lift for those of you keeping score at home!  He specializes in body contouring and has been working with massive weight loss patients for 10 years.  I had all the questions written down and Chris was in the office as backup.  The surgeon was very receptive to my questions and answered with a patience and depth I've never gotten from a doctor.  I know it's an elective procedure but general practitioners could learn a few lessons from this guy.

Here are the questions I asked.  If you're reading this post looking for information please know the answers are tailored for my situation and may not be the same for you.

1. How many and what type of drains will be used?  2 drains with bulb collectors will be used for the tummy tuck incision.  They are easy to tuck in clothes, drain and put back on.  For me, he doesn't think the other two procedures will need drains at all.
2. Who is oncall that weekend?  All the doctors are partners in the firm and take turns being oncall.  Whoever is oncall will know my case and have access to my file.  The good news is Dr. Eaves might actually be the one oncall that weekend.
3. How likely is a second nights stay in the hospital?  He gave me a 10% chance that I'd need another night.  He's confident that since I'm in such good shape, I'll be "go to go" after one night.  Most people choose to stay a second night for their own comfort and not on his orders anyway.
4. What is my expected mobility and self-care after the surgery?  He's going to have me up walking that same day.  I'll be able to walk around the house, go to the bathroom, and basically fend for myself - albeit VERY slowly. 
5. What about pain medication?  I don't do well with Vicadin and don't really have any experience with other meds so they will have to see what works at the hospital and go with that.  I'll have my meds before I leave on Saturday.  No rushing around looking for a pharmacy while I'm in pain.
6. Will I pre-admitted to the hospital?  All the paper work will be done when I arrive that morning.  He said there might be a chance the hospital would want me to come down the day before.  I'll definitely be getting an "info gathering" phone call from them as the date approaches.
7. Will the nurses on my hospital floor have experience with plastic surgery?  I'll be on the post surgery floor.  The nurses are very experienced with plastic surgery since all of the CPS "big" procedures end up on that floor.
8. Can I do any exercises to aid in recovery or help the outcome?  The doctor advised me to keep up what I'm doing now.  With my weight (195 lbs) and body fat percentage (~13%), I'm really at my "prime" for the procedures.  He said it wouldn't help the outcome to lose any more weight or even put on more muscle.
9. Can I supplement with anything that will aid the recovery?  He was candid in saying that nothing has really been proven to help quicken the healing process.  General advice was a multi-vitamin and vitamin C daily. 

You can tell which questions are from the nurse brigade and which "two" are mine.  The booklet that was sent to me was very informative and I didn't have a lot more questions that it couldn't answer.  CPS has been quite responsive over email and I can send them anymore as I think of them.

In the next post, I'll recap what was done in my first consult including why you need to "check" your modesty at the door when having this type of plastic surgery.

Thanks for reading!

Are you pondering what I'm pondering?

Six years certainly is a long time to ponder and debate something. When the something is elective plastic surgery, I don’t feel that I took too long to make the decision. The biggest factor was cost. Sure, I’m financially secure but independently wealthy… I am not! I knew I didn’t want to take out a loan to have it done so I started saving. It costs about the same as a new car so why not a loan? It’s not like they can repossess a tummy tuck or thigh lift! When it comes to money, I lean more toward of the school of thought that carries as little debt as possible. I’ve not made a conscious effort to be that way - it’s just part of my personality. It’s funny how my lifetime batting average with money is much better than my average with food. BUT HEY, the food stat is getting better daily. (BIG SMILE)

Price tag aside, I didn’t want to “cheat” on my quest for a fit-looking body. I held the mentality that with a real fitness dedication the skin would tighten up or be filled with muscle. I really felt that plastic surgery would be a shortcut to what I could do with hard work. It took a few years for me to realize that reality wasn’t exactly bending to my will. The reality is that I caused my skin too much irrecoverably damage by being so big for so long. I grew up obese and my skin grew with me. It’s never been a normal size. So I faced reality and now I know plastic surgery isn’t cheating. It’s repairing the damage I’ve done to myself. I did, however, suffer a really great side effect of all my own efforts to reduce the skin. I became quite aerobically fit!

Once I realized it wasn’t cheating and I could eventually pay for it, my last hurdle was vanity. No, I didn’t have to overcome vanity. I had to see I wasn’t being vain when I wanted the skin gone. I made many efforts to be happy with the body I had from losing the weight. The flabby skin was caused by past mistakes that I had corrected. Now, I’m super healthy and fit so my loose skin shouldn’t matter, right? It does matter. It often makes me feel like I’m still fat even though “deflated” is really the truth. It saps my motivation since my workout efforts can’t really show. I often wondered if it would be an excuse for me to slide back into unhealthy eating – I’m really glad it wasn’t and I didn’t! Like my efforts to work off the skin these efforts weren’t wasted. The efforts helped me realized I shouldn’t be ashamed of the loose skin and that it’s not vain to want this damage from my obesity fixed.

I’m scheduled for another consult with the surgeon on Friday. I’ll make note of all the questions I ask and his answers. I’ll also post which procedures I’m getting done and what to expect if you’re considering a consultation. I can offer this bit of advice right now. If you’re in the same situation as I am then look for a surgeon who specializes in body contouring after massive weight loss. There are special considerations when dealing with this kind of large scale plastic surgery. A body contouring specialist will help you avert potential problems and use all the procedures to work toward a best shaped you.

As always, thanks for reading.

How Did I Get Here?

I briefly mentioned a life changing epiphany in my first post.  I'd like to go into the details of that event.  First, I'll start with a little background on when I started having weight problems. Shortly after my 4th birthday, I broke my left leg in a fall. I snapped my tibia in half and was put into a double legged cast. Up until this time, I was a normal, preschool kid without any signs of a weight problem. In the cast, I got fat. After the cast came off, I didn't lose it. I entered kindergarten at a weight of 60+ pounds. I can't say why the weight didn't come off. I wish I could. I only know that breaking my leg altered the course of my life and those weight problems persisted.

I was 420 pounds when I came face to face with the reality of where my obesity was leading. Early August 2001, a red rash developed on my lower right leg. It started to pain me and became hot to the touch. By the time I went to bed that night, I was in agony. The next day I went to WebMD.com to search the symptoms and got the scare of my life. The first hit that came up was GANGRENE. Silly I thought, it's the middle of summer, but I still read the link. I read and the sinking feeling started. When I got down to the word Diabetes the feeling turned to doom. Did I have Diabetes induced Gangrene? Was I going to lose my leg? I logged off and was literally stunned. I decided that I couldn't take not knowing so I went to the emergency room. The wait in the emergency seemed to go on forever because of my panic. I was finally called back and several tests were done including a blood sugar test. I knew the news would officially mark the beginning of the end. All that I dreaded was about to come true. Then everything I expected - didn't happen. The test was normal. I didn't have Diabetes nor was I going to lose my leg. It was simply a mild skin infection. That scare was life changing.

All my efforts went into avoiding the very possible and now "real" pain of that near future. The process that made me healthy (...still looking for wealthy and wise) also instilled me with solid confidence that I can accomplish anything I set my mind to. I could spend hours writing all the details of the process I went through but here is the core. I stared by reading everything I could about nutrition and made it the center point of my diet. I only had so many calories per day to eat and I "spent" them on the most nutritious food I could. I'm still amazed at what the body can do when you feed it right. Veggies and fruits were a mainstay and still are. After reworking everything in my life related to diet and becoming fit, I decided to stick with a 90%/10% rule. Basically, it’s a happy balance between eating highly nutritious food most of the time while leaving room for not-so-healthy (but oh-so-good) favorites.

The other part of my transformation was exercise. When I started exercising, it took me 20 minutes to walk a ½ mile. Fast forward to today and I've done 10K runs in less than 47 minutes. At 195 lbs, I’m truly in the best shape of my life. While running is recently out of my exercise regimen due to a knee problem, biking quickly replaced it. I am delighted every time I can enjoy any kind of physically activity that would have had me struggling for breath just 8 years ago. I've vowed never to become inactivity and am always looking for new activities to try.

That's my weight loss story and it's how I arrived with all this excess baggage (aka loose skin).  Between now and my surgery date, Dec 18th, I'll expand on it along with all that I'm doing to prepare for the procedures.

Again, thanks for reading!

Welcome to a chapter of my life

Today, I describe my life in overwhelmingly, positive terms. 

• My lifestyle is one of health and fitness.
• My attitude is undyingly optimistic.
• My outlook is always hopeful.

I now look forward to the future and to what life will bring. Just eight years ago, however, my description would have been very different. My life up to that time was completely defined by my weight.

Words like “fat”, “big”, “obese” along with many other “less kind” labels permeate that life especially my childhood. Some of these adjectives weren’t intended to hurt but many were directed in cruelty. I didn't handle that cruelty very well at all. I've always been naturally shy and the taunting made me even more so. I guess it was like a self-defense mechanism. Just be quiet, don't say anything, and maybe they will eventually stop. It worked to some degree but that approach made me very reclusive. I regret that I became more introverted but regret even more that I got used to being that way. Luckily, I made some really great friends during my school years, two of which I still see regularly. I’m so thankful that these friends saw past the weight when so many others didn’t.

What changed eight years ago that caused me to do a complete 180 and enabled me to lose over 220 pounds? I’ll share that epiphany later in this blog. For now, please know that life changing moment allowed me to lose much more than the weight. I lost my terrible eating habits, my negativity toward life, and my hopeless future. I also was blessed to gain a desire to be fit and active for life, a roaring fire of optimism, and a snowballing of self-worth. There is one thing I didn’t gain that I still really want – a fit looking body. The fat that vanished left behind the skin that held it. The remaining extra, loose skin is the focus point of this blog.

I reached my goal weight of 200 pounds in January 2003 after 16 months of hard fought diet and exercise changes. I’ve waited six, almost seven, years to finally make my decision about plastic surgery and have my extra skin removed. During that time, I’ve continued to become more fit and improve my body fat percentage. I’ve also squirreled away the funds to pay for this elective procedure. This choice has been a hard one and was not made lightly or easily. I certainly want to explore my reasons for the surgery here and also give first hand information to others looking into the same procedures. I hope this journal of my thoughts, expectations, and experiences will help others in their goals and in their lives. The title, Unzip My Skin, has a double meaning. Physically, it refers (somewhat crudely) to what the doctor will be doing. Emotionally, it reminds me that I’m letting other people “into my skin” by revealing part of my soul.

To whoever reads this blog here’s a big, THANK YOU!