Abdominoplasty Surgery Day

Stomach front view before abdominoplasty

On 17 December 2019 I would go in for an abdominoplasty with no muscle repair.  Just skin removal in a fleur-de-lis cut.  In the grand scheme of things, this is a much heavier surgery than the 8 liposuction procedures I’d done since February 2016.  I’d not only be going under general anesthesia for the first time since having my gallbladder taken out when I was 17 years old (back in 1997) but there was going to be a lot of flesh cut off.  I don’t want to downplay liposuction but damn, my no complication streak has come to an end.

Stats Going Into Surgery

  • Height 167 cm (5 feet, 5 inches)
  • Weight 115kg (253.5 pounds)
  • Stomach circumference 127cm (50 inches)

The Night Before Surgery

Before abdominoplasty side view

Unlike all 8 liposuction procedures, where my surgeon wanted me to eat a hearty breakfast, for the abdominoplasty I was to stop eating 6 hours before surgery.  Since I was scheduled for 8am surgery, I needed to stop eating around 2am.  I had a dinner that wasn’t going to spike my blood sugar to hell and back around 7pm and then went on clear liquids until 6am.  The one thing the hospital did want is for me to be very well hydrated.

I have had the “omg, what am I doing to myself” jitters several weeks ago, but the night before surgery I was pretty calm and I actually slept from the moment I went to bed around 8pm until I needed to get up and get dressed for the drive to the hospital at 5am.

I already put together a small bag of stuff to take with me since I knew I’d be staying at least 1 night at the hospital (up to 3 was included in the price I paid for my adominoplasty).  What I packed was:

  • extension cord with 3 power sockets
  • 3 usb plugins for my phone, tablet, and insulin pump handset (I only ended up using 2 of the 3)
  • insulin and pump supplies
  • birth control
  • flipflops
  • bath robe

What I should have brought with me since I ended up staying an extra night:

  • tank top
  • shorts
  • theracane (for when muscles start cramping from being forced to stay in bed)
  • heating pad (for cramped muscles)

Checking in For the Abdominoplasty

We got to the hospital for the 6:45am check in time.  It was myself, my husband and my mother who had flown from the states to help take care of me after surgery.  I also suspect my husband needed a little emotional support (and likewise for my mother) while I was in during surgery.

Before I was taken to the bed that I’d be staying in, a nurse took me to a room to go over a few things and check my vitals.

We did the control yet again (birthdate, name, what I was coming in for in my own words) and she checked my blood glucose with their own glucose monitor (it was kind of cool, the test strip had a bar code they could key to my file), took my blood pressure and temperature.  The nurse also double checked with me on my weight (but didn’t have me actually step on a scale) and my height.

Once that was all done the nurse took me to my bed.

One of the things that’s kind of cool about the beds is there’s a computer, with keyboard, that you can pull down.  With this you can plug in headphones and watch TV or movies, order food, and even mess around on the internet.  I didn’t really use mine, I had my tablet and Netflix.  But at this time the nurse explained the TV/Computer to me, gave me what’s best described as a smock (it basically only covered your front, didn’t really have a back and came to your waist) and some boy short undies.

She also gave me 2 paracetamol and a diclofenac to take and had me get in bed.

Since my glucose meter was expiring, I went ahead and pulled it off and had my husband put my MiaoMiao (a little bluetooth device that sends constant blood sugar numbers to an app on my phone) in with my other diabetes things.  Then it was time to wait to be taken up to the OR.

Pre-Surgery Matters

About 7:30am a nurse came and took me up to the recovery room which also apparently doubles as pre-surgery.  The nurse that took over really hated my gel nails and made it all seem like the surgery was going to get called off because I had gel on both my fingers and toes.  I’m a good patient, honest! If anyone had mentioned this to me I’d have gone and had the gel nails removed from a finger or three.  So if you’re thinking about surgery and have gel nails, have one nail completely clear!

As it turned out, it was fine.  I actually had about 3 weeks out grow and the heart rate monitor worked just fine.  Apparently if it hadn’t they could have placed the HRM on my ear so the nurse probably was just having a bad morning.

I met with one of the anesthesia nurses that was on my surgery team and we went over the controls again (name, birthdate and what I was going to have done in my own words).  They gave me a hairnet and put a warm blanket between my legs at this point as well.  Before I knew it I was being wheeled into the actual operating room.  I got a glance at the clock and it was 8am so they were serious about having me as the first patient of the morning.

Diabetes Management and Angry Anesthesiologists

So during surgery (and I think it works this way in most hospitals), the anesthetist takes control of a diabetic patient’s blood sugar management.  In my case, I actually had an anesthesia team that had either 1 or 2 nurses and the actual anesthetist.  This little team (and the actual surgeons/nurses) was pretty pissed at the nurses who had me not replace my blood glucose sensor since they LOVE diabetic patients that have them.  Especially those of us who wear CGMs (I don’t officially wear a continuous blood glucose sensor, I actually wear a flash glucose monitor that you need to scan but modified with a bluetooth device to make it an unofficial CGM).

One thing they did that I wasn’t expecting is decide to have me leave my insulin pump on even though the surgery was going to be about 2.5 hours.  Apparently they have some leeway on hospital procedures.  So I took the opportunity to teach them how to use my pump handset in case they needed to temp raise or lower my basal rate or shut off the pump entirely.  I also showed them how to disconnect it if necessary.

They went ahead and took my blood sugar and I was in the OR with a 7.1 mmol/L (127.8 mg/dL).

Almost Night Night Time

At this point the surgeon came in and had me get out of bed so he could draw on my stomach.  Compared to my liposuction surgeon, this surgeon took about 10 minutes to do his markings with his assistant looking on intently.  We also had a discussion about my belly button.  We had sent an email stating that I wanted him to go ahead and remove it since I didn’t want to tempt fate with infection or a rotten looking belly button.  He said he really didn’t think saving it was going to be a problem and he didn’t think I’d really decrease my chances of infection by skipping it.  I decided that he was the expert and this is part of what I’m paying him for, so I decided to bow to his expertise in the subject and let it go.

At this point he had me go ahead and get up on the operating table myself and the anesthesia nurse went to work trying to get an IV into my left arm.  I just wished her the best of luck and you could see her get an “oh shit” look on her face.  She tried finding it but ended up having to call the actual anesthetist over since she thought my vein would have to be found with ultrasound.  Luckily the anesthetist found it.  She did tell me that they may go ahead and put a bigger one in while I’m under to get more fluid in.  She wasn’t going to put it in now since it’s kind of uncomfortable (spoiler, it hurts like fuck).

After they got the IV in, the surgeon had them gather to go over what they were going to do and the nurse put an oxygen mask on my face.  The anesthetist told me good night and I was out.

Recovery Room

The next thing I remember was someone gently shaking my shoulder telling me good morning.  I also remember coughing my lungs up.

After about an hour of dozing I was a lot more aware and one of the nurses came over to take my blood sugar.  It surprised everyone, I was still at 7.1.  What can I say?

They gave me a Popsicle for my throat, which was pretty raw from having the tube down it, and the surgeon’s assistant came over to see me and look at the stitching.  She said they took about 3kg of skin and fat off me and everything went really well.  I also at some point got some extra pain medication since my pain level was at a 6.  Basically the incisions felt like they were on fire and burning.  I think they gave me a shot of morphine and that burning sensation went away as quickly as I had become aware of it.

At about the 2 hour mark of being in the recovery room, some nurses came to pick me up and take me back to my room.  The ride was fairly uneventful except we got stuck in an elevator for about 5 minutes.  Someone apparently pressed all the buttons so we kept riding up and down.  The nurses (who were students) were slightly mortified and I was trying not to laugh since it hurt.

3 Hours Post-Op

fbt

Everything was done and over, I was back in my room by 3pm.  The nurse that was in charge of my room came in and asked if I wanted to eat.  I ordered some yogurt with muesli and tea.  At some point I sent my husband down to get me a coconut macaroon that one of the shops sold (I LOVE coconut macaroons, great recovery food) and a bottle of water that I could keep refilling since the little shot glasses of water didn’t really amuse me.

At about the 3 hour post-op point I started getting pretty warm.  To be fair, they keep the hospital rooms really warm for recovering patients but I was starting to sweat everywhere.  I had my husband remove my compression stockings that I was wearing (just my normal, everyday stockings that they apparently kept on during surgery) to make things a little cooler.  I also had both feet sticking out from under my blankets.

3 hours after skin was removed from stomach

The surgeon assistant did come by to check my incisions and everything was fine at this point.

Around the 4 hour mark I had both my mom and husband take off home, nothing else exciting was going to happen (so I thought) and I probably was just going to sleep.  Unfortunately, after they left I started getting hotter and hotter, incredibly thirsty, and very, very sleepy.

I had been up to go to the bathroom once or twice, but I was pretty dizzy and I wanted to throw up.

I’d like to say that I went to sleep and woke up the next morning feeling loads better, but that wasn’t going to be the case.  I was having my first ever surgery complication and my day was far from over at this point.  However, you’ll have to wait for the next post for that part of the story!

PetraAnn

PetraAnn was first diagnosed with Lipedema in fall 2015 after years of eating keto and exercising with no weight loss results.After diagnosis, she has gone through 8 tumescent liposuction procedures from 2016 until 2018 and on 17 December 2019 underwent an abdominoplasty to remove the remaining 3-4 liters of lippy fat and loose skin.
PetraAnn

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