The time for my 7th, and hopefully last liposuction for lipedema procedure, has finally come. This final surgery is to take care of the lipedema fat on my sides, hips, and my surgeon wanted to try to get some fat he missed during my butt liposuction.
I could have had this liposuction procedure much earlier this year, however, I figured that like last year (2016) we’d have another very hot spring and summer and I absolutely refused to be stuck in hot, sweltering, oppressive, compression garments for another summer. Of course, this summer was hot and we had some heat waves that gave us the hottest summer days in the past 20 odd years. So at least I was right in waiting a bit. However, as you can see by this photo post sports massage of the serratus anterior, the lippy fat under my arm still had to go at some point.
Through my lifting, I managed to get a disconnect of the serratus anterior and rhomboid major where they pulled against each other causing some pretty intense pain under my left shoulder blade. Part of setting this disconnect right was making sure to add in cable flys and reverse cable flys into my lifting routine. Then I needed to work trigger point areas on my chest (pectoralis minor since it’s the opposing muscle group for the lower trapezius), serratus anterior and rhomboids with foam rollers, rubber balls, fingers, therapy stick, and sports massage.
Since I couldn’t get into the serratus myself as it was too painful, I asked my massage therapist to do it. Needless to say, it hurt 200% more than it should because of the lippy fat. That’s how that bruise came to be, 1.5 weeks before this surgery.
If you haven’t read any of my other surgery day liposuction posts, then you’ll want to go to my Lipedema Journal and choose any of the surgery day posts because surgery #7 was just like 1-5. There were only 3 differences.
- The barely there thong actually fit and the hospital gown not only stayed closed, but covered everything.
- I was allowed to have my mobile phone to play on while waiting for the surgeon to come in and draw all over me (still wasn’t allowed to take it in for the surgery, probably because it would hurt my surgeon more than the foam balls when I get pissed and throw something at him).
- My surgeon took me into the locker room to draw on me so I could point out the areas I really needed him to operate on since this time we had a slight difference of opinion.
My surgeon really wanted to revisit and area above my tailbone that he obviously missed in my butt liposuction (it’s a big painful lump) as well as the fat at my hips leading up my sides (which he tried to get during my butt liposuction). This was already a lot of fat to be taken out. However, I absolutely insisted he get the fat directly under my arms and when I showed him that glorious bruise from almost 2 weeks ago, he finally agreed to try to get it all out. Again, pretty obvious it’s lippy fat from the bruising, pain, and the marble feeling under the skin so it had to go.
After meeting with my surgeon, it was back into bed where I did some work (yay for Slack and Skype that puts me in touch with my development teams!) until the drugs that I was given did their work and I decided sleep was more attractive than dealing with programmers. Before I knew it, I was being taken to the toilet for one last time and then taken in to prep for surgery.
Aside from having a new nurse in the actual surgery room, preparation for infiltration and liposuction was pretty comparable to the other 6 times. The nurse had me step out of my hospital gown and rip off the glorious, barely there thong (1.5 years down the road I still have no clue why they bother with that thing). I have to say that this time I was pretty sleepy, although that was short lived. As soon as the nurses got me up on the stool to dowse me in disinfectant, they not only got a scream out of me (it was COLD), but I was wide awake.
Since this surgery was for my sides and lower back, they had me get on the table on my stomach. This really didn’t make it any easier on my back, but I’ll get to that later since it’s not really surgery related.
Infiltration was pretty normal as well except instead of the 7 puncture holes that were marked out, my surgeon made me a pin cushion with about 11 different puncture holes. As always, the first puncture stung quite a bit and the very first part of the infiltration was uncomfortable. But as the fluid was pushed to new areas, the pain eased and there was only occasional moments of severe pain (6 or 7 on a pain scale). For the most part I’d say it was maybe a 4 through infiltration. Honestly the most painful part was the vibrating cannula on my ribs (they’re pretty sensitive as detailed in this part of my stomach liposuction post).
As per usual, I was left to percolate for about 30 to 40 minutes while the local anesthesia did it’s job. Oh, and I did get the squeeze balls for infiltration, but they ended up getting used to prop my chin up instead. They did make kind of a comfortable addition to the pillow. This of course made the nurses laugh since I’m the first person to use them in this manner.
After the local anesthesia had time to do its work, my surgeon came back in and started on the liposuction. First he started on my lower back, getting the spots that he missed during the previous liposuction on my butt and lower back. Then he had me roll over onto my side, one at a time, and got the fat off of my hips and sides up to my armpits.
This surgery was a bit different in that I was pretty drowsy for a good portion. I’d say the pain levels were around 4 or 5 during about 60% of the surgery. There were a few 8’s and that was when he had me on my sides and was suctioning along my rib-cage. Keep in mind I have a freakishly high pain tolerance and the “pain” that got it up to around 8 is a different type of pain. I’m the type of person that can go through the pain of surgery and recovery of 7 liposuction procedures but I can’t stand the pressure pain on my lower back or the vibration pain of a drill in my mouth. So the pain I was experiencing was the very uncomfortable vibration of that damned cannula on my rib-cage as it sucked fat and worked on bruising the living daylights out of me.
When my surgeon was doing the liposuction on my hip area, there was a few weird moments where he hit some nerves and it felt like someone hooked me up to an electric fence and shocked the shit out of my leg. This of course caused the very much involuntary reaction of me kicking out and twitching all over the table. I’m guessing that this is probably fairly normal since my surgeon just adjusted himself to not be in kicking range and didn’t tell me to try to hold still. To be honest it felt like it happened over and over but in reality it probably happened maybe twice on each side, the left side being much more violent than the right. I also wouldn’t say it was necessarily painful (maybe a 3?), more unsettling.
After about 3 hours in total, my surgeon was done, however he wasn’t exactly happy about how this surgery went.
While my surgeon was taking care of my lower back, I could not only feel him working hard trying to get that cannula moved around, but he was out of breath several times. I asked him if this was replacing his trip to the gym for a week and he only grunted.
It turns out that the spots that he had missed during the butt liposuction had quite a bit of scar tissue in it. I’m not sure if this was a result of the previous surgery, or if there was a lot of scar tissue in there from all of the dry needling, massaging, and general issues I’ve been having in my back over the past year. I forgot to ask (I suspect it was the liposuction). I did know ahead of time there’s scar tissue there since the fysio I go to for dry needling bitches about the scar tissue ruining the needles.
My surgeon took as much out as he could in my lower back area until it started to actually bleed and at that point he didn’t want to push it any farther. All we can do is wait for the swelling to go down and see if enough fat was taken out to relieve the lipedema pain in the lower back area (it was like a small fist sides lump, nothing disfiguring just painful is pushed on like in a sports massage) or if some other action will have to be taken. If the pressure pain is gone, it’s good enough for me.
However, I now have a really good sense of why it’s so rough on surgeons when they find out their patients have fibrotic tissue under their skin.
Overall, he got just over 5 liters of fat out from my sides (armpits to hips) and lower back.
After my nurses got me patched up and tried to get me set up with some sort of absorption suit for all the liquid (spoiler alert, they failed), they got me into bed, fed me and took my vitals. In the meantime, my husband apparently was down stairs getting a parking ticket from the Rotterdam police who were actually out doing something vs. being on a perpetual coffee break. Unfortunately the clinic is right next to a school and I was done around 15:30 which was when school was getting out so there was no parking spots. However, my surgeon won’t release patients unless the car is out front and those few minutes between me getting dressed and getting down stairs to street level was enough time to get a ticket.
Trust me when I said I put on my best pathetic, just out of surgery, crying because of the ticket act to try to get us out of the ticket (another spoiler alert, it didn’t work… assholes).
After getting me loaded into the car and some words being exchanged between my husband and the police, he got me back to the hotel where he parked me on a thankfully red bench until he could get parked and upstairs since he forgot to bring the 2nd card key to our room. When I say that the bench was thankfully red, well, lets just say the makeshift absorption suit didn’t work and I leaked through my (very much black) sweatpants. Oops..
Once I was up in my room and managed to get out of my clothes, my husband got me into bed where I insisted on watching a movie that I slept through. Later on I did manage to get through the new Beauty and the Beast. Emma Watson did a good job!
Unfortunately, I’d learn as the local anesthesia wore off over the course of the evening and night, I developed a nice case of Spit.
So in english (maybe it’s an American thing?) we like to call this “throwing out our back.” More medically speaking, it’s lumbago but the dutch call it Spit (in Flanders it’s apparently called verschot or more literally “shot”). Basically, nobody knows why it happens. You could just have tweaked your back wrong when you bent down to put on your shoes, slept wrong, or twisted in such a way to anger the gods of back muscles.
It could have something to do with nerves, such as the sciatica nerve, degenerative disks in the spine, frozen muscles… yup, it’s really just a catch all for “my back is really fucking angry at me right now so can I please have some happy drugs like Valium?”
Due to the fact that I’ve been dealing with what I thought was spinal stenosis (but is something different) and coupled with managing to irritate things a few weeks before surgery at the gym, having to lay prone on my stomach for about 4 hours straight, the cannula vibrating across my lower back and the pressure/beating my lower back took during the actual liposuction, my back pretty much said “fuck this shit” and checked out. When I tried getting up to go to the toilet at about 3 in the morning, I could barely get out of bed much less get to the toilet and then back up into the bed. That was a bit of non-surgery related misery that I really didn’t need.
Overall, the preparation for liposuction was pretty normal with a little over 5 liters of fat taken out for over 40 liters in total. Even the infiltration and liposuction itself was rather uneventful and I dosed through it. The highest pain level I felt was around an 8 a few times but it wasn’t horrible.
Onto recovery, and hopefully some Valium for my poor back muscles!
As far as this being my last surgery, we’ll see. There is some obvious fat left in my thighs and my right arm. I don’t know if my surgeon will want to go in and get those places (we’re talking CC’s worth of fat) just to be rid of the lipedema fat in total or if he thinks it’ll be ok. It’s not disfiguring and it’s not painful, but if he thinks it might continue the progression then it might have to come out. I bow to his expertise in this.
There is a bit of a possibility that I might need to have one more go on my stomach. This all depends on if there’s enough loose skin to get insurance to pay for skin removal on my stomach. Apparently if there’s so many centimeters of loose skin, they’ll pay. Maybe I’ve become too dutch, but if it means paying 3500 euro for one more liposuction procedure to get the needed one or three more centimeters of loose skin vs. having to pay for the skin removal AND 3-4 days minimum in the hospital… I’ll happily pay for the 8th procedure. However, that decision will have to wait since the swelling from this surgery needs to go down enough for the plastic surgeon to give his opinion.
We also need it to be November when all the different health insurances put out their 2018 packages so we can shop around and see who pays for skin removal from extreme weight loss.