Feeling Old

I never used to think about getting old or worry about what I would look like as I got older. Until a couple of years ago, I used to think I looked relatively young for my age (or at least not *older than* my age).

I had a very hard time turning 30, but after that hump, I didn't worry too much about the number. I didn't freak out over getting some gray hairs. I think wrinkles in the right places can actually be cute! (I love "crows feet" that crinkle when people smile). 

Several months ago, someone said something that felt like a punch in the stomach and really made me question all of that again. And I hate that I let it bother me! I'm used to people talking about my weight--it's super public and I have no problem discussing it (obviously). But my age?

I'm 38. Jerry will be 40 in a couple of weeks.

I'd gone with Jerry to his appointment with the gastroenterologist about his stomach issues, and they ordered lab work. We went right from his appointment to the lab. We walked into the lobby, and Jerry brought his script up to the counter while I sat down in the waiting area. Jerry handed over his ID and insurance card, and the woman who took them exclaimed that she would never have guessed he was in his late thirties...

"I thought that was your mom with you!"

My mouth literally gaped open. The other receptionist immediately tried to explain "he just looked so young--not that you looked old". I couldn't even laugh about it. She thought I was his MOM?

Suddenly, every hair on my head was gray, and every wrinkle on my face was as deep as the Grand Canyon. I was a little old lady with a walker and bifocals, drinking prune juice and calling the receptionists "honey" in a thin, wavering voice. I was ancient. At Death's door. God's waiting room. Bill Knapps, for Chrissake! (And saying words like "Chrissake")

I write this tongue-in-cheek, of course. (The Bill Knapps reference is something that my friend Sarah and I used to laugh about in college--she worked at Bill Knapps and would talk about how most people who dined there were probably in their 80's.) But I'd never felt self-conscious about my age until that one comment threw me for a loop. One that is still circling. 

All of the signs of aging suddenly started to hit me. I hadn't thought about it until it was brought to my attention via a very nice receptionist who was not trying to be rude, but happened to blurt out the wrong thing to an insecure person.

Lately, I've been very conscious of my skin.

The sun is not good to my skin. For as long as I can remember, I've had vitiligo (a skin condition that causes white patches to form because the skin in those areas loses pigment). People tend to think of Michael Jackson when they hear about vitiligo--I do believe he had it as he claimed, but I think he probably had some sort of treatment to lighten the rest of his skin to "match" the vitiligo patches.

Anyways, I have patches here and there, which are easily hidden, but I also have it on my face (not so hidden). It honestly never really bothered me until a year or so ago when I noticed that I was also getting darker pigmentation in areas of my face, too (melasma, I believe, but I haven't been diagnosed with anything). Melasma is basically the opposite of vitiligo. I guess they are fighting for territory on my face?!

The vitiligo is most pronounced around my eyes, particularly my left eye (it almost looks like white eyeshadow). Ever since I started walking twice a day outside, the dark spots are getting darker which makes the vitiligo stand out even more. I really hate that the skin on my upper lip has darkened--it looks like I have a mustache!

I don't like to wear make-up, and I rarely do. But maybe if I did, people wouldn't think I was old enough to have a 39-year old son!

Whenever I go outside, I wear SPF 110 and a visor to shield my face. I always wear the sunscreen, even if it's cloudy outside or early morning when the sun is barely up. I hoped that by keeping my face protected from the sun, the dark spots wouldn't get darker. However, it just keeps getting worse, and each time I see my face in the mirror or pictures, I feel self-conscious of it.

Anyway, I know a lot of this is mental (ridiculous that I let one woman's comment trigger this consciousness of aging) but I really am concerned about my skin. Do any of you have melasma and/or vitiligo? I don't mind the vitiligo very much, because my skin is (usually) very light and you can't see the vitiligo patches very well. But this melasma (or whatever is making the skin on my face darken) is driving me crazy because it seems to get worse by the day.

I'm just curious if any of you experience it and if you have any advice--I'd love to hear/read! (I don't take birth control pills, which that is known as a trigger for melasma, so it's not related to that.)

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Starting the New Year with Bronchitis and a Biopsy

Well, 2019 is off to a rocky start for me!

But first, I have been doing really well with my goals (granted, it's only Day 4). The first week is always the hardest when making any changes, and I've managed to get through the first three days with ease. It's so interesting--when I switch from being "motivated" to being "determined", I can actually feel it. I don't even remember the last time I felt like this! Maybe 2016, when I was training for the 10K?

Anyway, to recap my three main goals for this year: 1) No alcohol for the entire year, 2) Get back down to a comfortable weight (about 140 or less), and 3) To get back in the habit of exercising at least 3 days a week for 30 minutes each time.

The alcohol goal is simple to track--it's very black and white. Either I drink alcohol or I don't. And I haven't had any, so I am on track with that. Only 361 more days, hahaha. Yesterday was actually a little tough--I wanted a glass of wine so badly! I had just finished cleaning up the house, and was ready to chill in my pajamas. Our TV died yesterday morning, so I sat down with a book. The idea of getting cozy on my couch, reading my book in my pajamas while sipping a glass of wine sounded romantic.

I realized that romanticizing the thought of drinking situations is the allure; it's not the drink itself, but more of the thought of the scenario. For example, thinking about having a happy hour drink with Jerry while we chat about what we want to do for vacation next year; or getting together with girlfriends for margaritas and Mexican food; or having mimosas on Christmas morning. Those ideas make it seem so inviting!

But the reality is never as good, and then I just wind up puffy and tired with a headache, having eaten more than I wanted because the alcohol makes my stomach a bottomless pit. I never think that far ahead, though. So, with this year of not drinking, I'm going to have to remind myself to think further ahead than happy hour. And that's what I did yesterday; I wanted the wine, and I was questioning why I even made this goal, but then I went over the reasons in my head. And it helped so much.

I happen to love tart cherry juice (I buy this concentrate and mix two tablespoons into about 6-7 ounces of water). When mixed, it looks identical to red wine. So, I mixed some in a wine glass and enjoyed that instead of wine. Once I was reading, the wine was out of my mind anyways.

I've also done really well with calorie counting. I'd tried to get back into it several times last year, but it was almost like I was spiteful about it. The last few days, it's been pretty automatic, which is what happens when my mind makes that switch from motivation to determination. It's like there isn't even a question about whether I'm going to do it or not--I just do.

I had been hoping to put together a grocery shopping list before I started, but I didn't even leave the house the first couple of days of January. I very rarely get sick, and I think the last time I had a cold was a few years ago. When I do get sick, though, it's usually pretty bad. It almost always ends in bronchitis.

And, that's where I am now--bronchitis. Aside from the coughing, I'm still blowing my nose a hundred times a day, and my sinuses are congested, but I think the virus has pretty much run its course. Hopefully in a few days, my symptoms will be nil.

I had been hoping to start the new year with a run in this gorgeous weather we've had (it's been over 40 degrees every day!), but there was just no way I could do it while sick. My friend Audrey's dad died and I couldn't even go to the funeral because it was at the peak of this cold and I was coughing constantly.

Shortly before Christmas, I noticed a spot on my forearm that looked like a patch of scaly skin--it was odd. It was directly over a tiny lump under the skin that had been there for a long time. I never really thought anything of it, but when the skin started looking weird, I consulted Google, and realized that I should probably get it checked out. It actually had the appearance of a non-melanoma skin cancer.

A few inches away from it was another lump, but it didn't have indication on the skin itself like the first one. I always associate skin cancer with moles or dark spots, and didn't realize that it can look like a scar or like a shiny patch of skin (which is what my spot looked like).

Because it was the holiday season, I put off an appointment until Wednesday. I thought for sure the dermatologist would take a glance, tell me that it's nothing to worry about and to try some hydrocortisone cream.

Instead, she said she can't know what it is unless she takes it out for a biopsy. Jerry was with me, and had been much more worried than I was. The doctor said that she would go in to the office early the next morning (yesterday) at 7:30 if I wanted to have it removed then. I made arrangements to get the kids to school, and then I went in yesterday morning.

It was super nice of her to go in early--there wasn't even a receptionist there, because it was before they opened. She injected a local anesthetic around both areas and then made a of tiny incision over each lump.

As soon as she took it out, she said, "Oh, it's a lipoma". I'd read about them, so I knew it was nothing to worry about. A lipoma is a benign tumor made of fatty tissue and they are very common. From the top of my skin, the lump felt like the size of a BB, but when she pulled it out, it was about the size of a pea. Lipomas usually don't cause tenderness or problems on top of the skin, like mine did, but they can. (She still sent them to the lab to verify, but she was certain they were just lipomas.)

She stitched up the incisions with a few absorbable sutures, and that was that. Jerry was relieved, but he's still nervous because he wants the lab results. I'm confident that the doctor knows her stuff ;)

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A Candid Discussion of Excess Skin (post weight loss)

When I had my lower body lift in 2011, I was thrilled with the results of my surgery.

The excess skin was very uncomfortable and I felt so discouraged that I would have to live that way for the rest of my life. I hated the fact that I "ruined" my body with so many years of overeating.

When Caitlin was here recently, we had a conversation about our excess skin (something that many people who have lost a lot of weight tend to have in common). We both said we wished more than anything that we could go back in time and take care of ourselves.

When we were overeating, we never thought about the long term consequences. One you've been overweight as long as we were, some of the damage is permanent. (Of course, there are people whose skin snaps back with no problems, but from my experience, that is not the norm.)

A lot of it depends on factors like how long one was overweight, just how much excess weight that person carried, how quickly the weight was gained, how quickly the weight was lost, etc.

I remember being very young (probably junior high school?) when I first noticed stretch marks. They were light red streaks on my upper arms, and I had no idea what they were. I was hanging out with a friend, and she noticed them. I told her I had no clue what it was, and she said that it was no big deal--she had them on her inner thighs.

I came to the conclusion that everybody had those "things', and I didn't think much of it. Within the next couple of years, I learned that they were stretch marks, and that they were undesirable. I immediately became embarrassed that my body betrayed me like that. Why did I get stretch marks, when none of my other friends had them (well, other than the one who showed me the ones on her thighs)?

When I was 16, I went on a trip to Washington D.C. with several people from my junior class. I met a boy there who I really liked, and after a fun day exploring the city, he kissed me when we got back to the hotel. We were sitting on some steps, talking, when he noticed my arm.

He asked what had happened, and I quickly thought up a lie--I told him that I had gotten boiling water spilled on me years ago. He accepted that answer, and I felt embarrassed. I knew that one day, he'd figure out what stretch marks are, and he'd know that the girl he kissed in Washington D.C. had them on her upper arms.

I became self-conscious of my arms after that, and I covered my them whenever possible. I started getting them on my inner thighs, too. At the time, I still didn't know that they were being caused from weight gain. I was so worried that they'd just keep "growing" everywhere.

They became really bad in college. I started getting them on my hips, sides, and abdomen. These ones were bright red, and thicker than the ones on my arms and thighs. I had gained quite a bit of weight my freshman year of college--from what I recall, I think I went from about 180 to 205 pounds.

When I got pregnant, I gained weight very quickly, and my stretch marks became even worse. With Eli, I gained 90 pounds! The stretch marks on my abdomen went all the way up to my rib cage.

A few years later, when I finally got my act together and started losing the weight, the stretch marks got smaller and more faded, but they were still very noticeable. When gaining weight like I did, the skin literally stretches until it can't anymore, and it pulls too far--causing the skin to thin out in just that stretch mark line.

The best analogy I can think of is one of those nylon hair ties. They have elastic in them, and they are covered with a stretchy fabric. For those of you that wear them, you know that when they get stretched too far, the elastic inside can break, leaving a small spot that is thinner than the rest of it and has lost it's elasticity.

That's what stretch marks are like--the skin gets to the point of stretching until there is no elasticity left. That's what I meant when I said I'd "ruined" my body--no amount of weight loss, exercising, expensive creams, etc, will remove the marks, because that skin has been damaged.

Anyway, on to my point of excess skin. Skin is very elastic, when you think about it. It can accommodate people up to 1,000 pounds or more. But, not without causing permanent damage.

When you blow up a balloon really big, and then let it deflate, it doesn't return to its original size or tight shape. If you blow up a balloon and leave it like that for several days, and then deflate it, it looks even worse. That's the best way I can describe excess skin. It used to be full, and then when it "deflates", the skin is still the same size it was when it was stretched--but since the inside of your body is much smaller, the skin hangs there, looking kind of "baggy".

This can cause all sorts of problems, and not just cosmetic ones. The "apron" of skin over someone's abdomen, for example, can cause rashes and yeast infections in that fold. Running was difficult before my skin removal surgery on my abdomen--my skin would bounce up and down, which was painful. (Think about running without a bra--that's what it felt like on my abdomen.)

My solution was to wear very tight spandex bottoms to hold my skin in place. That certainly helped with the bouncing; but then, by having my skin pressed together in a fold, and sweating from the run, I got chafing and rashes. By running, I was trying to do something good for my body, but I just couldn't win. (Again, I felt terrible that I "ruined" my body, and there was no going back.)

This photo was before I had the skin removal on my abdomen. You can see how I had to tuck in the skin to fit into very tight spandex to hold it in place.

I've gotten several comments and emails about how I don't look like I have loose skin. Well, flattering camera angles and clothing can hide that. But catch me from the right angle, or God forbid, naked, you will avert your eyes and not mention it again. Hahaha!

You may notice that I never run in shorts. The photo below was the only time I tried, and I asked Jerry to take a video, because I was curious if the skin on my thighs looked as bad as it felt. This is to show that there are certain angles that are more flattering than others, which is why people who read my blog may think I don't have loose skin. Of course I'm going to show the more flattering pictures on my blog!

So, to keep the blog honest and real, I'm showing you a comparison of an unflattering pic versus a more flattering one. (These are poor quality because they are screen shots of a video.)

(By the way, I never photoshop pictures of myself to make myself look better. I do use it sometimes to make goofy photos like the header of this post, though! But I want to be "real", so what you see is what you get.)

After I lost 125 pounds, people were naturally very curious about my weight loss. I was asked questions all the time--by friends, family, acquaintances, and even total strangers. When I was losing weight, I never imagined that talking about loose skin would be as painful as it was.

The first question I was asked was, "How did you lose the weight?" and the second was, "Do you have lots of loose (saggy/baggy/deflated/you name it) skin now?" I hate this question with a passion. Unfortunately, people asked me this ALL the time.

I spent the majority of my life (about 25 years) feeling incredibly self-conscious about my body. I was teased in school for being fat. I hated having people look at me, and I always assumed people were thinking about how fat I was. I hated myself; I hated my looks.

Fast forward to age 28, when I had lost 125 pounds. I felt amazing and I loved the way I looked--until I started getting e-mail after e-mail asking me if I have loose skin.

YES, I have loose skin. NO, it's not pretty. Do I need reminding of how grotesque it is day after day? No. (I've had people tell me that they don't want to lose weight because excess skin is gross. Gee, thanks!)

I know that when people ask me this question, they aren't calling me ugly, or saying I look gross--they are just asking out of curiosity. I get it. I was curious before I lost the weight, too.

But please keep in mind that it's a very sensitive question for someone like me who spent the majority of my life being self-conscious. That's why it irritates me so much when a complete stranger asks me about saggy skin when we've never even had a conversation before. If a friend asks, I have no problem talking about my loose skin--because that person cares more about me than about my weight loss and all the flaws on my body.

When the first thing someone asks me after learning of my weight loss is if I have loose skin, it's like saying that all the hard work I did doesn't matter; that losing 125 pounds means nothing if I have loose skin; that I might as well not have lost the weight since my skin is saggy now.

I so badly want to put to rest all of the bad thoughts I have about my body and learn to truly love my body--but it's hard to do so when people remind me that I have "gross saggy skin".

This photo is after I'd lost 118 pounds. You can see how loose the skin is on my upper arms--"bat wings", as people like to refer to this problem area. (Stephanie was setting up her camera to get a photo of the two of us together, and she told me to "look like you're putting your arm around me". Hahaha! I like to tell people it's my imaginary friend ;) )

I hate that when I wave to someone, my loose skin is about half a second behind my arm, hahaha.

All of that said, YES--I have saggy upper arms, saggy inner thighs, deflated boobs (which were never big to begin with), a saggy butt, and a stomach that looked like a deflated balloon (I had the abdominal skin removed in 2011, which I'll share about below).

This is a picture of the skin on my inner thigh. I was lying on my right side (hip on left, knee to the right, so the skin was sagging down). I took this picture to "prove it" (that I had loose skin) a few years ago, but now I realize how stupid that is--I have nothing to prove to anyone! Still, here it is. The picture is a little disorienting, because I was lying on my side in bed, with my other leg tucked underneath, so that you could see the saggy skin.

I was terrified at the thought of having surgery. However, when I broke my jaw in 2010, and surgery was inevitable to fix my jaw, I wasn't afraid of it anymore. (I'm sure the IV of dilaudid helped! hahaha.) I decided to schedule a consult with a plastic surgeon. I'd had no idea at the time, but she told me that my insurance would likely cover a large portion of the surgery. I was shocked.

After some stuff to work out with the insurance company, I scheduled my appointment for pre-op; and then for surgery on November 14, 2011. My surgeon said I would have fantastic results--1) Because I was at a "normal" weight and I wasn't doing the surgery to try to be smaller or lose weight; 2) Because I'd kept the weight off for over a year; and 3) I was running a lot, and in good shape underneath the skin.

Needless to say, I am THRILLED with the results of the surgery, even five years later (I wrote an update of the surgery with current pictures here).

Believe it or not, I could button and zip those jeans before surgery. It just took a lot of stuffing my skin into them. It felt different than trying to wear jeans that were too small.

Over the last several years, I've noticed more and more the toll that the excess skin has taken on my upper arms and my inner thighs. I really don't want surgery for these. But they are hindering things that I'm afraid will only get worse over time.

I will write more about this later, because this post is already long enough. Recently, though, I contacted my plastic surgeon to ask about having a consult. I have in no way made a decision to have more surgery (and I'm thinking that I probably will decide not to--the recovery for legs is terrible, from what a few of my friends who have had the surgery told me).

The consult will only be to see my doctor thinks it's a good option for me, based on the issues I'm having.

If I do choose to go through with surgery, I would likely plan for next winter (maybe November or December) so that my healing time won't be so miserable. We don't tend to do much in the winter months.

I want to make sure my weight stays pretty stable this year, too. I'd like to stay under 144, which is at the top of a normal BMI range for me. (Also, our debt will be paid off and we will be able to save up for the surgery.) Jerry is super supportive of me getting it--he's been mentioning it for a few years now, when he hears me complain about the skin for various reasons.)

Anyway, this turned into a very long-winded post! If anyone has questions about loose skin, I'd be happy to open up and answer them here. (If they are too personal, I will say so, but for the most part, I'm pretty candid about it now. So, ask away!)

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Liberating!

This morning, I had a five mile easy run on the schedule; however, I planned to run nine miles instead of five (I'll write more about that tomorrow). Since I finished Breaking Bad yesterday, and haven't decided on a show to watch next on the treadmill, I decided to run outside, regardless of the temperature.

It was a VERY humid morning. I headed out fairly early, at 7:00, but it was already really muggy. I just decided to pretend I was running in Key West ;)  I didn't carry water with me, because I usually don't need it for ten miles or less, but since it was so humid, I stuck close to home. I planned to do a six-mile loop and run by my house, stopping for water if needed, and then do a three-mile out-and-back.

It was a GREAT run today. Even though it was humid, causing me to practically drown in sweat, I felt really good. I don't know what planted this idea in my head, but I started thinking about ditching my tank top when I ran past my house, and running in just my sports bra.

I've never, in my entire life, bared my belly in public. I've never worn a bikini (even as a kid, I always wore a two-piece). When I was pregnant, and friends asked to see my belly, I was adamant about saying no. Shortly before I started losing weight, my friend Melissa asked me if I would want to go with her to auditions for The Biggest Loser (couples' edition). I said that I would rather stay fat than let anyone see my stomach.

But once I got the thought in my head, I spent a few miles talking myself into it. I know my belly looks much better than it ever has, thanks to the weight loss and the skin removal surgery. However, I still have stretch marks, and the skin is still loose (the only way to correct that would've be with a vertical incision from my breast bone to my pubic bone, and I didn't want that).

As I ran, I kept thinking about how absolutely terrifying it would be to run in just a sports bra, but how liberating it would feel to get rid of those insecurities. When I was obese, if someone had shown me a picture of my future stomach (what it looks like now), I would have been ECSTATIC with it. I would have said that I'd walk around naked, just to show off my new body! ;) But now that I'm here, in this body, I still have insecurities, although they aren't as bad as before.

So, I asked myself, "What's the absolute worst thing that could happen if you run in just your sports bra?" And the only thing I could come up with is that someone would make a rude comment to me while I was running. Big deal! Sometime over the past few years, I stopped caring so much about what random people thought about me. And I decided to go for it, even though I was super nervous.

At mile six, I stopped at home for a  second to throw my shirt in the house. I didn't want to look in the mirror, because I was afraid I would chicken out. I hesitated at the door to go back outside, but then, before I could change my mind, I opened the door and ran off the porch, down the driveway, and into the street.

I was running... without a shirt. Something I never, in a million years, would have ever thought I'd be doing.

And it was SO liberating! The breeze cooled me off much better than when I had my tank on. When I looked down, I could see the skin on my stomach bouncing a little, but I honestly didn't even care. I had thought that maybe I would just run around my neighborhood, so I wouldn't run into many people/cars; however, I was feeling so good, that I went on a busy road and ran a mile and a half out, turned around, and ran home.

Nobody made comments to me, no cars crashed from my blindingly white skin, and people barely even glanced at me as they drove by. It was awesome!

50 Shades of Pale

I thought it was pretty funny when I looked at my splits. I was trying to run an easy pace (high 9:00's to mid 10:00's). You can see just how nervous I was when I took my tank off, because my pace for that 7th mile was 8:58. When I'm nervous, I always run faster!

It was fun to do something that was so scary for me. I don't look anything like the high school girls that run cross country in their sports bras (who I see out training occasionally), but considering I'm a formerly-obese mother of two, I'm very happy with how I look now, and I'm going to keep working on not feeling self-conscious of my flaws!

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Loose skin issues

This whole post is full of TMI (too much information), so I am sorry in advance for that... ;)

Yesterday morning, I had one of the worst runs ever. I wore my new shorts (which isn't the reason for the bad run), and was excited to try them out on an easy four-miler outside. It was hot and humid, but not ridiculously so.

When I first started running, I almost immediately turned around to change out of the shorts. I hated how uncomfortable the jiggling of my loose skin was. Chafing wasn't an issue at all, thanks to the Aquaphor I put on my thighs, but loose skin moves a lot. The best way I can describe it would be like running without a sports bra. Normally, I wear compression-fit capris, which hold everything really tight, so jiggling isn't an issue.

Since someone always comments that I don't look like I have loose skin on my thighs, I'm going to post a graphic picture for the first time, showing that I'm not making it up. Loose skin is a sensitive subject for me. I worked extremely hard to lose the weight I did, but this is the result of the weight loss, and evidence that I used to be morbidly obese. Here is a picture of when I was lying in bed last night. It's not a flattering angle, but it shows just how loose the skin really is (that's my inner thigh):

As much of an inconvenience that the loose skin is, I would choose my loose skin over my obese legs any day. When I was obese, my legs rubbed together constantly, so I was chafed all the time. It was hard to walk because they felt so heavy. I had to stuff them into my clothes, which was extremely uncomfortable. The loose skin isn't pretty, but it's much more comfortable and easier to deal with than the issues I had when I was obese.

Anyway, I wanted to give the shorts a fair chance, so I decided to just run the whole four miles before deciding whether I liked them.

When I got on the main road, I was very self-conscious of the jiggling. Logically, I knew people probably weren't staring at my thighs; but the fat girl inside my head was remembering when people used to yell out their car windows at me--"Fat cow!" "Moo!" "Look at fattie run!" and stuff like that. After about a mile or so into yesterday's run, I stopped caring about what I looked like, and just tried to focus on keeping good form.

Something I wasn't expecting about wearing shorts was that it would throw off my running form. The movement of the loose skin made me swing my legs outward a little on each step, and I could feel it in my knees (a twisting motion). Not a good thing.

It was when I got to mile two and turned around that my run got really bad.

I was extremely nauseous for some reason. I was running at an easy pace, so it wasn't like I was exerting myself too much. All of mile three, I was just trying to focus on breathing normally, and trying not to panic at the nausea that was getting worse. After I reached mile three, the nausea was so bad that I wanted to stop and just vomit on the side of the road. But stopping would mean I wouldn't be at home, and I desperately wanted to get home.

I was trying not to think of throwing up, because it kept causing me to feel more panicky. Instead, I focused on breathing and I finally--FINALLY--made it home. I sat down for a couple of minutes, and the nausea went away, but my stomach was feeling really icky after that. (I had a wave of nausea after breakfast this morning, too. Not sure what's going on. No, I'm not pregnant!)

I'm glad I tried the shorts, because I'd always been curious about them; however, I'm going to stick with my compression-fit capris, because they are much more comfortable.

Today I had speed work on the schedule. I was hoping to go to the track, but it was thunder storming outside, so I ran on the treadmill instead. I did one of the Hansons' speed workouts: 4 x 3/4 mi with 400 jogs. Basically, that was a 1 mile warm-up, then 3/4 mile at 7:30-ish pace, 1/4 mile jog (repeat for a total of 4 times). On paper, it didn't seem that hard; but when I did it, it was a tough workout! I kept thinking I'd never last more than two intervals. Somehow, I managed to get through the entire thing, though.

I felt like I was drowning in sweat when I was done. I just sat in front of the fan for a couple of minutes trying to cool off. But it felt great! I love that feeling of pushing my body to the max (well, when it's over, I love it).

Even after taking a cold shower, my face was still flushed. A good workout!

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Taste Test Tuesday was a big win this week! I bought this new flavor of cream cheese:

As I've mentioned before, I love anything jalapeno, so I was excited to see this at the store. However, I don't eat cream cheese much, so I wasn't sure what to do with it at first. I ended up making a sandwich with an English muffin, a vegetarian chicken patty, and a tablespoon of this cream cheese, and it was insanely good!

It's the perfect amount of spicy, too; not so spicy that you can't taste anything else, but not a "barely there" kind of heat, either. I used just one tablespoon for the sandwich (for 1 PP) and that little bit went a long way. I'm going to experiment with it a little more, too--maybe on eggs, or as a spread for other kinds of sandwiches. Maybe even on some sort of pizza? Jerry gave this two thumbs up as well; we both loved it!

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By the way, I forgot to post this earlier... A few people asked about the bracelet Brandi gave me. Her friend has an Etsy shop, and she custom made it with my own quote: "determination always trumps motivation". I love it!

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Indiana, Day 3

I slept horribly last night. The bedroom Jerry and I are staying in at the rental house is right next to the family room, and everyone else stayed up MUCH later than me. Nathan and Shawn (my brother-in-law) were up until 6:30! They were being pretty loud, so I didn't get much sleep at all.

This morning, I went for a run as soon as I got up. Everyone else was still sleeping (except for my parents), so I headed out for the same route as yesterday--three miles. Today, I deliberately tried to run fast. It was really nice outside, and perfect for running!

When I got back to the house, my sister was awake and she said she was a little disappointed, because she was hoping to go for a run with me (I had told her that if she brought running clothes, I'd go with her while we're here). I had only run three miles on my own, so I told her I'd go with her anyway.

She's been doing really well with Couch to 5K training. She's been doing all of her training on the treadmill, and she said she was nervous about going outside to run. I knew she would enjoy it, so I was glad that she wanted to give it a chance. The plan was to run 3/4 mile, then walk 1/4 mile, and repeat one time. Jeanie had been doing her running segments on the treadmill at a 4.5 mph speed (a little slower than a 13:00/mi pace); so I told her that she could set the pace, and I'd just run along for company.

She really liked running outside, and was surprised how quickly the time went by. She went faster than she thought she was, too. These are the run/walk splits:

She planned on a 13-ish pace, but she ended up running under a 12:00/mi pace on the running segments! I find when I run outside, I feel like I'm going slower than I actually am. When I run on the treadmill, I feel like I'm flying, but the pace doesn't reflect that. But anyway, I'm glad she enjoyed running outside, so hopefully she'll feel confident enough to do it again.

This afternoon, my sister asked me if I had a bathing suit to wear in Key West. Um, no. The last bathing suit I bought was a size 12/14. I hate to swim, so I never have a need for a bathing suit. But I started thinking about how I should probably get one for Key West, just in case.

I'm super self-conscious of my thighs and my stretch marks. My thighs have very saggy skin, and my belly still has stretch marks. So I wanted a bathing suit to cover those things, and it's hard to find a cute one that does the job! Jerry and I decided to go to JCPenny, so I could see if they had any suits. Being December, I wasn't hopeful.

It turns out they had just ONE left. And what's kind of funny is that I thought it was pretty cute! I tried it on, and it worked well enough. I'm still self-conscious of my thighs, but if I get really desperate, I think I can pull it off. I will not embarrass myself by posting a picture of me wearing it, but here is what it looks like:

Not a bad suit for being the very last one they had! It has an optional neck strap, so I would certainly use that if I end up wearing it. But anyway, I'm glad to have it in case I need it. My other bathing suit is so baggy that you can seriously see my butt cheek through the leg hole.

We leave for Florida two weeks from tomorrow!! I cannot believe it's coming up so fast. I'm super excited!

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Guest Post: The Unmentionables of Running

As I've pointed out more than a few times, after running my first marathon, I discovered that one of my toenails was turning black. I never thought it would happen to me! I've heard of runners losing nails, but I just thought I wouldn't have that problem, because I'd never had the problem before. But it sparked a conversation about the "unmentionables" of running.

And who better to ask about those topics than The Boring Runner? One of the things I enjoy most about Adam's blog is his bluntness. He is not ashamed to talk about things that would make other runners blush, or admit when runner's trots got the best of him. "The Boring Runner" is not at all what I would call 'boring', because it's extremely entertaining--Adam has a way of talking about boring stuff and making it interesting!

I asked Adam to write this guest post about the grosser parts of running, and I think you will find it entertaining and even informative. Also, and I didn't know this until I read his guest post, Adam is a fellow weight-loser--he's lost 50 pounds! I hope you enjoy his post, and make sure you check out his blog as well. I look forward to his Funny Foto Friday posts all week ;)

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Six days a week, my routine is very similar.  I wake up, stumble around a bit, put in my contacts, fill my water bottles, and wait.  Oh, I might read a blog or two, check up on twitter, but mostly – I wait. You see, after 6 years of running I’ve learned many interesting and amazing things about my body.  The most important? Waiting 10 minutes before a run to go poop is oh so much better than duck walking half a mile to the local convenience store at mile 4 of a 10 mile run. Quite simply, I’ve learned that, while my body propels me to speeds I only dreamt of, on occasion it reminds me just who is in control.

First things first, I suppose that I should introduce myself.  As you might expect, this is not Slim Katie.  My name is Adam and I blog over at The Boring Runner, where I have a reputation for saying all of the things that everyone is thinking but doesn’t quite feel comfortable saying. Poop? Yep.  Frost bite on my pointy bits? Yep. Talking about how I met a nice homeless person while peeing behind McDonalds? Yep.   My blog follows my journey of completing 15 marathons and counting, losing 50 pounds, taking a full hour off of my marathon time, and becoming a running coach.....all while trying to balance work, fatherhood, and my horrible reality TV obsession.  

Katie recently reached out after her marathon (likely after a post wherein I spoke of corns on my feet or snot on my shoulder) asking if I would write a quick blurb about some of the not so glamorous things that happen to our bodies as a result of running. Just like a runner to a bowl of free breadsticks at Olive Garden, I dove in head first.  What follows are a few of the not so pleasant tidbits about what happens to our bodies while running (and what to do about them!) that I’ve picked up along the way.

Runners Trots: Isn’t it funny how marketing companies have a way with making anything about poop seem cute and cuddly? Example: Those cartoon bears in the toilet paper commercials. What do THEY have to do with toilet paper? I think if I saw a bear using toilet paper I’d ship him off to the circus faster than you could say “hey Yogi, ride this tricycle”.  Same goes for runners trots.  Cute name, not so cute bodily function. Quite simply, this is the urge to “go” (poop) while you are running. We’ve all been there – a sweaty in a gas station bathroom we wouldn’t normally set foot in.

There are two main reasons that “cause” the often VERY sudden urge: First, blood is diverted away from your GI tract into your legs and lungs (stopping digestion) and second, the sloshing of everything frankly helps it break free. Lovely.  There are lots of things that you can do to try to prevent them (other than making sure you’ve “went” before).  Caffeine is the biggest culprit, but also avoiding greasy or fatty foods the night before, avoiding dairy, and of course the day before is NOT the time to start an all fiber cleanse. Making sure you are well hydrated will help with the aforementioned “going” beforehand... and well, toilet paper in a ziplock is never weight wasted.

Sweat / Chaffing: Other than to clear bowels, most people run to burn calories.  The problem? Burning calories creates heat. (In fact, a calorie isn’t a unit of ice cream, it is officially a unit of heat!) When it gets hot, bodies sweat. A lot. It can turn those cute white Nike shorts into a bit of a peep show - fast. Sweating has its purpose. In fact, the more you sweat (or rather, the more your sweat evaporates) the cooler you’ll be. But sweat has a nasty side....Chaffing.

Whenever you mix fabric with moisture and two pieces of skin rubbing together (insert inappropriate joke here) the skin revolts into a red, sometimes bloody, always painful rash.  The solution is either a product like body glide / Vaseline (that stains clothes) or tighter fitting clothing.  Put it wherever skin meets skin or where seams touch your skin (waist, bra line, crotch, under arms...pretty much everywhere).

Calluses/Corns/Black Toenails: Running can help you lose weight to become a slimmer, sexier you....but running is hell on your feet.  Each time we take a step while running our feet absorb 2.5x our own body weight.  Oh our poor feet. They callus, get dry, corns may develop, and you might even lose a toenail – all in the name of running! (I’m really selling running right now, huh?) Being a guy, I haven’t found a solution to this that doesn’t question my manhood.  I assume that you could probably get weekly pedicures to shave off the calluses.  Black Toenails are usually a sign of shoes that do not fit quite rite (or a 2nd toe that is much longer than the first).  Feet swell up to a full size bigger when running long distances, so your little tootsies need room to grow!

Snot: Honestly? I have no idea why running causes so much snot. But it does. Blow away! Just practice your aim.  Trust me.

Those are the high (low brow?) points.  There are lots of other examples of unmentionables that go along with running (farting anyone?) but the four above are certainly a great start.  I mean, once you have those figured out, running is actually pretty fun!

50 pounds down!

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The lumps and bumps

This will be the last you read about my damn marathon outfit, I promise! I went to Dunham's today to return the wrong-size capris, and while I was there, I searched for another outfit. I found a yellow shirt to possibly wear with my yellow slash capris, so I picked that up to try on. I also picked out a light turquoise shirt and capris to match (although they weren't as cute as the slash capris).

Some of you mentioned that you don't see how I could have "lumps and bumps", so I will show you a picture of what I'm talking about. This takes a lot of courage to post, so please be nice! I will show you comparisons of shirts. These are all the same brand (Under Armour), but different sizes and fits...

Cringe! These are the lumps and bumps I was talking about.

Way too see-through! You can see my belly button.

This is the one I'm going to wear. It's not to tight, not too loose, and it matches my capris!

Despite the fact that the yellow is kind of see-through, I'm going to wear the semi-fitted yellow shirt with the yellow slash capris. Please don't tell me it's the wrong choice, because I'm so sick of thinking about this stupid outfit! I'm going to have my waist-pack (water bottle thing) on, so my stomach won't even be too visible regardless.

See what I mean, by clothes hiding a lot of flaws? Since I just had a lower body lift, my upper body still has a lot of excess skin. My arms are the worst, but also under my arms, and even my upper back. It's not "fat", you can see bulges from my loose skin. I'm not too worried about it. The stomach REALLY bothered me (obviously, because I had the skin removed); but the upper body is just normal annoyances, I think. I just have to take care when picking out clothes.

So I finally got that taken care of. I just took the shirt to a place about 30 minutes away to have my blog address printed on the back, as well as my name printed on the front... they told me it would take 3 days. I was really bummed! So I won't have that stuff on there, but at this point, I really don't care. I just want to be done thinking about the clothes.

Jessica and I had our LAST training run today!! It was a 2-miler... and no, that's not a typo. Two miles. We actually met at a frozen custard shop and ran one mile out and then back. We did our fastest pace to date, I'm sure... a 9:29/mi pace.

I kept telling Jessica we were going too fast, and she better not pull that shit on Sunday, or she'll be running alone. It barely felt like we even started our run before we had to turn around. We finished and ordered frozen yogurt, of course! They had strawberry and chocolate, so I ordered a twist of the two. Jessica just ordered the strawberry.

Supposedly, the 4-oz serving of frozen yogurt was only 70 calories! I should go there more often. That was totally worth 70 calories.

Tomorrow morning, Jerry, me, and the boys are leaving for Cleveland. We're probably going to go to the zoo and maybe the science center tomorrow. Jessica isn't leaving for Cleveland until Saturday, so I'll meet up with her then. Renee and Andrea are going as well, and they will be our cheerleaders on Sunday. I am SO excited that they are going to be there! They've both run marathons before, so they know how big of a deal this is to Jessica and me.

I'm going to bring my computer with me, to hopefully write a blog at the hotel on Friday and Saturday, but I don't know for sure if I'll have internet access. If not, you'll probably get a race report on Sunday night--if I survive, that is! ;)

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A morning at the rec center

Today was the kids' last day of Winter Break from school, so we decided to take them to the rec center this morning to go swimming. I told Jerry he could watch them in the pool while I did a run on the indoor track, and then I'd watch them in the pool while he did whatever he wanted to do.

I brought my bathing suit because the kids really wanted me to swim with them. I hate swimming. I don't like being wet, I don't like how disgusting my hair feels from the chlorine, I don't like having to wash a ton of towels and stuff when we get home... but I agreed to swim with them.

First, I did my easy three-mile on the indoor track. It was kind of boring for the first mile, because nobody else was on the track. But then some guy came in and started lapping me. He was probably running a 6:30 mile, but he quit after about a mile.

Right when I was finishing my run, I walked over to my water bottle and saw this guy that I went to high school with. I started going to that school in tenth grade, and he was my first crush at that school. I even asked him out to the Sadie Hawkins dance (the only time I've EVER asked someone out!) and he said no. Hahaha, he didn't give me the time of day!

I wish I could say that I looked really awesome today and he was checking me out and all that, but no--I had just run 3 miles, my hair was in a bun and I had no make-up on. My shirt was a little sweaty, and it happened to be my horribly embarrassing "Half My Size" shirt. I don't know if he recognized me, but I avoided looking at him while I stretched and then I went downstairs.

I went into the women's locker room and undressed to put on my bathing suit. It's way too big (a size 12 suit) and I knew I looked ridiculous. But I hate wearing bathing suits, so I avoid shopping for them. I hoped that I'd be less self-conscious of my body now that I've had the skin removal surgery, but I was actually MORE self-conscious. I was very aware of my saggy thighs and upper arms. The bathing suit was really baggy, so I kept pulling at it make sure it was in place. I was the very definition of 'awkward'.

I was relieved to actually get in the water so I could hide myself.

I swam with the kids for about a half hour, the whole time dreaming about getting in the sauna to warm up when I was done. I brought shampoo with me to get the chlorine out of my hair, so I washed my hair and then happily skipped over to the sauna. I was so looking forward to feeling that hot, steamy air hit me in the face when I opened the door.

When I opened the door, it was just as cold as the air outside. It wasn't turned on :(  So I just hurried and changed into my clothes and we left. Next time I'll need to remember to turn on the sauna before I get in the pool, so it's nice and hot.

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I sneaked a peek at the scale this morning, and my weight is going back down since I quit the challenge--hallelujah! In the three days since I quit, I've dropped 5.5 pounds. I started the challenge at 136, got up to 144.5 in the three weeks that I was doing the challenge, and then today I was 139. I think quitting the challenge early was definitely the right decision!

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My Victoria's Not-So-Secret Purchase

I got up bright and early today to get ready for my doctor's appointment. Remember how I mentioned that I had a little pucker of skin where my drain tube was after surgery? The skin kind of folded a little while it healed, so Dr. Tepper wanted to fix that with a simple, in-office procedure.

Since I was going to be in Dearborn anyway, I asked Jessica and Renee if they'd want to come with me and then we could go out to lunch at none other than LA PITA--yum!  I drove up there and then gave them my Jeep to go to the mall or out for coffee or something while I had my appointment.

Renee suggested martinis at La Pita, and I was definitely on board with that idea, since I'd never had one before. We each had a dirty martini to start:

I was very surprised that I drank the entire martini. I really thought I would hate it, because I'm not a liquor person at all--but I rather liked it!

Then we had warm pita bread with lots of garlic sauce, and then our entrees of a chicken kabob, rice pilaf, salad, hummus, and more garlic sauce. I was in Heaven! I tried to take a picture for you all, but as I've mentioned before... THIS is why I'm no food blogger:

See that little black ramekin with white stuff in it? That is the garlic sauce, and is my sole reason for living favorite part about La Pita!

And since I got a free birthday dessert, I definitely couldn't pass that up--we shared a piece of carrot cake. It was amazing, despite the fact that I was stuffed from the rest of my lunch.

My doctor's appointment went very well. They had a room that was like a mini-OR set up, and I had to lie on the table. The nurse gave me a heated blanket to cover with--love those things! Dr. Tepper gave me a local injection to numb me, so I didn't feel anything. It was very strange to watch her work though--using a scalpel and stitches and all the surgical stuff. I could feel some tugging, but no pain. The stitches she used are internal and will dissolve, so the scar looks just like it did before, only without the pucker.

After my appointment was over, Renee and Jessica picked me up and we went to the mall. They both agreed that the dress I picked out yesterday made me look old--lol, I'm so glad that I have friends that are honest!--so they had found a couple that they liked while I was at my appointment. I tried on one at Forever 21 and it was WAY.TOO.SHORT. Like, you could see my you-know-what if I bend over kind of short.

We went to Victoria's Secret next, which as you all know, I was excited to buy something cute/sexy with my gift cards. I tried on about five things, but I really fell in love with the one I ended up buying. And since there is no way in hell I would ever post a photo of me wearing it, I'll show you what it looks like on the hanger ;)

Super cute, right? And of course it was super expensive, so not only did I have to use both my gift cards, but all the rest of my birthday money as well. Ah, the things we do to feel sexy ;)

After that, we went to Express so I could try on the other dress that Renee and Jessica picked out. I loved it!! I'm a little self-conscious of it because it's strapless, and my arms have a lot of excess skin, but I can wear a shrug with it if needed. Maybe I'll post a photo on Saturday. I think I might wear it to Winers Saturday night, just for fun.

Came home and really wanted to just lie down and digest my food, but I've got a lot of cleaning to do. The kids are spending the night at my parents' house tonight, and Jerry is off work tomorrow, so we're going to be spending the day working on the house. Fun, fun, fun.

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All About My Skin Removal Surgery, Part 2: The good, the bad, and the ugly

Click here to read Part 1 first.

Having a lower body lift after losing well over a hundred pounds was one of the best decisions I've ever made. It's been over seven weeks since surgery, and I'm SO HAPPY that I did it! It wasn't all sunshine and roses, however. Here, I will share the good, the bad, and the ugly parts of the skin removal surgery...

The Good

I'll start with the obvious: My mid-section looks a million times better than it did before surgery! Even from the first day post-op, I was thrilled with the results.

The surgery wasn't nearly as painful as I thought it was going to be. The first few days were rough, which I'll talk about in "The Bad" section, but the rest of recovery was pretty easy. My stomach and incision were completely numb, so it didn't hurt. I switched from Vicodin to Motrin after about a week, and I'm sure I could have done that even sooner.

Before surgery, I was very worried about the incision across my back (which is at the top of each butt cheek, very low). It really scared me to have an incision that went all the way around. But after the surgery, I actually paid very little attention to that part of the incision, because I kind of forgot about it. The back lift part of the lower body lift was the easiest part of the surgery.

The compression garment wasn't nearly as annoying as I'd read about online. Actually, I kind of liked wearing it. It's a secure feeling. It's very tight, but I wasn't uncomfortable wearing it at all.

I was able to move easily on my own after about five days.

I was cleared to start running again (or any exercise except ab work) after just eight days post-op (but I chose to wait until 4 weeks).

I feel SO MUCH MORE CONFIDENT in my body now. I don't feel like I have to "hide" my figure, and I feel confident to wear cute clothes and tight jeans. It has done wonders for my self-esteem!

I recovered very quickly. I thought I would be layed up in bed for six weeks, but I was moving around easily by two weeks post-op.

I didn't have a single complication. This might have been luck, or maybe the fact that I followed my surgeon's instructions right to the tee, but I was very happy not to have any complications.

The Bad

I was extremely nauseous after surgery for about 15 hours. I even dry-heaved a few times in the hospital, and it hurt very badly because my abs were sore. I've never experienced nausea like that! It was so bad that I cried (which made it hurt more).

My mouth was extremely dry after surgery for about 24 hours. I was told that part of the anesthesia causes you to stop producing saliva for about 24 hours. It was extremely difficult to chew and swallow food because I had no saliva in my mouth. I drank a ton of water just to be able to eat.

It's hard to get comfortable while lying down, and it hurt my abs very badly to turn over. I slept on each side and my back, turning every couple of hours so I didn't get too stiff, but turning over was very painful in my abs.

I was extremely weak. I cannot believe how tired I got from everything I did. For about the first week post-op, I became exhausted from something as simple as taking a shower or walking to the bathroom. I would have to do my shower quickly enough so that I could lie back down. I was out of breath from just walking to the bathroom. It was a weird feeling, because I was in great shape prior to surgery, running 3-5 times a week. I can't imagine doing this surgery if I was OUT of shape to start with. The weakness was probably THE hardest part about the surgery.

The drains are a pain in the ass to carry around. I had four of them, and it was impossible to tuck them into my pants, so I had to come up with other creative ways of wearing them. While at home, I just hooked them to my shirt or waist band, not caring that they were visible.

I had a weird burning pain on my thighs for a few weeks. It was a surface pain that felt like I had been burned (like a sunburn). I don't know what it was from--the skin looked totally normal there--but it resolved after a few weeks.

After taking four weeks off from running, I wasn't able to just pick up where I left off. It was painful in my abs, but mostly, my lungs felt like they were on fire from being out of shape. I was very winded, even going at a slow, easy pace.

My hip bones felt very strange for a few weeks post-op. They weren't really painful, but I couldn't stand to press on them or have any pressure on them. I couldn't wear tight jeans for a few weeks because they pressed against my hip bones and it was a very weird, extremely uncomfortable feeling.

My abdominal muscle repair was the most painful part of the surgery. Like I said, my incision didn't hurt, but my ab muscles were sooo sore for about ten days. I walked hunched over for about a week. Sneezing, coughing, and laughing were pretty painful for a couple of weeks.

I had to eat a ton of protein. This is under "The Bad" because I've never been a "protein person". I don't like meat very much, and it's hard to get a lot of protein without eating meat. I ate a LOT of pan-fried salmon, tuna fish, and nuts to get protein. I had a protein shake every morning, and my snacks were string cheese and nuts. My doctor wanted me to get 100+ grams per day, and I complied by getting probably about 130 grams. That is VERY hard to do!

Salmon and parsley potatoes--my lunch every single day!

I definitely needed help around the house for the first five days or so. Luckily, I have a super supportive mom and husband. They took great care of me! When Jerry was at work, my mom came over and did housework for me and helped me move around. Jerry waited on me hand and foot. My parents kept my kids for a few days. This surgery would be extremely difficult to get through if you don't have someone to help you.

The Ugly 

Initially, the incision looks kind of gross. There is a lot of dried, crusty blood, but I didn't want to peel it or pick at it for fear of opening up a wound.

My belly button still looks red and irritated, but it's just the color of the incision right now. It doesn't hurt (and never has) but it looks kind of gross for a while. When I first came home, I had gauze packed in there with tape over it.

On each side, just behind my hips, there was a spot in the incision a couple of inches long that looked puckered. I asked my surgeon about it, and she said that it was normal and after the sutures dissolved, it would smooth out. (She was right, it has smoothed out now). But the first couple of weeks, it looked gross--wrinkled and kind of gathered on the bottom half of the incision. My surgeon said it was from the bottom half being larger than the top half--which makes sense. Of course the skin isn't going to line up perfectly. So it was wrinkled while it healed. (You can see that in the below photo)

My back was very bruised (from about the middle of my back all the way to the incision line). This was from the small amount of liposuction that my surgeon did on my lower back. The bruising didn't hurt, but it sure was ugly!

The drain tubes coming out of my body didn't bother me, but I guess many people would consider it ugly ;)  There was one on my left hip, close to my butt, two just under my pubic hair line (one of the left, one on the right) and one on the front part of my right hip. The one on my left hip was pretty sore and I was relieved to have it removed.

My belly button looked off center at first, and I was worried about having to get a revision down the road to fix it. But it must have been because of swelling or something, because gradually, it centered. It's still a little off, but that's how it was before surgery. The surgeon doesn't actually MOVE your belly button--they just move the skin around it.

The swelling is pretty bad for a few weeks. Immediately after surgery, I was excited to see that I wasn't swollen at all. I thought I was just lucky. Then it hit me after about a week, and I swelled up a lot. Even now, I'm seven weeks out from surgery and my very low abdomen is still swollen--it looks like a baby bump.

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I think that pretty much sums up everything I can come up with about the surgery! Of course, I'm happy to answer questions, so feel free to e-mail me.

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All About My Skin Removal Surgery, Part 1

After losing well over a hundred pounds, I knew I was going to need some skin removal surgery--particularly from my abdomen. My skin was so deflated and saggy, and it got in the way all the time. I got rashes and infections under the "apron" of skin and in my belly button. Running for exercise was hard, because my stomach would bounce up and down, causing a lot of pain.  My clothes didn't fit right, because I had to tuck my extra skin into my pants. And no matter how big my pants, I always had a hangover of skin on my sides (love handles).

I called my insurance company, just to see if it was even possible to get the expensive surgery covered by insurance. Surprisingly, they told me that it's possible. They told me to go see a plastic surgeon, who would determine if it was medically necessary, and then submit the claim. I had no clue what the surgeon would be looking for, and more importantly, I had no clue how to pick a surgeon.

When I went for a consult (I'll explain how I picked my surgeon later), she told me I was a perfect candidate for not just a tummy tuck, like I was planning on, but a lower body lift (also called a belt lipectomy, or circumferential tummy tuck, among other names). Basically, the surgeon makes an incision ALL THE WAY AROUND your lower abdomen, and all the way around your upper abdomen, and then pulls the top down to meet the bottom, and sews it back together. It includes a muscle repair of your abdominal muscles, which pulls your muscles together and gives your stomach the very flat look--rather than a rounded, beer-belly look.

I was very anti-body lift, because I'd heard it was much riskier, and I really didn't care what my butt looked like. However, I eventually decided to get it (I'll explain that more later, too). I had the surgery and am THRILLED with the results! Here, I will write ALL the details for anyone who is considering the surgery. This is all from my own experience--remember, I'm not a doctor! ;)

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Candidates for surgery

This is NOT a weight loss surgery. I can't stress that enough. If you are overweight, you will not get skinny from this surgery. The surgery is meant for people that have lost a large amount of weight and have saggy skin around their middle.

To get an idea of the results you can expect, put your hands on your hips and holding tight, pull up all that skin--you'll notice your hips, butt, and abdomen all lift up tight. If you don't have a lot of flabby skin on your butt or hips, then maybe a tummy tuck would be the way to go. I would talk to a plastic surgeon and see what they recommend.

Insurance

There is a (very small) chance that your insurance company might pay for a part of your surgery. I almost didn't even ask, because I was SO SURE that my insurance company wouldn't cover it--but I'm glad I did, because I was pleasantly surprised to find out that they covered about 3/4 of the cost.

I would call your insurance company ask what the requirements are to get a panniculectomy covered. A panniculectomy is the removal of the "apron" of skin on your lower abdomen. This does NOT include  muscle repair or replacing your belly button to where it should be. I learned that a panniculectomy would be covered, but everything else would be considered cosmetic, and I would have to pay out of pocket for that.

The requirements for MY insurance to cover the panniculectomy were: 1) Must have lost at least 100 pounds; 2) Must have kept the weight off for at least 6 months, and 3) Must have rashes caused from the excess skin. Since I met those three requirements, my insurance covered that part.

The rest of my surgery--muscle repair, replacing my belly button (both of which are included in a full tummy tuck, or abdominoplasty), and the hip and butt lift part were considered cosmetic, and not covered by insurance.

Choosing a plastic surgeon

My selection process was actually quite simple. I only went to one consult and decided she was the surgeon for me. But first, to select a surgeon, I decided that I wanted to pick someone in the Henry Ford Health System. I've seen great doctors in that system, and I used to work for a fantastic OB/GYN in the HFHS. My jaw surgeries were at Henry Ford Main Hospital in Detroit, and I was happy with how everything went. So I started looking online at the plastic surgeons of HFHS, and reading their bio's. All of them sounded impressive. There were a few that specified they worked with post-bariatric surgery patients--while I did not have bariatric surgery, I did lose a lot of weight, so I knew that these surgeons were probably the right choice. One really stood out to me, for some reason--Dr. Donna Tepper. I never thought I'd pick a female surgeon, but I liked her bio.

I decided to e-mail the surgeon who performed my jaw repair surgery and ask him if there was a plastic surgeon he would recommend for me. I really liked him, and trusted his input. When he wrote back, he said Dr. Tepper--without my even mentioning that I liked her bio. So it was almost like a sign that I should choose her.

I set an appointment, which took about 5 weeks to get in for a consult. When I met her, she was VERY confident, and happy that I lost the weight through diet and exercise--she made me feel very comfortable. She had a great personality, sense of humor, and wasn't too pushy. She answered my questions and didn't seem like she was in a rush to get out of there.  I felt like I was talking to a friend. I really liked her, and didn't see any reason NOT to choose her. I listen to my gut feeling when I'm making an important decision, and deep down, I knew she was the right choice.

When choosing a surgeon, it's VERY important to choose a surgeon who is board certified. Don't just take their word for it, either--you can look here to check for yourself. I would also recommend that you choose a surgeon who has hospital rights, or who only works out of a hospital. Some surgeons do the procedures in their own offices, so if something goes wrong, you can't just go to the hospital to fix it. Dr. Tepper works out of several different HFHS hospitals, which eased my fears--and also made it more convenient, because I was able to see her in different locations, depending on what was easiest for me.

Also, and this is just coming from my opinion, of course... the very very popular plastic surgeons are not necessarily the best ones. A lot of times, they are only popular because they have commercials advertised on TV, or billboards with their names on them. They are probably very busy and won't have much time for you--a lot of people don't put much thought into selecting a surgeon, so they just pick the guy who has a television commercial, because he "must" be good to have his own commercial.

I think it's very important to choose a surgeon that you can tell LOVES HIS OR HER JOB. Dr. Tepper was very excited about my weight loss and I could tell she was excited that I was going to have a good result due to my hard work. Seeing that she was excited about it, I knew she was in it because she loved her job--and because of that, I knew that she would want to do her best job during my surgery.

When I read the tummy tuck message boards, I notice that everyone asks, "Who is 'the BEST' surgeon in such-and-such state/area?" and they let that be the deciding factor. But a lot of those people don't have very good results after their surgery, and then they later find out that their surgeon doesn't have time for them to work with them and make them happy, so they are stuck with a bad surgery. 

My advice would be to do your own homework--choose a hospital that you trust, and check their website for plastic surgeons. Read the bio's and see if any stand out to you. See if they specialize in post-weight loss surgery. Then meet them and see if they seem confident, excited about their job, and tell you what to realistically expect from the surgery.

Questions for your surgeon

Once you choose a surgeon, you'll want to come up with a list of questions that you want answered before surgery. Make sure you carry a list everywhere with you so that you can add to it if a question pops into your head. Some questions I asked:

*Is it possible for this to be covered by my insurance? Do you submit a claim for me?
*How long before I can run again?
*How long can I realistically expect to need help at home?
*How long is the surgery time?
*Do you take precautions during surgery to prevent blood clots, since the surgery time is so long?
*Will I stay the night at the hospital? Can my spouse stay with me?
*What can I do after surgery to recover as quickly as possible?
*Do I need to buy a compression garment?
*Can you show me exactly where my incision scar will be? Will it be visible above my panty line?
*What positions can I sleep in after surgery?
*Will I have drain tubes? How many? Where will they be placed?
*If I have a question or problem after surgery, and I need to get a hold of you after office hours, what number should I call?

If you work, you'll want to ask about when you can go back to work, what the restrictions will be, etc. At your pre-op appointment, you'll want to ask everything. If your surgeon seems annoyed at the number of questions, I would definitely reconsider that surgeon! Dr. Tepper was very patient and answered everything I asked.

Pre-Op

I asked all my questions at my pre-op appointment (this was the appointment after my initial consult, and was more detailed), and was given the prescriptions for the medications I would need after surgery: an antibiotic to prevent infection, Vicodin for pain, and a muscle relaxer for muscle spasms.  I was also given two sterile antibacterial soap-filled sponges--one to wash with in the shower the night before surgery, and the other to use the morning of surgery.

I had about two months to wait until surgery, so I spent that time getting prepared. My husband requested some time off work to care for me, we started saving some money for those days he took off work, and I bought a few things that I figured I would need--gauze, medical tape, my compression garments that my surgeon told me to get, a Go-Girl thing so I could pee standing up after surgery (laugh now, but it was my best friend for two weeks after surgery!), and protein powder (the doctor wanted me to have a lot of protein).

About a week before surgery, I quit drinking wine :(  The instructions were not to have alcohol for 48 hours before surgery, but I figured a week would be even better. I filled my prescriptions so they were ready when I got home. I paid for the part of the surgery that my insurance wouldn't cover (see below for costs). I had to get some blood drawn for lab tests. And then I arranged with my parents for my kids to spend a few days there.

The day before surgery, I washed my bed sheets so they would be nice and clean. I cleaned my house and made sure there wasn't any clutter. That night, I washed with the special sponge they gave me, and I was told not to eat after midnight (I quit eating at 7 pm). I went to bed and set the alarm for 3:00 AM--crazy, I know. I was told to be at the hospital at 5:00 in the morning, and it was over an hour away. When I woke up, I took a shower and used the second sponge, then dressed in comfy, baggy clothes. Jerry drove us to the hospital.

Cost of surgery
The cost of the surgery I had varies ENORMOUSLY, but I'll share the costs that I incurred. The costs are broken down by anesthesia, operating room use, hospital stay, surgeon fees, etc. Keep in mind that my insurance covered a huge chunk of it...

Out-of-pocket expenses:  $134 one-time consultation fee; $200 for 4 compression garments; $4,380 for the cosmetic portion of surgery; $808.73 for co-pays to insurance after surgery. TOTAL: $5,522.73.

I'm not sure how much the surgery would cost if you paid straight cash (no insurance whatsoever) but I'll ask my surgeon next time I go in. The average cost of this particular surgery (from what I read online) is $18,800. Yes, that sounds like an insane amount of money--you could buy a car for that! But this is something that I wanted more than anything else, and if I have to make payments for a few years to pay for it, it's worth it to me.

But like I said, the cost varies enormously, so don't write off the surgery if you don't think you can afford it. I would at least go see a surgeon to find out the cost and what your options are. I was SHOCKED when I discovered that a huge chunk of the surgery was covered by insurance.

The surgery
You can read about my experience the day of surgery here.

The hospital
I have to admit, when my doctor said she wanted to do the surgery at a tiny little hospital called Cottage Hospital in Grosse Pointe, Michigan, I was nervous. I was hoping she'd want to do it in the huge Henry Ford Hospital in Detroit--it just seemed "safer" because it was bigger. But the doctor's secretary told me that Dr. Tepper really likes the staff that she works with at Cottage, and that it's in MY best interest to go where the doctor is comfortable. I could have insisted that I have the surgery in Detroit, but of course I wanted my surgeon to be happy while she's working on me! So I agreed to go to Cottage. It was the best decision I could have made, and I'm SO GLAD that I had the surgery at Cottage Hospital. (So keep in mind that it's important for your surgeon to feel comfortable).

We were the only people there at 5:00 in the morning, which was a strange feeling. The whole staff that interacted with me was SO FRIENDLY and nice and made me feel very comfortable. There wasn't a single person who I was displeased with. All the nurses, the anesthesiologist, even the security guard who had to unlock the doors for us--super nice, and helpful.

My doctor had me stay for '23-hour observation' after my surgery, and I'm very happy I did that. I was literally the ONLY overnight patient in the hospital--crazy, right?! But it was fantastic--anytime I needed something, the nurses were right there. I had a catheter in, so I didn't haven't to get up to go to the bathroom at all. The nurses took very good care of me, emptying my surgical drains, getting me water (constantly, I was so thirsty!), even setting up a bed for my husband to stay with me overnight. Dr. Tepper came to check on me after the surgery, and then again the following morning, when she said I could go home whenever I was ready.

I honestly cannot say enough good things about Cottage Hospital.

Post-Op

I have a lot of blog posts about the aftermath of the surgery, but I'll explain the gist of it here.

I had four surgical drains placed during the surgery. The drains are tubes that come out of your abdomen with a bulb on the end that collects fluid (blood, saline from irrigation during surgery, etc) so that the fluid doesn't collect inside of your abdomen.

The drains were not painful to me at all--just a nuisance. You have to empty the drains and record the amount of fluid that you empty--and my doctor said she would remove them when they were draining less than 30 cc's per 24-hour period. Three drains were removed on Day 8. The last wasn't removed until Day 17. The removal did not hurt at all, it just felt very strange. It's important to leave them in long enough so that you don't have fluid accumulate and form a seroma, which can get infected.

I also had to wear a surgical compression garment. My doctor gave me a pamphlet at my first appointment and showed me the one she wanted me to order. She said to get two--one in beige and one in black. She told me to bring the black one to my surgery, and I would wake up from surgery with it on. (She said black because it would certainly get stained in the first couple of days, and the stains aren't as noticeable on the black). My garment fit like a pair of granny panties that went up to my rib cage--only very very tight. The garment is actually pretty comfortable, and I liked the secure feeling while it was on. I was told I would have to wear it 24/7 for six weeks (except while showering).

The incisions were very easy to care for. All surgeons have their own instructions, but my surgeon told me that there would be no dressings on the incisions, and I didn't have to do anything special. I didn't have external stitches--she used some sort of Dermabond to close the top layer. In the layers of skin underneath, there were absorbable stitches. There was also a strip of tape on the incision, but I didn't even know this until Day 8, when she told me I could take it off. It was stuck on there really good!

Because my incision went all the way around my body, I was told that for ten days, I would have to lie down or stand--no sitting! I could lie on my sides or my back, or even my stomach if it was comfortable (but I chose not to because of my drains). The reason for not sitting is because it would put strain on the incision across my butt.

I was given Vicodin for pain, but I learned that Vicodin doesn't help at ALL for me. I switched to plain old Motrin after about a week. The pain was the worst the first 2-3 days--it wasn't the incision that hurt, but my abdominal muscles. They were extremely sore, like I did a million sit-ups. After Day 3 or so, the pain wasn't bad at all for me. I still felt sore, but nothing unbearable.

I was allowed to shower from the day I got home from the hospital. She told me to wash gently with the regular soap I always use, and pat dry. The hardest part about showering was the drains--I had to put a chain around my neck and clip the drains to the chain. The first few days, I had my mom or Jerry reach into the shower and hold the drains while I washed quickly.

As far as exercise goes, my surgeon told me that I could exercise whenever I felt comfortable--just no ab work. I had no interest in exercising until about Day 14, but I hurt my knee, so I waited until almost 4 weeks post-op before I ran again.

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A few random questions that I've gotten...

*What happens if you become pregnant now?*
Jerry and I are done having kids--we made that decision 'permanent' after Eli was born ;)  I don't know much about this, because it wasn't relevant to me, but I would certainly recommend waiting until you're done having kids to get a surgery like this to get the best results possible. Pregnancy caused a LOT of stretch marks on me, and I'm sure that wouldn't be any different if I'd gotten pregnant after my surgery. But this is something that I would ask a plastic surgeon.

*Why didn't you wait until you were at your goal weight to have surgery?*
I never really reached my goal weight, and when I went to surgery, I was about 15 pounds higher than my goal. However, I had maintained that weight for about a year, and I was comfortable with my size--wearing a size 4/6 prior to surgery. My surgeon said I was at a healthy weight and she had no concerns about my losing weight before surgery, so I went for it.

*Did you pick November for surgery for a particular reason?*
I wanted to get the surgery as soon as possible after my consult, but I had to wait for the insurance clearance, and then I was in my friend's wedding in October, so I had to wait until after that. November was a good time because I would be all healed up by summer :)

*Did you have to wait six weeks to have sex after surgery?*
No, my surgeon told me that whenever I felt ready it was fine to have sex. But I wasn't interested for a while! I waited about 5 weeks.

*Was it embarrassing having Jerry or your mom help you in the bathroom/shower?*
They've both seen me give birth, so helping me in the shower was no big deal :)  I'm not self-conscious in front of Jerry at ALL, and while I was a little embarrassed to undress in front of my mom, it was certainly no time to be modest. I didn't need help going to the bathroom, but I needed help showering (they held the drains). And I felt extremely exhausted, so it was nice to have them there if I felt faint.

*Did you get to see the video of your surgery?*
Not yet--I'm going to ask my surgeon for a copy of it when I see her next week. My surgery was videotaped (with my permission) for educational uses. I didn't think I'd want to watch it, but I kind of do now!

*How was the drive home from the hospital? When were you allowed to drive after surgery?*
I don't remember the drive home very much, but it wasn't TOO bad. My husband was careful going over the bumps :)  I had to recline my seat back as far as it could go. I was able to drive once I was off the pain meds AND it was at least 10 days post-op--because my doctor wanted me to lie down flat for 10 days, only sitting to go to the bathroom. I was driving by day 11.

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I think this pretty much sums up all the facts about the surgery. In the next post, I list all "the good, the bad, and the ugly" parts about it!  Click here for Part 2.

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