Day 1 - Thursday

I'm pretty lucky that my husband and I have an adjustable bed. Although the first night sleeping after surgery wasn't easy, I think it was much easier with both my head and legs lifted on the bed without having to only use pillows.

My husband did put the pillows on our bed to good use, though, by barricading me on my side of the bed. He didn't want me to fall out and he didn't want to accidentally touch me during the night, so I literally had 2 pillows on my left and 2 pillows on my right making a cocoon around me.

It's honestly really uncomfortable trying to sleep with the drains in. If you turn the wrong way, the drains pull a little on your skin. Since you don't know how much of the drain is actually in your body, you're not sure if you can pull it out, so you panic, wake up your husband and then have trouble getting back to sleep.

My husband was also worried about my pain, so he set his alarms to get up during the night to make sure that I got my pain meds, NSAIDs and antibiotics.

I got some Entenmann's mini coffee crumb cakes for me to eat in the mornings so I could have something in my stomach before I took my meds. I thought they would be something easy that my husband wouldn't have to make, just open... easy peasy lemon squeezy. But, not so much. What I didn't think about were the crumbs that are so much a part of crumb cakes! My husband had to place a paper towel between the plate and my mouth so that the crumbs didn't end up in my bra and my sutures.

My husband told me that he hoped I didn't have a whole bunch planned. That I needed to make sure I got up and walked around, so we didn't have to worry about blood clots, as the doc told us to stay off the Xarelto until Friday when he wanted to see us back. I was worried about seeing the doctor so quickly after surgery. Almost everyone else that I had read anything on said their first post-op appointment was 1 week after surgery. Hopefully, there isn't something I don't remember the doc telling me about.

I did come out of our bedroom to sit in the recliner in the family room. Again, my husband barricaded me with pillows, but this time it was due to our dogs wanting to jump onto my lap.

Day 9 - Friday

Today was a red letter day for my doctor's appointment. I was going to get the stitches out that were holding the skin on my breasts next to my nipples. I had 17 stitches in the right and 16 stitches in the left. I was not looking forward to today at all. When I got the stitches out as the drains were removed, they hurt, so I was assuming that every little stitch was going to hurt.

But, before we get to the doctors, I took a shower today and for the first time I was able to wash my own hair by myself and put my own conditioner in. I still needed help putting the shampoo, conditioner, face wash and body wash in my hands, but I was able to use all of them by myself. I kept my elbows close to my body while washing my hair and it was a little awkward, but I did it. I was so happy. It's nice to have your husband do it, but my husband has been so worried about hurting me (even though my head didn't have surgery) that I wasn't sure he was getting my hair actually clean.

I did ask my husband to wash my back...and he ended up washing my legs, too, since I'm not supposed to bend over and I'm still taking pain meds, so balancing on one leg to do my other leg isn't easy.

I stood for a while in the shower letting the water run over my body. With the itching of my surgical areas, the water washing over them feels really good.

I was also able to put a shirt on over my head. The shirt was fairly loose and had large armholes, but it felt good to wear an outfit that made me feel good while heading to the doc.

Now, back to the doctor. When Dr. S came into the room and asked if we were ready I told him "NO!" My husband told them I'd been nervous and I didn't sleep well last night thinking about it. Dr. S asked me if I just wanted to leave them in and I said, no, not really, so he opened the front of the gown that I had on and he started on the right side. I had a couple of little twinges, but for the most part, my worry was much worse than the actual.

He then moved to the left side and there seemed to have been more feeling in that nipple because it hurt a little bit more, but still, my imagination was worse than the pain of getting the stitches out. About halfway through getting the stitches out of my left breast the doctor said...'Diane, it's ok if you take a breath." I didn't realize that I'd been holding my breath!  lol

I put on the clean surgical bra that morning so we would know how much bleeding occurred after the stitches were out. There's been a little, but not as much as I expected.

I did forget to ask the doc some of the additional questions that I had, so I sent an email to his assistant, but it was after hours today, so I'll have to wait out the weekend to find out about wearing my bra all the time, the Arnica Montana rub that they recommend and when I can start a little more exercising!?!

We had leftovers for dinner, which I was able to put on the stove and cook myself.

Day of Surgery--post op

I honestly don't remember a lot about waking up. I have no idea how I got dressed. Or if I had crackers and pop before heading for home. I'm not even sure what time it was when I came out of surgery.

The first thing I remember is the nurse, Thai, wheeling me out to our car. Oh, that's another thing to think of before surgery. We have a really short car, a Mini Cooper, and a much taller car, a Jeep Grand Cherokee. We decided that it would be much easier for me to get down out of a car than to try to push myself up, since you're not supposed to push, pull or lift anything over 5-7 pounds for the first 2 weeks...and that includes pushing yourself out of your car. So, if you have the opportunity to take a taller car, do it.

We also didn't have a comfort pillow with me in the car, so my husband put the lap seatbelt over me, but put the shoulder strap behind my back. It was the only thing to do as I wasn't sure if I could hold my hands up the entire time going home. I think I was still pretty out of it, because I remember getting into the car and getting out of the car, but I have no idea how we got home and I don't know if it was still raining or not..lol.

Although I wanted to be in the family room in the middle of everything, my husband put me in our bed with me propped up to keep the swelling down.

We have two large dogs, Belgian Malinois, and they always get up on the bed with me when I have a migraine, so we had to put up a baby gate at the door to our bedroom to keep the dogs out. I did get up to carefully say hello to them so they would know that I was ok. Besides having kids be careful around you, you also need to make sure you have someone that can take care of your pets for a few days while it still hurts quite a bit to move around.

I don't remember the first few hours. I know my husband went to CVS and got my prescriptions filled. I got Celebrex, Oxycodone (I already take hydrocodone on a daily basis for pain, so they had to go with something a bit stronger), I slept for most of the day, kept the bed propped up and emptied the drains every 8 hours.

I had done some meal preparation before my surgery, but tonight my husband cooked the baked ziti that I got from Schwans earlier in the day. Having meals prepared is another thing you can do for yourself and your family to make sure that expenses don't start adding up by having pizza or chinese delivered every night!

Day of Surgery pre-op

So, the day for surgery is finally here!  I'm so excited and terrified, but at least I will get this taken care of. We wake up to horrific storms and I'm thinking that we will lose power or something that will delay our surgery. Thankfully, that didn't happen, but we did have some gorgeous lightning to watch while on the way in.

Because of the flooding on the roads, we were a little late, but we were immediately brought to the admissions desk and started the process. The only bump that we had that morning was when I first sat down at the admissions desk. I didn't bring my purse, or anything but my phone with me and the first thing that the admissions person said to me was....you have a co-pay today and you don't have your wallet, how are you going to pay? My husband had dropped me off at the front door of the surgery center and was parking the car so he didn't hear her ask me that AND he was the one that had the CC we would be using to make a deductible payment. I guess her rudeness gave me something else to be focusing on and not the upcoming surgery.

We were immediately taken back to the pre-op area to get everything ready for surgery. I have to tell you, the OU Surgery Center in downtown Oklahoma City is a wonderful place to have surgery. The entire nursing staff was incredible, my anesthesiologist was the most detailed I had ever worked with and the pre-surgery area gives you nice warm and fuzzies before you go into surgery so you know you'll be well taken care of when you get out of surgery.

Dallas was my first nurse...I told her that I sometimes had a vasovagual response when I had an IV started and that I had nodes in my hands that sometimes made it difficult to put an IV in. A vasovagual response is a sudden drop in heart rate and blood pressure leading to faiting, often in reaction to a stressful trigger. There were a number of times when I got an IV that I would get hot, see black spots and feel like I was going to pass out. I didn't want this to happen. Thankfully, Dallas was awesome with my IV, it was in before I felt it and she started putting fluids in me as I told her that the storms outside were trying to give me a migraine.

The surgery was scheduled for 7 am, but soon after I got in the wonderful hospital outfit...the head cover, the gown and the booties, we got a call the the doctor was also caught in the storms and he was running about 30 minutes late. That didn't stop the process, we got a visit from the anesthesiologist. As I said, he was the best one I'd ever worked with. He told me exactly how the process would go, what I would be getting (based on the medications that I already took) and how things would affect me. I told him about my impending migraine and he told me that if we had migraine meds with us, he would let me take them. I was also surprised since I wasn't supposed to eat or drink after midnight, that the first three meds that he gave me were pills that I took with water...albeit a very small amount of water, but water nonetheless.

I didn't think that it was affecting me, but my husband told me that I had started talking even more, so I guess the celebrex started to kick in. So, we were just engrossed in some conversation that I thought was important at the time when the doctor finally came in. It was time to do some drawing on me.

The doctor used a tape measure for a couple of measurements, but most of the writing that he did was freehand. The first question he asked me was what size I wanted the final product to be...I told him as small as possible and my husband piped up with something...the doctor looked at me over his glasses and said that was something we should have discussed long before the morning of surgery! He was half joking and half serious. He kept drawing and drawing....my husband said he had a great job...draw on women's breasts all day long...made the doc laugh and made me less self-conscious of him just drawing on my breasts. He gave my husband both of the pens that he used to draw on me...my hubby put them in his Diane collection...along with the titanium plate that my spine surgeon gave him after my second ACDF surgery.

The doc finished and said we needed to get this show on the road, so the anesthesiologist showed up and said he was putting some Versed in my IV and they would be wheeling me away. The last thing I remember before waking up was kissing my husband goodbye and thinking that my headache was already gone.

Husband concerns

My husband has been more than supportive throughout this entire process...in fact, he was the one who kept on me to go to the doctor to get it done....even if insurance wasn't going to pay for it. But, in the back of my head I was worried for a number of reasons:

• Would he still be interested and in love with my body?
• What if the feeling never came back in my breasts or my nipples?
• What if they ended up being too big, even after surgery?
• What if they ended up being too small that even I didn't like them?
• What if the surgeon wasn't as good as I thought and they looked terrible?
• What if something happened to me and I didn't make it through surgery?

I discussed most of those issues with my husband and told him my concerns. I used my breasts to show him how bad they could look and his comment to me was....'honey, boobs are kinda like pizza...even when they're bad, they're GOOD. I cried, of course, but he calmed most of my fears.

I tell my husband everything, but my fear about leaving him alone if something were to happen to me during surgery I couldn't share with him (until after surgery, but that's another story!) So I texted my best friend and my sister and told them I needed the biggest favor ever...if something happened to me and I was a vegetable, they needed to help my husband let me go...I didn't want to have an advanced directive and not give him the chance to make the decision, but I also didn't want him wallowing and pining for me if there wasn't a chance that I could come back to my former self.

After I came out of surgery, I actually told my husband about what I made my sister and friend promise...neither of them were happy that I told him...

Pre-op visit

Well, I'm not sure what I was expecting at a pre-op visit, but I didn't actually meet with the surgeon, just his assistant. We went over all the paperwork that I had to sign, she said that all my test results had been faxed to them and they looked great and she reviewed the post-op instructions for me.

I was having my surgery as an out-patient at a specialty surgical center and my check-in would be at 5:45 am for a 7:00 am surgery.

It actually took me longer to get to the surgeon's office than my entire pre-op appointment.

I didn't have any additional questions for Ana, so I went home to wait my 15 days for surgery.

Primary care visit and research

I wasn’t sure if my primary care physician could do the EKG, the blood work and the chest x-ray that my plastic surgeon said needed done before surgery, but I am on Xarelto, a blood thinner, for previous DVT, so I made an appointment for July 17 with my PCP.

At my visit, my doctor and I discussed my upcoming surgery and he gave me a piece of information that I'm glad I didn't find out until after my insurance had been approved. He told me that in 25 years of his private practice he had recommended a number of women for a breast reduction, but that none of them had ever been approved.

He was very happy for me and said that he would put the orders in for my tests, but they could only do the EKG at his office, the other ones would need done at the main hospital. We then discussed how long before the procedure I should stop the Xarelto, whether or not I would need a lovenox or heparin bridge and when to restart the Xarelto after surgery. We decided that 3 days before surgery would be enough time, that I wouldn't need a lovenox bridge, and that I should start the Xarelto the day after surgery.

The nurse did the EKG and the doc said that everything looked great.

I was already dressed and out for a doctor visit, so I headed right to the hospital to get the blood work and the x-ray done right then. It was already only 1 week until my pre-op appointment and I just wanted to get it done.

I got the x-ray and blood draw and went home to wait for the results.

I was already getting more and more nervous about the surgery...I had been reading everything I could about other peoples experiences, I watched the animated video on the doctors website of the surgery and I even watched a real surgery (I don't recommend this!) The surgeon's assistant told me that I could email her with any questions or concerns I had, so I sent her a question about the type of anesthetic that my surgeon would be using and let her know I was slightly freaking out. I'd had my breasts since I was 15. I literally was flat chested at the beginning of the summer before freshman year and by the beginning of the school year I had my 36G chest.

The one thing I noticed when I was researching was that there were a lot of younger women who had been blogging about their experience, but none of them were older....I'm only 50, but the last video that I watched where I got the idea to go to Ulta to get a blowout was from a senior in high school. Her recovery experience is a little different than mine, thus, this blog.

My blood work came back fine and my chest x-ray showed my heart was fine, but that I had a couple of little issues that wouldn't interfere with the surgery. The one thing that the x-ray did show, which wasn't in the initial insurance decision was that I had mild thoracic spondylosis...another reason to get the surgery.

Next, we go to the pre-op.

The waiting game

I left the plastic surgeon’s office hoping that I would get a call that insurance would pay, but the surgeon’s assistant told me it could be a while and not to hold my breath. She said the insurance company usually denied all initial requests, but they would get more documentation from my doctors, physical therapists, surgeons, and massage therapists and resubmit the appeal. She told me it could be as short as a week or as long as a couple of months, so they’d contact me if they needed anything else.

That was June 21, 2018.

I assumed it would be a while before anything happened, so I went on with my physical therapy, pain lotions, spinal injections and such. On July 9, I got a call from Dr. Satan’s office....I assumed they were telling me we were going to submit additional information, but to my surprise, they told me that my procedure was approved and let’s go ahead and get the surgery scheduled. I was honestly floored. Of course I said that I would take the first available day....that day happened to not be until August 8. But we scheduled my pre-op appointment and she emailed me the releases and the orders for some tests that I needed to have before my pre-op appointment, which was set for July 24.

I was excited and scared to death. Excited because it was finally happening and scared because it was actually happening.

I quickly downloaded the documents for surgery and read through all the documents...a couple of times. I called my husband and waited for him to come home so we could make sure this was going to work (well, my husband said there was never a question, but the worrier wasn’t sure).

How insurance paid

If you’re reading this, you’re either considering breast reduction surgery(bilateral reduction mammoplasty, as it’s called by the surgical team) or you’ve already had it and you’re looking for helpful information to see if you’re experience is normal or what to expect day by day. I’m going to try to post every day, so. I don’t miss anything.

If you haven’t had it and are looking into surgery, you might want to see if your insurance would pay for it as mine did.

I’d been thinking of having the surgery for years, even decades, and it actually took my husband losing his job to decide to try to get insurance to pay for it. I’ve had 2 neck fusions and still have major back issues, so my spine surgeon actually helped me set the wheels in motion to support my insurance claim.

But, I need to back up...I searched for a plastic surgeon for a while. I read reviews, asked people that I knew had any type of breast augmentation, include a couple of breast cancer survivors who had reconstruction. I even asked the women who run the store near me that specializes in bras for breast cancer patients. I probably over-researched, if there’s such a thing, but these are my breasts. They’ve fed children and given me and my husband pleasure for years...they’ve also been the bane of my existence since I got them in 8th grade. I finally settled on Dr. Kamal Sawan. I liked his website and I had a personal reference.

I called his office and one of the first things they asked me was whether or not I was going to try to have insurance pay for it. I said that I was, so they said to wait to get an appointment until I had a referral from my doctor. They said if I came in first, without a referral, my insurance company, United Healthcare (UHC), would consider it cosmetic and not pay anything for it. They sent me the specific guidelines that UHC uses so I could see exactly what UHC considers medically necessary. It’s called the ‘Coverage Determination Guideline’. The doctors office said there is very little difference between the insurance companies guidelines, but made sure to get my UHC specific one. United Healthcare guideline for breast reduction.

There were a number of things on the Indications for Coverage list that I didn’t know could be contributed to Macromastia, the term used for large breasts. Obviously I had back and neck pain, but headaches are also on the list, restriction of physical activities, bra indentations that don’t go away, rash under breasts, acquired kyphosis and ulnar paresthesias. I wasn’t sure what those last two were, so, of course, I googled them. Kyphosis is a rounding of the back that happens as a result of your large breasts. I had ulnar nerve release in 2015, which I had no idea could have been caused from my large breasts.

In addition to the above issues, you also have to have a certain amount of tissue that will be removed.   The calculation is on the guideline, but it’s some actuaries formula using height and weight with the amount of tissue removed. This part can’t be determined until you actually see the surgeon.

So, I had my doctors document and send to the plastic surgeon. We finally made an appointment and I apprehensively went to see Dr. Sawan. He took pictures of my breasts with his iPad and showed me where my breasts should be (sad how droopy they were), made some additional notes, asked me what size I really wanted to be and sent me on my way. There was nothing I could do now but wait to see if it got approved. So I went home to wait...

Things to make recovery successful

I decided to document my experience as most of the blogs or blogs I’ve seen are of younger women. I searched for someone closer to my age as surgery approached, but never found one, so I’m taking the blog leap of faith.

So, I will go through my day by day experience with a breast reduction, but I thought I would first give some hints on how to make your recovery the best experience possible. To do this, you’ll need just a few items...(I’ll explain the how’s and why’s in my next post...just get this stuff!)

Very supportive relative or friend (one who can see you naked!)
The brobe
Ice packs
Comfort pillow
Flexible straws
Yeti short tumbler with handle
Lid for Yeti tumbler
Ulta blowout
The grabber
Button down shirts
Kids shower gel
Waterproof bandages
Charmin wipes
Alcohol wipes
Medicine app for your phone
Body pillow
Breakfast tray
House slippers
Alcohol pads
Bleach alternative
Stain solution
Stain brush
Mesh washing bags
Face wash
Dry shampoo
Miralax
Wedge pillow
Easy to prepare and eat meals that taste good!

Wow, the more I thought, the more I realized I used! You’ll understand why for every item on the list when I go through the process and progress I’ve made. I regret not having it done years ago.

I had my second post-op today. My surgeon loves the progress I’ve made. Nipple stitches come out Friday. I’m a little apprehensive about that, cause, hey, nipples....but I’ll let you know how it goes.


Btw...I’m not being paid for linking you to any of the above items...they’re just what worked for me!