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Monthly Archives: February 2013

WLS Plastics from the Patient Perspective

This is likely one of the hardest blogs I will ever write for you, even as I do it, I am nervous, I am scared and I am self-conscious, but I feel that there is something we’re not talking about out loud in the WLS community and that is, the realism of results and success of body contouring and reconstructive plastic surgery to address the sagging skin that so often occurs after we have successfully lost a good amount of weight.

I get so many questions from readers and fellow Bariatric Surgery patients about plastics; but the thing I get asked the most is, “Can I see your before and after pictures?” I’ve usually quietly avoided the topic; I mean who in the world wants to show someone some of the most unflattering pictures of you ever taken, pretty much naked, with a bunch of extra skin hanging off your body?

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The Before Part of Plastics from the Patient Perspective:

Let’s talk about those before pictures for a moment. I hate them. I hate everything about them. For me personally, the skin hanging off my body was worse than the weight ever was. At 420 lb it was very easy for me to look at myself in the mirror and say “I’m cute, if you don’t think so flip off.” That got harder and harder for me as the skin started showing itself. I’d find myself standing in front of the mirror trying to see the 195 lb body that was underneath all that skin that was left behind and I was more self-conscious, more unhappy and found myself more unattractive than I had ever before.

For me, the biggest emotional success of my weight loss journey is the fact that I can honestly say that I have gone from being a victim, to being a survivor, to actually living for the first time.  For me there were several things I wanted from Plastic Surgery.

  • I wanted a body that represented the hard work I have put into it.
  • I wanted to remove the excess skin that I saw as remnants of my abusers hold on my life and their ability to still affect my life nearly twenty plus years later.
  • I wanted to enjoy exercising more because I didn’t have all this skin swinging off me when I moved.
  • I wanted to feel pretty again, or to be happy enough with myself at 195 lb that I could look in the mirror and say “I’m cute, if you don’t think so flip off.”

I did my research. I looked at before and after photos. I consulted with two different plastic surgeons and I selected my surgeon based on which one’s staff was more willing to work with my insurance. I had spoken to my insurance company several times about the possibility of Reconstructive Plastic Surgery after losing 260 lb and I had several ideas, tips, hints, and suggestions about how I might get the skin removal surgeries covered.

My approach was three-fold:

  1. My insurance covered “complications” of Gastric Bypass so my first approach was that the excess skin was a complication of Gastric Bypass surgery.
  2. My insurance company had told me that they would consider anything that was “Medically Necessary.” With the amount of extra skin I had on my body, I still had skin folds and rolls of skin on my body that allowed for things like rashes, infections and sores and removing the skin would alleviate these issues.
  3.  I have a diagnosis of Discoid Lupus. It is a skin disease that causes rashes and legions on your body, usually in sun exposed areas. For me however, with the excess skin, instead of just the normal photosensitive Lupus issues, I developed Lupus symptoms in the skin folds, in places where my skin touched skin, under my breasts, under my arms, under my stomach. Because of this diagnosis, the “Medical Necessity” of my plastics was even more prevalent.

Getting the insurance approvals on the surgeries wasn’t ever difficult. Of the three surgeries that I did, the insurance company denied only the second one the first time we submitted and that was largely due to the fact that we had included a breast augmentation and implants in the paperwork. All it took was a letter from my Plastic Surgeon clarifying what was medically necessary which was sent the day after we got the denial and just a few days later we had an approval.

We had the insurance approval. We were ready to get started. I was elated… and I had completely unrealistic expectations.

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The Hardest Part of all: The Recover, Recoup, Re-cut Phase

There are so many things about this phase of Body Contouring after plastic surgery that I feel I should share with you I am not even sure where to begin.

First let’s address one of the other questions I get all the time. “Was it painful?” – Yes. It was by far the most painful thing I have ever done in my entire life. I’ve had my tonsils pulled out, my wisdom teeth yanked, my appendix removed, I’ve had a hysterectomy, I’ve broken bones, I use to be a self-mutilator who liked to cut myself and I’ve been physically abused by people a lot stronger than me. NOTHING has ever hurt as bad as reconstructive plastic surgery. Was it worth it? Yes a hundred times over. But did it hurt? Yeah it sort of felt like I had been hit by a truck, severed in half and sewn back together.

And it wasn’t exactly easy on the emotions and feelings either. There were phases that were so difficult. Between surgeries I would hate the parts of my body that were not fixed. I’d stand in front of the mirror grabbing my skin, yanking and pulling on it to trying to envision what my body was going to be like when it was gone. I stopped going to the gym and swimming because I couldn’t handle how much skin was on my thighs and how horrible I felt I looked. It was amazing to me, at 420 lb I had no problem putting on a bathing suit even though I knew people would start at the size of my thighs in astonishment of their girth; but now, I couldn’t handle having anyone see all the skin hanging from them, it embarrassed me and humiliated me more than being heavy ever did. This is hard for a lot of people to understand and wrap their head around, so let me help you…

The hall was crowded, kids bustling around as they rushed to their lockers to get their books for their next class. She stood at her locker with her back against it, cradling her books to her chest as if she were protecting them.  Her right foot moved slightly as she readied herself to leave but it halted as a frown appeared on her face. Standing in front of her, blocking her way was one of the more popular girls; one of the “mean girls” if you will. “Awe look at the little fat girl hugging her books because nobody else wants to hug her. Stop eating Ding Dongs and Twinkies and you might not leave high school a never been kissed virgin.” The blond-haired girl clutching her books as if there was safety in them, took a deep breath and even though her voice cracked as tears threatened to stream down her face, she responded courageously, “I might be fat, but I can lose weight, you’re just ugly inside and out and you can’t ever change that.”

At 420 lb I had two things that I could console myself with whenever I felt ridiculed about my weight. I had the control in the knowledge that I could somehow change my situation, and I had the vision in my head of what I would look like when I did that.  Those two things are what helped me get through nearly 25 years of different unhealthy levels of obesity between the ages and sizes eleven to thirty-two.  Now that was gone.  Prior to my thigh lift surgery in November, I wouldn’t wear a bathing suit because I was so embarrassed of my thighs and because with the skin hanging off them, weighing 165 lbs  there was no more change that I personally could evoke to improve the situation. No amount of exercise was going to make it better, losing more weight would only make it worse, there was no more control and no more hope and it was an emotionally defeating place for me to be living.

Setting aside the physical and emotional aspects there were the financial ones as well. Now I will say I had some complications after the first surgery, but pretty much my year went like this.

  • January – Move Heather here so I had someone to help take care of me after the surgeries.
  • February – Reconstructive Surgery #1
  • March – Healing
  • April – Healing
  • May – Healing / Walked a Half Marathon
  • June – Healing waiting for Surgeons Release to move forward
  • July – Preparing & Submitting for next surgery
  • August – Reconstructive Surgery #2
  • September – Healing
  • October – Healing – Attended the OAC event and spent  1 month in CA with Family
  • November – Reconstructive Surgery #3
  • December – Healing

Now after the first surgery in February I had some complications that took a bit longer to heal from. But pretty much after each surgery for about 6 to 8 and sometimes even ten weeks I was pretty much a lump on a log healing unable to do much and definitely not working. I was very lucky, in that my insurance covered my surgeries thus allowing me to use a $22,500 loan I took out to pay for these surgeries to pay my portion of the first surgery and then, to live on throughout the year when I wasn’t working to keep the bills paid.

Even doing all that, by the end of the year I ended up $30,000 in debt on top of that on credit cards. But you know what, going into this my Family and I expected to end up somewhere around 60,000 in debt on plastic surgery, we’re not surprised to be here, but that doesn’t make it any more comfortable or less stressful and even though my household makes a decent amount of money, when you’ve been living paycheck to paycheck to make ends meet and you’ve maxed out your credit cards and taken out loans for your body that cost more each month than your car payment, it can be a bit overwhelming.   All that said would I do it again in a heartbeat? Yes. I would.

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After the plastics: The Realism of WLS Plastics

This was probably the hardest part of the entire journey for me. In fact, I am not sure that I can tell you with 100% certainty that I am beyond this part. What I can tell you is that my expectations coming into plastic surgery, despite what anyone told me, is that I would have a tight, lean body when all was said and done. Now is my body better than it was before? Hands down and I am grateful. But there are still some areas of my body that I would like improved. I would like my arms tighter and more symmetrical. I would like there to not be puddles of skin hanging from my abdomen when I do a push up. I’d like my breasts to be a bit fuller and I’d like there to not be extra skin hanging from my forearms.

These are things I want, and someday, if and when I can afford them, I will do them because they will make me happier. I’m not sure when that will be, but it will happen someday. In the meantime I won’t allow the little things that I am unhappy with myself about hinder where I am, what I am doing or invalidate the hard work and effort that has gone into having the body that I have, even if that body isn’t perfect.  The truth is I can never expect it to be. I am never going to have the body of a playboy model or a personal trainer who has never been 260 lbs overweight. What I do have is the body of a woman who used to weigh 420 lbs  lost weight and put it back on for years, and finally managed to get to a maintainable healthy weight and is working on being as fit and as healthy as her body will allow her to be. What I do have, is a body that can serve as an example to others who have lost or need to lose huge amounts of weight and give them a realistic idea of what they can expect afterwards so they are not as shocked and disappointed as I was when I realized that plastic surgery wasn’t going to get me the body I first envisioned.

It is with that goal in mind that I am publishing a Before and After Gallery of my Reconstructive Plastic Surgery.  If you’d liked to view these photos you can do so by visiting this link. The page is password protected to insure that you realize that the photos you are about to view are for educational purposes, and may be considered offensive to anyone that has a problem with partial nudity.  You will need to enter the password: PANDORASPLASTICS in order to open the page. By imputing the password you agree that you wish to view these photos.

Comments are not allowed on the gallery page itself but please feel free to post any comments or questions that you might have on this page instead. Please remember that I reserve the right to remove any offensive comments from my blog.  Basically, be kind, I am doing this to help educate people, not to be ridiculed or teased.

Excess Skin, Body Dimorphic Issues,  Weight Dissociation, Plastic Surgery, and Unhealthy Emotional Associations are something that I don’t think we talk about nearly enough in this community and that I do not feel there is nearly enough, patient side information out there on.

It is my intention to open the doors of communication here, and to try to be one of the voices that can both answer some of these questions, and, hopefully, advocate for others so that they might get the sort of medical coverage that I did paying for these life altering reconstructive surgeries.

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One Person Can Make a Difference Choose To Be That Person

It’s so hard for me to decide what to write about sometimes. Usually I have so many ideas that picking one is difficult, tonight though I have one pressing thought in my mind.

“One Person Can Make a Difference.”

Pam Davis and I at the OAC Convention Costume Party Welcoming Ceremonies Dinner in Dallas, TX October 2012

This was the title of a blog post by Pam Davis, RN, CBN, Chairman of the OAC Board of Directors. It really got me to thinking.  Several months ago I was sitting at a round table with four other women at the OAC Advocacy Training Session where we were taught the basics of advocacy and participated in mock legislative visits. The biggest lesson that I learned that day at was that the power of one person, telling their story, can make a huge difference.

Your voice and your story are the most powerful advocacy tool that you have.

Before attending the OAC Convention in October I had a dream, I wanted to become a personal trainer, go back and work with other pre-op Bariatric surgery patients and help them achieve the same sort of things I did through my weight loss journey. I wanted to help others fight this obesity epidemic.  But my dream was a little bigger than that too, humbled and grateful for the insurance coverage that had covered not just my gastric bypass, but three rounds of extensive reconstructive plastic surgeries, I wanted to make sure that I did something to help make sure that other people received those same sorts of benefits, and I wanted to make sure that I somehow helped those less fortunate than I.

I have said before that the OAC Convention was a life changing experience for me.  Let me tell you a little bit about my life since October.

Since leaving the OAC Convention in October I have worked on making sure that wherever I go, and whatever I do, I am using my voice and my story to try to make a difference.

This Sunday I embark on a whole new adventure. I’ll be flying to OH on March 3rd to spend some time with Heather’s family. While I am there I will be meeting two women for the first time that have been following my blog and my journey for a while now.  I’ll be attempting to hook up with the OAC while I am there, taking a trip into Washington DC and hopefully doing some advocacy work for them. While I am there I have two women that are currently working on losing weight that are committed to running a 5K with me.

Thanks to my time at the OAC Convention, and the people I met there, I’ll be spending the entire month of June in Dallas Texas at the Cooper Institute taking classes to get my Personal Trainers Certification and a few other certifications as well; this was made possible for me by a $600 donation form a blog reader that wanted to help me help others and generously donated the amount I needed to take the CPT Course. More was made possible by the Susan Sterling Scholarship I received from the Cooper Institute for $500 and the rest, well; the universe is looking out for me. I have faith.

Once I get back from the Cooper Institute and have my CPT Certification I am planning on a business Launch in July with a small-scale fundraiser for the WLSFA so that any money we raise goes to helping someone else start this journey.

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Since October I’ve had lots of exciting things happen but there was one, which beyond a shadow of a doubt changed all the cards for me. Since last year I have had a sort of pseudo-friendship on Facebook with Celebrity Fitness Trainer Chris Powell.  I’ve had several exchanges with him and his wife Heidi Powell on Facebook and it is one of my biggest dreams to meet and work out with them.  Recently I posted something on Chris Powell’s Facebook page and some of my friends went in and commented. There were a few comments that just really took my breath away.

“I admire Pandora for all she does to bring us all together and help us be successful. She’s not just in this for herself; she sees the big picture and is doing something about it” – Angie Bulakites

“Pandora is my WLS idol!!! Her amazing determination and willpower inspire me every day to continue on in my personal WLS journey to a healthier and happier life.” – Jessica DikeyBariatric Beginings

“I have only met Pandora once in person and heard her talk and ask the right questions and in that one small time frame of our interaction she has impacted my life tremendously. I can only imagine how my life would be if I saw her more often. Everyone she come in contact with whether it be on Facebook, her blog, or conferences and I can only assume in person as well.” – Michelle Mata

“Not only has this woman transformed herself into a fitness inspiration, she is actively helping others make the same journey. I urge you to give her your support. She is moving small mountains.” – Colin Hatcher

But the one that brought tears to my eyes was Heather’s cousin, a woman I have yet to meet:

“Pandora is truly an amazing woman! she doesn’t just inspire WLS peeps. she has been such an inspiration to me and my husband, to the point that we have joined a gym and have completely changed our way of eating. since January 6th, my husband has lost 32 lbs and i have lost 17 lbs  my husband has diabetes and sleep apnea, among other health issues and I have battled with my weight my whole life, but there is something real about Pandora that has sparked something in us. I think she has just saved our lives. we, and our 4 daughters thank you for inspiring her!!!” – Jennifer Heredia

In her article Pam tells you “All you need to become an advocate is your personal experience and to feel passionate about the issue. The OAC will help you with the rest.” She couldn’t be more right. Just attending the OAC Convention changed so many things for me and propelled me forward in my goals of helping others and now, there are many people; Some that I met at that Convention. Some that have known me for years and some that have never met me at all, that will tell you that I have made a difference in their life. In fact, some of those very people nominated me for a WEGO Health Activist Award and their judges selected me as a finalist among sites that have to do with all sorts of different sort of health issues. It was never my intention to become an “Advocate” it was just my intention to help make what was a lonely and hard fight a little easier for someone else. It was never my intention to be an “Activist” I just really wanted to help others and continue my WLS Journey through doing so. Pam is right, when you start sharing your story, when you start sharing your personal experiences:

  • You will be heard
  • You will be appreciated
  • You will make a difference
  • And you will be an advocate
  • And you’ll feel amazing when you see it happen.

There is nothing more rewarding than to know that I have touched people’s lives in the way that I have. The fact that people feel like I bring them together and help them be successful or that I inspire them in their WLS journey and their quest for a happy healthier life or that some people feel I have helped saved their life is amazing to me. It tells me that I am doing something right. I know that the path I am on started at the OAC Advocacy Training Session and that the OAC has empowered me an helped point me in the right direction. If you are not a member of the Obesity Action Coalition I encourage you to join and stand with this national non-profit organization whose sole focused is helping individuals affected by obesity.

93 Million Americans are affected by Obesity and advocacy comes in many forms. Whether you are writing blogs, going to the hill or signing petitions and sending letters to your elected officials you can make a difference in the lives of these people by getting involved in the OAC Advocacy & Support Programs.

“Never forget that you are one of a kind. Never forget that if there weren’t any need for you in all your uniqueness to be on this earth, you wouldn’t be here in the first place. And never forget, no matter how overwhelming life’s challenges and problems seem to be, that one person can make a difference in the world. In fact, it is always because of one person that all the changes that matter in the world come about. So be that one person.” – R. Buckminster Fuller

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Author: Pandora Williams

Author of Desperately Seeking Slender

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