Saturday, July 23

Jeez Diane I wish I could see the good stuff as easily as you. You've had a damn rough go of things and you're still managing to see the positives. And our faithful Miss Sadie is all better!  Please give her a big squishy kiss on the nose for me!

Supah-Saturday to you all!

Glad to see you here.  My own family is still sleeping and I needed a bit of company this morning.  I think today is going to be a lower functioning sort of day. 

I also tried to use carbs for comfort.  For me, it was in the middle of the night. Carbs don't help pain. Imagine that. 

The rest of this is a too-long post about how we are (apparently) medically different from other folk, even tho we can now pass for normies.  I say apparently, because there just aren't scientific studies in us.  We are too new and too few.

In the Seattle metro area, I think there are just 4-5 plastic surgeons whose practices include a large volume of massive weight loss (mwl) patients.  

The ones that don't specialize in that group intellectually push back on the idea that we are different to the point where it makes a difference as far as plastic surgery results goes.  But, I think my recent experience suggests that we are likely different and we may receive different care based on whether our surgeon has experience or not. 

My plastic surgeon is a woman who doesn't engage in idle chit-chat.  At our first consult, she only discussed the difference in mwl patients (which she specializes in) when I specifically asked.   In recent days, she freely offered observations which you might find interesting. 

She noted that everyone knows that we have very large blood vessels, left over from when we had much larger bodies. 

She also noted that scientific studies in mwl patients are generally absent.  But there is "talk" among those with practices with a lot of mwl patients, that those large blood vessels may make us more prone to surgical oozing -- so increased drainage in general and excessive oozing where it doesn't occur in normies.   (In my example, excessive dripping on the floor from a drain insertion site.) 

Also, those large blood vessels skew lab work results, especially in extreme situations.  Again, studies are lacking so the MD really has to rely on her clinical judgment.  In my case, my lab work results plus my low blood pressure plus excessive oozing/bleeding made it LOOK like I might have a post surgical internal bleed that needed a second surgery to correct.  

Yesterday at my follow up appt, she said that if I had been a non-mwl patient, she would have been more likely to opt for second surgery to look for a bleed.  But, she knew for sure even in a normal patient, the results were diluted because of the IV volume pumped into me.  She suspected that my "huge" blood vessels diluted the lab results much more.

She opted not to do the second surgery because she wasn't convinced that I was anemic.  She thought all of my issues could be traced back to blood vessel size unique history of massive weight.  She did decide, tho, that it was worth a night in the hospital, just in case her clinical judgement was wrong.

In the end, she was right.  I paid a bit more for this out-of-network doc to do my surgery, but I am glad I did.  Even if a non-mwl surgeon was technically able to handle the skin (and I question even that) I am not sure that he would have had the background to come to the same clinical decision about whether I needed that second surgery.  

Have a great day!

Shel

That's fascinating stuff about our blood vessels and its impact on surgery. More evidence of us being pretend normies only. 

Scale is backing off now, with feedback at 113 today. That's good.  Trending up is not good, even when I'm below goal. 

Busy-ish day yesterday with our first RV dinner guests. Might be the final visit with the Aussies, whom I adore. It definitely offset the negative of DH immediate family. Of course his sister has not yet managed to see us, despite many opportunities over the week we've been here. Boy but her 'pain' (aka drug addiction) is serious stuff. 

Will visit with some old school friends of DH this evening. They're lovely people and wonderful hosts so should be fun. Today we need to replace our hail damaged roof vents - discovered all five were broken. Gorilla tape has created an interesting look. 

Oh boy now there's another commitment to visit with family this evening too. FML forgive me but this has gotten really old.  

Considering dropping down into Idaho next to do some dedicated riding. Nothing firm yet, but right now my biggest goal is to escape the family visiting. Sorry but there's nowhere else I can voice this stuff. 

You're doing really well David. Clearly getting into a better path. And I'm loving that you've so quickly become an integral member of our little family. Besides, now you have to stay so we can continue to live vicariously through you doing the Airstream reno ;)

Glad to read everyone is doing well. No change here. Busy day ahead. 

Greetings all you Busy Skinnies

Seems like everyone has lots of interesting stuff to report. David you are indeed a welcome addition to our little family. 

So interesting about the big blood vessel thing for MO people.  Interesting to hear your doctor's reasoning. I think doctors make judgements like this  all the time based on a variety of complex factors. So glad you have a good one Shel. 

Loving the travel descriptions Linda.  Yeah, family visits can get old. Thats what vacations are for - to escape. Take violet out for a good ride. 

So much junk work to do here in clearing out the living room junk. Drives me nuts so I just go to the studio. And I ate ONE modest spoon of peanut butter last night resulting in a half pound gain. 132. But had too few steps yesterday. I think I will take our ancient dog to the beach. Might be the last time. 

Diane O so glad you are improving - especially in spirit which matters a lot. Hang in there. Can't wait to read that you are well again. 

More drama going on at my Mom's. Endless struggle to keep caregivers who are decent.  

Puppy is still a terror but has her quiet sweet moments if we walk her enough.  Gotta do that today.  Diane S