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Mod Pluto’s Top Surgery Experience!

Mod Pluto is:

• 31
• Nonbinary and genderqueer
• Not on HRT
• Able-bodied and in athletic condition
• Uninsured (USA; aka I have no healthcare and paid everything out of pocket)
• Living in a state that requires a therapist letter for surgery
• Living alone (important regarding recovery)

For top surgery, it should be noted that I was small chested and opted to go for no nipples/nipple grafts.

And I just got top surgery Dec 30th, 2022! This is my post where I go over some of what the process has been like for me, something I wanted to do because I poured over a lot of preparation posts and while overall helpful, there were quite a few things that ended up not really applying to me, so I ended up with a bunch of supplies I didn’t need. (If you’re looking for a more specific guide or more voices than mine, I cannot recommend transgenderteensurvivalguide enough! Though a lot of links have ended up broken, they do an excellent job of posting a variety of perspectives and resources and many are still available. I’ve linked specifically to their top surgery references but they have all sorts of references for all sorts of experiences and considerations. Micah’s logs over on genderqueer.me/neutrois are also excellent.)

This post will be organized into different stages of pursuing top surgery:

DISCLAIMER: My healing was fairly smooth and easy. I’ve definitely heard from others who heard it worse, so don’t take my story as a sign you won’t need any help or support. Everybody has a different reaction to surgery, and you’re better safe than sorry.

• Prep - Research
• Prep - Consultation
• Prep - Pre-Op Appointment
• Prep - Personal Preparation
• Surgery
• Post-Op - Day 1
• Post-Op - Day 2
• Post-Op - Day 3 & 4
• Post-Op - Day 5 and Beyond

I will link to specific photos where relevant in these posts, but you can also see a photo timeline of some surgery pics here. These include before photos, as well as photos of my open drain hole wounds and a photo of the drains with a minor amount of bloody fluid in them. View at your own discretion.

If you have any questions, feel free to ask them here and I’ll expand as requested!

Prep

Research

For context, this is a process that took yeeeeeeaaaaaars. Even the time of me doing purposeful research and contacting surgeons/therapists was a very drawn out process as I battled depression and would get discouraged and leave the idea alone again for several months or more before getting the drive to keep trying.

For a long time, I considered top surgery out of reach due to A) not having insurance and needing to pay out of pocket, and B) not living in an informed consent state and not having the mental energy to deal with the process of getting a letter.

Yet I couldn’t get rid of my desire to have top surgery. I started futzing about doing research and reaching out to surgeons and therapists. There were some good resources out there to try and help people in my position, such as the GALAP project, meant to help connect trans people to accepting therapists who would help them get their recommendation letter with the least hoops to jump through.

Unfortunately, my state of New Mexico didn’t have any therapists associated with GALAP. So, I reached out to a sister state therapist, someone in Colorado (a place I have traveled a lot and would feel comfortable going between). The therapist said she could help me as a last resort but I should really try to find someone in my own state. I felt very discouraged by this response and lost motivation to continue discussing with the CO therapist.

Finally, I did look into LGBTQ+ friendly therapists in NM. I reached out to one to inquire about what getting the letter would be like and what the cost would be. IIRC, it was $100 or $150 per session and he would require me to continue sessions until he felt confident I was fully informed of what surgery was like and was emotionally prepared to handle it. The process was just very discouraging, demotivating, and demoralizing. I chafed at all of it. Having to prove my identity to some random stranger and have to pay money to do it. Having to prove I was an emotionally competent adult just to affirm my gender when people can get all sorts of cosmetic surgery for free on the regs just by asking. It pissed me off. It hurt me. I never responded to him. I wanted top surgery desperately but just couldn’t ever see myself being in a mental or emotional place to handle this BS process of begging a stranger to let me ask a doc to yeet my fatty chest sacs.

I was at another dead end. And then my sister happened to pass along to me that one of her exes had recently gotten top surgery and suggested that if I wasn’t using insurance, then I may not even need a letter at all if I did surgery with Dr. Morehouse. (I knew that the letter was for insurance purposes, but I’ve also heard plenty of people say their surgeons also preferred a letter just for legal purposes and such.)

I felt like I had a chance again. So, I tried to reach out to Dr. Morehouse’s office to ask if this was true. The person I spoke to on the phone was absolutely adamant that they couldn’t answer any financial questions and that a consultation was a requirement, and if I wanted an answer, I’d have to come in for an appointment. I was livid at being yanked around. I was exhausted at this rollercoaster ride. I absolutely didn’t want to waste my time taking time off work to go into an office just to be told they couldn’t help me. I hung up on them and started looking at other options.

I figured if I couldn’t get surgery in my state, then maybe I could get surgery elsewhere that for sure had informed consent. In July 2022, I received responses from a surgeon in Houston, TX and Denver, CO that they would perform surgery with an informed consent model. Since I had yesses from both of them, I went with the Colorado office since they were overall geographically closer to me. I contacted them to set up a consultation. The earliest available appointment (which they agreed to do remotely and just warned me that I’d need to upload some pics for them) wasn’t until four months away in Nov.

Once I got that appointment, I took some time to think. Considering COVID has still been ongoing, and I know several people who had their top surgeries delayed and postponed as a result, I wasn’t really surprised by the time. However, realizing the wait ahead helped me get over a bit of my ego. I called back Dr. Morehouse’s office and set a consultation with them. There was still a two month wait, but they had a spot open at the end of September, which would not only be quicker but also more convenient since it wouldn’t require travel.

I did keep both appointments at the time. The original plan was to see how I meshed with the surgeons and their offices and see what sort of surgery schedule they could offer me.

Prep

Consultation

Finally, after much waiting, the day of my consultation arrived. I was told I needed to wear a disposable mask into the building but that’s all I needed to bring/prepare.

The consultation was very quick. It was actually a bit of a whirlwind. I remember being surprised at how fast it went (about 15 minutes for the appointment itself, plus the driving time and the wait time, as they had me show up 15 minutes early and fill out some typical paperwork on medical history) and that I actually had enough time that I ended up returning to work to finish my day.

Dr. Morehouse’s practice works with a lot of trans patients, including nonbinary patients. There were spots on their forms for my preferred name and my pronouns. And all the staff were really great at respecting and using these, from the receptionist to the nurse to Dr. Morehouse and the financial secretary.

A nurse called me back and made sure to clarify my name and pronouns to make sure she had them correct. She took some basic measurements/information like my weight, heart rate, and blood pressure. Then she gave me a hospital gown, told me to put it on with the opening towards the front, and gave me privacy to change (which we laughed about). Once I was done changing, Dr. Morehouse came in.

He also confirmed my name/pronouns, went over my basic information, and then told me what the process of surgery was like and asked some of my surgery preferences. He honestly answered all my questions in his informal spiel. He asked if I had insurance, and I said no. He asked if I had a letter, and I said no, and that’s actually one of the main reasons I was there for the consult. He said that was great and that we didn’t need to deal with that without insurance, anyway (confirming that he worked off informed consent for patients paying out of pocket!). I said I wasn’t interested in keeping my nipples, and again he was very positive and said that was becoming more common and he honestly preferred it because it made both surgery and recovery easier. He said some people had a strong preference for the placement of their scars, such as wanting the scars in a position to help enhance the appearance of the pecs, but I said that I was fine with just straight cuts wherever they ended up. In fact, I didn’t really want a strongly masculinized appearance. The more androgynous, the better. I felt I would be upset by any attention drawn to the shape of my chest, really.

And at that, it was time for him to see my chest. For this, the nurse came back in and subtle-y served as witness for nothing inappropriate happening.

Dr. Morehouse was very animated, friendly, and easy-going. He commented that I was so small that surgery wouldn’t take long at all, which is oddly really affirming/euphoric to hear. (Left, center, right views of my chest.) He also observed that one of my breasts was a bit bigger and asymmetrical from the other, so he would have to take special consideration to try and keep the cuts/scars evenly placed. There was some minimal touching where he kinda poked my nipples into my chest and folded my skin together to get an idea of the placement of the cuts he would make. This bit where I was exposed lasted all of maybe 3 - 5 minutes.

Then he brought out his book of pictures from previous surgery results to show me a bit of what to expect, though he honestly didn’t have any photos of anyone as small chested as I was. We talked more about scar placement, and he did have some no-nipple results to share with me.

Finally, he asked if I had any more questions. I do remember asking one or two just to make sure I had my bases covered, but I can’t remember exactly what I asked.

After that, I as left alone to dress, then I was brought to the financial secretary, who gave me more concrete numbers on what payment would look like.

She outlined:

• $5,500 to Dr. Morehouse w/ $500 of that being required as a downpayment to schedule surgery (would be refunded if canceled early enough but would otherwise count towards the total $5,500 so that only $5000 would be due at the time of the pre-op appointment)
• ~$2,500 for Sandia Surgery Center, where the surgery would be booked. Dr. Morehouse estimated 2 hours for surgery, noting that it would probably take him 1.5 hours. The extra half hour would mean he had time if anything went wrong (for which I would have already paid for and not have to be surprised by another bill later). It also meant that if everything went as expected, then I would receive a half-hour refund from the Surgery Center for a couple hundred.
• A small payment to the center that tests for breast cancer (I cannot remember what she quoted me; it was somewhere in the range of $100 - $350, I think.), as Dr. Morehouse always sends off tissue samples from top surgery patients to check for breast cancer, since top surgery doesn’t negate the odds of developing breast cancer. As of Jan 9th, I’m still waiting to receive a call from the center with my results and the bill (since I don’t have insurance to run it through). I will update this once I receive that.

She gave me her contact information and told me I could call anytime if and when I was ever ready to schedule surgery.

Then my appointment was over. I walked out of the building. Didn’t have to schedule or pay for anything at that point (consult was free, which I wasn’t sure about).

I knew immediately after I left her office that I was in. Everything went as well as expected. There were no more barriers standing in my way. Because I have been both extremely privileged (scholarships covered my education, and I graduated without debt, plus my parents bought me my first car) and do nothing to ever really spend money, I ended up with enough in savings to comfortably pay the amounts they were asking.

Anxiety told me to act like I at least needed to take a few days to think about it before I called to make the appointment.

When I called, I had to give my card number over the phone to submit for the $500 downpayment required. They were super booked up, but she had a couple of date options to give to me. One was for mid-October from a very recent cancellation (it was the beginning of October at this point, and you’re supposed to have a pre-op appointment two weeks in advance of your surgery), which was super tempting but I knew was logistically a bad idea. Then the next available appointments weren’t until Dec 15th or Dec 30th. My parents are not accepting, so I didn’t want to do top surgery and then have to do Christmas with them while I was still healing, so I picked Dec 30th and my surgery was scheduled.

I kept my consultation with the Colorado office for a while longer, but I did end up ultimately cancelling it. It had already been so much later than my NM appointment that I didn’t have any faith surgery would be any less of a wait and didn’t see much of a point of keeping it.

During this time, I also gave in on my caregiver situation. I had been planning to hire a caregiver to look after me for the couple days after surgery, but after considering costs, I realized that was silly when I did have people I could ask and just wasn’t because I didn’t want to bother them. Having known so many people whose surgeries got postponed, I was trying to stay pretty tight lipped to avoid jinxing anything, so I waited until after Thanksgiving to let my sister know that I had surgery upcoming and ask if she could drive me to appointments and such. She was super excited for me, said of course she’d help out, and then went home and did her own research of what she’d need to do to help, and started on the hard work of wearing me down to accept that she could stay over and do more for me for at least a couple of nights.

Prep

Pre-Op Appointment

Finally, as surgery started getting closer, I got a call sometime in the beginning of December to schedule my pre-op appointment, which was set for Dec 15th.

This appointment was spent mostly with the nurse, who went over all their preparation and aftercare instructions with me and gave me several pieces of paper with all this information.

The very first thing she did was double check my name and pronouns. Because I use less common pronouns, she made sure to write them really big and circle them so nobody at the Surgical Center would miss them and misgender me.

We discussed medications (including herbal supplements) and medical history to make sure there weren’t any special considerations for after surgery (since certain meds can interact with pain pills or impact surgical considerations such as bleeding and clotting). I am only currently prescribed a monophase birth control pill (which I use to skip periods), and the only supplement I take is a BCAA for muscle recovery, so there were no special considerations in my case.

She told me to to stop taking any blood thinners, which meant no ibuprofen. She suggested I buy tylenol if I needed a pain med before/after surgery.

She told me to stop smoking (and drinking), but I don’t really do either.

She told me to get some vitamin C pills and take 1000 mg a day starting as soon as possible. I’d already bought vitamin C pills and several other things off prep lists other had written up, so that worked out well. (Vitamin C helps aid healing.)

She said constipation can be a problem after surgery, so if it was a problem for me, they found miralax to be the best, but Dr. Morehouse even suggested that you start taking stool softener or laxative a day before surgery to help things along. I had already bought a gentle laxative (stool softener) and stimulant laxative just in case.

She informed me that I should shower before surgery and refrain from using any lotions and deodorants, going into surgery completely “natural”. She also said I would get a call from the Surgery Center closer to surgery with further instructions.

She informed me that I’d need to take out my contacts and piercings for surgery. (Dr. Morehouse would confirm with me if I had any non-visible piercings to take out; however, he said it was fine to leave my facial piercings in.)

She suggested I wear comfortable pants and a button-up shirt for surgery.

She gave me the address to the surgery center and showed me what it looked like, then we went over some post-op care.

She informed me that I’d have drains for a couple days after surgery. She took out an unusred drain to show me what it looked like and showed me how to use and empty them, plus gave me a sample cup for measuring the output.

She told me that she’d need to measure me later for a compression vest to wear after surgery (then looked at me and went ’…oh, you’re a small’ and never measured me, lol). The compression vest was to be worn 24/7 for 4 - 6 weeks. I would be able to take it off an hour a day to shower.

She told me not to use ice packs or a heating pack on my incisions after surgery.

She said that I wouldn’t be able to drive after surgery or for as long as I was on the prescribed oxycodone. I had to be 24 hours off oxy in order to drive. Then she prescribed me oxycodone and an anti-nausea med and sent them to my preferred pharmacy.

She said recovery was usually a lot easier than people were expecting. She also cautioned that a lot of people felt they needed to do t-rex arms, but it was fine to do a bit of movement and do things like make fresh meals for myself - I just wouldn’t be cleared to lift heavy, put body weight on my arms, or lift my arms above my shoulders. For two weeks, the weight limit was no more than about a gallon of milk and I should wait a few weeks before doing any cardio either.

A post-op appointment was automatically scheduled for me the day after surgery at 8:30 am with Dr. Morehouse. I guess some surgeons will do next business day, but Dr. Morehouse prefers to see patients even on a Saturday so he doesn’t have to worry and can go about his weekend without distraction.

Then she asked if I had any questions. I told her I’d read about people who wore anti-nausea patches the night before surgery, and asked if I should do that. She said that she certainly could prescribe me one, but the last time she’d been in for a procedure her nurse told her that the meds they used these days were good enough that this really wasn’t necessary. She’d gone through her procedure without an anti-nausea patch and did fine. Since nausea has never been a big problem for me (I don’t have motion sickness, and I haven’t had big reactions to meds in the past, such as when I got my wisdom teeth removed), so I ultimately declined the patch. I figured she’d already prescribed me some anti-nausea meds just in case, so I would trust that was enough.

After that, it was time for pictures and to meet with Dr. Morehouse again. We went from her office to a patient room. I was again set to get into a hospital gown with the opening towards the front. Dr. Morehouse peeked at my chest again to confirm what he’d be doing. He also drew a couple of dots on me with surgical marker to give me an idea of where the scars would be placed. Then, he left, and the nurse asked me to take the robe off altogether and stand in front of the wall. She took front, left profile, and right profile pictures of my chest.

Finally, I was dropped off at the financial secretary’s office. I got a cashier’s check from my bank earlier in the week, and I gave the payment to her. I wanted to avoid any extra charges (though I have a debit card, so would have been fine) or any hassle with my bank flagging such a large charge as potential fraud. (For the cashier’s check, I gave my bank the name of Dr. Morehouse’s location “Lovelace Medical Center” and had them put my name in the memo notes - otherwise your name will not appear on the check at all. I didn’t request any other info go on the check and it was accepted just fine.)

The financial secretary gave me my receipt, gave me another paper with the final amount for the Surgical Center, and reminded me the testing center for breast cancer would contact me on their own later.

Again, I left the appointment without having to do anything else with the receptionist on my way out. All that was left was to get to surgery!

Prep

Personal Preparation

So I mostly utilized lists from transgenderteensurvivalguide over what I should purchase beforehand to support recovery. Since shipping times have been all over the place since COVID, I ordered most this stuff 3 - 4 weeks beforehand.

I bought:

• 1000 mg Vitamin C pills, which I started taking 2 weeks before surgery and will continue to take until they run out
• Gentle laxative/stool softener pills
• Stimulant laxative just in case (probably could have skipped this one, but for some tmi, I have a pretty high fiber diet and I’ve always tended more towards diarrhea than constipation - I have never been constipated before)
• 200 alcohol prep wipes (using these to clean my drain holes and around the incisions, but the incisions are covered by surgical glue and don’t really need much care, so I think I’m going to end up with a ton extra of these, too)
• 10 extra ace bandages (the list I read mentioned they got icky fast and were hard to clean — I ended up never needing these at all because I went into the compression vest right away)
• 200 small gauze pads (I’m using these on the holes left behind from my drain ports, but I’m going to end up with tons left over)
• 50 large gauze pads (I used these for around my drain tubes but the ones I bought aren’t padded, and Dr. Morehouse gave me padded ones to use over my incisions for the first week, after which the nurse said I didn’t need them at all anymore, so now I have way too many of these)
• Medical scissors
• Medical tape (bought a two pack and don’t think I’m even going to go through one)
• Generic neosporin (always handy)
• Tylenol
• Arnica gel for bruising/swelling relief
• Bio-oil scar treatment (which you can’t use for at least 4 weeks, so doesn’t need to be bought this early)
• Big body wipes for bathing (which I think I’ll use when especially depressed, but since I went without nipple grafts, I was cleared to shower right away, so I don’t technically need these)
• Dry shampoo for bathing (again, will probably use when my depression is bad, but since I went without nipple grafts, I was cleared to shower right away, so I don’t technically need this; also it’s more difficult to use without help and your limited arm movement range)
• Table tray with legs for bed (which I don’t regret buying but haven’t used as much as I thought, as my sister tended to take it away from me really fast as she wanted me to lay down and get comfortable, and it’s honestly really hard to set up on my own while trying not to put any pressure on my arms)
• Collapsible bin to keep all my new medical supplies in
• Peppermint oil to use in my oil diffuser to help with nausea
• Unscented body wash (which the Surgical Center ended up not caring about or requiring)
• Soft flannel button-up shirts. I only had one. I ended up buying two more so that I had some options. I went for long sleeves since I got my surgery during the winter.

My surgery was on Friday. I went grocery shopping on Monday. I had a list of ideas for kinds of food I wanted (keeping in mind that my sister already warned me she’d heat up food for me but wouldn’t be able to really cook for me and, being a militant vegan, I didn’t want to try making her handle a lot of food I know upsets her). I just wanted to get as much easy, accessible food as possible, since I didn’t know how long I’d feel weak or unwell or how long I’d be on pain pills (and unable to drive). I did want to get enough food that I wouldn’t have to go shopping for at least two weeks. I did not budget my trip at all or do any specific meal planning, which was a HUGE mistake. I just kept buying, buying, buying. I ended up spending 4x my weekly food budget and now I’m just avoiding working out how much food I have left and hoping I can stretch it out for an entire month. >.>

But! Here’s the kinds of things I bought to best aid my health and recovery:

• Ginger tea (for nausea, though it also ended up being a really good purchase considering the breathing tube they shove down your throat during surgery can really mess up your throat and lip); I bought a box of 3 ginger and a box of lemon ginger and the lemon ginger in particular was great
• Water flavor to keep things fresh and new
• Low sugar orange juice (vitamin C for healing)
• Natural cherry juice (antioxidants and good for inflammation) - I actually found this cherry syrup that you mix with water, so I get a ton of servings in a reasonable sized container)
• Hot chocolate to treat myself because I love it
• Tons of soup - and the big containers of ‘freshly made’ soup specifically (which again was a great choice for my throat and the general feeling of healing and taking things easy)
• Protein bars (you need a lot of energy for recovery and protein is especially great for this)
• Protein shakes (bought a variety, including these pure yogurt CarbMaster shakes which have been the best)
• Yogurt (easy, high protein snack)
• Cottage cheese (easy, high protein snack)
• Dried fruit (flavored raisin packs, mango, and apricot when they were out of pineapple) for some “fresh” food that will last longer
• Turkey jerky (easy protein)
• Ready packet oatmeal (again, really great choice for an easy breakfast on my sore throat that my vegan sister wouldn’t be offended by)
• Applesauce (easy on stomach/throat)
• Fresh apples, oranges, and pineapple (I go through fruit pretty quick and was hoping to tempt my sister into eating some of it with me)
• Frozen waffles
• Frozen turkey burritos
• Keto cinnamon cereal I’ve wanted to try for a while
• Small roll of cinnamon rolls to treat myself with one day (well, two days)
• Bread for toast (and peanut butter or grilled cheese sandwiches for some of the soups)
• Cinnamon raisin bagels (great snack or breakfast with peanut butter)
• Eggs for scrambled eggs (light on the stomach, high protein)
• Everything bagels for sandwiches
• Deli meat, deli cheese, and greens for sandwiches
• Greens, tomatoes, and light dressing for some easy salads to get in some quick and easy fresh veggies
• Low fat, veggie-forward microwaveable meals (mostly frozen, which I’ve kept refrigerated - guidelines suggest you eat these within 30 days if keeping them in the fridge; again I was trying to make sure my sister would be fed while at my place, but she absolutely refused to eat any of my food because she wants to make sure I’m taken care of and that I was worried about money and brought her own)
• Dried cauliflower, tortilla chips, and popcorn kernels to make my own low-oil popcorn for a crunchy snack knowing that I tend to crave salty things
• A couple of fresh veggies (which I bought specifically for my sister since she mainly eats roasted veggies, but again, she refused to eat any of my food as to not take advantage of me, so now I’ve got too cook soon, lol)
• Oatmilk (for cereal and hot chocolate)
• Spaghetti/sauce for easy to make meals
• Chickpea rice (easy to make, high protein)

I didn’t have to buy low-sugar peanut butter because I had plenty on hand, but I definitely would have bought some if I didn’t! Another easy, high protein snack. Another thing I didn’t have to buy but appreciated having was honey to go with the tons of hot tea I have downed.

I don’t think I am going to make it a full four weeks before I have to do a small shopping trip (I’ll probably want fresh fruit before then and maybe bread), but looking at the amount of food I still have, I do think I will make it 3 - 4 weeks before having to really go grocery shopping again. My sister also bought me a GrubHub gift card for Christmas, so I can also use that to supplement and help stave off the shopping trip.

Miscellaneous things I did to prepare besides shop:

• Clean the apartment!!! Vacuumed, mopped, cleaned the bathroom, did laundry (sheets, towels, and clothes). I live alone, so I knew I needed to do this to help keep my place nice while I was recovering. Laundry was especially important as I have a mini apartment washer/dryer that I have to lift to drain and is waaaaay over weight limit, so I’m going to have to go to a laundromat while recovering. (My sister was really great and insisted on taking the clothes I’d built up since surgery to do at her place.)
• Move everything I was likely to need to an accessible location considering the limited arm range.
• Double check that I could reach everything else with the aid of my foot stool without moving my arms out of range.
• Paid my rent and utilities early so I wouldn’t have to worry about it after surgery.
• Notified my work of the time off. I told them I was taking about a week for sure but might need up to two and would notify them after one week if I was to return or stay out.
• Went over all the appointment locations and times with my sister and kept her updated.
• I already had my bed set up with long phone and iPad (which I use for streaming) chargers, but another list mentioned this as a must for them and I agree it was really helpful and handy.
• Threw away my bras!!! (Okay, I kept my sports bras to throw away after surgery just in case surgery was cancelled last minute and I still needed them for working out.) :DDD
• Set out some clothes like camisoles I’d gotten to help camouflage things and bra pads I’d gotten to replace for sports bras to see if my sister or her girlfriend wanted any before I donated them
• Wrote my sister some notes for around the apartment (about eating food, looking through the clothes, and how to use my heater), since I wasn’t sure how alert I’d be after surgery.
• Talked to my sister about her bringing her camping pad for her stay, since I sleep on a twin bed and don’t have a couch.
• Batch cooked a dinner (I usually cook enough for a couple days of leftovers).
• Did some meal prep for some quick lunches (what I do for work is chicken, potatoes, and broccoli with hot sauce, so I have five of these cooked, portioned out, and ready to re-heat). Plus, chopped up the pineapple I bought.
• Got another cashier’s check for the Surgery Center.
• Got my bed ready to prep for recovery the morning of surgery. I bought one of those reclining pillows with arms a couple years ago to make sleeping when I was sick with a respiratory infection easier, and it’s been an absolute lifesaver during surgery recovery! If I didn’t have one already, I absolutely would have wanted to buy one to prepare for surgery! It’s great for sitting in bed. I can also prop pillows on it to help myself sleep upright and on my back during recovery (required), as otherwise, I’m likely to unthinkingly roll on my side (not allowed for a few weeks).
• Didn’t eat or drink after midnight the night before my surgery.
• Night before and morning of surgery, I showered to make sure I was free of sweat/grime/lotion/deodorant.

Having had surgery, is there anything I’d do differently?

Honestly, just buy less things. I bought pretty much everything on other people’s lists but with Dr. Morehouse’s directions, I haven’t needed all of that. I made note of these in my original shopping list. I think the differences mainly come down to the fact that I didn’t do nipple grafts, so there’s generally been less cleaning and general restrictions for aftercare. If you’re getting nipple grafts, then you might have more use for some of the things I would go back and not purchase.

Also, I didn’t need to buy so much food at once. I was really worried that, especially if I returned to work, I’d be too exhausted to handle a shopping trip, so I wanted to set myself up for as long as possible. It’s been nice not going to the store, but the heart attack I had at the price might not have been worth it. I could have handled going back to the store after a week or two and been fine.

Some things I already had or didn’t buy that I would suggest:

• Reclining pillow
• Extra pillows if you don’t have many for comfort (you gotta sleep propped up for a couple of weeks), especially if you don’t have a recliner and have to stick to your bed
• Pillow for under the leg (sitting/lying down so much pinched a nerve or something and now I can’t sit or lay down without leg pain if I don’t use a pillow under my knee)
• Backscratcher (ugh, my body knows I can’t really contort to scratch my back and it’s so itchy!!!)
• Heating pad/bag (NOT FOR INCISIONS but for body aches for other parts of your body - this will feel really good when you’re cramping and stiff from staying in one position for so long)
• Footstool or small ladder to help with reaching necessities that you don’t have room to keep out in a lower access place

Surgery

I received a text from the Surgical Center one week before surgery confirming my appointment and letting me know I’d get a call by the day before surgery for information on how to prepare and show up for surgery. I didn’t receive this call until the afternoon the day before surgery, which was really anxiety inducing because I knew I was gonna need to fast and there seem to be really different requirements of how early to start this depending on center. But, I did finally receive the call.

Here are the instructions I received to prepare for surgery:

• Surgery time was 9 am, so arrival was 7:30 am
• Avoid all anti-inflammatories and blood thinners like aspirin and ibuprofen
• Avoid green tea, as it apparently can cause clotting issues (which Dr. Morehouse’s staff didn’t tell me, and I wish they had because I drink green tea pretty regularly…)
• Avoid vitamin E and fish oil
• No eating or drinking, including water, after midnight the night before surgery (I called this the Gremlin Rule)
• Brushing teeth the morning of surgery was fine, just make sure not to swallow any water or anything
• I could shower the night before or morning of surgery
• No lotion, deodorant, moisturizer, etc.
• No contacts in your eyes (as my vision isn’t too bad, I opt not even to bring my glasses to the center)
• Scented products in the shower were fine
• I could leave facial piercings in but all other piercings (ex. nipple, genital, dermals, etc.) needed to be removed for safety reasons (if they have to shock you, these piercings can act as a conduit and cause the electricity to jump)
• Wear socks and slip-on shoes
• Wear loose, comfortable clothes, including a button-up or zipper top
• A mask wasn’t required but due to COVID, I wasn’t allowed to bring in a bag; all personal items needed to be placed in baggies instead (the contradiction of not requiring masks but requiring baggies seems silly to me)
• Bring my photo ID, a credit/debit card to keep on file just in case, and method of payment for the Surgical Center
• I could bring my phone (I checked if it was okay to bring a book, too, and she said I probably wouldn’t have time to read but I could if I wanted)
• No sleeping pills or similar aids to get to sleep the night before surgery
• No jewelry or other metal on my person
• They asked if I had any crowns, caps, or a retainer in my mouth (I think for similar reasons to the piercings? I only have one filling, so these questions weren’t applicable to me and I didn’t have to do anything further)
• Don’t bring any medications inside the building aside from if I’d been prescribed an anti-nausea patch or clonidine if prescribed
• Tie up long hair with a non-metal tie if applicable

They didn’t specify but Dr. Morehouse’s staff did warn me that the COVID protocols meant that my caretaker wouldn’t be allowed to wait in the waiting room. They’d need to drop me off, and they would be given a call by the surgical staff on pick-up time when the time got near.

One thing they didn’t tell me that I was grateful I read in another guide: they would need to collect a urine sample first thing when I went in. I knew to expect this, so I didn’t use the bathroom in the morning when I got up until I got to the surgical center, as I was very concerned I wouldn’t be able to pee later if I did, since I wasn’t allowed to drink after midnight.

So, I arrived at 7:30 am and was checked in. I gave my ID, card, and payment. She told me that if I got a refund for a shorter surgical time, it would be in the form of a check. I gave her my caretaker’s name and phone number. Then I was handed off to a nurse. She weighed me, then had me do a urine sample. While we waited for the results of the urine sample, she took my heart rate and blood pressure (my heart rate was really good but blood pressure was a bit high, which she ascribed to nerves). Then we went over some consent forms. I signed off confirming what procedure I was here to receive. I consented to receiving a blood transfusion and being transported to the local hospital in case of emergency. She asked if I had a preferred hospital to be transported to, which I didn’t. Finally, she had me look over the information printed on my hospital ID bracelet (legal name, preferred name, date of birth kind of stuff), then placed it on my right wrist. Then she checked my urine results. All clear, so she led me back to the surgery prep room.

She provided a large bag to put my belongings in and a hospital gown. She told me to put the gown on like normal with the opening towards the back and to strip down everything, including underwear, except for my socks. She also gave me a hairnet to put over my head. Finally, I got some “calf socks” to put over my calves. Then she gave me some privacy to change. Took off all my clothes, except socks, and my shoes. Put all my clothes and the few things I’d brought in the bag for my stuff. I was allowed to keep my phone out to give me something to do until I was wheeled back for surgery (this is the short time I would have had to read my book, but I just chose to scroll my phone instead). When I was wheeled back, the nurse would take my phone and put it in my bag of belongings for me.

Once I was done, she came back in and tied the back of my gown. She put some tape over my eyebrow piercing and gave me some tape to put over my nose piercing. Then she turned on a heating pad for the bed. She told me to flare out the gown when I got in bed so that I wasn’t laying on top of the gown. She kinda turned away to let me get into bed.

My memory is a bit fuzzy of the order of events here, but I think the next thing she did was put a circulation machine on my calves. There were these kinda calf-wrap sleeves, which wrapped over the calf socks I put on. The machine would intermittently pulse, kinda like a leg massage, in order to help circulation and prevent clotting. She said the machine would stay on and only be unplugged when they moved me from the prep room to the operating room, at which point it’d be plugged back in.

Next, she inserted an IV into my left hand, which was very quick and easy because apparently I have really great veins. This definitely pinched and was minorly uncomfortable, even just sitting there. I’ve never thought about this being painful before now because it’s so commonplace in all medical shows and stuff. At this point, they were just giving me some electrolytes.

The nurse fussed around a bit, making sure I was comfortable. She provided a pillow to prop my IV hand up a bit so I could still use it to play with my phone. The heating pad in the bed got turned off at this point, and she told me if I was cold to let her know. They had a machine that they could put under the blankets and have it push out hot air. I was fine at first, but just a few minutes sitting there not moving in the air conditioned room, and I did quickly get chilly, so she set this up for me. Literally just a big tube was fed under the blankets and blew hot air to keep me nice and cosy. (Photo I texted my sister of myself all set up in bed.) She also gave me a head’s up that after surgery, I would be returned to this same room, but I’d be on the other side facing the other way (with my belongings waiting for me over there), so if I was confused at first, that was normal.

Then the nurse left me, but she told me that both Dr. Morehouse and Dr. Greene (my anesthesiologist) would be checking in with me. I had bits of time here and there where I was alone to scroll my phone, but I mostly had staff flitting in and out of the area (which was sectioned off by a curtain) to check in on me and perform various tasks.

The surgical nurse came by to confirm my information again and what surgery I was getting. She had me confirm my legal name and date of birth while reading my ID bracelet to make sure it was correct.

Dr. Greene saw that I had asthma (which is unmanaged because I don’t have insurance and inhalers are hella costly, but tbh, I was intentionally vague about that with them because my asthma’s not so severe that I’m having regular attacks or anything), so he wanted to check my lungs. He listened with the stethoscope and gave the all clear. He went over with me what getting anesthetized would be like. He said I really wouldn’t remember anything. It’d be like one moment I was here, then suddenly I’d be waking up from surgery, which could be a bit disorienting. He also talked about how he would be monitoring me the entire time, so going under anesthesia was really safer than getting on a plane. I really wasn’t scared or nervous at all, so I didn’t need the reassurance, but it was a part of his spiel.

Dr. Morehouse came by and untied my gown. I let it drop down so he could see my chest to draw his marks. In dotted lines, he outlined around my breast tissue to mark how far out he should remove tissue. Then he replaced my gown and went to go get ready.

Dr. Greene came back and asked if I wanted some drugs. We joked and he started pushing a minor amount of anesthetic.

Very shortly after that, the surgical nurse and Dr. Greene were disconnecting the circulation machine on my calves, lowering my bed, and wheeling me back. They were very good at being friendly and casual. I remember joking with them as they wheeled me into the hallway.

And then nothing.

Next thing I know, I’m very groggy and tired. The bed is leaning up again. I’m back in the prep room area. I’m already in a compression vest. The surgical nurse is talking to me and telling me it’s only 10:48 am or so. I tell her something like 'wow, that was quick’. She tells me that my sister is waiting for me in the waiting room. She’s flitting around doing things, but I think this is mostly a few moments to help give me time to orient myself and help me gain my bearings.

I get a choice between ginger ale and water. I choose the ginger ale, which I get with a straw in a can. She checks in with me about pain and nausea and says to let her know if I feel either. I’m fine at first, but the bubbles in the ginger ale start getting to me, so I ask for the anti-nausea meds, which are pushed through my IV. She also takes the ginger ale to give me a break from it. She asks if I’d prefer regular crackers or graham crackers and tells me she’ll give me some for the road. I pick graham.

I feel more and more oriented, but I’m also exhausted. Staying awake is a physical effort at this point. My eyes want to droop. But I manage to stay awake. My lip feels weird, but I won’t realize until my sister points out later that it feels weird because it’s very swollen (on the left bottom lip presumably where the breathing tube was rubbing).

She helps me put my shirt on, and I think she buttons it for me. I’m not sure my fingers would have worked that well. She brings out my pants and underwear. She uncovers the blanket from my legs a bit and gets the underwear and pants started. She says she can give me some privacy to get my underwear on the rest of the way if I want. I’ve been butt ass nude in front of these people for hours. So even though I’m usually rather prude-ish, and I know that they’ve left the gown over my lower half and haven’t actually seen anything, I’m not feeling particularly private at the moment. I tell her I don’t care, so she helps me. She helps me swing my legs over to the side of the bed and stand up, at which point she pulls up my underwear and then pants. I probably could have managed on my own, but the anaesthetic is making me feel stiff and awkward. Bending over to get to my underwear and pants, even around my knees, would have required a bit of thinking and effort.

Once I’m dressed, she navigates me into a wheelchair. My belongings are still in the giant bag they provided, which is hooked on the wheelchair handle. Then I’m wheeled out to my sister!

I’ve got a paper they gave to my sister with some instructions, which I believe they went over with her and had her sign. Most of the instructions are things they’ve gone over me in my pre-op appointment and such.

They include:

• Don’t remove dressings until the post-op appointment
• Keep dressings clean and dry
• Only sponge baths until cleared during post-op appointment
• No ice on the area
• Begin taking antibiotics right away (I wasn’t given any?)
• Take pain meds as prescribed
• Take all meds with food
• Clear liquids to regular diet as tolerated
• Day of surgery, keep foods light and bland
• No blood thinners, fish oil, vitamin E, or green tea until cleared
• Caretaker to stay with patient for at least 24 hours
• Don’t drive or drink alcohol for 24 hours
• Don’t sign legal documents for 24 hours
• Rest as much as possible, avoid strenuous activity, but do get up and walk every few hours until bedtime if possible (helps prevent clotting as well re-regulating body systems after anesthetic)
• Start deep breathing/coughing after surgery to prevent clots and pneumonia (ie, just don’t hold it in)
• No lifting anything over 10 lbs
• No soaking in water/baths
• Sleep with chest propped up on pillows for 2 weeks
• Wear compression vest 24/7 for 4 - 6 weeks
• Call physician for any increased pain or swelling, excessive bleeding, excessive or foul smelling drainage, elevated temperature, persistent vomiting, inability to urinate
• Urinating can be hard after surgery; call the center if patient hasn’t urinated within 6 hours of being discharged
• No driving while on prescribed pain meds
• Call surgical center (with an after hours service to page Dr. Morehouse provided) if patient has a fever of 101+ (F), there’s new redness around incision with unusual drainage, or severe bleeding/pain/vomiting

The nurse also verbally went over a bit of this with me and my sister again. She said to just take the anti-nausea meds as needed, encouraging us to take more than prescribed if I needed it. Though Dr. Morehouses’s nurse said t-rex arms were unnecessary, this nurse says I’ll probably have t-rex arms for a while and that’s fine, as it’ll help me not stretch the area for better healing. She gave us another sample cup for measuring drain output, even though I did note I’d gotten one from the Medical Center. I never did get my graham crackers, but tbh, I was so disinterested in eating that I didn’t bother asking for them.

After that, she helps us to my sister’s car. She takes my wheelchair out to the car and is there to help me if I need while getting into my sister’s car. However, she tells me to use my glutes and abs to stand and with a little conscious thought, I’m able to stand up from the wheelchair without her assistance or using my arms. She says I’m doing absolutely amazing. She buckles me in, placing the top part of the seatbelt behind my back and telling me to do that for a few days to keep pressure off my chest. Her buckling me in is necessary because I’m still so constrained from anesthetic, I don’t think I could have managed twisting around and successfully buckling myself in.

Post-Op

Day 1

My sister drives really carefully to avoid jostling me, but tbh I’m still too out from the anaesthetic that I don’t really feel much. When we reach my apartment, I unbuckle myself, but my sister tells me to go slow and wait for her. She insists on opening the door for me and helping me out. She wraps her arm around my waist to help me walk. I don’t particularly need the support, but I also can’t manage anything other than short, shuffling steps.

I’ve got my bed all set up, so all I have to do is manage to get into it while not using my arms. I think we’re both unprepared for my sister actually manhandling me into bed, but fortunately, I’ve got enough muscle control that I figure out how to do it on my own.

Something that is very common after surgery that no one told me about was how the breathing tube can mess up your throat and lip. I have a HUGE fat lip (photo) and my throat is extremely sore and swollen.

My sister is very on top of offering me pain meds and anti-nausea meds, water, and food. She offers very generously way more often than I end up needing. At her prodding, I do decide to go ahead and take one each for a pain and anti-nausea pill. My sister gets horrible nausea (her wisdom tooth experience was absolutely terrible - her body didn’t agree with any of the meds they prescribed to help afterwards), so she was really pushing for me to eat something with the pills. I should have gone for applesauce but I totally didn’t even think about having it. Since I don’t have crackers, I ask her for a plain slice of bread instead. I nibble on it a little, but my throat is so thick and I am just not at all hungry. I don’t manage to eat more than a bit off the corner. I also ask for some of the hot ginger tea.

I swallow the pills with water. I think the ginger was too strong for me that soon after surgery because about halfway through the cup of tea (maybe 15 minutes after taking the pills), I know I’m gonna vomit. They gave me a nifty little vomit bag at the hospital and the tea goes right back into it. Fortunately, it’s more regurgitation than vomiting. I don’t know if it’s the anaesthetic or what, but it’s not the deep, stomach clenching kinda vomiting. It’s easy and doesn’t really hurt. My tea just comes back up and that’s that.

My sister fusses over me. She takes a bag out of one of my trashcans and brings it over. She tries to get me to take another pill since I probably just vomited up what I just took, but I tell her that I’ll wait a while and see if I need a pill in a bit. I think I finish my tea out of spite, but I’m really afraid I’ll vomit up the rest of it. Then I finally give into the drowsiness, and I sleep for a while.

I nap on and off. My sister sits in my office chair by my bed to keep vigil over me. She keeps offering me pills, water, and food anytime I wake up. I also let her know about the peppermint oil, so she keeps stocking my oil diffuser with new tea lights and plenty of diluted peppermint oil, which is lovely. At some point I wake up enough to realize I’ve still got my socks on and am severely overheating, so I ask her to pull them off for me. I drink some water and try pills again. All the guides I read were really big on being proactive about constipation and not ending up needing medical intervention after not pooping for 5 days, so I’m really paranoid about this happening (even though none of the doctors have really talked about it much), so I get my sister to give me 1 stool softener pill. I’m feeling a little better and like I could actually eat, so I ask for the bread but as toast with apple butter. My throat is still thick, but I do manage to eat the piece of bread.

More out of a desire to get up than a real need to pee, I decide to try the bathroom. Peeing is difficult. It takes a lot of conscious thought (I think the anesthesia is still wearing off), and my pee comes out very slowly, but I do successfully pee. The clothes I’m wearing are thicker and warmer for traveling outside, so I have my sister help me into one of the flannel shirts I bought and a pair of pajama pants.

And I nap some more. I really nap most of this day. A lot of sites I’ve read said you really experience more discomfort than pain after top surgery, and I find this true for my situation. My sister is pretty on top the meds, so I really feel neither the first day. I try a couple more cups of tea that go down fine. I have my vitamin C pill and my birth control. I think I finally have an applesauce but I don’t think I eat anything other than toast and applesauce this day.

I’ve been told that I should leave everything as is until I see Dr. Morehouse, but I do empty my drains that night. Here’s what the drain set up looks like with everything all closed up. (For drain care, you want to empty them in the morning and a night, note the amount that drained from each side, and empty them more often if the bulb is getting half full or more. Once the drains are outputting less than 30 cc in a 24 hour period, they can be removed. I have an automatic appointment that was set for Jan 5th for drain removal but am told to keep them updated via my patient portal if drain output is still too high and my drains need to stay in longer.) I’m given a sheet to record these drain outputs (that I no longer have, as they kept it when I went in for drain removal - bringing the sheet is necessary or they won’t take out your drains). IIRC the right gives 10 cc and the left 20 cc. I’ve been told up to 25 - 50 cc the first two days is normal, so my output already seems pretty low, which seems good.

I also take off the gauze they put on my hand over where the IV was. There’s a surprising amount of blood on it and my hand is a bit bruised, but my hand looks and feels otherwise fine.

Since my post-op appointment is at 8:30 the next day, my sister and I settle down pretty early for bed. There’s a lot of fussing and re-arranging with my pillows to try and make a more comfortable sleeping position for me because my sister doesn’t think anything looks comfortable even though I keep telling her I’m fine. It’s sweet.

Post-Op

Day 2

Sleep the first night is not great. I wake up every couple of hours. It’s the one time in my life I don’t need an alarm to get up in the morning. I wait until my sister starts moving around to do the same. I think I have another cup of tea before we leave. I’m walking way better today. My sister helps open the car door for me and buckles me, but she doesn’t try to assist me in walking.

Since it’s the weekend, the Medical Center is actually closed, so we’re given special instructions to drive around to the back and call Dr. Morehouse once we’re there so he can let us in the staff entrance. He remarks how well I seem like I’m doing, getting out of the car and walking by myself just fine.

He leads us both back to a patient room and asks me to unbutton my shirt so we can do the big reveal. I have my drains clipped up on my chest on the vest because that’s where the Surgical Center placed them, but Dr. Morehouse says I can clip them anywhere if I want (which is definitely good for anyone with dysphoria because up on my chest, they really feel/look like annoying detachable boobs I’m carrying around). He unclips them and clips them lower onto my shirt, then unzips and unclasps the vest and takes out the padded gauze pads off. Everything is pretty clean, so he helps me off the bed and leads me to the mirror so I can see my chest for the first time. (Center view of my chest post-op.)

He gives me a few minutes to admire things, and I’m mostly just struck by a really quiet happiness. What I see isn’t shocking or weird or upsetting. It helps that the incisions are really tight and clean. But it was always seeing my boobs that was shocking and weird and alien to me. Seeing my flat chest without even nipples…it just feels right. It feels like me. Dr. Morehouse asks if it’s what I expected, and I don’t have the words to properly convey my happiness and gratitude to him.

He leads me back to the table. He takes the gauze off the areas where the drain tubes come out my side. He wipes them and applies some antibiotic cream. He tells me to just keep them clean and apply an antibiotic on the site once or twice a day. He says that most people who use neosporin find they develop contact dermatitis if they use it for 7 days in a row or more, so he suggests another brand I can’t remember. I’ve already bought a generic brand that I’m just gonna put up with. Then he replaces the gauze, produces new padded gauze pads to protect the incisions from chafing, and he re-closes the vest. Since the incisions are covered by surgical glue keeping them closed and clean, I don’t have to do anything with cleaning or caring for those. There is a bit of pain/discomfort around my sides near my armpits (where the incisions go back to) as he squeezes the vest, but that calms down once the vest is slow. I’m left to re-situate my drains as I prefer and button up my shirt.

He asks if we have any questions or concerns. I note that I’m having a bit of trouble with my asthma and the vest and ask if it’s okay to take it off to breathe for a while. (It’s messing with my ability to take deep breaths and there’s been a few times where I’ve been panting because I can’t get good enough breaths.) He says that’s fine and to just try and wear it as much as possible. And then we’re cleared to leave!

The whole visit takes maybe 10 minutes or less. My sister helps me buckle again and we drive back home. Dr. Morehouse asked about if I got a refund from the Surgical Center. I was too out of it to really remember. I tell him I do recall them mentioning something about it to me, but wasn’t sure if they’d already given it to me. After we get back home, my sister gives me the envelope with the $360 refund check from the Surgical Center, as surgery did take 1.5 hours rather than the full 2 hours booked.

At this point, I’m feeling like I could actually start eating. I’m not really hungry, but I don’t feel full and stuffed. I request some oatmeal (apple cinnamon), which tastes really amazing. I also get some hot tea and water. I also start trying to drink a protein shake a day. Afterwords, I empty my drains again. I think it’s something like 25 cc from the left and 10 again from the right.

The rest of the day goes much like the day before but I’m feeling more and more mobile. When I’m awake, I get my sister to watch movies with me. Each movie takes me out and it’s hard to make it all the way through, so by the end of one movie, I’m ready to nap again.

Since I’m feeling more, there are times where I feel some discomfort around the incisions, mostly up around my arm pits. I use that as a signal that it’s time for more pain meds. My sister gives me an anti-nausea pill anytime I take a pain med, as the nurse encouraged her to be pretty free with them. At this point, I haven’t defecated yet, so I take 3 stool softeners (directions say 1 - 3 a day).

As it’s New Years Eve, my sister asks if her gf (who she lives with) can come over for a while, to which I’m very agreeable to. Her gf has already eaten dinner when she comes over, so I don’t manage to get her to eat any of the food either. My sister makes herself food. I request soup. I’m trying to be proactive about walking around a bit, so I come and pick my soup and portion it out, but she heats it up and comes and serves it to me in bed. We all settle in and end up watching a few episodes of The Mole, which my gf’s sister has already watched in entirety but has hyperfixated on and begs us to watch.

We get through a couple of episodes before I need to get up to pee. Due to the layout of my apartment, this means everybody getting up and shuffling around. I pee and then I go ahead and take care of my drains. I think I’m down to something like 10 cc from each side this time. I can also actually see the outline of the drain under my skin in places, which is vaguely unsettling and odd. My sister replaces the gauze around my drain tubes, too. The drains are positioned so that they’re a vaguely awkward placement for me and it’s just easier for my sister to take care of while she’s there. (Left and right views of drain tubes in. The right drain tube is situated slightly more forward out of respect for my tattoo. I talk more about this later, but you can see on the left how the stitches appear to be pulled out slightly. The gauze is really to help pad for any discomfort of them rubbing against the vest.) I put the arnica gel on my chest, though I don’t seem to have too terrible much bruising or swelling. But I bought the gel, and I’m gonna use it.

I can’t help but poke and prod at my chest a bit. There’s a weird sensation of recognizable numbness around the incisions. It’s not just that I feel nothing; it’s that I feel numb. Reading about the numbness after surgery doesn’t do justice to how alien it really feels on your own body. There’s also a bit of what I hope is post-surgical swelling, particularly on the ends of the incisions in the middle of my chest. (I’m not quite at a point where I can report if this is indeed swelling or just a look that I’m going to need to get used to.)

This leads to a natural break up of our watch party. Plus, my sister and her gf have animals at home that need fed and let out for a potty break, so my sister’s gf goes home. My sister gets my bed situated for sleeping again, and we both scroll on our phones for a bit before we go to sleep before it’s even midnight. Again, I don’t sleep super well, so I wake up during the midnight fireworks going off in my complex and wish my mom a happy birthday and new year.

Post-Op

Day 3

I sleep a little later today but wanting to empty my drains on a 12-ish hour schedule still gets me up pretty early. Draining is going down pretty nicely.

My sister makes me breakfast and keeps me supplied with tea and water. We talk a bit and watch another movie. However, we are getting to a point where I’m feeling pretty mobile and capable of taking care of myself, and honestly I need a break to prove my autonomy and independence. As well, my sister is in the middle of moving and she does need to go take care of things. We chat a bit and I subtly prompt her about her plans for the day. She leaves to go work on her move and go take care of her animals sometime in the afternoon.

We’ve been a bit awkward in my studio apartment with not wanting to bother each other, so I also finally feel free to put on some noise. I turn on a show to watch, but I’m still dealing with a lot of grogginess, so I end up napping on and off through most of it. I get up a couple times to get tea/water. My butt is killing me sitting in this position in bed, so I switch to the one chair in my apartment for a while and again end up napping there.

My sister set up a post-it and a pen near my meds so I could write down what time I take anything, as I’m not confident in remembering when I take my pills. I utilize this and find it really helpful. Still no bowel movement, so I take 3 more stool softeners today.

I take a walk outside just to my mailbox. It feels nice to get some fresh air.

Near dinnertime, my sister comes back to check in on me and help me with drain care. I have soup again but also feel well enough to make myself a grilled cheese to go with it. She does my dishes for me (and continues to do so every day she comes over), which is really, really great because dishes is one of the things I always struggle to stay on top of.

The drain tubes are stitched in place to keep them where they’re at, but at some point, the left drain tube seems to have pulled out a bit. I don’t know when because it didn’t hurt, but the stitches look a bit pulled out and there’s some blood to clean up around the tube today. We wet a gauze pad to use to clean the drains then wipe up with an alcohol prep wipe.

The drainage in the right is continuing to go down. The left is still around 10, which means I’m still getting 30 cc in a 24 hour period. I try to will the drainage to lesson.

I try taking the vest off for an hour today to help my breathing, but it turns out the vest is really helping with the pain and discomfort. The longer the vest stays off, the more I start to feel my incisions. It’s like a pulling sensation and a general aching. I end up putting the vest back on before the hour is up because this discomfort is worse than the shortness of breath.

Day 4

Day 4 is the worst day for me. With all the sitting, at some point, I do something to mess up my leg. Left unsupported in one position for too long, it starts to get extremely painful. It’s a sharp, persistent pain. It wakes me up in the middle of the night, and I spend the rest of the night fussing around trying to find a position I can actually sleep in. I sleep in my chair for a bit (which is really not meant for laying down) until that gets too uncomfortable. Then I go back to my bed.

It takes both my sister and a friend I’m texting with to tell me to try a pillow under my knee. I guess this just sounds silly to me, and I get a stubborn fit and refuse to try this for hours. Doing it brings instant relief, though. I have to use the pillow or I can’t even manage to stay lying or sitting.

Even though I’ve been eating well, I also wake up nauseous because I’m so hungry. I think my mind and body are finally totally synced back up again and my mind is registering how much energy my body needs to heal.

Sleeping with the vest messing with my breathing, I’m also waking up very congested and dealing with big coughing fits in the morning trying to clear the phlegm from my throat.

I take a 10 minute or so walk outside to get in some fresh air and movement.

I switch from oxy to tylenol today because I think it probably would have been fine from the start and I want to make sure I’m cleared to drive if I need. I don’t think contributes to any badness, but it is just worth noting for my timeline.

I still haven’t had a bowel movement, so I also go from stool softener to stimulant laxative today because I’m getting paranoid and concerned. I don’t realize until later how much this contributes to me feeling bad. My stomach gets crampy, and I just feel a kind of general malaise. On the good side, I do finally defecate, at least, so the laxative works. But it’s not comfortable.

I’m just overwhelmed by everything. I have a bit of sensory problems (avoidant), and I just feel everything. The compression vest. The shortness of breath from the compression vest. The drain tubes being pressed into my skin under the vest. Having the bulkiness of the drains hanging off my chest (I switch them to my pants for a bit, which helps an eensy amount). I actually have the thought that maybe surgery wasn’t worth it because this day is so bad. I genuinely don’t know if I’m going to mentally survive if healing continues to feel like this.

My sister comes to help me again with drain care at night. By the time she does, I’m just miserable and ready to be done. Unfortunately, there’s not really anything she can do about it but let me vent and affirm my feelings and tell me she hopes it gets better.

Post-Op

Day 5

I’m still not really sleeping all the way through the night, but I’m sleeping in longer and longer. The downside of this is that it’s messing up my drain times and it’s not helping me with waking up incredibly hungry and therefore nauseous.

My right drain is definitely less than 30 cc in 24 hours. I’m getting a scant amount from it each time. My left is still kinda iffy. It’s hitting 30 cc to a bit less but it is finally lessening.

I am doing way better, mentally, than day 4, though. I realize how close I am to getting the drains out, and I’m pretty confident that’s going to help a lot. The drains are just kinda in the way and annoying. The drain tubes are causing extra discomfort under the vest. They’re just mentally exhausting. I think I can deal with the rest if I just get the drains out.

I continue taking a couple stool softener pills just to help ease things along inside. I definitely don’t need the stimulant laxative again, though.

I am also utterly exhausted this day. I’m not sure if it was the mental stress or the short walk I took, but I’m wiped. Again, I spend the majority of my time just napping.

My sister comes over and we chat about tomorrow. Technically, I can drive, but tbh, with the drains, I just feel clunky and don’t really want to. I know my sister appreciates getting to check in on and help me out, so I accept her offer to drive me.

That night, my left drain is really low, and I celebrate because they’re definitely ready to come out.

Day 6

My left drain is really low again, which is a relief.

My appointment isn’t until 2:30 pm. They want me to show 15 minutes early. My sister isn’t worried about it, but I’m a goody two-shoes, so she agrees to leave earlier for me. I eat and kill a bit of time before she gets there. To my appointment, I bring a mask (it is required still at the Medical Center) and the paper with my drain notes.

It turns out that there’s unexpected construction, so it’s good that my sister and I leave early because otherwise we would have been late. My sister waits in the waiting room for me to do the drains in private.

When the nurse calls me back, I get yet another comment about how it looks like I’m recovering really well, and I’m getting very curious about if they say this to everyone or I’m actually more mobile than average.

In the patient room, I’m told to hop up on the exam table. She pulls out the shelf for me to put my feet on. We chat a bit as I unbutton my shirt, unclip the drains, and unzip and unclasp the vest. I mention the vest is really mentioning with my sensory issues and asthma, and I really like this nurse because she takes this really seriously and really cares that I’m uncomfortable, which we’ll come back around to in a bit. She checks my drain paper and how low the amounts are and says the drains are definitely ready to come out.

She sets up the area a bit, placing a big medical cloth over my legs and getting out scissors, gauze, and tape. Then Dr. Morehouse joins us. They clearly have a little bit they do together to help put patients at ease. I’ve been told that getting my drains out isn’t painful but does feel weird. I’m not really nervous or scared - just excited.

Dr. Morehouse has me lean back against the back of exam table, which is propped up, so that I am sitting up but resting. I kinda just fling my arms out away from my body, trying to give the nurse and Dr. Morehouse room to maneuver around the drain tubes. Dr. Morehouse cuts the stitches on his side. These pull a bit, and I think it’s because his side is the side where the stitches stayed tight and close to my skin. I don’t feel the nurse doing her side, which is the side where they’ve been pulled away from my skin a bit.

I’m not sure if they told me to close my eyes, but I did. Dr. Morehouse instructs me to take a deep breath in…then out. And again. And again. As I breathe out the third time, they both pull on the drain tubes and rapidly remove them from me (there’s a good amount of tube inside - at least six inches or more, I’d estimate). It isn’t painful. It is very odd - and very hard to describe. A bit like a snake slithering around under my chest. One moment they’re there, the next they’re not (Dr. Morehouse’s technique is to pull as fast as humanly possible, and the nurse would prefer to go slower but tries to match his speed so it’s less uncomfortable for the patient). It’s not a huge thing, but it is a thing I can feel. Dr. Morehouse celebrates that he didn’t get any blood on me. No one warned me that I should wear clothes I would be okay with getting bloody to this appointment, so this is my warning to you: wear clothes you’re okay if they get a few drops of blood on them when you get your drains removed. Dr. Morehouse and the nurse wipe up the port sites, apply antibiotic, and place new gauze over them.

I also receive absolutely shocking news from Dr. Morehouse. Both his nurse and the Surgical Center gave me instructions to wear the vest continuously for 4 - 6 weeks. Now Dr. Morehouse tells me that I only need to keep wearing the vest for another 1 - 2 days and then I can abandon it. My mind is reeling from this information. He also says he would like to see me again in another 2 - 3 weeks, but that’ll be it!

Then Dr. Morehouse leaves me with the nurse. She finishes cleaning up their supplies. She did get a little spot of blood on my vest, which she tries to clean up a little for me. I discover that Dr. Morehouse may have missed me with the blood, but it’s spattered all over the exam table and a bit got on my cell phone (put your personal objects out of reach during your drain removal!). She gives me new padded gauze pads, though tells me that the padding is unnecessary at this point, and I can change them to whatever - which may also help lessen my discomfort with the vest if I just use gauze squares without padding.

Then she fusses over the vest. She hates that I’m so uncomfortable. She says the small looks like the correct fit on me but does offer to see if they have a medium they can give me instead. I’m really grateful, but I also know the vest is to help your skin adhere back to your body and keep down swelling and fluid build-up. I’m already worried about what may or may not be some swelling I’m experiencing. I don’t want to screw myself over in the long-term, especially if I really do only have to wear the vest for a few days longer, so I thank her but turn down her offer.

I’m instructed to tell the receptionist on my way out that I need an appointment with Dr. Morehouse in 2 - 3 weeks. Then I’m left to finish closing up the vest and my shirt, and I wander out on my own. Dr. Morehouse is so booked up that the earliest appointment the receptionist can finagle me is an entire 8 weeks out in March. My plan is to just communicate with the team in 2 - 3 weeks via my patient portal and see if there’s anything in particular they want to discuss at that point.

When I walk out with my sister, I feel a million times lighter and happier. I’m so much more comfortable without the drain tubes bugging me or the drains sitting all bulky and clunky on me. My sister drives us through an ATM on our way back so I can deposit my $360 refund check, which also feels great.

Today is the day I realize how foggy I’ve been. I felt overall well, but I start to be able to actually focus and be interested in doing something besides just lying around half-napping and half-watching TV. I feel so much more mentally clear. I actually have the ability to focus on something for more than 5 minutes. I feel like I can hold a conversation and actually engage with the other person. I feel motivated to sit at my desk for a while and interact with people on forums and check my email and eat here instead of in bed.

I do my nightly ritual of putting arnica gel on my chest, cleaning out the drain wounds, and taking a minor breathing break from the vest. (Center view of my chest around this point.) I guess I had imagined the drain holes being more like slits, so I am surprised to find they are actual holes that are pretty gnarly. (Left and right views of the drain hole wounds.) The gauze pads I remove are gooky, and cleaning the area actually tracks up some blood and ooze.

Day 7 and Beyond

Day 7 is the day I finally take a shower, though I was cleared to long ago. I’ve been kind of anxious about somehow doing it wrong or messing it up, but after a week, it’s time. I’ve been using the body wipes, but my face is really oily and my hair is starting to get icky to the point of bothering me. No one gave me any special instructions on showering, but I read online to be careful and keep the incisions facing away from the spray of water, so I do that.

Showering is not as big of a deal as I made it out to be. The water feels good. There’s no pain. I am careful around my incisions and don’t really touch them. I just let soap and water run over them. Shampoo and conditioning is a bit awkward trying to keep my arms not raised above shoulder level. Drying off is the most difficult part due to the limited arm range, but that, too, is navigated.

For work, I originally took off the day of surgery, the full next week, and then Monday the week after, so that if I was ready to go back, I would only have a short week. Tbqh, I am feeling well enough that I could return. However, work politics end up that I decide to take a full two weeks off and return for a full week. (Among other things, I am really wanting to quit this job, so I figured I may as well take the full 2 weeks time off I get now. If I need more time off later, then that just may be my motivation to quit at that point.)

It’s somewhere around here I stop waking up nauseous. I am also sleeping through the night - though my previous circadian rhythm has taken over, and I’m going to bed later and later. I also finally stop taking the stool softener, as I know it can cause issues if you take it too many days in a row.

By day 11, I am still taking tylenol. I am mostly fine, but there are times when my chest does start feeling really tight and itchy. For the most part, I wait until things start bothering me before I take a couple pills. I am not regularly taking the anti-nausea meds, though I was taking them when I was waking up nauseous.

On day 8, I even go out and play Pokemon Go for a bit. I probably push it more than I should. I walk around for a couple of hours. I am mindful of going slow and taking plenty of breaks. You aren’t cleared for any cardio until 3 - 4 weeks after surgery; part of this is because the effects of exercise can make swelling/inflammation/fluid build up worse, which I do want to avoid. By the time I’ve found a couple of kecleon, my body is telling me that it’s time to sit down and take it easy again. I don’t feel sore or bad, but I’m aware of how I’m feeling and that I’ve been walking around longer than I probably should have been.

I sometimes experience what’s like a burning sensation around my incisions, which I noticed around day 4/5 and seems to randomly occur. I read this may be nerves healing? It’s not uncomfortable. It’s mostly just warming. I don’t mind it, but I do find it interesting.

On day 8 or 9, I decide to start doing more of my normal routine. I’ve only been brushing my teeth and combing my hair in the morning and night. I start adding in flossing and washing my face.

I’ve done some research about the compression vest…and ended up really frustrated. It appears to be just preference of the surgeon. Some places follow the guidelines the nurse and Surgical Center gave me: wear the vest continuously for 4 - 6 weeks. Others align more with what Dr. Morehouse cleared me for: 1 - 2 weeks is enough. And yet some others suggest to wear the vest 24/7 for 1 - 2 weeks, then wear it for half days (either during the night or during the day) for a further 2 - 4 weeks (which would be total 4 - 6 weeks wearing the vest in some capacity).

As of day 11, I have decided to wear the vest for the full 2 weeks, then take stock of how I feel after that. If taking the vest off still results in more discomfort, then I may as well keep wearing it for a while. Also, if the area that I’m hoping is swelling is still looking the same, then I may wear the vest during the day. I would like to stop wearing it at night because it just messes with my breathing too much when I’m lying down.

Other than that, I love looking at my chest (most recent center view). I love getting to stand in front of a mirror and my clothes just being flat on my chest. It just brings me so much euphoria. I’m so glad I made this decision and went for it. I can’t wait until I’m cleared for tattooing because I have an awesome/hilarious idea for my chest (I am NOT doing nipple tats; I’m so uninterested in having anything resembling nipples; my nipples were probably the worst part of having boobs).

And this concludes my journey thus far! If you have any questions for me, please feel free to ask.