Joining the Flat Belly Society

A few days ago, I saw a plastic surgeon in Toronto to see if I can finally move on a little from the brain-numbing excess skin situation.

I've written extensively and openly about my issues with my excess skin. It bothers me in a way I wasn't really expecting. I knew it would be there, of course, but the way it messes with my brain was surprising. Not everyone is affected this way. There are some who say "Screw it," and live with it. But as for me, I find it very difficult to literally carry around flesh-and-blood reminders of what I did to my body and why I'll never look normal through my own efforts. It is my fault and no matter how much I work out or what I do, they are there. Like Guilt Tumors or something. I struggle with that. And in that struggle, I sometimes seek comfort in my old friend, food. This, and the stress I endured last year over my employment situation, definitely caused me to regain some of the weight I initially lost. It's coming back off slowly. I hope the good news I received on Wednesday will help me get my head straight and continue on my current path.

I've turned into one of those women constantly saying "If I could only lose 15 pounds..." Well, I might think it; I'd never say it in certain company. I used to hate those women, bitching about 15 pounds when I had over 250 to lose! And they are not even remotely similar situations, so please don't bitch about 15 pounds in the presence of a 500-pound person. You might get punched in the neck. I know I held myself back several times...

I had a really bad experience a couple of years ago with a plastic surgeon (PS) in London. She came recommended by a friend who had bariatric surgery and had her panniculectomy covered by the Ontario Health Insurance Plan (OHIP), through this surgeon. It was a nightmare and kinda put me off seeing another PS. When I asked my family doctor for another referral, her first response was "But you already saw one and they said the panniculectomy wouldn't be covered." I had to talk her into giving me another referral. Nothing is easy, right?

But through some friends I've made in my support group, I heard about a new PS in east Toronto - actually, Scarborough. Everyone has been so sure he would work with me, so sure that I should get the panniculectomy covered, that I decided to give it another shot.

So on Wednesday, I set out to drive to Scarborough - by myself. In the rain. This is already a laughable situation, as I loathe driving in big cities and can't see my hand in front of my face when driving in the rain. Erich taking the evening off work to accompany me wasn't really an option; that would mean losing a lot of money in overtime because of the way his company calculates hours. And, well, the tummy tuck "upgrade" I want ain't gonna pay for itself.

The drive wasn't too bad, save the accident I nearly got into at an intersection 5 miles from my destination when two cars in front of me wrecked (thank you, Good Brakes) - but as I sat in the waiting room, I listened to another patient speaking to the PS's assistant. They were having a "discussion" about pricing. This woman was also a bariatric patient looking to have a tummy tuck upgrade after an OHIP-approved panniculectomy. As I listened to this exchange, I got more and more nervous. Erich and I don't have a lot of money. We get by, but don't have large amounts of cash sitting in the bank. My husband has been working his fingers to the bone, accepting overtime whenever it is offered in order to sock away some money to get me as much surgery as possible. I need *A LOT* of skin removal, but the panniculectomy and tummy tuck upgrade are foremost on my mind. Listening to these people argue over price and money made me uneasy because the figures his assistant was tossing around weren't the ones I had in mind. I started feeling a little sick.

My nervousness quickly subsided when I got in to see the PS, though. I really liked him. We talked about my weight loss a bit and he took some measurements. According to him, there was "no way" I wouldn't be approved by OHIP for the panniculectomy. He seemed very certain of this. It should be noted that 90% of his patients are folks like me, bariatric patients. So I trust his judgement. This was a great relief! I told him about my earlier experience in London and he was genuinely puzzled by that surgeon's lack of empathy, her unwillingness to submit paperwork on my behalf, to even try for me. "If you don't get approved, I will go and beat them up," he joked in his slightly accented English. Again...great relief. We also talked about other surgeries I need, like an inner thigh lift, a boob lift, removal of the "batwings" under my arms. I didn't ask him about the skin under my chin, which surprised Erich because I'm always bitching about my turkey neck. But all in all, the experience was night-and-day different from the one in London. He was so reassuring:

Me: "So it takes 6-8 weeks for OHIP approval, right?"
PS: "Call me in four."
Me: "Ok, great! Do you think we can do this by the end of the year?" (He's a very busy man, for obvious reasons.)
PS: "Yes, sure."

The type of tummy tuck he recommends is called a fleur de lis, sometimes referred to as an "extended panniculectomy" which is the most common for patients who go through massive weight loss. You can click on the link for more info on that, as it explains things better than I can.

The only thing that left me cold were the prices of the "upgrade" surgeries. I can get the tummy tuck upgrade but that's it. I was hoping for either the boob lift or batwing surgery to go along with it, but no. He has significantly raised his prices since my friends had their surgeries done just a couple of years ago. That's disheartening but hey...that's my luck! If I'd gone to see him in 2010 instead of the PS I saw in London, I would've gotten a much better deal. However, his prices are still significantly lower than the London PS; he will charge me less than half the price she would've.

But....I WILL GET THIS TUMMY TUCK!! That is so fantastic to me, I can't even tell you. It will be life changing for me in much the same way that actually losing the weight was. I can't wait to have it and start the next chapter in this never-ending journey.

Me with a flat stomach? That is mind blowing...

Let's finish it

Ah, the excess skin issue. It doesn't go away for those of us who have lost massive amounts of weight.

Recently, an articleappeared in an area newspaper about a woman who lost weight successfully with weight-loss surgery but felt she needed to have the excess skin removed from her abdomen to feel "done". And she believes OHIP (Ontario Health Insurance Plan) should pay for it.

I agree on both counts.

Ontario does cover a surgery called a panniculectomy under extenuating circumstances. "The pannus should hang below the level of the groin/pubis to qualify. In addition, the patient must have significant pain, chronic skin breakdown and recurrent infections and if the surgery is related to weight loss, the patient’s weight must be stable for at least six months." Ok. I get that.

I believe my excess skin keeps me from feeling like a success. I still have huge handfuls of skin around my stomach and it's really hard to feel like I've lost weight successfully sometimes. The reflection in the mirror is just "meh".

There are things that haven't changed for me, even though I've lost well over 200 pounds. I get in the shower and still have to lift up my stomach, make sure I get everything clean in the folds of flesh. This is reality, and it's no different than the way I showered when I was 444 pounds. Actually, there are MORE folds of flesh to worry about now, and my hanging stomach is heavier.

I still have to shop for longer tops to cover it up. It still hinders my intimate relationship with my husband. I have to buy a bigger size jean to get it over the stomach (stuffing it inside), then cinch a belt around my fairly small waist in order to be semi-comfortable....but I guess the bright side is at least I can wear jeans now!

I really do try to be one of those people who say "Screw the excess skin. I'm healthy now and that's what I focus on." But it's hard. It's a true psychological barrier I wasn't prepared for when I started to lose weight.

Not long ago, a "friend" told me "his wife said" if I'd lost weight "naturally", I wouldn't have excess skin. Thanks! While I know that statement is complete bullshit, it's just more guilt that I didn't do this the right way and the way I abused my body is something I chose and can't change.

Would I qualify for the panniculectomy? Probably. Friends who have been through the process tell me I would, without question. But I feel like I'm not small enough for it. I've gained a little bit over the past year and want to get that weight off before I try. That's all my fault, I realize that.

So the goal this year is to get that damn panniculectomy, at least. I think OHIP should pay for the full tummy tuck, but it is what it is. I need to get this skin off because it's starting to break me down psychologically, and is getting in the way of my maintenance. I can't let that happen.