Pre-Op Visit

I went to Portland today to see the plastic surgeon and to get some blood drawn.

But I took the long way to Portland - and it was longer than expected. I decided to do a quick visit to Spirit Mountain Casino - and at one point, I was $20 up. I ended up $5 to the positive before leaving to Portland.

Unfortunately, I left a little too late, maybe 15 min. late.

Then, I didn't catch the sign that said that I should go straight to stay on Hwy. 18 so instead I ended up heading south on Hwy 22, so after I discovered that, I tried to get an alternate route and ended up driving Hwy 99W all the way to Tigard - stopping at all the towns along the way!

Then, once I got to I-5, I ran into traffic. A big semi broke down.

I was a full 45 min late. Luckily, her office didn't mind, but it did mean that I waited an additional 90 min to talk to her. My own appointment was about 30-40 min all together.

Then it was time to go to get the labs drawn. I finished my day there around 3:50pm.

So, with the plastic surgeon, I found out some things to expect:

1) Dr. T thinks she can do a pedicule flap (one in which the muscle stays attached to its blood supply) which is a simpler procedure. She wants to use my latissimus muscle, but in case the blood vessel for it has cancer and needs to be severed, she will have to use my pectoral muscle.

2) Patients who do this surgery tend to experience a little more pain than those with a TRAM flap - for that reason, she puts a catheter in which will allow the nurses to administer a novocaine-like anesthetic. This will also allow me to get off pain meds sooner rather than later. I like that idea.

3) I will lose the implant, which I expected.

4) The surgery to remove the diseased tissue will take 2-3 hours; Dr. T says that her part will take 4-6 hours. If there isn't a viable blood supply for the pedicule flap, she will have to do a free flap procedure, which involves micro-surgery to connect the blood vessels. This will take an additional 1-2 hours.

5) Dr. T will need to do a skin graft. She will take it from my upper thigh and I can expect pain - the kind you get from a skinned knee.

6) If I have a pedicule flap, I will probably stay in the hospital three or four nights. If it's a free flap, since there is always danger that the blood supply to the flap will fail, so I will be in the hospital 4-6 days so the nurses can keep an eye on the flap to make sure it's okay.

7) If I have a pedicule flap, then I may be feeling strong enough to go to a conference in Vegas three weeks later. If it's a free flap, the recovery time is longer.

8) Dr. T felt that my "muffin top" may be happening because the growth has outstripped its blood supply so it is starting to atrophy.

At the lab, the only thing that ws interesting was that my heart rate was high (about 92, which is about 20 beats higher than usual). This was after I walked from the Tram about 1.5 blocks to the lab, which had a slight uphill. When I mentioned that I was anemic (9.5 for the hemoglobin), she thought that that was why, because I also had shortness of breath. I may have also been slightly dehydrated, since I hadn't had much water to drink beforehand, waiting in the exam room for the plastic surgeon. This also explains my fatigue. At any rate, I need to try to increase my hemoglobin as much as possible.

I got home about 6pm and with the time change, it was still light out. Yay!