My Top Surgery Experience

I traveled on Mon, April 28 to Vancouver, BC for my Top Surgery.

Getting first hand advice

Later that day, we met up with a friend and his partner and had the chance to hear their first hand accounts of his top surgery. He had the same surgeon and went to the same clinic, but had a different procedure than what I would be getting: double incision as opposed to peri-areolar concentric circle. It was very helpful to get details from his experience–they satisfied numerous questions I had about the general schedule of things to follow. He also kindly provided me with additional homeopathic remedies (in addition to the Arnica that my doctor supplied me with.)

After this enjoyable meeting, we checked into the 910 Beach Avenue Apartment Hotel (formerly The Meridian), which was the ideal place for us to stay. Our suite included a full kitchen, was extremely quiet, and the hotel has a great downtown location, just a few blocks from the surgery clinic. That evening, we walked up to Davie St. and found a nice quiet restaurant where we enjoyed a light meal of salad and salmon.

Surgery day

We both had a good sleep that night and woke early to prepare for my 7:20am check-in at the Ambulatory Surgical Centre. We walked there and chatted about how extremely calm we both felt–it was just very natural for us to be going through with this after so many months of intense preparation. After arrival, we were immediately ushered to a private room where I changed into hospital gowns. A cheery nurse arrived and took my blood pressure (which was low as always.) Next, Dr. Bowman arrived and drew some lines on my chest. Originally, he thought my nipples were within range for male size, but this morning suggested that if blood flow was good enough, he could do some nipple reduction to give me even better results.

The anesthesiologist arrived next. He asked about allergies and walked me through what he would be giving me. I asked him if I could take the Arnica that my doctor had recommended that I take right before surgery, and after looking it up for possible complications, he agreed that this would be fine.

Then a nurse arrived, I removed my glasses and followed her down the blurry hallway to the OR. I walked through the doors and saw several people preparing everything for my surgery. I managed a quiet and somewhat awkward “Hello,” then laid down on the bed, which was shaped like a cross, with a length for my body and two lengths extended from this for each arm. I looked at the ceiling and noted that the surgical lighting was the same apparatus that I pointed out to my GF from the street looking up to the windows of this room on the 7th floor the afternoon before. The anesthesiologist gave me an injection that made me very relaxed. I told him it was probably too early in the day to feel that good. Dr. Bowman asked me how I was feeling and I replied, “Surprisingly mellow.” Then the mask was brought down to my face, and I was out. There was no counting backward–it happened much too quickly.

I have a memory of trying to remove the mask, feeling claustrophobic in it, and a hand then removing it from my face. I imagine this happened in the OR after they gave me drugs to bring me to. I was also hot, and tried to pull the covers down. Then a woman’s voice, “It’s all done, you’re in the recovery room.” Some minutes later I reported that I was feeling a little nauseous and was given something (Gravol?) intravenously, and oxygen tubes were put in my nostrils. The tubes were removed at some point, and I must have stayed in there about an hour or so. I had one visitor during that time, Ali, Dr. Bowman’s clinical assistant. Then two nurses helped me walk to a recliner chair, and my GF was brought in. She later said I looked quite yellow. My legs started shaking, the result of the drugs in my system. Generally speaking, I felt OK, and felt just a bit nauseous once more. I drank an apple juice box, then one of the nurses called us a cab, and wheeled me out to the street. The wheelchair ride was a little dizzying. I hate the way cabbies drive. STOP. GO. STOP. Very jagged. What’s up with that? Why can’t they drive more smoothly?

I got right into bed in the hotel room, then my GF spoon fed me some miso soup, which was the best miso soup I’d ever had, not surprisingly. Everything was going just fine until we had to empty my drains for the first time that evening. This proved a little challenging for me, and I slumped out of bed onto the floor and promptly threw up my soup. Thankfully, my chest was still pretty frozen, so this wasn’t painful. About an hour later, I devoured a bowl of warm applesauce my GF made for me, with cold soy milk on it. It was delicious!

I got a good sleep that night, and we cabbed to Dr. Bowman’s office for a check-up the next morning. He thought everything was looking great. Ali recommended that I get outside for a walk, so we left the office and walked down to Granville St. where we caught a bus back to downtown, then walked to the hotel. I spent the rest of the day in bed, and moved over to the pull-out couch bed at 4pm to watch a great Jays/Red Sox game. My GF and I split a dark chocolate KitKat and a pint of coffee Hagendaaz.

We went for another walk that evening down by the boardwalk, watching the little tugboat ferries put-put to Granville Island, and lots of healthy Vancouverites roller blading and jogging. In contrast, my slow pace was probably pretty revealing of a medical condition. I felt a little jealous of everyone’s easy mobility.

Traveling home

I did not sleep well that night–I got up every hour to pee–but my spirits were good. Then we undertook the 6-hr trip home the next day. It started out with arriving too early at the piercing shop, where I needed to get my bellybutton ring put back in. They weren’t scheduled to open for another 45 min., so we walked down to the Ramada and sat in their lobby. The wait felt long. Then we walked up to where we would catch the bus to the Horseshoe Bay ferry only to find the area under (loud) construction, so we had to walk an extra 5 or 6 blocks to the next stop. Luckily the bus arrived immediately, but the ride was jarring, like the cab ride a couple of days before. We had to wait almost 3 hours for the next ferry and the waiting area was cold. When we finally boarded the ferry, I slowly walked to our seats, being cautious that no one bumped into me, and then ended up shedding a few tears when I finally sat down. I was tired, cold, and in some pain, overdue for my next T3 (codeine). I took my pills, and my GF fetched me a hot tea and some food (chicken, my first taste of meat since the salmon on my salad the night before surgery.) The ferry ride went by quickly, as did the drive to the next ferry, and the final drive home (where my sister had erected a colourful “welcome home” banner on the deck railing!) The traveling was a bit rough, but it was worth it to be home!

Healing up

I’ve spent the past few days being very mellow, lots of (uncharacteristic) naps, and light eating. I did manage a 5km walk to the beach yesterday, which felt great. I’ll do that again today, I think. The exercise feels good. Without it, my body feels weak and my mood takes a hit. I’m trying to ween myself off the T3’s, but alas, I don’t have any Tylenol in the house, only Ibuprofen which I’m supposed to avoid. My GF talked about going out to pick up some more bananas and lemons today, so I will ask her to grab some Tylenol as well. It’s important to me to get off the codeine as soon as possible.

The pain is manageable. I’ve gone 12 hours between taking a single T3 (as opposed to every 4 hours.) On a couple of occasions, I’ve taken one and a half codeine, but not once have I taken two. The most pain comes from the drain incisions, which are located below my armpits. They burn. I have been icing them daily.

The drains are a pain. They limit what I can wear, and I can feel the tubes and catchment pods dangling against my skin, which is kind of an icky feeling. I am emptying the drains once a day now, at 8pm. The drains can be removed once the daily output is less than 25cc for two days straight. Today will be the second day of less than 25cc output, but since my doctor’s office is not open on Mondays, I will have to wait until Tuesday to have the drains removed, when I travel back to Vancouver for another post-op check-up. Just over 48 hrs with the drains left!

On Friday night, I started wearing a compression vest. It’s OK, but I wish it were longer. It stops just above my bellybutton, so my mid-rift is exposed. I’m used to wearing a tank top daily, but I can’t get one on right now, so I’m dealing with some drafts that leave me chilly unless I keep the heat cranked.

Closing advice

At the risk of sounding annoying, I’ll close this account by offering once piece of advice for anyone planning to get top surgery: GET FIT! I think this would all be much more difficult if I were overweight and out of shape. I have relied on my stomach muscles to maneuver my body in the absence of being able to use my arms as much. My leg strength and balance have also been incredibly useful. And lastly, had I not lost 20 lbs before surgery, I would not have been able to get the peri-areolar concentric circle procedure, and instead would have been left with the large scars of the double incision method. Being fit has been a big part of getting to and getting through this experience, and I’m grateful I made it a top priority.