July 2010


OUCH!

I have a friend who lives in LA who just had a tummy tuck and breast augmentation.  She is on her first day after surgery.  She is a tough cookie, and her words to me today were, “This really hurts!!”

One of the most common mommy makeover surgeries is breast augmentation and tummy tuck.   These by themselves are the two most painful surgeries we do as plastic surgeons.  These surgeries hurt because of the muscle.  For tummy tucks, I like to put in a pain pump which drips numbing medication internally to help.  In addition we give you pain medication and some of us use muscle relaxants as well.  Even with all of this, it still hurts.

For planning how to deal with your family life (as you are a mom, hence the mommy makeover):

  • the first 2-3 days you are OUT. You will be on medication round the clock.  Someone else should care for your kids.  And you. 
  • The first one to two weeks you will be very sore.  No driving until you are off pain medication.  As for when you will feel normal again and be doing your daily life things, people vary.  Every person is different as to when they get over the “hump” and feel better. 
  • No heavy lifting (yes, this includes your adorable children) until much farther out.  Exactly when you can lift something over 5-10 pounds is not a hard rule.  Some of it depends on you and your tissue.  Your doctor will know what that means.  Here plastic surgeons differ on their recommendations for activity level, so defer to your doctor.  Tensile strength of your wound (how strong your repair is) is weakest at three weeks out from surgery.  Usually you can’t do any exercise until at least 6 weeks out.  For core body exercise (pilates, crunches, that favorite daily method place in menlo park, etc) I extend that until 3 months.

Give yourself time.  It took you 9 months (and for those of you with multiple kids, multiply that time) to get into this mess, it will take you a while until you feel normal again.  This is normal.

Who doesn’t love that glucose tolerance test? Who can forget the “cola” flavor which 1. does not taste like cola, and 2. does not taste better when chilled.   Did you wonder why you had to do that? What is gestational diabetes?

Gestational diabetes is when you develop diabetes (high blood sugar) while pregnant.  You don’t want your blood sugar to be too high.  People with long term diabetes have issues all over their body due to problems with blood flow- heart disease, loss of sensation, loss of limbs, higher infection rates, vision issues to name a few.  In pregnancy, diabetes is associated with higher birth weight of your baby, early delivery, higher C section rates, diabetes in the mom, and future diabetes and obesity in your child. 

A study came out in the American Journal of Obstetrics and Gynecology of 65,000 women studied from 1991-2008 at Kaiser.  It showed for recurrent gestational diabetes:

  • if you have gestational diabetes with your first child, you are 6x more likely to have it again with your second pregnancy
  • if you have it with your first two pregancies, you hae a 26X risk for having it with your third pregancy
  • higher rates found in Hispanic women, and Asian/Pacific Islander women
  • higher recurrence in women over age 30
  • higher recurrence when bigger time gap between pregnancies

This may seem like a “of course that makes sense” kind of thing.   But for those women who have had gestational diabetes, are older, or are certain ethnicities, that glucose tolerance test is extra important.