Pain: The Price of Beauty?

"I'm going to cut that off," Dr Z said, grabbing the skin on the underside of my upper arm and squeezing it firmly, one day after seeing me in a sleeveless summer dress.
"Okay," I nodded, thinking he was joking.
"I mean it," he said and I grinned.
"Sure." I nodded and we both smiled at each other, as though we'd just made a deal.



~~~


"So, when are we doing the surgery?" Dr Z asked, eyeing the "bat wings" on the underside of my upper arm with visible distaste.
"The what?" I asked. "You already cut into me once, transplanting skin from one part of me to another, isn't that enough for you?" I was genuinely confused and had no idea what he was talking about, our conversation from some weeks ago long forgotten and out of my mind.
"The surgery," Dr Z said, pointing at my upper arms. "A simple cut, from here to here, on the underside of your arm naturally, so nobody sees the scar, s-shaped incision. I'll cut off the excess skin, remove the fat issue, pull both sides of the skin together and sew it all up. Easy. Simple."
I swallowed hard, visualising what Dr Z had just explained to me and contemplating just how strong my sudden need to puke up the dinner I'd just finished was.


~~~


"The surgery, you'll do it yourself, yes?" I asked somewhat sheepishly, having spent the last few weeks contemplating Dr Z's offer, still none the wiser whether I actually had the guts to do it, but wanting to be sure either way.
"Of course I'll do it myself!" He replied, looking at me long and hard, clearly hurt by the underlying suggestion of my question.
"Okay." I nodded. I could live with that answer.


~~~


Two years ago, after successfully losing about 35kg, I blogged/bragged about my weight loss for the first time (you can read about it here, if you haven't yet), because what girl doesn't like to be told that she looks beautiful! I've now lost more than 40kg which has made a huge difference to how I feel and act as well as what I wear or should I say "can wear"? I've written about my fitness regime and how it has changed me for the better. I believe I've probably managed to somehow talk about my regular exercise in the gym in every blog post I've published since. It's really made a huge difference, not just to my weight and shape but also to the person I've become, but especially to my self-confidence. I've never been one for sports before I joined the gym but now I can't live without it. I'm currently benched until mid-December, but given the circumstances that's okay.

My efforts with cardio, aerobics and regular classes with my trainer (who has unfortunately left my gym *sob sob*) have definitely shaped me up and the results show. Sadly some things simply can't be fixed by regular exercise and a healthy diet, so throughout these last year or so, no matter how hard I tried, I just couldn't get my upper arms to shape up. Of course my trainer managed to whip my muscles into shape but the excess skin flapping about the underside of my upper arms like bat wings even he couldn't fix. My regular exercise resulted in a lot of burned fat but the saggy skin just wouldn't go away, there was just too much of it. At times it made me quite self-conscious and very hesitant about which clothes I'd wear. Sadly I had no idea how to fix my problem, not until Dr Z mentioned brachioplasty or arm lift surgery for all you layman out there. It is a type of plastic surgery that removes excess, saggy skin from the underside of your upper arm. It also reduces excess fat issues, tights and smoothes the underlying tissue and in simple terms makes your upper arms look nicer, giving them a more natural shape. 


I was blissfully unaware of this photo session, since I was already fast asleep under the heavy influence of a beautiful drug cocktail commonly referred to as general anaesthesia, courtesy of the anaesthesiologist in charge of my surgery. As you can see the saggy skin really doesn't look nice and makes (or should I say 'made') my arm look like the trunk of a tree.

A couple of months ago I decided I definitely wanted to do the surgery and Dr Z agreed that he would personally take care of it but he told me to wait until the weather gets cooler to reduce the risk of post-surgical wound infection. Wuhan gets seriously hot in the summer and you sweat a lot so Dr Z's advice made perfect sense. Also, I'm a complete wuss when it comes to needles and scalpels, anaesthesia or not! When Dr Z did the skin graft to close the burn wound on my thigh, he actually had to join me in the operating theatre way before the anaesthesiologist was ready to put me under just to distract me and keep me from doing a runner, which I by the way couldn't have done since I wasn't able to walk very well at that time.


~~~


"Aaaaaaaaaaaaaaaaaaah! Owwwww!" I yelled, extremely displeased when the male nurse in charge of my IV drip missed the vein in my foot for the third time, causing me extreme discomfort on top of my feeling ridiculously cold and nervous.
"What's wrong?" Dr Z asked in Chinese, striding into the operating theatre.
"Speak English, okay?" I begged, grabbing his hand and squeezing his fingers so hard that he winced.
"Why aren't you sleeping yet?" He asked outright and I started to shiver so much that the anaesthesiologist supported my chin for fear that I might bite my tongue.
"They think I'm a burn patient, I'm not," I complained, squeezing Dr Z's fingers even harder, hearing yet barely registering the anaesthesiologist's request to her nurse to prepare some relaxants. "They don't know what kind of surgery you're doing, I tried to explain this to them but they don't understand what I mean. They also can't find a vein. My feet hurt like hell, I don't want them to try and stick another needle in there. I'm nervous, I'm scared and I'm cold. The anaesthesiologist that I'll be in a lot of pain after the surgery." I almost cried and squeezed Dr Z's fingers so hard that the skin turned white and he winced again. He'd just managed to change into his scrubs but hadn't scrubbed in for the surgery yet when one of the operating nurses had called him in a panic, asking him to talk to his crazy (she didn't say that) patient, flipping out on the operating table (she didn't say that either).
"Put the needle in her neck," advised Dr Z speaking directly to the anaesthesiologist while squeezing my shoulder with his free hand to keep me relaxed.
"What?" I squealed, definitely not in excitement but on the verge of a full-fledged panic attack. "A needle in my neck? Are you crazy?"
"Now," Dr Z instructed the anaesthesiologist. He could tell that I was about ready to jump and run, this time not being incapacitated by a nasty burn wound. I felt something cold on my neck, a very mild sting, and then the needle was in and the anaesthesiologist secured it expertly, then started the drip while one of the nurses covered me with a second blanket to keep me warm. "Seriously, of you're this nervous then we'll just cancel the surgery and you go home." Dr Z said to me, eyeing me seriously.
"No," I mumbled.
"Well, you clearly don't trust me." He mocked.
"I never said that. I do, I do, I do trust you," I whimpered.
"You don't." Dr Z stated flatly.
"I'm just scared because she (I was referring to the anaesthesiologist) said I'd be in a lot of pain after the surgery." I almost cried.
"I told her you're scared of pain so she said that because she was offering you an intravenous analgesia pump post-surgery, you silly, silly girl." Dr Z laughed and his eyes (they were all I could see) twinkled mischievously.
"Oh" I mumbled, "I'm still scared. I couldn't explain the surgery to them and that nurse just couldn't find a vein."
"Your Chinese isn't good enough." Dr Z taunted me. "Are we doing the surgery or not?"
"Yes,"
"Are you sure? Do you trust me?"
"Yes, I do." I nodded, then started shivering again. "Why is it so cold in here, I'm freezing!" I shuddered more, my teeth clattering louder than a thunderstorm. I squeezed Dr Z's fingers again, holding on for dear life.
"Okay, that's it. Cancelled, you clearly don't trust us. Fine, let's call Dr W, you know him, he's a plastic surgeon, he can do the surgery!" Dr Z snapped, fed up with my paranoia.
"No, no. You, I want you, just you." I begged, focusing on him and squeezing his fingers so hard that he winced and shifted uncomfortably from one foot to another. Still, he didn't pull away.
"Okay, you sure? You need to trust us."
"I trust you." I repeated.
"That's not good enough, you need to trust all of us, we're a team." Dr Z tried to look menacing but what with the surgical cap and the face mask he didn't quite manage... or I just couldn't tell.
"I trust you." I mumbled, feeling more relaxed than before but none the wiser as to why. A unknown face to my right distracted me from my conversation with Dr Z and it took a moment for me to register that it was the assistant surgeon and the doctor in charge of my case. She'd appeared right out of nowhere and it took me a moment to recognise her in her scrubs, surgical cap and face mask. "Oh it's you," I eventually mumbled and she nodded.
"Yup, me." She chuckled, slipping her hand into mine, squeezing gently.
"Alright, put her under." Dr Z ordered and I watched the anaesthesiologist add something to my IV. Seconds later I felt sleepy, then my eyes started to feel heavy. I tried to say something but I'm not sure I made any sense. The last I remember is a mask over my nose and mouth and Dr Z telling me to breathe...then blissful nothingness followed.


~~~


As you can tell I'm a total wuss when it comes to surgeries and that day when talking to the anaesthesiologist and the nurses in the operating theatre my Chinese completely failed me. I got too worked up and too nervous and I scared the crap out of Dr Z's the entire surgical team. I scared them so much that they didn't dare to do anything without Dr Z's presence. He told me later that I only released my iron grip on his fingers when the general anaesthesia kicked in. He also spent about five minutes massaging his fingers since they'd gone numb from all my squeezing, but he said it with a smile, not because he was holding a grudge.

Originally I was supposed to have both arms done in one surgery but Dr Z had to split the surgery into two parts since the entire procedure took longer than expected. I was under for nearly six hours while he took care of my left arm. His part of the surgery took over four hours and since I was so nervous most of the pre-op preparation was done while I was under to avoid causing me any more distress, adding serious time to the amount of time I spend under general anaesthesia. It obviously took some time to bandage up my arm and then it also took some time to get me out of the general anaesthesia and ready to return to the ward.

With regards to immediately post-surgery, I don't remember much since it took me forever to return to a semi-conscious state. At that stage I was already well out of the general anaesthesia but I tend to feel seriously groggy and tired after surgery so even after they brought me back to my room and introduced me to the Ayi, Dr Z had called to take care of me, I just slept the whole afternoon and evening. I remember eating a few grapes in the evening and hoarsely asking for some water but that's about it. I think I briefly looked at my phone, then slept most of the night.

Post-surgery day 1, left arm all bandaged up and incapacitated, drugged up but overall in good spirits. Me and my intravenous analgesia pump had some serious fun for the first 48 hours post-surgery. The first 72 hours post surgery are most painful so I was grateful for the relief. I'm really not good with pain and my ability to withstand pain has gotten worse since my burn accident, something Dr Z knows since he had to listen to my wailing cries every single time he changed my dressings.

I never thought I'd ever end up having plastic surgery but I don't regret my choice. I worked hard on my weight loss and failing to fully tone up my upper arms due to all the excess skin ended up frustrating me more and more, to the degree where I didn't even want to look at myself in the mirror while wearing a sleeveless top. Even in 40 degrees heat, yes Wuhan summers do get hot, I would insist on a cardigan or shawl of some sort, much to the utter astonishment of my friends. "It's freaking hot, you'll sweat to death!" My friend would exclaim but I would insist. In most pictures I would hide my upper arms behind a shawl, long sleeves or I'd keep my arms behind my back. If I wasn't happy with the photo I would threaten my friends with the death penalty if they even as much as thought about putting the picture online.

So while I was shit-scared to have the surgery, it's a decision I don't regret at all. I'm still not a fan of breast implants or double-eyelid surgery, which is really famous here in China, though I can understand it, but I stand by my decision and defend my choice to go under the knife to change something about me which I failed to change through hard work in the gym. I did have to endure some pain and I'm still enduring it, but it was worth it.

My lead surgeon, Dr Z, and his assistant surgeon, Dr C, were absolutely fantastic, the whole hospital was. From the beginning Dr Z said he would take care of me and he did, a real friend will always stay true to their promise. Dr C had to do all the dirty work e.g. stitching, dressing changes, removing the stitches since Dr Z claimed that he was too busy to take care of that. As the director of the department he's indeed a busy man, but I think he just doesn't like seeing me in pain so he pawned me off to somebody else. I do forgive him though since he spent eight hours cutting huge flaps of skin off me, which isn't exactly a walk in the park, even if it's his job. I had the joy of seeing a picture of the amount of skin they cut off, but I'll spare you that.

On the morning of the second surgery, all smiles (though I'm not entirely sure why), and ready to make a second trip to the operating theatre.

It took me decidedly longer to recover from the second surgery due to an unforeseen little incident which might or might not be related to the pain medication I got post-surgery, the doctors aren't sure, though it scared them good.

Yes, I do have a knack for scaring the doctors and nurses around me, here in China. This incident started pretty inconspicuous with me feeling groggy, tired and most definitely not in the mood to get out of bed one day after my second surgery. At all started with me lying in bed, because that's what you do when you're stuck in hospital with both your arms out of action, when my right arm suddenly and very painfully reminded me of its existence. The Ayi in charge of looking after me, handed me by intravenous analgesia pump and I pressed a pretty yellow button for an extra shot of pain meds, which did nothing to take the edge off. Dr C checked in on me after I continued to complain of unbearable pain and she even called Dr Z to ask whether she should give me extra pain medication, he told her not to give me anything.

The pain stopped after a while but speaking became such a chore and while everything made sense in my head, what came out of my mouth was incomprehensible gibberish. The Ayi taking care of me couldn't understand a single word and when she left the room to get the doctor for the second time, I freaked, since I had no idea where she'd gone of to. With both my arms out of action and unable to sit up without help to press the call button I simply freaked. It was around that time that I realised nobody understood a single word of whatever I was saying. I tried to speak English and managed two words - HELP ME - which I yelled repeatedly and loudly until the head nurse and a Dr X came running into the room, panic written all over their faces. 

I repeatedly tried and royally failed to explain my discomfort and Dr C, Dr Z and an anaesthesiologist were called for help to determine whether the drugs in the intravenous analgesia pump were screwing with my brain. Another Dr Z and Dr H, good friends of mine, came to visit and they too were clueless about my strange behaviour and incomprehensible babble. My fabulous medical team eventually managed to rule out any serious problems and Dr Z explained to me that I wasn't about to kick the bucket, so could I please relax. I still don't know what actually happened, but the pain medication wasn't the cause for my inability to coherently express myself.


~~~


"Oh my God, you really drive me crazy!" Dr Z snapped, displeased with my ridiculous behaviour while doing his rounds.
"I'm scared, I'm scared of getting the stitches out, I'm scared it hurts." I whimpered, attempting to get out of bed, which proved to be rather difficult, since there were about six doctors standing around it.
"It doesn't hurt, okay? Not much, I promise." Dr Z sighed, his voice somewhat more gentle, but still clearly displeased with my escapades.
"I'm scared, I've never had stitches before so I've never had to have them removed."
"Fine! Fine! We'll remove them in the operating theatre, we'll put you under and remove them," Dr Z glared, "You can spend another 3000 Yuan on that for each arm! Do you have that kind of money! Really? Okay, no problem, we'll do it your way!" Dr Z didn't just look furious, he actually was furious with me for the first time ever. "Just so you know general anaesthesia can kill, nobody ever died from having their stitches removed!" Dr Z said angrily, the rest of his medical team standing around him in silence, not wanting for him to possibly direct his anger towards one of them.
"I'm sorry," I mumbled, handing my head in shame.
"Hmm," Dr Z grumbled, stalking out of the room.
"I'll come back later to change the dressing and remove your stitches." Dr C said quietly, patting my left forearm gently, before following Dr Z and his medical team.


~~~


You see, Dr Z is an excellent doctor, a marvellous surgeon and a very good and patient friend. Over the course of our friendship he's listened to a lot of crap from me so usually he is calm, collected and funny. I've rarely seen him angry. Sure, I previously managed to piss him off a little (his words) but never did I manage to actually make him angry, not even when I acted all crazy before my first surgery. He's really understanding but even he has his limits and there was no way in hell he was going to agree to me having any kind of anaesthesia for a simple procedure such as the removal of some stitches.

I brooded a little bit after he bit my head off like that, then realised that I'd been utterly childish and profusely apologised to him for being an idiot. At that point he'd already forgotten all about it, although I'm pretty sure that he's going to hold this over my head for his own amusement and my embarrassment. Oh the joys of our friendship!

My left arm, all bandaged up in metres of dressing and layer after layer of cotton cushions and gauze. It actually looked quite scary.

My favourite food, courtesy of a friend who works at the hospital. It is truly astonishing how quickly you learn to use a spoon and chopsticks with your right hand when your left hand has been put out of action by a surgeon and his scalpel. I gotta tell you though, since I'm naturally left-handed it feels pretty weird (and a little wrong) to use chopsticks with my right hand.

Dressing change complete, my arms will have to remain wrapped in these elastic dressings for the next three months or so, but even with the elastic dressing the change is obvious: no more saggy skin!!!

The cute and handsome Dr X and me. I sort of forced him to take a photo with me, pretending to be jealous when he posed for a photo with another girl, for work-related reasons. My sajiaoing skills melted his heart and he agreed that we should take a photo together.

Two very cute bears and beautiful pink carnations

Those white lilies smelled so, so, so good! 

I didn't get flowers for ages, then decided to have surgery and in the space of three days I received three beautiful bouquets of flowers.

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