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I was able to go the day without painkillers and shuffled around in a bit of a haze.  I hadn’t slept well and couldn’t really study nor do anything like clean.  I didn’t do anything today except make a crappy cake.  I think the cat was even underwhelmed with what I managed to accomplish today.   I’m glad I return to work on Monday.

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The drainage tube extended a full 8″ into me from the start of the incision below my armpit and parallel with my nipple.  It sat collecting fluid into a suction bulb that I drained every 12 hours which I assiduously measured as a proxy for healing.  I had four of these in me, in total, two into my chest and two into my abdomen.  The drainage rate on two had slowed enough that the surgeon felt comfortable removing them and today I had that done.  Removal was very quick requiring a snip from scissors on a suture and a methodical tug.  The surgeon also wanted to check on my scar sight and began peeling the adhesive plastic layer from my stomach to investigate.
Surgeon: I’m going to start peeling back the adhesive layer, you may feel a bit of pain.  Tell me if you want me to stop. *pulls*
Me: Stop.
Surgeon: Ok, I’ll try slower. *pulls*
Me: Stop!
Surgeon: I seem to be taking the hair too.  You have a bit more of that than most of my patients.  But we need to get this off so…
Me: How about I take it off in the shower when I get home.  You said I could shower again, right?
Surgeon: That should do.
I went home, excited to shower, and removed my clothes and the two layers of wraps.  This left me holding the two bulbs still in me while I set the shower to the appropriate temperature, got in, and felt water from something besides a sink tap wash over me for the first time in nine days.  I soaped up the area around the adhesive wrap and began peeling.  Despite the action of the water and soap, peeling hurt and took much hair with it.  Once I had peeled the adhesive layer to the point of my surgical scar,  the pain skyrocketed and the peel rate went down again by half.  I began running out of hot water.  I was standing in the shower, holding two vacuum drainage bulbs, being pelted with cold water.  My vision began to narrow and I felt like I was about to faint.  I refuse to drown in my own shower, so I crawled out, toweled off a little, and sat on the toilet to finish what I had started.  When done, I held up the adhesive piece which looked like a wookiee pelt and I scratched my head.  My hair was still oily.  I spent 30 minutes in the shower and had failed to actually wash.  I rewrapped myself, rehung my blood grenades and crawled into bed to let the hot water heater recharge.

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Immediately after surgery I spent about half to two thirds of the day in a Percocet-induced haze.  The sleep that came was not restive and my days settled into six hour cycles of four hours knocked out, about an hour of just being slightly dazed and then an hour in pain waiting to take my next bout of pain killers.  By now, that cycle had turned into two hours of being somewhat loopy, two hours of being useful but not being about to completely think straight, and two hours of dull ache.  During most of the day I still didn’t have the mental acuity to study so I passed the days with other things.  Today that thing was trying to learn how to do Tuvan throat singing.  I found some instructional videos on Youtube and over the course of five hours taught myself the basics of overtone singing.  

The muscles used in this style of singing seem to be used for almost nothing else and after my first few rounds of singing I found the muscles of my face starting to fail me.  At the end of five hours, everything between my nose and neck hurt like hell and I realized spending four hours a day practicing would result either in an inability to swallow or a tongue that’d be able to crack walnuts. I felt like hell but was another day closer to recovery.

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I transitioned back to my house from my mother’s today and I was glad to return home.  I noticed the smell of cat and smoke as I do every time I return home after an extended time away and Max seemed excited to have me back.  He even seemed to pick up on my frail state and was extra energetic when playing with his socks or bedding so I wouldn’t have to do much work to play with him.
The stairs were slow going and going up and down them in a 15 minute window left me winded.  Sleeping still required me to prop up my back and bend my knees and achieving this posture required gathering six pillows from around the house, that is to say all of the extras.  My dad knew that nicotine would interfere with my recovery and politely hurried through his cigarette when he saw me approach.
Some standard elements of my house had become traps.  The tubes in me had a tendency to catch on door knobs and chair arms so whenever I stood it was with caution.  The mail box seemed an impossible distance away and getting up to let out the dog or cat required willpower.  Max no longer bothered me to let him out at night just so he could come in and get a treat and the cat seemed to use his litter box more.
This household too molded to my needs and I appreciated it.

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After four days I could now shuffle around the house at about 3/4s of a mile per hour.  This mobility was exhilarating for someone used to running and I did repeated donuts between the kitchen, living room, and dining room to celebrate.  In the mid afternoon, I was visited by the mother of a friend of mine from middle school.  She asked me a question I’ve chewed on a lot, “when did you decide to start losing weight?” and I finally answered it:
I never decided to lose weight.  There was no Damoscene moment where I resolved to be slim, in fact it was the opposite of a planned choice.  I had taken a very long road trip and managed to lose 10 lbs during this time by simply eating two large meals in a day instead of foraging interspersed with proper meals.  I hadn’t decided to start doing anything, but only to continue doing things that I had done almost at random out of the necessities of travel.  Each subsequent change was largely like this, I had found myself doing something that seemed to work and resolved to make it a habit.
This reminds me of how the body evolves defenses to infection.  The body spews out white blood cells until one of the variants works.  That one gets to reproduce and the other die.  Here, I tried a bunch of things at random from changing my treadmill speed to not eating hot dogs and if something seemed to work I stuck on with it.  Some odd things came out of this like learning that I do better having a very rich dessert after dinner but only if I eat three hours or so before bed.  This calorie burst seems to sedate me for the evening and I have no urge to snack before bed.
I didn’t choose to lose weight, I simply chose to habituate things that seemed to lead to weight loss.  So far that’s worked.  I hope it continues to.  She brought me fruit salad.  I hate grapefruit but the thought was nice.

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Today I was contacted by the MetLife regarding my short term disability claim.
Claims Investigator: When do you think you’ll regain the mobility required for your job? 
Me: Probably a week but mobility isn’t the restricting factor. My work is mentally demanding and doing it on pain medication will prove difficult.

In comparison try chugging a bottle of Nyquil and then doing your taxes. 
Claims Investigator: I think I understand. How long will you be on pain meds? 
Me: Three weeks. 
Claims Investigator: We will check on you then.

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I tried eating today and encountered a problem.  Food caused my stomach to expanded and my expanding stomach pushed against my abdominal wall and that felt very uncomfortable.  It took me over two hours to eat an apple and a serving of toast was about my limit.  I took to calorie dense foods to get around my perpetual hunger and ate some cheese.  The cheese tasted wonderful and that’s mostly what I ate for the day.  Drinking also proved uncomfortable for the same reasons as food so I felt pretty dry most of the time.
Late in the day, I felt like I had a bowel movement coming so shuffled over to the toilet for the first time post surgery and waited.  Normally, I would have pushed a little to get things moving but the muscles involved in that proved unresponsive or were in pain so I could in no way help my stool along.  So I sat and sat while taking sips of water.  I felt foolish after 30 minutes rolled around but I certainly had no where to be.  The pain meds made me a bit loopy making studying out of the question.  So I simply sat.  Three and a half hours later I pooped and I felt like I should look into the bowl to find a golden egg based on the effort that went into birthing that single tiny turd.
My mother checked in on me every three hours or so and I received a medication of some sort every six.  It was odd being checked up on.  These visits seemed to happen around the clock and there were stretches where I wasn’t sure what time it was despite having ready access to a clock.  Each activity had to be temporarily relearned in some way that I didn’t need to use my abdominal muscles.  Sitting upright required rolling onto my side and using my arms to push me up while rolling back.  Coughing, sneezing, and laughing all hurt like hell and I was perpetually hunched over at about a 15 -25 degree angle from the horizon.  I didn’t have the mental capacity to listen to audiobooks let alone study and I passed the day in an indolent stupor.

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Our dinner stop was longer than I anticipated and I got home at 4:00am.  My father rose at 5:00am to take me to the surgical center and I didn’t bother trying to sleep.  As per the doctor’s instructions, I took a very long shower with an antibacterial scrubbing sponge and washed my nails and in between my toes as indicated.  I knew my shower was long when the hot water started giving out and I dressed in lose clothing after a final rinse down.  I packed a back of clothing I had from a past life to wear after surgery and my father drove me to the surgical center.  It was quiet there and I extended this quietude by turning off the television.  I posted to Facebook and changed into an examination gown.  The doctor marked where the incisions would go with a purple marker and provided a courtesy shield so I wouldn’t see it.  I felt like I was about to receive a tribal tattoo or face a microtome.
Me: Done this before?
Him: More than you know.
Me: Well, let’s see, you seem to be in your mid-fourties, you probably finished your surgical residency in your early thirties and you seem to operate four days a week.  Assuming one of the two procedures I’m getting constitutes a quarter of your business that comes out to about 50 a year for say 15 years.  You probably weren’t fully scheduled to start, so let’s say you went at full speed the last ten years and half that before.  You’ve probably done this about 500-600 times then.
Him: Actually, I hadn’t thought about it.  Sounds right, though.  You’re an actuary, right?
Me: Yeah.
Him: Makes sense.
I don’t remember the injection that knocked me out, but I woke up later and everyone was looking at my toes.  Somehow I had stubbed my toe during surgery and it was swollen and sensitive. The doctor asked me how and I mentioned that I wasn’t awake for it.  My abdomen hurt and I very much wanted to cough.  I tried to do so and I was warned that it might hurt.  I hugged a pillow and coughed.  This probably stands out as the most painful thing I’ve ever forced myself to do.  I felt like my insides were on cinders and that each movement of my diaphragm would rip it from my abdominal wall.  I was told I needed a gallon of intravenous water before surgery to raise my fluid levels and suddenly the “no fluids including water” mandate of my surgical prep period seemed odd.
I was offered a wheelchair to make it to the car and I refused.  I pivoted in the bed and tried to avoid using my abdominal muscles. It hurt like hell but I was on my feet.  I shuffled out to my mother’s car and noticed that I was wrapped up tightly in a compression garment, a secondary compression wrap, and that I had four vacuum drainage bulbs attached to me.  I made it to my mother’s, issued a single painful cough and planned to sleep.  My bed needed to allow me to stay jack knifed.  It would be a month before I could stand upright.  Sleep  involved bunching up pillows behind my back and beneath my knees.  Getting in and out of bed took about 10 minutes.  I went to sleep after taking a pain killer.  Day one of recovery had begun.

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Me: Hi.
Coworker: Today is your last day before you leave for surgery, correct?
Me: Yes. I’ll be out for two weeks.
Coworker: Our manager indicated that I should hug you because you and I went to school together. I do not think that would be appropriate so I would like to offer you a handshake. *holds out hand*.
Me: Thanks *shakes hand*
Coworker: May your recovery speed be a positive outlier in your favor.
I feel that last line should be the actuary’s blessing.

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The surgeon was in a fine mood when we talked about the recovery times and limitations of my dual gynocomastectomies and abdominoplasty.  He’d be making an incision from hip bone to hip bone which would take six months to fade and one below each of my man-boobs that would be white in an equally long time.  There would be drains in me for two weeks or so and I’d need to get very comfortable sitting rather than lying down.

The surgery didn’t sound pleasant but the most painful incision would be to my wallet.  I was dressed in a gown and booties on an exam table when I was asked how I wanted to pay.  I said I wanted to arrange credit terms and was told this needed to be done ahead of time.  I said I’d then need to delay the surgery but the receptionist had an idea.  She handed me an iPad with the webpage for a medical loan firm on screen and I placed a quick call to my father to get his driver’s license number.  The form completed, I hit submit and moments later I was approved for a $12,000 loan.

I received a $12,000 line of credit while in a surgical gown on an exam table.

When did the future get here?