Blood Tests Before Surgery

I've been asked a bit not about the blood tests I had done.   It seems that most Drs require pre-op blood tests. 

My local hospital were very familiar with the requirements so they seem to be a standard list - but do check they are the ones you need to have done, don't just use my list incase things change or your Dr has different requirements!

Hanse wanted the results of my bloodtest 10-14 days before surgery.  You can't have it done too far in advance as the results need to reflect your health when you have surgery.   They asked for:  Blood count

                    INR, PTT

                    Creatinin

                    Sodium, Potassium

                    ALG, GGT.

These tests measure things like how fast your blood clots to ensure you won't have a more of bleeding.  

You need to get the results printed out as Hanse need the numbers.   For example my APTT was just outside the normal range.  By having the numbers they were able to look at how slowly I might be clotting and decide if that would prevent my surgery going ahead.  

I would arrange the test for say 16-14 days before surgery as they take about a day (in my area) to analyse the samples and then you'll need the GP to review and print your results for you to collect.   

Shopping List for Liposuction for Lipoedema

This list is a starting point for things you might want when you are having liposuction for lipoedema. It is designed for you to print it out and amend it.

I based this list on some of my pre-surgery preparation posts and created it for the Facebook community at MY LIPOEDEMA  JOURNEY - FOR LADIES GLOBALLY.  I thought it would be good to post it here too, so that it is an open resource. Please tell me any feedback you have so I can improve my list.  

  The Facebook group I have referenced above contains details of surgery experiences from a range of international ladies and is the home of the comprehensive international list of Lipoedema Liposuction Doctors.  I am a frequent user of that group, not the owner of it!  

Item you might need	Why I recommend it/advice
Waterproof bed sheet.	A great one is Gokart from Ikea (you can order from Ikea or on eBay).  This one is comfortable to sleep on as it has a fabric top over the plastic.   You can also put “puppy pads” or other absorbent bed pads in your bed, but they can move as they are loose, so the waterproof sheet is more reassuring.
Puppy Pads/stay dry bed pads (absorbent pads)	These are large items (not sanitary towels) which you can put on a bed or chair.  You may be given some of these by your clinic.  I used them to stand on after a shower in the first day or two to avoid dripping red tinged fluid on the bathmat.  Used for either reassurance or absorption.  Pack of around 20 for £10 on Amazon
Extra dressings/plasters	These are larger than household plasters (plasters is a UK word).  For example 6cm x 7cm.  They are an absorbent pad covered with medical tape that is breathable and soft on skin.  Brands like Mepore are available for around £7 for 60 dressings on Amazon, or you can get them in a local chemist for around £0.20 each.  You will want to use something like this until your incisions are healed dry.  If you shower every day you will need to change them every day to get the wet pad off your skin as they are not waterproof.
Vinyl gloves	If a friend or partner is helping you change your dressings, until your incisions are closed it is good hygiene to have them wear gloves.
Medical tape	If you do leak quite a bit you may need to tape gauze or puppy pads over the outside of your dressings.  Some clinics will give you tape and gauze, so check before you buy.  If you buy tape, something like Durapore is around £2 a roll and is nicer than Micropore as it sticks well but comes off gently too. If you are sensitive to plasters then try the tape first before you go!
Shewee/Go girl/funnel	If you are having your thighs done then you may find it tender to sit on the loo.  You can use a funnel with open crotch compression to wee standing up without taking your garment down (or with pulling your compression down a bit).  From £1 to £10.
Rubber toilet seat ring.	Again inner thighs – an option for using on the loo instead of a funnel or for when you are not having a wee.  An air filled ring is still hard to sit on so I personally didn’t use it much as it was a core muscle workout and a bit distracting from going to the toilet! One that needs inflating with air (check if you need an adaptor – probably works with a bicycle pump as mine did)£10 on Amazon)
Painkillers	You may be given some from your clinic.  You will generally not need anything stronger than the ones that are sold without needing a Dr to give you a prescription.  In the UK purchasing a cheap packet of paracetamol and one of ibuprofen would be fine.  You may want to take painkillers 20 minutes before showering or changing your compression in the first few days after surgery.
Other tablets/products	You may like to take arnica tablets or other vitamins.  Check with your Dr before the surgery if you should start or stop taking anything like this.  Some people find they get itching as their skin heals.  A product like Piriton which is sold for allergies in the chemist may be helpful.   http://www.boots.com/en/Piriton-Allergy-Tablets-30-Tablets_11235/ around £4.
Moisturiser/skin care products	Wearing compression makes your skin dry, so you will want to moisturise.  Avoid the incisions until they are totally healed
Scar healing products	The incisions will leave most of us with small scars.  Once they are healed closed you can treat them.  Popular products are Gel to rub in: KeloCote is around £20 and Contractubex is around £8.  You can order them on eBay.  Some people use BioOil.  Contractubex is most popular in our group.  Contractubex also make overnight healing patches which you use at night (gel in the day only then).  These are not sold in the UK so you may want to ask your clinic to help you with a local pharmacy who can order them in for you if you have surgery overseas.  Or ask an EU group member to help you by posting them to you.
Rubber gloves with grip or gloves with silicone dots on them	You'll need to adjust your compression garment and I find these gloves from Lakeland (also available on Amazon) look cute and are helpful for grabbing wrinkles and pulling up or smoothing out bunching.  I always use gloves with my compression.  Light gardening gloves are also a good option.  Around £2-5
Flip flops/crocs/large slippers	Surgery on upper or lower legs means you can drip fluid on your feet.  Shoes you can slip on and off and rinse clean are great.  You will likely go to the operating theatre in your own footwear but their clothing so think about something easy to get on to walk back to your room/recovery area.  If you are having lower leg surgery you will usually need footwear around 1 size bigger than normal for your journey home/early days.  That will allow for your swelling and the compression and extra bandages etc.  If you need socks (especially if you had lower leg surgery!) get ones with very soft elastic at the top – often labelled as suitable for diabetics/diabetic socks.
Clothing	Loose tops, thick socks and baggy trousers.  Needed for coming home from the clinic and for lounging around at home.

First Long Haul Trip

5 months after my surgery I took my first long haul flight.  The flight was approx 11.5 hours and was travelling to West Coast USA so to a hotter country than the UK.  

For the actual flight itself I wore: Solidea Arm Sleeves., some Marks & Spencer firm compression thigh shorts/pants and Sigvaris Comfort tights.

I took a bag with me to put on the floor as a footrest, so I could get some more comfortable elevation of my feet, rather than trying to keep them on the little footrest from the seat infront.  

I made sure I was in my compression from early in the day before I flew, so I was starting off with very little swelling - other than the arm sleeves which I forgot to put on and had to pull them on in the airplane loo!  I also kept the compression on at the other end until I got to my hotel when I removed my arm sleeves.  

In flight I did some walking and stretching but nothing exceptional, and just checked my compression for wrinkles/ensured it was staying in place from time to time.  

On arrival at my hotel I found my ankles were around 1-1.5 cms larger than normal.  This took a few days to go back down.  Do bear in mind that I did not have liposuction below the knees, so this could be a normal part of my lymphatic circulation and so doesn't mean this will happen to anyone else.  

I didn't have all my measurements with me so can't be quite sure if I was bigger all the way up my legs or not.  

I had no pain or discomfort.

I wore my compression garments daily, wearing a combination of the Sigvaris Comfort Class  2, Sigvaris Diaphane Class 3 (so the same mmHg as different class system) and Mediven Ellegance Class 2.  The Comfort were the coolest and most comfortable in the heat but the ellegance were OK too.  

The main thing I did that I think got my leg swelling down after 3-4 days was a daily pool session. I either went to an actual aqua class or did a session in the hotel pool so was doing around 45 mins to 1 hour a day.  I went to Walmart and purchased a couple of pool noodles for less than £5 and a childs inflatable ball to help me get a good solo workout.

I had travelled on business so in the office I elevated my lower legs on a chair wherever possible.  

Flying back to the UK again my lowers swelled up and took several days to reduce - again I was going to the pool as much as I could but not as easily as in the US.  

    

Marks & Spencers Control Pants as a top-up

Despite wearing class 2 compression, I have wanted more panty support (to be honest I felt like capris with my tights would have been great as they would have covered all my surgery areas with extra support).  Now that I am in month 5 I feel less need of the extra support other than for sport.  

As I didn't enjoy wearing full compression leggings over my tights, I went for compression type shorts under my tights.  If you like the idea you could try the Solidea range or the Haddenham Veni capris.  Solidea have a wide range of lengths which runs from pants at around £20 through to shorts and capris at around £40 and then the full leggings.  They are generally only light compression of around 12mmHg so I wouldn't wear them on their own. 

I wanted something that would go under dresses and skirts without poking out as I moved, and I was a bit impatient so I went into M&S to try control underwear.  This does not have a compression rating but the first set you see here, which was labelled firm control, felt quite similar in fabric style to my comfy ETO compression.  



The only problem with these shorts was that they have a seam which is stuck down on the front.  As you can see on the right it came apart.  I returned the first pair, but then seemed to have the same effect happening with the replacement, but not as badly.  








I liked the feeling of support and the lack of overheating groin, so I invested in some extra pairs in a different style, which might be a little less compressive as the tummy is slightly less firm.  You can get previous seasons cheap on ebay so I got two pairs for around £5 each!  They are a little shorter and are made of the same fabric all round so don't have the front seam problem.  They feel a little less compressive and I have to be careful when getting my tights over them not to roll up the bottoms of the legs, but they are very comfy for all day wear.  

  

I have been wearing these nearly every day under my compression (unless I wear the Sigvaris Comfort Bodyform tights I got recently, which have compression to the waist and which are now, at six months post surgery, supportive enough on their own for daily living and badminton!).  

I find these are easy to put on without gloves.  I pull the bottom of the legs down and ensure they are smooth before putting my tights over the top.  Once I've got my tights up I slide my hand down inside and again pull the legs flat or run my hands over them if needed, to ensure they are smooth. That can need repeating as you take your tights down and up when visiting the loo!

I think if you want some extra support to supplement your garments as you heal, or for sports, then this can be an economical option that my husband says looks nice on!  

Swimming in Lübeck

I spent the six months before my surgery getting fit.  I did that in several ways, one of which was to attend every aqua exercise class I could find, so prior to my surgery I was at several classes a week.  I became so keen on the water that I was sad to think about having to stop whilst my incisions healed (and as it turned out I had a leaky one it was around a month before I could get back into the pool).  The hotel I stayed in didn't have a pool so on my way back from the consultation with Professor Schmeller, my long suffering husband joined me at the local swimming pool, Zentralbad Lübeck.  The photo above shows the opening hours (and that if  you are brave or have some German you could even join in an aqua exercise class on a Monday!) but you should check them out at the highlighted link to be sure they are current when you go.  Incase it isn't obvious, Öffnungszeiten means opening times and Zentral is central so I believe this is the main swimming pool in the town.  

The price of a swim was 4 euro each, so I thought it was good value.  The water temperature was a bit cold - 26 degrees Celsius according to their website but I can only say it felt cold to both me and my husband. He still remembers it as a bit on the cold side but says it was OK.  It was one of the coldest pools I had been in for a while so I had to move around briskly - so it did me a favour really!  We went in the shallow pool as they have a shallow pool and a deep pool - the deep one was full of lane swimming at the time.  Maybe that pool is warmer but I am sure I touched it before leaving and it felt the same!

My tips for the pool (other than be prepared for a bracing temperature!) are:
* take flip flops or pool shoes as no-one wears outdoor shoes in the locker or changing areas.  That is a strict rule and will be enforced by the staff (they are friendly and will help you and show you the way around etc)
*the changing area was separate for men and women so ensure you have separate bags and shower items if you go with someone of the opposite sex
* I can't remember if you needed a coin for a locker - if so they would take a one euro coin
* the shower was a communal open shower (but just for your own gender as I recall) - so again I recommend using your flip flops.  The shower temperature was fine though!  You will need to take toiletries with you.  
* I don't remember about hairdryers - I left mine towel dried as we walked just around the corner straight into a restaurant for dinner so I was dry before we went for the longer walk back to the hotel.  

The pool was nice and clean so I would swim there again and would recommend it to a water lover.  I wanted to get a bit of pressure on my lymphatics after the flight and before my surgery, in the hopes it would help (and I find water workouts and swimming great stress relief).  If you feel the same I hope this post helps you!

In checking the details for this post I found that there are  other swimming pools in Lübeck so I have included a link which reviews the Zentralbad and the others.  

Haddenham Veini - like Goldilocks but not finding the "just right"

Great customer service.  Haddenham were the best firm I have dealt with so far with a faulty item.  My tights had a small hole in the heel when they arrived and Haddenham sent another pair straight away and told me I could mend and keep the first pair.  Fabulous super fast response within hours of my email.  I really want to love their tights as I loved their service. 

 The Haddenham Veni tights come in a range of colours. I was able to have a chocolate brown on NHS prescription which is a very welcome change from black and beige.  You can see the shade better in the pictures below. 

The colour made me very happy as I felt I could pass for someone wearing a pair of ordinary brown opaque tights.  These would be a good choice if you want to avoid black and "granny beige". 

 My skin against the tights to show that they are a nice deep, rich brown shade, and how dense the colour/texture is as it is hard to see that in the full leg images above.  








Why would you spoil this nice colour by sewing the seams in black thread?  Not what I want my husband to see, big black seams :(  This was not a sexy look.  

They also have the waistband style which is a turned over fabric to form a channel through which a piece of elastic is threaded (unsurprisingly it is black elastic).  I found the elastic would do the usual turning over and folding in the wash trick so I needed to fiddle around getting it flat before wearing.   


In the photo you can see that I am wearing under shorts and they are creased on my left leg and riding up. You can also see on my left leg that, despite wearing shorts, the tights were giving me a terrible little bulge right in my inner thighs below the groin.  Not a nice look, nor what you want after liposuction on that area.  Without the shorts the bulge was really obvious and I had a terrible under bum shelf.  I've never seen a pair of tights give me that almost sharp line where the compression stopped.  

I would say the panty section on these tights had no compression.  On me the size I was measured to fit was too baggy (the legs fitted but even without undershorts the top was loose over my tummy) and had no compression to my hips and stomach.  That might be great if you hate the feeling of compression on your abdomen (so great for eating out!) but my thighs want strong compression for support so these tights looked bad and felt bad on me.  On the left you can see the first size I was given - if you enlarge the photo you can see it was wrinkling around my ankle and how there was no stretch in the panty area. 


I rang the clinic and explained they felt really loose at the top and unsupportive on my thighs, so she arranged for me to be sent the next size down.  Yellow top is the smaller size and red top was me in the larger size.  The "knickers" you can see are my knickers, the tights are that more transparent shade all the way up.  So good if you don't like a very dark panty section.

As you can see the under bum crease was terrible in the smaller size.  I have never seen anything like it and I blame it on the lack of any compression in the panty area.    
 

 Here you can see that the problem I had was not the seam of the panty section starting; the tights were cutting in about 1cm below that, forming that crease under my bum.  You can see the effect happened on the front too, but not as badly.







Overall, I really wanted to like these tights as they were not beige and the customer service was really good.  However, I don't think I am a good match for their sizing charts as it was like Goldilocks and the 3 Bears' beds, going from too big to too small, but in my case with nothing "just right".  

Personally I want tights that make my thighs feel supported when I run up stairs or take any exercise - these gave me nothing.  No support, just aching thighs.  

If you like the texture options and colours that their website has, and would like a loose and comfortable panty section then these may be your ideal tights.  Sadly I had to give in and buy alternatives to wear as even with added shorts they would give me the funny little creases and I was concerned that this was not good for me.  

 

Mediven Forte

As I've been looking for a stronger compression to wear for exercise, the Mediven rep at the Lipoedema UK conference suggested I try their Forte line which is still round knit but firmer than their other round knits.  She kindly sent me a pair of their petite socks in this fabric so I could feel and try them to see if I would like to order a pair of the tights. 

You can see the normal "medi" writing on them in pink and the nice purpose made elastic areas at the calf top and the open toe end.  I like the robust and comfortable stretch in the finishing of these open ends.  I think they would be comfortable for longer wear and they did feel firm.   

I really liked their texture, they did indeed feel very firm but supportive and had a nice comfortable foot band.  I would like to try running around with them as I imagine they would be very comfortable.  The colour is the predictable "too dark for pale celtic skin" as you can see - these would not be at all discrete unless you could get a better colour match. 

You can see that the sample I was sent was a petite and I am not a petite, as you would not normally stop that far below your knee!   
 

 
You get the usual device with them for putting on open toed garments.  It is really big so be careful it doesn't go right round the back of your heel as it will be hard to pull out through the toe.  I have size 4 feet so had a bit of a tug of war when I realised I had got it up behind my ankle inside the sock!



So overall these are an interesting texture which do feel more firm than the Mediven Elegance and I think they are worth trying for sport or active lifestyles.  I would need to find out about the compressive panty section to decide if I wanted to buy these as tights for my sports.