My Timeline of Top Surgery & Recovery with Dr. Raphael in Plano, Texas.

This is just a master post of my top surgery experience & recovery. I had double incision mastectomy with nipple grafts in Feb of 2016. I also had lipo. The total was $6,750 ($6,000 for the masc and $750 for the lipo on the sides.)
Pictures will be made available at request.


  • Because I do not live in the Plano area I drove 5 hours to Plano the day before my surgery and had my pre-op apt that same day.
  • At pre-op I met with one of the nurses and with Dr. Raphael. This is your opportunity to talk to him about your chest, incisions, to bring up concerns and so on. In my case, my mom asked all the questions because she wasn’t as versed as I was on what was going on. 
  • At pre-op they give you a lot of things to sign, they take before photos, and just go over the basic run down of everything you need to do before surgery.
  • Try to plan your pre-op apt as early as possible that day. You will have to go get your prescriptions the day before your surgery and you don’t want to run into the pharmacy closing on you or any issues with the pharmacy not accepting the scripts. I went to Walgreens to get mine filled and they gave me a hard time which led to an hour run around between Walgreens and the doctors office.
  • I was prescribed extra medicines because I had issues with nausea in previous surgeries. If you have concerns about nausea tell the nurse at your pre op and they will get you what you need to prevent you from getting sick. They will walk you through possible medicines you may need based on your medical history and/or allergies you have.
  • The anesthesiologist will call you the night before your surgery. They will tell you not to eat anything too heavy for dinner and to make sure it is pretty bland. I couldn’t eat any dairy either. Also, clear liquids for the most part. Of course they advised me not to eat after 10pm for safety. 
  • Make sure you have a support system with you. First of, you can not have surgery without someone to be with you but I took my mom, my best friend and his brother with me. The surgery center also will not let you have surgery without people to care for you afterwards.
  • Pack or get yourself some button up shirts. You will not be able to get into t-shirt well if at all that first week or so. If you are trying to get into t-shirts that first week you will more than likely pull something as you are not supposed to be lifting your arms at all. (Think about the arm range of a T-Rex. That will be you.)
  • I am a pretty hairy individual so I shaved my chest a couple days prior to surgery. About a week before surgery you should start prepping your body for surgery. You will wash your chest with Betadine Skin Cleanser. You should get this information when you set your surgery date. If you don’t get it, email the office.
  • You will take 500mg of Vitamin C daily in addition to any multi vitamin you may be taking. DO NOT take any extra Vitamin E because it may cause some bleeding.
  • Do NOT take any aspirin or ibuprofen one week prior to surgery and up to two weeks after surgery. (i.e. Bufferin, Anacin, Advil, Motrin, Datril, Excedrin, Anacin-free, etc.)
  • NO SMOKING. Especially 1 week prior and two weeks after surgery.
  • Also, you will have to stop testosterone 2 weeks prior to surgery.


  • My surgery was at 7am and lasted about 3 hours according to my best friend.
  • When you get there you will check in at surgery check in desk on your right after you go through the doors.
  • When they call you back you will change out of your clothes into the hospital gown and socks. (I took this opportunity to take my last selfie in my binder.)
  • You then will be escorted to your surgery bed. The nurses will get you all cozy and warm (I personally overheat easily so I had to have them cool me down a little bit) and start your IV. The anesthesiologist will make an appearance to just walk you through some things. Dr. Raphael will also come in and draw the incision marks and other surgery related things on you.
  • After everything they will use your IV to put you to sleep and start wheeling you to the surgery room. I remember being wheeled to the back and everyone being all smiles. I knocked out right when then they put me on the surgery table.


  • I woke up and I only remember them asking me if I wanted something to drink (sprite? ginger ale?). I also remember being wheeled out to the car and my best friend and his brother getting me in the car. I remember being placed in the bed in the room. I remember taking a post op selfie and being able to use the restroom by myself.
  • Wearing sweat pants and/or athletic shorts are a must after surgery.
  • My first meal after surgery was mashed potatoes and gravy. Something pretty light is always best.
  • You can only sleep on your back and you have to sleep elevated.
  • I personally had a problem staying awake the first 3 days after surgery or so. I would fall asleep in the middle of doing things. 
  • You will have a post op the day after surgery. Here they will teach you and whoever taking care of you how to care for your dressings for the next week.
  • Your chest is dressed with pads to soak any blood from your incisions. If you had lipo you will have a half pad on those entry points below incisions. Over that is 2 ace bandages that are wrapped tight to deal with swelling. (They are meant to be tight but if you have trouble breathing then loosen them. They are there for support.) The ace bandages will be wrapped over your chest and your lipo points. The ace bandages stay on majority of the time unless you are changing the pads. DO NOT MESS WITH YOUR TAPES OR ANY OTHER BANDAGES! Only change the pads once a day.
  • Dr. Raphael does not use drains.
  • I developed a minor rash around my lipo points because I had to much moisture there from the neosporin. If that happens to you stop putting the neosporin there.
  • At your one week appointment they will remove the dressings and you will see your chest for the first time.
  • Reveal day is very emotional for most people and I knew that I would forget everything that the nurses told me in terms of my continued aftercare. My tip is to have someone record the entire exchange so you can re-listen to the aftercare instructions later.
  • At one week I was told I could drive again, I could sleep on my sides, I could shower again, and that I could wear t-shirts again. (I personally waited to drive longer than that though because I did not feel comfortable at all.)
  • You will continue to wear the ace bandages for a month. It’s hard to think about binding after surgery but its to contain swelling, so don’t cheat your recovery.
  • For your nipple care, you will be given Adaptic (non-adhering dressing) that is meant to keep your nips moist. you will apply some vasoline to the Adaptic. Then you cover that with a gauze pad and medical tape or fabric tape. (All things you can find in the first aid aisle at the store. The nurses will give you some to get started.) You will do this until you run out of the Adaptic they give you. Which should be about a month to 6 weeks.
  • The tapes on your incisions will fall off on their own. Don’t pull them off. They should all fall off on their own around 4 weeks to 6 weeks.
  • After they fall off you will place provided silicone strips for your scars for a while.
  • At the time of surgery, I was delivering pizzas for a living. I will admit that I jumped the gun on returning to work too early. I ended up going back after 3 or 4 weeks. When you can go back is determined by what kind of work you can do.
  • At 6 weeks, my left nipple looked to have healed wonderfully. I pulled the last of my visible sutures, as instructed, that day. My right nipple still had a little spot to heal but seemed to be healing just fine.

Random Tips:

  • If you have a hard time taking pills like I do. You can try taking them with apple sauce.
  • Make sure you have Miralax and Fiber. Pooping after surgery is really important because the pain meds will stop you up.
  • Don’t over do it. Sit down and rest. I am the type of person that will do everything but I can not stress how important it is to sit down and rest and not try to be Superman. Watch your range of motion, even if it feels, “just fine”. It will have effects on your healing.
  • Netflix. Netflix. Netflix.
  • I don’t hear this referenced too much but for those of you who play instruments, I play violin among others, I would suggest waiting the entire 6 weeks before playing again. 

The nurses will honestly give you everything that you need for recovery. There is no need to worry about recovery supplies. They really give you everything. Make sure you read all of the paperwork they give you in terms of pre op and post op. I did have surgery in Feb of 2016 so things make have slightly changed. This is also MY experience and MY experience alone. My health is different than yours so please listen to the nurses and doctors. I shared my experience to help others have an idea on what to roughly expect.

If you have any questions, feel free to message me or send me asks!

I have a lot of everything.. It’s my own personal pharmacy.

top left row:
60 Gabapentin 400mg, 10 Butalbital 40mg, 30 Hydroxyzine 25mg

middle left row:
60 Gabapentin 500mg, 90 Gabapentin 300mg, 28 Hydroxzine 10mg, 40 Baclofen 10mg

bottom left row:
87 Lamotrigine 25mg, 50 Ambien 5mg, 30 Ambien 5mg, 30 Hydrocodone 325mg

Miscellaneous pills in the corner:
2 Xanax 10mg
3 Dilaudid 4mg
1 Oxycontin 20mg
2 Oxycodone 5mg

anonymous asked:

Do you have any recommendation of salty foods that don't have many calories? I have hyponatremia so my sodium levels are way too low but I've been trying to eat healthier and don't want to eat all of the regular salty stuff like junk and fast food. I love your blog! ❤️

Cottage cheese: ½ cup has only 82 calories and nearly 500mg of sodium.
Soup: a lot of soups are very salty but pack few calories and lots of nutrients.
Deli meat: not necessarily healthy but lots of sodium in just a small amount.
Pickled veggies: brines contain a lot of salt so the veggies are saturated in it.

Hope I could help!

~Doctor Bieber~

It’s been a while since I updated soo, why not start back with a dramatic ass imagine,

Also Posted on my Wattpad Account: Aliciax33
Imagines Book #2

“The roads are icy Y/N? Are you sure your going to be okay out there.” My mother spoke into the phone.

I grabbed my keys and pushed my phone on my shoulder putting on my jacket. “Mom I’m going to be fine, I’ll drive slow. I promised you I’ll be there for thanksgiving this year so.” I chuckled.

“Be safe, I love you. Text me as soon as you stop for gas or you reach the city.”

“I will, okay love you bye.” I smiled hanging up the phone grabbing my purse heading out the door.


I tapped my fingers to the music listening to my favorite song right now. I pulled up to an intersection where 4 roads meet stopping at the red stop light. I pulled out my phone seeing my mom send a picture of the whole family with another text.

“We’re all waiting on you, can’t wait to see you. Love you, drive safe ❤️”

I smiled and looked at the red light before texting my phone saying “I love you too” seeing the light screen hitting send then starting to drive only, to hear moments later a loud beep and feeling everything go in slow motion then speed up.

I opened my eyes, taking a deep breath placing my hands on the inside of the roof of my car. I looked around before seeing someone’s car stop and the man immediately rushed over.

“Hold on I’m going to get you out of there.”

And after that everything went black…


“22 year old female, brown eyes found on interstate 81 flipped over on the side.” I looked up looking at the lights seeing doctors rushed over me.

“Where am I…” I whispered in barely a voice.

“Mam your going to be fine.” A Doctor with brown hair and hazel brown eyes with tattoos on his sleeves.

I slowly began closing my eyes before I hear him continue to say. “Stay with me mam, don’t close your eyes.” Echoing in the background before I once again blacked out.


Justin’s POV.

“Get and IV hooked up to her now!” I spat quickly putting on my stethoscope cutting open her shirt placing the stethoscope on her chest.

“Her vitals are dropping.” I quickly took off the stethoscope and rolled up my sleeves washing my hands putting on gloves.

Once they get one placing the IV, I looks at her vitals still dropping before I hear a long beep and the vitals drop completely making my heart stop.

“She’s going into cardiac arrest! Quickly bring me the defibrillator!” I called for making e grab the paddles rubbing them together.

“Bring it up to 300.” I pressed it on her, “clear!” I watched her vitals still dropping.

I shook and head. “350.” They nodded and turned up the shock. I rubbed the paddles together and pressed it once against her chest.

“Clear!” I watched her vitals and seen they were still flatlined. I quickly thought to myself, “450.” I spoke.

“But Mr. Bieber-”

“Turn the damn thing up to 450 now!” I spat making them nod. I took a deep breath,

“Come on baby girl…” I took a breath and muttered.

“Charging 450… Clear!” I shocked her before hearing her vitals start to revive again. You heard everyone sigh in relief.

I placed back the paddles. “Before I give any medicines I wanna run a few tests on her.” I told them sternly.

“Get a CAT scan and a MRI ready to make sure we have no broken or injuries.”

They nodded and everyone went to work.



I slowly opened my eyes before closing them shut groaning. “Well, good morning.” I reopened them seeing the same doctor writing down stuff on a clipboard.

“What year is it.” He asked making me look confused.

“Why are you asking me this.” I groaned feeling my head pounding. You had a slight trauma to the brain durning the accident, but nothing life threatening.

“So, what year is it?”


“Date of birth…”


He nodded, “And one last question. Do you think I’m attractive?”

I looked at the doctor and he looked up raising his eyebrows. “Is that a rhetorical question?”

“Nope.” He smiled, “Eh, I give you a 7…” I laughed winching in pain.

In my mind he’s more than a 10….

He put down the clipboard and coming over before put something into the into my IV. “What’s did you just give me?”

“Just 500mg of ibuprofen, to take away the pain that your experiencing.” He muttered, before sitting down next to me.

I looked confused. “Is this the part where you tell me I’m going to die?”

“You did. But… I revived you.” He spoke sternly.

I just looked at him lost for words, before feeling my eyes water. “T-thank you.” I whispered with my voice cracking.

“It’s my job sweetheart,” he smiled and stood up. “Get some rest..” he patted the side of my bed walking towards the door.

I sniffles wiping my tears, “Wait… what’s your name?”

“Justin.” He paused in the doorway.

“My names Y/n…” I muttered, hearing him let out a little laugh. “Get some rest Ms. L/N.” He smiled lightly before turning around leaving the room.


Well.. it wasn’t as dramatic but lol, I hope you enjoyed it and sorry for the late responses. If you wanna see what I’m updating next? Just go follow my new

IG: @viabiebs

"20 minutes!! You Put Pills in a Bottle!"-Pharmacy Follies
-One of my regular assholes came in to get a refill. Here’s where the fun begins…

Me: “Did you want to wait or come back?”

Asshole: “Oh no, I want to wait.”

Me: “Ok, it will be about 20 minutes or so.”

It never fucking fails. When his script is ready, he starts bitching…

Asshole: “Why does it take so long?! You’re only putting pills in a bottle!”

Because I go through this shit EVERY TIME he gets a refill, I fucking let him have it…

Me: “If it was as simple as putting pills in a bottle then the FDA would just make this OTC. Because the general public can’t be trusted to medicate themselves properly, therefore not accidentally killing themselves in the process, they decided it’s better that educated individuals, who specialized in the study of pharmaceuticals, be in charge of dispensing such medications. Not only that, you’re NOT our only patient.”

Seriously folks, this isn’t a burger joint. Even at a burger joint, if your food is cooked improperly due to haste, you can suffer consequences ranging from vomiting and diarrhea or even ending up in an emergency room. Now, if eating an improperly cooked burger can land you in the doo doo station with a horrific case of the shits, imagine what the WRONG MEDICATION could do to you. If you think shooting pond water out of your ass for a few hours is bad, I don’t think ending up in a fucking funeral home is even better because you were dispensed the wrong medication. 

Trust me, we like to get you in and out as quickly as possible. We know you, or your kids, feel like shit. However, it’s not just putting pills in a bottle. We’re also billing insurances, making sure there’s no drug interactions with what is prescribed along with everything else you’re taking, making sure that your doctor’s chicken scratch writing really meant Levofloxacin 500mg and not Levetiracetam 500mg and making sure that the correct medication is put in the vial with the correct label especially if you’re getting more than one prescription. 

And the biggest reason you’re waiting long? BECAUSE YOU’RE NOT OUR ONLY PATIENT! On a busy day, we can fill over 500 prescriptions. On a regular day, we fill around 350 prescriptions. Just because you don’t see 350 to 500 sons'o'bitches milling around the pharmacy does NOT negate the fact that people dropped off prescriptions before you did, doctors are calling in/faxing in/escribing prescriptions or people used the automated system to refill their scripts.

In short, have some God damned patience. We’re dealing with medication here. Mistakes that can KILL you. Granted, I wouldn’t let my dog piss on you if you were on fire, but it will be a cold day in Hell before I rush my pharmacist, putting their jobs on the line, because you’re in a fucking hurry and because you’re too fucking stupid to use the automated service to refill your monthly fill of Simvastatin ahead of time therefore negating sitting around for 20 minutes at the pharmacy.
Testosterone Enanthate Cycles and Doses

Testosterone Enanthate is one of the oldest forms of testosterone ever made available and is further by-in-large the most popular and commonly used testosterone of all time. Very powerful, equally androgenic as it is anabolic Testosterone Enanthate is one of the most versatile anabolic androgenic steroids ever synthesized and well-suited for almost any purpose. Athletes from all walks of life regularly supplement with Testosterone Enanthate as this is a steroid that will bring about all the attributes commonly associated with and desired through anabolic steroid use. Moreover, even though it is very popular and in high demand, as most steroids that are highly sought after are generally high priced Testosterone Enanthate is both fairly cheap and in high supply across the board.

The benefits of Testosterone Enanthate are nothing short of perfect and certainly nothing short of amazing. Through the use of Testosterone-Enanthate we create a perfect environment apt for bringing forth the attributes of increased muscle mass and strength, as well as an improved metabolic rate due to the increase in tissue as well as the steroids control over fat promoting hormones. Further, because testosterone is imperative to repair and recovery after intense activity, when our levels are increased through the use of Testosterone Enanthate we readily speed this process up as well as give it greater efficiency.

It is a common misconception, many who supplement with Testosterone Enanthate assume they will add piles of lean tissue to their frames simply because use is active; unfortunately it does not quite work this way. While some lean tissue may indeed be gained simply through use, in order to really see a change you must feed the body but this is good news. By its very nature, through testosterone supplementation we increase the effectiveness of our food and the efficiency in-which it performs. As this is true for those who are looking to gain the same principles apply to those who are seeking a leaner physique. To lose body-fat we must be in a calorie restricted state, below maintenance; often, because the body needs energy in order to function it will take what it needs through existing muscle tissue when stores become too low. By supplementing with Testosterone Enanthate while on a calorie restricted diet we readily create an environment apt to preserving this tissue, thereby increasing metabolic activity; not to forget, as mentioned, testosterone will block muscle wasting hormones and as they are highly present when dieting this is simply an added benefit.

Testosterone Enanthate and Testosterone Cypionate
Go to any gym, log on to any message board and you will find those who swear on their lives that Testosterone-Enanthate is a better steroid than Testosterone Cypionate and vice-versa. Not only is such thinking wrong it’s in truth nothing short of ridiculous and is only exasperated by the ignorance of many. The truth is simple; Testosterone Enanthate and Testosterone Cypionate are for all intense purposes the same steroid as both are testosterone and the Enanthate and Cypionate ester are almost identical in every way. The only difference of any worth is in the half-life of each; Testosterone Cypionate carries with it a half-life of approximately 12 days, 36 hours longer than Testosterone-Enanthate and since both stretch past a week the difference is nothing short of negligible. Regardless of the form you use, assuming all things are constant, diet, training, etc. the dosing of each when comparable will produce the same results with either form.

Testosterone Enanthate Cycles & Doses
Regardless of the reason of use you will be hard pressed to find a more perfect steroid well-suited for all purposes regarding anabolic steroid use. Be it cutting or bulking or simply a desire to gain an added athletic edge Testosterone-Enanthate will provide what you are looking for. For most who are beginning anabolic steroid use 500mg of Testosterone-Enanthate will prove to be nothing short of perfect; moreover, as this is a highly effective dose it is a dose many will never surpass as it is often all that is needed and generally very well tolerated. As testosterone will in most cases necessarily be the foundation of any cycle or even used alone, regardless of the stack two weekly injections of equal doses will prove to be efficient and provide stable testosterone levels. Interestingly enough many competitive bodybuilders, especially in recent years have begun administering the hormone every other day in smaller doses spread out over the week. While this proves to be unnecessary when we look at the hormone and its active half-life, as is not unusual in the anabolic world, sometimes reality and what’s on paper do not match up perfectly. Many of these competitive bodybuilders report a more stable feeling; that’s right, they simply feel better and ask any athlete and they’ll tell you that’s often the name of the game.

While 500mg per week is a standard dose many individuals will choose to use more. 1,000mg per week is far from uncommon and can in many cases be safely used. Further, especially in bodybuilding and power lifting circles doses that surpass 1,000mg are not all that rare but there is an important factor you must understand. Most all anabolic androgenic steroids carry with them a risk to reward ratio; the greater the dose often the greater the results; however, the greater the dose the greater the potential is for negative side-effects. In the end responsible use will always prove to be key but always understand the effects of abuse are on you and you alone.

As for your Testosterone-Enanthate cycle, most will find 8 weeks of use to be the bear minimum with 16 weeks being far more efficient. Regardless of your duration of use a solid post cycle therapy (PCT) plan must be in place. Because Testosterone-Enanthate is a long ester based testosterone you will necessarily begin PCT 3 weeks after your final injection, which may include hCG, Nolva and/or Clomid. Those who use hCG are advised to begin use approximately ten days before Nolva/Comid for approximately ten days of use.

clandestine-consciousness  asked:

Vitamins! These are the ones I take every day: Biotin 5000mcg by NATROL, Digestive Probiotic by TRUNATURE, Iron 18mg by NOW, C-500 complex 500mg by THE VITAMIN SHOPPE, Women's energy, metabolism, and bone support gummy by VITAFUSION, and simplygood high potency vitamin B-12 3000mcg by VITAFUSION. I try to limit the amount of gummy vitamins I take because of the sugar content (that's why only 2 of my dailies and gummy form). I think the Biotin, Iron, & Probiotic are the top 3 most important.

Oh wow, thanks for being so specific! And thank you for the info about sugar in the gummy vitamins (I was considering getting a bunch of them…)
Thank you for sharing!! 🍓🍓🍓

I feel like I should probably go to a hospital.. I took 500mg of benadryl last night, which isn’t too bad, but then Mail fucking took two full boxes of it..??

I don’t know if that’s.. bad? But I’m really lightheaded and disoriented..

From the minute I woke up this morning until about two hours ago, my entire right side of my head has felt like it was going to split open.  Just a line of hot, throbbing pain from my eye all the way up and over my head, down my neck.  Like, it literally started before I even woke up, I was dreaming about how badly my head hurt D:.  800mg of ibuprofen and 500mg of acetaminophen didn’t even touch it.

I ended up having to tape over my eye to block the light completely while putting a cold gel strip over my forehead.  I was getting halos, blurred vision, and nausea every time I tried to see out of my right eye.  I’ve had to pee every thirty minutes from chugging ice water. 

Today was not a good day. 

I don’t get migraines this bad very often (sadly, they seem to always coincide with my period) but I feel absolutely drained and exhausted and frustrated over a wasted day.

anonymous asked:

How long would 500mg of dilaudid last you?

Right now it’d last me forever cause I managed to quit all opium use for a few weeks, heavily using meth everyday to mask my withdrawals. So my tolerance is back to square one, for a little bit. But back when all I did was eat, sleep, and breathe Dilaudid, it’d last me at the most of 2 weeks. And that’s overestimating.

anonymous asked:

Lol I think it depends on the person I'm 130 lbs and 250mgs was what I took the first time and I got mild hallucinations and a decent body high and the best trip I've had was 500mgs with barely any body high but amazing and realistic hallucinations~

Yeah it seems to definitely depend on the person, your weight and tolerance can help me kind of gauge how much would be right but ive seen people get high off like 3 pills and weigh a lot / vice versa