the beginning~

I decided to start this blog to document the process I've been through and will be going through to get these lesions removed from my eyes.
I've always known that I had high cholesterol. Its been high since I was a teenager. I also knew it wasn't because of my diet. Both of my parents have/had high cholesterol and I was the lucky one to inherit it. Generally I managed to keep it at around 250 until I was 35 years old. Then, what seemed like all of a sudden, I gained weight, and my cholesterol shot up to 329. Not good! I started taking Lipitor and it came down but then these lesions started forming around my eyes. I didn't connect the dots until around 4 years later when my doctor told me the lesions were Xanthelasma and it was caused by the cholesterol. He said that maybe the Lipitor would help keep them small but he didn't really know. Time passed, and I was switched to Crestor. My doctor wanted me to take 10mgs but I had awful side effects like shoulder and leg pain so he dropped it back to 5mg. It brought my cholesterol down to around 240ish but the Xanthelasma kept growing. My PCP suggested I see a plastic surgeon since I wanted them removed. The first plastic surgeon I went to looked at my eyes, told me its 100% cosmetic (as I knew...) and that he would try to get authorization from my health insurance but they would likely deny it. He also explained that without insurance, I would have to pay for his fee, the facility fee and anesthesia. He gave me the option of having it done in his office with just a local as a cost cutting alternative. Okay. I went home and waited for the call from his surgical coordinator. 4 weeks passed and I heard nothing. I called her and she said she had lost the paperwork but would find it and take care of it. Another 3 weeks, and still nothing. I decided they weren't the office/surgeon for me. Meanwhile, my Xanthies were getting bigger.
About a year later, I went to see a dermatologist. He said the Crestor should reduce the size and that he would just leave them be. Ha! That was easy for him to say. He didn't have these ugly yellow plaques on his eyes. I never went back to him again either.
My third try was about 6 months after the dermatologist. I figured I'd try another plastic surgeon. This guy told me "Sure, I'd be happy to remove them for you...." and then gave me the fee just to do the bottom ones. I almost fell off the chair. $3000.00 for just the bottom lids, and I would still have to pay the facility fees and all. I left his office stunned at his price and decided he wasn't the surgeon for me either. 2 weeks later, his secretary called and asked when I wanted to schedule the procedure. I laughed and told her "when I hit the lottery."!
After seeing 3 different doctors, and still no result, I had kind of convinced myself that I was destined to have these things forever and I would just find makeup to cover them. That plan actually worked for the past 3 years. The top lids were easy to cover with coverstick and eyeshadow. The bottom lids were a little harder to cover. All the while, they were getting bigger! I also figured out that if I got a tan, they didn't show up as much. Needless to say, I stayed tanned as much as I could.
That brings me up to the present. Hope this hasn't been too boring so far!
In April, I asked a friend who knows a doctor if he would ask that doctor about my Xanthies. He did and we got the name of a doctor that was close by. I didn't get my hopes up until I went on his website. This guy is an Occular Plastic Surgeon. An opthamologist AND a plastic surgeon all rolled up into one guy!! Wow. I had never thought of going to an eye doctor. I called and made an appointment for a consult. On May 5th, I went and met Dr. L. He looked at my eyes and said "Sure, I can take care of those for you..." A real funny feeling swept over me. I'd heard that before... He explained the procedure to me and said the biggest obstacle is getting insurance to pay for it but that they would try. He called his surgical coordinator in and we all talked about my insurance plan. Let me tell you, I have a very basic EPO plan with a regional carrier. I didn't get my hopes up too high on this being approved. However, since my Xanthies were quite large and I was no longer able to cover them up, I told Dr. L and the surgical coord. that I would be willing to pay out of pocket to have this done if necessary. Dr. L said lets talk to your insurance first and then we'll explore options if we have to. Gee. This guy sounds either really uninterested, like the first plastic surgeon I saw or really confident. At this point, I couldn't figure out which, but I liked him. Yeah, you read that right. I liked him. Not in a funny/weird way, no, not like that. I've worked around doctors for 25 years and I'm not the best patient. I've had my share of doctors that I just didn't connect with but Dr. L seems to be one of the good guys so in my head, the really confident option won. I decided before I even left his office that whether my insurance paid or not, I was having this done and he was the guy to do it.
So, I went home to wait--again. This time the call came exactly 7 days later. My insurance had approved my surgery and all I would have to pay is the out patient surgery copay of $250.00. Okay... I was stunned. Stunned into near silence. As we all know, Xanthelasma removal is cosmetic. Insurance doesn't cover cosmetic surgery. OR... maybe I was just under that impression because that's all I had been told for so many years. Once I got my speaking capability back, I told the surgical coordinator to go ahead and schedule it. I'm ready! 4 days later, I got the paper work in the mail. I had to go to my PCP to get a pre-op physical with EKG and if he said I was okay, the surgery will be a go!
On May 23rd, I had the pre-op. My PCP thought it was great that I was getting them removed, and gave me a clean bill of health, except for the cholesterol and smoking of course. With that hurdle out of the way, I moved on to thinking about taking time off from work and getting everything ready. I'm self employed which means I work a lot of hours and a lot of people depend on me. I had no idea how much time was going to be needed so I went to the Internet to research this surgery. Guess what... there is no information! Sure, lots of websites tell you what Xanthelasma is, and where it comes from, but in all my searching, I never found anything about what it was like to have them removed. Thus, the idea for this blog was born.
On Monday, June 1st, I went for the pre-op visit with the surgeon, Dr. L. Once again, the surgical coordinator came and talked to me to have me sign the consent, and she gave me pre-op and post op instructions along with a cute bag that had bandages and gel packs (the kind you can freeze) and eye covers and tape. She explained what would happen from when I get to the surgery center to the time I leave. She also informed me that my eyes will be bandaged and that I cant take the bandages off until the next day. (what...??!!!!) Then, I went into the room to see Dr. L. He asked me if I had any questions. I asked him how long it would take to do the removal, he said about an hour but he really didn't know because every case is different. He said my eyes would set the time. Okay. I asked him about pain; he said I'll be in twilight sleep so I might hear music or talking but I wont feel anything and of course I would be given a local anesthetic. I nodded and then asked about pain afterwards. He said I shouldn't have any. Okay... I'm good with that. He looked at my eyes again really close and said that normally they like to hide the incision in the crease of the eyebrow but in my case, on the upper lids, my Xanthies straddle the crease. That means they are on both sides and kind of all around. (yeah, I knew that!) He said the bottom shouldn't be a problem because the scar would just blend in as a wrinkle. He went on to say that once he removed the lesions, he would see where the remaining skin fell and then go from there. He told me that Xanthelasma infiltrate into the skin so you cant just peel up the skin and scrape out the yellow stuff. You actually have to remove the skin completely to get rid of these things.
I left the office feeling pretty good but also starting to get nervous. All kinds of thoughts ran through my head. Good and bad. I was either going to be pretty again... or my eyelids wouldn't fit right anymore... that kind of stuff and a bunch of other things. I wont bore you with my craziness on that.
That brings us up to today. The night before the big surgery! I'm a little anxious about the whole thing. I got all my work caught up (not an easy task) and cleared my desk. My oldest daughter came over so she could go with me and be with me afterwards. I'm sitting here typing this while she is cooking dinner. She's going to stay with me until Friday evening when she has to go back to work and then my other daughter will come and stay over the weekend. I think I'm all set---maybe....
As for my plans for this blog, I will try to be detailed and descriptive and include photos of my progress. This may be a bit too much for some, but I really wish I had found something like this online when doing my own research. My goal is to help anyone else looking to have their Xanthies removed and let them know what it will be like. I'll tell you in advance, I'm a lousy patient and get irritable when I don't feel well.
More tomorrow....
In the mean time, here is my before photo. Pretty little things aren't they...?