January 22, 2018

Everything You Need to Know About Breast Reduction Surgery

How to decide whether to have breast reduction (reduction mammoplasty) surgery, how to pick a breast reduction plastic surgeon, how to deal with insurance companies for breast reduction, what to expect during breast reduction surgery and breast reduction recovery. Breast reduction tips. Breast reduction advice. Why you should have a breast reduction. What I wish I knew before breast reduction surgery. Weight loss vs. surgery for breast reduction. Breast reduction before and after |  brazenandbrunette.com

Today's post is a little off in left field, but once again I found myself looking all over Pinterest and couldn't find any truly helpful posts so I felt the need to write one myself. So a month ago I reduced each breast by about a pound! I know most of y'all won't ever have this surgery, but if you're one of the few readers who will need it or are just curious in general then read on my friends.

To keep this post from being unnecessarily long, I'm going to skip over my how-I-decided-I-needed-surgery story and my how-my-life-has-changed story. If any of y'all are interested in that, just comment or email me and I can make a mini-series of posts about this whole thing. But here is a good summary of that...



Once I realized that my boobs were getting out of hand and honestly getting in my way, I started to try to get them in control. The problem came when I lost 10 pounds my 1L year but they stayed the exact same size. Even worse, I had lost weight around my ribs directly under my boobs so now I couldn't find bras with a large enough cup size and small enough band size. This is when I realized that no amount of push-ups or other "breast reducing exercises" were going to help. Both of my grandmas and now me just have the body type of "large boobs" so I could lose as much weight as I wanted to, but I would still have a whole lot of tissue. And if I ever gained any weight back, it all goes to my boobs first and then elsewhere in my body so this was a problem that I realized wouldn't solve itself simply by working out my pec muscles.


Insurance

Unfortunately I ended up wasting almost as much money as the surgery costs just trying to get insurance to cover the surgery. I first checked on my company's website and saw that the procedure was covered. Then I went to my regular doctor to get her medical recommendation that surgery was needed and to get a referral for my plastic surgeon (cost: copay). Then I went to my PS to be evaluated and she sent off a recommendation to my insurance company (cost: specialist copay). I was denied by my insurance but had been warned of this so I went back to my doctor for pain meds to help and another letter (one more copay + pain medicine). Then I went to a chiropractor and learned that I had a slight curvature just from the weight on my front so I went through adjustments and physical therapy for a month and a half to fix that problem and also get a rec letter (copay + PT + x rays). Then my mom wanted me to get one more opinion so I went to my gyno because she's been seeing me for a while so she knew my boobs weren't going to stop growing any time soon (copay). 

I was denied again and this time we found out that it's because it literally was excluded in my policy (think like before iPhones when data just didn't work on your phone if you didn't have a data plan). My dad owns his own company and I'm on his plan so we were like okay we'll just change policies to one that includes the surgery. However, we found out that this would make his premiums go way up and all of his employees are guys so from a business standpoint he just couldn't do it. I then tried to see about possibly getting on my own insurance plan since I was young and still in school so I figured maybe I could get on the cheapest plan that covered it. This turned out to be a waste, too, because I would pay more just in premiums then the surgery was actually worth.

So my mom called her insurance company (she's a teacher so she's on her own plan through the school) and verified with them that this could be covered and they told her that as long as it's medically necessary and not just cosmetic then they'd cover it. At this point it was over a year since I'd first seen my PS so she wanted me to come back in because she didn't want to write a rec letter over year-old measurements (another specialist co-pay). So we sent off all my old and new records and found out that for this company, "medically necessary" means basically only a mastectomy and since I wasn't going to die without this surgery, it wasn't "necessary" to them. Being denied three times by insurance companies is really terrible because you're basically sending them your nudes (yes you do have to send them pictures) and they come back and say meh they're big, but I've seen bigger and is just really frustrating.

Finally we realized that at this rate we might as well just pay for the surgery outright. Thankfully my parents are super understanding so they were totally okay with helping me pay for the surgery (although I'm not counting on getting a big present for my next birthday). I ended up being glad we went this route because this let me have 100% of the decision making power and didn't have some insurance company dictating how many grams I was going to be taking out. I also was able to choose where my surgery would take place since I didn't have to worry about out-of-network hospitals or anything like that.


The surgery

I found my surgeon simply because I went to my regular doctor and asked who she'd recommend for a breast reduction. I loved my surgeon and a great way for you to do some research on surgeons in your area is to read reviews on RealSelf.com

The week before my surgery, I had a pre-op appointment with my doctor to discuss size and look at pictures of her previous surgeries so I could see what would be proportional to my body. Then she answered all of my last-minute questions before she sent me off to get pre-op blood work. I also went ahead and filled all my prescriptions (just pain meds, nausea medicine, antibiotics, and a xanax for the night before) so my mom wouldn't have to deal with that on the day of my surgery. 

I got there at 8 that morning in my button-up shirt and leggings and house shoes all ready to go. Then there was some last minute testing to make sure I didn't have any nicotine in my system and I hadn't gotten pregnant in the past week and then I put on my gown, hair net, and compression socks. I tried taking a picture of this but I had a slight anxiety attack the morning of so my eyes were red and puffy in the picture and so I obviously had to delete it haha. My doctor came in to again talk with me to make sure she knew what I wanted and then to mark me up. Next I got an IV hooked up for the meds and a shot to make me calm and relaxed and sleepy. My surgery lasted a little longer than an hour but honestly I don't even remember leaving the pre-op room.

It's true what my doctor promised, I woke up and I couldn't feel my boobs. Not like they were still numb couldn't feel them, but like they just weren't crazy heavy. If you were to take a sports bra on and put two one-pound hand weights in there and wear that all day and then take it off at night, that's exactly the relief that I felt. That feeling alone instantly made me reassured that surgery was the right choice for me.

How to decide whether to have breast reduction (reduction mammoplasty) surgery, how to pick a breast reduction plastic surgeon, how to deal with insurance companies for breast reduction, what to expect during breast reduction surgery and breast reduction recovery. Breast reduction tips. Breast reduction advice. Why you should have a breast reduction. What I wish I knew before breast reduction surgery. Weight loss vs. surgery for breast reduction. Breast reduction before and after |  brazenandbrunette.com
The day before my surgery
How to decide whether to have breast reduction (reduction mammoplasty) surgery, how to pick a breast reduction plastic surgeon, how to deal with insurance companies for breast reduction, what to expect during breast reduction surgery and breast reduction recovery. Breast reduction tips. Breast reduction advice. Why you should have a breast reduction. What I wish I knew before breast reduction surgery. Weight loss vs. surgery for breast reduction. Breast reduction before and after |  brazenandbrunette.com
1 week post-op


Post-op

As for recovery, within just a few days I felt totally normal and fine. The problem is that incisions this big take a long time to heal so even a month out and I'm still covered in band-aids and gauze, so it's weird to look like I'm still recovering while feeling as if nothing happened. 

I spent the first two days basically just sleeping and only would wake up to go to the bathroom or take my meds. For some reason I had zero appetite for the first several days and would gag if I tried to make myself eat anything. Within the first week I felt good enough to stop taking the prescription pain meds and switched to OTC. After switching to less-strong medicine, I wasn't as drowsy all the time and slowly could walk around my house and then felt good enough to accompany my sister on a trip to the grocery store. 

Probably the weirdest part of the first week was that my boobs were so swollen they were almost on my collar bones, which my sister said they felt like hers did when she needed to breastfeed so now I know what to expect with that haha. During this week I also had to recruit my sister to take a shower with me because I couldn't reach up to wash my hair, which was also weird because we haven't taken a bath together since we were like 5. I was actually super nervous about showering just in general because I was afraid some of the tape that was covering my incisions would accidentally get too wet and wash off. 

Here's a fun story— about 5 days after surgery I was home alone and hungry but too lazy to make myself anything and I couldn't drive yet so I figured I'd just make myself a bowl of cereal. My mom keeps the cereal on the top shelf in our pantry just because it's the tallest shelf and when I reached up to get it I felt this terrible pain below my armpit and realized that I shouldn't have done that. Then I went to grab the milk and we had just gotten a new gallon so it was way too heavy for me to hold and so I instinctively dropped it because it hurt so bad. Obviously milk spilled and went everywhere on the floor, so I tried to clean it up but when I bent over to wipe it up there was a lot of pressure on my chest that again hurt really bad. So there I was, covered in milk and sticky from it; in pain from reaching too high for the cereal, from holding a too-heavy gallon of milk, and from bending over like I wasn't supposed to; so I just started to cry out of pain but also just general frustration... Yes, I did cry over spilled milk haha. 

The day of my 1-week post-op checkup, I got my new Stitch Fix box in. I had told my stylist that I was getting the surgery so she'd know huge boobs were no longer a factor for choosing cut and styles of clothes. I teared up trying on the first top once I looked in the mirror because I realized how much skinnier I looked now! Before I was actually worried surgery would make me look bigger since my big boobs made my stomach look flat in comparison, but after trying on this top I realized how I now fit in smaller size tops that could fit my body better overall and it was much more flattering. 

By week 2, the swelling had gone down so I at least felt completely normal. But this was also when everything started itching as scabs formed and my body healed, which was super not fun. This also was the week where the bruising from the liposuction they did around my armpits really started to show up so I look like I'd had my ass kicked pretty badly. I also had bumps from the lipo too because there was scar tissue forming around where she'd poked and prodded me to reshape my boobs. This was also the week that I was moving cities so that was a little hard because I couldn't bend over to put anything into boxes and I couldn't reach up to get anything out of cabinets and I couldn't lift hardly anything so I was basically completely useless while moving. It also was still uncomfortable to reach up when washing my hair and I tried to get my hair stylist to just shampoo my hair for me but she up and got married and had the salon shut down while she was on her honeymoon so I just made due with lots of dry shampoo and baseball caps.

I was actually only 3 weeks post-op when I started my new externship and really nothing was different except that I kept running to the bathroom to make sure I had gauze in place because how do you explain blood-stained boobs on your first day of work? The only other problem that I still have is my skin is super thin from the surgery so I'm having to use a crap ton of coconut oil all over to keep my skin moisturized enough that it won't rip and bleed if I take off a band-aid (I use oil because my doctor doesn't want me using lotion just yet so I don't irritate anything). And by now I'm healed enough where I just have band-aids over areas that are healing the slowest. What's really cool is that I have a friend in med-school who actually did a rotation with my PS! So when I snapped her that I finally went through with the surgery, she sent me this. 

How to decide whether to have breast reduction (reduction mammoplasty) surgery, how to pick a breast reduction plastic surgeon, how to deal with insurance companies for breast reduction, what to expect during breast reduction surgery and breast reduction recovery. Breast reduction tips. Breast reduction advice. Why you should have a breast reduction. What I wish I knew before breast reduction surgery. Weight loss vs. surgery for breast reduction. Breast reduction before and after |  brazenandbrunette.com

So that's where I'm at! I'm super excited for it to warm up so I can start wearing strapless tops just because I finally can again haha. As far as being my first surgery, this actually hasn't been too bad and I'm just glad that I finally got this over with and can live my life without looking like Pamela Anderson.

January 19, 2018

Life as General Counsel

What it's like working as general counsel for a company, what is the difference between general counsel and in-house counsel, the pros of general counsel, and the cons of general counsel. the life of an in-house attorney. working as an in-house corporate attorney. law school externship. law school blog. law student blogger | brazenandbrunette.com

I have this friend from Study Abroad who is a year older than me and is in med school and one cool thing I've found out through her is that when you're an upper level med student, you go through these rounds of spending 2 weeks working as a family doctor, 2 weeks working as a pediatrician, 2 weeks with plastic surgery, 2 weeks with internal medicine... you get the point. And I am so jealous that they get this opportunity because it's a way for them to experience first hand all of the different areas of medicine and find out what's for sure not for them and narrow down what they want to do. Sadly law students don't get this opportunity so you never really know if there's a field of law out there that you would absolutely love if you just try. I'm a week shy of the med student 2 week experience, but I thought I'd share with y'all what I've already learned so far about being general counsel to give you a little snapshot to see what it's like!


What is general counsel

Traditionally, businesses would hire law firms to do all of their legal work (like Harvey Spectre). Then businesses realized it'd be cheaper and more efficient to have their own attorney employed by their business just for them to handle the day-to-day legal needs and then if there's a big suit or a complicated area, then they can hire a law firm to handle that. I think of general counsel (AKA in-house) as being like the mom of the company. People come to you to complain about problems they need resolved, come to get your advice, and come to when they need to settle an argument. 

How GC is different than just working in a law firm is that usually in a law firm you get really good in one area (say, real estate) and spend most of your time doing that for all kinds of different clients. This is just the opposite where you do a little bit of everything, but for just one client. So you are working on vendor contracts, leasing agreements, trademark licensing, employment issues (workplace safety to avoiding wrongful termination), mergers and acquisitions, anti-trust, buying and selling contracts, ensuring federal and state compliance, dealing with any countries that your company does work with, counseling officers and board members, and basically just any other problem that a business might encounter just trying to operate.

Pros of general counsel

I met a lawyer my 1L year at a networking thing and I asked him what was the worst part about being a lawyer and he said "billable hours fo sho" (okay I'm adding a little "mere puffery" here lol). But as GC you don't have to do that because you're basically billing your client (AKA your employer) with your salary. So whether a document takes you two full weeks or two hours to get done, you get paid the same.

This brings me to my next point of normal business hours. One of the lawyers I work with is married to a private practice attorney and she was explaining to me that while sometimes they both end up with 80-hour work weeks, he has them much more often then she does. And usually she ends up having a 40-hour work week. So if tbh as a woman I really like this idea because I could have kids and not feel guilty about missing their wholes lives because I'm working all the time. Plus, you're missing a lot of happy hours if you're working 80-hour weeks hahah.

One big thing that I've come to realize that I like is just having one client. When everything you do all-day, every-day is for the same client, it can be easy because you understand where they're coming from and what they want. You can be strategic and make decisions not just about what's good for this one situation, but what will be beneficial for the company as a whole in the future. Plus, your client can't be too crazy demanding because they should have a good sense of all of the work that's on your plate (although kinda not really because the finance people don't know what the property people have already given you). But I will point out that a downside of this is that your client is always there so you could be getting calls, emails, or drop-ins all day from people constantly needing help if it's one of those if-it-rains-it-pours kind of days.

Another thing that I personally like is the variety of the work. If my eyes start to bleed from reading regulation after regulation to make sure our policies are up-to-date with them, I can just switch gears and redline contracts for a bit. Detour: redlining a contract is basically we're negotiating a contract with someone else so they'll send us their contract and we mark out all the parts that are bad for us (think like "you waive all rights to sue us ever") and put in our own suggestions (think like requesting that they have a higher liability insurance policy if we're sending our employees onto their property); I personally think it's really fun (law nerd) because you get to be all bossy.  

You don't "real lawyer." One of my bosses jokes that any time she's ever had to go down to court to file a pleading or motion, she's doing "real lawyering." This is pretty rare because usually something like a cease & desist letter can fix a problem or if it's a big problem (think we're going to trial), then outside counsel will hop on board. For me, I don't feel this big urge to be litigating because if you've ever researched for a brief or sat through a trial then you know how it can be really stressful. While GC obviously isn't stress-free, I know that when I show up for work I won't need to have all of the Rules of Evidence or Trial Procedure fresh on my mind to be shouting out all day. Although, if you like the thrill of litigation then I guess this point would go in the next section for you.

Cons of general counsel

Although I am loving my externship, no job is perfect. For starters, these jobs are harder to come by. My company has only two lawyers that handle everything (except for the outside counsel they hire for the more complex issues) and on the other hand, some law firms have literally hundreds of lawyers. I've read both that some companies prefer to cherry pick the best (usually super experienced) person from a law firm and recruit them to their GC but also that now some companies prefer to hire fresh-faced law students so that they grow up learning only how to do things the way the company does. Ideally I'll be able to find a company like the latter (because if we're being honest here as much as I love my company and I'm sure they love me back, they just don't have the need for another lawyer so a job offer definitely isn't waiting for me), but realistically I know I might have to work at a normal firm to gain some experience before I can be qualified enough for a job.

And if we're being blunt then the money of general counsel usually isn't quite the same as a law firm. Since there's no billable hours or contingency fees, as a GC you're salaried just like a normal job. And while the sales team and everyone else at your job are actually making your company money with their job, all you're really doing is helping them not lose money so it's not like you have the opportunity to earn any bonuses. But also, you're still being a lawyer for a company so you're still making good money, just not like a quarter million a year (unless you work for Disney). You also are giving up the chance to be partner because there's really only the position of lawyer or lawyer in the legal department (although you could rise up to be like president of a branch of the company).

Okay so that's all I have so far! I'm sure I'll have lots more to say about this as time goes on, but I wanted to get this post written now while all these concepts are still new and fresh on my mind. Have a good weekend everyone and once again, enjoy studying while I do nothing because I'm basically done with school muahahahahaah 

let's be friends!

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