Today I had my first breast reduction consultation. I did my make up and put on sexy lounge wear - I was headed to Carmel Valley after all! Where McMansions grow like mold spores and luxury SUV's clog the roadways. The doctor's office in the same building as my OB and pediatrician. It's ironic to me that a place I associate with snotty noses, pink eye, and the dreaded pregnancy scale also houses the office for my potential plastic surgeon.
I arrived 17 minutes early. I am never early. I sat in the waiting room with an overweight elderly woman wearing sunglasses and an Asian teenager with her mom. The staff was within a hair of being overly friendly. I sat down with a current (yes, CURRENT!) magazine prepared to waste ten minutes. Unfortunately (I had a babysitter!), I didn't even get to open the magazine because I was called back right away to the Consultation Room.
This room was basically a smaller version of the waiting room, complete with higher end waiting room vinyl furniture. There was a three-seater sofa, two arm chairs (How many people come to a consultation? Is this room ever full?), and my own private coffee machine. Well, not quite a coffee machine. It was more of a fancy, electronic hot/cold water dispenser with a nearby basket of Tao teabags and packets of instant Starbucks coffee. I selected green tea then discovered the hot water function was not working so I settled for a styrofoam cup of cool water.
I flipped through the March 2011 Glamour (did I mention how current their magazines are?) and tried on the new Coach perfume. A slight knock and in walked the affable Dr. S.. He's a bit older, fatter, and balder in real life than the picture mailed to me. I couldn't help but think I would have raised my eyebrows had this been our first date after meeting online.
He flipped through the medical history I'd sweated over the night before, asking me about the pain and discomfort my breasts cause. He was impressed I'd figured out to use antiperspirant under my breasts. Apparently many women don't think of this seemingly simple solution to sweaty boobs.
I asked him if he was a boob man and noted his Navy experience.
"Good question," he replied. "You'd be surprised how many breast reductions we did in the Navy. On average about 3-4 per week. It's amazing who comes out of the woodwork when price isn't an object. I would say I've done between 500 and 600 breast reductions over my career."
We exited the Consultation Room and he walked me to the Exam Room, handing me a gown that was more of a robe. I thought the formality of him closing the door to let me take my shirt off so he could exam my tits was amusing. My too-small hot pink bra with molded cups decorated one of the seat backs.
Dr. S. came back in with a tall blond nurse with short hair. He had me stand up and face the beige wall, dropping the cotton garment to my waist but leaving my forearms covered. He noted the grooves in my shoulders and how one shoulder is higher than the other. His hands checked my spine.
"Interesting," he said in a mild tone.
My eyebrows raised.
"I can see some slight curvature here in your upper spine."
He gently lifted the robe back up over my shoulders without grazing my skin asked me to turn around and face him. He adjusted the open robe off my shoulders, down to my elbows again. Before he could finish his next sentence, the nurse handed him a small black tape measure. He made a lighthearted but sarcastic joke about her always having to be asked twice for things.
He again noted my uneven shoulders and then pulled on the tape measure. The white tape was placed at the slight groove at the base of my neck between my collar bones and then ran to my left nipple.
"29," he said to the nurse.
"That's centimeters, right?" I apprehensively asked, terrified he say inches.
"Yes, centimeters," the doctor reassuringly replied.
The same measurement was preformed on my right breast.
"28."
He lifted each boob to check the chaffing and rash underneath then made note of my bigger lefty. There wasn't half the groping I expected. The two exited so I could put my bra and shirt back on. They instructed me to open the door once I was dressed.
Shortly, the doctor came back in and directly stated, "If you were my wife, daughter, sister or girlfriend I'd tell you to have the surgery. So what's stopping you?"
We discussed my fears: MRSA, disrupting my children's self esteem, being too small chested.
He said most women feel they can't have small enough breasts after they have the surgery. I learned I have fatty, not dense, boobs and therefore they will end up on the smaller side if we go through insurance. Lefty will require removal of an extra 100-150 cc's just to make sure the two girls are even (that's almost an entire cup size!!!!). Because I have so much extra skin on my breasts, I am not a candidate for the lollipop incision (incision and scar around the areola and a straight line down to where the flesh of the breast meets the chest). I asked about the Le Jour and he told me that it's a complicated procedure and the Canadian woman who developed it has a difficult time even teaching it to her fellows. Regardless, I wouldn't be a good candidate for that less-scar producing procedure because of the excess skin on my breasts.
So in Dr. S.'s view, I definitely need the traditional anchor incision and subsequent scar. I expressed concern about the "dog ears" - the flaps of skin that can form if an incision is too long. He told me that dog ears are not terribly common but if it does happen, it can easily be fixed with a little surgery under local anesthesia.
With my questions answered, Dr. S. left and a cute Asian nurse came in. She was my escort to the Consultation Room. Nurse M. asked me undress my top half so she could take photos of my breasts to submit to the insurance company. A total of six photos were taken: one of my back, one of the front (straight on), and two profile shots of each side - one at 90-degrees, the other at 45-degrees.
After the unglamorous photo shoot, I was ushered into another room where I spoke with the Patient Coordinator. She outlined everything for me. She's also the woman in charge of making all sorts of required doctor appointments that a patient must have before undergoing surgery. A sort of personal surgery secretary, if you please. She gave me the general time line:
Thirty days before surgery I go in for a full physical with my Primary Physician. I also meet with a Patient Account Representative, a Patient Service Representative and a Patient Educator all in this 30 day time frame and often in the same day (the appointments are short, some a formality). One week before surgery, I have my pre-op appointment back at their office. At this time, all my prescriptions will be sent to the pharmacy of my choice to be picked up before the procedure.
On the day of the breast reduction surgery, I must arrive 1-1.5 hours ahead of time. The procedure itself will last about 2.5 hours. Time spent in the recovery room: about 1-2 hours. I will then be sent home unless there is a very rare complication like high blood pressure that will require additional monitoring. The outpatient surgery is done at the Anderson Clinic which is directly connected to Scripps Green Hospital should an unlikely emergency arise.
One week after my operation, I go back to the doctor. Within 2 weeks of the surgery I will pretty much be back to normal. For the two months following the procedure, I will feel quite fatigued and will probably need daily naps. The recovery is faster than recovery from a c-section. Because I am young and healthy, I should heal quickly.
-----
This afternoon I made two more consultations. I have one next week and one in two and a half weeks. I might even be able to schedule the surgery as soon as May 1! We're going to three weddings this year so the timing of the surgery is crucial. After hearing about my spinal curve, I'm realizing this is more of a medical necessity than I originally thought (apparently chronic back pain, neck/shoulder strain complete with grooves, and rashes aren't a enough of a medical necessity to me!).
Being only a C cup is a little scary. A 34C equals a 36B. Dude, a fucking B cup!!!! That's really super teeny compared to where I'm at now. I think I need a glass of wine.
Wednesday, March 2, 2011
Tuesday, March 1, 2011
What about the Children?
I am filling out my medical history for tomorrow's appointment. Fuck. This is so real. Medical conditions and illnesses; surgical histories; anesthesia history; medications and dosages; family history; social history; current bra and cup size...
One of my fears about this whole process is that I'll be somehow letting my children down and warping their own healthy body image. I remember when I first became self-conscious: I was in Kindergarten. My son is 4. My daughter is 1. I feel like it's "safe" to have the surgery right now but if I wait, I might totally fuck up their psyche.
------
My baby girl was was supposed to be named Anya. I still love that name. Anya. Anya Sophia. We were going to use the Russian spelling but I liked the Greek spelling Onya as well. We called her Anya for almost six months while she was in utero. It means "grace, favor" in Russian and "inexhaustible" in Sanskrit. When I was less than three weeks from the due date, I pulled the plug on a name I loved. Why? Because I know by age 12 she'll have a nice rack. Her 7th grade boobs will make college co-eds pissed that their Victoria's Secret miracle bra was a waste of money.
I could hear the cat calls of the future: Nice tits you got ANYA!
Some lanky limbed, sweaty boy with a whisper of a mustache, "I wanna get ON YA and fuck your tits."
She'll hear enough stupid comments about her budding breasts. I couldn't add to her adolescent misery by giving her a name that was the perfect fodder for asshole 14 year old boys. Fuck, for the asshole 45 year old guys who still think shit like that is funny even though you've got two half grown kids in tow (my mother was still receiving lewd comments about her tits in her early 50's from men her same age. I suppose I should be grateful I have good genes but enough already!).
I will feel like a successful mother if my daughter can make it through her teen years just liking her body. Of course I would rather she LOVE her body but even if she just LIKES it, I will consider that a success.
Like most mothers, I just want to do right by my kids. I try to walk the walk and show them how to love their body by loving my own. I don't call myself fat. I try to exercise and show them how important it is to get enough sleep, eat vegetables, and wash hands by doing the same things myself. What am I showing them by having plastic surgery?
My daughter is too young to be affected right now. My son is young enough and boys typically don't have the same body issues as girls. What if I wait a few more years? Am I more likely to impair my daughter's sense of self by having my breasts done when she's 5 or 8 or 12? Will my son be adversely affected?
Maybe this is a reason to have the surgery now: maybe I should have this surgery while my daughter is too young to internalize how she views her body. I don't want my decision to have plastic surgery to encourage my daughter to start a vicious cycle of self-loathing. She's too perfect and too beautiful just the way she is. She will have her own battles to face and enough nightmarish pubescent experiences without her mother adding to the mess.
One of my fears about this whole process is that I'll be somehow letting my children down and warping their own healthy body image. I remember when I first became self-conscious: I was in Kindergarten. My son is 4. My daughter is 1. I feel like it's "safe" to have the surgery right now but if I wait, I might totally fuck up their psyche.
------
My baby girl was was supposed to be named Anya. I still love that name. Anya. Anya Sophia. We were going to use the Russian spelling but I liked the Greek spelling Onya as well. We called her Anya for almost six months while she was in utero. It means "grace, favor" in Russian and "inexhaustible" in Sanskrit. When I was less than three weeks from the due date, I pulled the plug on a name I loved. Why? Because I know by age 12 she'll have a nice rack. Her 7th grade boobs will make college co-eds pissed that their Victoria's Secret miracle bra was a waste of money.
I could hear the cat calls of the future: Nice tits you got ANYA!
Some lanky limbed, sweaty boy with a whisper of a mustache, "I wanna get ON YA and fuck your tits."
She'll hear enough stupid comments about her budding breasts. I couldn't add to her adolescent misery by giving her a name that was the perfect fodder for asshole 14 year old boys. Fuck, for the asshole 45 year old guys who still think shit like that is funny even though you've got two half grown kids in tow (my mother was still receiving lewd comments about her tits in her early 50's from men her same age. I suppose I should be grateful I have good genes but enough already!).
I will feel like a successful mother if my daughter can make it through her teen years just liking her body. Of course I would rather she LOVE her body but even if she just LIKES it, I will consider that a success.
Like most mothers, I just want to do right by my kids. I try to walk the walk and show them how to love their body by loving my own. I don't call myself fat. I try to exercise and show them how important it is to get enough sleep, eat vegetables, and wash hands by doing the same things myself. What am I showing them by having plastic surgery?
My daughter is too young to be affected right now. My son is young enough and boys typically don't have the same body issues as girls. What if I wait a few more years? Am I more likely to impair my daughter's sense of self by having my breasts done when she's 5 or 8 or 12? Will my son be adversely affected?
Maybe this is a reason to have the surgery now: maybe I should have this surgery while my daughter is too young to internalize how she views her body. I don't want my decision to have plastic surgery to encourage my daughter to start a vicious cycle of self-loathing. She's too perfect and too beautiful just the way she is. She will have her own battles to face and enough nightmarish pubescent experiences without her mother adding to the mess.
The Surgeon Search
My first consultation is about 24 hours away. I don't know quite what to think about it. Excited anticipation and slight nervousness are the best descriptors at the moment. In many ways this might not be the best time to be considering such a drastic surgery but me being me, I have to constantly research something and this is the topic du jour. I am definitely in the information gathering stage. I suppose I could end up under the knife in two months but I'm not completely sold on the idea. This surgery is a quality of life decision and not an easy one.
It's much more difficult to find a plastic surgeon than I originally thought. My search wasn't a simple "San Diego Plastic Surgeon" google query. It took me several hours to whittle my list down to three surgeons. I'm not sure which website eventually lead me to The American Board of Plastic Surgery but that is where the search truly began.
Unfortunately you cannot search doctors by specialty. From a friend, I know that not all surgeons are created equal. Some do great tit work; others are known for their face work. Some surgeons have a passion for reconstructive surgery while other just do enhancements. If you're having your face done, you don't want the boob guy: you want the face guy. And of course, this is a two way street. My friend had her face done but she unknowingly went to the boob guy. She later discovered this from her hair stylist. These surgeons might KNOW all the procedures and yes, some might practice many, most, or all of them, but I want the surgeon who loves breasts - and not big, fake, scary boobies. I have until tomorrow morning to figure out how to question this professional to uncover just how much he loves boobs and how much care he'll put into reshaping mine.
So after I perused the A.B.P.S. website and picked out several names that sounded good (Dr. Wolf and Dr. Gold both had wonderful websites and their names seemed slightly Jewish), I called their offices. Neither take insurance. It must be awesome to be on a cash (or credit) option only basis with your patients - no insurance companies in contention with profits! Both of these doctors have websites with samples of their work on display and pictures of their spa-like offices. One of office was in La Jolla, the other in Rancho Bernardo.
[I must say I am grateful to live in Southern California while considering plastic surgery.]
Back to square one. I called my insurance. I found several names within my medical group and then crossed referenced them with A.B.P.S.. Unlike Wolf and Gold who both offer free consultations, the Scripps Group of plastic surgeons charge a $75 consultation fee. I haven't decided if this is good or bad. Fortunately for me, I have Cadillac insurance thanks to my husband's long years in graduate school and I just have to pay our standard co-pay.
Tomorrow's appointment is with Dr. S.. His picture reminds me of Dr. Janosz Poha from Ghostbusters 2 (actor: Peter MacNicol). Is that awful? He has the same lip bite thing going on and receding hairline. He was Chief of Plastic Surgery for several years. He's a Navy guy and I think that worries more than anything else. I don't need my ear sewn back on because it was blown off in combat - I want my tits done. What do Navy guys know about boobs other than they're awesome? Is he an artist with the scalpel? Will he do my ladies justice?
I also don't want to be sold on other... enhancements. I am going in for a breast reduction and don't want to be sold on the Mommy Makeover (breast reduction/lift and tummy tuck plus lipo, if "needed"). Maybe the benefit of the Scripps guy is that he won't need to sell me other... enhancements because he's more of the corporate type surgeon while the no-insurance-accepted surgeons may feel the need to enhance their revenue with extra procedures done at my expense.
It's much more difficult to find a plastic surgeon than I originally thought. My search wasn't a simple "San Diego Plastic Surgeon" google query. It took me several hours to whittle my list down to three surgeons. I'm not sure which website eventually lead me to The American Board of Plastic Surgery but that is where the search truly began.
Unfortunately you cannot search doctors by specialty. From a friend, I know that not all surgeons are created equal. Some do great tit work; others are known for their face work. Some surgeons have a passion for reconstructive surgery while other just do enhancements. If you're having your face done, you don't want the boob guy: you want the face guy. And of course, this is a two way street. My friend had her face done but she unknowingly went to the boob guy. She later discovered this from her hair stylist. These surgeons might KNOW all the procedures and yes, some might practice many, most, or all of them, but I want the surgeon who loves breasts - and not big, fake, scary boobies. I have until tomorrow morning to figure out how to question this professional to uncover just how much he loves boobs and how much care he'll put into reshaping mine.
So after I perused the A.B.P.S. website and picked out several names that sounded good (Dr. Wolf and Dr. Gold both had wonderful websites and their names seemed slightly Jewish), I called their offices. Neither take insurance. It must be awesome to be on a cash (or credit) option only basis with your patients - no insurance companies in contention with profits! Both of these doctors have websites with samples of their work on display and pictures of their spa-like offices. One of office was in La Jolla, the other in Rancho Bernardo.
[I must say I am grateful to live in Southern California while considering plastic surgery.]
Back to square one. I called my insurance. I found several names within my medical group and then crossed referenced them with A.B.P.S.. Unlike Wolf and Gold who both offer free consultations, the Scripps Group of plastic surgeons charge a $75 consultation fee. I haven't decided if this is good or bad. Fortunately for me, I have Cadillac insurance thanks to my husband's long years in graduate school and I just have to pay our standard co-pay.
Tomorrow's appointment is with Dr. S.. His picture reminds me of Dr. Janosz Poha from Ghostbusters 2 (actor: Peter MacNicol). Is that awful? He has the same lip bite thing going on and receding hairline. He was Chief of Plastic Surgery for several years. He's a Navy guy and I think that worries more than anything else. I don't need my ear sewn back on because it was blown off in combat - I want my tits done. What do Navy guys know about boobs other than they're awesome? Is he an artist with the scalpel? Will he do my ladies justice?
I also don't want to be sold on other... enhancements. I am going in for a breast reduction and don't want to be sold on the Mommy Makeover (breast reduction/lift and tummy tuck plus lipo, if "needed"). Maybe the benefit of the Scripps guy is that he won't need to sell me other... enhancements because he's more of the corporate type surgeon while the no-insurance-accepted surgeons may feel the need to enhance their revenue with extra procedures done at my expense.
Friday, February 25, 2011
Redemption & Betrayal
After loathing my body as a whole and my breasts in particular for over a decade, I fell pregnant in my mid-20's. My breasts swelled to an unmanageable size. Coupled with my enormous belly, I of course suffered some back pain and couldn't sleep most of my pregnancy. As this pregnancy was a "surprise" and my at-the-time fiance was in graduate school, I didn't have an extra $80 to buy a supportive bra that I would wear for maybe three months. I knew that my breasts would grow with my belly and expand even more after I eventually gave birth. I eked through my pregnancy with ill-fitting bras and clothes.
My birth was an utter failure. Being my first pregnancy, I conceived a wonderful birth plan that had me delivering in water at an off-site birth center. My son was 15 days late and my care was transferred over to a hospital where I was induced. Thirty hours after the induction, my cervix had opened to barely three centimeters and the baby's heart rate was starting to drop. I had a c-section. I cried. My birth was everything I did not want it to be. My body was the hospital's playground from the time I checked in until the surgeon sliced through my uterus. Everything that was supposed to be natural and wonderful about being pregnant, the birth and the the strength I thought I had within, didn't exist. The emotional trauma lasted several months postpartum and wasn't fully exorcised until I had my second baby three years later.
But my breasts, my wonderful breasts, redeemed my disaster of a birth. My newborn son latched onto my darkened nipple and began to suckle while in the recovery room. Nursing was so natural and so easy, that the experience brought a begrudging acceptance to my stretched marked body.
My oldest was exclusively breast fed until he was 16 months old. By then I longed for my body to be mine again. I wanted my breasts to resume their sexual status. It was difficult for me to let go of the instant comfort suckling brought my teary eyed boy when he fell or was frightened. My breasts were lovely, soft objects of comfort to the world's sweetest child. How could I hate my own body when it brought forth and sustained life? How could I hate my breasts which my son loved? My breasts were his direct line of comfort, love, and nourishment.
With my second pregnancy I knew what to expect of my body. I knew I would vomit for nine months and I knew I was not going to attempt a vaginal birth. My planned c-section was a wonderful experience and allowed me to fully heal from the trauma of my first birth. My absolute confidence in breast feeding allowed me to surprise the lactation consultant when I pumped an ounce of milky colostrum out of each breast only a day after delivering.
The pumping of breast milk continued when I was home. My freezer was proudly full of frozen breast milk. I had such an abundance of milk that I was considering selling it on the black market to the fetish community. However, when my daughter was only six weeks old, I developed a lump on the top of my right breast.
I watched this flat red bump swell over the next week until it was a large boil. Towards the end of the week I woke up at 3am in severe pain and drove myself to urgent care. The infection was lanced and pus removed. The doctors packed the wound and antibiotics prescribed. I was told to continue nursing and that it would assist in clearing my mastitis, a breast infection common in nursing mothers. Because the wound was so severe, I had to return to urgent care the following night to redress my wound.
By next night the infection had spread; red spider veins enveloped my entire right breast and it was hot to the touch. The doctors immediately put me on IV antibiotics and told me I had to stop nursing because the antibiotics were lethal to my newborn baby. I had to return to the urgent care for several nights to receive two hour IV doses of Vancomycin, a drug my husband studied in graduate school. My official diagnosis was MRSA - Methicillin-Resistant Staphylococcus Aureus. Mastitis is a common breast infection caused by Staphylococcus (staph) for nursing mothers; my common breast infection turned lethal because it was a MRSA strain of Staphylococcus.
While I was sick and under medical care for this virulent infection, I had to stop nursing. I pumped and dumped my precious breast milk for two weeks in hopes of keeping my milk supply up so I could resume breastfeeding after the infection was purged. My freezer supply lasted three days and a friend donated some of her breast milk but by day four we resorted to powdered formula.
The difference between bottle feeding and breastfeeding is never more extreme than at the 12am, 230am, and 5am feedings. To pick up your rustling baby, lift your shirt and latch her to the breast while laying down in your darkened room is easy. To pull yourself out of your bed, wander into the kitchen with its too bright lights and measure out a bottle while your baby's screams intensify is jarring and stressful. To add to the stress, my daughter was mostly breast fed, barely taking a bottle a day. As I coaxed the silicone nipple in her mouth, she waged war and fought for my nipple, my milk. I sobbed in the dark as I fed her from the bottle neither of us wanted.
This caused a disconnection in the bonding experience. I had what she wanted - my lovely, soft, milky breasts. She could smell my milk and I couldn't give it to her. I was terrified I'd pass the infection to her and in my extreme sleep deprived state, the thought she didn't love me because I stole my breasts from her plagued me. This notion that she didn't love me was exacerbated when her father, not me, received her first smile during my imposed nursing hiatus. I felt crushed and defeated. My formally redemptive breasts turned against me.
Eventually I was treated for postpartum anxiety. I believe that while I would have gone through an extreme version of the emotional and hormonal adjustment all new mothers undergo, my condition was worsened by my infection and not being able to nurse my baby. After I completed my course of antibiotics, I resumed breastfeeding but had to retrain my two month old daughter because she'd grown used to the bottle.
My breasts acted as redeemer for my first baby and potentially killed me the second time around. I was later told by my childrens' pediatrician that I was lucky I didn't lose my breast. The only permanent marking of my infection is a small, flesh colored disc that is barely half the size of a dime. A teeny scar for such an ordeal.
My birth was an utter failure. Being my first pregnancy, I conceived a wonderful birth plan that had me delivering in water at an off-site birth center. My son was 15 days late and my care was transferred over to a hospital where I was induced. Thirty hours after the induction, my cervix had opened to barely three centimeters and the baby's heart rate was starting to drop. I had a c-section. I cried. My birth was everything I did not want it to be. My body was the hospital's playground from the time I checked in until the surgeon sliced through my uterus. Everything that was supposed to be natural and wonderful about being pregnant, the birth and the the strength I thought I had within, didn't exist. The emotional trauma lasted several months postpartum and wasn't fully exorcised until I had my second baby three years later.
But my breasts, my wonderful breasts, redeemed my disaster of a birth. My newborn son latched onto my darkened nipple and began to suckle while in the recovery room. Nursing was so natural and so easy, that the experience brought a begrudging acceptance to my stretched marked body.
My oldest was exclusively breast fed until he was 16 months old. By then I longed for my body to be mine again. I wanted my breasts to resume their sexual status. It was difficult for me to let go of the instant comfort suckling brought my teary eyed boy when he fell or was frightened. My breasts were lovely, soft objects of comfort to the world's sweetest child. How could I hate my own body when it brought forth and sustained life? How could I hate my breasts which my son loved? My breasts were his direct line of comfort, love, and nourishment.
With my second pregnancy I knew what to expect of my body. I knew I would vomit for nine months and I knew I was not going to attempt a vaginal birth. My planned c-section was a wonderful experience and allowed me to fully heal from the trauma of my first birth. My absolute confidence in breast feeding allowed me to surprise the lactation consultant when I pumped an ounce of milky colostrum out of each breast only a day after delivering.
The pumping of breast milk continued when I was home. My freezer was proudly full of frozen breast milk. I had such an abundance of milk that I was considering selling it on the black market to the fetish community. However, when my daughter was only six weeks old, I developed a lump on the top of my right breast.
I watched this flat red bump swell over the next week until it was a large boil. Towards the end of the week I woke up at 3am in severe pain and drove myself to urgent care. The infection was lanced and pus removed. The doctors packed the wound and antibiotics prescribed. I was told to continue nursing and that it would assist in clearing my mastitis, a breast infection common in nursing mothers. Because the wound was so severe, I had to return to urgent care the following night to redress my wound.
By next night the infection had spread; red spider veins enveloped my entire right breast and it was hot to the touch. The doctors immediately put me on IV antibiotics and told me I had to stop nursing because the antibiotics were lethal to my newborn baby. I had to return to the urgent care for several nights to receive two hour IV doses of Vancomycin, a drug my husband studied in graduate school. My official diagnosis was MRSA - Methicillin-Resistant Staphylococcus Aureus. Mastitis is a common breast infection caused by Staphylococcus (staph) for nursing mothers; my common breast infection turned lethal because it was a MRSA strain of Staphylococcus.
While I was sick and under medical care for this virulent infection, I had to stop nursing. I pumped and dumped my precious breast milk for two weeks in hopes of keeping my milk supply up so I could resume breastfeeding after the infection was purged. My freezer supply lasted three days and a friend donated some of her breast milk but by day four we resorted to powdered formula.
The difference between bottle feeding and breastfeeding is never more extreme than at the 12am, 230am, and 5am feedings. To pick up your rustling baby, lift your shirt and latch her to the breast while laying down in your darkened room is easy. To pull yourself out of your bed, wander into the kitchen with its too bright lights and measure out a bottle while your baby's screams intensify is jarring and stressful. To add to the stress, my daughter was mostly breast fed, barely taking a bottle a day. As I coaxed the silicone nipple in her mouth, she waged war and fought for my nipple, my milk. I sobbed in the dark as I fed her from the bottle neither of us wanted.
This caused a disconnection in the bonding experience. I had what she wanted - my lovely, soft, milky breasts. She could smell my milk and I couldn't give it to her. I was terrified I'd pass the infection to her and in my extreme sleep deprived state, the thought she didn't love me because I stole my breasts from her plagued me. This notion that she didn't love me was exacerbated when her father, not me, received her first smile during my imposed nursing hiatus. I felt crushed and defeated. My formally redemptive breasts turned against me.
Eventually I was treated for postpartum anxiety. I believe that while I would have gone through an extreme version of the emotional and hormonal adjustment all new mothers undergo, my condition was worsened by my infection and not being able to nurse my baby. After I completed my course of antibiotics, I resumed breastfeeding but had to retrain my two month old daughter because she'd grown used to the bottle.
My breasts acted as redeemer for my first baby and potentially killed me the second time around. I was later told by my childrens' pediatrician that I was lucky I didn't lose my breast. The only permanent marking of my infection is a small, flesh colored disc that is barely half the size of a dime. A teeny scar for such an ordeal.
Tuesday, February 22, 2011
How to Calculate your New Breast Size - the Insurance Way!!! and other Fears
I've never been one to worry too much about scars. I think of them like tattoos - they tell interesting stories. If I go through with the reduction there will be extensive scarring. The most common procedure leaves the Anchor Scar. A surgeon cuts around the areola and removes the nipple. An incision is then made underneth the breast where the breast meets the chest. It's almost like a smile is cut into the tissue. From the hole where the nipple used to be, two incisions are made down to the "smile" creating a keyhole effect. Skin and breast tissue are removed and then nipple is repositioned higher on the breast. The two vertical incisions are sewn together and the "smile" is stitched back up. The resulting scar looks like an anchor and goes around the new (often smaller) areola, straight down to the "smile" and then all along the "smile."
It freaks me out a little. There are a few other techniques that produce a little less scarring but I don't know what procedure will be best for me. I also am not sure what my insurance company will require.
The general guideline for some insurance companies is to simply remove 500 cc's from each breast. Other insurance companies use the Schnur Sliding Scale. With the Schnur Scale, you have to calculate your Body Surface Area (BSA) and then it's determined how many cc's need to be removed from each breast from the Schnur Sliding Scale. If you want to find out how much breast tissue you're eligible to have removed, just click on the links above.
I've been playing with the BSA calculator, adding or subtracting an inch from my height (a shorter person gets a lower BSA) and playing with the difference of 5, 10, and 20 pounds. Right now I have a BSA of 1.94. According to the Schnur Scale, that means the insurance company would require 575 cc's removed from each breast. If I lost 20 pounds, my BSA would be 1.82 and the minimum amount of tissue removed from each breast must total approximently 460cc's.
To give you an idea of what all this means, a cup size is 150-200cc's. The cc to cup size ratio varies between women because some women have dense breasts while others have fatty breasts. I have no idea if I have fatty or dense breasts. Because fat weighs less than dense material, and cc's are a weight not a volume measurement, if I have fatty breasts, they will end up very, very teeny.
So if my insurance company uses the Schnur Sliding Scale, and using my current BSA, I could be required to have a minimum of 575 cc's removed from each breast. This could mean going from a 34F to a 34D -or- from a 34F to a 34B. This would give me my 7th grade boobs. I'm not in 7th grade. Don't get me wrong, I want smaller tits but I don't think I could handle B cup especially not after having so much cleavage for so long.
I have two main fears with a breast reduction surgery: ending up with a teeny B cup and not being at all proportionate; and there's this awful (to me) scar hazard called "dog ears." From what I understand, a dog ear is where the "smile" scar digs into to your flesh under your arm pit and pinches out a flap of skin. I can handle smooth scars but they have to be smooth. I could not handle a fucking flap of skin under my arm pit.
I have a few other reservations as well. Going into surgery itself is a little scary. There's always a risk of death. It's not like I'd be having a cancerous tumor removed; this isn't a life saving surgery. The recovery is rough. You cannot wash your own hair for two weeks because you aren't supposed to lift lift your arms above your head for fear of splitting a stitch. I have two little children. How could I not pick them up? I'm also wary of contracting MRSA or the much more terrifying VRSA. I don't want to end up dead because of my horribly inconvenient breasts.
Then again, it would be awesome not to have to modify yoga positions because I can't put my chest on my knee. Or it would be rad to sit up straight for extended amounts of time without back pain. It would be awesome to go into Target and buy a super cute $16 bra instead of being fitted at Macy's or Nordstrom's for a fucking ugly ass piece of beige fabric that still doesn't fit me quite right. It would be amazing to run with my kids in the park without clutching my flopping tits. I would love to know if my shoulder grooves would actually go away. It would be awesome to not have to put deodorant under my boobs during the summer to ward off the embarrassment of breaking out under these enormous hunks of flesh. It would be fun to go clothes shopping and try on clothes in styles that have been off limits because of my stupid ridiculous bra size.
Last night I asked my very supportive husband if I'm ready to have this surgery. He said, "If you have to ask, then you're probably not ready." I just don't know. I want it so badly but I have valid fears. Only eight more days until I meet with the first surgeon.
It freaks me out a little. There are a few other techniques that produce a little less scarring but I don't know what procedure will be best for me. I also am not sure what my insurance company will require.
The general guideline for some insurance companies is to simply remove 500 cc's from each breast. Other insurance companies use the Schnur Sliding Scale. With the Schnur Scale, you have to calculate your Body Surface Area (BSA) and then it's determined how many cc's need to be removed from each breast from the Schnur Sliding Scale. If you want to find out how much breast tissue you're eligible to have removed, just click on the links above.
I've been playing with the BSA calculator, adding or subtracting an inch from my height (a shorter person gets a lower BSA) and playing with the difference of 5, 10, and 20 pounds. Right now I have a BSA of 1.94. According to the Schnur Scale, that means the insurance company would require 575 cc's removed from each breast. If I lost 20 pounds, my BSA would be 1.82 and the minimum amount of tissue removed from each breast must total approximently 460cc's.
To give you an idea of what all this means, a cup size is 150-200cc's. The cc to cup size ratio varies between women because some women have dense breasts while others have fatty breasts. I have no idea if I have fatty or dense breasts. Because fat weighs less than dense material, and cc's are a weight not a volume measurement, if I have fatty breasts, they will end up very, very teeny.
So if my insurance company uses the Schnur Sliding Scale, and using my current BSA, I could be required to have a minimum of 575 cc's removed from each breast. This could mean going from a 34F to a 34D -or- from a 34F to a 34B. This would give me my 7th grade boobs. I'm not in 7th grade. Don't get me wrong, I want smaller tits but I don't think I could handle B cup especially not after having so much cleavage for so long.
I have two main fears with a breast reduction surgery: ending up with a teeny B cup and not being at all proportionate; and there's this awful (to me) scar hazard called "dog ears." From what I understand, a dog ear is where the "smile" scar digs into to your flesh under your arm pit and pinches out a flap of skin. I can handle smooth scars but they have to be smooth. I could not handle a fucking flap of skin under my arm pit.
I have a few other reservations as well. Going into surgery itself is a little scary. There's always a risk of death. It's not like I'd be having a cancerous tumor removed; this isn't a life saving surgery. The recovery is rough. You cannot wash your own hair for two weeks because you aren't supposed to lift lift your arms above your head for fear of splitting a stitch. I have two little children. How could I not pick them up? I'm also wary of contracting MRSA or the much more terrifying VRSA. I don't want to end up dead because of my horribly inconvenient breasts.
Then again, it would be awesome not to have to modify yoga positions because I can't put my chest on my knee. Or it would be rad to sit up straight for extended amounts of time without back pain. It would be awesome to go into Target and buy a super cute $16 bra instead of being fitted at Macy's or Nordstrom's for a fucking ugly ass piece of beige fabric that still doesn't fit me quite right. It would be amazing to run with my kids in the park without clutching my flopping tits. I would love to know if my shoulder grooves would actually go away. It would be awesome to not have to put deodorant under my boobs during the summer to ward off the embarrassment of breaking out under these enormous hunks of flesh. It would be fun to go clothes shopping and try on clothes in styles that have been off limits because of my stupid ridiculous bra size.
Last night I asked my very supportive husband if I'm ready to have this surgery. He said, "If you have to ask, then you're probably not ready." I just don't know. I want it so badly but I have valid fears. Only eight more days until I meet with the first surgeon.
Monday, February 21, 2011
Gym Time!
I went to the gym this morning. I wore a pink sports bra that is too small (in effort to really squish the boobies in place) and then wore a workout top with a built in sports bra over it. Both bras are racer back style and dig into the base of my neck because of the weight of my bodacious ta-tas. My breasts looked nice and plump and I looked like I should have been working out in Pacific Beach or Jersey Shore - not my sleepy neighborhood gym half filled with retirees.
The elliptical posed my first activity of the day. This machine tends to be a bit easier on the boobage because there is no direct bouncing - my feet stay on the pedals the entire time. With my heightened sense of everything boobs, I looked down to stare at my cleavage several times. Even on the smooth elliptical and harnessed into not one but two sports bras, the girls still bounced. This is why I don't run. The pounding motion on a treadmill creates an awful pulling sensation as my breasts rise and fall with each step. I can actually feel the tissue inside my breasts breaking down creating even more sagging. Because I am used to my low physical activity level, I wonder if I would ever actually consider doing something as far reaching as a half marathon if my breasts weren't so bothersome.
After the cardio warm up, I got to focus on strength training which is what I've been looking forward to since Saturday. My husband is teaching me how to lift weights. I love dropping the kids off in the gym daycare and having a work out date. Today we lifted back and biceps (Saturday was chest and triceps). As I lift and pull on these machines, some of the exercises are definitely more difficult because of my breasts. Today we did a lat pull exercise that works the upper back. The motion is similar to a reverse pull up and involves sitting down on a bench, taking a bar and pulling it down to your chest. With my over sized mammaries, I have to alter the pull down motion to avoid slamming the bar into my tits.
With my new interest (and membership) in the gym, I can't help but think that maybe if I exercise enough and build up my muscles, especially those in my back and chest, that maybe my boobs will get a little lift, might shrink, or maybe I'll just have the muscles to be able to support my frame. Maybe I wouldn't need a breast reduction after all. Then again, if I want to have some serious fitness goals - like a half marathon - I can't have breasts like these.
The elliptical posed my first activity of the day. This machine tends to be a bit easier on the boobage because there is no direct bouncing - my feet stay on the pedals the entire time. With my heightened sense of everything boobs, I looked down to stare at my cleavage several times. Even on the smooth elliptical and harnessed into not one but two sports bras, the girls still bounced. This is why I don't run. The pounding motion on a treadmill creates an awful pulling sensation as my breasts rise and fall with each step. I can actually feel the tissue inside my breasts breaking down creating even more sagging. Because I am used to my low physical activity level, I wonder if I would ever actually consider doing something as far reaching as a half marathon if my breasts weren't so bothersome.
After the cardio warm up, I got to focus on strength training which is what I've been looking forward to since Saturday. My husband is teaching me how to lift weights. I love dropping the kids off in the gym daycare and having a work out date. Today we lifted back and biceps (Saturday was chest and triceps). As I lift and pull on these machines, some of the exercises are definitely more difficult because of my breasts. Today we did a lat pull exercise that works the upper back. The motion is similar to a reverse pull up and involves sitting down on a bench, taking a bar and pulling it down to your chest. With my over sized mammaries, I have to alter the pull down motion to avoid slamming the bar into my tits.
With my new interest (and membership) in the gym, I can't help but think that maybe if I exercise enough and build up my muscles, especially those in my back and chest, that maybe my boobs will get a little lift, might shrink, or maybe I'll just have the muscles to be able to support my frame. Maybe I wouldn't need a breast reduction after all. Then again, if I want to have some serious fitness goals - like a half marathon - I can't have breasts like these.
Sunday, February 20, 2011
28AAA
This is the story of my breasts. My wonderful, horrible lumps of flesh that have tantalized and tortured, nurtured and embarrassed. I have a complicated history with my boobs. They started to grow when I was just 9 years old. My first bra was purchased at the Macy's in Union Square in San Francisco. I was much more excited about riding in a taxi for the first time (and bitterly disappointed it was a yellow station wagon and not a classic yellow cab).
But that's when my complicated relationship with my breasts began. When they became more than just... well, when they just became.
I remember what I wore on that autumn day. It was my favorite dress - a stone washed denim dress with silver buttons that cut cross the left of my chest and then back down to my navel. It was 1989, after all. My long hair was in scrunchie (side pony tail, of course) and I was going shopping with my mom in San Francisco. It was one of the last family weekends we had (funny, how I remember this now as I type - my parents had been divorced for 3 years but there we were, away for the weekend together).
I was fitted for a bra by an actual bra lady not just my mom. We were on one of the top floors in Macy's. I felt incredibly grown up. I felt like I was in a movie - glamorous at age nine. We settled on a white cotton bra, no underwire, just thin white cotton triangular cups. Size: 28AAA. I was thrilled to have a bra and I remember once we got back to the hotel room, showing my poor Dad my bra strap by pulling my dress collar off to the side. I wore the bra out to dinner that night. We ate Italian.
Once the weekend ended and we were home, I remember not having to wear my bra absolutely every day. It was just for fun at that point. It was definitely NOT the most comfortable thing to wear. It itched. It was hot. It bunched up.
And then I was in the 6th grade. Oh, I had boobs. I definitely had boobs and HAD to wear a bra. I think I might have only been a 32A at that point and in 7th grade I leaped to a 34B. I had the cutest bras in the 7th grade. Pink ones, blue ones, patterns like you wouldn't believe. I loved my bras. My mom and I bought them at Ross. My breasts were awesome. I had them! I wore bodysuits and BONGO jeans. I felt totally cute while my sexuality awakened.
And then it woke up. In the 8th grade I filled out even more... By now I was a 34C. My mom mandated underwire bras. As only hindsight can express, I had a wonderful body - too bad my 13 and 14 year old self was beyond self-conscious. I was 5'7", 135 pounds and wore a 34C cup. I was a woman - in junior high. My girlfriends were barely 5'2" and 110 pounds. Some hadn't even crossed over the 100 pound (or five foot) mark yet. I felt obese. I weighed 20 pounds more than any of my friends. I had moved past the cute B boobs of the 7th grade to the slightly grotesque mongo C tits of the 8th grade. The only girl with bigger boobs than me was Hope: the incredibly fat white girl with greasy brown hair who rode the same bus as me. In her desperation to flirt, she took off her bra on the bus to prove she wore a 38D cup. The tag was faded and dirty and no one wanted to touch her brassiere.
During this same period, I was whistled at for the first time. I was 12. I thought they were whistling at my mother. We were walking back to the car after grocery shopping. I was incredibly embarrassed yet secretly pleased. I didn't know what to do with myself. Should I look at the guys? Look at the ground? Was I supposed to be offended? It felt good to be considered attractive but I was clueless how to respond.
I also had no idea how to respond to my boobs first nicknames. The oh-so-clever moniker's Bill & Ted were thrust upon my bosom. Bill & Ted became my foes for P.E. class.
Starting in 7th grade we had to "dress down" for P.E. in the incredibly unattractive uniform of kelly green sweat shorts and a cotton t-shirt. Having a C cup meant having to clutch my boobs when I did jumping jacks or ran. I made up every excuse I could think of to get out of P.E. or I would revolt and simply walk instead of run. When I outgrew my awesome and darling 34B bras, I gave them to a girl in my P.E. class. One of the bras had polka dots. I would totally wear that bra today if I could. It was super cute.
------------
So two days ago I called three plastic surgeons to set up consultations for a breast reduction. Only one of the three takes insurance. I meet with Dr. Schneider on March 2. I'm a little nervous. I'm not sure if I'm ready to say good bye to the girls. They've been with me for so long... I used to really hate them but after nursing two children, I have a healthy respect for them and I don't hate them anymore.
This blog is the story of my breasts. I'm not sure when or where it will end. My boobs have been my friend and they have absolutely been my enemy. We've called an emotional truce for the most part but there hasn't been a physical truce. My upper back aches so much that I take ibuprofen almost every night to sleep; I have permanent grooves in my shoulders from bra straps; I am unable to purchase bras in my correct size (I think I'm a 35F or G and I'm stuck wearing a 36DDD because it's the closest, most affordable option); in hot weather I have to apply antiperspirant under my breasts to avoid breakouts and rashes; I still cannot run or do any vigorous activity because the only sports bra that MIGHT work on my is a $90 contraption that has to be special ordered from one magazine and I doubt it will work as advertised; my posture is atrocious; most clothing doesn't fit me properly.
I've had these complaints for over a decade and I am now ready to explore a breast reduction as more than just fantasy. I'm just not sure if I'm ready to take the scalpel. My breasts have been mine, for better or worse, for over twenty years. No matter when I finally do it (this year or in four, as my original plan), I will mourn the loss of my girls.
But that's when my complicated relationship with my breasts began. When they became more than just... well, when they just became.
I remember what I wore on that autumn day. It was my favorite dress - a stone washed denim dress with silver buttons that cut cross the left of my chest and then back down to my navel. It was 1989, after all. My long hair was in scrunchie (side pony tail, of course) and I was going shopping with my mom in San Francisco. It was one of the last family weekends we had (funny, how I remember this now as I type - my parents had been divorced for 3 years but there we were, away for the weekend together).
I was fitted for a bra by an actual bra lady not just my mom. We were on one of the top floors in Macy's. I felt incredibly grown up. I felt like I was in a movie - glamorous at age nine. We settled on a white cotton bra, no underwire, just thin white cotton triangular cups. Size: 28AAA. I was thrilled to have a bra and I remember once we got back to the hotel room, showing my poor Dad my bra strap by pulling my dress collar off to the side. I wore the bra out to dinner that night. We ate Italian.
Once the weekend ended and we were home, I remember not having to wear my bra absolutely every day. It was just for fun at that point. It was definitely NOT the most comfortable thing to wear. It itched. It was hot. It bunched up.
And then I was in the 6th grade. Oh, I had boobs. I definitely had boobs and HAD to wear a bra. I think I might have only been a 32A at that point and in 7th grade I leaped to a 34B. I had the cutest bras in the 7th grade. Pink ones, blue ones, patterns like you wouldn't believe. I loved my bras. My mom and I bought them at Ross. My breasts were awesome. I had them! I wore bodysuits and BONGO jeans. I felt totally cute while my sexuality awakened.
And then it woke up. In the 8th grade I filled out even more... By now I was a 34C. My mom mandated underwire bras. As only hindsight can express, I had a wonderful body - too bad my 13 and 14 year old self was beyond self-conscious. I was 5'7", 135 pounds and wore a 34C cup. I was a woman - in junior high. My girlfriends were barely 5'2" and 110 pounds. Some hadn't even crossed over the 100 pound (or five foot) mark yet. I felt obese. I weighed 20 pounds more than any of my friends. I had moved past the cute B boobs of the 7th grade to the slightly grotesque mongo C tits of the 8th grade. The only girl with bigger boobs than me was Hope: the incredibly fat white girl with greasy brown hair who rode the same bus as me. In her desperation to flirt, she took off her bra on the bus to prove she wore a 38D cup. The tag was faded and dirty and no one wanted to touch her brassiere.
During this same period, I was whistled at for the first time. I was 12. I thought they were whistling at my mother. We were walking back to the car after grocery shopping. I was incredibly embarrassed yet secretly pleased. I didn't know what to do with myself. Should I look at the guys? Look at the ground? Was I supposed to be offended? It felt good to be considered attractive but I was clueless how to respond.
I also had no idea how to respond to my boobs first nicknames. The oh-so-clever moniker's Bill & Ted were thrust upon my bosom. Bill & Ted became my foes for P.E. class.
Starting in 7th grade we had to "dress down" for P.E. in the incredibly unattractive uniform of kelly green sweat shorts and a cotton t-shirt. Having a C cup meant having to clutch my boobs when I did jumping jacks or ran. I made up every excuse I could think of to get out of P.E. or I would revolt and simply walk instead of run. When I outgrew my awesome and darling 34B bras, I gave them to a girl in my P.E. class. One of the bras had polka dots. I would totally wear that bra today if I could. It was super cute.
------------
So two days ago I called three plastic surgeons to set up consultations for a breast reduction. Only one of the three takes insurance. I meet with Dr. Schneider on March 2. I'm a little nervous. I'm not sure if I'm ready to say good bye to the girls. They've been with me for so long... I used to really hate them but after nursing two children, I have a healthy respect for them and I don't hate them anymore.
This blog is the story of my breasts. I'm not sure when or where it will end. My boobs have been my friend and they have absolutely been my enemy. We've called an emotional truce for the most part but there hasn't been a physical truce. My upper back aches so much that I take ibuprofen almost every night to sleep; I have permanent grooves in my shoulders from bra straps; I am unable to purchase bras in my correct size (I think I'm a 35F or G and I'm stuck wearing a 36DDD because it's the closest, most affordable option); in hot weather I have to apply antiperspirant under my breasts to avoid breakouts and rashes; I still cannot run or do any vigorous activity because the only sports bra that MIGHT work on my is a $90 contraption that has to be special ordered from one magazine and I doubt it will work as advertised; my posture is atrocious; most clothing doesn't fit me properly.
I've had these complaints for over a decade and I am now ready to explore a breast reduction as more than just fantasy. I'm just not sure if I'm ready to take the scalpel. My breasts have been mine, for better or worse, for over twenty years. No matter when I finally do it (this year or in four, as my original plan), I will mourn the loss of my girls.
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