I wasn't eager to see my body post-surgery. I knew that the scars would be red and raw. I expected that there would be bruising and swelling. Intellectually, I knew that all of those indications of trauma would fade over time. Emotionally, I had no idea how I would react to seeing my new body.
I had three pregnancies and deliveries without a caesarian section, but now I would have a c-section scar. My breasts, which fed all three babies effortlessly and then surprisingly reverted to their original size and shape, were unlikely to look the same. My reconstructive surgeon, Dr. Piper, was honest in telling me that I should expect twelve (12) months for my body to settle into its new shape. I figured, what's the rush to take a peak?
Additionally, post-surgery, I was well-covered in bandages and gauze. The nurses would check the pulse of the flaps from my abdomen every hour in the ICU and every two hours when I moved to general adult surgery. They could do this without me seeing my body. Even the mandatory shower that constituted my get-out-of-hospital card didn't require me to look in the mirror and see what my gifted surgeon had done.
So I waited.
I wanted to know if I would remember my former body when I saw this new version. Seeing the latest version might prompt grief or relief. I was balancing fear and curiosity. For at least a week, fear won.
My body has changed throughout my life. I was a high school gymnast and sprinter with powerful legs. In my twenties, I was petite but muscular. In my thirties, I created three incredible people and marveled at what my body morphed into with each pregnancy. In my forties, I fought the belly pooch and battled with my body and weight changes despite my exercise regimen. So here I am in my fifties, and hopefully, I will have flatter abs than I have had in years and perky boobs.
After seven days, curiosity won out, and I stared into a mirror to inspect this new body. I felt like an explorer or scientist examining a specimen, but the specimen was me. The scars didn't look too bad. My breasts were broader than previously, and the nipples were not pointing in quite the same direction. The bottom half of my abdomen was flat and tight. There was a prominent bulge between my breasts and my new belly button. My surgeon did great work on that belly button.
The bulge didn't flatten, and when I saw my surgeon at six weeks, she agreed that my upper abdomen shouldn't look like that. Ideas:
Separation of the abdominal muscles from pregnancy
Extra weight - particularly visceral fat (the fat that surrounds the organs)
A hernia?
Something else
I was confident that my abdominal muscles had not separated since my children were grown, and this was the first time I had an abdominal bulge. The doctor examined me for a hernia and didn't find anything. I inquired if the massive kidney cysts might be causing the bulge. My visit to the urologist confirmed they were vast and harmless, except that I had an upper abdominal bulge.
My sister and her husband own an impressive fitness facility and offered to measure my visceral fat. It was higher than it should be, and losing weight was the only way to lose it. My sister provided guidance and consulted with one of their nutritionists to re-engineer my diet to lose weight. Middle age is not kind to women who want to lose 10-15 pounds.
While I accept that I need to lose a few pounds to flatten the bulge, it was too prominent after the surgery for weight alone. I hadn't gained weight during chemo, and I didn't have that notable of a bulge before surgery.
My thesis was that the DIEP restricted the distribution of my abdominal organs away from my lower abs, and my rib cage restricted distribution upwards, leaving my 5'2" body with no space for massive kidney cysts.
My urologist offered to aspirate the cysts so we could determine if eliminating their contents impacted the abdominal bulge. When he aspirated the left cyst, he drained 1.15 liters of fluid. And the bulge materially reduced. A few weeks later, he drained the right cyst of 300 ml of liquid. We are curious to know if the fluid is gone for good, and we'll check in six months to see if they are refilling. If they are, I'll ultimately need surgery to drain and cauterize those cysts so that they're permanently empty.
Getting to know my new body turned out to be interesting and didn't trigger additional grief. I appreciate the incredible work of my surgical team. My clothing still fits properly. My revision surgery will fix things that don't settle "quite right," I feel confident that the final result will be attractive and familiar to me. My husband likes this new, upgraded body as much as the old one. My new breasts cannot kill me. My abdomen will be flat enough for me. Joelle 2.0 is alright.