The bras I wore before surgery.

One of the bras I wear now.

The typical candidate for breast reduction surgery: overly large, pendulous breasts, grooves in the shoulders, and so on. They can't show the amount of pain she's in, unfortunately.

A "keyhole" breast reduction procedure: breast tissue is removed from the bottom half of the breast. The nipple is raised and repositioned. Sometimes it is removed; sometimes it remains attached to a pedicle of breast tissue so that it can maintain its blood supply.

Once the tissue is removed, the breasts are closed along the dotted lines like so. Sometimes the tissue can sag on either side of the vertical incision, causing a "boxy" look to the breasts.

Over time, scars will appear, thicken, and then slowly fade. Surgeons try to hide the scars as best they can - which is why they don't do much to the top half of the breast.

It's amazing how your life can totally turn upside down in the course of a couple of hours.

They just called me at about 2:45 today, and now I'm having surgery in a little more than a week.

Kaiser San Rafael has two waiting lists for breast reduction surgery: the regular waiting list, which at last count was about a two-year wait, and the "short notice" list. What that means is, when someone cancels, they start calling people on the "short notice" list to see if they can take the cancellation's place. If you're on the regular list, you get 6 weeks' notice, time to plan, all that kind of thing.

I'm lucky that I had more than a week's notice. They called me today, a Wednesday, to ask if I could do it a week from Friday. I never thought I would be able to get this much advance notice, but I'm glad because it means I can do it.

When they first asked me, I said no. That was my gut reaction. I can't do anything Fridays because work is so hectic with trying to get the paper done, so my automatic response is that I can't do something on a Friday. But then I got off the phone and realized that of COURSE I could do it. I called them back, hands shaking, and said that I wanted the appointment.

Of course, the first person I told was Devin, in part because I needed to make sure he could give me a ride to and from the hospital. He's with a new job so we didn't know for sure. He got approval to work from home, which will work for us, Friday and Monday. I don't know how long it will be before I'm able to be up and around after the surgery. Some say 24 hours, some say longer.

I told my brother second, because I was freaking out and Devin kept having to go back and forth from chatting with me and doing his work. He listened to me for a little bit, which helped me calm down.

I told Kaiser it was tentative because I still hadn't asked if I could get the time off. I remembered that of course this is a medical reason and that it's not like I'm taking a week of suddenly to go to Hawaii or something. After I let my first wave of panic subside, I called my boss and asked if I could have the 6th off as well as the following week, and he said he'd find a way to make it work out. He said one should always take opportunities like these if you're waiting for something, and that I should do it now so I can be healed up before summertime. It's cool that he was so understanding about that - but I had a feeling he would be.

So then I called Kaiser back and told them I wanted to take the appointment. Between now and then I have to see a nurse and then a doctor. I think I have go through a complete physical checkup, and then discuss with the surgeon exactly what she's going to do, how much to take off, all of that stuff. They wanted to try and get me to see them both at once, but I could only do that at 8:30 on Friday morning. Again with the Friday. I asked if there were other opportunities, so I'm seeing the nurse on Tuesday and the surgeon on Wednesday. In the meantime I can't take any aspirin or motrin, probably either because it thins the blood or it might have some reaction with the anesthesia, and I can't have vitamin E, because it will reduce my skin's ability to heal post-op. I can have tylenol, though, if I need it between now and the surgery.

I have so many thoughts in my head. I'm trying to remember everything they told us when I went to Kaiser for their breast-reduction workshop last February. There were about 15 women, all in various stages of breast-largesse, all desparate to have the surgery. I remember things like how I can't have a shower for three days because of the stitches, how they have to install a drain to keep the wounds from getting infected, how I'm supposed to wear an ace bandage around my chest for like a month. They said something about my not being able to drive for a week or so after, but that's probably okay. It's all stuff I knew before, and it's all stuff that they'll tell me again before the 6th. But it's kind of like walking around in a dream right now. Everything's hazy.

Of course, my back is killing me today. I guess that makes the decision a little easier.

I am also thinking about, of all things, my nipples; will they have to remove and reattach them? Probably. What about other things? I've only been under general anasthesia once, when I was 15 and having my wisdom teeth out. I was in better physical shape then. Is there anything I can do in a week's time to make myself more physically ready for this surgery? I'm sure lots of women older than I am have done it successfully, even overweight. I should be okay. My heart's healthy. I think.

Will I have to stay overnight in the hospital? They told us that this is done on an outpatient basis, so I'll probably go home Friday evening after I wake up and everything. Unless there are complications, of course. Which, hopefully, there won't be. I hate hospitals.

I wonder what it will feel like? I know that everything will hurt a lot right after surgery and probably for a couple of weeks after, as things begin to heal. But right away I should notice a significant lack of weight on my chest, which I have been dying to feel for years. My breasts weigh something like 5 to 8 lbs. each. They're HEAVY - and cause everything from upper back aches to migrainelike headaches.

I'm worried I won't be able to fall asleep on my back, which I'll have to do until my breasts heal. I worry too much probably. :) There are so many complicating factors, and this isn't even major surgery in the sense that they're not working on my internal organs or anything like that. It's just a couple of hours on the operating table. It should be fine.

So why am I so nervous?

The orientation, which I mentioned earlier, is coming back to me a bit at a time. I remember they took a picture of my breasts, measured them around the middle and from armpit to nipple. They were checking us out to see if we would qualify. "You definitely qualify," the surgeon told me. At Kaiser in Sacramento, they have stricter rules, including that you can't be more than about 20 percent over your ideal body weight. No ifs, ands or buts. No matter that it's hard to be trim and fit when you've got 15 pounds of breast on your front. You can't run or ride horses or do anything that involves a lot of jumping up and down, that's for sure. (I for one am looking forward to jumping up and down, and wearing empire-waist dresses, and lots of other things).

They asked things like: what size cup would we like to be after the surgery? They tell you to go to clothing shops and look at the bra sizes to see what might fit you best. I remember when I went to see another surgeon, many years, he said he'd make me a B cup, which sounds good to me. Just enough there to have something, but not like it is now. My best friend was surprised that you could make such a drastic change. "They'll let you drop down that much?" She said. But it's about getting you to a comfortable and natural breast size. It's not cosmetic. You can choose your size to some extent, but you do have to lose at least 1 kg. of breast on each side, if I remember correctly.

I think they told us a lot of frightening things in that orientation because they know if you're not willing to risk the possibility of never feeling your nipples again, or breastfeeding, then you should know that up front and not have the surgery. I don't think it scared many of those women away. They also tried to make jokes to ligten the mood, like about the Ace bandage: "Your first halter top!"

Another thing they tell you is that of all the reconstructive and plastic surgeries out there, this one has the highest rate of satisfaction. You feel better almost immediately, and most women are thrilled that they had it done. It's stuff like this that really makes me glad I finally decided to do it.

I sent out an email to some friends and my family letting them know about the surgery. I'm not telling a whole lot of people just now - I mean, it's going to be obvious soon enough anyway. But I did tell people that they could ask me questions if they wanted to.

Last night, Devin said, "Congratulations - you out-waited Kaiser's waiting list." Koba said congrats too, as did my brother. Damian said "Kickass!" instead. It's nice to have all this support. I'm glad I told the people I did tell.

Damian started asking me questions right off about how the surgery works and everything. He wanted to know if the stuff inside breasts is "like pudding." Eric wanted to know what size I wanted to be, and then bickered with me for a while about his thoughts on what size would "look right." He meant this in a friendly way. My favorite thing he said was, "Nobody will recognize you anymore. :-)"

My dad took it well, too. He offered to drive me around if I need, or to let me stay with him up in Healdsburg if I need some full-time care. I think it'll be okay, and I told him as much, but it's nice to know I have the option if things get weird.

I was telling Eric I thought I'd like to be a B or a C cup. Thinking back, I hardly remember being a B or a C cup when I was younger. I think I went from an A almost directly to a C (of course, this might be in part because I was in denial and went bra-less for most of 6th and 7th grades). I remember that my breasts grew so fast, they were entirely red from the stretch-marks. It freaked me out. By the end of high school I was definitely huge, and continued to get bigger until I was in my early 20s.

Now? I don't even know what I am. I wear a DDD, but could wear an EE or an F depending on the manufacturer. Of course... most manufacturers don't MAKE them that large, which is part of why I wear the size I do. Of course, there's this whole notion that huge breasts are great. Men allegedly love them, etc. No one ever considers the amount of weight that comes with them. :P

Tomorrow I go in for my first appointment for the pre-op stuff. I'm supposed to see the nurse for about an hour and then go see the anesthesiologist, probably. I got my packet of info from Kaiser today (which was supposed to arrive three days ago). It told me much of what I already know: no aspririn, no motrin. But it also said I should be taking a multivitamin, which the guy on the phone didn't mention.

Today I went bra shopping - to see what size I think I'd like to be. When I filled out the forms last year I said a C cup, because if I lose weight I could lose breast tissue, and I still want to have SOMETHING there to hold my my bra. :) But lately I kept thinking I'd want a B cup for some reason. I guess I'm so eager to have the weight off my chest that I could have gone a little bit overboard. I looked today, and to me the C cups still look pretty ample. But I guess for my ample figure, it'd be just fine. There were so many gorgeous bras, I almost started crying, thinking I might someday be able to wear them all. I found plenty of C cup bras but not too many Bs (I was shopping in a plus size store, which is what I'll have to do - I know there are plenty of B cup bras in the world, but probably not as many that will fit me). So I guess I'm back to my original plan.

I filled out the forms Kaiser sent me for the pre-op stuff. They asked a whole series of questions about my medical history. I think I filled out a similar one last year during the seminar they did. But of course that was a while ago. They asked things, too, like whether or not I have a living will. Stuff I should be thinking about but don't want to.

I am beginning to get nervous/excited/scared about it. I felt my stomach go all fluttery tonight for a while while I was thinking about it. I hope it doesn't get too much worse, otherwise I won't be able to sleep between now and Friday. :(

Today I had my appointment with the plastic surgery nurse to go over some of the information about the pre- and post-op care as well as make sure I was healthy enough to have the surgery at all. The first thing she asked me was "what is your occupation?" and I said "journalist" and she said, "oh really, where?" and I said "Marin Scope Newspapers" and she asked what that was. I told her we were a chain of weeklies and she said, "Oh, like the News Pointer?" and I said "I'm the editor of the News Pointer" and she said, "no wonder your name looks familiar." I suppose this is the first time I've ever had a medical examination from someone who has admitted to reading my newspaper.

Basically, she went into a lot of depth about what to do between now and the time of surgery, and then what to do afterward. They sold me a bottle of iodine cleanser to use the night before the surgery, from neck to groin, to sterilize myself for the operation. I also got a bunch of these post-surgical pads, and three sports bras to wear after surgery. The pads go in the cups of the bras and help protect my breasts as well as collect any material that seeps out of the wounds.

For the first couple of days after surgery, I will have these drains, one in each breast, with tubes leading to little egg-shaped rubber receptacles. I have to empty these out every so often and measure how much is coming out. If the amount of drainage increases, then it can be problematic. Ideally the amount of drainage decreases until about the third or fourth day, when the drains are removed by the nurse. Until then, I wear a bandage wrapped around my chest and can't bathe or shower at all. But after those come off, then I go to the bra/pads thing, and can shower normally. The sutures are covered with this sticky tape to protect them. After 10 days the tape and stitches are removed.

Surgery itself lasts about three hours, she said. I'll be put under a general anesthetic (I had a brief trip to the anesthesiologist today as well), then a local anesthetic will be given to each breast. After the surgery I'll wake up and Devin will take me home, as long as everything's fine. Everyone I've talked to so far seems pretty optimistic here, since I'm young, in good health and I don't smoke.

There's so much to remember. I can't move my arms for a few days, hardly, so I don't exacerbate the fluid drainage. I have to rest a lot, but I also have to walk around a lot. I'll be taking Vicodin, at least for the first few days until the pain decreases. I'll also be taking antibiotics to make sure the wounds don't get infected. I'll probably also end up taking acidophilus to counteract the antibiotics' effect on gastrointestinal and vaginal bacterias so I don't either get stomach problems or a yeast infection. I'm going to be miserable enough as it is. Oh, and I have to use a backup birth control method for a while because antibiotics can interfere with the effects of oral contraceptives. Fun, huh?

I also have to come in with no jewelry on, and take out all my earrings (most of which are tension bead earrings, and difficult to put in/take out), because in case they have to cauterize something, it can increase the risk of my getting burned. Ouch.

I'm not supposed to do any strenuous activity for a few weeks, anything that causes facial redness/sweating, because it can increase swelling in my healing breasts. So I said, "You haven't said anything about sex." Basically she said 1) be creative, 2) don't do anything involving heavy exertion, 3) avoid contact with my breasts that could injure them, and 4) don't do anything kinky with the nipples until the wounds have healed. She actually used the word "kinky." I was charmed. :)

The other day when Kevin was here, he said, "Congratulations on the surgery." Then he said, "They wouldn't let ME have it. They said I was too overweight." :)

Today, when a volunteer at the hospital took me from the plastic surgery place to the anesthesia department, he asked, "Did you ever think you were going to have the surgery?" He's seen a lot of women come through there, I think. He says they have two books full of names of people waiting. He says there aren't a lot of cancellations, and when there is one, they can sometimes call everyone in the book and no one can come in on short notice. He implied a certain irony that all these women wanted to have the surgery, but sometimes they can't find someone willing and ready to go.

Tomorrow I go see the surgeon and she'll make some specific decisions about how my surgery will go, how much she'll take off and all that kind of thing. I'll also pick up my drug prescriptions, which I dropped off today. Waiting for your drugs at Kaiser is often at least a half-hour ordeal, so I decided to skip the waiting, since I'll be there tomorrow anyway.

I still can't get over the fact that you can buy a sports bra for $7.50 at Kaiser. They're $7.99 at Kmart. Apparently it's a recent addition - before this, you had to just wear an Ace bandage for like a month. Now, I just have to wear the bra 24 hours a day (except showering) for the first three weeks. Pads for the first week, and solo otherwise. After that, I can wear any bra I want, although they recommend something with good support for pretty much the first year.

It's all starting to feel a little more real to me, now, but it's also quite surreal still. By now most of my co-workers know I'll be gone, but don't know exactly why. That's okay. They're all acting sad that I won't be around to help them, though. I'm sure they'll be fine. I'm worried about my temptation to call them up and see if anyone needs help. :)

Today was the visit with the surgeon, which was a lot more brief than I thought it would be. Since I already signed all the release forms yesterday, she didn't need to have me do that. She took a quick look at my size, and described the basic procedure, and asked me if I had any questions. More specifically, they don't do the typical "keyhole" style surgery done with many breast reductions, where they cut out a keyhole shape from the nipple downward and then sew it all back together again. Here, she said, they do a kind of "sine wave," which allows for more and stronger skin at the bottom of the breast. It creates a more shapely breast when it's finished with less stress on the bottom scar, she said.

She also said they'd go ahead and attempt to leave the nipple attached. "We'll watch it and make sure it stays pink and happy," she said, "and if it turns blue and unhappy then we'll have to make a nipple graft." This is a cutesy way of saying they'll do what they can to save the sensitivity in my nipples, but no promises. I had already prepared myself for the possibility of them just removing my nipples and sewing them back on again later, so this gives me a little hope for sensation there in the future, although I still won't be able to breastfeed.

Tomorrow I call in to find out what time my surgery is.

It's been six days since the surgery and more than week now since my last entry, but I've been so busy with preparing for, having, and recovering from the surgery that I haven't felt much like writing everything down. for the first day or two post-op, it wouldn't have made much sense anyway. :)

I was told to come in to the hospital at 10:30 in the morning. I showed up at the main admitting room and they took down my information and asked for my co-pay - a whopping $5 - to cover the surgery. I think I was probably grinning when I handed it over. From there, they told me to go up to the ambulatory surgery office and check in, and then wait. When I got there I was told my surgeon was running a little bit behind. I saw next to my name that it said 12:20 but I didn't know whether that was my scheduled time or the belated one. Devin and I sat down to wait in a room full of people whose family members were either in surgery or about to go in.

I read the newspaper halfheartedly, both eager to get it over with and eager to see what it would be like. About an hour later I was called in and told to take off all my clothes, put on their gown and robe and little hat and socks, and put all my clothes in a bag which would be put under my bed. When that was done, I was led to a bed with my name on it and they asked me to just kind of sit there and wait. I didn't know how long it would be. Shortly after they asked me some stuff and checked my heart and lungs and mouth, they let Devin come in and sit with me.

The area was buzzing with activity. I was in the prep room but I was facing a doorway which led into the recovery room. I could watch people wake up from their general anesthetic, and then get moved so the next person could go into the "wake up" spot. Next to me a Latino man was preparing for shoulder surgery, and I listened as they prepped him, checking his blood pressure, giving him a sedative, letting his family sit with him.

Finally my surgeon came by and began to mark me for my surgery. She drew a long line down my sternum from the base of my throat to the top of my stomach, and then used a measuring tape to begin to measure where my nipples would end up. She drew some dots and then pulled out a hardware level to make sure they were even. She couldn't get them quite even with the level but managed to do so with her fingers, touching one to the spot on each side and letting me tell her if it felt right. She said in the end sometimes that winds up being more accurate, anyway. She also wrote on my shoulder my height (5'2") and my desired cup size (she wrote "C to D-"). On the leg of her scrubs she wrote Devin's cell phone # so she could call him when they were finished with me.

Then the anesthesiologist came over and started talking with me, again checked my mouth and throat (I think they do this in case they have to put a breathing tube down your throat) and began giving me the rounds of anti-nausea stuff that would hopefully prevent me from getting sick after being under general anesthetic. One was an oral medicine, and the rest were put into my IV, which was already pumping much-needed saline into my body. Some of them were supposed to begin to make me drowsy, which they most definitely did.

At that point I actually started to get scared and want them to stop, knowing full well that I had a ton of drugs in me and there was no point in going back. I always get scared once they start sedating me, even for dental stuff. But soon I was pretty out of it. I only vaguely remember saying good-bye to Devin and being wheeled on over to the operating room - I was fading pretty fast. I know they moved me onto another table and I was in a room full of equipment and several people, but after that I don't remember a thing.

The next thing I knew, I was waking up and someone was trying to put an oxygen mask over me. But I suddenly felt my stomach turn inside out and they knew I was vomiting. They got a little tray for me to spit into and someone said how good I was to hold it in until they got the tray. I almost threw up a second time, but just spit and then kind of went back to sleep. I slowly started coming out of it, and they gave me oxygen through a tube under my nose, monitored my blood pressure and my heart. I could heart my heart, beating pretty fast. I was really warm and there was something right over me, which I found out later was a kind of full-body ambient heater because the operating rooms are often so cold. I also had circulation-enhancing warm wraps around my legs, which I didn't realize until I was much more awake and I asked if I could have some air on my legs because I was so hot. After what seemed like an incredibly long time, they moved me from the wake-up spot to another spot and let me slowly, slowly, slowly, come awake.

I was still pretty nauseous. The various medicines they'd given me hadn't helped, or hadn't helped enough. I was mostly awake now, and asked to see my family. I could see a clock and it was nearly 7. The nurse told me my family had been waiting a long time (my dad came down in the afternoon to see me post-op; they told him to come at 3, and I found out later I didn't even get out of surgery until 5), but when she went to go get my dad and Devin, they had gone to get dinner. My surgeon came by to talk to me and she told me all kinds of good news: that they had removed about 3500 grams total (this she also had written down on her pants) from my breasts - more than 7 pounds! - and that she had been able to keep my nipples "pink and happy" during the surgery, meaning I'd be able to keep some sensation in them.

Unfortunately, I was resisting more anti-nausea medicines, but when my surgeon said she wanted them to keep me overnight if I didn't stop being sick I let her try one last thing, which involved an injection in the butt. I lay there for a while, and soon my dad and Devin came in and I did slowly begin to feel better. Not hungry, but better. We talked for a long time, and then finally the nurse helped me to the bathroom. She taught us again about the drains and how to measure them, clear them and everything. She wrapped a little white mesh "stockingette" around my bandages to hold the drains to my body. Then she helped me get dressed, wheeled me to the car, and Devin drove me home.

By then I hadn't still really gotten a good look at myself - I had been so occupied with trying to get out of the hospital I had hardly worried about what I looked like. I realized that I was much smaller, and that actually my breasts didn't hurt too much. I was pretty sure I'd had some hefty painkillers though. The ride home was okay - some bumps jostled me a little bit, but it wasn't bad. Devin helped me inside and I sat down to have a bit of toast so I could take my medicines, because Vicodin must be taken with food. I ate about 2/3rds of half a bagel, took my drugs, and went to bed, and aside from getting up to occasionally eat a small something or take my medicines, I slept throughout the next day.

That evening, my appetite felt good and I wasn't in too much pain so I asked Devin to make me some chicken and rice for dinner. It tasted so good, and I ate a bunch, feeling good. I took some more meds before bed and went to sleep. But around 4 or 5 a.m., I woke up feeling very nauseous. I went to the bathroom and did a long meditation at the sink, trying to decide whether to throw up. I coughed a few times, then went back to bed. A little while later I was up again, and this time I was throwing up. Devin woke up, stayed up with me for a while, and then helped me back to bed, where I slept for a while.

But I started to worry, because I couldn't take the painkillers without food, and I couldn't take food in this state. I decided that I should probably just switch from Vicodin to Tylenol and not eat anything until I was ready. I only had a little water and soda water the whole day, and managed to eat a cracker and about one spoonful of chicken broth before I went to bed that night. The next day was better, and I've been VERY slowly improving since then.

Meanwhile, I did finally get the chance to look at myself in the mirror, and I began to like what I saw. My breasts were an unbelievably different size, but more than that, they were up high and sort of perky (although they're pretty swollen). I couldn't really see them since they were all bandaged up, and once I got sick I didn't want to look at the drains, which contained small amounts of blood and lymphatic fluid, for very long. But Sunday night, when I was sick and hadn't eaten all day, I cried for a while, feeling lousy and wondering if I had done the right thing. I don't think I regretted it, but I did ask "How do I know if I did the right thing?" Devin talked to me for a while, until I stopped being so upset. I realized how much stress I had been carrying around, from before the surgery and immediately afterward, and was glad to let a little of it go. I think it, in part, is what's made my stomach hurt so much this week!

On Monday, as predicted, the amount of drainage was down to a reasonable level so I called to make an appointment to have the drains removed. I was a bit reluctant to see what my breasts would look like under the bandages, but eager enough to have a shower that it seemed worthwhile anyway. I called my dad, who had agreed to take me to the clinic. My friend Violet came over and we watched a movie, "The Company of Wolves," and then my dad came to take me to Kaiser.

I didn't have to wait long once I got there - they took me in almost immediately. The nurse was amazingly nice. Both nurses (I should say their names to give them credit: Kathy Blaskower was the one I saw pre-op and Karen Kidd was the one I saw to have my bandages off) and my surgeon (Jan Johnson) have been incredibly caring. The nurse had me sit down on a tall chair and take my sweatshirt off. Then she cut through the stockingette and let the drains fall down. She looked over the measurement chart and agreed they could come out. From there, she gently removed the bandages over my breasts and I could kind of see them for the first time: very bruised, covered in tape and markings and a little blood, but nicely shaped for all that. She brushed my nipple with her fingertip and asked if I could feel it, and smiled when I said yes. I'd been feeling my nipples kind of poke out occasionally under the bandage, or THOUGHT I was, anyway, but couldn't be sure how sensitive they were until then.

Once the bandages were off, she touched my breasts gently to make sure they felt okay, said that I had a remarkably small amount of bleeding and other such stuff, and proceeded to clip the sutures that held in my drains. She did the left side first, having me put my left arm on her shoulder while she cut them and pulled them loose. Then she cut and removed the sutures on the other side, which took a little more doing. This stung a bit, but she made me relaxed enough that it wasn't so bad. Then she moved back to the first side, and told me to take in a deep breath and blow it out slowly like I was blowing out a candle, so I would relax in the right way for the drain to be pulled out. I did this once, and then a second time, and she pulled quickly and the drain came out and she put a gauze pad to my side to catch any fluid that came out. The amount of drain that was inside me was at least 4", maybe more. I was sort of amazed. The other one came out the same way; she put little bandages over the holes and told me to give them 24 hours to close, and then I could shower.

My dad took me home, stopping on the way to get me all kinds of food that one can eat on an upset stomach, and then Violet came back to watch over me until Devin got home.

Since then, nothing specific has happened: I'm slowly feeling less nauseous and in better humor, I'm able to eat more, and I'm getting used to my new shape a little at a time. I've realized that I almost automatically stand up straighter now, and I can sit upright with little to no upper back support without pain. I can feel my shirts brushing the top part of my stomach, which was always covered by my breasts before. I can wear shirts that used to be too short for me! Even though my back's been sore for other reasons, like I'm not used to sleeping on it and I've been sitting in some funky positions, and it's getting used to not having the same weight load, it's getting better. I looked in the mirror this morning with my hair up and was amazed how much SMALLER I look from the chest up. Laughing feels different.

Each day my breasts seem to go through a battery of "nerve tests." One day they were kind of itchy, then warm. The next day one of them was a bit twitchy while the other felt like it had a buzzer in it. Then they were sore, and a bit cold. Sometimes they get a creepy-crawly feeling, other times they kind of sting. It's interesting. I know that tons of nerves, both inside and on the surface, are just GONE. So the remaining ones are getting used to their new positions and blood flow and growing together again or whatever it is they do in there. It's an interesting process, looked at objectively. Even though it is often-times unnerving and uncomfortable, I'm fascinated by it.

When I finally did have my shower, Devin got to see my new breasts for the first time. I know that even though he was VERY supportive of me having this done, he's also been a little sad that something that was part of me is now gone. I am too, I suppose, but I'm already forgetting what it was like to have them in a way. Anyhow, I unwrapped them from the sports bra and the surgical pads and everything, and he just stood and looked at me for a long time. He touched them very gently, very tenderly, very lovingly, and smiled. He managed to say that they look nice even though (in my opinion) they're still pretty unpleasant to look at. But the general shape IS nice, and everything else will improve, slowly, with time, mainly over the next few weeks and to some extent over the next several months.

Not a lot to report, but things are continuing to slowly improve. My stomach feels MUCH better, although my breasts are still pretty swollen and sore. My drain holes keep refusing to close - in part because my skin keeps trying to heal to the sides of my bra. We're going to try to fix this today with band-aids I think, although Devin says he's seen wounds try to heal to the sides of them before, too.

I actually drove my car yesterday. Only to move it 10 feet, but still. It didn't feel too badly. I'm paranoid I guess. I just imagine my stitches unraveling or something gruesome like that. I'm gearing up for Easter at my dad's tomorrow and driving myself to the clinic on Monday to have my steri-strips, the tape over my sutures, removed. I'm also paranoid that NO healing will have taken place and they'll just put new strips on. Augh.

I'm starting to think my bra is too tight. I ache a little from just the amount of compression. My ribs aren't used to being constricted in that spot, either (my bras were never very snug around the ribcage). Maybe it's just right. We'll see what happens when I stop having to wear the surgical pads in it.

Lastly, I've been trying to find out more about nerves and how they heal. I am reminded, both by the sensations in my body and the reading I've done, that the nervous system is an electrical system. Hence all the buzzing and tingling, I guess. :) The consensus seems to be that nerves do heal, but do so slowly. "An inch per month" is what a lot of people say. I'm not sure how that correlates to my situation, although I'm finding it amusing thinking, "but I've LOST inches, so I should have retroactively healed by now!" I'm too impatient for my own good.

Today was my "10-day appointment," meaning 10 days after the surgery. The appointment is intended so that the nurse can remove the steri-strips holding the incisions, trim any sutures that've come loose (or trim knots and ends that were left on at the time of surgery) and make recommendations for the next two weeks. I went in and saw the same nurse I had last time. She peeled off the strips with a pair of big tweezerish things, taking care not to pull the skin too far, especially around the nipples. The adhesive underneath was pretty sticky and some of it still stuck to me. I was bleeding along my incisions in a couple of places, and I could really feel the weakness of my skin in the places where the tape had just been removed. It was a little painful and a bit alarming. At the time, I actually didn't yet realize that she was going to put more tape on. So even though I kind of was looking forward to going home naked and tape-free, I was relieved that she was going to put more on.

More relief came as I realized that most of those dark blue lines (as well as some old blood) I kept seeing under my tape was attached to the tape, and not to me, so it came right off with the tape and I had mostly naked skin (with lots of bruising, of course) underneath. But I was sort of shaken by seeing it all, too. She cleaned off some of the old adhesive, especially on my sides (from the first couple of days of the bandages), and taped me back up as quickly as she could. It looks much better with clean tape and everything. She told me how the second set of tape would probably just wash off on its own in a week or so, and that if it doesn't I can remove it by rubbing everything with a lot of Vaseline and letting it sit overnight, then removing the tape in the morning. After that, on April 27 (which is 3 weeks after the surgery), I need to start massaging the scars lightly with this lotion/ointment they gave me, to encourage long-term healing as well as soft scars.

She was just helping me back into my bra when I began to feel really dizzy and faint and sweaty. I got my bra on and she had me lean back, put a cold cloth on my face and then turned me over in the chair (which is fully motorized and reclines and everything) so my head was tilted down. I moved my legs up and down to pump the blood and began to feel better in a few minutes. It was the closest I've ever come to fainting. I guess the sight of everything under there, and the anxiety I have over hospitals and surgery and everything, caught up with me. She was extremely nice though, helping me recover to the point where I could sit up and then setting me up with another nurse because she had another appointment to keep. I ended up staying there, after moving to their little waiting room once I stopped being so grey-faced, for about 40 minutes, with the nurse bringing me some apple juice and checking on me periodically.

I guess if you're going to nearly faint, in the doctor's office is one of the best places to do it. But I was faintly woozy the rest of the afternoon until I came home, ate, slept a while, and then got up and wrote some of this stuff down.

Tomorrow I'm going to try to go back to work. Until I had this experience today I thought I was entirely ready - after all I went up to my dad's yesterday for Easter and other than getting a bit tired, I actually felt pretty good all day and my pain and swelling seemed dimished. Now I'm feeling a little more iffy, but I guess I shouldn't worry. If I'm tired I can always lay down there, and I did fine driving my car today other than the fact that the seat belt fits me even worse now than it did before I had the surgery. And if I feel really terrible I can always come home again, although things are usually so relaxed at work I should be fine.

I've been back to work for two days now. Yesterday I only worked about five hours and came home feeling sleepy (and then didn't sleep - once I got home I felt fine, as is often the case. I guess it was just what Asa calls "mid-afternoon narcolepsy."). Today I worked a full day; I was still sleepy in the afternoon, but had some tea and went on working.

I'm beginning to think my co-workers are a little ... unobservant. I know a few people noticed but didn't say anything; a couple of them, however, asked me where I'd gone on my vacation. :) My supervisor is really nice and keeps telling me that if I get tired and need to go home, it's okay with him.

My stitches seem to be bothering me a lot; every time my nipples tense up for instance, it pulls on the stitches around my areola. Now I notice some pulling all along the length of my incisions when I do certain things, or sometimes when I'm doing nothing in particular. I was aching a lot this afternoon, and into the evening (comparitively speaking; it's never THAT bad), even though I took a painkiller in the early afternoon. But I just did some dishes and oddly I feel a little better now. My nipples are very sensitive to the touch though. I decided to go without the pads in my bra today to see if it felt differently (also in the hopes of desensitizing my nipples a little bit). It felt about the same, although if my nipple brushes anything it still aches quite a bit.

My back hurts also, mainly because I can't do the stretches I like to do - raising my arms over my head, or arching my back really far. It'll be another two weeks before I can even dream of doing those kinds of things.

I found a web site last night in which a woman recounted her breast reduction surgery, from a few days pre-op to one year post-op. Her surgeon did things very differently from mine, and she was not at all happy with the way her breasts looked afterwards, but she was still thrilled with how much better she felt (she also wished she'd had more breast removed). She had to fight to get her insurance company to cover it. The amazing thing is that she only had a little more than 400 grams removed, and I can't imagine going through all this for just under one pound. But if it makes someone happy, I guess I could see doing it. I'm still amazed that they took 7.7 pounds off of me and I still have good-sized breasts. I said to Devin, "something very wrong happened to me when it came time to grow breasts. Someone pushed that button for waaaaaay too long."

I'm improving, slowly, slowly. I managed to do almost a full week back at work, and it allows me to take my mind off of things for a little while, which is good. I don't think we heal as well when we're constantly thinking, "Ow, what's THAT pain coming from?" Although I realized some of the discomfort I was having is due to the steri-strips, which when they dry out are kind of crinkly and they pull on my skin when I move. Since they've over the tenderest skin -- breast skin which is trying to heal -- it causes a lot of uncomfortable sensations, most of all this kind of painful prickly feeling.

But it's getting better. Other than the fact that I awoke the other night stretching my arm all the way over my head, and then found two tiny spots of blood in my bra where I probably pulled something open, I haven't had any further bleeding. I have quite a lot of aches and pains inside my breasts still. Fortunately they don't both hurt at once. The left side was hurting off and on yesterday, and then the right one was hurting for a while this morning when I woke up. It's nice of them to be considerate and hurt one at a time. :)

I found two more online journals of women who'd had the surgery. One is long but much shorter than the one I mentioned in the previous entry; one is pretty short. I'll probably link to them from the bottom of this journal so people who are looking for multiple accounts of women who've done this don't have to search all over the internet like I did. Each experience seems to be pretty different. Reading these journals I feel pretty lucky that I haven't had more complications, aside from the drain-wound on my right side not healing up very quickly (it had almost closed when we looked at it yesterday, though). I'm also glad I didn't have the traditional "keyhole" surgery which leaves you with a line of sutures under your breasts. Okay, it's because I can't imagine how much more it would hurt to have a wound under my breast right now, with a bra rubbing against it, but of course the tradeoff is that the scar's more hidden then. But I tend to have scars that fade pretty well on their own, so I don't think the scars I have will be THAT bad. Plus I think scars are pretty cool.

(We'll see how I feel about that in a year)

My steri-strips are still sticking to me pretty thoroughly even though the nurse said they'd begin to come off on their own. I've decided I won't take them off before April 27 (when I'm supposed to start applying ointment directly to the incisions). If they come off on their own, which I doubt, then that's okay. I'm too scared that the incisions will be weak as it is, so giving them plenty of time to heal sounds like a good idea. Even then, she said they'll only be at about 30% strength. I wonder how this is measured? Do they gain 10% a week? Maybe healing and strength builds more quickly once everything has closed. I dunno. Still, 30% strength doesn't seem like much, and yet they tell you it's ok to go bra-less at night after the third week. I shouldn't think about this stuff so much -- this is probably what made me nearly faint at the doctor's on Monday.

I was just writing to a friend tonight and I remembered that when I was sitting with Devin in the pre-op room, I told him a shortened version of the story of Inanna's descent into the underworld. I felt very much at the time like I was going into a similar journey, and I felt quite comforted knowing her story and its outcome.

In Sumerian lore, Inanna was the Queen of the Sky or "Queen of Heaven." She had a sister, Erishkegal, Queen of the Underworld. Inanna decides one day that she's going to visit her sister. So she goes to the gate of the underworld and she leaves someone there to wait for her. She says if she doesn't come back, to send someone down after her. As she descends, she passes through seven gates, and at each one they take something away from her: her clothes, her scepter, her crown, her jewels, until she is naked. Utterly naked. (In a visualization Starhawk wrote in one of her books, she is stripped of her skin, her bones, her memories, everything).

Once she gets to Erishkegal, the welcome's not really a warm one. Erishkegal fixes Inanna with the "eye of death" and turns her into a corpse and hangs her from a hook on the wall to rot.

It takes a while, but someone finally notices Inanna's been gone an awfully long time and sends these two little beings to heal Inanna. They do, and she returns to the world above. In the Starhawk version, she and Erishkegal merge and become one being - a duality. (Also in the Starhawk version, Erishkegal processes the woes of the dead and is seen as essentially compassionate, which I like).

Anyhow, by that point, they'd taken all my clothes and belongings and even stripped me of my dignity, given I was wearing an open gown and fuzzy blue socks and a disposable shower cap on my head. I was going to "go under" in the sense of anesthesia; I knew there was a chance I might not make it back. And if I DID make it back, I was going to be physically different when I did. So there was definitely a certain amount of resonance there. Not to mention I had family waiting for me to "return." :) At that moment I was particularly glad for the lessons of mythology, and for my interest in myth as a way of putting life into context.

On a more mundane note, things are going pretty well. I'm trying again to go without padding in my bra. It hurts a bit, but I want to try and get used to my breasts moving around. The tape is irritating me - I can't wait to take it off but I am definitely going to wait until Thursday night or Friday morning to try. I did peel off a tiny bit of the tape, in my cleavage, to see what's underneath and found a fairly solid-looking new pink scar under there, with little bristly bits where the stitches are. I felt a little relieved after seeing that; it looks pretty strong.

So last night we took the tape off my breasts. We started at about 11pm and it took nearly an hour, probably in part because of all my complaining. The tape was stuck on really well; I bought a bottle of medical adhesive remover to make it easier, and we ended up using quite a lot because everything was so glued together. I was very nervous, scared, and even crying a little bit just worrying about how everything would be underneath the bandages. Devin did most of the tape-removal, so I ended up being crabby at him throughout the procedure, but he was good about it and just kept going, slowly and carefully, until everything was off.

He was also great about encouraging me in terms of how I look. He got out the big mirror and held it up to show me what I look like; I was a little hesitant. He pointed out to me that I look in-proportion (he thought I looked in proportion before, too, but differently so). He touches my breasts a lot, just really gently, to let me know he's accepted them as part of me. He says he already likes them better than my old breasts. I asked him if I should give the surgeon his compliments. He said "Yes... and so should you."

The incisions feel MUCH stronger than they did in the doctor's office on the 16th. I don't feel like I'm going to burst open at any moment. Having the tape off is nice in the sense that it's not pulling and irritating me. I still have some sticky spots though, so I'm sticking to my bra a little bit in some places. I also realized that some of my scabs were ready to come off, but were stuck on with adhesive. Almost everything is healed up into nice pink grooves, which I'm guessing will fill in as time goes on. I have lots of scabs around my nipples, but I think those will probably come out soon. My breasts kind of look like baseballs at the moment, with their red seams. There are dimpled places where there's a tight stitch or a knot.

When I first took everything off and washed it all, and then put the bra on, I was super itchy and irritated. This morning it was better, but there have been moments of pain throughout the day. I did put the Aquaphor ointment on this morning, and will do so again tonight. I had periodic pain and itching throughout the day, mostly worsening when I did something like walk or drive, where there was a lot of friction between my skin and the bra. I'm hoping this will improve; I can't imagine that it won't, though.

I'm sort of eager to get to the doctor's on Tuesday and find out how SHE thinks everything looks.

I'm also eager to get new bras, but I have a feeling I should wait a while longer for that...

On Tuesday May 1 I had an appointment to see Dr. Johnson, who did my surgery. It was a pretty brief meeting, but I expected that. I didn't know what she was going to do, whether she would deal with stitches or anything along those lines. She looked at me and seemed very encouraged by the way in which everything was healing. She said that pretty much everything had closed up (which is true, except for a few places on the skin surface) and that she wouldn't need to see me for another six months. She also said that if I wanted her to fix my left nipple, which is much longer and more oval than my right one, she could do that at the six-month mark with very little effort. I told her I'd decide how much it really bothers me. At first it bugged me a little, but now I'm not sure it would be worth going through more hassle. I suppose I'll make up my mind later.

She also told me I was ready for "tactile contact," and that I could go out and buy regular bras if I wanted to. Actually, I went over to the mall right after my appointment with her and tried a bunch of things on. I knew my band size was 42 since I am 37" around at that point and you're supposed to add five inches to get the band size. But what I didn't know was my cup size. I tried on a number of different bras in the D, C, and B range, and they all have the problem that there's a small gap in the fabric in the tip of the cup because all bra manufacturers seem to anticipate women having breasts that are fuller vertically than mine are, which are mainly full horizontally. I tried again on Wednesday to find bras, but still haven't had any luck. A woman at Lane Bryant recommended to me a place where they do exact bra sizing, so I might go there tomorrow and see if they can't help me in my dilemma.

The pain in my breasts has been rapidly diminishing. For the most part they don't hurt, or even ache, that much right now. The nipples are still sensitive in a kind of painful way, even just with shower water falling on them, and sometimes the bottoms ache if I've been folding my arms under them. They hurt a little this morning, I think because I slept on my side for the first time and they're not used to having gravity pull them in that direction. I also discovered that some arm stretches still pull them in uncomfortable ways, but it's improving. Going over bouncy stretches in the car doesn't hurt them too much anymore, except for some of the worst bumps.

I'm still having some stitches come out, the ones that are along the surface. As they slowly break, I'm having to pull them. This is the part that makes me feel slightly faint at times, although I'm not really sure why. But most of the little spots that were bleeding or oozing have pretty much closed up, which is nice.

Yesterday I went to a small shop in San Leandro which was recommended to me by the woman at Lane Bryant. It was surprisingly easy. I've never felt comfortable having my breasts sized before - maybe because they were so big - but I just walked in and told one of the ladies that I needed to be sized. She put me in a dressing room where I took off my shirt and bra. She came in a moment later and looked at me, asked to see my back for a moment, and then went to find a couple of bras.

She returned with two. One was a size 44B and fit me almost perfectly except, as usual, for a small gap in the cup. But she showed me how I could tuck the fabric under at the bottom of the cup in order to smooth it out and create a wrinkle-free fit. The other was a non-standard sized bra, just "XL" size, with a front closure. It didn't quite fit in the cup - it was too small - so she got one in the next size up and it fit just about perfectly. I asked if it came in any other colors besides white, and she said that yes, the company also makes them in black. They're made of stretch lace with lining in the bra cups to give support. I ordered four of them, at $20 each, which will be sent to her and then she will mail them on to me when they arrive.

I was amazed that without the use of a measuring tape she could find things that fit so closely. She said that because I was so big before (another thing she had guessed), I still need a big band size - the 44 helps deal with how widely-set my breasts are now. She also groused a little bit about how if the surgeon had put my nipples higher, I wouldn't be having these problems filling bra cups and things would be a lot easier for me. So in actuality my bra size is more rare than it was before! But as I said, she showed me how to look for bras that are stretchy with a single layer of fabric in the cup, and how to stitch it so it fits better, and that will help considerably. At least now I have some bras on their way to me which will fit and are reasonably pretty.

Of course, when I took off my sports bra last night there was dried blood in it. A small place which hasn't previously given me trouble opened up a bit. It probably happened when I was helping to carry things we'd just gotten at IKEA, or possibly when I took out the garbage. Or maybe it was unrelated to lifting things and just happened on its own. I'm not really sure. Everything else seems to be continuing to close up though, including the drain hole on my right side, which is much smaller now. Perhaps someday I won't have to put a band-aid on it every day. :P

I'm taking more and more time between entries, but I guess that's because things are going pretty well. I still haven't gotten the bras I ordered yet but I should have them this weekend. I DID find one at Ross last week, but it's lace and a little too itchy for right now. I've also started rolling over onto my stomach in my sleep, even though it hurts a bit. My friend Damian said, "If you're going to your stomach when you're asleep, then your body's saying it's okay to do that." Then he said, "Pain is your body's way of recognizing something's wrong, and when it does that, it heals the problem. So if you're in a little bit of pain, it's probably encouraging your body to continue healing." It made sense at the time, anyway. :)

I saw my family this weekend for Mother's Day, and my older step-sister told me that I looked good. She said she'd seen a video on breast reduction surgery and that she thought I was very brave for having it done. And in a lot of ways I DO feel brave, although this has been a difficult time for me and at certain points I wondered if I'd done the right thing. I'm still healing, day by day, but I am more and more happy with the results as time passes. I went hiking this weekend and it was so nice to not have my breasts flouncing around. I like having them up and out of the way, and relatively small.

Sometimes in the shower I forget and go to lift them up so I can wash underneath them. I don't have to do that anymore. That's really the only time I can think of where I defer to how they used to be, although Devin says I still hug people as though my breasts are going to be in the way. I'm trying to practice a new style of hugging but it's taking some time. At least I have lots of people around with whom I can practice. :)

I don't know if I'll add any more to this journal. It's already so long. I just hope it helps people who are considering the surgery to see what might go on in their minds throughout the process. It's certainly helped me to write it all down.

Today is the one-year anniversary of my breast reduction surgery. I thought I would use the opportunity to update this journal and let everyone know how I'm feeling now that everything has healed. The past 11 or so months since my last entry have been fairly uneventful. My scars are healing and fading, very slowly. I am fair-skinned so this is something that just takes time. Sometimes I don't notice them at all, although of course they are still pretty noticeable to someone who doesn't look at them every day. My breasts have softened over time, relaxing into a fairly natural feel.

I discovered that one of the reasons I couldn't find well-fitting bras in the first couple of months is that my breasts were still too swollen to be very flexible. I had a wonderful bra-shopping experience a few weeks ago at Lane Bryant where I discovered that my breasts are now soft enough I can move them around more, meaning I can put them where the bra cup is and fill it. Of course I never imagined I could have TROUBLE filling a b-cup, but now I find it kind of funny. :) Still, it was a major relief to find that I could go out and find bras, although I am probably still limited to plus-size shops like Lane Bryant which will carry b-cup bras in a band size higher than a 36.

In October of last year, I went in to have a mammogram. This is something the HMO wanted me to do so they could have a record of my scar tissue and see if anything was amiss. I got a card a few weeks later saying they had found some extra lumpiness that they believe to be benign, but that I should come back in in several months for another exam. My breasts have always been lumpy so I wasn't particularly surprised. The mammogram went as well as could be expected -- the nurse was really nice, and she let me say "okay, that's enough squishing." They got good x-rays and didn't need to do any repeat shots. Unfortunately, my breasts ached for a couple of days afterwards. Everything's still healing in there!

In general, I am finding that my breasts are more tender than they used to be. Even wearing an underwire bra all day can make them a little sore. Part of this, of course, is that they are still healing, and part of it is that there isn't so much weight hampering the nerve endings and making everything numb. On the plus side, it no longer really hurts -- and just feels good -- when my boyfriend touches my breasts. It hurt quite a lot for the first few months, probably because my nerves were trying to figure out what they were supposed to be feeling.

The best thing about everything that's happened is that I feel a lot sexier than I did. I'm starting to buy clothing that shows off my breasts a bit more, even though a lot of it also shows off my big stomach. :P Devin and my doctors are still the only ones (besides me) to have seen them naked, but that's okay. I know what they look like now, and they look good and feel good to me, despite their many (objective) imperfections. They suit and flatter me. I have almost forgotten how I looked before -- and am occasionally surprised when I see old photos from before my surgery. I've started to feel as though I have always been this way.

I am having my one-year appointment with my doctor later this month, and after that, my medical relationship with the department is over unless I have trouble down the road. They weren't kidding when they said the dissolving stitches would still be coming out at one year -- I've found a half-dozen or so in the past few weeks. Amusingly, even though it doesn't bother me to see them anymore, it still occasionally makes me feel light-headed.

People who have asked me about this surgery always seem to ask whether it was worth it, whether I am happier, whether I regret anything. Obviously the whole process of having surgery is a very taxing one, mentally and physically. There's no getting around that. But am I happier? Yes, I think so. Was it worth it? Definitely. Do I have any regrets? No, I don't think so. I came to an acceptance of myself as I was -- and then realized that my condition was not healthy for me. I feel much better about myself, now, both in terms of looks and in terms of health.

I had even gotten accustomed to men staring at me on the street. Big breasts, in our culture, are supposedly a big turn-on and attractor. Very few men actually approached me or hit on me, but they definitely looked. They don't do that anymore. In one sense I kind of miss it, but in another sense I'm glad. My breasts didn't define me to anyone who actually knew me, and in fact it was a much bigger deal for me to have this surgery than for anyone else. A lot of people didn't even notice a change, which I find interesting. Sometimes when I meet someone new, I think, "They don't know what I used to look like."

So it's been a curious process, some of which has happened publicly, most of which has happened in my mind. I can't describe the day-to-day mental transitions I went though, as they were so subtle I hardly noticed them myself. But I hope this journal is helpful to those of you who are considering the surgery, or those of you who are in the recovery process. Good luck.

For further reading:
Breast reduction FAQ
Jenny's breast reduction page
Renea's breast reduction diary, which includes plenty of helpful tips for during and after surgery
Another breast reduction journal
A third breast reduction journal
A fourth breast reduction journal
The breast reduction photo gallery (warning: some are pretty graphic)
Another informational site
More information and before/after photos (patient #3 looks a bit like me, pre- and post-op)
Larry Wall's cornea transplant surgery diary. Yes, I know this is entirely unrelated, but I read it after my surgery and it made me laugh.