Monday, July 16, 2012

contemplating my navel

(I renamed this post, so if you received it twice, just ignore one of them.)
I called the doctor today who had the surgical solution to bring the skin together in three surgeries. It was bothering me about the fact that my navel would be off center. I mean, if I am going through all this trouble aiming for symmetry, why settle for an off-center navel?

He said that he is not doing on me a tummy tuck. In a tummy tuck, you pull down both sides of the belly skin, loosening up everything under the skin including the navel, and repositioning things, putting the navel back into center. I am not doing anything near that. This surgeon would focus only on my left side, gently drawing the healthy skin together and removing the graft. He wants to be careful of the mesh which is there, not to disturb it. A tummy tuck is more invasive and it can take chances with the mesh.

He said the navel being off center would be very minimal-- nothing in the face of what we are concentrating on doing. He used the Hebrew "Tip'eleh"... translated like "just a bit" [off center]. Oh, and BTW- this surgeon is quite young- like our age, maybe younger? Lat 30's, early 40's? I am putting experience into question. When I asked him if he had ever done anything like this, he answered (very surgeon-ly, smugly- "I have done procedures much more complicated and difficult than this".

I guess I could deal with that if I had to, but please pardon me for being vain at a time like this... but I would like to go for symmetry, right? The other [mean, unsuitable) doctor said he *would* raise all the skin and do what is in essence a tummy tuck. he'd leave two scars at the bottom of my tummy, like a tummy tuck, just that the left one would be much longer, going to my hip bone, of course. Of course this is after six months or so of painful, hard (when filled with saline), skin expanders. But looking at the differences, six months of skin expanders isn't much worse than three painful surgeries six months apart, right? I *absolutely would not* go with that doctor-- he will never touch my body again, as long as I am conscious and in control of decisions. There are other options as far as great surgeons.

I am going to the plastic surgeon in Ichilov on August 2nd. We know each other, I have consulted with him about gapey before. He had also suggested at the time (three years ago? It was before I had the mesh) to use the expanders. We had spoken about the possibility about me going to Soroka (here) to get them filled each week, but the main visits would be with him, and of course the surgery. That got a rousing "No Way." One surgeon has to oversee everything. There is no division of jobs, indifferent cities, because if something messes up, it really does have to be the one surgeon to deal with, not two. I get that. It will be interesting now to see if he would still do skin expanders, or if he has found some new-fangled way to do it.

There is also another doctor to see here.
he is the head of the plastic surgery department in Soroka. He very well knows gapey, and it was he who I consulted with a few years back about whether he can do the reconstruction. At that time, he said I'd need a mesh to hold everything in safely, first. Then when that is done to come to him and we will talk about reconstruction.

I keep calling him, and I must have a wrong number. It is the number that has been given to me by three different reliable people (including a nurse in the department). Or, I have the right number and possibly he is out of town. I think I will try to call the nurses station again and ask. They don't like getting phone calls- I know they are so busy- but I really need to know if he is around, and if so, how can I reach him.

Meanwhile, back at the ranch...

My leg is not doing better. No, it's not.
I am seeing the orthopedist next week (Dr. Rath), so we'll see what he has to say. I believe that that attack of pain (the Big Bad Pain), which lasted almost a month, was bad news for the surgery, and me. The kind of constant pain I have in the back *and* front of the hip CONSTANTLY does not bode well for successful surgery. I have just tons of pain now, since then. I have no idea what happened (but the Big Bad-ness of if it has mellowed, thanks GD!).

So, with this orthopedic problem still going on, the reconstruction surgery can't really be perused. If, though, if there is a long line to have this done, I'd sign up and have the waiting time.

How to solve the orthopedic problem is a mystery to me. I hope my doctor doesn't blow it off and tell me to do more PT and say "this is it, can't do any more." "See you in 10 years and we'll see about that replacement hip."

My fears are speaking.
My fears also speak when we are thinking about the reconstruction surgeries. Damn, I'm scared. Really? Three painful surgeries six month apart? That leaves me with about two years of bed rest and mild moving around. We all know how good *I* am about not moving around.

Or, possibly skin expanders for six months sticking out from my lower left belly, and two more on my thigh. That is six months with weekly trips. Then a massively long surgery, and it's done, with my navel in the middle.

Or the wile card we don't yet know about.
Or there will be orthopedic problems trumping everything. I may need a new hip... then I have to do gapey first...

How is this ME? God, isn't it enough? I know that the character in the Torah writings named Job (Iyov) asks that a lot of God. The answer was, for most of the book, "no, Job... it is not enough. *I* say when it is enough."

I tell my kids not to let fear make decisions for themselves.
I gotta walk the talk.
I want to make informed decisions without fear.
But the fear is there..... I am working so hard on it, but sometimes it is useful.
I am so confused.
I don't want to sign the doted line on setting dates for more pain. Yes, I know it heals, and it is temporary, but when you are in it, it feels quite permanent.

I spoke to Shifra about it on Shabbat; we were playing Barbies together (not a laborious request from her- I have fun changing their clothes and playing with all the nifty Barbie sized stuff!), and it felt right to talk to her about it.

So, we talked about it. She said, taking everything into consideration, do the reconstruction. I was sure she'd be upset about mommy being unavailable for a huge period of time... again. ("not true! We can come into your bed with you! On your good side,  of course.) She wants me to be able to get a hip replacement, whenever the time may come. She wants me up and around for when she has a baby. She wants me to be her doula (OMG what a labor of love *That* would be! Please Gd, at the right time).

She wants for me to feel good when I look at my body. (I told her that it doesn't make me feel bad when I look at my body, but it also doesn't make me feel good. And yes, she is acquainted with gapey.)

Mostly she wanted me to grab any opportunity, large or small, to alleviate even just a little of the pain I have. That, I am able to think positively, could definitely be the case. It wouldn't be a lot of the nerve pain; just the pain from having the graft itself, and of the mesh behind it.

Looks like I'm stuck with the rest of the nerve pain. Me & Dr. Z will work on that with changing meds. *That* makes me feel sad, ...what can I tell you.

She wants to know when we will be able to ride bikes together. (should I dare try? I do it in PT for 10 minutes each time, and it is hard work for me still, but that is without hills and rocks, and sand-- or the problem of-- if the pain gets too great, just get off the bike.) But even having said all that, I do see a time that we will be able to do that. I want it so bad.

I want a life without pain, and without more surgeries.
It's not a lot to ask, is it?
It is the lot I've been handed.
I've just got to deal with it, and make grounded, 'adult' decisions.
And the input I have received, both in mail, comments, and a phone call (I loved that, B.W.!) has helped *so* much. Please keep that coming. I find it encouraging.

I'll keep you posted, as always.
I believe, with total faith, that I *will* make the right decision. 
I just may not be so happy about it in the short run.


  1. How off center is off center? how much pain will it save? and of course how many people see your navel? are not exactly in the bikini set. But as I know all of us horn players strive for perfection and are VERY frustrated when it cannot be obtained or it is out of our control.

    1. "Tip'eleh" he said yesterday when I called him to specifically ask that very question. A few centimeters, I'm assuming, but he, nor any plastic surgeon, I assume, can tell someone like me- with *so* much skin to be stretched, where exactly the navel will land. If I wanted perfection, he could fix it in another 6 months after yet a _fourth_ reconstruction surgery, but he's not sure if it'd be covered! It should be- it is the same process. He said he doesn't know from insurance, talk to his secretary about it. I am not happy with this, but I am not ruling him out.

  2. Can they reconstruct it? I lost mine with the tummy tuck/ reconstruction and they made me a new one. Off centre. Probably less than a cm, but I notice. Not a big deal in the grand scheme of things, but one more little hung that is noticed!

  3. Replies
    1. He could reconstruct it only in a 4th procedure, spaced 6 months from the 3rd. He was very adamant that he does not want to separate the skin from the stomach wall muscle in any of the actual "gapey" reconstruction procedures. Putting the navel back in the center would stretch too much of the skin which is needed to cover gapey. Technically I do understand this-- gapey is big, and the useful, healthy skin which has to cover it is limited, and needs to be stretched over three surgeries (*if* I take this route which I am *completely* not sure of), and it will pull the navel toward gapey. I *DO NOT* want to automatically want to plan a 4th surgery, and I don't think I would at all be happy with an asymmetrical finished look. I think less than a cm isn't so bad, really. But you *do* notice it. Imagine if it was more... it's a wild card here, I don't know what to expect.
      Enter 3rd opinion! Aug 2nd.

  4. This comment has been removed by a blog administrator.

  5. ask 'Dr. few centimeters' how he would feel if we were to move his nose a tipeleh....we all want to be beautiful. not for someone else's standards, but first and foremost to ourselves. if the off center thing just kind of mistakenly happened, well that's one thing. but in this case, you are shopping around in advance not just for someone with a kind approach but also for someone who is aiming for an outcome you can be happy with....before he even touches you with his scalpel.. Keep shopping around for someone with a better idea....and if you don't find any better plan than you will know if this is your best option.... but i expect you will find a solution that feels right in your kishkes.... after all, unless this procedure promises you a definite and significant decrease of pain, it's natural to want to return to a self image of youth, normality and health... Love you, Sarah... hang in there......for me anyway you're already super gorgeous and complete inside out....