The Straight Tuck Talk

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Worth it 

Almost 7 years ago I gave birth to two beautiful, identical twin boys. It was not an easy pregnancy. I had gotten so big, so fast, that I developed horrible sciatic pain that lasted almost 8 months. My cute little chunkers continued to grow at such a rapid pace that at around 7 months they cracked apart the front of my rib cage when I sneezed…like a wishbone. If that wasn’t enough, the docs threw me on bed-rest for the last 6 weeks, much of it in the hospital. Of course, because the boys were growing so hearty and healthy,I continued to tell myself (and many people reminded me) that all the pain and suffering was worth it.

At 36 weeks they took me off bed-rest and told me to walk around. Unfortunately, because the twins were putting so much weight on my pelvis floor, it was almost impossible to move my legs without someone giving me a slight nudge from behind. I’m not kidding when I say that people would literally point and shout obscenities my direction when I walked by. (Like I couldn’t hear them!) The last measurement of my waistline before my delivery was 65 inches…the height of an adult person.

This picture was taken the night before the twins were born.

When they were born they were both healthy and almost 6 lbs each. It was truly the proudest achievement of my entire life. Immediately, the boys took to breastfeeding like champs; I quickly lost all my pregnancy weight, and then some. However, what they left me were two lifetime badges of honor – one called Twin Skin, and the other Diastasis Recti.

The Truth Set Me Free 

TWIN SKIN is the term commonly used for the (twin) postpartum skin that has been stretched passed its ability to re-conform to its original, pre-stretched elasticity. It has lost all its collagen, resulting in saggy, wrinkly, loose-feeling skin usually surrounding the belly button. Think of a balloon. Now blow up that balloon as big as you can without popping it. Let it all out quickly and take a look at what you’ve got. That’s the general idea of what I have been left with for the last 7 years. What’s worse, the more weight I lost the more skin I gained! Often it was so uncomfortable, that when I sat down, folds of skin were literally in my lap.

DIASTASIS RECTI is a vertical separation between the two abdominal muscles that cover the front surface of the belly. Think again of a balloon, but this time it’s one of those long children’s party balloons. Now imagine it is blown up, nestled between the bottom of your breastbone and your belly button. For many, the more you try to “work it” off in the gym, additional damage is done; strain on the muscle causes the size of the “balloon” to increase as well. And yes, I even tried following the Tupler Technique to a “t”, but found it to be useless. After 2-3 years of trying everything, I finally had to admit what several PT’s had been telling me all along: there is no non-surgical correction for muscle laxity this severe.

Nope, not pregnant.  This was me a few weeks ago.

I know that this is hard to hear, especially if you’re struggling with this condition. People get focused on their boot camp routine, and are hopeful that reaching their fitness goals will alleviate the problem. For some, the issue may not be as severe as my own. But for me, in order to feel truly good about myself, I needed to accept that surgery was my only option. And to be honest, this acceptance set me free. For several years, I felt strong,healthy, fit and able to keep up with my kids, as well as reach my personal fitness goals. I wasn’t fixated on changing anything about my stomach. Basically, I just ignored it’s existence; deep down I knew that one day it would be gone.

The Double Standard

Over the years, I tried to open up to other moms about how disconnected I felt from my battle scars. I’ve talked about how, over time, they have left me feeling less feminine, less like myself, and sometimes even less human (trust me, s**t got weird). Unfortunately, some folks felt the need to compare my feelings of distress I have about my twin pregnancy, and the travesty it has made of my body, to the amount of love I have for my children.

“But, you wouldn’t trade anything in the world for those kids, right?”

“The more you love your kids, every day, the more you will accept this as just a part of being a mom.”

F**k that. I’m sick of feeling ashamed of wanting to look human again. Or feel that, for some reason, I need to be a martyr for my children and wear some sort of “badge of honor” in the shape of flabby skin on an inflated tummy. Of course I accept that this is one prospect that can happen to some moms. That said, I don’t have to love it, and I certainly don’t have to feel like a bad mom for wanting to change it. Sure, my kids are worth every worry-line and sleepless night, every ruined blouse and scratched coffee table, every ache and pain and scream of every second of birthing my darlings. But I AM WORTH SOMETHING as well.

So screw the paradoxical notion that makes moms believe they have to trade being a proud mama for wanting to reconnect with their body. Once I started to listen to my heart without criticism, without judgement, and without fear, I allowed myself to be hopeful of the possibility of change. Thinking about the prospect of ‘wiping the slate clean’ gave me hope, and made me feel happy.

Also, this may blow your mind, but I’m not someone with low self-esteem. I feel good about who I am and even what I look like. I feel even better about what my body has been able to accomplish! I celebrate it! But in all honestly, I also felt I owed it the rehab/repair it deserved, from all the hardship it’s endured.

7 Years Later.

So what was I waiting for?? When the twins were 5, heading off to kindergarten, my husband and I finally decided to have another baby. The pregnancy had minimal complications…wretched back pain, an over-due delivery… but WAY easier than the twins. It did, however, make the diastasis recti worse. The twin skin? Oh, I was tucking it into my tube socks by then! (A slight exaggeration of course, but check out the size of me with only ONE baby in there!)

my singleton pregnancy, after twins

With our family complete, and once I was done breastfeeding my little dude around 14 months, it was definitely time to do something about this mess.

The first step, finding the right doc, was a piece of cake. My neighbor had experienced the same procedure earlier in the year and she loved her surgeon. At my first consult, I was also pleasantly surprised. I was expecting a car-salesman type white man, with slicked-back hair and big, super bright teeth. Instead, I was greeted by a tall, middle-aged woman with a gentle smile and very nurturing demeanor. She answered all my questions thoroughly (I had a list of THIRTY TWO), and I soon felt confident that I had easily found the best plastic surgeon in town. I was so excited! Then, two days later, her gal sent me my estimated total cost. WOWZA! Are you sure I can’t just do more sit ups??

So let me again remind you that this is only MY STORY. Abdominoplasty might not be for everyone, and I will be the first to admit that its f’n expensive. No, your insurance company won’t pay for it. Trust me, I tried everything. We wrung our hands for quite some time trying to figure out how to obtain the loans possible to pay for the procedure. In the end, I am so happy that we did. Even with my most recent bouts of recovery-induced pain, I have no buyer’s remorse.

I Did It! 

This was major surgery, and of course when the time came, I was terrified. I listened to meditations every night leading up to the big day. I tried to stay off the internet, where I was bound to find endless stories of botched jobs and regret. My husband continued to remind me of my courage and the strength in my family’s support of me. I continued to remind myself that I was finally at the end of a long journey that began 7 years ago.

I am now on day 5 of recovery from a 2-part procedure that fixed both problems: abdominal plication (the muscle repair) and abnominoplasty (the tummy tuck). Seeing as I’m not a doctor, and chances are neither are you, we’ll keep the explanation short and simple. 1) She cut my abdomen open, from hip to hip. 2) Pulled and stitched my muscles back together vertically, down the middle of my belly. 3) Cut off all the unsightly loose skin. 4) Pulled the skin tight. 5) Lastly, stitched me back up, from hip to hip.

STILL Worth It? 

So, while I’m currently in the “thick of” recovery, now might be a good time to ask… Would I do it again? Absolutely. That said, it’s not for the faint of heart. It is taxing on your wallet, your body, and also your relationships. Over the next several weeks I will be more dependent on others that I am usually comfortable with (as is the case for most mothers, I’m sure).

Recovery is difficult. These past 5 days have not been easy, but every day is 100% better than the one before. While my husband holds down the fort with all three boys at home, I’ve had the luxury of camping out on my mother’s recliner … a poor-(wo)man’s medi-spa if you will. I’ve been told I’ll be on pain meds for at least 2 weeks, and possibly up walking around slowly in the next day or two. The real kicker is the amount of time I will need to resist picking up anything heavier than 10 lbs… 8-10 WEEKS. That means my needy, fussy toddler and I will have to come up with an arrangement that works for the both of us. But I’m confident we’ll get through it.

I knew I wasn’t alone (check out the comments on this photo for example) yet I still think many women feel that they are. Because of this, I thought it was best to go public with my experience and possibly help another mama gain some perspective and a bit of hope. Whatever you decide to do with your torn up tummy, don’t forget to love YOU. Allow yourself the grace to feel good about whatever decisions you make that will ultimately help you become your best self.

My brood.  Worth it.

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Twinfant Tuesday: Twin Skin, Back Pain, and Why You Still Look Pregnant

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Disclaimer: I am not a medical professional. Speak to a doctor or other certified professional before making medical decisions.

I, for one, gained 60 pounds and was 52″ around by the end of my twin pregnancy. At 61″, I was nearly as round as I am tall. My belly itched something awful from about 10 weeks until 35 weeks, when my skin sort of went numb. I don’t know exactly what I expected would happen to all that extra flesh, but the real mystery was what was happening underneath it.

What you need to know is this: twin pregnancy + c-section = jelly belly

A year later, the skin is still there – but (glamor secret!) I can tuck most of it into my panties. The fat under the skin is mostly gone. I’m surprised that I didn’t have to do much to make that happen, aside from nursing every waking hour for 6 months and most of the time after that. Oh and lugging a couple kids around everywhere.

But the muscle itself required a more hands-on approach.

An avid Pilates-goer pre-pregnancy, I figured I’d hit the Hundred and things would start to firm up. Oh, the naivete. First of all, if I had time to lie down, I wasn’t doing ab work, I was sleeping. Secondly, my abdominal muscles were sort of…missing. I couldn’t even feel them. When I was still having trouble sitting upright at 8 weeks post-partum and my back pain was becoming unbearable, I discovered the underlying cause: diastasis recti.

Basically, your abdominal muscles have two sides (picture a six-pack and think right and left pack). Normally, the sides are held together by a thin membrane. During pregnancy, the membrane stretches, causing the two sides of muscle to separate. This separation is called diastasis recti. Many women will have a little pooch after becoming mothers, and this is why. Without that firm membrane, the organs behind the muscle are no longer firmly held in place, creating a mild protrusion. Sometimes it also causes an “outie” belly button that never pops back in. My friend describes hers as a “lion’s nose belly button.” There is a spectrum of severity, measured in finger widths.

Here’s how to test yourself for diastasis recti.

Many mild cases heal on their own over time, or go unnoticed because they don’t cause any problems. In my case, after a gigantasaurus twin pregnancy, that little membrane didn’t stand a chance. I had a 4-finger-wide, 3-knuckle-deep diastasis at the belly button (my widest point), and my abs were weakened from pregnancy and surgery. I needed some help to rebuild strength that would protect my back (and slim down that 6-month pregnant look I was still sporting).

Some facts about diastasis recti:

  • It can be prevented or kept very small by avoiding excessive abdominal work in the first trimester of pregnancy and doing certain exercises during pregnancy. Not all women get diastasis recti during pregnancy, but multiple babies certainly up your risk.
  • It can be healed and even cured.
  • It’s never too late to start correcting your diastasis.

There are three proven interventions that can improve a diastasis recti:

  1. Surgery. This is super expensive and has a pretty extensive recovery period. Plus I’m not sure if I’m done having kids, so this was out for me.
  2. Wear a support device. For months, I wore the giant elastic band given by the hospital after my c-section. Not all the time, but when I knew I would be walking any distance or doing a lot of baby carrying. I later learned that a compression garment is less effective than a specially designed splint, but it did give me some much needed support as my abs healed.
  3. Tupler Technique. This is a special workout designed to heal diastasis recti. The technique has undergone rigorous scientific testing, and was found to be quite effective. Here is an interview with Julie Tupler for details. I found a local Pilates studio that specialized in Tupler Technique, and signed up for a 12-week series. It was AMAZING. Not only did I get some much needed me-time each week, I gained valuable information and moral support. Through the series, I developed a baseline of strength that greatly reduced my back pain and reconnected my awareness to my core. It was the best thing I could ever have done to recover from twin pregnancy. And it cost approximately one billion dollars. I would 100% recommend going to special classes for diastasis patients, but if you can’t afford it, use the information available online to learn the basics and do them yourself at home. It is worth it!

Need the quick version? In order of importance:

  • Avoid crunches and twisting motions (yeah right, but as much as possible). These move your abs further away from each other.
  • Aim to get up from your side rather than jack-knifing forward, especially if you are supporting the weight of a baby too (i.e., rolling over to nurse side-lying on the other side).
  • Learn how to do Elevators and Contractors (from Tupler Technique) and work them into your day.
  • Base your post-partum workouts around cardio and safe ab-strengtheners, like planks or, my personal favorite: get onto hands and knees. Tuck your toes under. Make sure your back is straight, tighten your abs, and lift your knees a millimeter off the floor. Hold. (I could not do this for weeks. Keep trying, the effort is working!)

Following my Tupler series, I continued doing the exercises at home, when I could. My diastasis has shrunken down to 1-finger-wide and 2-knuckles-deep. I only look one trimester pregnant, not two! Even bigger than this improvement is how I feel.

Do you have experience with diastasis recti? What is working for you?

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Belly Up

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Alright gals, I did it. After two years of agonizing over the appearance of my belly, I finally got the gumption to go to the plastic surgeon. Don’t get me wrong, I didn’t actually have anything done. But I took the first step with a consultation. And let me tell you, it was fifty bucks well spent.

First off, if you have the ambition of making a crap-load of money during your time here on earth, become a plastic surgeon. I stepped into this guys’ office, and I felt like I was at the Venetian in Las Vegas. Super deluxe…and I live in Austin, Texas, where you can go to a five star restaurant in jeans and a tank top (and don’t forget your cowboy hat!). When I got a look at his fees; let’s just say he makes somewhere in the range of $1,500 an hour. Not bad!

I was oddly comfortable waiting for Dr. 78735 in the plush terry robe and g-string scrubs, although it would have been nicer if they had offered me a glass of wine and a pedi while I waited. He entered the room and after brief introductions, asked me what I was interested in. Huh – isn’t that what you’re supposed to tell me? I admitted that I was a total neophyte and meekly stated a tummy tuck and a boob job. He asked if I wanted both a breast augmentation and lift. I answered with a blank look. After some discussion over the technicalities of each procedure (more blank looks), it was time to disrobe (eegads!).

The unveiling wasn’t that bad. I was diagnosed with a large umbilical hernia (which my insurance would cover – whoopee!), major diastasis (above and below and all around the tap that my Be Bo has become), stretched-out skin and, of course, stretch marks. He pronounced that I would need a full tummy tuck to correct everything. He’d try and use my existing c-section scar and then cut a smiley face to each hip bone, a general surgeon would come in and fix the hernia, he would pull my ab muscles back into place, and then stretch my skin downwards to get rid of all the unsightliness. All of the skin and stretch marks from my belly button down would be gone (as in cut out forever), and the stretch marks above my BB would be much less visible because they would be, um, really stretched. Lovely.

As for the boobs, he said I wouldn’t need a lift. After 13 months of breastfeeding two babies, imagine that! At least there was some good news to this visit. But he said an augmentation would “restore the look and fullness” to my deflated mom boobs. He said silicone was the only way to go, because it feels the most like breast tissue. I nodded and tried to mask another blank look.

We sat back down and talked more technicalities of the actual surgery. It’d last about 4 hours, I would need at least one overnight in the hospital (he recommended two), and a pain pump was the way to go (kind of like an epidural for the stomach). The kicker was when I heard about the recovery time. The boob job was hardly anything. The tummy tuck? Six weeks. Yes, you heard me. Six weeks of lifting no more than 10 pounds. With twin two year olds, one of whom attaches himself to me as if he wants to be back in utero, good luck on that one!

After the consultation, I had the pleasure of posing in my g-string scrubs for some pictures. With mirrors and umbrella lights in each corner and a pretty, skinny young thing taking the pictures – let’s just say it was a humbling experience. She took about ten photos, and to add insult to injury, made me step on the scale. They program this whole experience just right, because then I was ushered into a room to view before and after pics. All I can say is AMAZING! I couldn’t believe my eyes. And I loved seeing bellies that looked far worse then mine looking gorgeous after a tummy tuck.

A lovely lady in her 50s entered the room with lots of paperwork and walked me through the process and the expenses. Pretty amusing that she went into all of the details of surgery and recovery, as if I had already signed on, before going over the itemized estimate. Nice to know I have the option of spending my second night of recovery not in the hospital, but at the beautiful Barton Creek Resort where I would have nurses waiting on me and lymphatic massage therapists at my disposal. And then I saw the only piece of paper that mattered. All in all, even with insurance covering the hernia portion, a tummy tuck and boob job would cost…

$14,000. Yes, you saw that right.

She pulled out the doctor’s schedule and asked me what time frame I was looking at. I answered her with an unabashed blank look. I managed to ask if there was any “wiggle” room in the estimate (the negotiator that I am). She said if I removed the second night at the hospital and got rid of the pain pump, that could bring it down $750. Oh, and the $50 consultation charge would be deducted from the cost. Wow. Great.

Now that it’s been a few weeks, I’ve decided against the boob job. After some quick research, I learned that boob jobs have at most a ten year life span. So once you get one, you can plan on getting another every ten years until you have no more money left. Not my cup of tea. Plus, the silicone that was recommended has a lot more maintenance. Like MRIs every few years to check for leaks. With saline, if it pops, you know it. All of the above I wish to never experience in my lifetime (nothing against boob jobs, though!). So I plan on calling them back and getting a new estimate for just the tummy tuck. Not because I’m going to get one anytime soon, but just so I know how much I need to save over the next five years. Amidst a downward spiraling economy.

Belly be damned, I do plan on getting you fixed eventually. But for now, it’s you and me, belly. No matter how ugly you are, we’re in it for the long haul.

You can read my other post on post-partum ugliness here. And to be totally jealous of one HDYDI mama who has a killer and unscathed post-partum belly, read here.

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The post-partum twin belly: there is hope

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Looky, Daddy!‘s wife, The Mom, wrote one of my favorite twin blog posts. “The Mom on Going All the Way” is about women who make it full-term with twins. The advice most expecting twin moms get is full-term twins are about as likely as having a completely normal post-partum twin belly. We are told to prepare for premature babies and completely ruined stomachs.

As soon as my twinshock wore off after our 20 week ultrasound, I became obsessed with twin bellies. Besides worrying about the health of my gestating boys, I worried about my ever-expanding stomach.  I googled “twin belly pics” and read twin entries on The Shape of a Mother. I posted my own belly pics on my blog and watched my google hits rise.

During all my obsessive internet reading about twin bellies, I never heard stories like my own. And it is from that perspective that I share today my BIG twin mom secret: my post-partum twin belly is completely normal. I made it to 36w, 3d with 12 lb 4oz of baby in my 5’4″ body. I have no stretch marks, no twinskin, and no abdominal separation. I didn’t do anything special and there is no secret. Just like twin moms who make it full-term, there is no rhyme or reason as to why this happened to me.

I thought a long time before sharing this, because I don’t want women to feel ashamed of their post-partum bodies. But just like stories about full-term twins, stories about “normal” post-partum twin bellies are missing from the multiple moms dialogue. It is rare, but it happens and it happened to me.

36 weeks with twins:

36weeks.jpg

21 months post-partum:

sidebellypicdownsized.jpg

frontbellypicdownsized.jpg

 

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Semblance of my Former Self

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When I was pregnant with my boys, I remember very early on being obsessed with looking at belly shots. I can’t tell you how many times I googled “pregnant twin belly photos.” I just couldn’t fathom what two babies growing on the inside of me would look like on the outside. And honestly, I was scared to death. When I started telling people I was pregnant with twins, just after their elated congratulations would come, “you are going to be HUGE!” Thanks, that’s just what I needed to hear. So what better place to go and find out exactly how huge I would get then the Internet! Big mistake.

I found several sites dedicated to pregnant bellies with twins and triplets, along with blogs and personal websites. And what I saw, in many cases, was even more frightening then what my imagination had conjured. Crazy stretch marks. Full-term size at only 25 weeks. OMG! What was going to happen to me?!?! And then I hit the mother of all pictures that induced such fear and spine-tingling horror…the postpartum photos. What the hell is “twin skin?!”Now, I’m not a vain person. But I am 5’3” on a very good day and weigh about 120. Aside from thinking about these frightening future aesthetics, I wondered if my body could even handle this?

33 weeksWell, of course it could…and it did. Despite being fairly paranoid of how enormous I was getting, I lucked out and didn’t reach full-term size until I was 33 weeks. I delivered at 36 weeks, thank god, because my belly felt like it just couldn’t stretch any more. But that doesn’t mean I didn’t get my twin “badge,” or I like to say “badges,” because if these suckers were like girl scout badges, I’d have a whole sash filled in. Yes I have stretch marks. Yes I have twin skin. Yes I have a herniated belly button (the outie that just won’t go back in). Yes I have diastasis (my very own abdominal crevasse). Yes I want my old stomach back!

I think some women are blessed with a combination of great skin genes, a long torso, height in general, and can manage to have a twin pregnancy without all the postpartum ugliness. But I think most moms of multiples have a constant reminder of their pregnancy written across their tummies. I’m not trying to scare any preggos out there who are reading this, I just want to be realistic. Because I deluded myself while I was pregnant, rubbing tubs of 100 percent organic cocoa butter and vitamin e thinking I would be spared. I would be one of the lucky ones.

I know everyone is different, but it wasn’t until six months postpartum that I could even look at my stomach in the mirror without totally cringing. The good news is that after a year, I’m starting to get used to how my stomach looks. It’s actually not THAT bad. The stretch marks have definitely faded, and if it weren’t for the hernia, I’d feel pretty comfortable with it all. My husband tells me that when the time comes (i.e. when we are officially “done”) and if I’m so inclined, I should just get it fixed. And I’m so NOT the plastic surgery type, but I have to say the idea of walking into Dr. Reys’ office on Dr. 90210 and asking for a “BJJ” – belly button job – is hysterically intriguing to me. Because really I should get a hernia fixed, shouldn’t I?!?! And while I’m there, I might as well get my abs pulled in and skin smoothed, too, right?

And just like that those badges would be gone, forever erased from my twin mom sash. But I don’t think I’d mind a bit, because these two beaming faces smiling up at me are all the reminders I need.

oz and abieP.S. Just like my obsession with researching pregnant bellies, I did the same for the ultimate stretch mark solution. I now rub my belly with some stuff called Bio-Oil and I’m convinced it helps. You can get it at Walgreens.

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