Nothing More Than Feelings

One of the problems I’ve found with having a brand new set of tits is the question of if and when to tell suitors prior to any shirtless situation. I still have scars, so I know that the topic should be broached prior to any upper-half undressing, lest I have to stutter some explanation about falling down a flight of stairs with a set of steak knives. Because I haven’t had playtime with anyone who didn’t know me and my body before surgery, addressing the issue hasn’t been more than a fleeting bout of anxiety prior to arriving on a first date, anxiety that inevitably ends with me bestowing a bro hug and affixing the dude firmly in the friend-I-don’t-text-back zone.

All of this changed last week.

I’ve been seeing a new guy, and while it’s nothing serious (and judging by my robot-like failure at pair-bond formation, it won’t be) it has progressed to the point of me tailing his car back to his house after dinner in order to catch the third period of an Isles game we were watching at a bar.

I might be small, but I’m not dumb. I knew what would happen, I just hoped it would occur after the shoot-out heroics of Okposo. I’m lucky I have good ears and a pretty good imagination. While having Howie Rose play my personal Barry Manilow, my new fellow went to work trying to get me to fuck him.

Wasn’t gonna happen. He plays offense and I only put out that easy for goalies.

how to connect cords!

As we made out, and my cochleae tried to process the overtime action I couldn’t see on account of the action happening in my face, it occurred to me that this dude didn’t know my boobs were made via medicine. When should I disclose prior to the big reveal? Would he feel their unnaturally round and hard shape and think I was a goddess, or just a really piss-poor liar? Or, worse, and most untrue, that I had some sort of shame surrounding my surgery?

“I…I have something to tell you. Two things, actually,” I awkwardly stammered, his face mere millimeters from my own.

Already aware of how boy brains work, and I knew that, at this point, if he was savvy, he thought I was going to mention

  1. a) a boyfriend
  2. b) a divorce
  3. c) an STD or STI

“I want to go slower than I usually would,” I said, which, while true, sounded slutastically stupid. “Because I like you,” I hastily added, lying like a shag carpet. It was actually because I didn’t want to leave the room with the television and because I was lukewarm on the turned-on scale. “Also, my breasts? Aren’t real. And they’re new.”

His face was that of a kid finding the red Schwinn under the tree at Christmas.

“That just makes me more excited to feel them!” he replied.

I went from lukewarm to just below room temperature, and snuck a quick glance at the television. Final zamboni run.

Another two minutes into making out and his hand was up my shirt. While I didn’t really want to, I let him, because I had brought them up. And, hey, why not. He wasn’t so much as stealing second as being walked due to the following batter being hit by a pitch.

And that’s when I noticed something. I could feel his forearm on my belly, and his mouth on my own, but his hand was suddenly missing, like he was an amputee. Was my bra still on? Was he under it? Was I suddenly suffering from frostbite? I couldn’t tell.

In fact, I couldn’t tell anything.

If faking an orgasm is bad, not being able to tell what you’re faking is worse. Was he tweaking the nip? Was he even on it?

While I hate seeming like a wet blanket in bed, and credit myself for very rarely getting into situations that require forced theatrics at this age, I was at a loss. I didn’t know whether to moan even though I was absolutely numb, or do I call time out on account of needing to have another huddle.

I opted for neither, instead seeming more silent in the sack than a mute Amish girl on her wedding night.

When I got home that night (and actually watched the period that I had conveniently DVRed) I wondered why that was. I feared that like a sequel to The Little Mermaid I made a trade, only instead of voice-for-gams it was one of nerves-for-curves. I feared that this condition, like tattoos or my new tits after death, could last forever.

numb from the neck down

Neurapraxia, or nerve injury, is common in cases like mine. I mean, after all, some dude with a fancy degree opened me up, severed my muscles, and shoved orbs of silicone somewhere near intercostal nerves three and four. The anterior branches of these fibers supply the sweater puppies with sensation. (“…to the side and the forepart of the chest, supplying the skin and the mamma…” Swoon.)

So what’s the deal? Will I forever be a sensory slave to my prostheses?

As with overpriced education systems, fantasy football leagues, and the level of spice in Thai food, there are classification systems. In the case of nerve damage, the degrees are rated one through six. The first two have stripper names, the aforementioned Neuropraxia and the second-degree, Axonotmesis. Both recover over time, and are the most likely culprits for what’s (not) going on in my new additions two months out from the OR, at least in my understanding.

http://plasticsurgery.wustl.edu/en/Patient-Care/Nerve-Injuries/Nerve-Injury#Figure_1

[table via]

The cool thing about nerves is that, like Real Housewives programs and TuPac’s discography, they continue to grow and generate new units at a fairly steady pace, especially following first and second degree injuries. In order to restore nerve function, these new nerve units have to establish the right connection, may it be motor nerves to muscle or sensory ners to skin. At a rate of one inch per month these new bundles are produced, and thankfully sensory function is usually reestablished within three to six months after surgery, fully being restored usually after a year.

In the case of augmentation, sensory function is only permanently lost in 10-15% of patients. (I recognize that “only” is probably not the best word to use here, and my heart goes out to my synthetic sisters who can no longer feel their nipples for good.) What’s kind of cool, and hella interesting, is that, even after long stretches of time where there’s been a loss of nerve supply, sensation can be recovered. Unfortunately muscle reinnervation can’t happen after a while without nerve innervation, so if nerve-to-muscle connections aren’t reestablished in time, you can say sayonara to that function.

That said, the risk of a definitive and forever failure of the tit nerves is low. Sensation changes due to stretching of the nipple and areola are common but, again, I can cope with that, especially with a new push-up bra.

http://instagram.com/p/ts8ofAqJDc/?modal=true

[via Instagram]

On December 5th, I’ll be up to month three, and should start sensing more in the area, if I’m on the three-to-six month regeneration path. Unfortunately I don’t think that the other night’s right wing will be on the lucky front line of nipple nips that I can actually feel in my bits once the sensation is (hopefully) reestablished.

But, hey. There’s a silver-lining. If I do permanently have nerve damage, getting the girls pierced again will probably be painless…

(You’re welcome.)

Sweet Child Not Mine

I do not possess a maternal instinct. Blame it on me being an only child, or growing up at the end of a long road in the boondocks of the north shore where no kids lived, or maybe that I fell face-first out of my crib more than once before the age of three, but I have never been a “kid person.”

My mother handed me off to a caregiver as soon as she got home from the hospital, so perhaps this lack of bonding capabilities is genetic. I don’t know. What I do recognize is that I’m better equipped to write a research paper on particle physics, create a new kind of fire, or thread a needle with only my left hand in the dark than I am to be left alone with a child under twelve for even a few minutes. I don’t have patience or the ability to refrain from talking about things like anal fistulas or skull fucking, let alone to pretend I know anything about diapers or playsets or that blonde trollop from that animated movie Freezer or whatever.

I can immerse myself with the acts that create babies, but I cannot even approach an actual baby.

Which is why it was a decidedly poor choice on my part to have my first continuing education class following my massage licensure be a four-day long course to become a Certified Educator of Infant Massage.

Foolish, foolish move.

To my defense, I took an incredible class during massage school called Prenatal & Infant Massage. Blessed with a capable, witty, soft-spoken teacher, I got hooked on the idea of prenatal massage, even if the first class convinced me that birth control should not be optional.

Soothing the bodies and psyches of mothers-to-be? Laudable, purposeful, and fun. Massaging the parasites after they emerge from those bodies? Terrifying, purposeless*, and dumb.

Science break! There is indeed a point to infant massage. Countless non-woo studies have shown that applying gentle touch to newborns, especially preemies, serves numerous benefits for the child, including improving growth rates, aiding thermoregulation, and being a viable option for treating nasty digestive troubles like colic. But when it comes to healthy, full-term babies, after taking this course, I don’t think there’s much of a need for having massage as it is to be taught. While we were instructed in a routine to demonstrate on a doll and teach new parents, I believe any soft touch and affection given to a tiny human is beneficial, but it’s my opinion that this is something that doesn’t need to be instructed in a class setting, let alone for $150 a pop.

fuck this

My experience with rubbing babies prior to the course was antiseptic enough; I had rubbed a three-pound, twenty-inch, baby-shaped lump of fabric and plastic for a handful of minutes during my Pregnancy & Infant Massage class during school…and I’d been lucky enough that a friend who had taken the class before me had let me have her doll.

“I don’t need this,” she’d said as she haphazardly handed the mock baby to me from the trunk of her car. “I was gonna throw it out anyway.” I continued the tradition, passing along the infant stand-in to another student who I knew would need it during the following term.

So when the instructor of the CE course contacted us to see if we needed a doll for the class, at the cost of $49, two things came into my mind:

  1. We would be massaging dolls.
  2. After spending nearly $700 on the class itself, bitch should have thrown in a free doll gratis.

The cost of this endeavor was high, and apparently going up, but I figured it was worth it. I mean, there’s science behind the practice, and it would be helpful to those new moms who I’d (hopefully) massaged during the course of their pregnancy. Besides, it was a CE course that seemed easy, unlike the real shit I was interested in. I liked the idea of aiming low to begin my career. Rubbing dolls in a room filled with strangers in Manhattan for less than a week didn’t seem so bad.

Grumps' commute
Baby in a bag.

Let’s start with the basics: massage therapists, on the whole, are weird. I am not exempt from this description. But while the snarky, medicine-obsessed, tattooed midget is a rare form of bizarre, the probably-gay, married white guy is not.

He was there. So was the out-and-proud male equivalent of Rosie Perez, who was taking the course to be able to teach, as well as to prepare his husband for their eventual family. The rest were women, not all of them MTs, some of whom were occupational therapists. One student was an early childhood program director, and there was one retired old lady who strongly resembled Roz from Monsters, Inc. who was taking the course as something to do.

There were twenty-one of us in total, just enough for me to be able to text during the lectures without seeming too rude, and just few enough that I would seem like an antisocial asshole when I refused to talk to anyone during our breaks. Both of which were what happened during the duration of the four interminable days.

Allow for me to state a few facts about myself. Other than being devoid of any motherly qualities, I am not cute and cuddly on the whole. I show affection by remembering details and worrying excessively, and when I truly love and care I will get extremely angry for no reason and say things that make me seem like I feel the opposite about you. I do not snuggle. I do not nest. I do not sing lullabies or cry in front of groups of strangers when relating stories of things I found “beautiful,” as the male, effeminate therapist did.

Among the activities of the week that I can still recall from the traumatized vortex of sticky, screaming PTSD that is in my skull, there was the instruction on such massage techniques as “Ears, Cheeks, and All Those Chins,” “I Love You!” and “Sun and Moon,” which included singing.

Oh yeah, and actual babies.

Babies. There in the room. With their parents. Next to me. Behind me. Around me. Babies…everywhere.

Along with their parents who we were to teach how to massage their real, live children on our dead-eyed dolls as though we had an emotional attachment towards them. And we were to continue to instruct, even when the tiny terroristic sound cannons went off one by one or if they stole a size 6.5 black ballet flat and crawled off, sticking the shoe in their mouth, while the shoe’s owner – me – was to look on, frozen in fear and shoeless.

When I tell you that the highlight of my week was hitting a UPS truck on 33rd Street while in traffic, thereby giving me a viable excuse to arrive over a half-an-hour late on day number three, believe me.

On the first day we had to name our dolls. Then we were told to sit in an intimate circle, where we were to say our “baby”’s name and the reason why we named them as such. We went around: Violeta, because it was a family name; Vincenzo, because her daughter had named the doll at the breakfast table this morning; Sarah, in honor of a pregnant friend…The circle got to me.

“Grumps. Because he looks like a Grumps,” I said.

Dead silence.

My doll was wearing a pink onesie and a pink hat.

After a moment the circle continued, but clearly my role in the tribe had been set. That is the Crazy One. Let her make her braid invisible licorice inside of her yurt in peace.

I started going to the bathroom for longer and longer during the duration of the course, and while I concocted a brilliant excuse having to do with PCOS and diarrhea, nobody questioned, nobody seemed surprised. My incessant reaffirmation as we went around the room that I both did not have and did not want children, along with my constant citation of studies instead of warm-and-fuzzy baby stories, and perhaps my choice of baby name, led to the group as a whole to decide that I shouldn’t teach any actual infant massage to, well, anyone, and allowed for me to lead the discussion segment of the session at the very end of the class.

Grumps
Grumps.

Obviously everyone but me knew that I shouldn’t be there. But I was enlightened to this fact, and quickly. It took no more than one sharp, shrill, hour-long scream courtesy of a seven-week-old named Desi for me to consider walking out and giving up while gaining $700 of relief…and that was before the shoe incident. (Different baby.)

Instead I stuck it out, even after one of the kids urinated on a pillow that the mother handed to me before proudly adding, “He went twice!” Even after my SI joint fired off searing angry memos to my brain after sitting on the floor for so many hours in a row. Even after the mandatory team-building exercise and instruction to treat our dolls like actual babies at all times.

The final stand-off between my self-will and conformist tendencies came during our practice session before the parents arrived for the class. As we performed our stomach ‘routine,’ the instructor taught us a lullabye in Hindi. We were to sing it to the rhythm of our strokes. It meant something nice and benign, like “you are loved, precious baby” or “I love you, sweet baby,” I don’t know. What I do know was that the word “baby” was present in the three-sentences that made up the song’s lyrics, among the mumbo-jumbo of syllables and consonants I did not understand. It sounded like an incantation summoning the devil.

Hard limit: I do not sing. Especially not lullabies. Especially not in groups.

The instructor soon noticed that I just sat, staring at Grumps, rubbing is seamed, cloth belly, with lips joined in a hard, unmoving line.

She sang louder. The class continued their chorus. Everyone was lullabying to their dear quasi children but me.

She made eye contact with me but I was unwavering. She swayed and rocked to the song, and the other students followed suit, pitching and heaving their torsos as they sat cross-legged, chanting and petting their dolls.

After the lullabye went on for long enough that students started looking around wondering if this was some sort of initiation rite and we were going to have to start sipping some Flavor-Aid, the Mexican standoff came to a close. We were done. No more singing. I had won, my fully-grown, non-reproducing body still silent and still.

Fuck this, I thought to myself.

Fuck you, the instructor probably thought.

grumpsmiddlefingerup

So that was my last week, a lesson in how aiming low can sometimes cause the bullet to ricochet back into you. I won’t be teaching five couples how to massage their new infants on my own, which, along with a test packet, is part of the certification process. (Nobody fails, by the way. One of the more astute students had asked.)

I will never, ever become a Certified Educator in Infant Massage and, as it turns out, those CE credits won’t count towards my extended licensure anyway. But, hey, at least I can feel confident the next time I have the argument that, no, even though I’m getting into those biological alarm clock years, I will never be delusional enough to consider having children.

Rub-a-Derp-Derp

When I was at my post-operative appointment, my doctor said that I’m no longer prohibited from having sex at the end of two-weeks (…whoops…) and that I should begin massaging my new breasts at the end of the third.

This is supremely ironic, as I’ve been spending the past weeks of my recovery feverishly checking the state’s Office of the Professions website to see if I passed or failed the massage boards exam.

Prior to my foray into plastic surgery, I attended a state-funded school to get an Associates Degree in Massage Therapy. The conclusion of this academic exercise in futility and administering naps was an exam to get licensed by the state. It’s required. Otherwise that whole 1,000 hours of education and clinic hours spent rubbing octogenarian feet was for naught. Breast massage was briefly taught in a Medical Massage class by an ancient professor who jiggled her own sagging right tit in her hand through her brightly-colored Chico’s blouse. I’ve tried to block it out.

The irony of having to rub myself is two-fold as well because, ahem, getting breast implants was partially motivated by a desire to have other people massage my breasts. But I guess breaking them in on my own would be a start.

We must, we must...

One of the first things that happened after I pissed and metabolized the rest of the anesthesia away over the course of two days was the fact that I felt my breasts weren’t my own. (“Well, they aren’t,” an astute friend pointed out.) My initial reaction in the recovery room had been to slowly lift my hands up to my bandaged tits and rub them, like a slower, more drugged climax of “Eye of the Beholder.”

After the early proprioceptive confusion, I had to take a shower. The first few times were a bit awkward, and…gross. I trembled and felt like I was on the verge of retching, not because of pain. I didn’t want to touch them. I didn’t want to look at them. Not because I regretted anything – in clothes I was suddenly a Hentai character, and not in a bad way – but because I didn’t know what to do with them. Still numb from the tampering my fourth intercostal nerve had been subjected to, they literally felt like someone else’s. I could sense pressure, but not sensation on my skin. Massage, at least how I knew it, would be impossible.

Fast-forward two weeks. Sensation in the left breast fully returned (now with nipple!) and halfway returned to the right. Small swaths of them are slightly-to-completely numb, but I can touch them, poke them, and basically use them as fragile projectiles. It was time to start massaging.

But how?

Now, I know that my two years of manual therapy training should have left me with a bevy of gropey tools in the proverbial ‘move’ toolbox, and that my cursory understanding of human anatomy and physiology should have blown away any and all dust-bunnies of self-doubt, but no. I approached my new tits with the type of trepidation as a twelve-year-old boy copping his first prepubescent feel.

I squeezed like I was checking the ripeness of a rare tropical fruit. I pushed with the pads of my fingers as though trying to nudge a precious family heirloom into its right place on a shelf. But mostly I just stared at myself in the mirror.

I was clueless, helpless, but no longer boobless. It was time to consult the oracle. I typed “breast augmentation self massage” into the Google search bar and waited to attain enlightenment.

up to the collar, down to the sides, wear a tiara

“Massage” refers to the “displacement exercises” that you need to do postoperatively.  This is VERY important.

Massage is at best unnecessary and  at worst counterproductive.”

From the get-go, I could tell that I’d been wrong. I was not going to be able to simply click on a WikiHow link of how to pummel my gummy bears into corporeal compliance. The forum porthole into the rabbit-hole of comments sections is what I fell into. Hard.

One doctor in Minneapolis said to push the implant in all different directions, holding each ‘push’ for a ten count in order to stretch the pocket and avoid capsular contracture.

Another doctor in New Brunswick, New Jersey said that capsular contracture was an immunological response and therefore any manual manipulation was for naught, whereas the prescription of Accolate post-operatively was essential. (Not entirely true. Etiology is commonly cited as unknown. I was not prescribed Accolate or antibiotics.)

A doctor in Manhattan and another in Austin said that self-massage is contraindicated for textured implants. Three or four from various locations said it was absolutely crucial. One other plastic surgeon, also from Manhattan, said it didn’t matter either way.

I found myself judging the efficacy of self-massage on whether or not I liked the city of origin of the majority of the doctors in each camp. It was an equal split. (Nine for, nine against, two neutral, one who had too many typos for me to pay attention to his response.) One doctor who went into a detailed argument about why massage was useless made me get wet over his vitriol and thoroughness of argument.

Capsular contracture arises from biofilm within the pocket resulting from a low concentration of bacteria and the associated extracellular matrix. The bacteria do not cause an infection, yet cause the capsule to contract. Minimizing bacterial contamination and growth helps prevent capsular contracture. In fact a recent study that followed outcomes and several variables found that the patients who did implant massage had a higher rate of capsular contracture! And the theory that “massage enlarges the implant pocket” is ludicrous. Why would one want their implant pocket to be excessively large? The implant should fit within the pocket and not pin-ball around under the breast.

Well-done, sir. Well-done…now, if you excuse me, I need to wipe off my chair.

But I still didn’t know whether or not massage was effective, or how to do it. All I knew was that my supremely foxy doctor had told me to. And I’d been too lost in his gaze (and my post-op haze) to think of asking how.

like this?

So what did Team Touch Yo’self say about technique?

Start in a week. Start immediately, if the patient can tolerate it. Do it three times a day. Do it every day. Do it once in a while. Do it for four to six weeks. Stop when the swelling goes down. Do it forever. Do it “several” times per day. Twice a day for six weeks post-operatively. Do it hourly for three months after surgery. Start immediately after surgery, or at the moment that the patient is able to cope with the pain.

My doctor said to start during week three, which is now. I’ll default to two or three times a day, or whenever I remember. I mean, I’m naked about twice a day. Sometimes more. So, then. If I have the time.

And exactly how long is required?

Ten repetitions of a ten count.
Continuous circular motion until all aspects of each breasts are touched.
“A few times.”
Hold for twenty seconds.
“A few seconds per direction.”
Five-to-ten seconds, repeated five times.
Ten to fifteen repetitions.
“No magic number on how long or how often to do this.”

I felt like I was reading a modern witchcraft forum on how many times to perform an incantation, and with information and sources equally as believable.

Push the implants up, down, and towards the middle.
Never push down.
Push down, centrally, upwards
Never push upwards.
Pull them up towards your collarbone and hold..
Hold in each direction, “think about how you stretch your calves before running.”
Use a loose fist.
Use a pinching motion.
Place your hand on the lower portion of the left breast.
Your small finger should rest in the fold underneath your breast.
Apply gentle pressure.
Apply moderate pressure.
Apply as much pressure as you can physically handle.
Circles.
Pressing.
Move from the base “or you’re just moving the skin.”
Hold sequentially.

I would like to point out that all but one of the doctors who chimed in were male, and the one female didn’t answer the question. She simply described the risk of capsular contracture, and awkwardly, with a dangling, unclosed parentheses.

hold please

I decide that, much like the decision to get plastic surgery, this whole “displacement” or “self-massage” thing also had to be a personal choice. I’d do it, and I’d do it the way that I saw fit. Here’s my ‘scrip for you, if you’re looking for a way to soften up your new lumps or you’re just interested in some new breast-play techniques:

Use moderate pressure. Alternate between continuous motion and sustained stretch-like compressions. Sometimes use your fist (in the car when stopped at red lights, during commercial breaks while watching The Rachel Maddow Show, or between periods at Islanders preseason games.) Sometimes grab one like an overripe grapefruit and push ‘em wherever it can go, maybe hold it there, if you want to and aren’t in a rush. Then do the same thing on the other side. Nudging and poking also can be employed.

Repeat whenever. Do often. Have a friend help you. Enjoy your tits.