What do you see when you look in the mirror?

This was the question put to all the female interviewees at a recent 'Ladies Who Impress' event I attended. It was really interesting to see all three of these successful, confident women struggle to provide an answer to this apparently simple question and to me it demonstrated what a complex relationship most women have with what is commonly called their 'body image'.  What we want to see and what we do see are very rarely reconcilable and this can lead to very negative and damaging emotions.  Why do we have such difficulty accepting who we are?

In the introductory chapter to her very interesting book 'The Ministry of Thin', Emma Woolf, herself  recovering anorexic, cites a US study from 2011 which found that 1 in 6 women would choose to be blind than obese, whereas others would prefer herpes or alcoholism to being overweight.  In the UK, you only have to open a tabloid newspaper or gossip magazine to find an article focusing on a celebrity's weight gain or loss, featured as headline news. The obsession is universal, it appears, but why?

The media definitely has something to do with it, with the constant portrayal of slim, perfectly coiffed and made up celebrities. However, it is clear that those in the public eye also feel the pressure to look "good". It is rare to see a female actress, musician or model anything more than a size 10 (though there are some notable exceptions, whose size is never without media comment) and it seems all too common for young female celebrities in particular to seek to alter or cover up their natural appearance in many different ways; hair extensions and highlights, fake tan, false eyelashes, heavy make up and even breast implants have become the norm. Worrying numbers of teenage girls now think it necessary to employ the same techniques themselves on a regular basis to keep up with their style icons.

Even if you don't go to these lengths, it is difficult to find anyone who doesn't have at least one part of their body that they would desperately like to change (or, usually, reduce in size). I recall a recent skincare commercial which asked women to name the favourite part of their own body; not one had a ready answer. This physical dissatisfaction leads to an almost obsession with analysing everything that passes our lips.  I cannot remember a day when I didn't have at least two conversations with other women about "being good" in the face of gastronomic temptations, berating themselves for even considering indulging in chocolate or cake (but in the end doing so anyway and entering into a spiral of guilt as a result).  Why shouldn't we treat ourselves to a little of what we fancy ever so often? Would we not be a little bit happier? We might even stop at one slice instead of writing the day off as bad'un and consuming the rest of the cake, whilst being simultaneously consumed by guilt...

On the other side of the body image coin, Breast Cancer Care have recently released a video on the subject of Body Image, featuring a number of incredibly brave women who have undergone major breast surgery following cancer treatment, but who all seem to have retained (or perhaps regained) confidence and pride in the bodies they have been left with.  Faced with their own mortality, the ease with which these women appear to be accepting their new 'normal' is humbling and extremely moving.  It is of course absolutely true that you only appreciate the value of what you have when you lose it, or at least part of it.  But it is of course also true that we shouldn't have to wait for serious health problems before we discover our body confidence.

So, how has cancer affected my body image? To be honest, although I am proud of my body's resilience in the face of adversity, I cannot (unfortunately) place myself in the same confidence category as those wonderful women in the Breast Cancer Care video.  Having just experienced both childbirth and post partum complications, my body already felt so far removed from 'normal' so as to be unrecognisable. To then be told that I had cancer felt almost like a parallel reality at first and it was only when I had finished the treatment that the enormity of the experience really hit me. Although my breasts are still almost all my own tissue, with a little bit missing, they just do not feel like part of me.  This feeling of detachment isn't helped by the rest of my body all being that little bit larger than pre-pregnancy silhouette; a result of a combination of hormone therapy, not enough exercise and perhaps a few too many cupcakes...!

Put simply, when I look in the mirror, I don't see me.  For this reason, the prospect of reconstructive surgery doesn't scare me.  I know I can and I will adjust to the new body, whether it takes weeks, months or years.

I have a date!

So, the inaugural blog post. This is a little scary - putting information out into the world with no idea who may read it!

As I explained in the 'About Me' section, I made the decision a few months ago to undergo a double mastectomy and reconstruction and I now have a date for the operation in mid November. This is a purely preventative measure, which will reduce significantly the risk of a new tumour developing in either of my breasts later in life. For various reasons, the doctors do not advise implants in my case, so once the breast tissue has been removed, new breasts will be reconstructed by the plastic surgeons using tissue from my stomach. More scars, a more difficult recovery, but hey - a tummy tuck! Every cloud has a silver lining and - as someone who never really lost the baby weight and perhaps tends to over-indulge in the never-ending supply of birthday cakes in the office (whilst under-indulging in exercise) - this idea is not without its appeal.  

On a more serious note, I am all to aware that I have - unilaterally and voluntarily - chosen to have major surgery. An operation lasting between 8-10 hours, a week's stay in hospital and at least 6-8 weeks recovery. This is not a decision to be taken lightly. It is certainly true that it is an emotive subject, as demonstrated by the recent media coverage of Angelina Jolie's similar operation.  I have seen several comments on social media, mainly by holistic beauty practitioners, expressing huge anger about Angelina's decision to 'maim' herself, claiming that there was no scientific justification for such a step and that it would encourage others to do the same - thereby 'destroying' the bodies that nature gave them.  For others I have met, this kind of a decision is a 'no-brainer'; if there is a way of significantly reducing someone's chances of a potentially life-threatening illness, then why wouldn't you grab it with both hands?

I agree that Angelina's revelation is likely to encourage people to think about preventative surgery (and possibly lead them to request it when there is no real need - see Professor Mokbel's comments in the Evening Standard a few days ago), but it also gives women with a genetic predisposition to breast cancer who are being offered surgery, some comfort that it won't necessarily mean a radically altered physical appearance, as well as potentially giving them that greater peace of mind they crave. Angelina is a beautiful woman who relies on her appearance to further her career; the fact that she was prepared to have her breasts removed entirely and reconstructed demonstrates, in my view, both her sensible view of her own reality and her confidence in the medical profession.

For me, it is simply a matter of trying to take control of my own destiny. Even though all my screening since the cancer has been clear, there is still a small black cloud of anxiety following me around, leading to thoughts such as 'What if it comes back?' and 'I won't be so lucky next time'.  Whilst not completely obliterating the risk, this operation will reduce my risk of a new cancer by 90% and, given that the doctors estimate my chance of recurrence at 60% without the surgery, the numbers speak for themselves.  On a less scientific note, I am fairly young, with what I hope will be a long and happy life in front of me. I have a husband who I love dearly and a son who is my greatest joy. I want to be around to watch my son grow up, relishing in each stage of his development and showing him how wonderful the world is - in short, I want to be his mother. I have a list of places I want to visit, restaurants I want to try, goals I want to achieve.  I don't want to spend time worrying about the future, or in the worst case scenario dealing with cancer again (and I certainly wouldn't get away so lightly next time).

The decision wasn't easy, as a major operation is never an attractive prospect, but now I feel sure it is the right route for me and I am lucky to have the unflinching support of my family and friends behind me every step of the way. Watch this space!