As a teen, your body goes through physical changes that prepare you to be sexually active and produce children. For instance, your body weight doubles between the ages of nine and 18, your hair grows in new places, and changes occur in the parts of your body that people consider as sexual (breasts and genitals). Some teens find these changes hard to cope with, but others may not.
It isn’t unusual for some people to see some of the early changes of puberty at age nine, but it is equally normal to start seeing these changes at age 15. If you are worried about the timing of puberty, ask your parents how old they were when they first noticed the changes in their bodies and talk to your doctor or nurse if you have any concerns.
Being very sick before or after transplant can delay puberty. But that doesn’t mean that you won’t change in the same way as your friends.
There is a positive side to delayed puberty. Puberty signals that your body’s growth is starting to wind down. A few more years before you finish puberty means a few more years to grow taller.
You may also have to deal with physical changes due to your transplant, such as scarring from the surgery or other procedures (such as central lines), and weight gain or puffiness caused by your medicine.
How you deal with these changes depends on your:
- life experiences
- personality
- support system (such as your friends and family)
- self-esteem and body image.
Self-esteem is all about how much you value yourself or how worthwhile you feel. Self-esteem is important because feeling good about yourself can influence how you deal with different situations. For example, if you have high self-esteem, you will find it easier to deal with mistakes and be more likely to stick with something until you succeed.
Body image is how you feel about how you look. For some teens, this might be tied up with self-esteem. For instance, other people’s opinions of you may be important to you and you may be aware that your appearance is the first thing they notice.
Influences on your body image
A lot of things can influence your body image, such as:
- puberty
- your transplant
- media imagery
- comments from your peers
- personal successes.
Puberty
During puberty, you’re experiencing physical changes that can cause you to compare yourself with others, especially when you also want to feel accepted. You might feel you’re developing too quickly or too slowly, but remember that everyone’s rate of puberty is different. If you have been really sick either before or after your transplant, puberty can be delayed. We talk more about puberty later in this section.
The changes that occur during puberty can affect how you feel about yourself. You may feel uncomfortable with the changes or may wish that you were developing faster. Girls may feel the pressure to be thin and guys may feel like they don’t look muscular enough.
Your transplant
Sometimes being sick enough to need a transplant or not being “all better” after a transplant can make you see your body differently. This may be especially true if you look different from your friends because of the side effects of steroid medicine such as prednisone.
You might feel self-conscious about your scars, and see them as more noticeable than they really are. If you were an active person before your transplant, it might take you a while to get back to your previous level of activity. This can also affect how you see yourself and your body.
Media
The people you see on social media sites, on TV or in video games or magazines may not reflect what you see at school or at the hospital. Lots of skinny women and bulked-up guys with no oxygen tank or wheelchair in sight may make you feel that “everyone else” is fitter, healthier and happier than you.
Comments from peers
If you are taking prednisone, your body image might be affected by negative comments or teasing from classmates or “friends” about the way you look. A lot of the time, people make these comments out of ignorance because they simply don’t understand what you have been through. But even if you know this, it doesn’t stop the comments from affecting your body image and self-esteem.
Personal successes
Some things can have a negative impact on your body image if you let them, but there are plenty of things you can do to improve your body image.
Doing things that you can finish or do well is great for your self-esteem because it gives you a sense of value that’s completely separate from how you look. If your self-esteem is high, usually your body image is good too.
So whether you’re interested in playing an instrument, going to school, writing a blog, being on a team or taking things further by taking part in the World Transplant Games, pick your activity and put your energy into it!
Tips for maintaining a healthy body image and self-esteem
Be realistic
When your transplant team reduces your prednisone dose, don’t expect your weight to drop the next day. Similarly, scars take time to fade — you won’t see any changes from one day to the next.
Even though it takes time, scars do heal. Take a look through the scar healing slideshow below to find out for yourself.
Click the arrow on the right to move through the slideshow.
Make a plan to change your body weight safely
If your weight is higher than normal, don’t starve yourself or take diet pills. Instead, talk to the dietitian in clinic about a safe plan to gradually lose weight. Think about what you would like to accomplish in the short- and long-term. Then make a plan for how to do it. Stick with your plan and keep track of your progress.
Stop putting yourself down
When you catch yourself being self-critical, try to phrase your thought in a more positive way. Or distract yourself by thinking about something else, listening to music or talking with someone.
View mistakes as learning opportunities
No one is perfect. Accept that you will make mistakes - everyone does! Mistakes are a part of life and learning.
Try new things
Experiment with different activities that will help you explore different talents you may have. Then you can take pride in the new skills you develop.
Recognize what you can change and what you cannot
If you are unhappy with something about yourself that you can change, then work towards changing it. For example, if you want to get fit, make a plan to start walking home from school every day and eat healthy foods.
Exercise
While you are waiting for a transplant, you may have very low energy and not feel like exercising. After transplant, maybe you feel like your incision will tear if you do anything. After that, you might just not feel like it. But there’s a lot of evidence out there that exercise after a liver or kidney transplant will help you stay healthy and make you happier too.
Exercise will:
- increase your energy
- help you sleep better
- help you feel better about yourself.
Have fun!
Spend time with the people you care about and do the things you love. If nothing is fun, you won’t feel very good about yourself.
Make a contribution
Take part in a community charity event, volunteer your time in a local group or even help tutor a classmate who is having trouble. Feeling that you are making a difference and that your help is valued can do a lot to improve your self-esteem.
Consider doing something crazy!
We had a patient who hated her gastrostomy scar but still wanted to wear a bikini. At first she tried to cover up the scar with makeup, but that didn’t work too well. So (after talking to her doctor to make sure it was ok) she got the scar pierced and wore great jewellery!
Ask for help
Sometimes low self-esteem and poor body image can be too much to handle. If you are feeling low, it can help to talk to a parent, nurse, counsellor, social worker or doctor. They can help you put your self-image into perspective and give you positive feedback. You can also speak to a counsellor at the Kids Help Phone at 1800-668-6868.
