Been a busy spring/summer, and I'm afraid I've slipped behind a little. Nikki just had surgery #27 on July 1st, and it was another success. During a seven hour procedure, Ohio State's Dr. Miller did a lot of facial work on Nikki.
First, fat was liposuctioned from her tummy & injected around both eyes, and along her right cheek. Some of this fat is usually absorbed by the body, so this might have to be repeated multiple times in the future. The results are great, though, really filling in Nikki's facial contours & giving her face a smoother, more natural symmetry.
Then, Dr. Miller did extensive work on her nose. The nose was originally smashed almost flat in her accident in 2004, and has remained a little lopsided ever since. Several years back, another plastic surgeon took a small piece of bone from Nikki's skull & used it to build up the bridge, Over the years since, this work degraded in some fashion, and the nose was losing shape again. Dr. Miller determined that the implanted bone fragment was loose & no longer anchored properly. His goal was to determine if the bone fragment could be saved & re-anchored, or if another bone fragment would be needed- probably from her arm. He found that the fragment was fine, but the soft anchors used had detached. He repositioned the fragment & used a small metal screw to attach it to he bottom of Nikki's forehead. Next, he used a 400 micron metal sheet to build up the bridge, attaching it to the bone fragment & forehead. The nose ain't going anywhere now!
Once he was in surgery, Dr. Miller wasn't happy with how Nikki's right eye could not close properly, due to the eyelid damage from the accident. We had discussed working on this in a future procedure, but he decided he'd like to move forward with the repair now. After contacting me from the OR for approval, he proceeded to do an eyelid transplant. He harvested a small horizontal strip from her left eyelid, and attached this to the right eyelid... very fine, detailed work that took a long time.
When done, Nikki looked like she had gone ten rounds with a heavyweight boxer. Her right eyelid has been sewn shut, to protect the transplant, and both eyes have a lot of bruising, along with her right cheek. She also has a protective shield over her nose, as well as five small holes in her tummy where the fat was suctioned. Remarkably, she had little pain postop, and definitely looked worse than she felt. Nikki goes to the doctor this week, where the right eyelid will be freed up. She'll probably be off work for three weeks or so. After that, it'll be time to start planning the next procedure. Stay tuned for more!
Monday, July 6, 2015
Tuesday, April 7, 2015
The Last Surgery is Good!
Nikki has been back to Dr. Miller a couple of times since her surgery. He's very pleased with how everything looks. The eyebrow has actively growing hairs, with more looking like they'll be coming in soon. The area underneath the eye that was filled in looks very good, too. Dr. Miller is starting to look at other areas for Nikki's next surgery. Her right eyelid was mentioned before, and he also wants to clean up her neckline, presenting a cleaner appearance above the collar. Of course, Nikki is very excited to pursue this. She goes back in two months, when she expects to start serious discussions about her next surgery. I'll keep you informed!
Monday, March 23, 2015
Surgery #26 is a success!
Nikki's surgery went as planned on March 11th. The only snag was being called in early due to a cancellation, but then having to wait until the originally scheduled time anyway. It made for a long day, being at the hospital from 9am to 8pm. The results of the surgery were worth it, though.
As planned, the Dr. Michael Miller used liposuction to remove fatty tissue from Nikki's abdomen, and then delicately inserted it around her right eye. This eye socket has been sunken since her accident, over ten years ago. It looks like two small incisions were made to insert the tissue into the socket... hard to tell, because they're so thin & small. Next, the surgeon removed a small strip of follicle-laden skin from the back of Nikki's head. Then, using a magnifying apparatus, he proceeded to remove individual follicles from the strip of skin, and implanted them one by one into her forehead, shaping an eyebrow. This was the longest part of the entire procedure, requiring a steady hand and keen eye. Altogether, she was in surgery 4-1/2 hours.
Nikki came through this surgery very easily, with little pain and no nausea. Her face looks great... filling in the eye socket made a huge difference in her facial structure. The eyebrow will take some time to develop. Right now, she has black marker still outlining the the shape of the eyebrow. Plus, as the follicles "take root", their current hairs will actually fall out, before starting to grow again. Dr. Miller says that some will definitely fail, but most should take. Nikki should be returning to work in a few days.
Dr. Miller also identified the next area that he wants to work on- Nikki's right eyelid. This lid was mostly destroyed in the accident, doing it's job and protecting the eye. Some limited reconstruction was done during her initial treatments, but more is needed. The doctor says that her eyelid is too small, not covering the eye properly. To rectify this, he wants to take tissue from her left eyelid & use it to build up the right eyelid. Delicate work, but not too difficult. This will better protect the eye, and also improve appearance. Nikki's all for it.
That's it for now. Stay tuned for updates.,
As planned, the Dr. Michael Miller used liposuction to remove fatty tissue from Nikki's abdomen, and then delicately inserted it around her right eye. This eye socket has been sunken since her accident, over ten years ago. It looks like two small incisions were made to insert the tissue into the socket... hard to tell, because they're so thin & small. Next, the surgeon removed a small strip of follicle-laden skin from the back of Nikki's head. Then, using a magnifying apparatus, he proceeded to remove individual follicles from the strip of skin, and implanted them one by one into her forehead, shaping an eyebrow. This was the longest part of the entire procedure, requiring a steady hand and keen eye. Altogether, she was in surgery 4-1/2 hours.
Nikki came through this surgery very easily, with little pain and no nausea. Her face looks great... filling in the eye socket made a huge difference in her facial structure. The eyebrow will take some time to develop. Right now, she has black marker still outlining the the shape of the eyebrow. Plus, as the follicles "take root", their current hairs will actually fall out, before starting to grow again. Dr. Miller says that some will definitely fail, but most should take. Nikki should be returning to work in a few days.
Dr. Miller also identified the next area that he wants to work on- Nikki's right eyelid. This lid was mostly destroyed in the accident, doing it's job and protecting the eye. Some limited reconstruction was done during her initial treatments, but more is needed. The doctor says that her eyelid is too small, not covering the eye properly. To rectify this, he wants to take tissue from her left eyelid & use it to build up the right eyelid. Delicate work, but not too difficult. This will better protect the eye, and also improve appearance. Nikki's all for it.
That's it for now. Stay tuned for updates.,
Sunday, January 18, 2015
New Surgery Scheduled
Nikki's wasting no time in moving forward with her next surgery. On March 11th, Nikki will return to The Ohio State Wexner Medical Center for another plastics procedure. This time, she'll be undergoing a procedure to fill in around her right eye. The accident burned away a lot of skin and underlying tissue in this area, making the eye socket look sunken and drawn. The surgeon will use liposuction to withdraw fatty tissue from elsewhere on Nikki's body & inject it all around the the right eye. The goal is to make the right eye as equal to the left as possible. At the same time, Nikki will get a new right eyebrow- the accident burned off that brow, along with most of her forehead. The doctor doesn't know yet what procedure he will use- a scalp transplant, or plugs. The transplant is simpler to do, as long as the conditions are right for it. Nikki is very excited for this one!
Future procedure will almost certainly involve more work around her neck. The surgeons have made great strides in improving looks and functionality here, but there's still more to be done. Stay tuned for updates!
Future procedure will almost certainly involve more work around her neck. The surgeons have made great strides in improving looks and functionality here, but there's still more to be done. Stay tuned for updates!
Sunday, January 4, 2015
It's 2015, and Nikki's Back!
Happy New Year! It's been two years since my last update to Nikki's adventures. Nikki is still doing well, even though she's had many ups and downs over the past two years. Physically, she's been doing very well. She's only had one additional surgery in this time. In August of 2014, she had some work done on her right cheek & eye, leading to a much-improved look in that area; this was surgery #25. She is meeting with the Ohio State Medical Center plastic surgeon again next week to begin planning her next cosmetic update.
Nikki's main problems over the last couple of years have been emotional / mental. The trauma of the accident in 2004 caused more serious psychological issues than first expected. The Post Traumatic Stress Disorder (PTSD) was much more pronounced than first thought, and has led to a host of debilitating and embarrassing problems. After several false hopes that Nikki was improving on her own, she finally stood up in late 2013, acknowledged her problems, and began to get the appropriate treatments. There is no "quick fix" or "miracle cure" for her issues, and she may well be getting some form of treatment for the rest of her life. Her situation is analogous to the war veterans that have trouble returning to "real" life.
Over the past year, my family moved from the east side of Columbus to the northwest side, where we lived when Nikki & her sister were in school. Nikki moved in with us for a while as she finished up the more intensive parts of her treatments. Now, Nikki is rooming with a former classmate & lives only a block or so from us. She has left the high-stress environment of the high-end restaurants & now works in a lower-key neighborhood dining place. She is back in the area where she lived in elementary & high school, and where many of her oldest friends still live. She is happier & healthier, and continues to strengthen her mental & physical health. She is once again the Nikki that her family & friends remember.
I'll continue to update Nikki's progress as she continues to deal with that horrible car accident from July 2004. Thank you for continuing to follow her adventures, and stay tuned- the ride's not over yet!
Nikki's main problems over the last couple of years have been emotional / mental. The trauma of the accident in 2004 caused more serious psychological issues than first expected. The Post Traumatic Stress Disorder (PTSD) was much more pronounced than first thought, and has led to a host of debilitating and embarrassing problems. After several false hopes that Nikki was improving on her own, she finally stood up in late 2013, acknowledged her problems, and began to get the appropriate treatments. There is no "quick fix" or "miracle cure" for her issues, and she may well be getting some form of treatment for the rest of her life. Her situation is analogous to the war veterans that have trouble returning to "real" life.
Over the past year, my family moved from the east side of Columbus to the northwest side, where we lived when Nikki & her sister were in school. Nikki moved in with us for a while as she finished up the more intensive parts of her treatments. Now, Nikki is rooming with a former classmate & lives only a block or so from us. She has left the high-stress environment of the high-end restaurants & now works in a lower-key neighborhood dining place. She is back in the area where she lived in elementary & high school, and where many of her oldest friends still live. She is happier & healthier, and continues to strengthen her mental & physical health. She is once again the Nikki that her family & friends remember.
I'll continue to update Nikki's progress as she continues to deal with that horrible car accident from July 2004. Thank you for continuing to follow her adventures, and stay tuned- the ride's not over yet!
Monday, January 7, 2013
Business as Usual in 2013
A very long time without a post, I know. As always, "no news is good news". Nikki continues to be healthy, but hasn't had any additional surgeries or treatments since early 2011. She's moved a couple of times since my last post, now living in a small, conveniently-located apartment. And more surprisingly, she's changed jobs, leaving Cheesecake Factory after many years. She now works for Brio Tuscan Grille, another upper-tier restaurant in the area. She felt she needed a change, and this seems to be working well for her.
Nikki still plans to have more plastic surgery, time & money allowing. I'll keep posting updates as interesting things happen, so stay tuned. Happy New Year's to all who follow Nikki here.
Nikki still plans to have more plastic surgery, time & money allowing. I'll keep posting updates as interesting things happen, so stay tuned. Happy New Year's to all who follow Nikki here.
Wednesday, March 2, 2011
A Bad Scare
The new year brought a new scare for Nikki. In mid-January, Nikki came down with a bad cold that she couldn't shake. Stubbornly, she kept putting off going to the doctor, expecting to get better at any time. After about ten days, she had lost 17 pounds and became *very* sick. Finally going to the doctor, she was diagnosed with the flu. She received treatment for the symptoms and was told to drink lots of liquid. Unfortunately, she didn't get better and started to be unable to work. She'd make herself go in to work, only to have to leave a few hours later.
Finally, there came a day in late January when she dragged herself in to work again. Her manager took one look at her and said "Enough". He had an employee who was off-duty take Nikki to the emrgency room at OSU Hospitals. She spent 12 hours in the ER, then was admitted to the hospital. Batteries of tests were conducted, including lots of imaging. The result came back the morning of the 2nd day; acute hepatic failure. Nikki's liver was failing, already operating at a dangerously low level.
The liver is the body's biochemical factory. It produces enzymes that do a great many things for us. It also converts many potentially toxic substances into non-toxic forms. The liver is very resilient, being the only organ that can regenerate; as little as 1/4 of a liver can grow back to normal size in only 6 - 8 weeks. On the flip side, the liver is irreplaceable; there's no mechanical or chemical substitute for it. When it goes, it's gone, and the only recourse is a liver transplant.
With this diagnosis, Nikki was transferred to an intensive care step-down unit & moved to the hepatic (liver) service. She was consulted by the transplant doctors early on- not because she was at that point yet, but because it takes time to be made eligible to receive a transplant and the docs wanted to get a headstart, in case the liver should completely & suddenly fail. By this time, Nikki was beginning to drift mentally, as toxins built up in her body. With the liver already struggling, they couldn't give her medications for this confusion. The staff expected this, but her family was pretty unnerved by it. She was actually having minor hallucinations and lost track of where & when she was. This lasted for a couple of days, and required Nikki to have a sitter with her at all times.
Finally, progress was seen. She was being given medications to help bolster the liver, relieving the stress on it. And the liver started responding, with hepatic function slowly improving. After a second day of improvement, her confusion went away all at once, and she began to feel better. A final diagnosis was still unclear, although the doctors believed that acetaminophen (Tylenol), alcohol and possibly a viral infection all combined in a "perfect storm" to damage the liver. With all of Nikki's surgeries, she's taken a great deal of acetaminophen-containing pain medication over the years. The theory is that this has caused cumulative damage. Add to that social drinking and possibly a nasty virus, and it was too much for her liver.
In the end, Nikki went from possibly needing a liver transplant on Monday, to being discharged to home on Saturday. She has some permanent lifestyle changes to make, though. First, no more acetaminophen... she'll have to use other medications, such as ibuprofen, and always in moderation. Second, no more alcohol... the doctors stressed that her liver is permanently impaired now, even though it may regain near-normal levels of production. It will always be very susceptible to additional damage. As a social drinker, this is a big change from how Nikki is used to hanging out with friends. However, she has a great support network and has adjusted very well so far. And third, she's to get to the doctor faster when sick. Many illnesses put a strain on the liver, and doctors will be looking for that from now on.
As of today, Nikki has regained all of her weight, her energy is back, and she's her old self again. She'll have a lot of regular bloodwork drawn for the next year or so, just to make sure that all stays well. She also has to wait for a while before going through anymore plastic surgeries, since the docs don't want to strain the liver with anesthesia for a while. When the time comes, there are specific drugs that can be used that aren't as toxic to the liver.
And that's it... just another chapter in the life of my little girl. She's never boring.
Finally, there came a day in late January when she dragged herself in to work again. Her manager took one look at her and said "Enough". He had an employee who was off-duty take Nikki to the emrgency room at OSU Hospitals. She spent 12 hours in the ER, then was admitted to the hospital. Batteries of tests were conducted, including lots of imaging. The result came back the morning of the 2nd day; acute hepatic failure. Nikki's liver was failing, already operating at a dangerously low level.
The liver is the body's biochemical factory. It produces enzymes that do a great many things for us. It also converts many potentially toxic substances into non-toxic forms. The liver is very resilient, being the only organ that can regenerate; as little as 1/4 of a liver can grow back to normal size in only 6 - 8 weeks. On the flip side, the liver is irreplaceable; there's no mechanical or chemical substitute for it. When it goes, it's gone, and the only recourse is a liver transplant.
With this diagnosis, Nikki was transferred to an intensive care step-down unit & moved to the hepatic (liver) service. She was consulted by the transplant doctors early on- not because she was at that point yet, but because it takes time to be made eligible to receive a transplant and the docs wanted to get a headstart, in case the liver should completely & suddenly fail. By this time, Nikki was beginning to drift mentally, as toxins built up in her body. With the liver already struggling, they couldn't give her medications for this confusion. The staff expected this, but her family was pretty unnerved by it. She was actually having minor hallucinations and lost track of where & when she was. This lasted for a couple of days, and required Nikki to have a sitter with her at all times.
Finally, progress was seen. She was being given medications to help bolster the liver, relieving the stress on it. And the liver started responding, with hepatic function slowly improving. After a second day of improvement, her confusion went away all at once, and she began to feel better. A final diagnosis was still unclear, although the doctors believed that acetaminophen (Tylenol), alcohol and possibly a viral infection all combined in a "perfect storm" to damage the liver. With all of Nikki's surgeries, she's taken a great deal of acetaminophen-containing pain medication over the years. The theory is that this has caused cumulative damage. Add to that social drinking and possibly a nasty virus, and it was too much for her liver.
In the end, Nikki went from possibly needing a liver transplant on Monday, to being discharged to home on Saturday. She has some permanent lifestyle changes to make, though. First, no more acetaminophen... she'll have to use other medications, such as ibuprofen, and always in moderation. Second, no more alcohol... the doctors stressed that her liver is permanently impaired now, even though it may regain near-normal levels of production. It will always be very susceptible to additional damage. As a social drinker, this is a big change from how Nikki is used to hanging out with friends. However, she has a great support network and has adjusted very well so far. And third, she's to get to the doctor faster when sick. Many illnesses put a strain on the liver, and doctors will be looking for that from now on.
As of today, Nikki has regained all of her weight, her energy is back, and she's her old self again. She'll have a lot of regular bloodwork drawn for the next year or so, just to make sure that all stays well. She also has to wait for a while before going through anymore plastic surgeries, since the docs don't want to strain the liver with anesthesia for a while. When the time comes, there are specific drugs that can be used that aren't as toxic to the liver.
And that's it... just another chapter in the life of my little girl. She's never boring.
Thursday, July 29, 2010
Business as usual
Nikki returned to work in late June, 9 days later than she originally planned. The same day that she got the go-ahead from her doctor to start working again, she stopped by Cheescake Factory to see when she could start. The two week bar schedule had just been posted, so she spent the next couple of weeks picking up hostess & serving spots. Other than sore feet, after 1-1/2 months of laying around her house, Nikki had no problems settling back in. She's been back on regular bar shifts for some time now & is doing fine.
Nikki's flap transplant continues to improve in appearance. Almost all of the dark, red lines around the edges of the graft have faded away. The actual suture lines are so small & fine, you have to look closely to see them. One small area, up near her ear, still has a red outline. This was also the slow-to-heal area that delayed her return to work. The graft continues to shrink as it settles in. It's uncertain whether surgical reduction of the flap will be needed.
That's all for now. I'll keep you informed of any updates or changes.
Nikki's flap transplant continues to improve in appearance. Almost all of the dark, red lines around the edges of the graft have faded away. The actual suture lines are so small & fine, you have to look closely to see them. One small area, up near her ear, still has a red outline. This was also the slow-to-heal area that delayed her return to work. The graft continues to shrink as it settles in. It's uncertain whether surgical reduction of the flap will be needed.
That's all for now. I'll keep you informed of any updates or changes.
Wednesday, June 23, 2010
Almost ready for work
Nikki has healed very well over the past month. The tissue flap has settled onto her neck nicely, and significantly reduced in thickness. The suture lines around the flap are still very prominent, the deep red of a healing cut. Her doctor has said within another 60 days or so, these lines will fade, causing the flap to blend in even better with the rest of her skin. The doctor has been very pleased with how her recovery has gone.
Nikki had hoped to return to work on June 19th, but she had to delay another week, due to a small open sore at the top of her flap. A very small area just under her ear healed very slowly and has only scabbed over in the past few days. She's been fully mobile for most of the past month, but an open sore in food service is a definite no-no.
Nikki would like to try to have more surgical work done by the end of this year. She'll have to juggle her finances, her job and other responsibilities before she can schedule anything, though. I'll keep the blog updated as the year moves onward.
Nikki had hoped to return to work on June 19th, but she had to delay another week, due to a small open sore at the top of her flap. A very small area just under her ear healed very slowly and has only scabbed over in the past few days. She's been fully mobile for most of the past month, but an open sore in food service is a definite no-no.
Nikki would like to try to have more surgical work done by the end of this year. She'll have to juggle her finances, her job and other responsibilities before she can schedule anything, though. I'll keep the blog updated as the year moves onward.
Monday, May 24, 2010
Home From the Hospital
Nikki was discharged and returned to her home on Sunday 5/23. Her recovery went well, with only minimal discomfort. Immediately after her surgery, her face had a dull ache all of the time, but never any sharp pain. She learned quickly, however, that she had to be careful how she moved her head. Any turning or twisting of the head put stress on the transplant, which hurt. Nikki also had trouble holding a phone in any kind of a comfortable position, so she tended not to talk long. Her leg hasn't bothered her much at all, in spite of the 10 inch incision.
Friday was a little rough for her, as she had a steady stream of visitors all day. The nurses finally told her they were concerned that she was over doing things, reminding her that she had just undergone major surgery. When we visited her that evening, she was tired, sore and grouchy, so the nurses were obviously right. Nikki finally agreed with them & warned off most of her friends for the following day, so that she could rest.
She was discharged around noon on Sunday, and her sister went to get her and take her home. She was home by 2:30pm & resting comfortably. One logistics problem at home- keeping her 90lb. American Bulldog, Reno, from jumping all over her. Reno loves everyone and gets very excited when people stop by.
Nikki won't be able to drive for a while, so she'll need the help of family & friends to make it to the doctor and any shopping needed. She is off work for 4 weeks, which always drives her crazy. Nikki likes her job, likes being active and likes being around people. Staying in her house, quietly, for a month is a real challenge for her.
I'll have more after her next doctor appointment, in a week or so. Stay tuned.
Friday was a little rough for her, as she had a steady stream of visitors all day. The nurses finally told her they were concerned that she was over doing things, reminding her that she had just undergone major surgery. When we visited her that evening, she was tired, sore and grouchy, so the nurses were obviously right. Nikki finally agreed with them & warned off most of her friends for the following day, so that she could rest.
She was discharged around noon on Sunday, and her sister went to get her and take her home. She was home by 2:30pm & resting comfortably. One logistics problem at home- keeping her 90lb. American Bulldog, Reno, from jumping all over her. Reno loves everyone and gets very excited when people stop by.
Nikki won't be able to drive for a while, so she'll need the help of family & friends to make it to the doctor and any shopping needed. She is off work for 4 weeks, which always drives her crazy. Nikki likes her job, likes being active and likes being around people. Staying in her house, quietly, for a month is a real challenge for her.
I'll have more after her next doctor appointment, in a week or so. Stay tuned.
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