Reconstruction: July - August 2006

8/20/06
We arrived at OSU Wednesday at 10:30am for the 12:30pm surgery. In her room by 11:00am, where the waiting began. Something was wrong in OR and schedules were shot. As the afternoon dragged on, we tried to stay patient… but no one was telling us anything. At 2pm we finally asked what was going on… the nurses at the desk seemed surprised to see us still there- bad sign. They made some calls and a resident finally rushed up to tell us that all was chaos.. an unscheduled, 6 hour+ case squeezed in ahead of us. The resident thought Nikki would be going down in another hour or so. My book was finished, my Palm Pilot was exhausted and so was I. About 4pm I went out to the nursing station again to see if there was any news. The late shift was on now and one of the nurses that we knew said "Oh, back from surgery?"- Another bad sign.

Nikki finally went down at 5:15pm, hit OR at 6:30pm, finished at 7:15pm, went through a very quick recovery and was back in her room by 8:15pm. Once again, no nausea… I hope they've found the perfect anesthesia for her. At 9:15 she was out and back home by 10:00pm. The small donor patch was taken from her upper thigh this time and grafted onto the neck area that wasn't taking right. Nikki went to the doctor on Friday & the early report is good- the site looks much better than it did with the previous graft.

Nikki has continued to do research on the free-flap procedure proposed by Dr. Kaufman and is becoming more & more convinced that this is the way she wants to go. If so, this will almost certainly happen in Cleveland at MetroHealth. As always, I'll keep you all updated.

8/15/06
Got a call at work today from Nikki… sort of snuffly & depressed. She had what was supposed to be a "quick" checkup today- and ended up being scheduled for surgery #23 tomorrow! About 30% of her graft is failing and Dr. Gordillo wants to quickly repair it and save the rest of the grafted area. She promises a "minimal" procedure.

Aside from being bummed by yet another surgery on her face, Nikki was expecting to return to work this weekend. Now, it'll be two weeks or so before she can work again. No problem with her work- they understand. Nikki's money was carefully budgeted, though, and this blows the budget. She thinks she can stretch things far enough, though, and we'll help what we can.

I'll give a follow up tomorrow when she's done… 12:30pm surgery, so it'll be another late one. Stay tuned!

8/8/06
Sorry for the tardiness this time- we've been pretty busy lately. Of course, Nikki had her 22nd surgery on 8/1 and everything went fine. Only one hitch… The home care nurses had removed Nikki's Woundvac the day before surgery at the doctor's direction, due to a mild infection that had started. Nikki left the machine at home on surgery day, thinking she was done with it… Nope, Dr. Gordillo planned to put it on again after surgery. I was already gone from the hospital on other errands, so Nikki chased down one of her friends to go to her apartment and get the machine. Her friend rushed so much that he was stopped by the police for speeding. The police actually believed his story about rushing to the hospital with critical medical equipment & waived the speeding violation. Unfortunately, her friend's tags had also expired and the officer wouldn't let that one go. So the friend got a ticket for expired tags & an admonishment to get them renewed in 24 hours.

Nikki kept the Woundvac on for a few days and then had it removed. So far, so good… we'll have to wait for the bandages to be removed to see how the graft is going. The doctor seems pleased so far, though. Nikki is already driving again and chafing to get back to work. Tomorrow, we're all going to the state fair, so she's obviously feeling good.

I'll have another update when I have something new to report. Take care for now…

7/19/06
See?... I can make two entries in two days!

Nikki did fine today, as expected. Her 11:30am surgery was pushed back to 1:00pm, she spent 2 hours in OR, 2 hours in recovery, 1 hour in the ambulatory surgery suite and was in her own apartment resting by 7:00pm. Dr. Gordillo excised a lot more contracted skin than originally planned, which made Nikki very happy. From just above her right eyebrow (or where it would be if she had an eyebrow anymore) down onto her shoulder and upper chest was tossed into the trash today. Integra went over this, followed by Acticoat, then the Wound Vac leeched powerfully over the whole mess. Nikki will keep the WoundVac on for two weeks, with thrice-weekly dressing changes- at home! Turns out that Medicaid will cover the home nursing, just not the Vac... go figure.

For the first time that I can remember, Nikki didn't have any postop nausea this time and rested very comfortably after surgery. Gordillo succeeded in raising the area around Nikki's right eye quite a bit, stitching it into place. The face looks much more relaxed now. Nikki also had her chief physical therapist (now a good friend) observing the surgery. The therapist & Gordillo went over Nikki very thoroughly, including looking at the tissue under the skin- much improved in texture with all of the therapy.

On August 1st. Nikki returns to have the actual grafting done, with her left thigh once again serving as a donor site. I'll be back by then with another update, so stay tuned!

07/18/06
Yep, I've let things creep up on us again! Nikki goes to OSU Medical Center tomorrow for surgery #21. I wasn't very clear on this in my last update. After getting the 2nd opinion from Dr. Kaufman on the free flap, Nikki talked it over with her regular surgeon Dr. Gordillo. Gordillo thought that it was a fine idea, but had not offered it to Nikki for three reasons. One, it's much more radical than the relatively simple skin grafting. Two, it's potentially disfiguring to the donor site and also can take several follow-up procedures to make the flap look "right" again. Gordillo knows that Nikki wants to look the best she can at all times and didn't think she would like this route. And three, Gordillo doesn't do this sort of microsurgery herself, so Nikki would probably have to go to Cleveland for it.

After some thought, they reached a compromise… one more grafting attempt. This time, Gordillo wants to use the WoundVac for two weeks, to give the graft its best possible chance of success. One problem- Medicaid won't cover the WoundVac for home use, so Nikki would have to sit in the hospital for two weeks!.. I know, it makes no sense. Workaround- the company that provides the Vac occasionally provides its equipment at no cost for needy people. Dr. Gordillo helped Nikki apply for this use and was accepted, so she gets to bring home a portable Vac for two weeks. No way to do the needed nursing care every 3 days at home, though, so she'll have to go to the doctor's office every 3 days.

Tomorrow, Nikki will have all of the contracted tissue removed from her face again. Along with Gordillo, Dr. Katz (occuloplastics) will be there doing some more work around Nikki's right eye. Then the WoundVac will be put in place on the open tissue and left there for two weeks. Nikki should be able to go home tomorrow evening. Two weeks later (August 1st), she'll return to the hospital for the actual graft, coming from her thigh. She has high hopes that this procedure will work & she can avoid the free flap procedure. I'll provide an update after tomorrow's procedure.

On a technical note… the blog is broke. I wiped & reloaded my computer a couple of weeks ago to solve several annoying issues that piled up over the years. While restoring it, I over-wrote a recent folder (and its backups) with an older one, instantly losing the last year's entries to the blog! I didn't even notice this until last night, when I began working on this update. Yes, I used harsh language. Thank goodness for Google and its web cache entries. I found a recent version of the page stored there, downloaded it and began putting the blog back together. I also lost some image files, which broke the links in the blog. I'm slowly putting things back together… text first, then images, so it'll look funny for a while. I'm doing a little restructuring as I go, putting older stuff on the second page so that the main page will load faster. Just bear with me for a few days.I'll update on Nikki's surgery soon… stay tuned!