Reconstruction: May - June 2005

06/16/05
Over a month since my last update, and again, no news is good news. Nothing is happening, and everything is good. Nikki has been left alone to heal, although there is a surgery coming up in the next few weeks. This will be another release to the right side of her neck and face. Skin will be grafted from her thighs, and the dreaded vacuum pack will be used again to speed the healing of the graft. This hasn't been scheduled yet, but will probably be just after July 4th. Later this summer, a more major release to the right arm and elbow is planned. Airplane splint time again....

Nikki has been very active, and is feeling fine. Sun is a problem; even small amounts cause her grafted skin problems. A life-long problem for this former sun-worshipper, I'm afraid. She's been using 45 sunblock for even quick exposures, and has her eye on some 70 block. Lots of lotion, too.

Therapy continues, and range of motion continues to improve. Nikki's getting restless around the house as she gets better. She's mumbling about going to work, but the doctors won't hear of that for quite some time yet. She's still easily injured, and has enough restricted motion that she can't drive or do many delicate tasks.

She just got back from Cleveland tonight as I'm writing this. She went to visit friends and to see Dave Matthews for the 3rd time in a month. She also dropped in to MetroHealth to visit the staff. I don't know who she caught on duty yet, so I'm going to wrap this up and go find out. I'll be writing again soon with details of the upcoming surgery, so stay tuned.

05/10/05
A long time without an update is usually a good thing- no surgeries, no misery, etc., and this is no exception. Things are going well for Nikki, with just the routine of physical therapy and doctor appointments. Her hand has healed nicely, with only the pinkie still looking kind of rough. The metal pin will be pulled from her ring finger in another couple of weeks. It's hoped that the finger will not curl back into its pre-op shape, and aggressive therapy will start on it immediately after the pin is removed. There's been no serious planning for the next surgery as of yet. It will probably involve releases on the elbow, shoulder and armpit of the right arm- again. This will mean another airplane splint, which thrills Nikki to no end.

Today was the day that Nikki assisted Director of Rehabilitation Bob Vaneko with a lecture to OSU physical medicine grad students. Nikki had agreed to be Bob's model for his lecture on the rehabilitation needs of burn patients. I urged her to do this, in order to become even more comfortable in displaying her burns. Summer's almost here, and Nikki is a minimalist dresser in warm weather. I've noticed a tendency for her to wear more concealing clothing than usual for her, and I didn't want her to fall into an unnatural routine. This also served as good exposure (pun intended) for her upcoming work in getting the OSU burn support effort off the ground.

I wasn't able to go with Nikki today, but her account was a very good one. She was nervous only at first, when she walked to the center of a ring of 50 grad students. Since they were only a little younger than her, though, communication was good, vibes were flowing, karma was high- whatever, she felt comfortable right away. Bob led her through a discussion of her injury and subsequent recovery. Several types of grafting were illustrated on Nikki's body, along with contractures and the work required to prevent them and to correct them. The kids learned about sheet grafts, split thickness grafts, full thickness grafts and so on. They learned that Nikki doesn't have sweat glands anymore in her burned areas, and that she sweats like a pig in the remaining areas as compensation. They saw where her right eyelid had been destroyed and then restored- a work in progress. They learned that after 9 months and 15 surgeries, she still has years of work ahead of her. The students learned that, unlike many common physical injuries, burn patients required a much longer period of intense physical therapy, often measured in years.

The grad students also learned about more than just the physical injuries. They learned that Nikki was somewhat unusual in her very positive attitude and outlook, graphically illustrated by her coming to the lecture today & displaying herself to total strangers. They learned that many victims have a lot of trouble getting past the appearance of their injuries, sometimes becoming depressed to the point that it hampers their recovery. In Nikki, they saw that good humor and optimism were healing tools, fostering better compliance to therapy and other treatments and leading to healthy and more rapid healing. Bob pointed out that Nikki is well above average in the speed, degree and quality of her healing. He also credited the expert care that Nikki received at MetroHealth in Cleveland.

Nikki then played anatomical dummy, and invited the class to come and touch her burns and injuries. Bob gave a running discussion on the various things that a physical medicine specialist needs to look for, and how to deal with them. Many students were surprised at how alive her skin felt, even where it looks pretty rough. They felt first hand how restrictive contractures are, and learned why they must be released. Nikki's face was especially interesting, as it displays a sheet graft, split thickness graft, full thickness graft, and a failed graft site. They noticed how Nikki's new eyelid doesn't stop tears from leaking down her face, and she explained that while that could be improved somewhat, it will be a problem for the rest of her life.

After nearly 3 hours, class was over. Many of the students collected Nikki's address, email and phone. All were at least a little touched at how brave someone would have to be to do what Nikki had done today, and very appreciative that she had chosen to share with them, at least a little, of what it's like to be a burn survivor. I think it helped Nikki some, as well. She was very excited at how the lecture went, and is still talking about it. We went to dinner tonight, with Nikki wearing a flimsy tank top and short skirt, and listened to her bubble with enthusiasm. She has agreed to help Bob with other such lectures, at least one every quarter, and she's really super-charged over getting more involved in the burn support effort.All in all, a day well spent, I think. Stay tuned for more!