Reconstruction: May - June 2006

06/29/06
Been a while, I know, but as before, it means good news- no problems. Nikki is tentatively scheduled for another face grafting in late July- more when I have it. In the meantime, though, we have good news from physical therapy- Nikki is reducing to one day per week! Her strength in the badly damaged right arm and hand has grown significantly this past 6 months. In just the last month, she's gained 10lbs of lift with her right arm, and her grip has also increased nicely. This is a major milestone and Nikki is very excited.

We should have more information on upcoming surgeries after the holiday. I hope everybody has a very enjoyable (and safe!) 4th of July.

06/01/06
Nikki & I made the long trip to Cleveland today to obtain a second opinion on her facial reconstruction. Nikki wants to make sure that she has all viable options in front of her, not limited by one doctor's viewpoint. For this "outside" viewpoint, Nikki chose Dr. Bram Kaufman, the MetroHealth plastic surgeon that did the initial (and great!) work on her face, just after her accident.

After clearing up some confusion about seeing a resident, versus the man himself, Dr. Kaufman made it down to see us. Just as pleasant as I remembered from 2004, he listened to Nikki explain her concerns about having three grafting sessions to her face so far, with little improvement to show for them. He examined her face & neck, seeming surprised at just how good her forehead looks (he did the original sheet graft over her burned-to-the-bone forehead in 2004). When told about the unimpressive doctor at OSU that tried to insert an expander under the graft, he just shook his head.

His opinion is that Nikki should consider an anterolateral thigh free flap. As opposed to grafting, this procedure surgically removes a deep section of skin, with all of its supporting tissues, including branches of the femoral artery, from the thigh and implants it into the burned area. Vessels are surgically reattached to provide blood to the transplanted chunk of skin. The procedure is a delicate bit of microsurgery, taking around eight hours in Nikki's case, followed by several days in the hospital. The flap will look like a large, fat piece of skin growing from the side of her face. After a couple of months of healing, liposuction and trimming will reduce the flap to more normal proportions.

The downsides include the hunk of tissue hanging from her face for some months, as well as a possible permanent indentation on her donor thigh. The upside is that the procedure neatly deals with the contracture problems that have affected every graft attempt to Nikki's face so far. With all of its support tissues moved along with it, the skin will stay soft & pliable, immune to contractures.

Dr. Kaufman will be forwarding his opinions to Dr. Gordillo, Nikki's surgeon in Columbus. Nikki & Dr. G will meet to discuss the pros and cons of the procedure, so that Nikki can get a very good idea of what it will really do for her. Then, she'll have to make some decisions…. Do the procedure? If so, which doctor?

In the shorter term, OSU is urging Nikki to come in for surgery on her eye this month. Dr. Katz (ophthalmics, plastics) wants to do some more reshaping around Nikki's eye, in order to get the lids closing better and generally improving the appearance around the eye.

Finally, as an aside, the local NBC news affiliate continued its interest in burn support by profiling a local victim injured some time ago. This woman was burned worse than Nikki, and also lost her husband in the fire. She obviously needs some support in dealing with her personal tragedy and the news article gave information on the fledgling OSU burn support group that Nikki is very involved with. This high-profile publicity is invaluable in helping the new support group to get off to a good start.

I'll update again after Nikki has time to reach some decisions… stay tuned!

05/20/06
Just a quick update… the NBC news crew did a nice job at Nikki's burn support meeting this past Wednesday. I thought that Nikki looked great! There's a lot of publicity within OSU for this new group. Other hospitals in the area are also being drawn into the effort. Of course, burn patients are also being made aware that a new support group just for them & their families is starting up. Such things take time and sustained effort to become self-sufficient… and some kind support from a great local news station doesn't hurt, either! Be sure to check out the new interview link on the blog.

Until next time…

05/17/06
Yep, it's been very quiet and peaceful around here… I like quiet & peaceful. It makes for boring reading on this web log, I know, but its good for the nerves. Nikki is working, driving, socializing- all the things that a normal 27 year old does. Physical therapy continues twice weekly, with slow improvements. Two weeks ago, Nikki played 'Show & Tell' again for a graduate class of physical medicine. Wearing skimpy shorts & halter top, she served as Director of Physical Rehab Bob Vaneko's display for what being a burn survivor really means. Students were invited to ask her questions and even to touch her. This is the second time that she's done this and she really enjoys opening the eyes of advanced students who thought they'd seen it all. For many, concepts such as "grafting" and "permanent disfigurement" were just that- concepts. She brought reality to a good group of kids that hope to help people like her in their medical futures.

As mentioned before, Nikki isn't really satisfied with the progress being made on her facial reconstruction. She's started shopping around for second opinions, including getting in contact with the plastic surgeon who did some of her original work in Cleveland. She hopes to visit there in the near future and hear what he has to say.

Tonight, Nikki is attending one of the first meetings of the newly formed burn support group here at OSU. Our local NBC 4 is also attending the meeting, providing some much-appreciated publicity for the fledgling group. Nikki is very proud to be a driving force in the reformation of this necessary support group.I'll be back with more when I have it. Thanks for staying in touch… I welcome any and all comments, as does Nikki. Don't be shy.