Reconstruction: September - December 2005

11/22/05
Just a very brief update for you folks, as there's really nothing happening right now. The doctors have decided that there'll be no more surgeries until after the holidays. Nikki isn't really satisfied with that, as she's impatient to keep moving along in her recovery.

While the last surgery was a success, she has already developed some new contractures along her face and neck. These are once again dragging down the right side of Nikki's face, and making her uncomfortable. This will mean more excising and grafting along the right neck & cheek. There's also still work to the done on the right shoulder and upper arm, and more work is needed on the right eye. 2006 will be another busy year for Nikki.

Things continue to progress with the new burn support group- just a lot more slowly than everyone would like. The interest and support is definitely there, and Nikki is already making contacts with web page designers, local fire stations, and so on.

Work is also going well for her. She's carrying a full schedule now as a server, and patiently (sort of) waiting to break back into bartending. Bartending is fast paced, requires mental & physical skill and is also more financially rewarding… plus, she's really good at it.

That'll do for now. I promise at least one more update by Christmas. In the meantime, we hope that everyone has a blessed Thanksgiving. All of you have things to be thankful for, and this is that special time of year to reflect on how lucky we all are. I know our family does.

Happy Thanksgiving!

10/26/05
It's been nearly a month since Nikki's last surgery- and my last update. Things are going well for Nikki, and there hasn't been much to report.

As anticipated, Nikki did leave the hospital the day after her surgery. She was very sore for a couple of days, and had to miss a wedding that she planned to attend. As usual, though, she healed quickly. The graft took very well this time, and the area around the eye also healed well. The donor site on the back of her head is already growing back in nicely. The bone harvest site over her right ear never did give her any problems.

Nikki returned to work last week, this time as a server.... no more hosting for her! Her manager has also made arrangements for her to begin picking up shifts as a bartender. Of course, her ultimate goal is to return to bartending full-time, and it looks like she's well on her way to that.
In another important step toward regaining her independence, Nikki moved into her own apartment this week. Just 15 minutes from here, and only 5 minutes from her work, this nice apartment is also close to a couple of her friends, and very inexpensive. There is a shuttle service that runs from the Easton Towne Center (where she works) to all of the apartment complexes in this area, which gives her an easy (and free!) ride to and from work- very important, since Nikki can't drive yet. It seems strange not to have her in the house for the first time in 13 months.

Returning to work has its problems. Her Medicaid health benefits will continue for nine months, but at a sharply increased deductible, or "spend-down". She still receives a $750 monthly stipend from Social Security, but $650 of it now goes to Medicaid. No complaints, though, since just her monthly medications cost more than $700. Nikki can't get insurance through her work until she's been there for six months.

The doctors were talking about one more surgery this year, but nothing is finalized as yet. I'll keep everyone up to date as things develop. Take care for now.

9/28/05
Surgery #18 was today, and Nikki's fine & resting comfortably in the hospital tonight. There were some minor issues, though.

Nikki was scheduled as a 2nd case, starting at 9:00am, so we were at the hospital at 7:00am. Everything went smoothly; so smoothly, she actually started surgery at 8:55am, her case slated for 3.5 hours. By 1:00pm, I'm wondering what's happening. Surgical schedules are always over-estimated, and Nikki has almost always finished early. The rare time or two that she's run over, a doctor has called the waiting area to tell me. Today, nothing. By 1:30, my wife is burning up my cell phone. Come 2:00pm, we're both driving each other crazy, and Bonnie is getting ill. I finally went to the attendant's desk in the waiting area and asked her to check on my daughter. She frowned when she saw how late we were running & got right on it. A few minutes later, she reported that the next case had been called for in Nikki's O.R., meaning they were finishing up. At 2:40, Dr. Gordillo finally appeared, looking exhausted.

She quickly told me that Nikki was fine, awake & talking. She apologized for the lateness, and explained that she and Dr. Katz had some problems with Nikki's right eye. The plan was to reshape the outside and inside corners around the eye. Dr. Katz did the outside first, trimming and pulling the skin out to the right a bit. Unfortunately, this put more tension than anticipated on the inside corner, by the nose that Gordillo was rebuilding. The two spent a lot of time moving things around, and also drawing plans all around Nikki's eye and nose. It was finally decided to forget doing any further work on the inside corner by the nose. This is a fairly minor procedure that Gordillo feels can be done on an outpatient basis later.

When Katz was done, Gordillo flipped Nikki over onto her stomach and harvested a 2" by 5" strip of skin from the back of Nikki's skull. She then removed the dark scar tissue from the last failed graft on Nikki's right cheek, then grafted the new skin there. This was originally envisioned as a two part process, but Gordillo like the quality of graft material that she was getting, and decided to do it all at once- something that Nikki had wanted. The harvest site was covered in Xeroform, then stapled. Interestingly, while stitches can kill hair follicles and leave a hairless line, staples don't.

Then the tricky part. Gordillo went to the right side of Nikki's skull, above the ear. A 2" incision was made, and a long, slender piece of bone was dug out of her skull. This is a somewhat delicate procedure, as it's easy to screw up the bone fragment and have to harvest another. When it was free, Gordillo then made an extremely small incision on Nikki's nose, just inside one nostril, in the septum dividing the two nostrils. She then slid the bone fragment carefully through the incision, just underneath the skin on top of the nose, all the way to the top of the bridge. A couple of small stitches closes this, and Nikki now has a defined ridge to her nose, instead of the flattened look that she's had since her accident. The bone harvest site, a very shallow thing, is also stapled over.

And that was it... 5.5 hours of surgery, and 3 of 4 planned objectives met. Nikki has a large bolster bandage stitched over the graft on her right cheek and the outside corner of her eye (take a washcloth, roll it loosely- that's a bolster). She has a 6" Ace bandage wrapped completely around her head, with hair sticking out of the top and bottom. Her right eye is swollen nearly shut, and looks like it'll be black & blue by morning. Her cheek and nose are also swollen. Yep, she looks like hell.

When I knew she was safe in recovery, I left for a few hours, returning later with Bonnie. Nikki was pretty sore and a little down- she had been told that all of the planned work on her eye wasn't done. I went over everything that was done in detail, including the problems the doctors had. She finally understood that a lot of good stuff had been completed, and lightened up. While we visited this evening, her IV infiltrated, causing a lot of discomfort. When we left at 8:00pm, the unit nurses had tried twice to restart the IV, with no luck. Nikki has been a very difficult stick since her accident, what with all of the skin grafts and scar tissue covering all of the usual spots. They called for a special IV team as we left.

Gordillo had said that Nikki could go home Thursday, if she felt up to it. She probably will, no matter how she feels, since she says that she always feels better at home. She goes back to the doctor Tuesday to have the bolster removed & everything checked over. I'll update again after that checkup. Stay tuned!

09/09/05
Just a very brief update tonight. Nikki's 18th surgery has been scheduled for Sept. 28th, and will be as described in my last post. She'll have a couple of days in the hospital for this one, and her work is ready for it.

Nikki worked her first shifts as server this week, which has really excited her. Serving (food or drinks) is really what she loves to do, and she's good at it. She feels like she's really come home now, especially since she's been able to handle the demanding work with no problems. Tips are also great... I suggested that she keep her bandages on from her upcoming surgery as long as possible .

On a basset note, the family just got back from Ohio Basset Rescue's Meet & Greet pizza party for the waddle this weekend. It was great to see many of our old friends and spend a few hours chatting, while the hounds also visited and stole pizza from the tables. Turn out was good, with many new faces in attendance. I hope to see many more at tomorrow's OBR Big Drool Carnival at Paws Park, here in southeastern Columbus. This large off-lead park (7 acres!!) should be a lot of fun for hounds and people. Several concessions & eating areas are available- just a perfect place for a picnic and dog carnival.

Ohio Basset Rescue and its members were a huge help to us during Nikki's worst times. Eva DeVaughn, the head of OBR, fed our dogs for more than half a year, and also donated medicines and other helpful things. Several members also pitched in with cash and other useful items, all very important to us. It was help like this that enabled us to concentrate on Nikki when she needed it the most. It's impossible to ever repay that sort of help. Nikki really enjoyed meeting many of these people for the first time tonight.

I'll have more basset stuff soon... Stay tuned!