Surgery #24 was a success

Up at 4:15am this morning, to be at OSU Medical Center by 5:30am... yuck. Nikki actually worked until after midnight last night and didn't get to our house until 1:30am. Of course, she got to take it easy all day ;).

She was checked in and up in pre-op by 6:00am, with surgery scheduled for 7:30am. Only one person could go with her during prep, so my wife sent me along. Nikki's surgery was actually in the James Cancer Hospital- a first. I didn't even know that the James had it's own O/R suites, but they have six of them. Dr. Miller prefers to operate and keep his patients there when possible, since most of his Plastics workload comes from cancer patients.

Nikki was once again a difficult stick- they couldn't get an IV started. Her arms are both covered with grafted skin from her burns, and this is very difficult to work with. The only suitable veins are deep ones, and it's very hard to pick them out through the scar tissue. Two nurses, a nurse anesthetist and an anesthesiologist all had a go at it... the doctor even used an ultrasound machine to pinpoint a good vein, to no avail. They finally decided to use inhalation sedation in the first round to put Nikki under, then dug around and started two IVs while she slept. Her arm is well-bruised from the efforts.

Nikki was taken to the O/R at 7:32am, although the procedure did not start until 9:00am. My wife Bonnie & I spent a long, dreary day in the family waiting area, reading & playing on our laptop. We left for lunch & snacks in the cafeteria, but didn't venture outside, since it rained most of the day.

Surgery was expected to last 7 hours; it lasted exactly 8 hours. Dr, Miller came to us immediately after, saying that all went as planned. He took a piece of tissue about the size of my hand from Nikki's left thigh, one of the few unburned areas on her body. This slab of tissue was about 3/4" thick and contained a portion of a major vein running through her leg. This vein, along with several smaller ones, was microsurgically attached to existing veins in Nikki's neck and face. It's very important that a good blood supply be maintained to this large piece of tissue, or it will fail. That, along with preventing infection, is the main reason that Nikki has to spend 5 days in the hospital. The tissue graft will be checked regularly with a sonic-amplified scope and ultrasound to ensure it's health and circulation.

We were allowed to see Nikki in her room around 7:00pm. She looked amazingly good and had no pain at that time. This is also the third time that she's had no post-op nausea. The tissue graft was completely uncovered, allowing us to get a good look at it. It's quite a large bulge of tissue, slightly lighter in color than the rest of her neck & face (her face gets more sun than her thigh). Dr. Miller said that the lump will settle and spread out some on its own as it settles in. If necessary, it can later be surgically spread out some more, or reduced through liposuction, to better fit the contours of her neck and face. The great news is that you can already see the relaxing of the grafted skin on her upper face, where it was pulled down by contractures previously. Her right lip and eye are already in better positions than they were. Her thigh is also in good shape; Dr. Miller simply pulled the lips of the wide, deep incision together and stitched them in a neat line, leaving no deep scoop or imprint behind. Her thigh will quickly replace the missing tissue.

One unusual side effect- the large piece of tissue on her neck will be dead to the touch, since nerves cannot (yet) be surgically reconnected. Over time (years), Nikki will regain some sensation there as nerves from her surrounding neck areas infiltrate the newly transplanted tissue. A small price to pay for a much better look to her face.

And that's it. After 14 hours at the hospital, Bonnie & I didn't linger long. We'll be visiting her during her stay, and I'll report anything that comes up. Thanks for following Nikki's latest adventure.