11.03.09
Check Up Part 2
Dr. Elliott is EXTREMELY pleased with how well the Twins are doing. He’s thrilled with how much they’ve softened and how well the scars are fading. He’s also pleased with how my back looks.
While he was looking and “groping” (forgive me Dr. Elliott, I don’t know what else to call it when you check to see how they feel) we talked about the things I was curious about. First, I found out the reason my back has that plasticky feeling like someone set down a layer of plastic wrap across a wide section of my back.
The reason for that is that he basically disected my back, probably doing more surgical maneuvering back there than in my chest. The crackly feeling is where scar tissue has formed in kind of a sheet. It will probably take another six months or so for that to release. He gave the same prognosis for the numb areas, although those could take even longer.
We also talked about how subjective the term “recovery” is. You “recover” in the recovery room. You “recover” in the hospital. You “recover” after the surgery and that can take over a year dependent on which aspect of healing we’re talking about. For instance it took me about six months to get my endurance level back to where it was. Some people take more time. Others take less.
It’s subjective.
We also discussed nipple reconstruction. I told him it probably wouldn’t be until this time next year. He said it didn’t matter. We could do it tomorrow, next week or five years from now. Personally *I* was just relieved that he wasn’t planning to retire any time soon.
Another thing we touched on was doing a breast lift. His concern is that there wouldn’t be much point to it because as heavy as the Twins are, they would end up right back where they are in no time at all. I would have to lose at least 30 pounds before it would become feasible.
My big issue with that is around that point the Twins will start getting smaller. As I’ve written before, to watch them shrink away is like watching my original breasts rot away. I just can’t handle that right now. I just can’t. As i sit here typing I can feel the panic rising and the tears filling my eyes. I CAN’T lose them again.
Okay, okay, I know logically that I’m not losing them. They’re a part of me and I love them dearly. I’m just SO not ready for that. And for the first time in my life I’m content to weigh 218.
We also discussed the two little places on my sides that look like little handles. he called them puckers I think. (Dr. Elliott, if you read this please leave a comment and correct my verbage). He said they were normal and occurred as part of the surgery. We could do a little lipo to lessen them but to tuck the skin would require another incision. Dr. Elliott didn’t seem very keen on another couple of incisions on me and I’m really quite okay with that. He explained that when you do the tummy tuck type breast reconstruction you get the same thing at the hip bone area.
Dr. Elliott made a point of mentioning that he was SO happy we had gone with the latissimus flap reconstruction rather than the tummy tuck. We both had been extremely concerned about possible complications. The tummy tuck procedure simply carries more risk and more risk was the LAST thing I needed.
So all in all the Twins are doing great. He wants to see me again Aprilish for my one year check up. In the mean time I REALLY hope that he checks in. He seemed really interested in my blogs.
And in case I haven’t said it enough, he’s an amazing doctor. Every woman who has to go through reconstruction for ANY reason should go see Dr. Elliott at Atlanta Plastic Surgery (http://www.atlplastic.com).
10.28.09
Packing Up
Even after the debridement the HiQ still had me packing the area with saline soaked wet-to-dry bandages. Every time I asked why this happened his reply was the standard “I don’t know”. When I asked him what was next, his standard reply was “We’ll just have to wait and see.”.
After the debridment I told him that “I don’t know” is no longer an acceptable answer. I let him know that I would accept “I don’t know but I’ll find out” and that I would expect an answer at my next appointment. When he DID finally give me an answer it amounted to “Sometimes these things just happen and we really don’t know why”.
Emotional meltdowns were a regular occurence. Ken still wasn’t allowed in with me. I wasn’t going to expose him to the horror I saw twice a day.
After the debridement there was just raw fatty tissue and flesh. Granular tissue started filling in some of the areas. granulation tissue the newly formed vascular tissue normally produced in healing of wounds of soft tissue, ultimately forming the cicatrix. A Cicatrix is a scar resulting from formation and contraction of fibrous tissue in a flesh wound So I was starting to heal.
Since the HiQ had removed all the necrotic tissue that he could, the next step was the other bad news. There was no way the implants were going to stay. They had to come out. So they scheduled me for the second surgery on November 2nd 2007. And lucky me, I got to pay for the cost to use the surgical center. Yes. You read that right.
In the next post I’ll talk about the shocking reality of law suits for malpractice.
09.30.09
Keloid Scars
I may I have covered this topic before but not as it applied to me, personally. I noticed something last night after I took off my bra. There is a two to three inch area on the underside of each of my new breasts that has some keloid scarring. These spots didn’t have tape on them consistently as they are furthest out towards my sides and the tape kept coming off there.
Imagine if skin could simmer like water and then be frozen in that state. That’s what keloid scars look like. Here’s a photo of keloid scars on someone’s chest.
Doctors do not understand exactly why keloids form in certain people or situations and not in others. Changes in the cellular signals that control growth and proliferation could be related to the process of keloid formation, but these changes have not yet been characterized scientifically.
The methods now available to treat keloids are:
- Cortisone injections (intralesional steroids): These are safe and not very painful. Injections are usually given once per month until the maximum benefit is obtained. Injections are safe (very little steroid gets into the bloodstream) and usually help flatten keloids; however, steroid injections can also make the flattened keloid redder by stimulating the formation of more superficial blood vessels. (These can be treated using a laser; see below.) The keloid may look better after treatment than it looked to start with, but even the best results leave a mark that looks and feels quite different from the surrounding skin.
- Surgery: This is risky, because cutting a keloid can trigger the formation of a similar or even larger keloid. Some surgeons achieve success by injecting steroids or applying pressure dressings to the wound site after cutting away the keloid. Radiation after surgical excision has also been used.
- Laser: The pulsed-dye laser can be effective at flattening keloids and making them look less red. Treatment is safe and not very painful, but several treatment sessions may be needed. These may be costly, since such treatments are not generally covered by insurance plans.
- Silicone sheets: This involves wearing a sheet of silicone gel on the affected area for several hours a day for weeks or months, which is hard to sustain. Results are variable. Some doctors claim similar success with compression dressings made from materials other than silicone.
- Cryotherapy: Freezing keloids with liquid nitrogen may flatten them but often darkens the site of treatment.
- Interferon: Interferons are proteins produced by the body’s immune systems that help fight off viruses, bacteria, and other challenges. In recent studies, injections of interferon have shown promise in reducing the size of keloids, though it’s not yet certain whether that effect will be lasting. Current research is underway using a variant of this method, applying topical imiquimod (Aldara), which stimulates the body to produce interferon.
- Fluorouracil: Injections of this chemotherapy agent, alone or together with steroids, have been used as well for treatment of keloids.
- Radiation: Some doctors have reported safe and effective use of radiation to treat keloids.
This is not a very common complication, but it can happen. There doesn’t seem to be a bias. It happens equally in men and women as well as all ethnicities.
08.12.09
You Get What You Pay For
As I said yesterday, I found a plastic surgeon on barter. So I called to make an appointment for a consultation. Before long both hubby an I were headed for the office on Dr. Phillips Drive.
I mentioned on Twitter yesterday that I still blame myself for this. BUT, part of being a literal cautionary tale is that you fess up. This is my confession. You would think the fact that the office is in a strip mall, called The Market Place, might have been some kind of indication. Here in Florida you’ll find some really nice restaurants in strip malls though. So I shrugged it off. I did more than shrug it off, I stomped flat that obnoxious little voice in the back of my mind.
Legally, because of the settlement that came later, I cannot reveal the name of the surgeon. Nor can any of my relatives, friends or even people I am acquainted with. Maybe one day I’ll auction off the name the way Carly Simon auctioned off revealing who “You’re So Vain” was about.
We arrived a little late to a well appointed office. There were cosmetic products in a glass case and up to date fashion magazines in the waiting room. I was nervous but excited. We were called back to a comfortable examination room and I was asked to strip from the waist up so that the doc could see what we were dealing with and I was given a thick comfy robe to cover up with.
The doctor came in and took a look. During the exam he actually pinched, hefted and squeezed (albeit briefly) my breasts to get an idea of volume and elasticity. He explained the anchor procedure to me and asked if I had any questions. I told him that I wanted my boobs put back where they were when I was 17. He told me it was not possible and that was an unrealistic expectation. He said that he could make them look perkier and fuller but they would never be like that again.
He also explained that I had wide-set breasts so it was not possible for me to have the kind of breasts that I brought in photos of. Yes, some plastic surgeons ask you to bring photos of breasts you like so that they have a visual reference of what you want.
He also asked me if I understood that I would have scaring. These people want to make good and certain that you understand that with the anchor lift, it’s not all sunshine and roses right out of the box.
Once all my questions were answered that’s when I dressed and we went into the business office to discuss the financial aspect. The surgeon’s fees were on barter but the anesthesiologist, the implants themselves and the facility fees were cash. I was given a brochure for a company called Care Credit that finances cosmetic procedures and the breakdown of costs and we went on our merry way.
Tomorrow I’ll talk about financing and the build up to my first surgery.
07.26.09
Midnight eMails
Regardless of the fact that I knew I had to be up early this morning to travel back home from Atlanta, I was down in the lounge at the Westin around midnight. I had, as usual, forgotten to ask Dr. Elliott a few things about the revision surgery we talked about at my appointment on Thursday afternoon.
We had hoped that the little spot near my cleavage would have rounded out a bit more by now, but it is still kind of squarish, So he’s going to kind of pinch that skin together to round it off. He has also suggested doing a breast lift because, as you’ve all seen from the first photo, the Twins are kind of droopy.
Of course, as part of my late night meanderings, I did research on various types of breast lifts. He did not mention a specific type. However in his reply to my email he DID say that there would be no new scars. He would simply make use of the ones I have now. This leads me to believe that he’s thinking of using THIS type of lift: http://www.breastlift4you.com/techniques_incisions.htm
As you can see, this type of crescent incision would use the scars I already have and would be a moderate lift. If the lift is included in the cost of the revisions and nipple creation, I have the general attitude of “Why the hell not?”. He’s going to be doing surgery anyway and I’m paying for it so why not just do the “one stop shop” deal and get it all done and over with at the same time? Dr. Elliott is enough of a pro to be able to do it and do it well.
There ARE other types of breast lifts that, as with the crescent lift above, do not reduce breast tissue volume the way the Anchor Lift does. http://www.plasticsurgery4u.com/procedure_folder/breast_ptosis_surgery2.html This site shows some good examples of the Donut and Lollipop lift.
I always feel better after talking with Dr. Elliott. So I think that, when we can manage the cost, I’ll be having the revision surgery. One thing I learned from my mother-in-law before she died was :Never Settle. So I might as well get what I want.
07.24.09
Nip Tuck It
Since we had to be in Atlanta anyway I got an appointment with Dr. Elliott. He ended up excising about 100 ccs of fluid from the same general area on my back. No big deal. It’s common with this type of surgery. I’ve gone over that before.
Something else he mentioned after doing the medical groping to check my progress was the revisions. He’s really good at what he does but sometimes skin doesn’t knit together quite the way you’d expect so there are little places that could be nipped and tucked to improve the overall appearance.
One of the things was smoothing out the corners. In my opinion there is a spot on the right inside next to my cleavage that looks a bit squared off. That should have smoothed out by now but it hasn’t.
Another thing he mentioned is possibly doing a lift. I sort of froze like a deer in headlights for a few moments there. The lift was one of the reasons I lost my nipples last time. Of course I know there are no nipples to lose this time, I have to wonder HOW he’d do the lift without making them smaller. I’m also not too excited about the possibility of more scars.
Time to do some research on that.
Either way I let him know that I would most definitely NOT be opting for another surgery any time soon. Right now I don’t care about the oddly shaped corner or the slight pendulous appearance. I love my new breasts and I’m happy with what I have.
Right now I’m even happy with what I DON’T have. I’m content with not having nipples. That may change again as my mood is rather changeable. Dr. Elliott told me in our first consultation that there would come a time when I would be ready and I’ll know if or when that time comes.
In the mean time I’m protective of what I have and I’ll keep the Twins just the way they are for the time being.
07.19.09
Briefs
***I’m STILL waiting for a call from Dr. Elliott regarding the whole weight loss/losing boobie volume issue. This is really the first time I’ve actually been truly disappointed with him. He didn’t call last week nor did his PA. Needless to say I’m somewhat miffed. I’ll be looking for an explanation when I call on Monday. I know he sees patients then.
***I heard back from Paul about the prosthetic nipples. He said he can do anything I want. So NOW all I have to do is decide what I want. Not as easy as it sounds. If I decide not to opt for surgery, these babies are my nips for life. Or until the wear out and I have to get new ones.
Mail order nipples… Now THERE’S a modern concept for ya.
***A friend of mine from another site who just recently started reading my blog said that I need to “pull myself out of the Abyss”. Someone else pointed out that the word “survivor” is frequently used as a crutch. Now THAT took the wind out of my sails. Those two comments have me wondering just how much of this blog consists of me whining about how truly awful things have been. I would LIKE to think that there is some helpful information in all of this. As for pulling myself out of the Abyss, THAT is what this blog is about for me. I have been in some very dark places since this all began. The things I’ve been discussing are surface issues by comparison. I know I still have healing to do.
There are times when I’m not very good at recognizing my limitations and boundaries. This is one of those times. I’m still somewhat enmeshed in the misery I suffered. Some days it clings to me like cobwebs. I wonder how much longer this sorrow will be with me. I suspect it will be years more because I have a book to write.
I also have allowed a few people to have a great deal of influence in my life. I wonder sometimes how much I’m doing just to make them happy and how much of what I do are things that *I* want for me. It’s difficult when I can’t seem to separate my desires from theirs FOR me. Not long ago I was explaining to someone that I tend to analyze the crap out of everything. So I am. It’s just part of the “Maria” package.
***That troublesome spot on my back has mostly scabbed over. Now it’s just a matter of time before it completely heals up. The wet-to-dry bandages really helped. The other side that had separated and scabbed is healed up now and has blended into the rest of the scar line.
***Intimacy has the most beautiful bras and panties for DDD+ cup sizes. The engineering that goes into these bras is phenomenal. Unfortunately, their customer service is HORRIBLE! I’ve had to keep calling multiple times to check on a back order. I called three times and left two messages before someone called me back to let me know that my original fitter was no longer with the company. Then it took 20 minutes for them to find my original back order paperwork and verify that those items were ones I still wanted. At that point, after being placed on hold for about 5 minutes I was told they were out of stock but would be getting them in soon.
Six weeks later I got a message saying that my back order was in. So I called back, ended up leaving two messages in a week and FINALLY got a human being a week after that. It took another 20 minutes to find and verify my back order ONLY to be told that they were out of one item that I ordered and it would have to be shipped from the Boston store.
If Intimacy could just get their act together customer service-wise, they would be more popular than Victoria’s Secret. Intimacy’s lingerie is better made, more supportive and will last longer. PLUS they offer life time tailoring. If you lose a substantial amount of weight, they will tailor your bras to fit as many times as you want.
07.01.09
Emu Oil
A couple months ago I mentioned that I was starting to use something new to try to speed healing of that lovely little troubled spot. I had read that Emu Oil works wonders for many people. I’m here to weigh in on the subject.
Yes, it works. It speeds tissue growth. The problem for me was that it speeds tissue growth in the wrong places. Instead of allowing the skin to grow over the wound from the edges of separation, it grew new tissue in the middle of the wound that actually IMPEDED wound closure. So now we’re doing wet to dry bandages. I’ve explained that process in a previous post.
My conclusion: Emu oil works but you’ve got to be aware of precisely how it is applied.
06.23.09
9 1/2 Weeks
From the title of the post, it’s pretty obvious what today’s topic is.
Medical updates.
The spot on my back is still troublesome. It’s not really getting any better. I’m still not too worried about it though as no one else at Dr. Elliott’s office is overly concerned. Last night Ken said he thinks I should “be seen” by Dr. Elliott’s contemporary down here, Dr. Roxanne Guy. I have an appointment for Thursday.
Honestly, I am SICK of “being seen”. I am SO over all of this medical crap. I just want to get ON with my life. I think that’s part of the reason I’ve started doing Ta Ta Tuesday. Even though I may not be completely done with all of this, I want to start enjoying the completion of the major stage.
The nurse at Dr. Elliott’s office had suggested that I wait another month to take the tape off the suture line. I got tired of waiting so I went ahead and took the tapes off four days early. Really I could have taken the tapes off at 6 weeks but I tend to be overly cautious as far as suture lines go.
I haven’t taken any acetaminophen for pain in a few days. I’m happy about that. It’s definitely a few steps ahead of where I was. My endurance, however, is another matter all together. I used to be able to be at Disney for anywhere from 12 to 14 hours. Now I can’t walk around for more than a couple hours without getting worn out. It’s possible that the heat could be exacerbating the issue, but I just don’t think so.
Mobility is another issue. I can raise my left arm all the way up next to my head. The skin in my armpit is still a little tight. My right arm is another matter. I can only raise it at a 55 or 60 degree angle without tightness and pain. It HAS improved since surgery. It’s just improving more slowly.
Emotionally I’m doing better, as the idea of TaTa Tuesday shows. I’m still trying to decide if I want to take a chance on nipple reconstruction. Some articles say that in experienced hands the failure rate is less than 2%. On other websites I’ve read women’s stories of how their nipples flattened out between six months to 2 years. There was also a fairly high incident of infection.
I have emailed Dr. Elliott and asked him to suggest someone who makes custom silicone nipples and write a letter of request. Every prosthetics maker I have found that does really good hand painted nipples requires a letter from a physician. Even if I decide to have the surgery later, I will still have the prosthetics in the mean time.
06.20.09
Under There
HA! Just made you say “Underwear”!
Seriously though folks, because of the relatively minor issues with slow healing on my back in a couple spots, I’m wearing camisoles either as my top or as an undershirt. It took me a while to find ones with half way decent support. I’ve found that shelf bras with wide eleastic bands do a pretty decent job. I found a bunch at Kohl’s on sale for $9.99 each. They have thin shoulder straps but the band is pretty wide so that sort of makes up for it.
I found two others at Macy’s with wide elastic shoulder straps and a wide band. I like those better as they tend to give better support. Unfortunately it’s summer in Florida and it is already reaching 99 degrees in the afternoons. I can only wear those once as undershirts before having to wash them. It IS nice just throwig on a cami and capris when I need to run out the door though.
I have all these pretty bras and panties and I still can’t wear any of them until these areas on my back are completely healed. Which brings me to a major complaint about Intimacy. I am STILL missing two pairs of panties. A couple weeks ago I got a call from a manager asking me if I had gotten everything. I let her know what I was still missing and that I had called leaving a message saying as much but never got a call back. She told me that she would investigate and call me back. I STILL have not heard from her.
I’m getting ticked off about this. They have such wonderful products but such hideous customer service that it’s really no longer worth it to shop there. For THAT kind of money per piece I expect MUCH better service. I will, of course, keep you all up to date about what happens. I WILL have my matching panties or someone will be dealing with an extraordinarilly pissed off Maria. That is NOT something anyone wants.
