Thursday, October 25, 2012

SOS

Wouldn't you know it, the "perfection" I was experiencing had to come to an end. Right?  I don't want to sound jaded or anything, but we just knew that it would. That being said, the issues that have come up are nothing new, nothing surprising. For the most part.

As usual with my removal surgery, I've had some wound issues.  Generally, my incision begins to split about a week post-op and it takes 4-6 weeks to heal up. Imagine our surprise when that split made an early appearance this time -- on Day 5.  Now, this has no significance.  We were just not expecting it so quickly.  Split #1 started out small, and quickly emerged into something more.  It was soonafter joined by splits #2 and #3.  What was more interesting to us was that the tear went into the nevus this time, rather than the new skin.  This does have significance. Positive significance.  The scar tissue that will form will not require any additional excision because it's in an area that will already be excised.  So this is a first for us and is definitely good news.

Mom and dad have been doing the wet to dry dressing three times a day, yada, yada, yada.  They know what to do.  They know it will heal.  They are not worried. Or at last they weren't until I had an unexplained fever last week and a little green substance coming from the two smaller wounds.

So, off to the doctor we went.  Nothing seemed too concerning, even with the otherwise symptomless fever, because there was no appearance of infection.  The wounds actually looked pretty good, all things considered.  Indeed, the largest one was healing faster than ever before.  But we take no chances with this process.  Better to have a professional take a peek.

Dr. Miller, my wonderful and amazing pediatrician, confirmed that there was no infection.  Whew!  But she too was concerned about the green substance.  No harm in doing a culture, so she cultured both smaller wounds.  Three days later, we heard a word we were hoping never to hear again... Pseudomonas.  That is the bacteria in my wounds.  That is the bacteria that utterly demolished my first round of expansion, caused an intense infection, and required emergency surgery just two weeks after my expanders went in.  Great.  

Ok, there are a couple of ways to look at this.  So, we are giving it our best to go the positive route.  Yes, the Pseudomonas is still present.  Apparently, it never left.  It is what the medical community calls "colonized" on my body.  Will it always be there?  Probably not.  But it is there now, and apparently all of the efforts mom and dad have put in to getting rid of it over the last almost-two-years have been fruitless.  However, we recognize that it has been almost two years since this stuff actually presented a problem.  I have kicked the tukas of seven other surgeries since that first awful experience without it presenting a problem.  So, there is the possibility that I will continue to get through surgery without infection.  Yes, the opposite possibility also looms.  But all we can do is push forward, and pray.  Pray for the best outcome, and pray that this bacteria, while on my body, remains inactive.

Yesterday, we wrapped this round up (at least when it comes to doctors, hopefully) with my suture removal.  As last time, it was performed in the O.R. while I was resting quietly under the influence of my dear friend, anesthesia.  So all that is left now is a little healing.  Everything looks good.  Everything is making progress.  Wound progress is slow, but we are used to that.  And, overall, we are VERY happy with the way this round went, my surgery, and the recovery period.  Lots of thanks are due -- to Dr. Bauer and his truly spectacular office - Mim, Susan and Kristi, to all of our understanding and helpful friends and family, to everyone who prays for us.  Thank you.

For your viewing pleasure, I saved the photos for the end.  They are graphic.  No surprise there, but you've been warned. Here is the chronology of my healing through today...

October 5, 1 day post-op,
during my first dressing change
October 9, split #1 rearing it's ugly head
October 10... yep, it's ugly!
October 14.  Healing has started in split #1,
but split #2 is starting to show (in the center).
October 16
October 18.  This is split #3.
Still October 18.  Split #1 looks very good,
believe it or not. Granulation tissue is
forming nicely.  Split #2 is in full-swing.
October 25.  Stitches are out.
A tacky, medicated bandage now covers
the smaller wounds. The larger is
now less a wound and more a healed area.
Hydrocortisone covers it three times a day
to help it make the final transition into scar tissue.
 

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