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Z-plasty? WTH is a Z-plasty? (Yet *another* nahtacruz blog)


JLMoran

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OK. Everyone else has been getting in on the "nahtacruz" blogs, it's my turn to join in!

If you happen to read my last real live blog, back in October of 2019 (or listened to episode 375 of the RCBlog Podcast), you may remember that when I started that cruise I was dealing with an old scar on my foot that chose a few weeks earlier to go and open up on me. For the fourth time.

Well it's been a year and a half, and a combined 7 months in 2 different wound care centers, and the darn thing has never healed properly. It's not exactly an open wound any more, but it's still really painful around the edges, I can't keep it uncovered without problems happening fast, and nothing I've tried as far as ointments / lotions / potions / unguents / poultices has done anything to help. Best I manage is to keep it stable.

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But thanks to a change in company insurance plans for this year, I'm finally back on a plan with a proper co-pay instead of an astronomically high deductible. And even better, I was able to find a good plastic surgeon who's highly recommended for fixing scars gone bad, and is in network!

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So on Monday, I will having some comparatively minor surgery to clear out all the scar tissue that's built up and close it back up again. Since this is a plastics guy doing the work, he has a few tricks up his sleeve, the main one a technique called "Z-plasty". (hence the title) Nutshell summary -- instead of sewing the skin shut in a straight line like a regular incision, a bunch of small angled notches will be made along its length that let the skin stretch out more (decreasing any strain that contributed to the problem) and increase the total surface area once the skin is healed. It also distributes out the new scar tissue that's going to form, so there's a lot less chance of having another single point of failure that makes this happen all over again.

I've got a lot of things in my favor for that outcome -- my circulation is good / no diabetes; on examination he said there was no palpable strain that the skin was under; and I've had many surgeries on the other foot that all healed up just fine with barely any visible scarring to speak of. So he is pretty sure that technique will do the job, and that this surgery will be a one-and-done.

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But he's told me it's possible it won't take, in which case a more-significant effort will be needed to fix this. I'm not going to go into that right now; if it becomes necessary, well, I'll talk about it then. In the meantime, I've got two weeks scheduled off of work under our short-term disability leave policy. That's how long I was told it normally takes until the stitches come out and I can expect to be comfortable sitting at a desk for 8 hours straight. So I'm probably going to start watching a lot of The Expanse; my brother has raved about it since season 1, figure I finally have the time to binge the whole series to date.

Going to ask everyone to keep your fingers crossed. Definitely want this done with the one operation, but at least I've got a whole year and change before my next cruise to deal with anything that might have to follow this.

Oh, and this will definitely not be a blog with lots of photos (wide-angle or otherwise ?). Unless of course you want to see a bunch of pictures of my living room, my family room, me getting shaggy after several days of not shaving (as I'm making an attempt at going from Van Dyke to full beard), looking goofy on pain meds, etc.

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My dad had a z plasty  years ago after he had a facial tumor removed the plastic surgeon did a great job it took about six months for the incision to disappear but it worked really well and this was in the 70's so the procedure is well known Good Luck with it and keep the scar out of the sun if you want a good outcome

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So the surgery went without a hitch. Got there at 6:15, was being carted into the OR right on time at 7:30. A few minutes later, I was in blackout from whatever cocktail they put in my IV before wheeling me in there.

I woke up at 8:30, zero pain in the foot. Doc said the local injections he was giving me should be good for 8, maybe even 10 hours. He also said, and this is the part I wasn’t so thrilled to hear, that the skin was pretty tight after he sutured everything up. Even with the Z-plasty approach he used. His estimate is a 50-75% chance this is going to work.

He said he was debating going the full skin graft right then and there while I was on the table, but decided to take a wait-and-see approach. There was nothing bad about the underlying tissue, and all the surrounding tissue looked good, so I guess he wants to see if I’ve got just enough Wolverine-type healing factor to pull it off.

It’s just wrapped in an ace bandage, with packing underneath where he worked. No weight restrictions, but I do need to keep it elevated as much as possible over the next couple of days at least.

He said on Wednesday I can remove all the bandaging and take a normal shower. No need to wrap the site in plastic or anything, but at the same time I shouldn’t scrub it or anything else “aggressive”. And then I’ll just need some gauze pads to cover it, and I can wear a regular sock.

Fingers crossed this is as “mild” a recovery as he’s thinking it’ll be!

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So the local lasted about 13 hours! Started to feel pain creeping in about 8:30, and took two Advil while it was still just a whisper. But by 9:15 it was mounting to a bit more than a dull roar. I know it’s important with any pain meds to take them before the pain is really bad, so took it right then and waiting now for it to fully kick in. Probably going to be zonked out before long, so I’ll get a good night’s sleep. And then a good morning’s sleep. And a good afternoon’s.

Yeah, pain meds typically hit me like a Mack truck once they fully kick in. Part of why I like to get off of them as fast as I can. ??

But I also feel that itching my Nonno called “knitting and purling”. So there’s definitely some healing starting up as well.

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On 2/6/2021 at 2:46 PM, USCG Teacher said:

We'll be thinking of you, Joe.  Oh, and enjoy the viewing. Your brother is right,The Expanse is painfully under-appreciated. ??

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The best sci-fi usually is!  We were late to the Expanse game and are now waiting very impatiently for more.  To fill in the gaps, I am watching a lot of YouTube videos of aftershows with Wes Chatham - he does a good job hosting. 

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On 2/6/2021 at 2:46 PM, USCG Teacher said:

We'll be thinking of you, Joe.  Oh, and enjoy the viewing. Your brother is right,The Expanse is painfully under-appreciated. ??

source.gif

 

8 hours ago, KathyC said:

The best sci-fi usually is!  We were late to the Expanse game and are now waiting very impatiently for more.  To fill in the gaps, I am watching a lot of YouTube videos of aftershows with Wes Chatham - he does a good job hosting. 

I’m halfway through season 2 already. This is a damn good show!

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I was instructed to take off the ace bandage and packing today, and just start using gauze pads and a regular sock. So much more comfortable without that bulky material and constriction around my foot!

And also moderately less painful. Today or maybe tomorrow is supposed to be the last of the “worst” days, so I’m hoping that means I’ll be starting to wean off the meds Real Soon Now and getting down to just Advil. I hate feeling so loopy for so much of the day.

Had to change the gauze after just a few hours, but I was also moving around a fair bit while making breakfast and coffee and then moving stuff off the floor so our robo-vac, “Puck”, could do the twice-weekly run through the living room and kitchen area. The doc did tell me no restrictions around movement or putting weight on the foot, and said to do as much of my normal home routine as was comfortable starting today, so there you go; I imagine that moving around helps circulation and improves final skin elasticity after it’s healed up.

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Our robo vac is Hazel.  Actually we have 2.  I had one for upstairs and one for downstairs but now that we have only 1 level, we just let them loose together.  Hazel 1 and Hazel II or big Hazel and Little Hazel OR Dumb Hazel and Smart Hazel...actually Dumb Hazel is much less of a PITA than Smart Hazel.  "Smart" Hazel is constantly getting into trouble and Little Hazel just scoots along without a worry in the world, plus Little Hazel's battery lasts significantly longer than her big sister.  Such is our lives during the plague.

Glad to hear that you are healing, Joe.  No weight restrictions seems like a good sign.

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First seeing this thread. Glad the surgery went well and you're feeling better. 

Our vac is called ROB after the NES robot from the 80s. Never had one but always wanted one ... Like the power glove ... Always wanted that too! Anyway it's always getting stuck and lost. It's a Shark and replaced a Roomba. We will be going back to Roomba for sure.

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2 hours ago, sk8erguy1978 said:

Our vac is called ROB after the NES robot from the 80s. Never had one but always wanted one ... Like the power glove ... Always wanted that too! Anyway it's always getting stuck and lost. It's a Shark and replaced a Roomba. We will be going back to Roomba for sure.

Ours is a Eufy model. Got it partly because I have other Eufy gear and know they’re a good brand, partly for lower cost vs Roomba, and partly because unlike every other robo-vac it’s low-profile — their whole lineup is almost an inch shorter than every other brand’s models, and I’ve seen it easily scoot under bedroom furniture that would have sent normal-size models bouncing away.

With two cats, a dog, and two long-haired humans in the house, Puck earns his keep every Wednesday and Saturday.

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5 hours ago, twangster said:

Life goal:  Rise to the level where one needs two robo vacs to keep up with @WAAAYTOOO

 

Oh come on!  I don't even have one yet.  Now I need to go get two?!  And if Raye has it, well then you know how the story goes...?

I want the Roomba...Hubby did not get the message for Christmas or Valentine's Day lol

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31 minutes ago, Lovetocruise2002 said:

Oh come on!  I don't even have one yet.  Now I need to go get two?!  And if Raye has it, well then you know how the story goes...?

I want the Roomba...Hubby did not get the message for Christmas or Valentine's Day lol

Wait until he hears he needs to buy you two...  

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2 hours ago, Lovetocruise2002 said:

 I want the Roomba...Hubby did not get the message for Christmas or Valentine's Day lol

Even something like a Roomba I refuse to buy as a gift, I look at it like "here go clean" LOL.

My wife also doesn't find my comments about how I outsourced her vacuuming duties.

Further, to her the robo vacuum is only good for "touch ups" but still need to vacuum weekly with the Dyson (she's a bit OCD / obsessed with mess). When she'll say something like "I have to vacuum" she doesn't laugh when I offer to help and press start on ROB. 

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9 hours ago, sk8erguy1978 said:

Even something like a Roomba I refuse to buy as a gift, I look at it like "here go clean" LOL.

Yeah but when I was married I would often receive tools as gifts.  One could argue that is basically like saying "Get off your lazy backside and fix something!".

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14 minutes ago, twangster said:

Yeah but when I was married I would often receive tools as gifts.  One could argue that is basically like saying "Get off your lazy backside and fix something!".

There are other gifts to buy a bot other than tools?

And Joe's blog has officially been hijacked to Robot Vacuum of the Seas blog ?

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20 minutes ago, twangster said:

Yeah but when I was married I would often receive tools as gifts.  One could argue that is basically like saying "Get off your lazy backside and fix something!".

Yep I've received tools too. One little set of small sockets and various bits I use frequently to tighten whatever or put whatever together.

Joking aside, I still buy things to make her life, heck our life easier, I just try to not wait until Christmas or whatever. Figure something like a Roomba is for both of us since I do actually help vacuum. Working from home through this pandemic has made that a bit easier. Don't get me wrong, I'd love tools, a grill, or anything else deemed "manly" as a gift. I'd just rather buy cleaning stuff she requests on a random April afternoon then her bday lol.

 

 

 

 

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17 minutes ago, Lovetocruise2002 said:

And Joe's blog has officially been hijacked to Robot Vacuum of the Seas blog ?

Only while he is loopy on pain meds. (maybe he won't notice)

 

17 minutes ago, Lovetocruise2002 said:

There are other gifts to buy a bot other than tools?

Memory upgrade.  A faster CPU.   A new OS like bot 2.0. 

 

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My pattern from past operations seems to be holding. I need the pain meds like clockwork for some period of time, and after that it’s like some switch has flipped and I more or less don’t need them at all, except to sleep for another couple of nights.

Today, only 3 days post surgery, that switch has already flipped. My last pain meds were at 6:30 AM and I haven’t needed anything since then. If I hold to pattern I’ll just need something for sleep tonight and maybe tomorrow, and then I’ll probably be done beyond taking Advil.


And why the heck is there suddenly a page about the merits of robovacs in the middle of my live blog?!? ??

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