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


JLMoran

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8 hours ago, JLMoran said:

And if I go swimming... well, I'll just have to be ready for some stares and possible comments.

You can always say it's results of a shark bite from your last cruise. 

Really though, you have some realistic goals and it will be the end of all you troubles. Good luck and we're still praying for you. ?

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  • 3 weeks later...

So this week has been kind of busy. Started off the week getting my surgery date locked in, regardless of which procedure he'll end up doing -- April 12. So I have just over a week of putting up with this, and then the recovery fun begins.

Once I had the date locked in, I called up the leave of absence coordinator and let them know I'd be out of the office starting on that date. "How long will you be out of work this time?" Umm.... doctor said to give it a month.

I had the MRA taken on my leg yesterday. Went fine, was a bit different than a regular MRI. I was still slid into the giant tube (no longer the old coffin-style, thank goodness) and still had to stay completely still for 30 minutes or so. But before all that happened, I had an IV started in my arm. And then I had a bunch of ECG-type electrode pads (which are connected to the MRI machine) placed on my chest. During the final 10 minutes of the test, they injected a contrast dye through the IV, and the MRI used the ECG signal to sync its scans to my heart beat before the dye could break down in just a couple of minutes. The goal was to catch the contrast dye, which contains a semi-magnetic metal and interacts with the MRI's magnetic field, as it flowed through the arteries of my leg so that they could get a clear picture of the arteries.

When it was all done and I was told all the images were clear, I asked the technician how often he has to do that particular test. I was expecting him to say a couple a month, maybe just one every few months. I was way off. He said he gets one patient like me in a year.

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I got a CD with the results as I left, but there wasn't really a need. I called the doctor's office this morning and confirmed he had his own copy waiting for him on his desk. Unfortunately, I'm still waiting to hear back from him as far as whether it gave the "right" results that clear me for this reversed sural flap procedure, or if I'll "just" be getting a skin graft.

Since I'm in hurry-up-and-wait mode, I just used the money I haven't spent on cruises (and then some) to buy a car.

image.thumb.png.5a229b37603bbdc77bc1c6b1f7f1cb55.png

My 2011 Sonata has been a bit overdue for replacement for a while now, and this lovely lady just showed up in Carvana's inventory last night. Fully loaded, only 10,376 miles, and nicely under my budget thanks to a higher than expected trade-in value. Couldn't have been easier. Well, besides the two months of frustration searching daily for a car like this, finding a few that could have equally worked but got snatched up by someone before I even knew it was there, a few more that were well over my budget, and a whole lot of "NOPE!" inventory.

They'll be delivering it to my house on Monday, and hauling away the old car. Good thing I have tomorrow off; I need the time to clean out the Hyundai, give it a good vacuuming and take it to the car wash.

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1 hour ago, JLMoran said:

So this week has been kind of busy. Started off the week getting my surgery date locked in, regardless of which procedure he'll end up doing -- April 12. So I have just over a week of putting up with this, and then the recovery fun begins.

Once I had the date locked in, I called up the leave of absence coordinator and let them know I'd be out of the office starting on that date. "How long will you be out of work this time?" Umm.... doctor said to give it a month.

I had the MRA taken on my leg yesterday. Went fine, was a bit different than a regular MRI. I was still slid into the giant tube (no longer the old coffin-style, thank goodness) and still had to stay completely still for 30 minutes or so. But before all that happened, I had an IV started in my arm. And then I had a bunch of ECG-type electrode pads (which are connected to the MRI machine) placed on my chest. During the final 10 minutes of the test, they injected a contrast dye through the IV, and the MRI used the ECG signal to sync its scans to my heart beat before the dye could break down in just a couple of minutes. The goal was to catch the contrast dye, which contains a semi-magnetic metal and interacts with the MRI's magnetic field, as it flowed through the arteries of my leg so that they could get a clear picture of the arteries.

When it was all done and I was told all the images were clear, I asked the technician how often he has to do that particular test. I was expecting him to say a couple a month, maybe just one every few months. I was way off. He said he gets one patient like me in a year.

giphy.gif

I got a CD with the results as I left, but there wasn't really a need. I called the doctor's office this morning and confirmed he had his own copy waiting for him on his desk. Unfortunately, I'm still waiting to hear back from him as far as whether it gave the "right" results that clear me for this reversed sural flap procedure, or if I'll "just" be getting a skin graft.

Since I'm in hurry-up-and-wait mode, I just used the money I haven't spent on cruises (and then some) to buy a car.

image.thumb.png.5a229b37603bbdc77bc1c6b1f7f1cb55.png

My 2011 Sonata has been a bit overdue for replacement for a while now, and this lovely lady just showed up in Carvana's inventory last night. Fully loaded, only 10,376 miles, and nicely under my budget thanks to a higher than expected trade-in value. Couldn't have been easier. Well, besides the two months of frustration searching daily for a car like this, finding a few that could have equally worked but got snatched up by someone before I even knew it was there, a few more that were well over my budget, and a whole lot of "NOPE!" inventory.

They'll be delivering it to my house on Monday, and hauling away the old car. Good thing I have tomorrow off; I need the time to clean out the Hyundai, give it a good vacuuming and take it to the car wash.

Hey Joe,

Wish you the best with your "procedure". Hope all goes well and gets you back on your feet quickly, so to speak. As far as "clean out the Hyundai, give it a good vacuuming and take it to the car wash". Yes I would clean out my personal stuff from the interior and trunk. But I WOULD NOT spend anytime/money vacuuming nor doing the car wash. Car dealers have folks on their payroll who do all that stuff regardless of what the vehicle looks like when it's traded in. Not unless this is a requirement that Carvana has. Keep us in the loop on your surgery progress, again wishing you the best!?

rjac

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A long-awaited day has finally arrived...

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Bit longer this time around, thanks to a larger crowd. But still only 30 minutes from getting on line to getting my arm jabbed; about 25 minutes of that time was spent just slowly snaking along the line. Arm is a little sore and not really anything else so far, but I remember it takes around 8 hours before second-shot side effects really start to hit. Hoping my immune system shows a good, strong response to this second jab.

 

Oh, and @rjac -- I totally hear what you're saying about not taking any major time or spending money. But the front part of the car was really quite a mess and I'd be embarrassed handing it over to the delivery guy in that state. I just used one of our older vacuums to clean up the worst of what was on the front mats and floor, and some cleaning wipes to get the major grunge up off the dashboard and console surfaces. The rest I'll leave to their detailing team; at least now the car looks lived in but not like a dumping ground. ?

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On 4/1/2021 at 8:15 PM, JLMoran said:

 

giphy.gif

Since I'm in hurry-up-and-wait mode, I just used the money I haven't spent on cruises (and then some) to buy a car.

image.thumb.png.5a229b37603bbdc77bc1c6b1f7f1cb55.png

Hey, I did the same thing!! Interestingly I traded in my fusion and got an explorer. Like @rjac said, I only got my junk out of the car. Mine was a 2010, pretty rusty courtesy of our salt filled winters, and had been in an accident. I knew mine was headed straight to auction and probably scrap, no need to detail it for that!!

Good luck with the further procedures!

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8 minutes ago, GregD said:

Hey, I did the same thing!! Interestingly I traded in my fusion and got an explorer.

Which is funny, because when I was first looking at hybrids years ago, the Explorer was one of the higher-rated options. But I just loved my BIL's Fusion Hybrid (his was the first model year released; 2011?) and have been itching to get one ever since. This one that was just delivered today is WAAAY more refined and spacious feeling than that original model (which IIRC had a lower roofline and might have been a bit narrower). And wow is it quiet! Took it for a test drive on delivery, road noise was almost non-existent.

 

Oh, and for those who are getting their second shot of Pfizer (and probably Moderna, based on tales I've heard) -- be ready for a rough day after. I was knocked out all day yesterday with body aches, low-grade fever, a sometimes-pounding headache, and just feeling totally beaten-down. Tylenol (all that I'm allowed now that I'm a week out from surgery) didn't do a heck of a lot, but at least it was only the one day of miserable-ness.

You know you're feeling lousy when you choose to watch the Ultimate Edition cut of "Batman vs Superman: Dawn of Justice", followed by the Zack Snyder cut of "Justice League"... and don't feel like that was seven hours of your life you'll never get back! ?

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Finally heard back from the surgeon. Seems my results got misplaced or something, and they only found them today. Test came back good, as expected, so I'm all clear for the flap procedure. And he spent a good bit of time answering my questions that I came up with based on what I'd read about it, so I'm feeling a lot less nervous now about what to expect and overall prospects.

Surgery is on Monday, at 11:30 AM. Glad I won't be up at the crack of dawn, but I'll be up VERY late Sunday night to make sure I have a good meal before my fasting window begins.

Hmm.... if it's right at midnight, is that still second dinner or is it first breakfast? I've gotta keep the proper Hobbit meal order after all. ?

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Hey all! Doc said the surgery went great, no problems at all. I’ve got one heck of a sore throat from being intubated for anesthesia for 2+ hours, and I’m only just now getting off my usual post-surgery nausea (or maybe not so much; sat up to help with doing the breathing exercise that helps clear the anesthesia and felt another wave hit me ?). But foot is decently comfortable with meds; and doc said he wants to see me tomorrow to change the dressing and do an initial evaluation.

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31 minutes ago, JLMoran said:

Hey all! Doc said the surgery went great, no problems at all. I’ve got one heck of a sore throat from being intubated for anesthesia for 2+ hours, and I’m only just now getting off my usual post-surgery nausea (or maybe not so much; sat up to help with doing the breathing exercise that helps clear the anesthesia and felt another wave hit me ?). But foot is decently comfortable with meds; and doc said he wants to see me tomorrow to change the dressing and do an initial evaluation.

Glad to hear it, Joe!  Fingers crossed that the news continues to trend positive!

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Saw the doctor today for dressing change and to confirm everything looked good. He said it looked perfect! ?

Color of the flap is exactly what it should be, the skin graft is taking properly, and he had even been able to simply stitch the larger “paddle” section closed instead of having to graft that as well.

I have a big lump where the graft is located, and he warned me not let that area get any pressure put on it; if it does that can badly impair circulation and cause me problems. So I’m being careful when propping it up on pillows, and going to make sure to baby it for the whole week.

Next follow up in about a week. I’m certain that as long as I take good care of it, this really will fix everything and I’ll be right as rain again. ☺️

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Nothing new here, really. But I just have to comment on how amazing modern surgery and pain relief have become. For context:

  • Somewhere in the early 80s, when I was in middle school, I had to get bunion repair done. I woke from surgery screaming in pain and had to get a shot of whatever that time’s pain med of choice was right in my keister. Which knocked me right back out.
  • In 2011 and 2014, I had bone fusion surgeries. I got a nerve block that let me wake up with zero pain, but desperately needed the morphine drip for 24 hours and was on strong pain meds round the clock for about three weeks, and not fully off them for a good few months.

This surgery, I was given a set of local anesthetic injections that I was told would last about 3 days. I’m on day 5 post-op and I STILL DON’T NEED ANY PAIN MEDS, apart from one when I go to bed so I can sleep comfortably. And I’m sleeping for 7 to 9 hours at a pop. I still get occasional stings from the donor site, or a suture that had a little too much pressure on it. But they go away within seconds and I’m not even bothered by it all that much.

I fully realize that skin-level work like I just had is almost certainly a heck of a lot less painful than having an entire set of bones broken and nailed together. But to not need anything at all except to sleep, and that one dose lasting for a normal night and then some, is mind-blowing to me. I’ve always feared surgery because it has always meant a nightmare of pain afterward. The advances that have happened in the 40+ years of surgeries that I can remember are just... miraculous.

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I stumbled upon this blog just yesterday and read through it.  Having had toe surgery (cheilectomy [happily avoided an arthrodesis by the skin of my teeth!!]), I truly know the pain...although your surgeries sound much more complex to mine.  Anyway, I am happy to hear this latest surgery/recovery is going well!  Thank you for sharing.  

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Just back from post-op visit #2. Everything is continuing to heal wonderfully, and I’m down down to minimal bandaging (mainly to protect the graft site on the back of my calf. Still a bit swollen in spots, but I’m seeing the finish line. ?

Best part was this exchange:

Doc: “Go ahead. Say it.”

Me: “Say what?”

Doc: “Why the hell didn’t you just do this the first time around?!?”

 

And what other bit of great news. I can finally shower again! Everyone downwind of me is quite relieved, despite my best efforts over the last couple weeks. ?

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  • 2 weeks later...

Not really much new to report. I'm able to keep the leg lowered and sit normally for 20-30 minutes at a pop now before it gets too uncomfortable. But because it's still so limited I spoke with the doc about my return to work date. He agreed it would make sense to push that out a week to May 17 instead of this coming Monday, and we'll see about restrictions on initial hours if even that doesn't get me to a point where I could pull off an 8-hour day at my desk right off the bat.

In the meantime, I've found out that the guy on the airplane at the start of Die Hard was right. Making fists with my toes on the rug while I'm sitting really is a great stress reliever! ?

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Second post-op visit today. All sutures are taken out now, except a few that will dissolve on their own over the next week or two. Graft site is still not healed enough, and did degrade a little bit at the lower end, but doc said it’s nothing of concern; he could see there is still healthy tissue growing in that spot, so it just needs another week or two to finish firming up. Everything else is looking great.

I’m able to sit normally for about an hour at a pop now before I feel like it’s time to put it back up again, so it seems I’m making some rapid progress on that front. I have another post-op visit in a week, and at that time I should be ready for a compression stocking.

And right after that, it’ll be time to get back to work! Maybe on reduced hours to start, but it’ll be good to get back to some normal day-to-day living again.

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  • 2 weeks later...

So a bit of a setback. Not sure what the exact problem is, but this is not healing properly at all now. I'm getting some splits along the stitch lines where the wound was covered, and the graft appears to have basically failed in all but a couple tiny spots. If I was going to describe it, most of it looks like a bad burn wound right now, with other areas that don't look as bad but are refusing to form proper new skin.

Doc has put me on a new treatment regimen, applying gauze pads soaked in "Dakin's Solution" twice a day over the entire graft and flap site, and wrapping that up in rolled gauze and an ace bandage. "Dakin's Solution" is apparently just highly diluted bleach -- the one active ingredient is 0.25% sodium hypochlorite -- along with a couple of stabilizing agents in water.

Started it last night, and I will say that where the skin was getting progressively more itchy it's already calmed down a lot. Hopefully this will stabilize everything again and get me back on course with healing. Next appointment is a week from Friday.

Body, can you seriously get it in gear already? I've got a cruise in just under 3 months and I will be damned if I'm going to miss it because you can't manage to heal decently.

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@melmar02, it’s definitely much improved. I’m starting to see some small areas healing fully and looking more normal. Not sure how long I’ll need to keep this up, but definitely until at least this Friday’s follow-up. I’m guessing I’ll need to keep it up until I have a complete skin barrier again so it can’t get reinfected.

And yeah, it was indeed a mild infection. I spoke with the nurse after the first couple days and she said it was almost certainly a pseudomonas infection. I read up on that bacteria, it tends to be antibiotic-resistant and I guess that’s why they wanted to use this treatment. Not much in this world that can live through prolonged chlorine exposure and alkaline environment.

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Yesterday’s follow-up went about as well as I guess it could have gone. Doc said the pseudomonas infection was definitely cleared out, and I can stop using the Dakin’s Solution. Everything is looking as good in his eyes as can be expected after that, now it’s mainly a matter of waiting through the delay in healing this caused.

Even before yesterday, I could see that some areas are starting to fill in again with healthy new skin. So fingers crossed I’m back on track, although the doc was more conservative this time in his estimate. He hoping that in two more weeks, I’ll be healed enough that I can safely start wearing a compression stocking, or maybe just my Bombas compression socks. That’ll also help with the swelling as I sit for longer and longer.

Got a silver nitrate swabbing before I left, to cauterize the open areas and promote more healing. He gave me a few sticks of the stuff (looks like a long match stick) so I can self-apply round 2 in a week and save the expense of another follow-up for just that. Hurt like the dickens in one spot by the time I was home, but I had some Tramadol left from before the surgery and one of those let me get the first 8 solid hours of sleep I’ve had in a couple months. Woke up feeling a hell of a lot better.

Oh, and I’m down to just a light gauze wrapping around the site. He wants it to get air, and it’s healed enough (finally) that the wrap is enough. No more ace bandages or gauze pads. So all around, things are finally turning the corner.

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AARGHHH!!!! Things have already gotten less-than-great again, and doctor wants me back on the Dakin's Solution. Quarter strength this time instead of half, but I imagine that's still going to irritate the heck out of the skin that's still healthy.

In hindsight, Royal canceling my August cruise might have been a blessing in disguise. At the rate things are going, this might be healed enough by then to have taken that trip or enjoyed it to the fullest.

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So the latest update is not a great one. Things were just not showing any sign of improvement last week, and on Friday I sent the latest pics to the nurse assistant along with a question -- Should I be calling the wound care center at this point?

The answer was a firm yes. Especially so since I'm supposed to be going up to Massachusetts the last week of July for a college visit with my wife and younger daughter (high-school junior). No chance to schedule that later, it's the last week they offer it for this year.

I had my first appointment with them today, and they took a sample for bacterial culture (hopefully the infection is cleared out again, but gotta cover the bases) along with coming up with an initial treatment plan. Real treatment won't start until next week when they have the culture results, and at that time I'll be going 3 times a week for cleanings and bandage changes for at least 3 weeks. After that we'll see, could be going down to twice a week if I heal well.

Given the mounting medical bills (although my new insurance plan with Anthem BC/BS has been phenomenal with how much they've covered), and the fact we learned our 20-year old refrigerator is on its last legs, we're giving up on any cruise plans for this year. A bitter pill to swallow, but there's only so much money available and it's being rapidly eaten up.

I'm not going to make any more updates to this blog until I'm healed. Not really much point at this stage, as there's a long slog ahead of me.

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I am sorry!  Financial setbacks are no fun, especially if they involve actual physical pain!  And a new refrigerator is nice, but it can't replace a vacation.

I hope that you are able to enjoy your upcoming college visit.  When my kids were looking at colleges, we tried to turn some of the tours into "mini-vacations" by exploring surrounding areas of interest.  I hope that your family is at least able to do that.

Best of luck to your daughter with her college decision and to you for rapid healing.

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4 hours ago, Fairlynew said:

When my kids were looking at colleges, we tried to turn some of the tours into "mini-vacations" by exploring surrounding areas of interest.  I hope that your family is at least able to do that.

We are actually hoping to visit the Salem Museum while we’re there. Next town over from the college we’ll be visiting and one of those things we figure we have to see once.

This college, Montserrat College of Art, is her first and almost only choice. She’s looking at a couple other schools as backup plans, but this is the one she’s been pining for and talking about nonstop since her sophomore year, when I convinced her to read their brochure and not just throw it away with the dozens of others that flooded our Mail back then.

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