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Monthly Archives: October 2009

Zombie

While I was doing the wet to dry bandages before the debridment, I frequently felt like I was a zombie. No, I didn’t want to eat brains, though I DID want to severely damage the HiQ.

***WARNING! GRAPHIC CONTENT AHEAD***

No what I mean is that when I would peel off the wet to dry dressing and pull away bits of dead flesh, I couldn’t help but feel like I was, at least in part, an undead zombie. Here I was dropping bits of flesh. And that’s what zombies do…walk around, eat people and drop bits of their body.

Instead of eating people, I felt like this situation was eating me alive. And not just in the literal sense. I began losing myself to this situation. I WAS a bouncy, vibrant, spur-of-the-moment type of person before I became Zombie Maria.

It has only been in the last month or two that I’ve come back to myself. I’m not there yet. I still shamble a bit, though there are no brain cravings. And unfortunately I still haven’t gottten past the point of wishing the HiQ ill. I really couldn’t actually do anything myself. I’m not that kind of person. But you can damn betcha that I wouldn’t be feeling bad if he were to accidentally get his hands crushed.

Misty Watercolor Memories

29 Oct

The human memory is an odd creature. Or at least mine is. I have been trying to remember incidents from the first four or five weeks after the initial lift and implant insertion surgery. I’ll try to zero in on that time and then my mind will slip sideways as though the memories had a silicone shield. Everything just slides right off. Non-stick memories.

I’m guessing this happens because I tried so hard to repress and not think about what was happening WHILE it was happening. I just dealt with one second at a time, did what I had to do and cried about it afterward. I was on what amounts to auto pilot. Either that or I detached and focused on the anatomical details. Although that really started more after the second surgery.

I wonder how much of this is a coping mechanism. Avoidance used to be a major part of my modus operandi. From what I learned when I was (briefly) a psych major, avoidance isn’t considered a healthy way of coping. Though I’m not so sure I WAS avoiding. I was changing the wet to dry dressings twice daily and going to my regularly scheduled doctor appointments with the HiQ.

I have to wonder how clearly people remember incidents of severe trauma. Does our brain initiate a response that allows us to be protected from the harshness of those memories? Is it some sort of conscious mechanism in which we tell ourselves that “this gets filed back here and we’re not going to remember this any more”. Rather like sticking our fingers in our ears and yelling “LALALALALALA I CAN’T HEAR YOU LALALALALALA!!”

***WARNING – VIVID DESCRIPTION AHEAD***

And then…sometimes I get some vivid memories back. Like one of the times I was pulling off one of the wet to drys and a big chunk of flesh the size of a quarter came away with the necrotic tissue and I felt like Imhotep from “The Mummy”. Or a Zombie.

I actually spent a moment or two trying to put it back in the spot. You know…like when you’re a little kid and you break your favorite toy. You try to put it back together and it won’t go but you just can’t figure out why it won’t go back together.

Yeah, I think I was a little insane for a while.

The Reality of Malpractice Law Suits

28 Oct

In the third week after the first surgery I called two different malpractice lawyers. They both told me the same thing. In the state of Florida a plastic surgeon is only required to carry a minimum of $100,000 in malpractice insurance.

That amount would cover the investigative and legal fees and I would be left with very little. In all likelihood it would not be enough to pay for reconstructive surgery.

In the investigative part of the law suit they subpoena the records from the surgery. Once the records are subpoenaed, (or even before that) anyone can go in and change the records to indicate a more favorable position for the surgeon and the surgical team. So by the time the attorney gets them, there may be no evidence at all of malpractice.

It is also difficult to define what exactly constitutes malpractice. Who’s error was it? WAS there even an error?

Much later I spoke to a surgical nurse an another site who said that she thought, from the bruising I described, that something must have gone catastrophically wrong during surgery. But there wasn’t really a way to prove it.

So there you have it. Make sure you know what you’re getting into. Ask how much malpractice insurance your PS carries. You only get one body. Make sure it’s protected.

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Posted by Maria_Myrback on October 28, 2009 in anchor breast lift, boob job, breast health, breast implants, breast lift, complications, cosmetic surgery, Insurance, malpractice, Medical, Medical Insurance, negligence, plastic surgeon, plastic surgery, Plastic Surgery Disaster, Surgery, Surgical complications, Uncategorized

Packing Up

28 Oct

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.

Debridement

24 Oct

It sounds scary. I was terrified when the HIQ said that at the next appointment he was going to “remove the dead tissue”. I anticipated pain. I even had a panic attack. As if I wasn’t enough of a basket case as it was. I didn’t even get an explanation as to how it would be done.

By this time I was crying at least once a day. It had finally sunken in that things were really bad. I had lost both nipples and areolae. The tissue was completely dead. The tissue itself was blackened and rubbery. In some places it crackled when I pushed down on it. So it had to be removed.

Dead tissue is a breeding ground for infection and if it wasn’t removed, it would have caused infection that would have gone systemic and eventually killed me. So debriding, even though it sounds terrifying, is actually a good thing.

When we came back for the next appointment, the HiQ STILL didn’t explain exactly what would be going on. Thankfully his nurse did. She explained that this wouldn’t hurt because the tissue he would be removing was dead so the nerve endings were dead too. Because the nerves were dead, there wouldn’t be any sensation except for a pulling sensation.

I sat down and kept my eyes closed the entire time. I do know that he cut the tissue off with surgical scissors because I saw the instruments before the procedure. All I felt was pressure and tugging. No pain aside from the emotional grieving of having lost an intimate part of myself. I grieved for the loss the same way an amputee or breast cancer survivor would.

It still freaks me out some that he was cutting tissue off my body. It sounds like something out of a horror movie, doesn’t it? Just the concept was enough to freak me out. Yet through all of this I explained calmly and in clinical terms to Hubby what was going to happen. He was, again, not allowed in. I refused to expose him to it and I was determined that I would do my best to maintain a facade of normalcy.

I failed about half the time by this point. But I tried, by damn. I tried.

The most important thing to take away from this post is that if you have to endure debridment, it is NOT painful. It sounds scary but what’s scarier is what will happen if you do NOT have it done. So have it done and do something really nice for yourself afterward.

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Posted by Maria_Myrback on October 24, 2009 in anchor breast lift, Anxiety, boob job, breast, breast lift, complications, cosmetic surgery, debreiding, debridement, Depression, fear, implants, Infection, mastopexy, necrosis, Nipples, Pain, plastic surgeon, plastic surgery, Plastic Surgery Disaster, Surgery, Surgical complications

The Valium Story

20 Oct

One of the more mind boggling instances of the HiQ totally blowing me off is what I refer to as the Valium story. After the initial surgery I did not have surgical drains. Drains allow for serous fluid to leave the body so that it doesn’t build up and cause complications in the tissues.

Serous fluid is the yellow sticky stuff that beads up when you scrape your knee. It’s the stuff that allows a scab to form. It also occurs when there has been damage to the capillaries. Basically your body is trying to heal itself. Mine produces a metric shit ton of the stuff. Unfortunately I didn’t know that THEN.

In the evening some time early during the first two weeks after the initial surgery I began feeling pressure in my chest. It felt like a baby elephant standing on my breasts. The pressure made it difficult for me to breathe.

So I had Ken call the HiQ’s answering service. I took off the surgical bra and laid down on my back because I thought the compression from the bra may be causing problems. I felt better and it became a little easier to breathe but I still felt pressure in my chest.

When the HiQ returned the call about 15 minutes later it was still kind of difficult to breathe. The first thing he told me to do was that I needed to calm down. I explained about the pressure on my chest and he said that I needed to put the surgical bra back on. He implied that not having the surgical bra on would make the pressure worse.

So I handed the phone over to Ken and did that. While I was occupied, the HiQ suggested that Ken should get me a Valium and that there was nothing wrong.

As I have said before, when the HiQ took the implants out he also found about 300 ccs of serous fluid in each of the pockets. That is probably what caused the pressure.

A couple weeks after that incident at a checkup one of the nurses noticed a bubble on the outside of my left breast about the size of a jumbo egg cut length wise.

Perhaps a little of it might have been anxiety. After all things WERE starting to go wrong. I’m still REALLY angry about being blown off like that though.

I also have a vague memory of him telling me that even if he had known about the fluid in the pocket there was nothing he could have done about it.

Dr. Elliott and Dr. Guy excised over 500 ccs of fluid from my back between the two of them. So how is it that someone with supposedly 15 years experience couldn’t do the same thing? It still just pisses me off to no end.

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Posted by Maria_Myrback on October 20, 2009 in barter, boob job, breast implants, breast lift, complications, compression bra, cosmetic surgery, Excise, excise fluid, Fluid, implants, mastopexy, plastic surgeon, plastic surgery, Plastic Surgery Disaster, Seroma, serous fluid, Surgical complications, Surgical drains, Uncategorized

What Is The Sound Velcro Makes?

15 Oct

This is going to be a slightly more graphic than usual post about wet to dry dressings and what necrosis looks like as it develops. So those without strong stomachs are cautioned. I will do my best to inject humor into this as I go. Humor and my support system are really the only way I survived this in the first place.

That, and I rediscovered the analytical part of myself. I mentally separated myself from the situation at hand. I used the phrase “THE breasts” as opposed to “MY breasts” and I never looked at myself in the mirror. So I dissociated to some extent while I was changing the wet to dry bandages.

Initially I didn’t really understand HOW wet the gauze was supposed to be. I was told by the nurse that the gauze should be damp. *I* thought that meant it should be dripping just a little bit. After a couple days I noticed there was little to no progress with the wet to drys. Progress would mean the removal of dead tissue. I was pulling off the occasional fleck here and there but nothing meaningful.

Let me explain a bit more about wet to drys. Once the gauze has been dampened in sterile saline solution, it is laid flat in one or two layers over the area to be debrided. It is molded to the body part so when it dries it is a bit like plaster. A successful pull makes a soft sound akin to velcro being pulled from its fuzzy moorings.

When I went back in for the next check up a couple days later the HiQ complained that there was not enough progress. I explained what I had done and was given the moisture level corrections. It seems that instead of dripping slightly, the gauze should be just slightly damp. Previous to this I had done what is called “packing” where the area is kept moist with wet salined gauze. Thus my confusion, I suppose. We’ll go in to packing later when things have gotten REALLY bad.

Once I had been given better information I was sent home for a couple more days. I was also told that I should only be changing the wet to drys one to two times a day. I HAD been changing them 3-4 times because that was what I had done when I was packing. No one told me to do anything different as far as changing went. Isn’t it amazing how nothing changes when there is no communication?

With the new changes I was getting more dead tissue off. When I pulled off the dried gauze it was definitely pulling away the blackened tissue. The HiQ had me do that for about a week and a half. In that time I still forbade Ken to come in during bandage changes and showering. No one should have to be exposed to that.

I had started crying at least every other day at this point and I was really depressed for obvious reasons. Pulling bits of dead flesh off your own body tends to do that. I was angry because I couldn’t get a straight answer out of the HiQ. The man had all the bedside manner of Dr. Mengele. Which was pretty evident by the “don’t scream” comment when he was sewing cadaver skin onto me and telling me that it was an extremely expensive treatment.

Really folks that all I can manage for today. Come back tomorrow and I’ll tell you the Valium story.

Pins And Needles

14 Oct

During the first few weeks after the initial surgery, there is another incident that stands out strongly in my mind. Personally I think that I spent the first 2-3 weeks after the initial surgery in shock. Like the kind of shock they talk about on ER or House, MD. That and the fact that I really don’t want to remember, might have something to do with this.

So why am I doing this if I don’t want to remember? I’ve talked before about how silent people are when it comes to botched plastic surgeries. People need to know and understand that even with an amazing surgeon, things can go wrong. Plastic surgery isn’t an instant fix even when it DOES go right.

So here I am, talking about it.

It was the appointment after the HiQ gave me a cream that was supposed to improve circulation. I left Ken in the waiting room because I was bound and determined that I wasn’t going to expose him to what was going on unless I absolutely had to. Quite honestly I was also terrified that if he saw what was happening to my body, he would leave me and I would be alone because I had insisted on having this done.

I still have a small part of me that blames myself for the entire snafu as regular readers know. Even two years after the fact I carry a part of that blame. I don’t know if I will ever shake the idea that, on some level, this was all my fault.

I remember sitting in the exam chair. The HiQ took a long needle from a steripack and stuck it directly into the blackened nipple tissue on my right breast. It didn’t hurt. I didn’t feel anything. I also didn’t really understand what was going on. The HiQ never said why the needle stick. All he said was “I’m sorry.”

I understand now that the reason for the stick was to see if the necrosis was just topical or if it had affected the underlying tissues as well. If the necrosis was topical, there would have been a droplet of blood from the stick. There wasn’t anything.

I didn’t understand what was going on. I wasn’t being told anything. I didn’t know what questions to ask because of all that. So I was just my usual, kind, cheerful self. It’s amazing what ignorance can do. It’s also amazing how rapidly the old defense mechanism of avoidance popped in. For the last 10 minutes I have been looking at how to create a website on iWeb so that I can finally get the BoobCast website up and running.

That may not seem like avoidance from your perspective. Trust me. It is. I was avoiding talking about what happened at the HiQ’s office that afternoon.

I checked my photos and unfortunately I don’t have anything for the four week span between October 9th and November 11th. I wish I had taken some pics during that time period. That way I could have better chronicled this story.

See? I’m doing it again.

So… Here I go. After the needle stick, I THINK that’s when the HiQ first mentioned debriding. That thought terrified me. I kind of knew that it meant having tissue cut off, and I anticipated a great deal of pain. I’ll talk more about it soon. It’s emotionally really rough but physically there isn’t any pain at all.

He said that he wanted me to start doing wet to dry bandages. He didn’t say why though. I had to figure that out on my own. Wet to dry bandages gently pull off dead or dying tissue. What you do is you take a gauze bandage and pour saline solution on it. Then you squeeze it out so that it is damp and spread it on the area to be debrided Then you put dry gauze over the top so that you don’t get your clothes wet.

I did that all on my own for a week. I forbade Ken from being in the bathroom when I was changing dressings or showering and I ALWAYS wore a surgical bra when I was around him. To my mind, I was not ever going to expose him to that as long as I could help it. Unfortunately, that would come back to haunt me in about a month.

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Posted by Maria_Myrback on October 14, 2009 in anchor breast lift, boob job, breast, breast implants, breast lift, complications, cosmetic surgery, debreiding, Depression, fear, necrosis, plastic surgeon, plastic surgery, Plastic Surgery Disaster, situational depression, Surgery, Surgical complications, Uncategorized, wet to dry bandages

Nipples Revisited

13 Oct

This weekend Ken and I drove down to Disney’s Vero Beach Resort. They have this great little second story restaurant that overlooks the ocean. We like to go out there, watch the ocean, enjoy the breeze off the water and get a little something to nibble on.

Saturday afternoon as we were getting ready to leave a couple came up from the water and sat down. She must have been cold because her nipples were fully extended through her swimsuit.

Up until that moment I was completely satisfied with the reconstructed breasts I have. Please understand that I love my Twins. The square-ish corners have evened out nicely. They’ve got a really nice rounded look to them now. They’re also finally soft and pliable while still being somewhat firm. Even without all those changes I would still be happy beyond words to have them.

I was really startled to realize that a part of me still doesn’t feel complete. I’m definitely not mentally ready to have another surgery. Even a minor one that only involves topical tissues. If I WAS ready we can’t afford it for a while yet. The nipple reconstruction will end up being around $9,000. About $7K for the surgery and the rest is the fee for the outpatient surgical facility.

Dr. Elliott always said that I would know when I was ready to have the first surgery. He said (paraphrased) that there would come a point where the feelings I had about the mangled wreckage that once was my chest would outweigh the fears I had and I would know when I was ready.

It is the same with nipple reconstruction. I know I am not ready for another surgery yet, financial situation aside. Having that moment of realization that I miss having nipples, however, is the first step in that direction.

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Posted by Maria_Myrback on October 13, 2009 in Anxiety, boob job, breast, breast reconstruction, cosmetic surgery, emotional healing, emotional scars, Latissimus flap, latissimus flap reconstruction, Nipple reconstruction, Nipples, plastic surgeon, plastic surgery, Plastic Surgery Disaster, Reconstruction, Uncategorized

Persistent Situational Depression

09 Oct

April 16th was a very good day. Aside from the morphine I was fortunate enough to get my breasts back. Not the originals, of course. These are the new and improved version. In JumboVision.

Yet it has taken me until today to see even more than a glimpse of my old self. I’ve been going through the motions of living distracting myself with new projects (http://www.fledgelingskeptic.wordpress.com) and just getting through the day-to-day aspects of living.

This afternoon I saw, for just a little while, that adventurous me. This is the part of me that takes unrestrained joy in just throwing a handful of clothes in a bag, getting in the car and driving just to see where we end up. If I had my way I wouldn’t be writing this entry right now. I’d be packing and getting ready to leave for who knows where.

Sadly, I don’t get to have my way. So that’s a bit depressing. This is the first time in years that I’ve seen that side of myself and it has been denied. Hubby would rather make plans for the weekend and stick with those.

While I’m depressed that I’m not going to be able to express that long-buried part of myself, I am so very happy to see that it still exists. I really thought it had long since died off. No more spontaneity. Ever.

I think that I had just gone through so much for so long that I got stuck in a situation-based depressive state. Now, almost six months after reconstruction, I’m finally returning to my old self.

I think it’s probably going to take a little while longer. I still have quite a bit of emotional recovering to do. I’m looking forward to the time that I don’t get sad during the first few weeks of October. I know that time will come. I just have to get to that point.

As people keep telling me, healing takes time. It’s not just the physical body that needs to recover. It’s everything else; the mental and emotional as well. It’s just a matter of time.

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Posted by Maria_Myrback on October 9, 2009 in Anxiety, breast reconstruction, communication, Depression, emotional healing, emotional scars, Healing, Plastic Surgery Disaster, Post surgical depression, Recovery, situational depression, Uncategorized

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Monthly Archives: October 2009

Zombie

Misty Watercolor Memories

The Reality of Malpractice Law Suits

Packing Up

Debridement

The Valium Story

What Is The Sound Velcro Makes?

Pins And Needles

Nipples Revisited

Persistent Situational Depression

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