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Category Archives: debridement

My Legal Settlement

17 Sep

Earlier today I received the following email from a regular reader here at the blog. For personal reasons, the reader has asked that they be kept anonymous.

Maria,

In your blog, you said you signed papers with your doctor not to name them.  Did you have a settlement?  Did you have the option not to settle, instead spread their name all over? Or did an attorney advice you about libel or defamation?

If you can comment without naming the doctor, much appreciated.

I have written before about how I tried to deal with the legal ramifications of what happened to me. I also wrote about the settlement that currently binds me from mentioning the name of the surgeon. HOWEVER, before I agreed to the settlement that prohibits me and my “agents” from mentioning the surgeon’s name, I wrote a few posts. Those are listed below in my response to the reader’s questions.

Dear Reader;

I am, unfortunately, also bound from talking about the terms of the settlement as well. I DID have the option not to settle. At that point I was deeply clinically depressed and traumatized. I didn’t want that person to have anything to do with my medical care any more. I would start shaking every time I had an appointment. I just wanted it to be over with so I went with the first available way out.

People keep telling me that I’m brave. This is one of those instances where I was not. I DID put up a synopsis of what happened on the Complaints Board [Editor's Note: This post has been edited on advice from my lawyer.Please visit the link for details]

I never spoke to a lawyer about defamation, but I was a journalist so I know that once I signed those papers, I am legally bound, along with my “agents”, not to reveal his name. HOWEVER, those two links were written up before the contract went into effect.

Here is where things get interesting. I just happened to notice that a person I am presuming is the doctor in question or one of the 2-3 staff members familiar with the case (aka one of his “agents”), made a brief response to my initial post on the Complaints Board. I am presuming this because of the use of the phrase “ridiculous herbal remedy’ in the response. That is FAR too personal to have been written by someone just reading entries on the complaints board.

And so, dear reader, I am going to war. For some reason I am having technical difficulties logging on and making a response to that accusation. Once I do, you all may want to stop by for a look because I can guarantee that things are going to get very, VERY interesting.

This surgeon does not know with whom he is messing. He’s about to find out.

 
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Posted by on September 17, 2011 in anchor breast lift, Anxiety, bad bedside manner, barter, breast, breast implants, breast lift, breast necrosis, cadaver skin, complications, cosmetic surgery, debridement, deformity, dehiscence, Depression, emotional healing, emotional scars, Fluid, Healing, implants, Law, Legal, malpractice, Medical, necrosis, Necrotic tissue, negligence, plastic surgeon, plastic surgery, Plastic Surgery Disaster, Post surgical depression, Post Traumatic Stress Disorder, PTSD, serous fluid, silicone implants, situational depression, Surgery, Surgical complications, Uncategorized, V.A.C. machine, Vacuum assisted wound closure

 

Excise Necrosis

08 Apr

I have been re-reading comments from my Breast Necrosis Photos article and I realized that I have to address this topic in MUCH more depth. I gave this article such a vague title because a couple commenters on the aforementioned article used the term “excise” for the non-surgical removal of necrotic breast tissue.

Excise means “to remove by cutting”. That is the least common use of the word “excise”. It also means to erase or remove by crossing out. I’m not sure how many surgeons are actually using the word “excise” in relation to the actual removal of necrotic tissue.

My experience was different. The nurses always used the term “Debridement” when talking about removing my necrotic tissue.  Debridement is defined as : surgical removal of foreign material and dead tissue from a wound.

So I suppose you could say they mean the same thing. The definition of debridement, in my opinion, sounds much less violent and painful. I’m guessing that’s why more medical professionals use it instead of excising. No one wants to have things cut off of us. It conjures up really frightening imagery.

I know it sounds downright terrifying to be told that your surgeon is going to remove the necrotic tissue. I know this because I was terrified beyond belief, myself. I want to reassure you, dear reader, that it does NOT hurt. It is in NO WAY painful. And while the entire situation is horrendous beyond my ability to describe, you will not feel anything beyond a tugging or pulling sensation while it is being done.

My advice: Don’t look while it’s being done. Bring your MP3 player and listen to something that will keep your focus off the process. Focus on breathing deeply and slowly. Think about something that makes you feel calm and at ease…a favorite vacation spot or a happy memory. Put all your focus on that.

The Procedure: The day I had my debridement done I came in to the exam room and they had me sit in the big chair with the surgical-style light over it. It looks kind of like a dentists chair but more comfortable.

To my right was a tray with a few instruments: Forceps, surgical scissors, a kidney-shaped tray, gauze, a scalpel and a few other things. The scalpel scared the hell out of me because I was anticipating pain already.

When the scalell was unpackaged from it’s sterile holder, I closed my eyes and started breathing deeply, focusing on trying not to cry or panic. Then they turned on the very bright surgical light above me. The nurse told me very softly that they were starting and all I was going to feel was some tugging. She urged me to try to relax and reassured me that it would be over with soon.

She was right. Since the tissue they removed was dead, there was nothing (no nerves) to transmit pain signals. I heard the occasional metallic snip of surgical scissors and felt some tugging and pulling, but there was NO PAIN.

As terrifying as debridement or excise sounds, as horrifying as having dead tissue removed from my body was, it wasn’t nearly as bad as it sounded. When it was all over there was a bed of healthy tissue so that I could start healing properly without the interference of the necrotic tissue.

 
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Posted by on April 8, 2010 in Anxiety, breast, breast necrosis, complications, debridement, Excise, necrosis, Necrotic tissue, Plastic Surgery Disaster, Uncategorized

 

Breast Necrosis Photos

13 Feb

Below you will find photos of what breast necrosis looks like. These are EXTREMELY graphic photos. This post is for MATURE VIEWERS ONLY!!

I am putting these photos up, not for shock value or to evoke pity. I am posting these images of breast necrosis so that when another woman has this happen to her, she will be able to look at the photos and evaluate for herself if she just has really bad bruising or if her tissue is necrotic.

I have said SO many times before that when I was going though this I did not have ANY pictorial references. I didn’t know what to look for. Now YOU, dear reader, do. If you are unfortunate enough to be reading this, searching for answers, please contact me at boobcast (at) gmail.com if you have ANY questions at all.

During the period you see below, I felt so very alone because I couldn’t find anything to compare myself to. I was also sheltering my husband and my family from what was going on. So I WAS alone. YOU don’t have to be.

The first photo (below) is approximately a week after surgery. Most of what you see is bruising. However the black spots are necrotic tissue.

The next photo you will see is closer shot. In this second photo you can see the difference between the bruising and the necrotic tissue. Here you can see the difference in the texture of the skin where it has really started to die.

This next photo is blurry and I’ll ask your forgiveness for that. You can see where a hole has opened up in the dead tissue.

There is a process called debriding where dead tissue is cut away. It doesn’t hurt because the tissue has died and has no nerves. It’s just rather horrifying knowing that part of your body has died and is being cut away. They don’t put you to sleep or anything. They just cut it off with surgical scissors. The completely black area used to be my nipple. That is was totally necrotic tissue looks like.

The yellow tissue is, as you may have already suspected, breast fat.

A photo of my other necrotic nipple and areolae:

Finally, a VERY graphic closeup of one of my breasts after the debriding:

 
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Posted by on February 13, 2010 in breast lift, breast necrosis, breast necrosis photos, breast necrosis pics, complications, cosmetic surgery, debreiding, debridement, implants, necrosis, Nipples, plastic surgery, Plastic Surgery Disaster, Surgical complications, Uncategorized

 

The 200th Post

18 Jan

As the title says, this is the 200th installment of BoobCast. Today I am writing about you, dear reader. Today’s installment is all about the support and the stories that people have shared with me since I first started this blog on Oct. 11, 2008.

When I first started writing this, I was also fairly active on a website called All About Plastic Surgery (http://www.allaboutplasticsurgery.com). When I posted what had happened to me it didn’t take long before I was inundated by questions about various aspects of the surgery. You can find that entry here: http://boobcast.net/2008/10/14/questions/ People expressed a great deal of concern about how well I had checked out the surgeon, what indications I might have had and what legal recourse I might have taken. During that period so many people gave their support and I am grateful for it. So my thanks goes out to the women of the All About Plastic Surgery forum. They were the ones who inspired the idea for BoobCast.

Now you’re probably asking yourself, “Gee Maria, why do you call it BoobCast? Were they wrapped in plaster or something at one point?”

No, dear reader. There are reasons this site is called BoobCast.  In 2007 the podcasting community lost a precious member by the name of Joe Murphy. He died of a vicious type of cancer that took him quickly. During his medical treatments he talked in vivid detail about what was going on, the testing and all of it. His strength inspired me. I wanted to be as strong and as brave as Joe Murphy. So I planned to podcast what was going on with my breast necrosis. The name of that podcast was going to be BoobCast.

I never met Joe but his life inspired me. It just turns out that I’m not that strong or that brave. To honor that bravery I have kept the name.

I also owe thanks to a very dear friend, Tee Morris. When I was trying to find the strength to create BoobCast, He was there for me. He gave me mental and emotional support by letting me know that I *could* do it. I’m sorry I disapointed you Tee but want to thank you for being a friend when I needed one.

In the time I’ve been writing BoobCast I have had people email me directly for advice. Of course, after reading the email, my advice was always “Contact your PS (plastic surgeon) and ask for [fill-in-the-blank]. Whether it was about bruising, skin texture or pain, I advised talking to their doctor. If they couldn’t get a decent answer from that doctor, talk to another one.

The one that really broke my heart was the husband of a woman who, a few days previous the email,  had the same procedure I had. According to her husband, the pain pills her PS had given her weren’t doing much and she was in constant pain. She couldn’t eat or sleep and she was suffering. I told her husband to call her PS immediately and insist on different pain meds and not take NO for an answer. i explained that, right now it was his job to advocate for his wife since she couldn’t do it herself.

A couple days later I got an email from him saying that her PS had changed her meds and she was doing MUCH better. It’s emails like those that made BoobCast well worth the emotional pain of writing those early posts.

I also want to thank everyone who talked to me about BoobCast at DragonCon last year. Being told in person that I’m making a difference means the world to me. Thank you for taking the time to talk to me.

Finally, my thanks to Carol Montoya, Lolly Daskal and the Woman At Denny’s. I promise that once I’ve had nipple reconstruction and recuperate from that, I WILL write the book. The foundation is in the works already.

My thanks to you all for reading, commenting and talking to me. Here’s to another 200!

 
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Posted by on January 18, 2010 in anchor breast lift, Anxiety, barter, boob job, Bra Fitting, bra sizes, Bras, breast, breast cancer, breast health, breast implants, breast lift, breast reconstruction, breast size, breast volume, Cash fees, checkup, chemotherapy chemical, clogged surgical drains, communication, complications, compression bra, compression dressing, cortisone, cosmetic surgery, cryotherapy, debreiding, debridement, deformity, dehiscence, Depression, Drain, Drugs, emotional healing, emotional scars, Excise, excise fluid, fear, Flashbacks, flourouracil, Fluid, granular tissue, granulation tissue, Healing, Hospital, Hospital fees, Hosptial Costs, implants, Incisions, Infection, Insurance, interferon, Invisibility, keloid, keloid scars, laser, Latissimus flap, latissimus flap reconstruction, malpractice, mammogram, mastopexy, Medical, Medical Insurance, memory, Nausea, necrosis, negligence, Nipple prosthetics, Nipple reconstruction, Nipples, Pain, Pain Management, plastic surgeon, plastic surgery, Plastic Surgery Disaster, podcast, Post surgical depression, Post Traumatic Stress Disorder, Prescription Drug Addiction, Prosthetics, PTSD, radiation, Reconstruction, Recovery, Scars, Seroma, serous fluid, Sex, silicone sheets, situational depression, Sleep, slow healing, suicide, Surgery, Surgical complications, Surgical drains, Surgical Fees, Ta Ta Tuesday, Uncategorized, V.A.C. machine, Vacuum assisted wound closure, wet to dry bandages, wheelchair

 

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.

 
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Posted by on October 29, 2009 in anchor breast lift, boob job, breast implants, breast lift, complications, cosmetic surgery, debreiding, debridement, Depression, Flashbacks, implants, mastopexy, necrosis, plastic surgeon, plastic surgery, Plastic Surgery Disaster, Post surgical depression, Post Traumatic Stress Disorder, PTSD, Surgery, Surgical complications, Uncategorized, wet to dry bandages

 

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.

 
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Posted by on October 28, 2009 in anchor breast lift, boob job, breast implants, complications, cosmetic surgery, debreiding, debridement, granular tissue, granulation tissue, Hospital fees, Hosptial Costs, implants, mastopexy, necrosis, negligence, plastic surgeon, plastic surgery, Plastic Surgery Disaster, Post surgical depression, Scars, situational depression, Surgery, Surgical complications, Uncategorized, wet to dry bandages

 

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 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

 
 
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