January 18, 2010

The 200th Post

Posted in Anxiety, Bra Fitting, Bras, Cash fees, Depression, Drain, Drugs, Excise, Flashbacks, Fluid, Healing, Hospital, Hospital fees, Hosptial Costs, Incisions, Infection, Insurance, Invisibility, Latissimus flap, Medical, Medical Insurance, Nausea, Nipple prosthetics, Nipple reconstruction, Nipples, PTSD, Pain, Pain Management, Plastic Surgery Disaster, Post Traumatic Stress Disorder, Post surgical depression, Prescription Drug Addiction, Prosthetics, Reconstruction, Recovery, Scars, Seroma, Sex, Sleep, Surgery, Surgical Fees, Surgical complications, Surgical drains, Ta Ta Tuesday, V.A.C. machine, Vacuum assisted wound closure, anchor breast lift, barter, boob job, bra sizes, breast, breast cancer, breast health, breast implants, breast lift, breast reconstruction, breast size, breast volume, checkup, chemotherapy chemical, clogged surgical drains, communication, complications, compression bra, compression dressing, cortisone, cosmetic surgery, cryotherapy, debreiding, debridement, deformity, dehiscence, emotional healing, emotional scars, excise fluid, fear, flourouracil, granular tissue, granulation tissue, implants, interferon, keloid, keloid scars, laser, latissimus flap reconstruction, malpractice, mammogram, mastopexy, memory, necrosis, negligence, plastic surgeon, plastic surgery, podcast, radiation, serous fluid, silicone sheets, situational depression, slow healing, suicide, wet to dry bandages, wheelchair at 1:47 pm by Herbwoman

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!

September 30, 2009

Keloid Scars

Posted in Healing, Incisions, Medical, Reconstruction, Recovery, Scars, Surgical complications, boob job, breast, breast reconstruction, chemotherapy chemical, cortisone, cosmetic surgery, cryotherapy, deformity, flourouracil, interferon, keloid, keloid scars, laser, latissimus flap reconstruction, plastic surgeon, plastic surgery, radiation, silicone sheets, slow healing at 12:14 am by Herbwoman

I may I have covered this topic before but not as it applied to me, personally. I noticed something last night after I took off my bra. There is a two to three inch area on the underside of each of my new breasts that has some keloid scarring. These spots didn’t have tape on them consistently as they are furthest out towards my sides and the tape kept coming off there.

Imagine if skin could simmer like water and then be frozen in that state. That’s what keloid scars look like. Here’s a photo of keloid scars on someone’s chest.

keloid_3_060802Doctors do not understand exactly why keloids form in certain people or situations and not in others. Changes in the cellular signals that control growth and proliferation could be related to the process of keloid formation, but these changes have not yet been characterized scientifically.

The methods now available to treat keloids are:

  • Cortisone injections (intralesional steroids): These are safe and not very painful. Injections are usually given once per month until the maximum benefit is obtained. Injections are safe (very little steroid gets into the bloodstream) and usually help flatten keloids; however, steroid injections can also make the flattened keloid redder by stimulating the formation of more superficial blood vessels. (These can be treated using a laser; see below.) The keloid may look better after treatment than it looked to start with, but even the best results leave a mark that looks and feels quite different from the surrounding skin.
  • Surgery: This is risky, because cutting a keloid can trigger the formation of a similar or even larger keloid. Some surgeons achieve success by injecting steroids or applying pressure dressings to the wound site after cutting away the keloid. Radiation after surgical excision has also been used.
  • Laser: The pulsed-dye laser can be effective at flattening keloids and making them look less red. Treatment is safe and not very painful, but several treatment sessions may be needed. These may be costly, since such treatments are not generally covered by insurance plans.
  • Silicone sheets: This involves wearing a sheet of silicone gel on the affected area for several hours a day for weeks or months, which is hard to sustain. Results are variable. Some doctors claim similar success with compression dressings made from materials other than silicone.
  • Cryotherapy: Freezing keloids with liquid nitrogen may flatten them but often darkens the site of treatment.
  • Interferon: Interferons are proteins produced by the body’s immune systems that help fight off viruses, bacteria, and other challenges. In recent studies, injections of interferon have shown promise in reducing the size of keloids, though it’s not yet certain whether that effect will be lasting. Current research is underway using a variant of this method, applying topical imiquimod (Aldara), which stimulates the body to produce interferon.
  • Fluorouracil: Injections of this chemotherapy agent, alone or together with steroids, have been used as well for treatment of keloids.
  • Radiation: Some doctors have reported safe and effective use of radiation to treat keloids.

This is not a very common complication, but it can happen. There doesn’t seem to be a bias. It happens equally in men and women as well as all ethnicities.