I wasn't able to stop the I.V. morphine until Saturday morning. I had discovered that the Norco narcotic I was given for pain was working well, and if when I felt the need for morphine inbetween the Norco doses, getting out of bed and walking a bit would decrease the pain so I could go without the morphine. I saw Dr. Griffiths Saturday morning (he had taken out the two drains from my ear the night before already) and he removed the "cue ball" that I had been carrying around (it was a gravity flow ball to pump the numbing medication directly into the rib area where they harvested the cartiledge. I had been scared about what pulling out that tube would feel like. It didn't hurt at ALL! It was maybe 2 mm in diameter. I was excited that I was finally free of all the wires! They even let me keep the pulse oximeter off at that point!
Unfortunately, shortly after that I did need some morphine because of all the muscle spasms (then they called Dr. Griffiths and he was able to prescribe me Valium to continue at home as well now that I was on less medications). So, since it was up to me what time I left, we decided I would stay until the evening once I could have some hours past when that dose of morphine would have worn off to make sure I would be okay without more. I also had yet to really walk without the walker yet. I did several walks without it, and Dr. Griffiths also made sure the nurses had me try some stairs in the P.T. room since there are some where I'm staying that I can't avoid. They said I did stairs better than flat ground!
Dr. Griffiths had also asked if I'd like to meet a 16 year old girl who he had done a reconstruction about a year ago. She and her Dad were in town. I said to just give them my number, and they stopped by in the late morning. It was nice to meet someone who had been in my shows not long ago and who also wasn't a young child at the time of reconstruction. I got to hear that a lot of my experiences were similar to hers, which helped normalize it all for me. I also got to see her ear, which was lovely! She had met with Dr. Griffiths the day before (her Dad had just randomly texted him to say they were in town and Dr. Griffiths wanted to meet), and he was actually going to do a little revision (she still had a bit of a bump in front of the ear) in the office before they went home to Washington state. It was nice to meet someone else, and also not have Dr. Griffiths around so I knew we could talk as openly as we wanted.
For the last couple hours I was there, they even let me walk to the bathroom without calling staff! The little things...
My friend Heidi came up a few hours before I left to visit, and then took me to fill a script and got me settled back in at the Foote House. I cannot describe how much of a godsend that was! I have to be SO careful to not overdo movements or I know I will wind up in the E.R. to get iv pain killers. So having someone insist on helping and reminding me that unpacking was her job, not mine, was beyond helpful!
I found out that night that I cannot lay flat. Once on my bed, my pain was excruciating, and then my ribs on my right side felt like they were popping in and out everytime I took a breath in or out. I did call Dr. Griffiths around 11:30 when it wasn't getting better after a couple hours and having tried propping myself up, etc. He said to call back if it got worse, but for the moment, just be sure my CPAP mask was on if I was going to sleep. I ended up sleeping sitting on the couch. I set alarms for every 4 hours to wake me up so that I can stay on top of my pain with the pain killers.
The next day I was excited that I got to sleep in a recliner and managed to recline. It was much comfier! However, the next day was bad. I saw Dr. Griffiths Monday morning. Everything is going well. I had asked over the weekend about two little puncture wounds (or at least that's what they looked like to me) on my front near my shoulders. When he saw them he sounded to surprised to confirm that they were in fact very tiny puncture wounds. He thought about it and then realized they were from where they had stapled the surgical paper to me. They sterilize a large area around where they will be working, and then staple a paper at the outsides of that area to prevent uncovering any unsterilized area during surgery. Note that they never hurt me, they were just a little raised and red and bruised.
The only thing that wasn't good was that I hadn't had a bowel movement in a week - before the surgery. I had been trying colace with very little improvement, so he gave me a sorbitol slurry to try. I spent a lot of time on the toilet the rest of the day. I was VERY painful since I had to engage my sore stomach muscles a lot. I was very sore by evening...even my right side and the right part of my lower back hurts bad. I'm okay right now, but hopefully I won't have to do that again...no movements today though, so we'll see.
Last night I was not able to recline because of the pain so I sat upright in the recliner. I was exhausted. At one point I woke up to go to the bathroom. I took off my CPAP mask, which I have to use hair clips to attach since I can't use the strap with my ears healing. When I sat back down to sleep, I got the clips ready to pin on the mask, and my next memory is waking up to my alarm for my next dose of pain killers and wondering why my mask wasn't on! When I went through the last time it was off, I felt for the clips and they were exactly where I had set them before trying to reattach the mask! Apparently I was so tired I conked out in the middle of doing something physical!
Today has been a hard day. I am in a good space mentally and don't think I'm getting depressed, but the last week is catching up to me. I've been really sleeping and kind of irritable. I realized I haven't really just sat down at all without needing to focus on something since I got to Boise. I'm still having a hard time sitting still, but I'm working on it. However, I do notice that when I look in the mirror and see my head with the tan ear mold over my new ear, my face already looks so symmetrical and I feel giddy and smile. I definitely did not think that the new ear would have such an effect on how I liked my appearance. I have always been happy with how I looked and embraced my little ear, so I didn't figure much would change. I was actually a little worried I might dislike changing it, so I'm very pleased that I already like the uniformity of the outline of two big ears on my head!
I still have a lot of pain when I breathe, but I'm learning how to adjust my movement and action to reduce pain. I've also realized that making noise when I'm in pain is ok and actually helps the pain. Yesterday, my friend told me there have been studies that show that making noise due to being in pain can actually increase pain tolerance...
Well, I really need to just sit. But Yay! Finally mainly caught up!
Goodnight.
Tuesday, December 3, 2013
Pre-Op
My pre-op appointment was on November27th - the afternoon before surgery. In an earlier post I did say some about what we did during that appointment, but I will be go into more surgical details in conjunction with the pictures I took after the appointment.
We started out talking about any questions I had. Since I was still not sure about rib graft versus medpor, that is mainly what my questions were about. I was pretty sure I wanted to do rib graft since I had started having a gut feeling a few days earlier that that's what would be best for me. Once I heard that rib graft ears are more flexible than medpor (which is pretty rigid), I was sold. Of course, Dr. Griffiths was still quick to remind me that I could still change my mind up until the morning if I needed to. As far as asking any sort opinion type questions about what he thought would be best, he was so neutral it was almost frustrating. I just wanted to be told, but he is very insistent that it's not his decision to make. He will, however, tell you as much as you want about both procedures, the outcomes, the pros and cons, etc. so you can make an informed decision.
Next, he went over some details of the surgery. I did tell him I only like to know the basics until after my surgery is over. He talked about how skin from different areas is like different types of fabric. They all look, feel, and act differently. That is why he uses skin grafts from behind the good ear and the groin to cover the ear, instead of the scalp like many of the other surgeons. He has found that the ear and groin skin matches better in thickness and color, get gets less waxy looking over time than skin from other places. I thought that was interesting, as I have noticed some reconstructed ears look VERY waxy. I didn't know it had to do with where the skin graft came from!
I also learned that one of the additional challenges with adults is the main artery that runs in front of the ear. In children, it is very straight, but in adults, it tends to wiggle more, which makes working around it a little harder (which, as you can see best in the last photo, is why he uses a doppler to map out the artery with sharpie). He marks it with sharpie, and also makes other marks of veins and surgical notes (hence the photos with sharpie all over). He did tell me that my anatomy was an "interesting case" and he had never seen anyone similar. He said it was fine and would be fine to do the surgery, but that he would just have to take it into consideration. He sounded like he was confident and happy to take on the challenge.
Finally, he used some sort of silicone (similar to what a dentist uses to make a mold of the teeth) that he caulks in and around your good ear to make an impression of it. Overnight, he uses that to make a mold (which he showed me in pre-op the day of the surgery - I have small ears!). He also uses a clear film to draw all the details and "levels" of the good ear so that he can match the new ear to it. He cuts along the lines indicating different depths/levels so that he can figure that out for the new ear.
Finally, he gave me a tour of where I'd check in the next day, the O.R., and the floor I'd most likely end up on.
He is very thorough and detail oriented. All the people at the hospital I met (especially nurses in the O.R.) love him and mentioned how much of a perfectionist he is. I have also seen how calm he stays all the time. If there's a problem, typically, he'll walk to a corner of the room and stand still while thinking through what his next move should be. Within a minute he usually comes back and has a game plan. I like that he doesn't immediately react, but takes the time to think through his actions and what the potential consequences will be. I really helps me trust him as my doctor. At first, these pauses scared me because I assumed they meant something terrible was wrong and he didn't know how to break the news to me. Now, I know what's happening and it actually puts me at ease because I know he is thinking about me specifically, my case, and what would be best long term for me and my body (not just being a cocky doctor and generalizing what needs to happen and shrugging off my worries). Learning this about him has made it much easier to put my faith in him - which is important for me not only because your doctor can be a source of knowledge and support when you're in a lot of discomfort and scared, but because I tend to overreact and fear the worst, but with him I am able to trust his judgement. However, I do keep my own opinion and gut feelings in mind. If I think something needs quicker attention of higher levels of care than he is providing, I would go to the ER. But most of the time, I am just fearing the worst, and I know that.
Lastly, you will notice that my BAHA has a jump ring hanging off the bottom of the back corner. That is what I use to attach my safety line. Traditional safety lines connect there through line that is basically clear, stretchy jewelry elastic cord. However, most people find those break. I have reinvented the safety line (http://www.etsy.com/shop/HearWithStyle?ref=shop_sugg). I use a metal ring (like a tiny key ring) through the hold on the BAHA (which I take off, but I had only removed my safety line a little before taking these photos). I use pacifier clips with a ring on the end to clip to clothing, and then I make beaded lines with jewelry clasps on the ends to connect the two ends. Thus less breaking and I can match my outfit! Honestly, if I'm going to have someone notice a line running from my head to my shirt, I might as well make it look pretty, right?
Enjoy the pictures! I'm just about caught up. Next up, Surgery!
We started out talking about any questions I had. Since I was still not sure about rib graft versus medpor, that is mainly what my questions were about. I was pretty sure I wanted to do rib graft since I had started having a gut feeling a few days earlier that that's what would be best for me. Once I heard that rib graft ears are more flexible than medpor (which is pretty rigid), I was sold. Of course, Dr. Griffiths was still quick to remind me that I could still change my mind up until the morning if I needed to. As far as asking any sort opinion type questions about what he thought would be best, he was so neutral it was almost frustrating. I just wanted to be told, but he is very insistent that it's not his decision to make. He will, however, tell you as much as you want about both procedures, the outcomes, the pros and cons, etc. so you can make an informed decision.
Next, he went over some details of the surgery. I did tell him I only like to know the basics until after my surgery is over. He talked about how skin from different areas is like different types of fabric. They all look, feel, and act differently. That is why he uses skin grafts from behind the good ear and the groin to cover the ear, instead of the scalp like many of the other surgeons. He has found that the ear and groin skin matches better in thickness and color, get gets less waxy looking over time than skin from other places. I thought that was interesting, as I have noticed some reconstructed ears look VERY waxy. I didn't know it had to do with where the skin graft came from!
I also learned that one of the additional challenges with adults is the main artery that runs in front of the ear. In children, it is very straight, but in adults, it tends to wiggle more, which makes working around it a little harder (which, as you can see best in the last photo, is why he uses a doppler to map out the artery with sharpie). He marks it with sharpie, and also makes other marks of veins and surgical notes (hence the photos with sharpie all over). He did tell me that my anatomy was an "interesting case" and he had never seen anyone similar. He said it was fine and would be fine to do the surgery, but that he would just have to take it into consideration. He sounded like he was confident and happy to take on the challenge.
Finally, he used some sort of silicone (similar to what a dentist uses to make a mold of the teeth) that he caulks in and around your good ear to make an impression of it. Overnight, he uses that to make a mold (which he showed me in pre-op the day of the surgery - I have small ears!). He also uses a clear film to draw all the details and "levels" of the good ear so that he can match the new ear to it. He cuts along the lines indicating different depths/levels so that he can figure that out for the new ear.
Finally, he gave me a tour of where I'd check in the next day, the O.R., and the floor I'd most likely end up on.
He is very thorough and detail oriented. All the people at the hospital I met (especially nurses in the O.R.) love him and mentioned how much of a perfectionist he is. I have also seen how calm he stays all the time. If there's a problem, typically, he'll walk to a corner of the room and stand still while thinking through what his next move should be. Within a minute he usually comes back and has a game plan. I like that he doesn't immediately react, but takes the time to think through his actions and what the potential consequences will be. I really helps me trust him as my doctor. At first, these pauses scared me because I assumed they meant something terrible was wrong and he didn't know how to break the news to me. Now, I know what's happening and it actually puts me at ease because I know he is thinking about me specifically, my case, and what would be best long term for me and my body (not just being a cocky doctor and generalizing what needs to happen and shrugging off my worries). Learning this about him has made it much easier to put my faith in him - which is important for me not only because your doctor can be a source of knowledge and support when you're in a lot of discomfort and scared, but because I tend to overreact and fear the worst, but with him I am able to trust his judgement. However, I do keep my own opinion and gut feelings in mind. If I think something needs quicker attention of higher levels of care than he is providing, I would go to the ER. But most of the time, I am just fearing the worst, and I know that.
Lastly, you will notice that my BAHA has a jump ring hanging off the bottom of the back corner. That is what I use to attach my safety line. Traditional safety lines connect there through line that is basically clear, stretchy jewelry elastic cord. However, most people find those break. I have reinvented the safety line (http://www.etsy.com/shop/HearWithStyle?ref=shop_sugg). I use a metal ring (like a tiny key ring) through the hold on the BAHA (which I take off, but I had only removed my safety line a little before taking these photos). I use pacifier clips with a ring on the end to clip to clothing, and then I make beaded lines with jewelry clasps on the ends to connect the two ends. Thus less breaking and I can match my outfit! Honestly, if I'm going to have someone notice a line running from my head to my shirt, I might as well make it look pretty, right?
Enjoy the pictures! I'm just about caught up. Next up, Surgery!
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