8 Week Update

Hi everyone!  I'm sorry this is a few days late...I've been really sick and pretty much in bed sleeping all week.  On top of that, I'm having a lot of unexplained abdominal pain.  It is highly unlikely a result of the rib graft harvest since I had pretty much no pain for so many weeks beforehand.  However, right now we are wondering if it is related.  Last Saturday (the day before the pain began) I had to carry my cat in a cat carrier.  My guess is that although I am fairly healed from surgery, that was too much weight (plus the weight kept shifting its center since the cat would move) and since the healing area is still week, I put too much strain on the surrounding muscles.  The worst pain started near the incision site, but now it's more right in the middle of my chest a few inches above my belly button.  I also have pain along the bottom of my ribs on my left side.  Needless to say, this is frustrating and until I see my family physician on Monday, I'm trying not to aggravate the area.  This means pretty much no movement of my right arm other than what I can't avoid, as well as no bending over, since that also makes my stomach hurt a lot.  I have been in contact with Dr. Griffiths and am keeping him posted.  The last time I spoke with him, I had not thought about the cat carrier incident, so I will mention it next time and see what he thinks.

So, some disappointing setbacks in my abdomen, but everywhere else is doing really well!  I plucked my first dark hair from the back of my left ear where the skin graft from my upper thigh went, but otherwise that area is finally starting to smooth out.  It's still not very nice to look at, but it feels better to the touch, so I'm more optimistic about the final appearance now.

My beautiful new ear has come a LONG way since last week.  I have found better ways to protect it overnight (I use hair tape - yes, apparently that's a thing...it's like paper tape but gentler - to tape gauze behind the ear and over the front).  I found that using paper tape was irritating my skin and actually caused some open sores on my face.  I found hair tape (I went with a friend to a cosmetologist only store) and tried that.  It's pretty much paper tape but gentler...plus I can now hold down the gauze from all 4 sides, instead of 2!  Yes, it does hurt a little to take out and pulls a few strands of hair out, but that's much less damage than the paper tape.  The pulling on the hair when I take the tape out is probably comparable to having a small knot worked on in your hair.  This is allowing me to sleep more normally.  The past few nights I have spent a lot of time sleeping on my new ear.  But I have learned something to keep in mind: invest in a memory foam pillow!  I just happen to already have one.  I also have a small pillow that I sometimes put over top.  I put the small pillow on top of my memory foam one last night and tried to sleep on my new ear...it was REALLY uncomfortable!!!  I felt like I had this huge lumpy bulge on the side of my head, and it was very uncomfortable.  I removed the small pillow and just used the memory foam pillow.  At first, I can feel the ear, but as soon as the foam conforms to my head, I would never guess it was there...it's probably safer for the ear too.  On the small pillow, I felt like all of my head's weight was resting on my ear!

Even though I've been sleeping on the ear more, I continue to wake up with less and less swelling every morning.  The outer rim is usually fairly defined these days, and the ear is in general appearing "thinner".  It still has a long way to go, but seeing all the tiny progress just makes me realize how much it's still going to change.

Before sharing some photos, I have one more thing I'd like to share.  I said that getting an ear was for me.  That I felt like I had a missing body part and that it had less to do with the ear's actual appearance.  I am happy to report that I am confident that I was not lying to myself in an effort to hide some vanity I was embarrassed to admit.  Yes, it's lovely and I do like keeping everyone involved in the process updated, but it ends there.  I'm not in a hurry to show anyone or talk to anyone about it if they don't already know about it.  I love how beautiful it is and think the artistry in it is amazing, and I do like sharing about it when people ask.  But mainly, I just like walking around - even at home - knowing that I have an ear there.  I don't feel the need to show it off, because I am satisfied inside just knowing it's there and having the feeling of an ear.  Now, that doesn't mean I don't like talking about it and showing it off and being excited about it with my friends and family - and all of you...because you all get it.  You're already part of the story, and who doesn't like sharing joys - and hardships - with friends and family?  There was some concern in the back of my mind that I was going to get this ear and just want everyone to see it and want to talk to everyone about it, and that that, in my mind, is not a good reason to have had this done.  So, as the days go by, and I find I am really happy to know that I am interacting with others like normal, not wanting to brag about my ear, but instead feeling very satisfied inside to know that I can feel its presence and no one seems to notice.  That makes me feel very good inside.  I have grown as a person, and I am at a point in my life where I can be happy for me, and that is enough.  This experience helped me get there, and now as I heal, is helping prove to me over and over again that it's true; I have changed, and I love every moment of it!

~Katie

Here are some pictures from this week:

When I first plucked the hair, it created a large pimple-like bump and I was a little concerned.  A few minutes later, I took another photo, and it was already calming down.  I have heard that if my new ear gets a bug bite in this first year, that the ear may very well get very red and swollen.  That's normal, and I have been told not to freak out.  So, I had my fingers crossed that this would work the same way.

And I always save the best for last...no comparison photos this week because the other photos have all been moved to my desktop, but I cannot operate my mouse or keyboard without abdominal pain, so I am back on my netbook for now.  I will tell you, though, that it's getting so much more definition...and that puffy white spot at the top is -again- starting to sink in the way it should.  As I said, the color has a ways to go, but in general, the shape is fantastic!  Unless I put this ear in direct comparison with my other ear, I forget that it is indeed much thicker than a normal ear.  I am very pleased with the overall shape and appearance of the ear at this point.  I know I'm still really swollen (my right temple is still puffy even), but that only makes me more excited since it means there's still a lot more swelling to disappear - and hence and even more defined ear!

7 Weeks Post-Op

I am almost 2 months out already!  It seems so long ago sometimes, but other times it's hard to believe it has been that long!

This past week I have been allowed to experiment with sleeping on the ear!  The rule is that I must keep something behind it to keep it from getting forced into the side of my head.  Since cartilage is living tissue, sleeping on that ear without support behind it could cause the shape of the cartilage to change shape over time.  I am still trying to find the best way to keep my support on.  The support I made out of a large Telfa gauze pad that I stuffed 4 cotton balls into in a row on one side.  I taped the ends, and shortened the area without cotton balls so that the support gently slopes from flat to 3-D...just like the back of the ear.  However, there's no convenient way to make anything stay behind your ear since there is hair on two sides...and mine is also short and fine.  So, you have to wear some sort of head wrap.  I have a few different things I've made and/or bought, but I haven't found the perfect one yet...they all tend to creep up overnight and end up going over the middle of my ears...which increases the swelling in my ear.  I'm working on it though, and it's getting better.

That's the thing I've noticed most this week: I have MUCH more swelling overnight than before.  Luckily Dr. Griffiths isn't concerned as long as it's just from laying horizontal overnight.  It would become an issue if something tight rubbed on the ear for long periods of time though, as that could create an ulcer.  Dr. Griffiths was actually more concerned about my abdominal pain.  I have noticed that certain activities really make me sore there.  I wasn't sure how big of a deal that was to my healing, but he said I should avoid doing anything that aggravates it.  This is frustrating, because the very few things that cause the pain, are things I really need to be doing (i.e. working on my quilt orders...ironing and using my rotary cutter are the primary irritants I have found).  So, I'm trying to be patient and just do a little bit of quilting as I can tolerate it.  Before I knew it was going to cause pain, I quilted too long and had so much pain I could feel tightness while breathing and laughing again!  The scary thing was that if I raised my right arm out in front of me, I could feel a popping/snapping sound/movement in my chest!  That is a definite no-no.  I took it very easy on my abs for a while after that one...

My two skin graft harvest sites are FINALLY healed!  Still very red/purple and shedding very thin layers of dead skin as it completely heals...but no more scabs of any kind!

The incision from the rib graft harvest site has been healed from scabs for a few weeks now, but I did have to remove a stitch from it the other day...there was a circle of red puffiness about 1/4 inch in diameter with a white scabby looking line in part of it (that was the stitch that was infected).  I sterilized my pointy tweezers and grabbed the stitch and it came right out.  That spot is back to normal now.  The stitch I removed was dissolvable, and may have dissolved over more time (or my body might have worked it out), but since it was clearly showing signs of a small infection, I thought it was best to help get it out.  I can see a deeper black (non-dissolvable) stitch at the very end of the incision, but that one is not irritating anything for now, and too far down for me to remove.

Over this last week, by evening, my new ear looks really nice.  There is starting to be a depression around the entire rim area with the decrease in swelling!  The back of the ear is completely closed up now, and the whole ear is definitely not as red as a few weeks ago.

My biggest annoyance is the itching!  My scalp and the outside edges of the new ear itch A LOT!  But, they are all still numb, so I can't lightly scratch/rub/touch the area to quiet the itch.  Luckily, my scalp has started to regain a little bit of feeling in the past couple days, but sometimes the itch goes too deep for that to do much.

Now, as always, it's time for the picture updates!

See you next week!

The last collage has photos at 7 weeks post-op...except for the swollen one in the lower left corner.

Six Weeks Ago...I got an ear...

Not too much new to report yet.  My body is still healing well.  I got the okay to start skiing, provided it's above 25 degrees and I keep my ear toasty warm!  I also found out that I will probably always have to protect my ear some at night since I will roll onto that side.  Dr. Griffiths said that something like gauze or cotton balls tucked behind the ear with a cap or band holding it all in place would work.  This needs to continue since cartilage is living tissue.  This means that if I spend a lot of time putting pressure on my new ear at any point in its lifetime, it could cause the cartilage to change shape, which I obviously don't want!

Dr. Griffiths also said that I should be able to go into next winter without being super cautious about the cold on the ear (just normally trying to stay warm - a hat's not a bad idea).  The same kind of timeline exists as far as friction (i.e. rubbing) against the ear.  This means I still need to find an alternate way to wear my CPAP mask for now.  I'm going to send a picture of me in it to Dr. Griffiths so he can also brainstorm.  My current methods of getting it on my head without it rubbing the new ear aren't working well enough and my sleep apnea is therefore not very well treated at the moment.  (I'm having 2-4 times more lapses in breathing an hour than usual, sometimes even beating the average times that they found in my sleep study when I was diagnosed!)

Since the ear is looking pretty similar, I thought I'd try something new today.  I made a very rough, hind-sighted time lapse video.  I say that because obviously each picture is not identical in size, lighting, etc. since I hadn't thought of this idea until a few days ago.  What's neat is that you can see that healing, swelling, redness, etc. is not a linear process.  It varies a lot day to day and hour to hour depending on what the ear has to go through each day and how long it's been since I was horizontal sleeping.  A few days ago, I did have a little mishap with the top of the ear.  I had a band around my head, but it had a hard point to it, which, while I slept, pushed into the new ear.  It's still VERY red, and a little extra swollen in that area, but luckily it did not break the skin at all.  I did ask Dr. Griffiths about it, and he said that it should be fine.  If it had broken through the skin, I would just apply the bacitracin ointment on it while it healed.

So, without further ado, here's the video I made (bear with me, I've also never even made any type of video before...I think maybe making this in OpenOffice Presentation might have been easier...but then again, I've also never worked with anything but Microsoft PowerPoint...and I purposely didn't date anything...I don't want so much focus on dates that you can't pay attention to the changes in the ear.

Enjoy!

1 Month,1 Week, and 1 Day Post - Op Photos...and...stitches?!

No, no, don't worry, I didn't GET stitches...but in the last few days I've had quite a few removed.  I think about 2 came out of my original groin/thigh crease skin graft harvest site (one was a string about 2+ inches long that slid right out!), 1 from the other thigh crease, and about 5 or 6 from behind my new ear where the additional skin graft was put on 18 days ago.

Since new news is slowing down at this point, I'm mainly just going to update after a big change of some sort or about once a week...whichever happens first.

At this point, I'm still having some soreness in my chest, but it's not even really annoying anymore.  It's more just something to be noticed from time to time.  I'm scared to really do sit-ups or something strenuous on those muscles because it's uncomfortable (not really pain, just tight, bloated, stiff feeling), but for everyday activities, I don't even think about it anymore.

I'm not back to my usual energy yet, but getting a lot closer.  Some days are worse than others, it really depends on how busy I am.  Basically, I need to not be running around for more than 3-5 hours a day (that includes "running around" in the house to cook, clean, etc.).  Otherwise, I get really exhausted way before bedtime!  But getting up keeps getting easier, so that's a plus.

The incision on my right groin/thigh crease is almost 100% de-scabbed!!  There are maybe 2 areas with tiny 3mm diameter spots, the rest is just red.  It really started shedding good about a week ago when I wrote my last update, and has moved along pretty fast.  The last scabs were flaking away last night, and as I gently brushed to loosen them, that's when I removed that really love thread from my thigh...it was very weird to realize it had come from inside me since I didn't feel a thing as it slid out.

The other thigh area is also doing well.  Not scabbed over yet, but not nearly as red or irritated as the incision on the other side (which was also 3-4 times longer).  It's only a few millimeters wide at the widest, so no worries.

The skin graft placed behind my existing ear is FINALLY starting to look like normal skin color...at least from a distance, and without catching it with the wrong light.  You will see what I mean in the pictures of it below.  Overall, I'm happy, especially since you can't see it unless I pull my ear forwards to the point where it cuts off most of my hearing from that ear since it covers the canal.  However, I also really see what Dr. Griffiths means when he says skin is like fabric...it's all fabric, but there are lots of different colors, textures, and thicknesses.  It's very apparent back there...I wonder what the tiny patch of the same type of skin will look like on the back of my new ear...

The new ear is looking fabulous!  I love running my finger from the rim down towards the canal at the top and seeing how far it's gone it.  However, I noticed a couple days ago that I can do this from the rim on the middle part of the ear (near the back of the head area) towards the canal and also just start to feel where the hard rim drops off beneath the swelling.  It's impossible to see in pictures, and not too noticeable in person, but it is happening!  Similarly, the raised area right before the ear drops into the canal is starting to look higher than the rim of the ear near the back (which is what's supposed to happen because that's the way my good ear is shaped).  So now, when I take photos, I can make the ear look a lot 'slimer' if I move the lens slightly in front of the ear than if I shift it just a tad farther back.  I didn't get a great comparison for this update, but will try for the next.  It's surprising...if my ear were a person, I'd say it lot 10 pounds between the two photos!

Most everything else about the ear I will cover in the photos or right before them.  The only other thing to note that I'm not sure I directly say in the photos is to take note of 'clues' in the photos that tell you swelling, etc. has changed.  It's hard for me to capture all the details in every photos, especially with different lighting and not being a professional photographer (heck, I'm using my smartphone afterall...), so sometimes those things are better indicators.  They include:

• Notice the top of the ear below the upper rim...first it puffs out, then it's flat with extra white and lumps, and now it's going in concave like it should.
• Notice the projection at the top of the ear where it connects to the head.  There becomes more height between where the ear connects to the head and the top of the ear rim.
• Notice how the ear is becoming more uniform in color (talking only about the grafted skin itself, not how it compares to the existing skin yet).  As well as the swelling, it can take a year or more for the color of the new skin to completely settle.
• A tell tale sign for swelling in the lower part of the ear is where the new skin was stitched to the lobe.
• Stitches fade and change color and size.
• Note time of day.  The ear will ALWAYS be more swollen in pictures taken early in the day.  The ear swells overnight when I lay horizontally, and "drains" during the day when it's at the top of my body.  (Unlike lower body injuries, which do the opposite)

Enjoy the photos!

~Katie

 This next one gets me.  I'm amazed at how the stitches on my scalp started off so wiggly, and have, over the last month, become a gently curving arch!

My 'Slug' story:

 ...and just 4 days later...

(p.s. - I thought my pan trick was really clever!  I am very proud of it!)

I'm not even sure I've mentioned this in my blog...but I use my BAHA overnight as a alarm system for my new ear.  Basically, I leave it on and if I try to roll onto my new ear (which I'm not allowed to do), the BAHA squeals and I am alerted and roll the other way.  That was also my invention.  In fact, after the revision skin graft surgery, Dr. Griffiths was debating the best way to protect the new graft.  I told him about my 'alarm system' because I had just done it 2 nights at that point and wanted to both make sure that that was okay, and to share because it's funny to have an alarm system on my head...he liked it so much we continued to use that to keep the new graft safe...I didn't have to have any more bandages!