Surgery #38

Well, another one over with.  Surgery #38 went well and I am happy to report there was enough skin to get what needed to be done, done.  The surgery was slated for about 2.5 hours but ended up taking about another hour.  It wasn't as simple as he thought it would be.  Waking up from this surgery was also not too pleasant.  I was waking up just as they were taking the breathing tube out and they were not gentle so my throat was pretty sore for a couple days.  The OBC was all full up so I stayed in the main part of the hospital.  It was all right.  The room didn't feel like home like the OBC does and the people didn't know me there and I didn't know them so the first night was a little rough.  Even more so because I was in a great deal of pain that first night that I couldn't stop from breaking down it hurt so bad.  But my night nurse was pretty good in staying on top of it and getting me my pain meds every three hours so I felt a little better come Saturday morning.  Most of Saturday I was still in a lot of pain but I had the opportunity to go home Sunday if I was able to get off the IV breakthrough pain meds so I took my last breakthrough IV pain medicine Saturday afternoon and tried to manage with just PO.

I got to see my original burn doctor Saturday with some of the interns that were in on my surgery so that was nice.  I always love seeing Dr. Pulito and he always stays in touch with me and with Garrett so he's in the know of what's going on with me.  He always gives me hugs and squeezes my hands lovingly.  He also came to see me Sunday morning before I left.  Such a sweet man.  I didn't see Garrett at all during my stay, just his interns.  But he did call Sunday morning as they were working on my discharge orders and talked to me.  Then around noon, the orders were done, I had my prescriptions in hand, the bags were taken down to the car and mom and I were ready to go.

I feel a lot better not having that horrid, giant tissue expander in my shoulder but it's been replaced with pain from the surgery.

There was quite a bit of scar tissue and contracture to clean out and he found that my right side sternocleidomastoid muscle was shortened significantly due to the contractures in the right side of my neck.  The sternocleidomastoid muscle is a muscle in your neck that runs from just behind the ear, over the clavicle and attaches to the sternum.

As defined by wikipedia:

In human anatomy, the sternocleidomastoid muscle, also known as the sternomastoid and commonly abbreviated as SCM, is a paired muscle in the superficial layers of the anterior portion of the neck.  When acting together it flexes the neck and extends the head.  When acting alone it rotates to the opposite side and slightly flexes to the same side.

It looks like this:

To help release the tightness of my SCM he cut some fibers in the muscle and hopefully with some stretching therapy it will elongate.  So the snipping of the fibers in that muscle have added on some more pain but in general, recovery should be quicker as this was a flap so there is no donor or graft site.  I will have to wear that dreadful collar when the flap is more healed to help keep any contractures from forming in that flap area as well as stretching therapy.  I can already feel a difference though.  My right eye and mouth do not pull like they did so that is a really great accomplishment from this surgery.  It feels a lot more flexible though it is still sore and swollen but I can tell already that despite how awful the tissue expander was, it helped enormously.

Last Tissue Expansion Before Surgery

 (From the front)

 (From the back)

(From the side.  Yeah, it's that big.)

Last night was my last tissue expansion in my fifth expander prior to my 38th surgery, which is next Friday.  And we went for it.  Since our visit to the doctor in January we were putting in 100 cc's of solution but last night we put in 20 extra cc's to really get this thing stretched so there will hopefully be enough skin to get what needs to be done, done.  My last expanders, which were in my shoulder blades, only had enough skin to make it halfway around my neck, which is where the scar line is and where the contractures formed to cause this current problem.  My left side has done well with z-plasty's.  But my right side has been a nightmare so thus the current tissue expander - tissue expander #5.  I have been in a great deal of pain and very uncomfortable since last night.  So uncomfortable that I have been awake since 3:30am this morning because I just couldn't get comfortable and I needed to relieve the pain with some pain meds and a hot rice bag.

A Bad Night Of Withdrawals

I've been up all night with morphine withdrawals.  Since I have been completely off the morphine there have been good and bad days.  And yesterday was a bad day and last night it only got worse.  During the day yesterday I was irritable and tired and then last night I was having physical withdrawals keeping me from falling asleep which I so desperately just wanted to sleep cause I'm so tired.  Not to mention my mind is swarming with broken thoughts that I can't shut off.  Now it is early, early morning, like 3am, and I'm up because the physical withdrawals have kept me from sleep all night.  Oh my God, how horrible these withdrawals can be.  It's going to create another bad day because I got no sleep last night.  I've been off the morphine about two weeks and I'm still going through withdrawals.  What a demon of a drug.

"But there are dreams that cannot be, and there are storms we cannot weather.  I had a dream my life would be so different from this hell I'm living...Now life has killed the dream, I dream."

That famous musical line runs through my head so often in those broken thoughts I spoke of earlier.  I wonder if my dreams will ever be.  I wonder if my dreams will be one of those dreams that cannot be and I wonder if I'll be able to weather this shit storm I've been living.  I once had a dream that my life would be so very different from this hell that I'm living.  I dreamed of love and success.  But life had other plans and so has killed the dream I dreamed.  Now I just hope to get through each day.  What kind of life is that?  It certainly wasn't the one I used to live.  I never felt more alive walking through the streets of Manhattan., wherever I was going, but especially when I was going to an audition.  I don't feel alive anymore.  Well...