Tuesday, April 26, 2011

no more thigh master for me...

the horror!  not that I did it anyway.  Ever.  But at least for a while, Suzanne Somer's miracle thigh thingie and I will not be formally acquainted.

So I went to see Dr. Polynice today.  And, it's not an if, it's officially a when.  I will be needing surgery.  It will involve one, or possibly both of my thighs.  And the research that I did, though competent for healing other more shallow types of wounds, would not in fact work on my tush.  The GOOD thing is, I will not be getting my butt cheek peeled off and stitched back on like I had found in my research of the gracilis muscle surgery for the perineal sinus region.  At least my cheeks stay intact, and I'm sooooo happy about that.

So this is what's going on.  Essentially, I'm "almost" healing from below, but there is granular tissue inside that has formed a pocket of non-healing area.  It's like the tissue is too saturated by itself to fully knit together.   What happens, what I presumed to be pus, is actually sloughing of the granular tissue to the outside.  Had the hole completely closed off like it was supposed to, it would have formed a large and nasty abscess.  So, in this case, not completely healing was a blessing.

Surgery, again at Albany Med, will go something like this: a 5ish hour surgery during which both Dr. Lee and Dr. Polynice will scrub in.  My tush will once again be excised by Dr. Lee, clearing out any of the nasty non-healing tissue.  Dr. Polynice will cut into one (or both) of my thighs.  There will be an incision made from the inner thigh/groin area down about 1/3 of the way, and another one down by my knee.  The one by my knee will disconnect the gracilis muscle ( http://en.wikipedia.org/wiki/Gracilis_muscle) from its attachment at the bottom, and the upper incision will allow Dr. Polynice to thread the muscle (one of the less necessary adductor muscles) through the pelvis and into the pocket of non healing area in the perineal sinus area.  Because the muscle is still connected at the upper end of the leg, it will have its own blood supply, thus stimulating proper healing and tissue growth in the sinus and healing this issue up once and for all.  He may need to cut into both thighs if the muscle from just one isn't sufficient enough to fill up however big the hole is internally. 

I asked about success rate, and though this isn't a common surgery to be performed, Dr. Polynice has had complete success with it.  Let's hope my body allows that track record to continue.  Healing/recovery time is looking like a few days in the hospital, a few weeks at home with drains in the leg and probably the sinus area, and hopefully total healing within a month.  Hopefully.  That's if my body decides to fully accept the surgery this time.  But at least Dr. Polynice has been forewarned about my lack of healing prowess :)

There is no surgery date set yet.  I go back to see Dr. Lee and Jody on Thurs (May 5) and I'm assuming we'll go from there for scheduling. 

That is all for now, folks.  In the meantime, I'm starting training (walking) this Sunday for the dash.  I've gotten myself a kickin' set of ankle weights with adjustable weight pockets, so they can range from nothing to 2.5 lbs per leg.  As I get more into training, those things will whip my legs into shape really quickly.  And I got a 5lb kettle bell, since I have a love affair with them, and I fully intend to start using that to strengthen core and upper body. 

Will post after Sunday, and again on Thursday.

Much love,


Oh, and with this being my 4th surgery at AMC, do I get my free vacation now?  I really think they owe me one after 4 surgeries in a year and a half.  Maybe they should send me on one just to keep me away from it, like a bribe to heal.  "If you promise to heal and NOT come back, we'll send you away for a week to some place tropical, where no one cares if you're already missing organs."  Sweet.  I'd buy into that club any day. 

Oh, and extra added bonus.  There's not much of me left that anyone could sell on the black market, so I never have to worry about the urban legend of the ice in the bathtub.  Extra added bonus :)

Monday, April 4, 2011

I get to see a plastic surgeon!

No no no.  Don't get your hopes up.  It's not for anything fun, trust me.  My dreams of having leg extensions to be over 5' still is not happening.  The surgeon actually does plastic AND reconstructive surgery, and possibly will be handling my next tush surgery.

I went to see Dr. Lee on Thursday, and the appointment went a bit as expected.  I told Dr. Lee that during the three weeks he had me off the antibiotics, the bleeding returned and the pus returned more, as did the abdominal pain and back pressure.  My butt is being a pain in the butt and NOT healing!   Bottom line, I don't know why.  My dentist (who also has Crohn's Disease and a permanent ileostomy) has his own theories.  He said he read research recently that children who develop Crohn's at an early age grow into adults that don't heal properly.  Because the body is constantly fighting against the Crohn's, it never fully develops the proper healing pathways necessary to fight certain types of things.  He thinks that, since I've had Crohn's since I was very young and now am having difficulty with a formerly Crohn's affected area, that it could be the cause of some of my problems. 


So Dr. Lee, Jodi (the WOC nurse who also conferences in with us), mom and I discussed what is the next course of action.  Because Dr. Lee did my initial surgery during Feb 2010, and second surgery Jan 2011, and a year and 3 months later I'm still not healed, we need to look toward doing another surgery to see what's going on.  We're just not sure if it will be a big surgery or an even bigger one at this point.  Dr. Lee said he's not sure if he would want to do an exploratory surgery (abdominal/rectal) to make sure there is no fistula or anything going on internally that shouldn't be.  What he's recommending is that I go to see Dr. Alain Polynice, a plastic and reconstructive surgeon with whom Dr. Lee has worked in the past in the very few cases he has seen like mine.  Dr. Polynice is brilliant in his field too.  Seriously.  At least I'm in capable hands with both of my surgeons :) 

Normal people heal properly for Dr. Lee.  I, as you all know, am not normal.  So, I have an appointment with Dr. Polynice scheduled for April 26 in Latham, with a follow up with Dr. Lee after that.  The surgery that Dr. Polynice would do is something like this: they will cut a muscle out of my thigh (one that the body doesn't really use, kind of like an appendix of thigh muscles), somehow pull it through my pelvic area, and sew it in place between the butt to try to encourage healthy tissue growth and a full recovery.  Dr. Lee told me this is a major surgery (oh joy) but at this point, what other options do I have?  It's either I go on with a leaky tush indefinitely, or get a surgery done.  If I do need the plastic surgery one, I'm going to see if he can even out my other thigh while he's at it.  Maybe I can get a 2 for 1?  Never hurts to check.

BUT.  and this is a big BUT (and no, not mine) there is something called the VAC system.  It's vacuum assisted closure, developed for people that don't heal well (like diabetes and aids patients).  I mentioned it to Dr. Lee and he wasn't familiar, so I sent him the medical journal with the study in it, and he said he'll look it over.  What I'm thinking, if he was to do the exploratory surgery to make sure there was nothing major that was overlooked, and everything looked fine, then we should do the VAC.  It's taken people who previously had chronic perineal sinus (what I'm dealing with) and healed them in 18-25 days.  By keeping the area sterile, it allowed healthy tissue to grow where it wouldn't previously, and they are fine now.  Wouldn't that be nice?  I will gladly go through another abdominal surgery if it meant my tush would be closed/healed without having to cut into my thigh. 

I swear, at some point I'm going to change my name to Sally and get tattoos on all of my scar sites to look like stitching.  After that, all I'd have to do is find my Jack and life would be great!  Kidding.  Sort of.  :)

So that's all for now.  Will keep you posted as to what Dr. Polynice says.

In the meantime, I swear to you, come hell, high water, or surgeries, I'm going to do the dash again.  The only thing that would stop me is the Apocalypse at this point.  Which may or may not happen, starting May 21.  We shall see.  As I start to train, I'll post about that too.  Can't wait to do it!

Love ya,