Funny!

Hospitalist

I received a survey today about the hospitalist who "cared" for me while I was in the hospital. A hospitalist is "a doctor who is not your primary care physician".
My hospitalist is the one who asked if my left eye " normally looks like that" early in the morning after turning all the lights on. I had been flat on my back in bed for hours. He also had the padding put on the sides of my bed because my heart rate went up (because of the pain of trying to sit up) in case I had a seizure. Instead of treating me for what I was there for he made me feel like a mental patient. He will not be getting high scores on the survey.

Tissue expander discomfort

OK, so the nurse at my appointment yesterday told me to take pain meds for any pain from the fill of my expanders. Nothing was bothering me at the time but at 3 am it woke me up. Kinda sore and uncomfortable especially on the sides. I think I'm less numb on the sides of my breasts. Now I'm reading until the meds kick in. Itchy, irritated, and sore but happy! :-)

Alloderm

The PS used an acellular dermal matrix (i.e. cadaver skin) on my right side. This article explains how it's used and reassures about the "ick" factor...

AlloDerm® in Breast Reconstruction

Released September 2007

AlloDerm® is a patented tissue matrix that was originally developed in 1994 by LifeCell as a graft for burn patients. Since that time, AlloDerm®'s remarkable versatility has led to its use in a host of other reconstructive applications, including facial reconstruction, abdominal wall reconstruction, and more recently, breast reconstruction. AlloDerm® allows surgeons to restore many type of tissue damaged through radiation, injury and disease using the regenerative power of their patients' own body.

AlloDerm® is created from donated human skin. LifeCell’s patented process removes all of the cells from the donated skin, while retaining all of the important biochemical and structural components. This makes AlloDerm® an acellular tissue product which will not result in rejection. Since AlloDerm® is derived from human tissue, there may be a concern that it might harbor disease carrying viruses. However, with more than one-million implants and grafts to date, the safety of AlloDerm® has been proven, as there has never been any evidence of viral disease transmission to any patients. Tissue donors are screened and tested for transmissible diseases, and a comprehensive review of each donor is completed by a medical director before allowing the tissue to be processed.

When placed in the human body, AlloDerm® repairs damaged tissue by providing a foundation for new tissue regeneration. Blood will flow into the preserved vascular channels in AlloDerm® allowing it to be incorporated into the body. As cells move into AlloDerm®, the process of tissue regeneration begins. With progression of the healing process, AlloDerm® is transformed into living tissue that not only resembles your own but also functions like your own.

For patients undergoing mastectomy, AlloDerm® is primarily used in the setting of tissue expander and implant breast reconstruction. In the first stage of reconstruction, AlloDerm® helps to provide coverage of a tissue expander and can help to decrease the number of times expansion is needed. The AlloDerm® serves as an extension of the surrounding soft tissue on the chest, allowing for a more immediate breast contour. In fact, for the right patient, direct-to-implant reconstruction, without the need for a tissue expander, may be made possible with the use of AlloDerm®.

In addition to first stage breast reconstruction, AlloDerm® has been used for numerous applications in secondary reconstruction. For example, AlloDerm® may be used in revision reconstruction to help camouflage implant rippling and to help correct implant malposition. Also, AlloDerm® can be utilized to help in nipple reconstruction.

http://www.breastreconstruction.org/InTheNews/AlloDerminBreastReconstruction.html

Second post-op, first fill

The plastic surgeon said things are looking good! She did my first tissue expander fill today. She used a magnet over my skin to locate the port on the expander. Since I'm numb there I didn't feel the needle at all! She filled my right side with 100 mls of saline and the left with 50 mls. She had put some saline in at the time of surgery so the total in my left is 100 and right is 250. It's pretty awesome to not be flat on the left side anymore!
She said my back pain was just the rib because it has no protection from that muscle. I suspect the drain tube is lurking in that area also because I think I can feel it under the skin.
I left home with all 3 drains and I came home with...all 3 drains. Darn! Oh well, I go back next Tues. She told me not to worry about the irritation around the drain sites.
So, a very good appointment!

Tissue expanders

Here's what they look like:

Since I had my chest muscle removed with the first mastectomy they used the lat flap for coverage. 

The yellow thing is the magnet that the surgeon moves over the skin to find the injection port.

Below shows a needle in the port. Skin is numb so it doesn't hurt.

Lat flap incision/scar

Took the tape off my back. Tried to get a pic showing the length of the incision.

The tape on my side is where the drains are.