hands are important

I saw the hand surgeon today.  He was glad to see that the graft is doing well.  He's still sorry about the tendon.  And he's still defensive about the donor site.  Today he defended the fact that it wasn't healing well and was still painful by saying he'd done a thicker graft than usual (for split thickness grafts) because he wanted to make sure it took, given the problems that exist with grafts on irradiated tissue.  According to him, a Bio-Brain dressing (like what I had last August) would have been unlikely to improve the current situation.  He could offer nothing in terms of easing pain or making the healing go more quickly.  And he said it was likely to be ANOTHER TWO-THREE WEEKS before the scab healed enough to fall off.  Aargh.

He did go off on a few hilarious riffs, though.  The last was about how losing a leg to sarcoma would be bad, but that people who lose legs can go on with their lives, and even be athletes.  What was the worst was losing a hand, especially a dominant hand, because that often meant you could lose your career, and really struggle to rebuild a life.  Spoken like a hand surgeon!

for any of you who is curious, here's what the donor site i'm complaining about looks like.  For scale, it's about 4 inches long and 1.5 wide:

reflection

One thing I noticed last night as I was considering my arm - the graft is actually smaller than the temporary graft I got in Houston.  It's close to the size of the graft from last summer.  Part of that is that if you close up the hole left by removing my ECRL muscle, there's less tissue inside.  But that was true after the December surgery.  Reid did say he'd pulled things nice and tight during the surgery.  Will be interesting to see, if and when I am able to build muscle (not the one I lost the ones that are left) whether the skin, including the graft, will expand along with the growth.  Guess we'll see.


After he caught me staring at my arm in tears last night, Bill brought me a little orchid plant.  So lovely.  I'm blessed in many ways. And Rosemary sent me some prescription-strength lavender to help heal the wounds.  Meanwhile Karen asked my permission to read this blog to her naturopath friends at an upcoming conference.  She thinks I should be using honey for wound healing. Just wish something would work.  Especially on the donor site which hurts like hell, even as it is so amazing to me that the graft itself no longer does, bacteria and pealing or not.  Drink a toast to the absence of staples.

Photos! (Don't look if you're squeamish)

Don't look if you're squeamish, but as one of my spiritual advisors says, this is what your body looks like now.  If you have to look at it, your friends and family may, as well.  Not like my forearm is going to be hidden under most clothing.  So, with due warning, here's the waffle graft:

And here's what my arm looks like without a ECRL:

The Pain Mind-Game & When 90% gets a Cheer

Dr. Reid took off his poultice this morning.  The graft looked good -- 90% took.  This was the main reason for this surgery, so this is a big success.  I don't have an open hole in my arm anymore.  Yeah!


It does have a slight odor. Reid said that reflects a common skin surface bacteria, which, now that the graft is open to the air -- and gets to be washed in the shower! -- should dissipate.  Meanwhile, the small places where the graft didn't take should fill in.  Going forward, it will heal, but the graft will never have nerves.  And, I don't know what it will look like, ultimately.  Right now, the surface doesn't look as much like a pie lattice as a waffle stamp:


He cut the stitches holding the dressing in place, removed the gauze (which of course was stuck and required pulling) and extracted the 14 staples, all without anesthetic in an open room at the back of the office (not in an examining room w/ a closed door).  That meant that everyone in the suite -- including Bill and the strangers sitting in the waiting room -- heard my yelps and whimpers. We knew that this procedure was going to hurt, but I hadn't expected to have the psychological addition of having my reaction to the pain being exposed.


2nd, he checked the tendon repair.  It was interesting to watch his face; what he saw left him puzzled.  I can still not lift my middle finger all the way up to straight.  So, the repair was not entirely (or mostly) successful.  He apologized.  He doesn't understand why, with 8 stiches, it doesn't appear to have held.  He took me to look at a diagram of the hand tendons, because he would also have expected the webbing between the fingers to have helped my ring finger lift my middle finger.  And it isn't.  So what's going on (or not happening) isn't clear but right now it doesn't work properly.  We'll need to consider whether another surgery is warranted.  But not now.  Need to heal and do some OT and see where I am in a couple months.  (Again, so much for a single surgical process that would address everything!)


3rd, he looked at the donor site.  He agreed that it wasn't healing as expected.  Again, he apologized.  Sadly, other than suggesting that I dab it with vinegar (!) or hydrogen peroxide, which might help dry it up, he didn't have much to offer, other than t continue to be patient (although some might argue I lost my patience a while ago).  It is healing, even if it doesn't look like it, just slowly.  Easy for him to say, obviously, since he's not the one trying to put a skirt on over it and venture out to professional - or social - functions.


What is most amazing, though, is that -- with the staples removed -- the pain in my arm is close to gone.  (I would note that in August, when I had the first graft, that she did without staples, the graft site on my arm never hurt much.)  But what's more interesting is that the pain at the donor site seems slightly less, too, even though nothing happened to make it better this morning.  So, my new theory is that the mind game of pain is that pain is not additive; rather, it's geometric.  All of which is good, and means (I hope) that I can back off the stronger pain meds.