Medically necessary medial thigh lift on 10/20/08

Nov 16, 2008

I had double medial thigh lift Oct. 20 by Adam Lokeh, plastic surgeon.
Due to extenuating circumstances (MS) initially had seven-night hospital stay, (during which a hematoma had been discovered on a labia, which I sarcastically called my 'testicle!  As fluid continued trying to move outward from the body, more swelling in the female parts appeared as two little 'nuts' accompanying the 'testicle'.  My hemoglobin sank very low, and on the third day, was given a succesful red blood cell transfusion.  Later that same morning, my entire body was covered by hives, and in my groggy state, I'd scratched myself raw, particularly the back of thighs and buttocks.  Benedryl was added into my IV, which alleviated the horrible itching.  However, that same day, I became horrendously nauseous and ended up with dry heaves, then even vomiting larger amounts I'd eaten or drank.  It was just the worse feeling, no energy, and sitting with the little puke tray hanging from my chin.  I'd had two separate visitors, who I had to send away, I was feeling just worse than rotten. Was the 'star' of the wing, as medical personnel repeatedly revealed their appreciation for my hard work and keen sense of humor!   On the seventh day post-surgery, was discharged to my home for three days, then a 911 call  brought EMTs who conferred with the surgeon, who recommended I go to the hospital ER (he was there doing surgeries that day). He'd subsequently checked things out, then admitted  me for observation, lasting three days.  From there, on Oct. 31st I was transitioned for skilled nursing care at a nursing home a mile from my own home.  I was at the nursing home eight nights.  What a horrible experience:  upon admission at seven p.m. a Friday night, was chastised for having my own prescriptions.  There forward, my dispensed medications were reversed:  was getting a.m. ones in p.m., and vice versa.  Saturday I felt like I was on a set for a horror movie for which I had no script.  Found out that Monday per admitting director, there was supossed to be a 'welcome' manual in the room.  Oh yeay, I didn't have to have the anxiety attack Sat. evening when I'd called my PS, who spoke to the charge nurse.  Have been home for good since last Sat. (11/8).  So far, I've received statements of charges for hospital charges only, totaling just over $74,000;  this doesn't even include the eight overnights at the nursing home for skilled nursing care, physical therapy, occupational therapy, the therapist who will be doing lympnoidic massage on a regular basis to expel more fluid out (awaiting surgeon's OK on when), plus the four weeks of daily home-care.  Daily nurse who comes here, cleans the wounds, packs the four naturally-opened gaping holes (part of the miraculous healing from inside out), implements appropriate 2"x2" or 4"x4"  gauze  pads soaked in sodium chloride then packed very snugly into the crevices.  Covered with , 5" x 9" ABD pads, and Ace-wraps on each leg from toes to groin.  The purpose of the packing is for them to dry out, then be removed dry or dampened, for the purpose of lifting and expelling gunk which must be removed. 
Dr Lokeh assured me that the fluid will get out of the body by any outlet available, that at times it may appear I've 'bled' anywhere, a cup of bright red blood, though it's merely the fluid trying to leave the body. It has varied from red, to yellow, to pink, to pinkish orange, to a very light yellowish brown, which is natural.
Due to the MS, Dr. Lokeh assured me he was taking extra precaution because of potential complications.  The reason this initial medial thigh lift had been medically necessary was because last winter I'd been frequently losing balance and falling.  Brain MRI showed no MS changes, thus she deduced the falling/balance issues were due to losing so much weight, became so tiny, that the extra liquid fat-filled loose thigh skin was shifting with ambulation, adversely affecting core balance and equilibrium.  Thankfully, Medicare and MA covering 100% of all charges, as was the initial WLS July 2006.

The first of two JP drains was removed 10/29, the other JP plus and internal drain in right thigh were removed 11/4. Has been amazing watching the body heal from inside out.  The sutures naturally open on their own, exposing layers of meaty flesh, changing nearly every day. One small opening on left inner thigh and four larger gaping holes on the right inner thigh.  Smallest is closing, although the other three, one measured at its largest as twelve centimeters long, six centimeters wide, and four centimeters deep.  Another large hole at the groin crease at its largest was seven centimeters long, three centimeters wide, and also four centimeters deep.  Both thighs have been relatively numb, which certainly helped when nurses cleanse the wounds, tightly packing with gauze 4"x4"s soaked in sodium chloride, which would've hurt like heck had I actually felt it!  Even at thisclose to four weeks out, the fluids continue every which way to expel from the body.  The home care nurse this morning finished the cleansing, packing, gauze and Ace wraps by ten.  It's only two hours later, and I already just changed the pads to remove the soaked ones which seeped through the Ace wraps.  Just a fact of life post-PS. 
Saw Dr Lokeh twice the week of Nov. 7th.  That Friday, the day before scheduled release from nursing home to my home, Dr Lokeh was concerned the right thigh was so swollen and sore to the touch due to a possible blood clot.  I was sent downstairs for an ultrasound, which thankfully showed no clot, just acute edema.  Yeay, knew I 'd be going going home the next morning!

My apartment is small, so at home I'm able to walk around unassisted.  However, I walk the halls minimum four times daily, using the walker to ensure safety.  I find I'm able to more smoothly and gradually increased the pace, still ensuring safety.  Looking forward to the next follow-up with plastic surgeon Tuesday, because last time I saw him (Nov. 7) his face beamed when he's complimented on my ambulating progress .  Is he going to be pleasantly surprised Tuesday! 

Tues. 11/18/08  Followup with Dr Lokeh was awesome!  He's very pleased with my progress, and said the wounds are 'looking just great.
My legs were swollen SO much, the wraps ended up rolling into the two folds under both knees acting like tourniquets, cutting off all fluid flow.  He literally cut them all off.  YEAY!  They were SO hot, so itchy with the draining fluid, absorbant pads and gauze beneath.  There was a three-inch round patch that was hot, red, and shiny--he said it was infected, so 'wicked' it open to get the infection out--oooh, that hurt BAD! He also pulled all the black threaded stitches, and there were some straight lines (looked and felt like fishing rod lines) which were supposed to dissolve, though as these sutures opened WIDE, he pulled what he could, and cut the rest--OUCHIE!.  He then cleaned it all up well, packed the gaping holes with wet gauze, then put gauze wraps snuggly around both upper thighs.  NO more ace wraps--so when I got home, gladly collected my growing laundry pile of them and happily threw them in the trash chute!!!  Celebration time. Am feeling FREE from literal bondage!

11/29/08 Per followup with Dr Lokeh this past Tuesday, I am free from using the walker, and now using my cane.  I've added a current photo, and was given the OK to return to work Sun. Dec. 14!  Wow, can't believe it will be exactly two months off for recovery, although looking back, it's really gone fast.  Am keeping busy walking, doing physical therapy exercises, resting with both feet elevated, and getting some very long naps. 

12/19/08  Final day of home nurse care was Wednesday 12/10, due to my PS approval for returning to work Sunday 12/14!  Gratefully, have two family holiday functions, one Sat. the 13th, the other Sat. the 27th.  That will give me a good month for additional recovery before returning to my normal schedule, every other Sat./Sun. at the assisted-living facility where I'm a part-time receptionist.  Lately both calves and feet become very swollen.  Still awaiting set-up for lymphedema massage by a specialized MPT. 

02/25/09  Yeay, day one at Sister Kenny for lymph edema massage therapy.  The MPT specialist measured my feet, ankles, calves, and thighs.  I received instruction and shown how to do various exercises and how to very lightly massage upper-body lymph nodes.  Cathe said I will definitely go down one pants size (!) and estimated my program will last two to three months.

03/09/09  Wow!  The swelling has very obviously lessened!  Both calves and knees show 'dents' where previous swelling merely showed hard engorged masses of stretched skin on feet, ankles, calves, and thighs.  Cathe (MPT specialist) has been very pleased with the rapid transformation, and told me today at the rapid pace I've encountered (with diligent, persistent exercise and instructions) that I will be all set for summer.  However, special suport hosiery will be ordered Wednesday via another specialist, and will have to be worn daily for the rest of my life.  Ugh...hose under shorts in hot weather does not sound apealing, although I'll be able to choose the colors of the two pair, and will go with a natural light color.  I asked her if I could just get a full body hose which will eliminate sun tanning!  She thinks I'm a riot, good attitude and sense of humor, although I'm very serious about the work I must do to get this lymph edema erradicated, so to have the mini-panniectomy sooner rather than later.   
 

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About Me
Hopkins, MN
Location
RNY
Surgery
07/25/2006
Surgery Date
Sep 22, 2006
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