it’s okay.

October 15, 2009

this morning i woke up to get the dressing changed on my graft site (which happens to be right underneath my flap incision…also in need of gauze and tape). my incision line is splitting. it’s not bleeding, but scar tissue is visible. common sense told my parents and i splitting incision lines weren’t good, so we took a few photos and sent them to my surgeon. i laid in bed all day waiting to hear back from him, worried i would split in two. i did absolutely nothing all day. well, i watched cory and topanga get married on youtube, but i did nothing. turns out, when someone gets this much of a nip and tuck, splitting incision lines are normal…a part of the healing process.

crazy isn’t it? somehow, the exact opposite of what i thought was healing for my body…is okay.

two days from now marks one month since the accident. i’m not really sure where i am. some days i am great. some days i am not. some days i’m going to wake up feeling pulled together. some days i’m going to feel ripped apart. i’ve come to learn that nothing in this healing process is certain. i went through a groin flap procedure and all i have to show for it is a splitting scar on my body. however, because the flap failed, i may gain more function in my hand. i have no idea how splitting equals healing. we’ll see.

sometimes the exact opposite of what we think we need…is okay.

six stages.

October 11, 2009

my next entry was going to be an account of my week at the hospital after the accident. i was at the hospital for an exact week (september 17th-24th) and i may or may not still post some sort of an account; however, i have had six surgeries since the accident and far too much has changed within the past two. therefore, the priority now lies in updating this blog fully so that my current situation can be known. i have dubbed each surgery as a “stage” in this healing process. for example, surgery #1 was “stage #1,” and so forth. to catch you all up to speed on what has happened to me within the past three weeks, i will give my account based off of each stage…

stage #1 – my first surgery after i made it to the ER the night of the accident (september 17th). after a CAT scan, some x-rays, and a phone call to my parents i was put under for an irrigational procedure and an amputation. my little finger was beyond saving. it was so mangled it wasn’t even a finger anymore. that night he amputated my little finger and spent most of six hours cleaning my hand of any debris from the accident. also, he did a minor skin graft with the original skin from the back of my hand. the skin had been pushed back. he reset the skin in hopes that it would save itself.

stage #2 – my second morning at the hospital (september 19th). the skin from the back of my hand was successfully grafted. my surgeon re-irrigated my hand, clearing out the last of the debris, and observed my index finger to determine a course of action to try and save it. my index finger had been stripped of all skin and tissue down to the bone below my finger tip. my finger tip and finger nail remained intact, but was only being fed by one artery. a simple skin graft would not create a finger after all the tissue had been lost…the skin would have nothing to attach to. this surgery helped determine stage #3.

stage #3 – my third morning at the hospital (september 20th). my surgeon performed a “groin flap” procedure to try and save my index finger. basically, he cut and peeled back a long flap of skin and fatty tissue from my hip above my left leg and laid it over and around my index finger. the “flap” remained attached to my body at one end while my index finger pointed into the other. yes, it is a very strange procedure. and yes, my hand was attached to my body through a tube of skin. the idea, was for the tissue and skin to grow around my finger, forming (and later to become) my new finger. because the flap was attached to my body through this process, it remained alive. and i was to remain uncomfortable for two and a half weeks until the flap could be detached and shaped. (the flap would be swollen and shapeless. my finger would endure more surgery before it would look anything like a finger again.) in addition to forming the flap on my finger, my surgeon also performed a nerve and tendon transplant. because my little finger had been lost, he was able to take from that area of my hand to give to my index finger. i left the hospital on september 24th, headed home to indiana, to wait out the two and a half weeks that had to happen before stage #4. it was uncomfortable to have my hand tied down to my side, but i managed to find ways to arrange pillows around me to fit a level of comfort. at night, my mom would help me get through a shower and my dad would redress my hand. redressing was an arduous process. the seepage from the tissue in the flap gave off a horrible smell and the flap got weaker every night. however, my dad did a phenomenal job with my bandages and i don’t know what i would have done without my wonderful parents in all of this.

stage #4 – my separation, out-patient at the surgery center (october 7th). after two and a half weeks i was busting down the doors of the surgery center, eager to get my hand separated from my side. in all honesty, the flap wasn’t going to remain attached to my body for much longer. the point of connection to my body grew weaker everyday. i have never been more excited to go under the knife. the separation went really well. my surgeon cut away all the excess tissue and sewed up my side where the flap had been. he was pleased to see “back flow” in my finger, meaning my hand was now feeding the flap with blood rather than my side. later, i would undergo two procedures to take away extra tissue and make the flap look more like an index finger. he did find that some of the flap, acting as a skin graft for the back of my hand, did not survive. also, my index finger had a dislocated joint due to tendon loss. he scraped away the dead skin on the back of my hand and suggested we come back in two days for a skin graft and a pin to be put in my finger for the joint.

stage #5 – the graft and pin at vanderbilt med. (october 9th). i went under for a skin graft on top of my hand and a pin for my dislocated joint. at this point, i was eager to be done with surgery for a while. i have plenty of IV scars on the top of my hand to prove it. about thirty minutes into the surgery, my surgeon left the OR to talk to my parents in the waiting room. the flap we had nursed for two and a half weeks was not going to make it. it didn’t have enough blood supply to keep it alive. he did not find any infection in the flap, but it was clear the procedure had been unsuccessful. he removed the flap and i awoke from surgery finding myself back where i started on september 17th. it was devastating. we had been so hopeful and we had worked so hard, with only a long scar (stretching around the side of my body) to show for it. i had two options…both of them sucked. option #1: i could try another flap, except this time take it from my waist. there was a chance this flap would fail as well, even during the shaping procedures (which could be up to six months in the making). option #2: i could have my index finger amputated, leaving my left hand with a thumb, a middle, and a ring finger. i had the 9th and the 10th to deliberate over my options. i chose option #2 – amputation. option #1 was a gamble without a very decent prize. had that flap been successful, i would gain an index finger, but its only function would be to take up space on my hand. the only benefit was appearance. i would have little to no function in the finger (due to the dislocated joint). additionally, my other two fingers (middle and ring) would have to wait on the flap procedure’s success before they could start rehabilitation. the longer the wait before movement is encouraged the more movement is lost. essentially, option #1 gave me an index finger, but those three fingers would have limited function. option #2 (amputation) gave me function. once my index finger would be out of the way, i would be able to start rehabilitating my fingers, improving the chances of complete function. it made sense and i had a lot of peace about it. i didn’t want to lose my index finger, but in reality, i lost my finger on september 17th. i don’t think i gave up on my finger, we tried really hard with the first flap. i’ve come to accept it all now. with my index finger gone, i can move forward and move on with my life. and maybe, i’ll grip a guitar pick again. i chose function over appearance and this morning, i moved on to stage #6.

stage #6 – amputation, my third morning at vanderbilt (today, october 11th). i don’t have an index finger anymore. my parents and i deliberated all day yesterday at the hospital. i’ve never been so sure of anything in my whole life. i’m ready to move on. my surgeon amputated my index finger and took a skin graft from my thigh for the top of my hand. i’m done with the OR for a while. he sent me home. i’ll go back to the hand clinic on the 20th for a post op check, but for now…all i have to do is heal.

thank you all for your continual prayers. i know this post has been a long time coming. i get behind and one handed typing is a slow process. i intend to keep my posts up to date from now on so you all can follow my progress better. most importantly, i apologize. such news should not be discovered for the first time from a blog; however, this is a much easier way for me to communicate this particular story and there was a lot to say. again, thank you for your prayers. more to come soon!