Surgical details

Things are different than I thought. I'm so glad I finally got a call with the surgeon the other day.

This is getting real. Like really real.

I am questioning myself second, third, and tenth times if I should go ahead with this, but going through all the moves of going ahead with this. I want the reconstruction so badly, I've wanted it since I had NF. Now seems like the ideal opportunity, but it's so friggin' scary. (it will always be scary)

And like most surgeons, he told me that it might not get rid of my pain. We don't exactly know what the pain is from, so how can he say this will get rid of it? He can't. But he's doing everything possible to make the conditions in my gut "right" by taking care of inflammatory situations.

First he's going to explore. There are decisions that can only be made "inter-operatively" (his words). One of them is the biggest decision, whether he can take out the mesh or not. He is fairly sure he can take out the anchor clips, of which one definitely always bothers me, so that is very good news. He can take out and replace the mesh *if* it's not integrated into my muscle. If it is integrated into the muscle, he's going to leave it be; taking it out would cause more damage than it's worth. If it is free floating, he will definitely take it out (because that could be a source of irritation). *If* he takes it out, I asked what material he will put in it's place... he said my own muscle. Turns out I was missing a big piece of information with this surgery-- a muscle graft. From my leg. He will need it to cover the femoral artery which is exposed now, and has been since I had NF. I can see my pulse, we don't have to press my arms to get a pulse- my femoral artery pulses along there and it is totally visible. The surgeon wants to protect it by putting a muscle graft over it, before closing it up with my own healthy skin (not a graft). Think of stuffing a pillow before sewing it closed.

So he says that the leg muscle he is grafting from is one that isn't used a lot, it is often used for grafting. I'm a little nervous about this mostly because my skin graft donor site, 12 years ago, left me with lots of issues and problems in waiting for it to heal. It didn't heal well, got secondary infections, and basically hurt me for most of that first year after NF. This type of muscle graft is supposed to heal well....let's hope.

I do think that if he can get the mesh out and replace it with my own muscle I might be better off inflammation-wise, having no more hardware in my abdomen. But we might not have that choice if the mesh is very integrated in my muscles of the stomach wall. I'll only know after I wake up what he wound up doing.

He did a good job in assuring me that I will have a closed wound when I wake up, that I won't need skin expanders, that he can pull the healthy skin together after removing the graft. That is *awesome* news. I won't have a graft anymore! Nothing to cause rashes and itching all the time, spontaneous bleeding, and inflexibility. It will be gone! I'll have one line of a scar closing me up; that sounds like a dream come true for me.

About the spontaneous bleeding-- he thinks there might be a little osteomyelitis going on in the hip bone. I told him I suspected that before, and my bone scan came out negative, but he said anyway he's going to be exposing that bone, so if there is a little osteomyelitis on it he can debride it (take away infected parts of the bone), and it wouldn't make any difference in my recuperating process.

Another main thing I found out is that I will only be in the hospital for three days after the surgery, and will *not* need rehab (I'm sure that makes mu insurance very happy). I will need to go to a "person's" house when the three days are up. I'd like to go to my friends in New Jersey (hi Dev!), but the commute might be too much for me. But if we rent a car it's doable. I just can't walk around Grand Central station and get to the Jersey transit buses, etc. I'd rather stay in Manhattan, closer to my doctor, but I don't know anyone who keeps Kosher in Manhattan. I know many people do, *I* just don't personally know them. I might look for a community (like the bikur cholim in Manhattan) to help me out and maybe sponsor me there for a while before I can really travel. Like Maybe the first week to ten days I'm thinking. The surgery is June 24th (I can't *believe* how fast that is coming up!), so I'm looking at getting out of the hospital on the 27th, and I want to be located in Manhattan, at least for the first week to ten days. I'll work on that.

That's about all the info I have for now.
I will have another conversation with the surgeon before we leave on the 20th of June. He said for his overseas patients that is routine, two conversations before the surgery. Sounds reasonable to me. Also, he confided that he hadn't yet had time to go over my scans with his radiologist expert, and he still wants to do that. So any new findings there will be revealed to me in our next conversation.

I basically feel more at ease that I have more information now. The scary part for me that I didn't know about before is that he's doing a muscle graft from my leg. The good part is the relatively short hospitalization, and no necessity for rehab. He said he's going to be giving me stomach exercises to do, and prescribe a certain amount of walking per day after I've recovered sufficiently. He said if I do need any physical therapy, that will be here when I get back home. Makes perfect sense to me.

I have a bunch of blood tests to do, and other pre-op things, and insurance things to work out still.

It looks like Shifra will be coming out to NY to help me when Robert goes back home. She really wants to do that. I wish she had a drivers licence, but I guess if I do go out to New Jersey to my friends that I'll have to do the driving. It's still up in the air as to living quarters for the month of July. As I said, ideally I'd like to be in Manhattan.

I guess this is going to happen. It's so scary on so many levels. Open surgery on my NF area. But it will be worth it. Please G-d watch over me!!!

Sarah Rachel Bat Tova.