FYI: I'm getting one assertive billy-goat station wagon!!

[elagache]

Dear WeatherCat users who occasionally stroll down memory lane,

I still cannot drive, so instead of taking my trusty wagon out for a spin during the Superbowl and I dug into another box of old slides.  Eventually, I came across this photo that brought back memories:



During the summer of 1993, one of my cousins was visiting from France and I decided to pull out my trusty campground guidebook and make a tour of the Sierra foothills with my cousin and a few friends.  Since Biquette was my car, she had the transportation duties.  I soon learned that what the guidebook didn't mention was more important than what it did mention!  The first campground was too close to the freeway and the noise kept us awake all night.  This photo was taken at the second campground.  My tent is in front of Biquette and obviously wasn't much insulation from the noise.  In that case there was a steady stream of heavy logging trucks.  One would pass every time you were nodding off to sleep!  The caption on the side of the box of slides was: "The camping trip from hell!"  Yes an exaggeration, but it was indeed one lousy expedition into the wilderness!

This is just one of the reasons why my motto has come when it comes to camping trips . . . . . .

Wouldn't you really rather have a Buick and an Airstream travel trailer!!

Cheers, Edouard   

P.S. There is one snippet of surgery-related news.  With the change of surgeon, surgery #2 has been pushed back from this upcoming Thursday to Tuesday the 22nd.

[Blicj11]

Thanks for there camping tale, the photo, and the surgery update. Since you aren't driving, how are you getting to hospital and back?

[elagache]

Dear Blick and WeatherCat faithful,

. . . Since you aren't driving, how are you getting to hospital and back?

Even if I could drive, I wouldn't be allowed to drive myself to these surgeries because they are under general anesthesia.  The previous and following surgeries are relatively long at 3-4 hours.  Under no circumstances could I go home without the accompaniment of a friend or family member.

Because of the various health issues in the house, we had already befriended a neighbor who has a franchise for a local taxi company.  So there is someone we can trust to provide the transportation.  For the return trip from the hospital, my sister volunteers to be present at discharge.

Still it is some involved logistics.  I arrange for the transportation at least one week in advance, and since we are on a major commuter path, the travel time is never certain.  It certainly isn't the easiest thing to do, but this sort of involved facial reconstructive surgery appears to be a rare specialty.  UCSF might be the only facility in the San Francisco Bay Area capable of this sort of thing.  So whatever the logistics, I've got to make it happen!

Cheers, Edouard

[elagache]

Dear WeatherCat community,

I have been conspicuously absent around here, but there is a rather amazing tale to explain it.  Surgery #2 was a week ago Tuesday (22nd.)  The main objective was to restore the cartilage supporting my nose that was lost when the cancer was removed on January 26th.  In order to do this, they needed to remove the stitches and gently lift up the skin graph from my forehead to get access to the structures beneath.  Alas in that process, they must have twisted or kinked the veins that drained the graph; constricting circulation.  After the surgery, the skin graph started to fill up with blood and effectively die.

The skin graph is a small part of me but just about impossible to replace at this point - drastic and unorthodox measures were in order.  From the surgery I went immediately to this hospital's ICU branch were I was treated with (believe it or not) leeches! 

At first, every 2 hours and then tapering off, a leech was allowed to drain off the excess blood and congestion from my skin graph.  That removed the backlog of blood and allowed for circulation to gradually be restored.  As the veins recovered from the distress of having been disturbed, the leeches became more like vacuum cleaners removing debris that was congesting the circulation in the nose.  From Tuesday night until Friday morning the procedures were continued until the skin graph that is my nose started to look more like normal.  I spent an additional day and a half in the hospital under observation before finally being discharged Saturday afternoon.  It is a curious procedure but apparently increasingly accepted.  Here is a quick web article about the use of leeches:

https://www.healthline.com/health/what-is-leech-therapy

I had my first follow-up visit with the surgeon he was pleased and relieved.  As he put it: my nose was finally back here it should have been at the end of the surgery!

It has been quite a learning experience.  These skin graphs are very fragile and these sorts of restorations are more an art form than science.  The nurses had some really amazing stories were leeches had once more been the difference between success and failure.

I'm back home and trying to get back to normal.  Last week was tough and it is definitely good to get back my usual habits!

Thanks for your support!

Cheers, Edouard

[xairbusdriver]

Yes, these highly trained invertebrates can do wonders that doctors and scientists can only dream of. I hope your insurance company doesn’t balk at the costs incurred. While the leeches were paid but a potency, their training is expensive and those costs are passed along to the patient, of course. You should simply be thankful that you didn’t have to travel to any of the swampy jungles where this treatment is offered at a considerable discount.

[271249horst]

Hello Edouard,

Yes, the use of leeches is well known and has already helped many people including you.

In any case, I wish you that the healing process continues normally.

Take heart.

Sincerely. Horst.

Text translated from French.

[Weatheraardvark]

I have known a few leeches that have worked.  I taught with them for many years, always wanted my lesson plans so they could copy them. The bastards

[Steve]

It is good to hear from you, and that things are headed back to normal.

I'm sure that your dermatologist will or already has given this warning, but if not, here goes:

Your "new" skin is going to be a magnet for damaging sun rays. Get a couple of wide-brimmed hats. Something floppy that you can stuff in a pocket, and maybe something with structure for the largest possible shadow. I have a cotton/canvas Tilley Hat for the latter. Great in hot weather, as it can be dunked in water and acts as an air conditioner.

If the doc thinks you are susceptible to more skin damage, wear collared shirts that can be flipped up to protect the neck and shoulders. I hardly wear a T-shirt any more. Just a gob of cotton or UV button up casual plaid shirts.

After over 20 years of various face and head related basal-cell carcinoma surgeries, I have become a master at seeking out shade. I once got a chuckle from an otherwise stern Doc when I told him I'd become a Shade Hopper. When I walk, it is from shady spot to shady spot. If you get to higher skill levels, you'll learn to walk in the open while keeping your head in the shade of telephone poles, tree branches, clouds, etc. Sorta like hop scotch.

Take care!!

[Blicj11]

Edouard and Steve:

Thanks for allowing yourselves to be vulnerable on the forum and sharing your insights and adventures.

Glad your are in a better place recovery-wise, Edouard. I am wishing you the best in the days and weeks ahead. You have been in my prayers for the best possible outcome.

Stay safe.

[elagache]

Dear X-Air, Horst, Weatheraardvark, Steve, Blick, and WeatherCat faithful,

Thanks everyone for your kind wishes and prayers,

Yes, these highly trained invertebrates can do wonders that doctors and scientists can only dream of.
. . . .

Well no, not exactly.  The nurses had some skin graph horror stories and in those cases the leeches needed more than a bit of encouragement to only suck blood from the intended source.  This sort of plastic surgery is really the last hope for people losing parts of their body to cancer and other causes.

I have known a few leeches that have worked.
. . . .

  . . . . No, no, not the same species of leeches.  These didn't have two legs! . . . . . 

I'm sure that your dermatologist will or already has given this warning, but if not, here goes:

Your "new" skin is going to be a magnet for damaging sun rays.
. . . .

Thanks for the warning.  No I haven't gotten that lecture exactly because there is still one surgery to go (and I suppose it is winter.)  For years I was already concerned about sun exposure and had taken precautions like wide-brim hats and clothing with built-in high SPF.  However, I can see that my exercising out of doors will have to be greatly attenuated at best.  I've started to reconsider how I'm going to get back into shape after this extended period of very limited activity.   As you point out, I am facing a very new reality.

Thanks again!

Edouard

[Steve]

The downside of shade hopping and avoiding the sun is vitamin D deficiency. I've done such a good job of it that I have been prescribed 2000 IU of vitamin D3 daily. A lesser one is looking like a ghost around everyone else who is all tan all year. Me in shorts is not something you'll find in GQ magazine.

The *best* side effect of my surgeries is that my then 17 year old daughter accompanied me to the first one. After spending several hours in the waiting room with people having skin cancer on arms, neck, face, head, etc, she swore to never use a tanning bed again.

[elagache]

Dear Steve and WeatherCat faithful,

So how do you drive if you need glasses but absolutely cannot put glasses on your partially reconstructed nose?  It turns out someone came up with a strange contraption that is a headband with a hook on the front to catch your glasses before they touch your nose.  It isn't perfect, but it has allowed me to start driving once more.  Yesterday, I finally got Biquette out after over a month of being idle.  My first stop was Orinda Motors so that I could catch everybody up on my health situation.  They were glad to see me.  While there I took this photo of Biquette next to a vintage pickup truck:

The downside of shade hopping and avoiding the sun is vitamin D deficiency. I've done such a good job of it that I have been prescribed 2000 IU of vitamin D3 daily. A lesser one is looking like a ghost around everyone else who is all tan all year. Me in shorts is not something you'll find in GQ magazine.

So far I haven't any issues with vitamin D deficiency even if I haven't gotten much sun at all since August.  However, that might show up after all these surgeries are over.  It isn't like I ever was interested in that tanned look.  Unfortunately I'm the only person left in the house still mobile enough get around in the yard.  Somehow, I've got to continue taking care of the unavoidable yard-work.  There is no one else who can do this for me.

The *best* side effect of my surgeries is that my then 17 year old daughter accompanied me to the first one. After spending several hours in the waiting room with people having skin cancer on arms, neck, face, head, etc, she swore to never use a tanning bed again.

Certainly, your daughter's tanning abstention is prudent since family history is another strong predictor.  Alas, medical statistics isn't nearly as good as people want it to be.  If you wanted to know what can be rigorously proven based on medical statistics - ask for a guarantee.  If that was the criteria, all that cacophony of medical advice based on statistics would be replaced by - a deafening silence!

Cheers, Edouard

[xairbusdriver]

it has allowed me to start driving once more.

Where there is a will...

there is a way!!

Yeah, I can't hear any more.
    Yep, my glasses are now an inch thick!
        I know, I know! I have trouble getting from the wheel chair into the drivers seat!
But I STILL HAVE MY LICENSE!!!

How do you like my air horn?!!!

Perseverance, thy name is Edouard!

[elagache]

Dear WeatherCat faithful,

Tomorrow is the third surgery in the sequence to complete the "transplant" of the section of forehead skin onto my nose.  In this operation, the doctor will cut off the graft from the blood supply it has been dependent upon from my forehead.  Basically, this is the "make or break" moment when this skin graft has to establish itself on my nose.

Alas, the proposed circumstances are hardly encouraging.  Neither of the previous surgeries went as planned and I'm feeling exhausted from the whole ordeal.  The facial plastics team is seriously overworked because they lost a surgeon to a bike injury in February.  My 2-3 hour surgery is scheduled for 4:40 pm!  They are still insisting that I will go home after all this, but that could very well bring me home after midnight.  Nonetheless, I'm not allowed to take any food after midnight tonight.  I'm certainly not going to be very strong by tomorrow afternoon.  Certainly not the most cautious and conservative path to insure a successful operation.

Still, it appears that "the show must go on."  All I can do is brave the challenges as best I can and let the chips fall where they may.

Oh well, Edouard

[xairbusdriver]

Still praying for your complete recovery. Also hope you have some helpful local friends and family.