Surgery success

Shade looks like half a chipmunk after a +12-hour muscle and skin graft surgery for his cheek yesterday at Duke University Hospital in Raleigh-Durham. He went in at 7:45 a.m. in the morning and got to the post-op area at 8 p.m. Aitza was at the hospital the whole time, having arrived with Shade on Friday for all his pre-op appointments. They met with Dr. Marcus, the plastic surgeon who had performed the nerve graft surgery on March 31. He was very happy with the progress of the nerve graft after Shade told him he kept having little electrical impulses in his cheek, like mini lightning strikes. They also met with Dr. Phillips, the muscle graft surgeon. Both doctors gave Aitza and Shade a rundown of the upcoming procedure.

Meanwhile I had been working in NYC on an HBO special and planned to get to Raleigh on Sunday morning, the day before the surgery. Being a certified idiot, I decided to hit the Manhattan nightlife Saturday with my buddy Larry, daughter Arianny, son Edwin and soon to be daughter-in-law Michelle (yep, Edwin proposed). The kids were smart and bailed on Larry and me before midnight, but we keep going. Suddenly it’s 5 a.m. at the club (Oh yeah, New York doesn’t sleep!) and we both realized that we had morning flights to catch. We Ubered to the hotel, speed-packed our clothes and Ubered to JFK airport in record time. No rest for the wicked.

Shade’s first snow experience

Larry took off for Seattle and I hung out at my gate for the 8:30 a.m. to RDU. But to my dismay, the weather gods decided to dump 13 inches of snow on Raleigh-Durham that morning, causing a chain of flight cancelations. Meanwhile, Shade and Aitza are having a grand ol’ time making snow angels and throwing snowballs. It was Shade’s first snow experience, so the blizzard was a special pre-surgery gift for him…

…and a kick in the goolies for me. After spending 12 uncomfortable hours at JFK waiting for a flight to open up (nope), I decided to fly back to Orlando, get my head on a pillow for a couple hours, and fly to RDU the next morning. But the snowfall caused a chain reaction of delays, so the next morning, after boarding my 9:40 a.m. flight, my plane sat on the tarmac for 1 1/2 hours, then turned back to the terminal where we disembarked until 2:40 p.m. Then we got back on and sat on the tarmac for another 1 1/2 hours before getting clearance to take off. So I missed seeing Shade before he went in. At least I got to Facetime him beforehand.

The black mark along jawline shows originally planned incision. The red marker shows where the two-inch thick skin graft was placed to cover the muscle.

I arrived two hours before he came out of surgery, and Aitza gave me a breakdown of the progress as per the doctors’ updates. Shade was prepped for surgery and went under at 8:45 a.m. Dr. Marcus and the surgical team made an incision from his right hairline down his sideburn, in front of his ear and down his jaw line. Then they lifted the skin up, exposing the cheek muscle, which has been paralyzed since his first stroke on July 14, 2011. Meanwhile, Dr. Phillips harvested muscle from Shade’s inner right thigh, which was placed on top of the paralyzed cheek muscle. Unfortunately, because the original cheek muscle had lost so much mass, the skin on his cheek had shrunk. So when the doctors attached the new muscle, there wasn’t enough skin to cover the incision area. Consequently, Dr. Marcus had to harvest some extra skin and fat from Shade’s thigh and graft that over the opening. Now there’s a two-inch thick strip of thigh skin stitched down his jaw line, which may make for some strange mutton chops. The last thing the surgeons did was put a little stitch at the corner of his right eye so that it doesn’t droop. This will help him close his eye and keep his tears from running out.

The oxygen level going to the grafted muscle must be over 60%. He’s well over that.

Shade’s cheek is the size of a softball because of massive swelling, which is normal. Inside his cheek is a monitor that measures the oxygen level of the blood going into the muscle. It’s supposed to stay above 60%, but currently Shade has 91% oxygen level, a great sign for healing progress. He has a drainage tube coming out of the cheek to release fluid build up. He’s also enjoying a hydromorphone drip, which he can press every 10 minutes. Perhaps “enjoying” isn’t the right word as he’s dealing with some serious pain in his cheek and thigh. He and Aitza also haven’t slept much since the surgery due to hourly scheduled visits by various nurses throughout the night and day, plus random drop ins from the surgical team, residents, nutritionist, admissions and me. And I was complaining to Aitza about not sleeping for two days after my New York party binge.

The good news is the swelling will reduce dramatically over the next days and then keep reducing for the months of healing to come. Dr. Marcus said that in another 10 months, Shade should have a third surgery to remove much of the grafted thigh skin and clean up the scar so that it’s following his jawline and isn’t visible from the front. In that time, the grafted nerve should have a chance to attach to the muscle and get it moving. Shade has a lot of therapy ahead of him, but by next year he should have a somewhat symmetrical face that can smile on both sides.

Advertisements

Past Progress and Next News

It’s been since last  April that I last posted in Shade’s Progress, when he had his nerve graft surgery at Duke University Hospital. Just a reminder, they yanked a wire out of his calf and threaded it from his left ear to his right so that his cheek could get some spark back. The following up surgery is coming up. I’ll tell you about it down there.

IMG_4861

Florida ID

IMG_4600

Registering to vote

First, let’s update. Shade got a Florida ID (not for driving. Trust me, you don’t want him behind the wheel. He drives his electric wheelchair like Mad Max.) and then he got his voter registration card. Civic duty awaited and our son got to experience for the first time that dirty feeling you get for voting for the least despicable candidates. Shade’s still serving up good will at The Simpsons Restaurant, meeting folks from all over the globe and local friends, like our Indian Guides buddies Chad Adams and Bill Ellenback, who work out there. If you go out there, stop by.

IMG_2865

 

Shade also traveled with his two brothers, Mayan and Edwin, his Tio Loco and Tia Gigi and Mami to England, where Shade got to enjoy a legal pint of beer. Shade’s a world traveler. Shade’s also been fully immersed in the Pokemon universe as is Mami and they’re constantly grabbing mythical creatures out of the neighborhood. It’s not rare to be caught in a car conversation that involves a Squirtle, Snorlax and Lickitung. If you have a Charmander prowling your neighborhood, call Shade. He’ll take care of it.

IMG_0845IMG_2006

IMG_2872

Finally, Shade has grown out his hair for a couple years and he recently got it trimmed off so he could donate it to cancer patients who need wigs with real hair. He’s sending silky locks to Locks of Love. Now if I can only get Aitza to get the decapitated pony tail out of the napkin holder on the dinner table and into a postal envelope… (I’m going to get hell for this crack.)

So now to next news. Shade healed up nicely after the last surgery, and has been feeling a lot of twitching in his face. Now comes Step 2. We’re heading back to DukeU Hospital for Facial Reanimation. Sounds like a movie. “Shadenator is back and he’s mad as hell!” What this boils down to is Shade’s muscle graft surgery. They’re going to take a muscle out of his thigh (not a whole muscle but a strand so it shouldn’t affect his leg strength. Then they’re going to go in under the skin of his right cheek and graft in the muscle where the nerves have already spread out they’re electric tendrils. Over time and with physical therapy, the nerves will splice with the muscle and soon he should be moving his cheek and mouth where previously it’s been paralyzed. Basically Shade will get his smile back. At least on one side. His other side already had a beautiful crooked smile which he uses constantly. (DukeU Hospital’s site will show you more details if you’re interested.) Oh, and during the surgery, they plan to put a stitch on the corner of his eye to lift the lower lid. That way he can close his eye a little more and the tears won’t be so ready to run out and dry out his eye.

IMG_9625

Shade taking the Lynx Access shuttle to work.

The surgery is scheduled for December 10. Aitza will fly up to Raleigh on the 7th and I’ll join them on the 9th, flying from New York, where I’m working the Two Dope Queens show at Kings Theater in Flatbush. Flatbush is a trendy spot in Brooklyn, for all you folk that haven’t explored the area. Brooklyn is a place in New York, for all you Florida folk who never left the state, or at least the South. I’ll keep you posted as details emerge.