Sunday, November 27, 2011

Scalp Surgery

Last week Catherine had three spots of dead skin removed from her scalp.  She was born with these three tear-drop shaped patches of dead skin on the crown of her head.  When she was a baby, a dermatologist told us it should be removed as it could contain pre-cancerous cells.  But, he wanted to wait until she was older.  Then when she was 27 months old, she started battling a brain tumor.  The oncologist said we should wait until she is off treatment to repair the scalp.

Of course post cancer treatment we have been focused on bladder, kidney, colon, and stomach issues.  Some of those issues are still in process, but things have medically kind of settled down for awhile.

So, last week we had the three patches, as well as a "bridge" of skin between them removed.  The surgery was supposed to take 30 minutes, but instead lasted an hour and a half.  Before the operation, the surgeon mentioned that he might need to put some bandages on the area to help protect the stitches, but he wasn't sure.  I was absolutely shocked when they returned Catherine to me with this on her head:
According to the surgeon, the operation went well.  We were told to keep the bandages on at least 24 hours, but preferably 48 hours.  He said that some kids will try to pull it off themselves, which could rip the stitches.  Once it comes off, we have to put a prescription-level antibiotic cream on it 3 times a day. We also have to shampoo it carefully every day and give her another antibiotic through her g-tube 4 times a day.  I guess infection is a big risk with this surgery!

She will have the stitches for 4 weeks, or right before Christmas. 

When Catherine woke up from the surgery, she was of course groggy.  But, she kept touching the bandages.  I told her that the doctor put a silly hat on her head to protect the stitches, but that she would only have to wear if for 2 days.  I asked her if she wanted to see what it looked like.  She said yes.  So, I held her in front of a mirror. 

Thankfully, she giggled when she saw her "silly hat" in the mirror.  The first thing she said to me was "now you can't comb my hair!"  Catherine's hair is quite wavy and gets tangled all the time.  So, combing her hair is usually a screaming and crying ordeal.  With these bandages, only a tiny part of her hair sticks out of the bottom. 

On Thursday, after Thanksgiving dinner, we had to take the bandages off.  Catherine wanted to keep it on, but we told her we had to take it off so we could start putting the cream on.  Catherine was quite a trooper as we removed several layers of white gauze.  The bottom layer, which was touching the stitches, had some dried blood in it mixed with her hair.  So, it hurt a little to remove that.

Then we have used the cream for another 2 days and actually washed her hair for the first time tonight.  We wanted to give the stitches as much time as possible to strengthen the incisions.  I know it hurt her as we had to wash her hair.  There were some sections which had blood and other gunk dried in there.  Some parts I just cut out, rather than cause her any more pain.  I bought some special de-tangling shampoo, but I am not sure it really made a difference.  I still had to put tons of conditioner in her hair to try to get a comb through it.  I also bought some detangling spray to use after I had rinsed her hair.  I think that did help a lot (of course she was pleased because it came in a Disney princess bottle).

I feel confident that with all the anti-biotics we are giving Catherine, she will not get an infection.  But, my bigger fear is that she will fall, hit the crown of her head and pop the incision open.  Sabrina's chin incision was popped open by a fluky fall, thus destroying any hope of having a pretty small scar.  Of course Catherine's "scar" will be on the crown of her head, completely covered by her hair.  So, unless she shaves her head, no one will ever see it. But, if it bursts open, it could become infected. 

As worried as the devil wants me to be, I have to remind myself that the stitches are completely on the crown of her head. So, to bump her head exactly on the top of her head would be quite difficult.  In fact, if she truly did land on the top of her head, I would need to be more concerned about a concussion or closed head injury than stitches breaking open. 

But, I know I need to trust God and not worry about this at all.  I am grateful for talented surgeons, prophylactic anti-biotics, skilled nurses, and an experienced six year old patient who is so calm in medical situations.  Catherine actually reminds us to give her her medicines, respects what the doctors say (of course that had bad consequences with her last surgery), and is careful with any kind of stitches, etc.

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