Orbital Floor Surgery

Last modified on March 7th, 2007

I met with my plastic surgeon this morning, and as I thought, we’re going to go ahead and do another surgery. The apparent source of my problem seems to be that the ledge that was supporting the implant ended up not being very stable, and the implant has collapsed slightly along with my eye. Also, there is slight herniation of some of orbital contents into my sinus near the back, which is most likely the source of my double vision.

The good news is that it should be nearly 100% fixable. They are going to put in another larger implant, and probably secure it using microscrews (sounds so exciting doesn’t it) so that it doesn’t drift.

Since one of the only things I’ve been looking forward to for a while is my 30th birthday, I’ve decided to postpone the surgery until after April 7th. I don’t really want to risk something not going quite right and having to miss out on my own big event. I have a meeting on April 13th to discuss the surgery a little more, and will probably have the actual surgery the following week, most likely on the Monday or the Thursday.

Mixed emotions right now I guess. I definitely would like to not have double vision anymore, and it would be nice to not have a constant reminder of November 4th every time I look in the mirror. I’m just not really looking forward to surgery and the associated recovery time, even though for the most part, it was relatively painless.

3 responses to “Orbital Floor Surgery”

  1. Deena says:

    In February of 2005, I had cosmetic surgery. I remember how excited I was the day of the surgery. I had such high hopes of regaining, at least, a bit of my youthful appearance. Haven just married the grandson of the most famout TV mother ever, I knew I needed a little tweeking.

    The surgery, it appeared, was a success. There was minimal bruising and the swelling was gone pretty quickly. Aside from looking like I had a bit of a shiner under the right eye, you would hardly notice that I had surgery.

    The surgery was healing and I was well on the road to recovery, or so I thought. It looked great, aside from the neck, which looked to need a little more work.

    Close to June, about three months after the surgery, I got swelling on my face. It started right at the scar on the right ear and went down my cheek. I also had fever, chills, night sweats and flu-like symptoms. I was in Florida with Drew at the time, while he was preparing for his July launch. I called my surgeon when I returned. He had me come in for a visit. He was a bit baffled, since the surgery had actually occurred three months prior. The surgeon drained the swelling with a needle and syringe and the contents were sent it to a lab for testing. I was placed on antibiotics and told to return in three days.

    Three days passed and there was no improvement. In fact the swelling had gotten worse, my fever persisted and I felt like death warmed over. When I visited the doctor, he reported that the results of the lab tests showed nothing. No staph infection, nothing. Again, needles, testing and antibiotics.

    This process went on for weeks. I again visited the doctor. At which time he stated that he wanted to look remove the internal stitch. We also decided that he would place a small incision in my neck and cut the fibrous tissue that had formed. I was led to the back of his office, to his surgery center, and prepped for surgery. I must have been in some sort of minor shock because I remember walking, down that hall. I remember being asked to lie down on the surgical table. I remember being scrubbed and painted with iodine. I remember the sharp needles in my face. I remember the pressure from the scalpel. I remember sharp pains on occasion and flinching. I remember the pulling. I remember the sound of the snips of the scissors close to my ear. I remember shaking uncontrollably. I remember my fear. I don’t recommend having surgery while you are awake. I was frightened beyond belief. I remember leaving his office blank and almost lifeless. I called my husband from the car sobbing uncontrollably.

    Unfortunately, removing the stitch did not help. More time passed and the swelling continued. Needles, tests, antibiotics. Even worse, now there were lumps forming on my neck around the incision that the surgeon made on the day of the stitch removal. Five lumps finally appeared. More needles, testing and antibiotics. The lumps would reduce in size occasionally and then they would swell to epic sizes. I continued to have all of the other symptoms as well. It wasn’t unusual for me to spend three days a week in bed.

    My surgeon then recommended that I see an infectious disease physician and a priority appointment was made. I saw the infectious disease doctor the very next day. By this time, I was extremely frustrated and exhausted with the entire process….months of needles, tests, antibiotics, fever, chills, flu-like symptoms, fatigue and the unsightly swellings and lumps had taken its toll.

    The Infectious Disease physician, of course, deals with all types of infections but his specialty was HIV. I remember walking into his clinic scared to death. The clinic was in a dilapidated part of Houston, close to the medical center. HIV information booklets, drug pamphlets and information for various HIV programs adorned almost an entire wall. There were, it seemed, close to a hundred plastic chairs in the waiting area. The office was extremely clean but I was overwhelmed with fear. I wondered what in the world could be wrong with me that would require my visiting a doctor of this sort. I was given a clipboard full of questionnaires to complete. I remember everyone staring at me. I was out of place. I could almost read their minds. They all believed that I, too, may have HIV.

    Too add to my discomfort, much of the questionnaire dealt with HIV. I remember reading a question that was worded something like “Are You Out?” I didn’t quite know how to respond. I think I probably scribbled something smart-assed like “I don’t know what you are referring to here… but I am not home, so I guess I am out.”

    I know this may seem insensitive to HIV patients, but, please don’t misunderstand me. That is not my intention. I’m sure that all of the patients that walked through that office had the same, or even worse feelings. HIV is indeed a horrible disease. I, at least, didn’t present to the physician’s office suspecting that I had HIV/AIDS. I didn’t believe that I might have something that could end my life. It was just a very uncomfortable situation.

    The doctor was a very likeable man. He is a very regarded physician throughout the world. My first visit consisted of about a thirty minute interview by the staff and doctor and blood tests and a request for my tests on the fluid in the lumps. The doctor admitted that he wasn’t sure, but that he suspected that it was an atypical mycobacteria. He further added that he had worked on a case in the past, and had read of a TB type of bacteria that affects some surgical patients. He explained that it wasn’t the same as the TB that is contagious and effects the lungs but comes from the dirt and other unidentified sources. I assured him that I don’t garden or come into a lot of contact with soil. I left with three prescriptions of strong antibiotics.
    I really had high hopes that this doctor would soon know what was making me so ill. I remember crying in his office and asking him to please help me get rid of all the ugly lumps. He assured me that he would do everything he could.

    Fast forward a month or so later. No progress. All symptoms continued to persist. The unsightly lumps would no go away. I spoke on the phone with the infectious disease physician several times and returned to his office for a follow-up visit. I learned on that visit that they had found nothing. We still didn’t know why I was sick. I was exhausted. I was frightened. I felt helpless and hopeless. The doctor then decided that he wanted me to go back to my surgeon and have him cut samples of the lumps from my face and neck. He asked that my husband immediately drive the specimens to the hospital to specialty lab analysts and doctors. Great, I responded, yet more scars! I was asked to discontinue all antibiotics for two weeks so that they could get an accurate sample.

    I drove to the hospital after the appointment and registered at the admitting office. It was pretty strange to register your excised lumps for admittance.

    I arrived back at the office of my surgeon two weeks later. Again, I took that long walk down the hall of his office, to the back, to the surgery chair. Once more I felt panic. I still wasn’t over the last fully-alert surgical session with him. Again, I remember being asked to lie down on the surgical table. I remember being scrubbed and painted with iodine. I remember the sharp needles in my face and neck. I remember the pressure from the scalpel. I remember sharp pains on occasion and flinching. I remember the pulling. I remember the sound of the snips of the scissors. I remember shaking uncontrollably. I remember my fear. Again, I left office blank and almost lifeless. Thankfully, this time my husband was with me.

    We then drove straight to the hospital and dropped off the large bag of specimen cups. Drove home and I went to bed. The next few days are foggy. I don’t know why. I just remember removing the bandage and looking at my neck. It looked like someone had cut it with a chainsaw. The incision was about five inches long! This was going to be one UGLY scar. At that point major depression set in. I knew, that I would never be the same. I knew that there was no fixing this scar. I felt ugly for one of the first times in my life. Totally, absolutely UGLY! This was totally life-altering.

    Weeks went by without hearing from the doctor about the biopsy. When I did hear from him, there was no definite diagnosis. Just statements like fibrous matter, fluid filled with inflammation… blah, blah, blah. More medication. No diagnosis.

    About a month-and-a-half or two months after the biopsy, I got a call from the infectious disease doctor. The cultures from my biopsy had finally started growing something. They weren’t sure what it was but it was definitely an atypical mycobacteria, but they didn’t know the strain. He then changed some of the medication, again. And, I was left with the promise that he would call me within two weeks with the results. All of the symptoms continued to persist. And, though most of the lumps had been removed from my neck during the biopsy, two more were now growing on my neck. Enough already!

    Months passed and I finally got a diagnosis on the bacteria. It was classified as mycobacterium fortitum. It’s, as the physician suspected, an bacteria kind to TB. He stated that it entered during the surgery, but he didn’t know how. The bad news was that it’s very hard to kill, many times more than a year. I was loaded up with three different antibiotics. The report showed that the bacteria wasn’t resistant to a lot of the medication that I had been taking for months.
    Finally, a diagnosis. Things will be good now.

    After taking the medication for about a month, with no success, I got yet another call from the infectious disease doctor. The culture was still growing and the medication would have to be altered. I would require IV therapy. This came about a week before Christmas. Drew was out-of-town for the shuttle landing and I was all alone.

    The very next day, I got a call from a home health company stating that they had received orders to start my IV’s. I had absolutely no idea about the medication, the procedure or how long this would last.

    Four days before Christmas, the home health nurse arrived. She was a very kind lady. Medicine was delivered…a huge shopping bag full of IV meds that must be refrigerated. Along with the medication, they delivered a rolling IV stand and bags and bags of other supplies (IVs, IV tubes, IV extensions, syringes and hypodermic needles, gauze, tape, boxes of syringes filled with Saline, boxes of syringes filled with Hyperin, alcohol swabs, dressing change kits.. it was mind boggling.) The nurse explained the process to me. She explained that the doctor had ordered twelve-weeks of therapy to be administered every day, with one of the medicines being administered twice a day. My heart sunk. Twelve weeks of being tied to an IV pole. Additionally, the nurses would come twice a week to change my dressing, check my vitals and run blood tests. WAIT, I thought, who is going to run all the IVs everyday? I later learned, that someone would be ME!

    The nurse had me sit at my breakfast room table where she looked at my arms for veins, found her victim and cleansed the area. She then proceeded to run an IV line in my right arm. I felt hot, my face was burning, I felt nauseous, I felt dizzy, I fainted. The line was run and I had to lie down a while before we could proceed with the first IV. To add insult to the injury, my six-year-old stepdaughter was home alone with me. My husband was still in California for the shuttle landing. I allowed his ex to keep her one extra day, but she had called and asked that I pick her up because it was our time and she had some Christmas shopping and wrapping to do and she couldn’t do it with the child there. I explained to her that I was to have IVs run and would be here alone but, her shopping and wrapping needed to be done!

    The nurse was very thorough with her instructions. My head was spinning there were so many steps to take for each bag. One of the bags was labeled that it took four hours to administered, one was labeled that it took an hour to administer with the smallest bag taking thirty minutes but had to be run twice a day. I was shown how to open the IV bag, how to attach the tube to the medicine, how to set the dial for drips on the tube, how to run the air from the IV line (with the statement, don’t have large amounts of air in the line or it will kill you.. YIKES). I was then instructed on how to clean the tube in my arm, told to run a saline syringe first and attach the IV tube in my arm to the IV tube on the medication and various other instructions. Again, my head was swimming.

    The two hour bag took over four hours to complete. At that time, the process started again for the second medication, open meds, attach IV line, set dial on line, run air from tubes, clean IV line on arm, saline syringe and run the medication. The one hour bag took over two hours to run. THIS STUFF IS GOING TO RUN AND RUIN MY LIFE.

    Final bag. WHOOPIE! Same process. The nurse had me do it all this time, reminding me that I would be doing this process everyday, several times a day for twelve weeks. I got through the process almost flawlessly. I was slow, I had to think about each step, but I got through it. Thirty minute bag took over an hour to run. Wow, eight hours after the nurse walked through the door we were finally finished. She asked me to repeat the process for her again, we went through the entire book of paperwork and she left.

    Just in time for me to run the evening IV bag again.

    The first week on the medication was an absolutely nightmare! I fumbled through the process, was sore from the IV line, tried to entertain a six-year-old and, to make matters worse, just a couple of days before Christmas we learned that the shuttle was delayed and Drew had to stay an extra day, at least and may not make it home for Christmas. My daughter was with her father for his holiday visitation. I was heartbroken. My first Christmas with my husband as husband-and-wife and he may not make it home. My stepdaughter and I may have to spend Christmas alone and stuck to an IV pole. The medication made me dizzy, nauseous and gave me extreme diarrhea. I was prescribed medication for the diarrhea. Great, more medication. I was a blithering lunatic.

    Luckily, the shuttle landed in Florida and my husband made it home in the evening of the 23rd. Talk about a close call.

    We had a great holiday, despite all the setbacks.

    Week two of IV my arm was hurting. The hurt went all the way up my arm. The IV line ran about four to six inches up my arm and it was throbbing. The medication took even longer to run and the IV port was leaking. When the nurse visited, she had to start a new line. Luckily, no dizziness or fainting spell this time. She had trouble finding a vein and had to stick me three times. By this time, you think I would be immune to the pricks, given the fact that they had to draw blood each visit. That wasn’t the case though. After she got a line in, she told me it was a temporary, and that they would have to come back and change it the next day. GREAT! After the line was run, she then had to find a vein to draw blood. Another three sticks. By this time, I feel like a pin cushion.

    Next day, nurses arrive to run the IV line, two of them. Only two sticks this time. Success. My blood pressure was elevated. Could be the stress from the needles?
    The next four nurse visits – high blood pressure.

    A couple of weeks passed and the IV line was starting to hurt again. My arm ached. It throbbed. It even hurt to touch the skin. At that time, the doctor decided that I needed to go to the hospital. They would run a direct port in my neck, directly into one of my main veins down by my heart and then tunnel the other portion of the line through my chest and the IV ports would come out just above my right nipple. WHAT NEXT? By this time, I’m beyond hysterical. Do I have a JOB complex? I was instructed to show up at the hospital the next day.
    Traditionally, I’m not frightened by doctors or surgical procedures. That has now changed. When I arrived at the hospital I was a nervous wreck. I had to once again go to the admitting department and register for admittance. At least this time I would be visiting, not just my body parts. The wait seemed forever, though in retrospect it wasn’t that long. I was then asked to go to the radiology department. Again, wait. When my name was called I was walked back to the special radiologic-surgery suite. I was briefed on the procedure, bombarded with questions and prepped for surgery. Again, I would have surgery, while alert. I was shaking so badly I felt that I would shake from the table. I had several people speak to me on the table… a nurse, a radiologist, the surgeon. The surgeon suggested that they give me a little sedative to calm my anxiety. WOW, what a theory! The medicine immediately made me groggy and things seemed to be okay now. The procedure didn’t take very long. I remember the large X-ray machine over me, my chest x-ray with heart and a few instructions.. turn your head this way, etc. The procedure itself didn’t take long at all. Less than 15 minutes. When they were finished I looked up at the x-ray and saw the tube sitting right beside my heart.

    Since I was sedated a little, they had me stay on the bed for an hour. I was then told I could dress and go home. I had a large patch over the right side of my chest and breast. I drove home and went to bed.

    That evening I experience a lot of discomfort. My shoulder and chest hurt and I had two IV tubes hanging out over my right breast. I couldn’t sleep. It hurt to move. Around midnight I started to itch on my right arm and leg. Soon I was itching all over. Bumps appeared all over my body. The bumps turned into small blisters. They were even in my mouth, my vagina and my anus. It was hell. I did managed to get about two hours sleep. When I woke Saturday morning, I was covered in blisters. I started taking benedryl. No help. Sunday morning, blisters worse. Called the doctor’s answering service. Nurse called back and requested that I go to the emergency room.

    Drove to emergency room. Not much of a wait. I was miserable. Itching, hurting, chest sore. The emergency room doctor came in and spent two minutes with me. He stated that he the pattern of the blisters on my back suggested a virus. I explained that I had just had surgery and the blisters appeared the night of the surgery. He again stated that it was a virus. But he gave me a prescription for Allegra (great, even more meds) he called my infectious disease physician who asked me to visit a dermatologist on Monday.

    Monday no break of blisters. Lucikly got an appointment with my dermatologist, who had just six months earlier removed a skin cancer from my back. She is a good doctor, I was happy that she could see me. Drove myself to the doctor’s office. She took one look at me and immediately stated that I had had a drug reaction. She gave me a prescription for prednisone and explained that it would lessen my immune system, a prescription for a lotion and an antihistime to help me sleep. She recommended that I call my internal medicine doctor to discuss the findings.
    I drove home and called the Internal Medicine Doctor, after I stopped to get my prescriptions. He instructed me to stop using all the IVs until the blisters were gone and then we would add only one of the IV medications back at a time until so that we could rule them out individually even though I had been taking all of the medications for five weeks prior.

    The rash was gone in three days and we added one IV back at a time. On day three, we got to the medication that is to be run twice a day. I had accidently wet the bandage on my chest that day and I decided that I would change it myself. I had seen the nurses do it sometimes twice a week for five weeks. I gently removed the bandage, cleaned the area with the alcohol, bathed the body with iodine and placed a new dry bandage. I ran my third IV that day. The next day more blisters. I took my prednisone and other medications and they left.

    Tomorrow is my last day of IV thearpy. WHIPPEE. Now, I only have to take oral antibiotics for months again. OH WELL. Funnier posts later.

  2. Duane says:

    Oh man, sorry you’ve had such a hard time. I hope my surgery goes better than the stuff you’ve been through…

  3. Hesty says:

    Don’t worry dude, the second time is the charm, speaking from personal experience. The first time, I had a neck lump that looks really stupid. The surgeon cannot book an operating room soon enough, I had to wait about 3 months between my first consultation and the surgery date. Of course the lump grew bigger in the meantime. I was seriously worried that the lump would burst leaving a hole in my neck. 🙂

    After the first surgery, they still cannot tell me what it was or what caused it. It seemed like they only removed the liquid inside the lump and patched me up again.

    A couple years later, the lump came back albeit not growing as fast. I was pissed off because they didn’t fix it right the first time. I thought “What does this mean? I have to come back every couple years to get my throat cut up? Why don’t you guys just put a zipper there?”. Anyway, they removed a “rubbery pouch” from inside my neck and it hasn’t come back since. To this day, they still haven’t figured out what it is. I hope it’s nothing important. 😀

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