Monday, June 16, 2014

Healing my keloid scar

It has been almost two years since my cardiac surgery. At my one-year visit my surgeon was not happy with my sternal incision. He thought I was too young to go through life with an ugly scar. He wanted me to see a plastic surgeon, but I thought it was too soon and was still mentally dealing with a lot of post-traumatic stress - so the idea of going for (potentially) more surgery freaked me out.
At my most recent visit, I was ready. I asked for the referral to the plastic surgeon and he readily agreed.

I sort of blame my keloid formation on a few things: 1) genetics. My mom gets them, my brother gets them, and who knows who else. I even had small keloids where my ear cartilage and naval were pierced. 2) my own stubborn attitude. Since working for a short time in paediatric cardiology, I know that they don't use staples on the sternal incisions - so naturally I refused to allow them to use staples on me. I happen to be persuasive enough to get my way. I also haggled on the number of chest tubes they could use.

Originally I had one keloid form along the bottom 1/3 of the incision, right where a bra crosses. It is itchy, painful and ugly as hell. I knew from day 1 it was forming and there is nothing I could do to stop it. From Noah's surgery, I knew that massage is helpful and I massaged the crap out of it - but to no avail. It still looked awful.

Over the past year, the upper 1/3 of the incision developed keloids that look more like blisters. They are itchy, but less painful and red.  As well, one of my chest tube sites is a keloid too. It doesn't hurt but it is ugly and red. My pacemaker site also has a thickened scar that he could treat, except when it's time to change the battery in 8 years, they will have to go back into that site so there is no point treating it (I say battery change, but really they change the whole pacemaker).

The middle 2/3's is perfect! If it could all have looked like this I would have been very happy!

So I saw the plastic surgeon a few weeks ago. Luckily, I was informed that none of this would cost me anything because it was a referral by my cardiac surgeon to fix his work - it is all covered by OHIP...thank goodness for our healthcare system!). Because the keloids formed on their own (and not in response to an infection), surgery won't help because after he cut the keloids out, I likely would just form new ones. That left me with only one option: injections. He will try steroid injections first, every 6-8 weeks. If I am not responsive there is a skin cancer drug that works on keloids, but he wants to try the steroids first. The steroid is injected right into the keloid. I have read online that this hurts a lot. I am terrified, but he promised it would get rid of the itching, so I am going to try. Apparently it will flatten out the keloid, and minimize the redness. It will not make the scar go away (obviously), but will make it look more white. There is a risk of micro vessels forming on the surface, but anything is better than what it is now.

I was told that tattoos are out of the picture - I was hoping for a couple of small ones - because they would keloid as well, and that would just be ugly. Also (he didn't say this, but it is implied), breast implants are out too ;) Oh well....

Here is my before picture:

Addendum: Um that HURT. Like...a LOT. Like, really really bad. I was arching off the table and sweating profusely. So they inject the steroid, diluted with solution to freeze the area. Regardless, it hurts and you feel it going in. It feels like it is tearing the tissues apart. Surprisingly, I assumed the larger bottom keloid would be the worst, because symptomatically it is the one that bothers me the most. However, the ones on the upper 1/3 hurt the most. The higher he got on my chest, the worst it felt. There is just no tissue there to adsorb the pain! I've been assured that next time won't be so bad. To be honest, the pain is worth it. It is only for the 10 min's it took to do the procedure. It's been two days and it hasn't been itchy or painful. So that is already a billion times better than it was!

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