Sunday, 6 March 2016

1.5 Year Update - [After Second Operation]

Greetings all, I trust you are keeping well.  Well, it's been 6 months since my last blog so it is time to send another update as I am due to update Dr. Umar this week. 

In summary, the progress theme seems to be steady, surely.  The last blast of steroids made a more visible difference than before and there is some more (albeit it modest) hair growth.  I have another session of my beloved steroids this week, so will update if any noticeable changes occurs shortly after that, otherwise I think 6months will be the next update, who knows what I will be able to report by then...

For now, judge for yourself by looking at the pictures below, however my honest opinion is that it looks better each time I blog and is the best it's looked so far and looking more natural as time passes.  Still not fully there yet, but looks calmer than the last time I posted and still heading in the right direction - Take a look:












Remember, you can click these images to see them larger.

Until next time, peace, and good fortune, excellent health and lots of other good stuff to you all.

Patient.AKN.UK




Sunday, 20 September 2015

1 Year Update - [After Second Operation]

Howdy People, it's been a while I know but...  I figured the next update would be better aligned to my next update to Dr. Umar which is September, soooo... here it is...

During July, I had an appointment to have the biopsy and my first of three rounds of steroids.  Upon arrival for my appointment the Dermatologist very kindly decline to perform the biopsy.  She told me she was happy to provide the steroids which she did, but then questioned why a biopsy was required.  I told her that it was required by Dr. Umar and needed in order to understand if there were any complications.  After asking her if she had contacted Dr. Umar on this point (as per my phone calls and confirmed emails) she said it's nothing to do with Dr. Umar as I was now her patient and she was best qualified to advise me from this point forwards and said she felt the steroids were sufficient, but the biopsy was unnecessary.  I respectfully maintained that Dr. Umar was still my Dermatologist and he needed the biopsy, this resulted in the Dr. stating I was free to seek another Dr. if I didn't want her opinion.  I politely asked upon which grounds she concluded that a biopsy was not necessary and she said she would seek the opinion of one of the other partners.  I agreed to have the the steroids the same say and told her I would be back in touch regarding the decision for the biopsy.  A few days later, I then went on a much needed holiday. 

After two fabulous weeks in the sun and well rested, I took up the challenge and asked again about the biopsy and got a very polite, thanks for asking again, but still NO!  I then started contacting other consultants from the reference list I received from my local Dr. and had an appointment booked with a much more helpful Dr. (having explained the pantomime that had taken place).  All was set and I was due to go the difficult Dr. again, but only for round two of my steroids and as if by magic, she had a complete change of heart, was very friendly, all smiles and said "OK, so today we first take the biopsy from the left side side, then give you steroids in the right side".  Huh (I thought)?  Did that just happen?  Did I dream the last month's conversation with this same Dr who was adamant not to give me a biopsy?  All very strange.  She was extremely helpful, calm and couldn't do enough to help, perhaps I just caught her on a bad day last time? 

Anyways, I got the results this week!  They confirmed that there was no re-occurrence of Akne Keloidalis Nuchae which was my biggest relief.  They did, however confirm that there was hypertrophy.  This explains the thickening of the skin on some parts of my scar.  This confirms exactly what Dr. Umar believed was the case and is what he believes is hampering the expected hair growth. 

I am to wait for the progress of the final of the three phases of steroids before being clear on the next course of action.  My wish is that the steroids will flatten the hypertophy sufficiently such that the hair that is still yet to come through the surface will grow and I can close this chapter.  I am so close, but still not quite there, so I remain patient.


See below for my current pictures:

Notice the two blue stitches below from the biopsy (one taken with a hair follicle, one taken without):


Although not 100% flat, it is much flatter than it was even after only the first shot of steroids.  I have since had a second and there is one more to go, so I anticipate the scar will become much flatter still.




As I received the biopsy one the left side, no steroids were given an the left as there would be risk of infection.  I did however receive the steroids to the right hand side of the scar.  These pictures were taken a week after the steroids, notice the flatness on the right compared to the left side.






More to follow after the final round of steroids is complete and I have given Dr. Umar my next progress report (December).


Until then, stay tuned.


Patient-AKN-UK.



Friday, 10 July 2015

9 Month Update - [After Second Operation]

Let's get straight into it this month and go straight to the update.  The progress since 3 months ago seems to be minimal in terms of hair growth.  What had previously started to grow has continued and got longer, but nothing more in terms of overall coverage.  There are a few new sproutlings, but barely visible to the eye (and not visible to the camera), however I can feel them breaking the skin surface like sharp little spears, they are definitely there.

I recently had a very meaningful conversation with Dr. Umar re: my progress.  Whilst it was agreed that AKN had been successfully removed, the aesthetic improvements were not yet as we had hoped.  Dr. Umar explained that I may have developed 'hypertrophy' which means some of the scar is harder and thicker than the rest and slightly raised.  This results in limited or slowed hair growth as the hair struggles to push through the tougher skin.  As a result, I have been advised to have:

1) a 2-3mm punch biopsy - For further investigation
2) 3x phases of intralesional steroid injections of Kenolog (triamcinolone) 4lmg/cc - 3 weeks apart


The plan is that this will flatten the scar and thus allow more hair to grow through the skin surface, however we will re-asses after the steroids and biopsy before deciding a way forward.  Take a look at the current status below:














I have my appointment with my local Dr. (under the direction of Dr. Umar) in 4 days time to take the biopsy and give the first dose of steroids, then I will go on holiday to the Caribbean.  I will provide more regular updates during the 3x steroid phases and also when I know more about the results of the biopsy.


Until then, take care and I will share more in approximately 3 weeks time...


Patient-AKN-UK.


Sunday, 29 March 2015

6 Month Update - [After Second Operation]

Well, I wanted to write this blog first thing this morning but the clocks went forward here in Europe and I was busily glued to the television watching the Malaysian Grand Prix.  FORMULA 1 IS BACK!!!  It's a shame my boy from Britain (Lewis Hamilton) didn't win today, but let’s remember he did win last week and he got a very respectable second place today so a great start to my Sunday.


Progress:

Sooo, what's been happening with my recover?  At lasteth, mine hair hath start’d to groweth!!! (Old English meaning "at last my hair has started to grow").  Whilst the growth is modest, it is growth none-the-less, progress is progress.  It is in-keeping with my expected recovery at this stage and is the most significant and amazing update since my sutures (stitches) and bandages were removed in late December 2013.  What began as initial sproutings around 12 weeks ago, are now long, wiry, wispy hairs that I refuse to cut.  Interestingly, the first hair growth was at the exact same location where my AKN began with an acne bump that never healed (circa 1989) - I consider this a symbolic and positive indication of the healing process, as if it is somehow stamping out the ghost of the AKN at the very location where it all began.  My AKN began at the back of my head in the lower central region, approximately one third of the way up from the hair line on my lower neck (approximately where most pony-tails would grow).  There is further hair growth along the lower hair line.  The hair is now very obvious when you see it closely (within a few feet proximity).  It is mostly a clump of soft wispy hair and a lower line which gives the overall impression that my scar is ever so slightly smaller, seemingly narrower.  Perhaps I should let it grow into a pony-tail...  Why (I hear you ask)?  Simply because now, after 28 years, I can :-D

One other point of note is the general pigmentation of my scar is darker than it was and is now closer to the natural colour of my skin, all of which has come together to improve the general appearance at the back of my head.  The darker pigmentation is from the lower hair line and seems to be rising.  This is by far the most significant aesthetic improvement to date and to me is a clear indication that my recovery is heading in the right direction. 



See for yourself.  Take a look at the pictures below (click each to see larger picture):











After Care: 

Daily Routine:
It's simple, twice a day I use Rogaine Foam (known as Regaine Foam in Europe) after each shower.  I gently rub in a small amount of foam into the scar and I am ready for the day.  It makes it feel moisturised and somehow rejuvenated. 

Washing:
I have been so happy with the Burt’s Bees BaoBab More Moisture natural shampoo as recommended by Dr. Umar that I have continued to use it.  It contains a lot of natural good stuff and does not contain a lot of the usual bad stuff (feel free to read up on this topic from above link for actual details).  My hair and scalp feels cleaner and somehow more in balance than with any other product I have ever used.



Concluding Statement:

To be honest, I remain measured in my celebrations at this stage as my healing still remains a work in progress.  I celebrate being AKN free for well over a year, I celebrate no further itching, flaking or bleeding and I celebrate initial hair re-growth and pigmentation improvements.  Although measured, I am optimistic for the future healing as when observed closely, I can also see many more hairs about to break through the skin.  I anticipate that the next two blog updates (June and especially September 2015) will show the likely extent of my finished healing and it will be clear whether I will be discharged from Dr. Umar or if further treatments are required.  Until then, take care...


Patient-AKN-UK


Monday, 29 December 2014

3 Month Update - [After Second Operation]

Seasons greetings, I hope you had a wonderful time however you chose to spend your time during Christmas.  As for me, it's been a great year, new job going well (although it's not so new anymore as I have been there over a year now), our overseas emigration also went well and my wife and children settling in nicely to our more relaxed life style.  I do however have this song annoyingly buzzing around in my head that I heard which somehow reminds me of the first trip to LA (I think it was playing in the Airport in Atlanta during a trip to Texas):

Roam if you want to (by the B52's)      - Is it now in your head too? hehe ;-)


As for my healing, well again it looks different to the last update, however seems to be in-keeping with expectations at this stage.  Please note the following:


Expectation:

0-2 months:  25 - 100% of implanted grafts expected to shed
2-4 months: Scar continues to heal
4-5 months: New hair will sprout in grafted area
12 months:  Should be clear the full extent of success of operation and a judgement may be taken if further grafts or any other treatment might be required
18 months:  Longest expected time for full hair growth to be present


What Actually Happened:

  • Scar has shed 95% of grafted implants (as expected)
  • Scar appears mostly flat, however there are some small lumps near the top - These are not obvious when viewed standing close to me, but can be seen if very closely observed or via close up photos
  • Pigmentation continues to gradually return
  • Impact to my donor area seems minimal as can be seen (or not seen) from the first 4x photos
  • Donor area seems to have completely healed and is no longer sensitive to the touch - There were some small hair bumps at one stage, but the prescribed Erythromycin Topical Solution administered twice per day took care of those in short order
  • Things seem on track at this stage and the scar's appearance is comparable to what it was prior to the second operation


So for now I continue to use Dr. Umar's special Minoxodil solution on my scar/grafted area twice per day and continue to use the Burt's Bees shampoo.  I am able to swim and wear a helmet again, however I will do neither of these until well into the new year just to be safe.  I have just started occasionally laying on back again this week, something I have not done since the operation (as instructed).


See below for this episodes's picture updates:

The first four pictures shows the aesthetic impact and is how most people see my scar under usual daily circumstances.  They also show the size of my scar in relation to the size of my head:







Picture below shows a close up of the scar which is mostly flat.  Also notice how the lumps near the top are not obvious from this angle and proximity:




This photo angle shows the slight lumps near the top of the ridge of the scar - Again note that whilst they present, they are not very noticeable or immediately obvious if you see me in person:




Left and right profile:




And a final couple of close up shots:




Well, that's it for 2014.  I hope that 2015 will be an excellent year for you in all the positive things you wish to do.  Next update in 3 months time (in-keeping with my updates due to Dr. Umar), so I will blog again in the Spring of 2015 (March), 'til then, take care.

Patient-AKN-UK.


Friday, 3 October 2014

2 Week Update - [After Second Operation]

Greetings!

I have but one, small question...  Where is Frankenstein?  (the author pauses to ponder for a moment)...  Where de did he go?  He sure aint here...  I am a HUMAN BEING again, the swelling has significantly subsided, the scabs, the dried blood has all gone.  There is no discomfort, however my donar area (the area from which the hair was removed) is still a little tender.  I moisturise it with Bacitracin gel (my good ole friend from the first operation) as and when it gets dry.  The recipient area (the area that received the grafted hair e.g. the scar area from my first AKN oepration), is still slightly swollen but not excessively so, almost back to how it was prior to the second operation.  No more Frankenstein here, be gone with you sir, be gone!!! hehe

My care regime is now very simple.  From the begining, I had a strict regime of pain killers, antibiotics, Bacitracin and Sonafine mixed together, Dr. Umar's specially mixed Minoxidil product, distilled water and Burt's Bees Shampoo (this stuff smells ssssssooooo good, I could almost drink it...  well, almost).  Compared to the first operation, this 2 week regime was an absolute breeze (so easy).  Now, all I do is use the special Dr. Umar mix of Minoxidil first thing in the morning and last thing at night, that's it!  Sleeping does however continue to be on my sides and I must remain out of direct sunlight, not go swimming, where a helmet etc. for a next couple of months.  Again, this is a small and easily achieavable sacrifice.

Hair is now visibly present and growing from a good portion of the recipient area.  I beleive that it can take upto 2 years for the hair to grow, so what I am seeing in just 2 weeks is truly amazing!  Anyways, enough cyber-babble and as always, the pictures speak loudest.  So, see below my current progress pictures (with which I am well pleased):

*** CLICK EACH PICTURE TO SEE A LARGER MORE DETAILED IMAGE ***








*** CLICK EACH PICTURE TO SEE A LARGER MORE DETAILED IMAGE ***


My blog is getting some serious hits, somehow people are reading it and taking an interest.  I hope to at the very least spread the word and inform other suffers of this particular option that I chose to use.  What people do once they know is of course their decision, but it would be a social injustice if I knew of a cure and kept it to myself.  I just wish this procedure was available 20 years ago...
  I think Dr. Umar should do a tour of the UK because there are ssssssoooooo many others desperatly seeking a solution and are tired of the empty promises of the many "Guaranteed Solution" adverts so prevalent in the big cities of Britain.

Next update in 3 months (in line with my next update schedule to Dr. Umar).  Unitl then, take care.


Peace and prosperity,


Patient-AKN-UK.

Monday, 22 September 2014

The 2nd Operation - Follicle Unit Extraction (FUE) - [Making it Pretty]


PRIOR TO DEPARTURE:

20-SEP-14:

I had experienced a gout attack the day before and was uncertain whether I could still proceed with the operation, but after checking with Dr. Umar and my local doctor, both confirmed no issues.  So, that was it...  I was still going to be able to return to to Los Angles...  WOOHOO!!!  Me and my sore ankle ;-)

Pictures prior to operation:










DEPARTURE DAY:

23-SEP-14:

Left work in good time and caught taxi, only to be monumentally delayed in dreadful traffic.  I've never missed a flight in my entire life until today.  I missed the closure time by 25mins, but thankfully the lovely lady on the British Airways desk took pity on me (knowing the issues with traffic and seeing me hobbling on crutches) and put me on the next flight to London without charge and arranged special assistance as it was difficult to walk.


24-SEP-14:

Today is 'fly to Los Angeles day!!!' :-D  Superfast breakfast, then a taxi to the airport where I met Mom.  We flew on the upper deck of the new AirBus A380, how incredibly civilised indeed.  Just 10.5hrs later, we arrived at Los Angeles (LAX), where the sky was deep blue, almost no clouds and the heat was relentless.  We picked up the hire car, then checked into the hotel for a quick shower.  Next important step was to hand in the mountain (and I do mean MOUNTAIN) of pre-operation paperwork to FineTouch Dermatology.  The always helpful lady on the front desk thanked me for it, checked it and said with a Californian smile, just a couple more bits of paperwork for you to fill out Mr. XXX.  I'm sure see must have seen the smile melt from my face as I felt I had over dosed on paperwork. 

I saw the prototype design of Dr. Umar's new surgery, WOW, very, very impressive and well deserved for the hard pioneering work he has accomplished.  I look forward to seeing it someday in the future.

A quick hello to Dr. Umar, then back to the hotel to relax and have dinner.  The drive back to the hotel was a pleasant experience with palm trees gently waving to me as I passed and the deep blue of the Pacific Ocean shimmering to my right.


OPERATION DAY:

25-SEP-14 (Operation Day):

13:00hrs:
After starting my day listening to typical West Coast music (Ice Cube) and a very average breakfast, I went for a walk with Mom, then arrived promptly at 13:00hrs ready for my operation.  This time I went upto the Pent House and met two additional and lovely members of Dr. Umar's team.  They were super friendly, helpful, patient and interesting.  Above all, both were very proffesional at all times.  As I settled down, I was asked (yes, you guessed it), to complete more paperwork.  I took a deep breath and duly complied.

All preoperation checks were completed, then I changed into a gown ready for theatre.


14:00hrs

Dr. Umar arrived, greeted me and then got ready for the operation.  I made certain I went to the toilet just before going into theatre, so I had nothing to fear right?   Wrong, about an hour into the operation I had to go, just had to go, I apologised and Dr. Umar explained it was the medication I had taken, phew...

One by one individual hairs were removed from the donor area, an area that was shaved into an... interesting design lol.  These were put in a petri dish and later inserted into pre-cut slits on my scarwhere the AKN had been removed 10months earlier.

I was so comfortably on the operating table, that I must have fallen asleep during the operation.  I know this because I awoke to a jolly good telling off from Dr. Umar "Keep still, keep still, you must keep still, stop moving and you have to keep still!!!".  To be honest I had no idea what was going on at that point, then I got my senses and remembered I was in theatre and had previously been instructed to warn the team before I move.  I was sweetly enjoying a deep sleep and must have moved to make myself even more comfortably, this did not go down well with Dr. Umar.  With this reprimand, I somehow snapped back to my senses pretty quickly, apologised and made absolutly certain I kept perfectly still, or at least gave warning before moving... oh and of course, I made absolutely sure I stayed awake after that! ;-)  No harm done and the operation was a success.


19:40hrs:

Operation is over and I feel elated.  The operation lasted 5hrs and involved approximately 500 grafts.  I look like a psycho with my medical style hair cut, but I frankly couldn't care less, I have a chance to be 'normal' again, so I proceed with confidence.


THE NEXT DAY:

26-SEP-14:

All must have gone well as no need for a check up.  Mom and I went for a drive to Santa Monica and picked up the plethora of required medication from the pharmacy.  An early night, then ready for the flight home in the morning.

I have been instructucted to sleep on my sides.  Here is how my pillows looked first thing in the morning:




And this is what I looked like the morning after the operation and pior to cleaning (notice the black dots on my old scar, these are the implanted hairs taken from the sides and back of my head):







And same shots, this time after tablets taken and all medication has been applied:






HEADING HOME:

27-SEP-14:

Heading home.  Returned the hire car, got to the airport and returned to the UK.  Said my fairwells to Mom, then waited for 3hrs before begining to board for my European flight home.  Upon arrival, I was greeted by my lovely wife and children 2hrs later and grinned at the comments from my children.  My daughter (6yrs) said "Daddy, the back of your head doesn't look the same, it doesn't look very nice now".  My son (4yrs) said Daddy your head has shrunk and your ears stick out".  I laughed so hard, it was sooooo good to be back.  Call to Mom to make sure she got home alright and then a shower, some dinner and to bed.


28-SEP-14:

First full day back home.  I look less like Frankestein as each day passes, but joking aside, the progress is clear to see.  Once the swelling subsides and the scabs are gone, I am optimisitic of the results.  Follow with me and see how things progress.


Thanks for listening, next update in 2 weeks...