Hello, 14 North!

My room in the hospital this time is located in Greenberg 14 North, the GI Recovery Unit. I'm now on the 14th floor (top floor) of NY Presbyterian, in a newly-built unit of single-patient rooms. Everything is brand new, super high ceilings, large LCD TV, mini-fridge, private bathroom with shower, and a huge window looking out at the East River.

Discharged From the Hospital

After 3 days in the hospital, I was discharged and sent home to start my pureed food diet.

Roux-en-Y Gastric Bypass

My surgery day. I'm getting a laparoscopic Roux-en-Y Gastric Bypass. Not nervous at all. Extreme confidence in my surgeon and the medical team, as well as confidence in the hospital. Woke up with just a little bit of pain, as the surgery was minimally invasive.

Cardiac MRI

IT'S A BOY!! Actually, it's my heart :) I got my cardiac MRI done last night. Had to be forcibly squeezed into the MRI machine, and stayed stuck in there for about an hour as they blasted magnetic radiation through my jolly body :) 

Odd feeling throughout the entire process...there were something on both sides of my hips when I was in the MRI machine that gave me a shock and made my hips and thighs tingle every time they took a scan. They took 1,499 scans, so I was a bit buzzed when it was all over. I think I now know how Magneto from X-Men feels, LOL.

1,499 images total; 25 images per second = 59 second video. Enjoy!

Surgical Staple Removal

THE NEW YORK HOSPITAL
06-26-95

KO, KANG WEI

2492702



PREOPERATIVE DIAGNOSIS: STATUS POST EXCISION OF EXTENSIVE HEMANGIOMA OF THE LEFT POSTERIOR THIGH AND CALF, WITH SPLIT-THICKNESS SKIN GRAFT.

POSTOPERATIVE DIAGNOSIS: SAME.

OPERATION:

1. DRESSING CHANGE LEFT LEG.
2. REMOVAL OF SURGICAL STAPLES.
3. RANGE OF MOTION LEFT LEG.

SURGEON: LLOYD HOFFMAN, M.D.

CONSULTANT:

ASSISTANT: 

ANESTHESIA: INTRAVENOUS SEDATION.

ANESTHESIOLOGIST:

INDICATIONS:
The patient is status post excision of a large hemangioma which required extensive grafting.  The patient has numerous surgical staples which could not be removed without undue pain as an office procedure.  The patient's knee is getting stiff, and he requires closed manipulation of the knee.

PROCEDURE:
The patient was taken to the operating room where successful intravenous sedation was achieved.  The dressing on the left leg was changed, and there was 100% take of the graft.  There were small areas of hypertrophic granulation tissue, and these were cauterized with silver nitrate.

The surgical staples were then removed, and Bacitracin was applied.  The left hip, knee and ankle were then vigorously manipulated, and full range of motion was achieved.  A sterile dressing was applied.  The patient transported to the recovery room, having tolerated the procedure well.

LLOYD HOFFMAN, M.D.

T:8700  J:87001  D:06/27/95  T:06/29/95  RR/FJP  NY087001.629

Surgical Pathology Report

 Surgical Pathology - 1995-05-26  08:12

MICROSOCOPIC DESCRIPTION:

1. The section show skin with an extensive vascular lesion involving all levels of the dermis and subcutis. The lesion consists of vascular spaces of variable diameter, most of which have thin walls. The vascular spaces are separated by sclerotic stroma throughout much of the specimen. There is no significant cytologic atypia of the vascular endothelial cells, and papillary structures are not identified. The lesion extends to the margins of the specimen.

DIAGNOSIS:

1. HEMANGIOMA WITH EXTENSIVE INVOLVEMENT OF THE DERMIS AND SUBCUTIS, SEE NOTE. (T-01000; T-02800; M-91200)  ICD9-V72.6  AND 216.90

NOTE: 

THE PREVIOUS BIOPSY (D91-4031), WAS REVIEWED. THAT SPECIMEN ALSO REPRESENTS A HEMANGIOMA WITH EXTENSIVE INVOLVEMENT OF THE PAPILLARY AND UPPER RETICULAR DERMIS. IF THIS LESION INVOLVES THE UNDERLYING SKELETAL MUSCLE OF BONE IT MAY REPRESENT A DIFFUSE HEMANGIOMA (ANGIOMATOSIS). CLINICAL-PATHOLOGIC CORRELATION IS NECESSARY.

Jon A. Reed, M.D./N. Scott McNutt, M.D.

JAR/NSM/lt
06/15/95
doc#6186S
doc#9238D
Surgical pathology billing 23, 025
TDWD: Dx. discussed with Dr. Hoffman, 6/14/95, 4 pm - JAR.

Status: Pending
Accno: CISWANGPATH-S95-12120

NYC:1001795690 NYP/WC:002492702 WMC:100554653 NYP/Q:03197633 NYPMG/QNS:501293 - KO, KANG WEI - Oct 24, 1976 - 48y - M

Hemangioma Removal

THE NEW YORK HOSPITAL
05-25-95

KO, KANG WEI

249-27-02



PREOPERATIVE DIAGNOSIS: GIANT HEMANGIOMA, LEFT THIGH AND LOWER LEG.

POSTOPERATIVE DIAGNOSIS: SAME.

OPERATION:

1. EXCISION OF MASSIVE HEMANGIOMA, LEFT THIGH AND LEFT LOWER LEG.
2. SPLIT THICKNESS SKIN GRAFT GREATER THAN 200 SQ. CENTIMETERS.

SURGEON: LLOYD HOFFMAN, M.D.

ASSISTANT: SCHWARTZ, M.D.

ANESTHESIA: GENERAL ENDOTRACHEAL ANESTHESIA.

ANESTHESIOLOGIST:

INDICATIONS:
The patient is a 17 year old Asian male who has a massive hemangioma of the left posterior thigh and posterior calf as well as the popliteal fossa.  This hemangioma has been present since birth.  It was treated with herbal wraps and the patient subsequently developed a burn over the skin.  This area continually becomes infected and has often bled.  MRI reveals a deep hemangioma and the angiogram revealed normal vessels.

PROCEDURE:
The patient was taken to the Operating Room where he underwent extensive preoperative preparation including Foley catheterization, IV lines, warming blankets and he was rotated into position following the induction of endotracheal anesthesia. The patient is a massive individual weighing greater than 112 kilos.

The entire leg and left upper thigh and buttocks were prepped and draped in the usual fashion.  Consideration was given to the latissmus dorsi flap and this area was prepped in as well.  A tourniquet was applied to the left upper thigh and the left leg was exsanguinated as fully as possible.  The tourniquet was inflated to 350 mmHg.

Incision was designed involving the medial aspect of the upper thigh extending inferiorly encompassing a large ellipse of involved skin and then proceeding inferiorly to a straight line again.  The incision was made using a 10 blade and skin flaps were elevated.  Even the normal appearing skin was involved with the hemangiomatous component.  Extensive dissection was carried out sharply and bluntly to remove hemangioma from between muscle groups as well as fascia.  The semimembranosus and semitendonosus and gracilis muscles were dissected out as the popliteal fossa was crossed and the gastroc muscles came into view.  The fascia was removed with the specimen and hemostatis was achieved.  Following excision of this large mass and submission to Pathology, the remaining skin was trimmed using the scissors.

The defect measured approximately 12 centimeters in width by 48 centimeters in length.  The decision was not to use the flap and skin graft this area.  The dermis was then tacked down to muscle and skin harvested with the Padgett dermatome from the upper thigh and buttock area.

The skin was meshed and secured with staples and wet clips.  Carefully molded splint was prepared and the graft secured with moist cotton and Xeroform.

The patient tolerated this procedure well and was transferred to the Recovery area in stable condition.  The sponge and instrument counts were correct.  The estimated blood loss was 200 cc.

DICTATED BY: LLOYD HOFFMAN, M.D.

LH/FVB/RR

TAPE: 6714

D: 05-26-95

T: 05-31-95

531NY03.FVB