(MissJ: here is my revised STICKY on the MixTo procdure, with the RIGHT diagnosis finally given. You can revise the title!)Just wanted to update everyone on my third and final diagnosis for the infection I had after my MixTo procedure. This afternoon, I saw a dermatologist, who basically confirmed what my GP doc had said 2 days ago: this was STAPH. The infection goes by different names, but it is basically the same animal: a toxic staph bacteria that poisons the entire body, and can be life-threatening if not treated in a timely fashion with antibiotic.
The good news is that he also confirmed what my GP doc had said: my prognosis looks GOOD! I'll make a full recovery and (ironically) have great results from the MixTo. This dermatologist has done Fraxel laser treatments, so he is familiar with what the outcome from fractional CO2 laser and what it should look like. Seeing the pictures of my burned, raw, putrifying skin after MixTo, he said, it should NOT look like that.
Lesson learned: go to the expert for treatment in that particular field.
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My Goal – Facial Skin Rejuvenation
As many of you already know, I opted to get the MixTo Microfractional CO2 Laser skin resurfacing treatment in May of 2010. At 54, I had fine lines, a few wrinkles, and smattering of age spots on my face, neck and chest that I hoped to rejuvenate with a single treatment, which is what my doctor had said would be possible with MixTo.
Facial Rejuvenation Options: Peels, Microdermabrasion, Lasers
While the MixTo technology has been around for more than 25 years outside of the U.S., it is still relatively new here, with early-adopters in the dermatology and cosmetic surgery industries making the investment in equipment and training only in the past few years. In the right hands, MixTo can deliver highly satisfying results and noticeable improvement in skin texture after just one treatment. But before jumping on the bandwagon, each patient has to explore their medical history, problem areas, desired outcomes, and alternative treatments with their doctor first.
Chemical peels and dermabrasion can be affordable and even less aggressive treatments than laser for skin rejuvenation. There is a quick comparison of these two treatments at:
http://tinyurl.com/2bc3w26A confusing array of other types of laser, such as Fraxel, ActiveFX, SmartXide, ProFractional, and more are also possibilities to explore. You can compare various laser options here:
http://fractionalc02.com/co2laserblog/brief-overview-of-laser-devices/. Some technologies are ideal for acne scarring, others target capillaries, freckles or age spots; still others claim to eliminate fine lines and wrinkles, with visible tightening of the skin after just one treatment. It so happens that the MixTo lays claim to addressing all these issues.
How Do You Know What Treatment Is Best for You?
In general, a person's age, skin color, texture and thickness, nature of skin damage, and even one's budget will determine the best route to take for skin resurfacing. The Mayo Clinic provides an overview of what you can expect from laser skin resurfacing, in general:
http://www.mayoclinic.com/health/laser-resurfacing/MY00560/DSECTION=why-its-done In particular, this procedure does come with a set of risks that you have to be comfortable with:
http://www.mayoclinic.com/health/laser-resurfacing/MY00560/DSECTION=risks If the patient and doctor agree that MixTo laser is the best way to go, and the doctor is highly skilled in administering this treatment (as evidenced by before-and-after shots, number of patients treated, etc.,) the patient needs to be completely familiar with what the treatment entails before, during and after. The MixTo website provides an FAQ with a brief overview of the technology and what the patient can expect during and after the treatment:
http://www.mixtoskinresurfacing.com/patients/frequently_asked_questions.htmlYou need to take the information in this FAQ with a big grain of salt! I can honestly say, having gone through this procedure on my face, neck and chest with what was described as “conservative over-all, a bit more aggressive around the eyes and mouth” this is NOT a weekend procedure after which a person can blithely return to work. Nor can the patient be treated and drive themselves home; they are often administered a mild sedative to relax them prior to the procedure.
Are You Ready to Take the Plunge?
You may think that having researched all the options for skin rejuvenation and found that MixTo laser is the optimal choice, that you can relax and focus on the outcome. Here is where you need to STOP and re-evaluate the decision, as well as who will administer it.
Prior to getting any form of facial laser treatment, you will be prescribed one and possibly two medications: an acyclovir-based anti-viral to prevent the outbreak of Herpes Simplex Type I cold sores, and an antibiotic to suppress any post-treatment infection. There is disagreement in the medical community as to whether an antibiotic should be given, because too many courses of antibiotic can give rise to drug-resistant strains. In general, dermatologists prefer to prescribe an antibiotic, but my doctor, a plastic reconstructive surgeon, opted not to. He knows that I am a healthy, non-smoker, who exercises regularly, maintains my body weight, eats healthy, and has no medical pre-conditions. It seemed like a no-brainer.
I Was the “Perfect Storm” Waiting to Happen
After my MixTo laser treatment, I was sent back to my hotel room with a bag of supplies (Aquaphor, popsicle sticks to abrade the skin, and gauzes) to administer to my own post-procedure recovery. I didn't know at the time that this procedure is essentially a controlled second degree burn – the very kind of trauma that typically sends a person to a hospital to recover under professional medical care.
The MixTo laser obliterates one out of every five cells on the skin surface, leaving 4 healthy cells to pull together, tighten the skin, and speed recovery with less damage and downtime. All it takes is one destroyed cell to act as a doorway for staph to enter the body. Within 48 hours, I had an infected eye. I didn't know it at the time, but the staph bacteria was already coursing through my bloodstream and poisoning my entire body.
Over the next week, I developed a fever, which gradually rose to 103.7 F degrees. At the same time, I had all the classic symptoms of a staph infection: vomiting, diarrhea, vivid purple skin, swollen hands and feet, bright red palms, mouth sores, achy joints. In my ignorance, far from home and not knowing any general practitioner in the area, I thought I had a severe reaction to the anti-viral drug, Valtrex. I stopped taking that, but my symptoms only got worse as the days went by.
Finally, my husband insisted that I return to my surgeon for a diagnosis. My doctor was in surgery all day, but his nurse took one look at me, took some vital signs, asked the right questions, and made an executive decision: I needed antibiotic. And I needed it NOW. She hooked up an IV, and I sat for 4.5 hours in the office getting a slow drip of antibiotic plus fluids. I later learned from two other doctors, one a general practitioner, the other a dermatologist, that it was her fast action that saved my life. But my journey was far from over.
Getting the Right Diagnosis Can Save Your Life
Even after getting the IV, I was never advised to see a doctor or dermatologist right away. Instead, I relied on my surgeon to diagnose me and suggest a course of action. He erroneously speculated that I had an allergic reaction to Valtrex, but he also took a culture of my putrifying, freshly-lasered skin, and put me on a 9-day course of Keflex antibiotic – days after the infection had already set in. When the lab report came back, he could see the culprit: staphylococcus bacteria – luckily the kind that responds to antibiotic, and not the drug-resistant variety. Despite having that evidence in his hands, he still did not insist that I see a primary care physician, and I, not knowing any better, limped along, returning to my hotel room, then coming home again, thinking I was on the road to recovery.
The staph infection completely derailed my recovery from MixTo, which in itself could take up to 3 weeks for the skin to heal and recover to the point where you can appear in public (with or without makeup as your choosing). In the weeks following my MixTo treatment, I experienced hugely swollen feet and ankles (a sign that the kidney is not functioning, and lymph system is overwhelmed). I broke out in a strange rash all along my neck and chest, then my chin. My hands and bottoms of feet peeled sheets of skin, and I developed painful blisters around my lips and mouth.
I was in frequent contact with my MixTo doctor, believing his diagnoses on the fly: first the allergic reaction to Valtrex (which I reported to the manufacturer and the FDA), then Herpes Simplex Type I virus, finally candida fungus. In short, he was groping in a medical area far out of his area of expertise, but unwilling or unable to hand off the situation to a specialist. And I was doing internet research and running out and buying products to help with first one diagnosis, then the other!
At my one-month follow-up appointment with my MixTo doctor, he advised me to have a soothing, healing, medical grade oxygen facial. Not knowing any better, I agreed, and my traumatized, lasered skin was once again compromised with gels, a strong blast of O2, and facial massage with an oily concoction of herbs that resulted in even more inflammation!
Finally, the Right Diagnosis and Treatment
Five weeks after my MixTo treatment, I took it upon myself to see a GP doctor. He viewed my pictures, post-MixTo treatment, heard the progression of symptoms, and declared, “This was no drug reaction. You had Staphylococcal Scalded Skin Syndrome.
http://emedicine.medscape.com/article/788199-overview Seeing how badly you were burned from the MixTo, I would have admitted you to a burn ward of a hospital asap.” A few days later, I saw a dermatologist, who basically confirmed that opinion, saying I had a life-threatening case of Toxic Shock Syndrome
http://www.emedicinehealth.com/toxic_shock_syndrome/article_em.htm the result of a staph infection that went undiagnosed and untreated for several days. He said, “You should have been admitted to a hospital immediately when the fever and vivid skin discoloration occurred. It's likely that the nurse who administered the IV saved your life.”
Both the GP doctor and dermatologist have since told me that the best treatment for burned skin is NO treatment: just leave it alone. Except for gentle cleansers, Aquaphor, light moisturizers, and a good sunblock, I don't need a thing. They both felt the O2 facial was inappropriate and actually detrimental to my new skin. The dermatologist said it's going to take at least three months until all the redness resolves from my new skin - which is especially prominent under and around my eyes. During this time of healing, he recommends that I abstain from any makeup - just use the best sunblock I can find.
The good news is that the IV I had at my MixTo doctor's office and subsequent course of Keflex antibiotic killed the staph for good. I am personally relieved that I don't have either Herpes Simplex Type I, which would be with me for life with future outbreaks, nor candida fungus, which would've required yet another course of medication. More important, I learned that when a health crisis strikes, you simply MUST take it upon yourself to see an expert. Do NOT rely on a medical professional outside of that area, and when in doubt, see a family physician first. Priority number one is to get the right diagnosis as fast as you can, so you can begin the right treatment.
For Elective Procedures, Always Have A Plan to Handle Crises
I have shared my road to recovery and the before-and-after shots with you here, as well as at other plastic surgery message boards, in the hopes of preventing others from going willy-nilly into ANY laser skin resurfacing procedure without knowing beforehand what the procedure entails, a likely roadmap to recovery, drugs that you may need examine closely for reactions and interactions, and finally, what other options exist outside of lasers for skin rejuvenation. I would urge anyone going into an elective procedure to have a plan for a possible untoward consequence, because ultimately that alone may save your life.
I Bug U
