One thing that is noticeable though… the time at which you shocked out. There was a rapid loss from day 12 to day 20… so this might be another indicator that it is shockloss and not something else. Shockloss occurs a couple of weeks post op in the recipient area. The loss in your donor falls within this time frame. Let’s keep our fingers crossed.
sorry to be negative but if my head looked like that i would be very worried 
i hope it works out ok for you.
» sorry to be negative but if my head looked like that i would be very
» worried i hope it works out ok for you.
Just looking at this from a technicians (not doctor) point of view… One can see that the punch size was larger than what most clinics use today… 0.75mm-0.9mm. It looks over 1.0mm. (dangerous IMO and unnecessary)
This can easily be confirmed by his 1-2day post op picture that is still crusty /bloody. You just never see that sort of thing when you use smaller tools…
I want ghost readers and clinicians alike to start looking at post op photos of different clinics with FUE. You will be able to tell punch size by shear comparison of post op donor areas even in the same day.
» I think you are on the right track. Keep us updated. My thoughts are
» with you.
Thanks Jessica! I appreciate your advice and support. I will definitely update all developments. I have an appointment tomorrow to see another HT doctor to get a second opinion. I’m curious to see what he thinks.
» sorry to be negative but if my head looked like that i would be very
» worried i hope it works out ok for you.
I don’t think you are negative at all. Anyone would be very worried it this happened to them. Friday and Saturday night it did affect my sleep a bit, but now that the shock has gone it is much easier. I am getting a second opinion tomorrow and hopefully I will end up with a better understanding of the situation.
Also, I am lucky that I have enough going on in my life that I don’t have too much time to dwell on it. My girlfriend is more supportive than you could imagine, I have a job that I really enjoy and I’ve got a couple of comfortable ballcaps, so it could be a lot worse.
this is great news norwood… Let us knows how it goes…
» » I think you are on the right track. Keep us updated. My thoughts are
» » with you.
»
» Thanks Jessica! I appreciate your advice and support. I will definitely
» update all developments. I have an appointment tomorrow to see another HT
» doctor to get a second opinion. I’m curious to see what he thinks.
Ive never seen hair loss like that, i would definiltey get a second opinion from another doc.
» » » I think you are on the right track. Keep us updated. My thoughts are
» » » with you.
» »
» » Thanks Jessica! I appreciate your advice and support. I will
» definitely
» » update all developments. I have an appointment tomorrow to see another
» HT
» » doctor to get a second opinion. I’m curious to see what he thinks.
»
» Ive never seen hair loss like that, i would definiltey get a second
» opinion from another doc.
I think maybe a visit to a dermatologist wouldn’t hurt, maybe a biopsy to see if there is any internal infection. Good luck.
I visited with an FUE HT doctor yesterday and I had a great visit. His diagnosis was basically that the hair in my donor area is experiencing temporary shock loss from an unusual cause that he had never seen before.
Unfortunatly it is late, so I will have to fill in all the details of my visit and his diagnosis sometime tomorrow (Saturday).
Congrats!
I’ve been following this thread and hoping for the best for you.
That news had gotta feel great.
Hope you are partying hardily or sleeping heavily.
Peace.
» I visited with an FUE HT doctor yesterday and I had a great visit. His
» diagnosis was basically that the hair in my donor area is experiencing
» temporary shock loss from an unusual cause that he had
» never seen before.
»
» Unfortunatly it is late, so I will have to fill in all the details of my
» visit and his diagnosis sometime tomorrow (Saturday).
Fingers crossed all will be well…Good luck
this is good news my bro…
A little background on my situation. In the late 90’s I had a series of 3 strip procedures with a now-retired SoCal ht doc, which left a nasty scar and left the backside of my head somewhat numb from nerve damage from the strip extraction. The numbness seems to be permanent.
On Thursday, I went to see Dr Harris in Denver. During the examination, he noticed that the hair fallout only occurred in the region where the grafts were extracted and there was numbness. The exact line of where the numbness ended is also where the hair fallout stopped. He explained there is a strong relationship between the nerves and the vascular system and that the numb area would have impaired blood flow. So when the grafts were extracted there may have been enough blood flow to support healing the wound or to support hair growth, but not both. So the hair went into a resting phase while the scalp heals. Dr Harris said I should expect to see regrowth beginning in about another 6 weeks.
He said that he had not seen or heard of this happening before and that he would have to start keeping this possibility in mind when dealing with patients with nerve damage from previous strip surgeries. Also, if my FUE extractions had been spread all throughout my donor region instead of being concentrated on just my right side and the back, it may have reduced or eliminated the shock loss.
If I have misstated anything above, I hope Hairtech_ or Dr Harris will let me know, so I can edit any errors.
Your description is correct… If you have a more right side picture(cropping out your face of course) we can show where the line exactly stops from the previous strip and where this shows the exact line of demarcation where you have shockloss as well as feeling and/or numbing. It is compelling. This picture might show this already.
The red line is where the strip was cut. Everything below it and on the right side where the purple line is, has feeling and no shockloss. Everything above the red line and to the left of the purple line is shocked out and completely numb.
Hi Mustpunch,
You told Dr. Harris that the numbness ends with the old scar line and that it can be seen that the shedding ends at that point. Dr. Harris’s instinct and experience makes him feel that there will soon be regrowth. I am sure you can trust that. The rest is just voodoo.
Think about this Marco… Mustpunch probably received tons of epi for hours on end to control bleeding. That is based on the fact the case for the 1000 FUE grafts went on until 1AM. And judging from the post op pictures the day after and showing massive blood and crust, one can guess that the guy bled a lot during the procedure… (punch size was a factor) Given this scenario, and from my experience with several doctors extractions are impossible without a clean field of vision… epi was used for probably 12-14 hours along with more marcaine/lido-epi mixtures to keep his head numb for the entire case… combining that fact with the already nerve/vascular damage… the scalp in that area could not support resident growth and/or healing or both. He the went into effluvuim and shocked.
Remember Zayden’s case? His flap re-attachment was improperly sutured back together and he got the worst case scenario from Zero blood profusing the flap…
Sort of the same premise here, but at least he will have more than likely a fast re-profusion(should have occurred after a day or so after the epi burned off.)But it was too late at that point.
I saw this one particular case(years ago) where a guy got too much of a concentration of epi in one area and his skin where the epi was injected, right in front of our eyes began to necrose and slough. Epinephrine is a powerful drug
I don’t have any difficulty accepting the conclusion and that is the most important thing for the patient, that his hair will almost certainly grow back. It is very common and understandable that a medic feels the need to explain the underlying causes to the patient in order to put the patients mind at rest.
The reality is that there are many explanations for why this kind of thing happens (drug or surgically induced shedding) and an acceptable answer has never been given.
The idea that there was enough circulation to either heal or grow is, lets face it, just a justification for something that is not understood. The idea that nerve damage and vascular damage are closely tied is not strictly true. There are parallel paths of the occipital nerves and vasculature but they heal very differently.
Another explanation is that the occipital protuberance almost exactly defines the scar and the circulation and dermis are much better supplied bellow this area. BUT THIS IS JUST A HYPOTHESIS as was Dr. Harris’s thoughts.
One thing of importance about Zydan’s case that you bought up; In fact there was no necrotic event and the scalp healed perfectly. The aberrant appearance is just the result of the design of the flap such that the bald scalp was bought down into the donor area and on the other side the flap was not taken from the safe zone and as a result continued hair loss left a scar in the forehead as the donor hair receded.
All the best,
Marco.
I don’t have a problem with accepting other possible causes but lets try to see what hypothesis more closely relates to what is going here. That’s all. And what was compelling Marco was the exact place that he shocked was directly in the exact place that was numb and where extractions were performed. There were extractions outside the numb area that were outside from the scarline that healed perfectly and had no shockloss.
I see what you are saying though about the nerve/vasculature coinciding as the cause for the shockloss. The numbed ares are IMO would be indicative of damaged nerves… and then one can assume that since there was already evidence for damaged via numb specific areas, then one can also assume there had to be a vascular damage that while not significant enough to cause an initial shockloss post op the strip surgery, it did have an event of shockloss after 14 hours of epi marcaine or whatever. Again there were extractions on both numb and non numbed areas
I guess it’s not really worth battling this one out but one thing that we both agree on and I know this is an area of interest to you is that the environment of the graft durring the holding phase as well as the environment of the graft at and shortly after insertion (chemical and biochemical and general vascular) are greatly understudied and its importance is probably greatly under-estimated.
True True…