How plastic surgery saved a diabetic after COVID and black fungus ate into her face

Fifty-four-year-old Shaila Sonar stares at a mirror and carefully compares her face with the photos clicked before she got COVID-19 and now. This is no exercise in vanity as she was one of the first patients in Maharashtra to suffer from a terrible side effect called mucormycosis in August 2020, which hollowed out her face. After several medical procedures, including corrective plastic surgeries for two years, she has regained 85 per cent of her looks as she knew it. But her speech is still slurry and restricted. So yes, looking at the mirror reminds her how she needs to hold on and get there. How she can complete herself.

The infection has not only disfigured her face but has left permanent scars in her mind. “A defacement for a woman who has always been appreciated for her looks is traumatising. I am even scared to attend public gatherings and refuse to put down my mask for family photographs. I have an identity crisis,” laments Shaila, a resident of Dhule. “Although the pandemic is almost over, I am still living in its nightmare since the last two years,” she adds.

The battle with Covid begins

Her struggle started on August 1, 2020 when the nation was dealing with the deadly Delta wave of the pandemic. The then 52-year-old Shaila, with underlying comorbidities like diabetes and hypertension, fought the virus valiantly and recovered after 15 days. But even before she could be discharged from the hospital, she complained of pain in her mouth and developed a swelling. The doctors had no answer to her new symptoms as in the first wave, Covid-associated mucormycosis was limited only to two or three patients in the state. When her condition deteriorated, her family shifted her to Mumbai in an ambulance and got her admitted to a private hospital in Parel. There she was diagnosed with sinonasal mucormycosis, which meant that surgery was the only option to save her.

Her family members didn’t even know about mucormycosis, also called black fungus, a serious but rare fungal infection caused by a group of moulds called mucormycetes. Patients like Shaila, who are diabetic, are more susceptible to the infection. They run the risk of losing their eyes, palate and even risk death, if not treated well in time.

“The fungal infection had spread inside her mouth which infected her palate. To stop the spread of the infection, the doctor had to partially remove the palate. Otherwise, it could have reached her brain and proved to be fatal,” says Shreya Devendra Sonar, her daughter-in-law.

Just when the family thought a life threat had abated, the infection reappeared again within days of her surgery and she had to undergo aggressive surgical debridement. This meant the surgeons had to remove some teeth, her gum and right cheek bone, which left her face disfigured. “I couldn’t even recognise myself in the mirror. I thought it was just a minor infection,” she says.

Then the facial reconstruction surgery was done at Sir H. N. Reliance Foundation Hospital in Mumbai by Dr Prabha Yadav, Head, Plastic and Reconstructive Surgery, and Dr Nikhilesh Borkar, Surgical Oncologist. “For us, it was a routine surgery. Due to the mucormycosis, the debridement was done which disfigured her face. So, we had to give her face a complete shape. Now, we are planning to put some implants as part of rehabilitation and restoration. As a part of her cheek bone had been removed, we took a bone from her left leg and reconstructed it inside the cavity. We took a bit of flesh from her right leg to reconstruct her palate,” Dr Borkar tells us. “She had a flap loss but the bone somehow survived so we had to follow up regularly. Later, the bone healed very well. That one complication we had to face due to her diabetes,” he adds.

The Black Fungus that pushed her to the depths of depression

The cost burden of treatment was substantial for the family, who spent almost Rs 50 lakh on her treatment, Rs 4.5 lakh on plastic surgery alone. The family, being well-to-do, could manage some funds but had to take some help from relatives.

After her bout of black fungus and treatment, Shaila was discharged on December 1, 2020. That meant four months of hospitalisation.

Still, her plight didn’t end there as she had body confidence issues. Due to the disfigurement, she soon slipped into depression. She refused to go out of her house, avoiding family get-togethers. “Even if she attended family events after a lot of insistence, she wouldn’t take off her mask. During family photographs, she would keep the mask on,” says Shreya. She kept lamenting about her face, and lost her confidence to look at herself in the mirror. “She just scrolled through the old photos on her mobile and asked us why this had happened to her,” says Shreya. “There was no guarantee that the surgeries would help to get her face back, so we were against it. Despite repeated pleas, she remained adamant and decided to opt for the surgery which left us quite concerned. But then everything came together,” says she.

Post-surgery was not easy for Shaila. Her face and neck were swollen for a long time and she had to rely on liquid food for almost a month during her recovery. Due to the trauma of the mucormycosis infection, she would often fear that her reconstructed palate would fall off, which further made her more anxious. Her diabetes meant that she took longer to recover. She struggled to walk and had to take help from her family members even to go to the washroom. “Despite all these struggles and lows, she didn’t give up,” says Shreya.

Now, after five months of her plastic surgery, with 85 per cent of her facial features restored, Shaila has started mingling with relatives. “She is more confident about her look,” says Shreya. However, her speech pattern is still impacted. Currently, she is consulting a dentist for denture implants which would help her chew food properly again and improve her speech.

A food-enthusiast, Shaila now does pop-ups for family

Shaila is not only a food enthusiast but also a great cook. So now the family arranges grand fests at their house where all the relatives gather to eat her deliciously-cooked food. But sadly, the infection has also impaired her sense of smell. “Retaining the perfect aroma in recipes is an art. By the aroma, you can judge if the food is delicious. But as the infection has also taken away my sense of smell, I have to ask my husband or daughter-in-law,” Shaila says. “My life will never be the same as before how much I try,” she adds. But that doesn’t mean she won’t keep walking. For at the end of the day, she does realise that she is fortunate to be alive after COVID.

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