While Karen rebuilds her old relationships on Staten Island, Renee clashes with her ex-husband and Drita receives shocking news from prison.

The Bitch is Back (air date: 2011-04-24) The showdown continues at Carla's birthday party as Renee and Karen both refuse to back down.On Sunday afternoon, Ramona replied to a fan who expressed hope that she’ll return to the series with a discouraging tweet. Carla Facciolo also returned for the show’s fifth season.Instead of saying that she’ll return to the show or is open to the idea, Ramona simply apologized to the fan for her absence. Unlike Karen, Carla didn’t make a full return but appeared in a few episodes and the reunion show. I got so used to being on it with the girls whether it was fighting or not, I think you get used to something. It’s just things didn’t work out cause we were all…So, me, Karen, Ramona, and Ramona’s sister [Roxeanne] who you don’t see on the show, [were friends]. A lot of them wanted to be close to us and our friends because of who our fathers were and so we all formed this kind of clique, and that included Drita’s husband Lee and a few other guys, my boyfriend, Ramona’s boyfriend at the time. When we were about 19 or 20, Karen had met Drita and Drita was actually dating this guy that we all kinda knew. Karen was with Lee and Drita was with this other guy and Karen and Drita became really close, and then through her, Drita started hanging around with our little girl crew.We’d go to clubs, we hung out, and then Drita moved in with Karen.Going into surgery, Renee was anticipating a flatter tummy and a rounder tush. There was a lot of scar tissue that was left inside. It’s very uncomfortable.”With her pain comes a warning. I would do it again, but know who you are dealing with,” Renee advises.What she got was a near death experience and more than two weeks in the hospital after she lost over six pints off blood when the stitches on her back ripped open during an attempt to sit upright. “You are making a life decision.”While her wounds heal, Renee is still hurt that her (seemingly former) friend and co-star Carla Facciolo made no attempt to come see her or even call during the difficult time.