The fallout - post seven months

Yesterday I was supposed to have the final surgery in my “dental transformation”. It was cancelled for other medical reasons (more on that later). Today is exactly 7 months since my jaw surgery. Wow, my recovery has been complicated, fatiguing, disappointed, and sometimes exciting. Do I look different. Yes, I very much do. Does anyone else think I look different? No, not really. Except my boss. Do I like the way I look now? No and yes.

I had planned on being off three weeks and was off closer to six. First the good: My teeth come together for the first time in my life. My pointy witch’s chin is gone (mainly from the first surgery). I have teeth on the lower bottom center now (mainly from the 2nd & 3rd surgeries). I can gently bite into things. When I smile you can see both my upper and lower teeth like a normal person. The main thing or “fallout” if you will from the surgery was that my left inferior aveloar nerve was cut. In half. By the saw used to cut through my jaw bone. It rests in the middle of the spongy bone, which is packed by hard bone on each side. Apparently I had no spongy bone and it was something they had never seen before, so they didn’t know to expect it. When they told me this after surgery, I was drugged up and just kind of blew it off, thinking it would be numb-ish for a while. And it was. Now it burns and tingles, prickly through the numbness. It’s painful to touch. I think another facial nerve was injured too, because I have some burning/itching up into my left ear on that side. I pray to God constantly that doesn’t turn out to be TG (I don’t even want to say the words).

The chin is a pain. I can’t really put on lipstick or chapstick because it is so uncomfortable to touch it. It is uncomfortable to kiss. I drop food out of my mouth when I eat and often when drinking out of a bottle or can, the fluid dribbles right out of my mouth. It is difficult to chew with my mouth open. I am constantly checking my chin & lip area to make sure there is no food stuck there because I can’t feel anything. I can’t whistle. I can’t blow bubbles. My speech was pretty slurred for a while. I discussed this with the surgeon, and he wanted to start me Neurotin, because he thought it would help. I didn’t start it yet. This really stinks and I try so hard to be positive about it. They think/hope it will get better with time.

Would I have the surgery again? Honestly I don’t think so.

3 Months Post Surgery Today

I haven't been feeling so great, but finally got around to taking some pics.
Please note I just finished running around at gymnastics with my daughter and it was a VERY long day. I still have some bruising under my eyes and my skin broke out something awful!

Baseline and post three surgery pics

I don't have the post surgery #4 pics yet. Remind me never to wear my hair like the second pic again. Thanks.


2007 (pre all surgeries)


March 2011 (post first three surgeries)

Slacker

That's me! But here is a gem from life After jaw surgery.
We are getting ready for bed in front of the bathroom mirror.

Husband: what is on your lip?
Me: (looks). Hmmmm
Husband: it looks like dried blood. You must have bitten it and not realized it.
Me: I guess so! I think I walked around most of the day like that and no one told me. Maybe they didn't notice?

So much to post about

But things aka LIFE is crazy. Will update with pics soon!

A picture - 8 weeks since my surgery

My husband and I at a wedding Saturday night. Notice his perfect teeth. Not much swelling in this picture. Right side greater than left.

A week of work

I've been back to work for a week now. I was worried about being fatigued, but actually I am feeling okay. Today I was in a meeting, and I found myself drooling down the the front of my shirt. Thank goodness I had my trusty towel my bad and mopped it up. It is better overall.

Two different people told me I looked swollen today. Another told me I had "chipmunk cheeks". I am still pretty swollen lately. It is worse in the morning after sleeping and lying flat. My eye sockets are still bruised and yellow/brownish. Concealer covers it up.

Otherwise, I am doing well. Still very numb.

Have to post some pictures!!!!!

Almost 7 weeks

After

Before

Skull View



Yesterday and today I've been having "shocks" or "pulses" throughout my upper lip and nose. They take me by storm and cause me to cry out. At night my ears and sinuses have been very sore again. Yesterday when brushing I noticed a hole. An actual hole in the flesh where it had rubbed against my braces. It really didn't hurt, but was quite swollen. Of course, I hadn't felt it because I still am so numb.

Today was my second day of work and it was rough.

I've enclosed my post surgery Xrays. Did you notice the tilt to my upper front teeth and jaw? I can see it now.

6 WEEKS - Long

Well folks, I finally hit the six week mark! The days of sleeping in the recliner, eating via syringe, and being unable to blow my nose are over!!!

Wednesday I had three appointments, the Oral Surgeon, the Orthodontist, and the Prosthodontist. It was an appointment day.

8:45 - Oral Surgeon
"My resident" was out of town so I had a new-to-me resident. He was very nice and asked me about my pain or if I had any concerns. My surgeon came in and clipped all the wires to the splint, which took longer than what I thought and it was a bit uncomfortable because I can't open my mouth wide or pull my lips back well. When the splint started to loosen, the smell became apparent. So did the taste of nasty unspeakable things. Ewwwwww. I started to taste the line of yuck that had adhered to my palate, trapped underneath that thing. When it came out, there was such relief. I went to the sink to brush and rinse and was surpised to see blood. Lots of blood. I rinsed with peridex and brushed. The entire roof of my mouth felt numb. My mouth bled the rest of the morning, but I never did identify from where. Also, the bad taste persisted throughout the day no matter what I ate or drank.

The surgeon was pleased with my progress. We briefly discussed the plan for my missing teeth in the lateral spaces. I was always told the plan was implants, but due to the bone loss in this area, I would need bone grafting. They had planned on taking it from my hip, but since I have fibromyalgia and pain issues, I am very against it. He said we may be able to use another source of bone. I also mentioned the possibility of a fixed bridge in this area. He said that he would discuss that with the rest of the team (yes, I have my own team :). I think I am starting to become vain because I really, really want teeth in those spaces. I want to smile :)

Another cone beam CT was taken (more radiation) and 6 week pictures. At least I had makeup on and my hair fixed (for once). I don't go back for a month.

10:45- Orthodontist
The "big guy" wasn't there, but the other Orthondontist thought I still looked swollen. My surgical wire was removed and the surgical hooks as well. It hurt to have the elastics changed because again, my lips are still numb and I can't open wide. I also received rubber bands on the band teeth in a triangle shape. I'm not terribly good and putting them in. I go back every two weeks for the next six weeks.

12:00 - Prosthodontist
My Prosthodontist I like to refer to as "super smiley man". He has a great big perfect super smile. He hasn't seen me at all since prior to the surgery. He thought I looked great. On the drive over I was examining my teeth in the rearview mirror and noticied my midline is waaayyyy off and my front four teeth are tilted. Neither place said anything about it earlier. I mentioned the implant vs fixed bridge issue to him. He didn't know if I could even have implants in that space because the tooth roots tilt inward into the space(if you look at my x-ray you will see what I mean). These roots tilt because I didn't have any laterals and my first Orthondontist when I was in Junior High moved the 1st cuspids over and they ground them down. Mr. Smiley said that he would discuss the bridge, implants and midline issues with my team.

NOTE: Getting the splint out was 100% better than I had anticipated.
It really does get better. I promise!!! So hang in there if you are immediately
post surgery.

I'm really lucky I have such a great team working on my case. I'm so grateful.

Mad at Blogger

I wrote a huge long post and it was posted; then disappeared. I'm ticked! Blogger has had issues the last few days.

The splint is out!

The splint is out!!! Yahoooooooo!!!! I'll post about my appointments (yes, I had three today) later :)

Almost 6 weeks post

I'm having a hard time today. My mouth is really sore. I'm a bit tired and thus I present you "the numbered post".

1. I have three big cankar sores just inside my mouth where my lips meet on the left side. It would be quite sore if I wasn't so numb. Apparently, that swollen flesh has been chewed on quite often. It's nasty. Tomorrow, I may call the resident and talk to him about what I can do.

2. My bite. I feel like my lower jaw is sliding all over the splint. When I was driving today I just kept grinding and grinding my lower restoration (where the four implants are). Then it becomes sore.

3. My lips. They feel like two numb pieces of flesh. They have still felt really numb lately and actually feel swollen. Maybe that is good, right? Does it mean feeling is coming back? Someone asked me if I had Botox in my lips? They are quite full.

4. Drool. Oh yes, I am still drooling. Mainly out of the corners of my mouth, even when it is closed. Especially when I am bending or laying down. I just put on a new shirt 45 minutes ago and there is a large circle of drool on it. This should be fun when I go back to work this week.

5. Nose. It just plain hurts today. The piece of flesh between my nose and upper lip hurts a lot today. Especially when I touch it. (I know, don't touch it).

6. Saturday night I went to a wedding. It was lovely to get out and I was very happy for the couple. I put on makeup for the first time in six weeks. Wow. It was uncomfortable to put concealer under my eyes. And lipstick. I couldn't really get the lipstick on because of the numbness and the swelling. IT was SO WEIRD. But it felt great to be normal again. The bad part is that between my gluten free diet and my chewing issues - there was nothing I could eat. NOTHING. I went hungry at a place where people were eating plates of food. The chicken, roast beef, rolls, potatoes and caesar salad all had gluten in them (I doubt I could have chewed them anyway). The veggies were very firm and I couldn't chew them at all. The wedding cake had gluten. When I got home I had a little cheese and a piece of soft bread.

7. The more I talk the more I my mouth hurts and my throat actually. This should be fun when I go back to work this week.

8. Three more days until I get my SPLINT REMOVED!!!! WEDNESDAY MAY 11th is PARTY DAY!!!

9. My smile. When I try to smile it looks like I had a stroke or something. Only half of my mouth moves. It is lopsided and looks so weird!!!

Happy Mother's Day Everyone!

5 weeks!

I am starting to feel like me again! Yay and thank goodness for that.

Last Wednesday I went to the Oral Surgeon for my one month checkup. It wasn't the best appointment. Things were very rushed. The resident came in, asked me if I was back to work (Uh no, you wrote me off), took a quick look and said the right side of my lower jaw was not in the splint, and was a Then he came in and was very nice. He thought my nose looked really good and my upper lip did too. I was still drooling and had a towel around my neck which he noticed. He hoped that would stop very soon. Have to keep splint in for another two weeks :( The hope was to get it out earlier, but no go. He looked at my bite and didn't say much. They said after the splint comes out, I am to go immediately to the Orthodontist.


I'm eating like crazy now. I don't puree anything except smoothies. Usually have some chopped up egg beaters for breakfast and finely diced bananas with peanut butter. Lunch is usually refried beans, rice, salsa, and guacamole. Dinner is usually tilapa and mashed potatoes and some (gulp) light ice cream. I need to eat more veg though. I get in eating ruts.

Been feeling stronger, trying to walk a little bit and more around more. Still get tired easily. I do something like load the dishwasher and maybe sweep the floor and then have to rest. Still taking iron which I think is a big help.

My nose is less numb now - probably 40%, mostly around the nostrils. My lips have been burning and tingling like crazy. They are probably 60% numb. Whenever I drink anything cold, they buzz and burn and hurt. It's not painful, just....weird. My chin is still 80% numb. It hurts quite a bit at the end of the day. :( I'm still drooling, mostly when I bend over or have just drank something. Last night I was up in the middle of the night with severe ear pain. I tried to chew some chicken at dinner and I think it was just too much for my jaws. Because I had to drive V to school in the morning, I just took Ibuprofen and thankfully conked back out.

29 days - 4 weeks - on month!

I made it!

*I've written a recap of my surgery as I remember it with pictures - March 31st blog post. Check it out and the pictures.
*I received the bill sent to my insurance. It didn't include my surgeon's fees, but still came in around $27,000. Oh my gosh. Wow. I'll have to scan and post it, because it is pretty interesting.
*There is still a lot of stitches left in my mouth. When are these going to dissolve/fall out/disappear?
*My swelling is very good. However, I still notice some puffiness in my cheeks and lips.
*My lips and chin are completely numb. My nose is still 50% numb, but I have seen improvement.
* I'm doing a little soft chew now and it is great!! I dipped some gluten free bread in hot soup (delish!), a ripe banana with peanut butter(Hmmm), and and some whitefish (yum).
*The drooling is still pretty awful. And frequent.
I've attached some pictures, but please remember that I have no makeup on, and my hair isn't done. They aren't the most flattering. Tomorrow I am going to put on makeup!! Can you see the bruising and remnants of my black eyes? My nose is still a little crooked which is normal. I like the way it looks from the side, the front I am still getting used to.

Day 27 Happy Easter

I can't believe it is going on a month since my surgery. I'm doing much better overall, but still pretty tired due to low hemoglobin and low iron. SOme days I don't do much at all, as healing takes my entire allotment of energy for the day. Since it was the Easter weekend, my husband was off Good Friday and my daughter's school was closed. I needed to desperately get out so my husband took me out to lunch. We went to a new Mexican place in town. Now, my bands are quite loose, so I can open around one finger and I received the clearance to try soft foods. This is easier than it sounds. It is sooo tiring and time consuming trying to ingest anything but liquids.

Anyway, I was reading the menu and feeling so sorry for myself. Paul ordered for me (people can't really understand me- blame that splint!) refried beans, rice, cheese, and guacamole. Wow, was it good! It was the first meal I hadn't drank since my surgery. I had a small plastic toddler spoon in my bag that works much better than a large utensil and shoveled it in. It was just what I needed. When I was done however, there was food all over the table, my face, my "scarf" aka "towel bib" and my pants. There was an embarassment factor, but my sweet husband thought I did great! It was super difficult not eating any of the tortilla chips though :(

Here is a picture of me smiling. Like my "scarf"? It is a large cloth restaurant napkin I acquired somewhere.

In negative news, I think I am getting another sinus infection. I've been snuffing thick bunches of mucus out the back of my nose and spitting into Kleenex. I can't blow my nose still. That is the worst!!!!!! Fingers crossed that it is just minor allergies or something.

3 weeks

Oh how I've longed for this day! I'm still hanging in there.

SLEEP - The last two nights I did sleep; Monday night - all night!! Last night I fell asleep at 9:00 pm and woke up at 12:00 am until 1:15 am when I took pain meds and had a snack. I then slept until 7:30 when a child played an electronic Barbie Laptop in the kitchen. Thanks sweetie!

ORTHODONTIST - Yesterday, I went to the Orthodontist. All the staff there is so kind; they treat me like a celebrity. The Ortho took a quick look and thought I looked great! He even gave me a hug. I don't have to go back until I get the splint out; and then the work begins. Hopefully that means the splint is coming out right on schedule at six weeks. Please?

EATING - I've been practice eating some more. Yesterday it took me 20 minutes to eat a third of a banana. Yesterday my neighbor bought me some gluten free raisin bread that is really crumbly (gluten free baked goods can be quite crumbly in general) and I've been trying to ingest little morsels of that which I've enjoyed. Last night Paul brought me Indian food like palak paneer (spinach w/paneer cheese cubes) that didn't even need blending and lentils. I found it to be a touch spicy for my taste, even after blending with some greek yogurt and cottage cheese. But it was nice to have something different.


PAIN/NUMBNESS - nose, lips, chin, cheeks completely numb. I had some ear pain last night in the middle of the night. Usually my chin starts aching and feeling cold in the evenings.

Trying to decide what to do for Easter. Weather is supposed to be crummy. Not up to a lot of travel. Can't go out to eat. Sigh.

Day 20

Well I spent a lot of this weekend feeling very tired. My mom came down to visit/help and I spent a lot of time talking, and did some running around. Which made me very, very tired. I didn't get naps or quiet time either. Last night I slept pretty poorly (the windchimes out clanging all night on the deck right outside the living room where I sleep in the recliner didn't help much). I need to remember to go remove the windchimes before I bunk down for the night. It's really a pain being in the recliner still. Saturday am I did a little test and tried laying down for a bit. It really made my neck and face and chin quite uncomfortable. It's difficult if we have guests because no one can be in the kitchen or living room where the recliner is since the light and noise keeps me awake. Frankly folks, I need my rest and I'm not getting great rest. I wish I could nap during the day, but that only seems to happen if I take some pain meds. I try not to take them during the day even I need them, because I don't want to be drugged up and feel crummy. Those meds make me feel like I have a hangover. I'm taking Ibuprofen every 6 hours or so half a dose of the Lortab before bed. I usually have chin and lip and sinus and ear pain by then. My chin, lips, cheeks, and nose are still almost completely numb. My swelling has gone down a lot on the outside, but I am still very swollen. By comparison it just looks like a lot less.

The drooling is becoming a little better. It is worse if I bend over. Talking is still a big chore. I tried some soft food to chew like cheese and banana. Wow, was it a chore. It is almost like my jaws forgot how to chew. I think I need to practice chwing. That sounds funny, doesn't it?

I am stilla huge mess when I "eat". I was sitting at the kitchen table with my mom, Paul, and V and drinking soup. Since my face is numb, this is what I looked like. Paul thought it was cute and picked up my phone and took a picture.

Do you see the black kitchen towel for drool and food around my neck? I also have my glasses off because they hurt my nose and sinuses.

Day 18

Today I don't have a lot of energy. Not sure why. I sat a lot of the day. I get up and do something, and then I rest for a while.

My chin has really been paining me lately. It feels numb and cold and tingly. My lips are still completely numb and quite swollen and my upper lip is really sore. There are still a lot of stitches under my upper lip (they did the majority of my upper jaw cutting there) and I have to keep wax on the brackets to keep my lips from bleeding. There is also an irritating stitch there.

My lower implant restoration mostly stopped hurting so that is a plus. My sinuses have improved slightly on the pain front.

Random stuff related to my surgery

* I finally tried the strawberry Myoplex drink today. Not too bad. Not too sweet, I don't like sweet tasting drinks.
* Tonight I had a bridal shower for a coworker and friend. Just not feeling up to snuff and I'm sad. She is so nice and I would love to celebrate with her.
* I'm a social cripple. I can't really drink in public, my talking is unintelligible to most, I drool, and I can't eat. What good am I?
* Still sleeping in the recliner. Getting really tired of it.
* I've certainly had enough of HGTV. It makes my house feel inadequate. Wish I could read, but my eyes still hurt because of that sinus pressure.
* I am stuck at 4 pounds lost since my surgery. I eat next to nothing! But apparently those smoothies are doing the trick to keep my weight steady. Hmmmph. I know the goal is not to lose weight and I am already a normal weight, but I did want to drop a little weight.
* It's difficult. Everyone asks how you are right after your surgery and now, everyone has forgotten about me. Seriously. I get texts from one friend (thanks Amy!), and visits from another (thanks Noreen!), and my neighbor stops by, but I'm lonely. I miss everyone.
* Since it is 58 degrees and currently not raining, I should go for a walk. But I'm tired today. Really tired.

Day 16 - two week check up

Today I DROVE MYSELF (my eyes hurt a lot during the drive) to Surgery Clinic 25 minutes away for my two week check up. I saw "my Resident" and he thought my swelling looked great. I saw my Surgeon and he thought I looked "outstanding". Everyone things my nose looks great! Apparently I did not receive a separate rhinoplasty, but they cut a small piece of cartilage under my nose during the surgery, which had the effect of pushing up my nose and changing the shape. My bite was slightly off to the left, but can be fixed with elastics, of which I received three new ones. We also took 2 week post surgery pictures. The sinus pain and light sensitivity I am experiencing is normal. I aksed when I could blow my nose and he said not for a while. I asked why, and he said that my sinsus cavities are full of stitches and I could blow them open with nose blowing. Okay, I'm convinced!

My Resident thought I should be off for another two weeks full time and then go back part time for two weeks. I tend to agree with that. But we will reevaluate that in two weeks when I return.


The good news is that I am allowed to chew soft things now - like eggs, pancakes, mashed potatoes. However, I can't open very wide with the bands and can't put them on myself due to the swelling and smallness of my mouth. Thus, I won't be soft chewing much. I tried to bite down on a few tiny specks of egg today, but it was like my mouth had absolutely no memory on how to chew and I had to spit them out. I guess I'll keep trying.

It's great not to feel miserable 24/7 again. But I'm a far, far cry from back to normal. But so glad my checkup was okay!

Day 13 - what do I eat

Someone is always asking me, what can you "eat" these days? Can you drink through a straw? I wish I could, but my lips are still numb and it is too difficult. I'm only down 4 lbs since the surgery; I had lost 2 prior to that due to not being to chew well after receiving my lower implant denture and it being so high that my back molars didn't touch rendering me unable to chew much food.

Yesterday I ate:

9:30 am - two eggs blended with some milk and butter. Water. a sweet potato blended with protein powder and vanilla soy milk.
12:30 pm - two cups of blended homemade corn chowder my husband made for me. 1 cup fruit smoothie (frozen fruit, soy milk, protein powder, little greek yogurt)
2:45 - became very hungry. blended 1/2 c rotisserie chicken, no salt organic chicken broth, instant mashed potatoes, butter and drank it. Delish!
6:00 pm - 1/2 refried beans, little greek yogurt, guacamole blended. Another small smoothie.
10:00 pm - felt a bit nibbly. Drank half of a 210 calorie vanilla muscle milk drink.

It's an added challenge eating gluten free. I also eat a fairly high protein diet, so it's difficult to eat so many carbs.

If you have any good ideas, let me know!

Day 11- Day of Pain

I am still taking about 400 mg of Ibuprofen every six hours. The Lortab (narcotic) I take usually around 8:00 pm because my muscles and sinuses are singing a pain song by that time. If I take Lortab during the day, I usually have to sleep it off approximatly 2 hours after taking it. Then I feel yucky and hung over. How do people function on this stuff? I feel guilty whenever I take it, like I don't really need it and am getting addicted to this stuff.

It's no secret I've had pain behind my eyes and in the sinuses immediately below my cheeks. It's this terrible dull ache and quite intense. The rest of my face is still somewhat numb and I get zings and burning twinges of the nerves coming back. This can be uncomfortable. The sinus/cheek pain started yesterday afternoon (I had it a couple of days ago), and didn't stop much of the afternoon. By the time Paul brough V home I realized I should have taken the pain meds. I took them around 6:00 pm and they did not help. Around 9:00 I took more ibuprofen. I was crying and putting a heating pad and writhing around in the chair it was so awful. Then my chin started zinging and hurting. Finally, I must have fallen asleep.

This morning - Day 12, I woke up feeling a little dizzy (ugh oh) and a little nauseous. I pray and beg that this doesn't develop into something.

Day 10 - double digits

I guess it is no secret I wish to leave this experience far behind me. Yesterday I saw a little improvement, but boy you guys, is it slow. I took a shower. And I loaded the dishwasher. During which I became short of breath. I then convinced myself I had a pulmonary embolism. Sigh. I think my Hemoglobin is low actually. I was anemic going into surgery and I see my Hemoglobin was down to 9.5 post surgery. Plus I'm not eating enough. A typical day I will "drink" blended rice cereal with peanut butter & soy milk, blended mashed potatoes w/broth & margarine, 2 boxes of high protein drink, maybe some more soup and a smoothie. Maybe 700 calories a day. It takes so looonggg to get everything ready and then to prepare it and eat it. Paul brought me home some blended (yay, saves time) lentil soup from the middle eastern restaurant last night and I drank two large cups of it.

I miss my routine. I miss work and being able to play and be responsible for my daughter. My husband is traditionally at the office until between 730-930 each night, he's had to do daycare drop off plus pick up so he is home by 5:20 most evenings. I like it but I know is extremely difficult from a workload standpoint.



The verdicts:
Down 5 lbs in weight
still red pus sinus drainage, but becoming clearer. When will this end ????
nose is so sore and crusty from drainage and wiping
Still can't breathe via nose
still hurts to wear glasses
Still haven't driven anywhere
Swelling is waaaayyyy down.
Still drooling. Lips are still numb and swollen.
my lower jaw slides around in and out of the split frequently. I don't think it is supposed to be doing that.
Still on antibiotics
Not taking much pain meds. Lortab maybe before bed when all the muscles are tired. Ibuprofen regularly to help with swelling
Much of my face is still numb. The nerves pulse and burn and surge frequently and it is a little uncomfortable.

I'll post pictures later.

day 9

I don't feel like posting today because I felt actually fairly decent yesterday but then am having lots of sinus pain. Ugh. I just want to get back to normal!!! It hurts just to be on the computer. My sinus are full of cement. Vi was up coughing all night too. I'm in HELL I think sometimes.

The only positive point? My swelling is waaayyyy down.

Need a side view pic. Like the dishtowel around my neck to catch all the drool from my numb unable to close lips? The left eye swelling has turned into a black eye.

Day 6-7

I think there becomes a point in people's surgery where they "hit the wall" so to speak. The worst part has come, and things have hit rock bottom and will improve from this point. I really hoped I reached that part yesterday. Because it was awful. I don't want to get any worse than totally miserable. I'm a step up from miserable today.

I don't remember if I blogged about this yesterday, but I woke up with a lot of swelling around my eye. New swelling. There also was the foulest nastiest sulfur taste and smell in my mouth. Yesterday, my nasal fluid had become thin and clear. It was orange and brown and puss like and did I mention the taste in my mouth? It make me want to vomit it is like rotten eggs.



I called the resident on call and came in. He said my bite wasn't in the splint and added about four more bands. Gee, thanks. He also said my mouth was dirty with food (I am trying so hard, you try to clean your damn banded shut with no feeling drooly mouth). He wasn't sure if it was an infection or not (It is, and I am sure it is a sulfurous bacteria like Actinomyces). I was given Clindamycin to take 20 ml four times a day. I think I notice a small difference today.








If you are considering this procedure, please be informed about all the potential awfulness this may involve. I'm also pretty darn depressed. I am lucky I have so many people to care about me..

Day 5

I really haven't had too much pain lately. I take Motrin twice a day and the Hydrocodone maybe twice a day. Last night I got myself into trouble. P was at work my mom was giving V a bath and all these nerve spasms hit me all over my face plus throbbing ears. P got me the painkillers, water, and made me feel so much better with a smoothie. I think I let it go too long, because it didn't kick in as I had hoped.

There is still tons of sinus drainage and swelling. WHEN IS THE NOSE FAUCET GOING TO STOP?

I brushed the teeth I could reach with saltwater and tried to rinse, but when your mouth is splinted and banded and almost swollen shut, it wasn't too successful. My mouth and teeth feel GROSS!!!

Day 4

It is only Day 4? I thought it was later.
My nose is still terribly runny. It is an orange tinged mucus. WHEN IS IT GOING TO STOP? I'm still pretty numb, but my ears and under my chin ache. I drool constantly and between my leaky nose, numb lips, and drooling, I am going through lots of clothes and small towels as bibs. Lots of swelling. So much work to drink anything. The skin sluffed off my lips, painlessly. Some scabs left around my mouth. I'm using ice packs on and off, but they are destroyed from frequent use.

I don't' feel that hungry but have been drinking as much as I can. It is much easier with my throat not hurting, but still really difficult with numb lips. Nothing sounds that good. With increased caloric demands for healing, I should be around 2000 calories a day, I'm probably doing 400-600. I'm trying so hard! Usually have some blenderized soup, some protein drink, and then nothing after that sounds that good. Today my mom made me some blenderized rice cereal and I ate 4 synringes of that which was a LOT of effort, but still was only 100 calories of food.

Day 3

I woke up feeling kid of grumpy and down today. As soon as I woke up I felt that the swelling haad increased. I knew that it could continue to increase until days 5-6. But my throat had improved and I found it much easier to drink. So I drank quite a bit today. My mom got her around 12:30 and before and after that I found myself napping on and off most of the day. My nose is still running like crazy. Running down my still numb face. It's more bloody tinged instead of blood now. I spend most of the day wiping my face of drool and secretions and trying to get my nasal passages clear. I am not allowed to BLOW MY NOSE AT ALL. Drinking is so tiring because my lips are numb and my mouth is sort of numb, so it just runs all over you.

I paged the Resident today because my lower jaw is no longer sitting in the splint that is wired to my upper jaw. Tomorrow my mom will have to drive me in and they will have to adjust it; he promised it just be just minor, but it feels way off to me.

Surgery Day

I had to be a the hospital for 5:45 am for a 7:30 start. Last surgery I had Paul wake up Victoria, drop me off, then join me later. That resulted in my being all alone prior to going back, and I didn't want that this time. Our wonderful neighbor girl babysitter came over at 5:15 and we took off.

During the drive and all, I was surprisingly unpanic-y. We got checked in, I changed to a gown, and then we sat. Everyone else had IV's and were all set to go. Not me. I sat and sat patiently. Finally the Chief Resident doing my surgery came in and then everyone came in a big swarm. The charge nurse, the surgery nurse, the Anesthiology Resident, the Anesthiologist, all at once. We went over the surgical plans and then of course, I started my usual dry heaving due to a combination of nerves and not having anything on my stomach. They gave me some Zofran and then something to relax me, and I remember little else. At all.


During the surgery they did a 3-piece Lefort on my Upper Jaw, a BSSO on my lower jaw, and tweaked my nose (for free!). Unfortunately during the surgery, my left avelolar nerve was cut in half, which may result in permanent numbness of my lower lip. Also noted was that my lower jaw does not contain spongy bone. Only hard bone. Apparently most jaws are made up of both kinds of bone, but mine is not. That is why the nerve was cut. They cut through the hard layer to the spongy layer, but since I had no spongy layer, it was easy to cut right through.

After surgery was much, much nicer than my other surgeries. They let Paul see me (I vaguely remember and only after he prompted me) in the hall when they moved me from the OR to recovery. When I woke up in recovery, he was right there. And that was soooo nice.

When I came out I was so glad I could breathe okay. That was a HUGE worry for me. Thankfully, he had not banded me shut yet, so I had much better breathing ability.
The bad part was that my throat hurt so badly from the breathing tube that even with IV narcotics, it was horrible to try and swallow anything. Waking up from that surgery was like having strep throat plus a really bad cold with tons of sinus pressure (They cut through the sinuses for a Lefort and they fill with blood) and enormous amounts of sinus drainage. In fact, my nose bled all night into the next day.

Later that evening - around 6:00 pm, maybe? My surgeon and my Chief Resident came by. They informed me about the nerve injury, but let me know everything went quite well. I remember being quite loopy and fist bumping them. How.Embarassing. He did say that on a scale of 1 to 10 difficulty, I was a 14. Glad to know that I am special!!!

I had some periods of nausea, and they gave me Zofran and phenegren. My throat and mouth were so dry that I thought I would lose my mind; I was unable to swallow and felt like I was choking. But I made it through. They had the blood clot stockings on me that would inflate and deflate every 30 seconds all night long. There were shots of heparin in my hip. I was on this ward where it was so nice and quiet. In the middle of the night a loud male patient came in. PLUS A FIRE ALARM. Sigh.

I slept on and off until 4:00 am when the phlebotomist came in and then the Oral Surgery guys at 6:00 - two Chief Residents and two junior residents. One said he had never met me, but heard a lot about me. They were quite nice and I was glad they stopped by to check on me. They pulled off the bandages around my head. At this point, I felt like my throat was going to kill me, and wasn't drinking much. I finally begged for something, I didn't feel like milk and I didn't know if the broth was gluten free. They finally found me an Ensure that was 550 calories. I lost half of it via syringe, but wow, was that good!!!

Here are some immediate post surgery pics that my husband took. I don't remember a thing.

i am home

pre



I don't have the energy post everything right now. Day 3 - today is the worst so far. Waiting for my mom to get here. The swelling and nasal blockage is pretty bad too.

Success!

Made it through surgery today. Extremely successful, doctors were very happy. Avoided needing bone grafted from hip, avoided vomiting, the biggest fears. Only real complication was nerve damage for the lower lip, which could result in permanent numbness. One significant outcome was a change in nose shape from pushing it up. Doctors said it was a very desirable look, one that people pay thousands for plastic surgery to obtain. Difficult to tell how everything will look in the end due to all the swelling, which will only get worse over the next few days. Will be in the hospital at least one night, perhaps two.

It's time

and I am 100% terrified.

My biggest concerns:
Bone graft from hip
Nausea and vomiting post surgery
migraine post surgery
plugged nose and not feeling like I can breathe
blood clot


I have to be at the hospital at 5:45 am which means I need to leave at the latest b 5:15 am. Need to call the babysitter and ask her to come earlier.

Please keep me in your thoughts and prayers.

Surgery Update

Surgery Update: The Resident called me this morning. Possible bad news. The surgery will last approximately 4 hours (not including all the pre, post, etc). That is actual operating time. They are doing a 3 part Lefort I and a BSSO. I will have a splint for AT LEAST six weeks and will be banded shut. When people ask if I am going to be wired shut, I am going to start saying yes. It's pretty much true, but you don't use wires. The BAD NEWS: They are going to take bone from the lower jaw to use in the upper jaw. There is a possibility they may not have enough bone. Then they would have to do a graft from my hip.  I don't want to mess with my hip and add an additional procedure. He said walking is pretty painful for an entire month. I made him promise to not do this unless it is very, very necessary. Please pray that it will not be. I was pretty freaked out and hung up the phone and was physically sick. I emailed my husband and asked why I even started doing this!!!! He replied: You need it. You will be better off for it. You have the courage to go through with it because the long term gain will be worth the short term sacrifice. And you have people at home that love you and will support you and take care of you as long as is needed. I have a pretty super duper husband, don't I?

Preparation

I have spent some time getting myself mentally prepared for this surgery. I won't be doing much exercise besides walking. I won't be able to hold my daughter for a while or read her stories or have her sit on my lap. I won't be at the office, I won't be talking (I'm a BIG talker), I won't be responsible for a LONG list of things like lunches, shopping, laundry, dishes. This is scary for me. I like routine.

Tonight I put together five different outfits including socks in the closet for my daughter for daycare each day for next week. Each evening, I put out an outfit for her depending on the weather for my husband to dress her in the morning since he mainly does drop off. He really doesn't understand her clothes at all, bless his soul, so it is probably best that I do that.

On Archwired.com, there is a topic on the message board addressing what supplies people found helpful post surgery. The last few times I found Boost helpful for taking a few swigs when I have to take narcotics. It has to be really cold and the high protein kind for me to be able to find it palatable. Ensure tends to have too much sugar for me and I can't tolerate sugary drinks in general. I'm going to hit Target Friday night and buy:

liquid vitamins
Boost
dark hand towels (to use as bibs)
frozen cold packs
liquid Motrin
protein powder
frozen fruit

and stock up on Diapers and wipes for the toddler.

I already have soup and Vaseline, baby toothbrushes, soups, broth, ginger ale and figure I shouldn't buy too much because I like to get out.

Today I would say I'm much less panickly that I've been for a while.

From one jaw to two jaw surgery

I don't know if I can take anymore. Yet I know that this is a necessary evil.

I was sick for the third time in two months with Vertigo, which is severe dizziness and nausea and vomiting. It is due to a disturbance in the inner ears. Since I received my lower restoration, my bite is very open and my back teeth don't touch. I think it may have changed the balance in my ears since they are all interconnected. Monday am, I woke up with severe dizziness, nausea, seeing double and puking. I lay in bed all day feeling like death. Finally at 4:00 pm, I was up and sitting up. I've eaten very little this week and still have some residual dizziness and those headaches. Oh those headaches. It's like having a hangover all week. On the advice of my doctor I've been taking Antivert and she prescribed me some nasal sprays to open up the passages to the ear along with some head exercises. Pray for me that this helps. If there is an possibility that I would have dizziness like this post surgery, no way would I do it.

Tuesday the Resident handling my case rang me and let me know that despite two different extensive mock ups, and meetings with my surgeon, prosthodontist, and orthodontist, they hadn't decided what to do. He also said I had to get the acryclic build ups (v. large) off my back teeth ASAP. These were put on by my Orthodontist (because my bite is so collapsed) to eliminate me biting off the brackets. They were added to open the bite more and then during my first surgery, added to again, so that I would not bit on the bone graft site. They are really, really high. The Resident also said we were most likely have to have an upper surgery too (I knew this all along) to get my maxillary rear molars into the proper position. This was pretty upsetting for me. I had pictured a BSSO, no splint, and a speedy recovery.

Thursday am I went to Orthodontist and received new wires and metal ties (yuck) along with three surgical hooks. They also did my before surgery pictures (it would have been nice to have had makeup on and to have done my hair that day), and I received the "pre-surgery" talk. She told me I may be depressed after surgery, but it will pass. Also clarified (I asked her to) that this was indeed the best course of action for me and really I didn't have a whole lot of alternatives left besides this.

I went into work for 90 minutes and then went to my 2nd appointment of the day - The prosthodontist. He is a very nice man and somehow got elected to spend 45 minutes drilling and scaling the acrylic build ups off my back teeth. . He also reduced the size of my back teeth. Apparently the backs of them are bulky? It was a pretty rough visit. Not from a pain standpoint, but from having your teeth be drilled on for 45 minutes straight. It may have even been more. we ran through a lot of drill burrs.

This morning I had to run back to the hospital to have another cone beam CT scan with the acrylic gone from my teeth. I talked to the resident on my case and I told him I hadn't been feeling well and just having a hard time getting my head around everything and having a two jaw surgery instead of one. He is really nice and he promised me that all would turn out well.

I'm really lucky to have some great professionals working on my case.

Planning appointment with Surgeon

My pre-op appointment to formulate my treatment plan was originally scheduled for March 4th. The Chief Resident handling my case (yes, I am going to a teaching hospital) called me to see if I could come the week prior as he believed they required a greater amount of time to plan my case. This the same resident that did my 2nd surgery in July '10 and I know him and he has a great bedside manner. I had requested someone that knew my case so that I could have some sort of continuity of care. I really like my surgeon a bunch and have an enormous amount of trust in him, but I don't see him for a great deal of time since this is a teaching hospital.

The appointment took a great deal longer than expected. A Junior Resident that I haven't met yet completed most of the assessments. First I had to bite into a thin tray with blue material that became really hard and really hot (ooh, that sounds dirty). Then the tray was hooked up to a sort of "Wii-Fit" like apparatus and I had to move around. Then a CT scan of the head still biting on the tray. My mouth was tired by then. My surgeon came in because there was concern regarding the large build ups of arcrylic on my back molars impeding the bite. These were built up once my orthodontist and once after my first surgery to avoid biting into the bone graft. My surgeon said that it wasn't a problem.

More impressions X 4 (the standard kind). Measurements every which way. Pictures with the camera, pictures of my bite which really hurt because my mouth is so small that they pulled the plastic holders SO HARD. One of the impressions ripped off a front tooth bracket. My prosthodontist also came in and at one point, I had physicians staring at me.

My surgeon thinks we will not have to do the upper jaw; only the BSSO accompanied by a large rotation downwards of my chin. He said that in a person of my age (hmmph) moving the upper jaw can be quite aging. I was concerned that my chin is now too small, but he indicated he didn't more it as much as he could have in the first surgery, because of this one. My upper lateral regions will also have bone grafts that they will take from my lower jawbone when they move it. I will need a 5th surgery for implants once those heal. There was going to be a planning meeting the week after my appointment and they would let me know the outcome.

I feel much more confident and much more at ease since I met with my surgeon.

Hello

Hi everyone.

Thanks for visiting my blog. I hope to update it with all the posts I have on another blog.

I have a newer picture post genioplasty and I think it turned out well.