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.