Friday, July 11, 2008

Post-Operative Care Instructions

I received my packet of information today from my OS with Post-Operative Care Instructions, and was pleasantly surprised with the thouroughness of the information. It looks like I will have to have a weekly appointment with my OS for 8 weeks after surgery, and then will move to an appointment every 2 to 4 weeks through week 16. My first orthodontic appointment will be determined by my OS and OD.

My 1st week, I'll be on strained liquids any color, particles cause infections. After 7 days particles in liquids is OK unless incision is open.

Week 1 though end of week 6 I will have full time elastic wear, and I'll start changing elastics after my 2nd post-op visit after surgery. I will then change elastics twice a day and do jaw exercises for 15 minutes with elastics out twice a day, replacing elastics. The elastics will be on nights only after the completion of the 6th-8th week.

Very short walks the week after surgery are mandatory. I can start light exercise (light weights, easy bike riding, golf, long walks, easy jogs) at 5 weeks post op. Hot tubs are to be avoided for 6 weeks. Avoid clenching with exercise for 10 weeks (disrupts healing of bones). No underwater swimming for 8 weeks, contact sports can be resumed 16 weeks post-op. Freestyle swimming is to be avoided for 6 months (exaggerated jaw movements associated with freestyle breathing can cause bite relapse). Snorkels and musical instruments – avoid prolonged biting on the front teeth for 12 months; these activities can cause relapse of the bite. Protective helmets (i.e. motorcycle) which puts pressure on the chin may cause lower jaw relapse for 12 months.

It mentions that hooks/screw(s) prevent jaws from relapsing, and are removed at 10-16 weeks. I am sure this does not refer to the rigid fixation screws, but possibly some microscrews used as anchorage devices. I guess this means I could have my surgical hooks in up to 4 months L.

For mouth care, I am to soak mouth in salt water (1 tsp per 8 oz water) 8 times per day. I should add peroxide to water for 2 of the 8 rinses (3 parts water to 1 part peroxide). Add mouthwash to water if desired. No vigorous mouth swishing, will open incisions. No toothbrushing until surgeon gives OK, usually at 2nd appointment post-op. Start modified toothbrushing when given the OK at 2nd appointment, do not brush lower back teeth which may open lower incision. Start normal brushing at day 21, include lower back teeth, Waterpik OK to use at day 21 and thereafter.

Another thing I saw in the materials that I thought was interesting is that he says pregnancy should be avoided for 12 months postsurgery because hormones associated with pregnancy can cause joint changes leading to relapse of lower jaw advancements. This was the first time I had seen hormonal changes as the reason to delay pregnancy.

Weight loss he mentions 10-15 lbs. There is a lot more information in the packet of information which I won’t outline here, but I tried to post the most interesting tidbits. My OS actually had BSSO last November for Obstructive Sleep Apnea, so I wonder if the completeness of his post-op instructions happened before or after his own experience with it. My dentist did tell me that he significantly changed his post-op protocol after his own surgery. The last time I saw my OS was before his surgery so it will be interesting to see him at my pre-op appointment.

I thought it might be interesting for some, although I know that every OS has their own opinion and theory regarding post operative care.

There was a lot of pre-op info as well, such as to stop taking all vitamin and herbal formulations 14 days pre-op, as well as aspirin, ibuprofen, Celebrex, vitamin E, and vitamin K. There was a long list of herbal/homeopathic preparations that are known to increase the risk of bleeding, including arnica flower, bromelain, onion and garlic. Interesting. I will save arnica and bromelain for post-op but clear with my OS when I can start taking it. I have to start taking an over-the-counter iron supplement one month before surgery.

So given the info I received today, I am thinking Paris is off. If I will be banded 24/7 up to 6-8 weeks post-op, I don't think I can even consider being at a trade show for 5 days at 5 weeks post op. Plus, it sounds like I wouldn't even be on soft chew by then. I don't think I will have enough energy to get through it, they are very long intense days, I am usually exhausted when I am in 100% good health by the end of the trip so with this new information I don't think it will be in my best interest. I will wait to hear my OS' determination, but for now I am going to think it's not an option.

Did anyone give blood before surgery? My OS originally said it shouldn't be necessary, but the materials they sent said I can choose to do it if I want , even though a transfusion is not usually needed after jaw surgery. I was thinking just testing my blood type to see if my dad has the same kind. My mom is RH negative, very rare, and I know I don't have her same blood type. Is there an over the counter kit you can buy to test your blood? If I have a close family member that is a match, I won't consider giving blood.

Things are moving along now ... I have an OD appointment on Monday so I am sure I'll have more to post then.


Anonymous said...

That's really useful info they sent you; as you say it's very thorough - quite reassuring I find.

I would agree, 5 weeks post op you shouldn't attempt the Paris trip. Well, I wouldn't. I'm 4 weeks and 3 days post op and I can just about manage to walk round the corner and come back!


Anonymous said...

Learn more about OSA obstructed sleep apnea and less invasive treatment options at

holski said...

Hey Stephanie!
Good luck with your surgery. Sept 9 is right around the corner. =) I am excited to see how things turn out. I think our surgeries will be kind of similar. ps-my airway is twice it's originally size now, and breathing is wonderful. My resting heart rate is even down! (I saw how small your airway was in your xray). Anyway, good luck and I will keep on reading!

Bella said...

Note to self: don't get pregnant for another six months.

Wow, that's quite the list. They didn't tell me any of that stuff before my surgery. I wish I had taken iron pre-op, because I am still battling with iron deficiency six months later.

Melissa M. said...

thanks for posting all this information; it was nice to get an idea of what i'm in for. hope everything goes well!

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