Sunday, September 28, 2008

Day 19 post-op

Wow ... what a weekend. On Friday, our house was like a revolving door. The cleaning people were here, and then the window washer came. The phone rang a couple times to ask for directions for a couple of deliveries??? I received a beautiful ficus tree from my godmother for my recovery, and some beautiful sunflowers from my boss and his wife. The morning was starting off to be a good one. Then, around noon, I was on working on my computer, and all of a sudden my mom showed up at my house with my best friend and her husband! They flew in from Denver ... apparantly they had been planning this with my husband for several months. It was a VERY nice surprise!!
Last night, we were out on the patio hanging out and chatting, and there were a few times I was just cracking up laughing. I had to hold my upper lip so I didn't smile too much as I was worried I'd pop a stitch. I ended up getting sharp pains in my ear, I think all of the tension in my jaw from laughing got to me. I swelled up considerably. Everything in moderation I guess.
I can only open my mouth up about one finger, I was able to get my vitamins and a bromelain pill in. When I open and do my jaw exercises, it feels almost like something is preventing the left joint from opening further, it's so wierd.
As for my bands, I spoke too soon after my last post. The second time I had to put my bands on, it was an absolute nightmare. I took about 30 minutes to get my lower left one in, and thought I would never get it. I was so swollen after that, it was ridiculous. The next couple times were a little better, but now I think I have the hang of it. Definately not fun at first.

Here are some pics from today, day 19. I can't believe it has almost been 3 weeks ...

Thursday, September 25, 2008

Day 16 post-op

Today I had my 2nd appointment with my OS, and lots happened today. First, when my OS was checking out my mouth, he said that my mid-line has shifted to the left on my upper jaw, and it was right where it should have been when he saw me last week. So, we are going to have to use rubber bands to get it back to where it should be. When I looked in the mirror, wow, it is way off ... I didn't measure but I would venture much more than before my surgery (I was 2 mm to the left) ... I think I am about 5 mm to the left right now. Yikes.

Then he saw the exposed plate. He said that wasn't exposed last week either! So, he has me doing Peridex twice a day now for the next couple weeks, apparantly it will help skin heal over the plate hopefully. I cringed when I heard him say Peridex because I know it stains the teeth, but he said only when used long term, so hopefully my teeth won't get too dingy from a couple of weeks of use.

He showed me how to change my bands, and tonight I changed them for the first time. I did it in about 15 minutes! I thought I would take much longer, but I have to say, the one on my lower left back molar is so hard bacause the hook is so close to the gum. Since I can't feel my gums, makes it a lot harder to try to hook the band on, and you don't know if you are beating your gums up. But, I did it, so I was happy. I also can brush my front upper and lower teeth, along with my upper molars. He won't let me brush my lower molars yet because of the sutures.

I am also cleared now for a blended diet and I can eat dairy now! So, after leaving my OS's office, I got a Vanilla shake from McDonald's and sucked it down. We stopped at the grocery store to get a few more things now that I am on blended, and I cooked up 3 strips of bacon and mixed them in the magic bullet with home-made black beans and beef broth. Wow, that was good, but it was so weird to eat something with particulates. Since I can't really open much, they didn't get into my mouth. Oh well ... the appetite is definately back and it was DELICIOUS!! I can't even describe how weird the eating process was, though. I envisioned moving to particulates much easier.

That's all I'll post for now. I should also mentioned that I lost all of the 8 lbs that I gained inicially and I am now down 9 lbs. from where I started. That seems more normal!

As of Tuesday morning, I was off all pain meds, including children's motring (ibuprophen). I took some tonight beacause my teeth are a bit tender from the new band configuration.

Monday, September 22, 2008

13 days post op ...

Last night, I coughed in the middle of the night and popped the band on my front teeth, so I called today and they had me come in, although I was going to see another doctor, not Dr. P. First I had my Ortho appointment. He checked everything out, and said things looked very good, although Dr. P had mentioned to him that he had a very hard time stretching my pallet (the tight skin issue). He said that I would be very happy with my progress by the 4 week mark, and that my profile was settling in very nicely. They took a few pictures (no lip retractors, but they had to stretch my mouth with the assistant's fingers so she could get pics of both side of my bite) and I was on my way.

I saw Dr. L at the Oral Surgeon's office, and found out some new information that made me understand Dr. P's conservative approach to eating much better. When he started checking out my mouth, he said to me that I need to do a better job of brushing. My mom and I glared at him and we both blurted out that I had strict orders from Dr. P NOT to brush, that I wasn't to disturb my sutures in any way. He wasn't sure why Dr. P wouldn't let me brush yet, and started looking around my mouth, and said "ah ... I see now. It looks like you have an exposed plate". What??? I guess that kind of freaked me out. He said that happens occasionally, that the skin will not stretch completely over the plate. The skin very well may grow over it while it is healing, if not, I can have it removed down the road. He said there was one gentleman that had been one gentleman who recently came in that had an exposed plate for 2 years now, he was just getting sick of food getting stuck there so had it removed, but otherwise caused him no problem. I will definately be asking Dr. P about this at Thursday's appointment. But it explains why he doesn't want me to have anything with particulates. I also asked Dr. L about eating dairy ... he said the reason I shouldn't have dairy is because it leaves a thick film on the teeth, and since I am not allowed to clean them yet, not a good idea. So I am really crossing my fingers that on Thursday Dr. P gives me the ok to brush (I know I won't be able to brush my back teeth because of the exposed plate, but at least the front) and move on to a pureed diet.

In other news ... the last two nights I have woken up every hour to hour and a half, and have had a hard time getting back to sleep. I asked Dr. L about this today, and he said that this is common when you are coming off the pain meds as they can be a bit addictive, even though I didn't take them for that long. So, hopefully that will be short lived ... as it is quite annoying not getting a good night sleep.

I am going back to work tomorrow on a part-time basis, just for the week, and next week I will be back to full time, although I will be working from home. It will be good to get my mind back on work so I can start focussing on things other than my mouth again, hopefully it will make time start to go faster as I think I have been feeling the "blues" these last few days.

Sunday, September 21, 2008

Day 12 post-op

Sorry ... I've been a bit lax lately about posting. I have pics from most days but I will post just the ones from today. I am completely off all my meds now, except ibuprophen. My vision is slowly returning to normal, it is not perfect yet but gets better every hour. Here are today's pics:
I am starting to get some tingling in my left nostril and roof of my mouth as the feeling is begining to come back.

I occasionally get sharp pains in my ears. Tomorrow is my first appointment with my orthodontist. I am looking forward to Thursday's appointment with my OS because I am hoping to graduate to any blended food. I just don't have an appetite so it is hard to get things down, but I am trying to force myself so I atleast get some calories in.

Wednesday, September 17, 2008

Day 7 and 8 post-op

I had my first post-op appointment with my OS yesterday. Everything looked good, and I've graduated from clear liquids to any liquids without particulates. So basically, I can eat any liquids as long as I strain them first to make them particulate free. That at least gives me a little more variety for the next week. I can't clean my teeth yet, only with peroxide/water/mouthwash and saltwater rinses which I do all day long. No matter how much I rinse, it still gets yucky up there. I can't wait until I can use a toothbrush!

Today I went for another session of Manual Lymphatic Drainage today. Since I just did it last Friday, she mixed in some Reiki this time and I really think it made a difference. Below are pictures I took this morning before the MLD/Reiki:

And here are the photos from after the MLD/Reiki session:

I have been slowly trying to reduce the use of meds, right now I just have my pain patch and anti-nausea patch which will last until Friday, and I haven't taken my Oxycodone since 7 am yesterday morning. I have taken liquid ibuprophen twice when I start feeling a bit of pain. I am hoping once the pain patch is gone I can just be on the ibuprophen.
I still feel like I have a considerable amount of swelling but I am making progress every day. I started taking some supplements, today I mixed in some soy protein and I crushed up some bromelaine tablets to put in my juice. I also had bought some Coromega (fish oil gel) ... I mixed it with a little bit of 7-up and put it in the Magic Bullet ... it was so good! It tasted like a "Dreamcicle"! I highly recommend that for those of you who want to get some Omega 3 in your diet if you can only take in liquids (I don't think opening a fishoil capsule would taste very good!). Tomorrow I will try crushing my Usana vitamins and mix in some L-Glutamine.

Monday, September 15, 2008

Day 6 post-op

This morning I though my swelling had gone up since yesterday, but I think it is definately much better this afternoon. The thing that is causing me the most discomfort for me at this time is the congestion. My mom called Dr. P this morning because she had a few questions for him, and he suggested that I take Dimetapp instead of Sudafed, he though I might have had a bit of an alergic reaction to the Sudafed. In any case, he wants me to come in tomorrow vs. the Thursday appointment we had scheduled. Even though I have most of my feeling, I can really feel the tingles today, my lips feel a bit raw, and I seem to be more sensitive to cold than I was before. I wouldn't same I am in pain, it is just different, a wierd sensation.

As of this morning, I was back to the weight I originally was when I went in for surgery. So since last Tuesday, I gained 8 lbs and lost it. I definately expelled more liquids today than I took in, so I am thinking tomorrow morning I'll show some weight loss on the scale. I still feel very bloted though.

I have to really take it easy on talking, I think I've pushed myself to hard and now I am really stiff, so I "sound" much worse than I did before, but that is just because I am congested now and my lips have become more stiff when talking.

I have been pleasantly surprised that I don't feel like I am starving yet. I have been surviving on water, chicken and beef broth, vitamin water, sprite and apple juice, but I have been making sure to get lots of those down, so I haven't felt too hungry. I can be drinking all day, though, and still don't think I come close to 1000 calories. I wonder if he'll give me the ok tomorrow to go on the blended diet, or if I have to stay on the clear liquids another week.

My mom and I went for a walk this afternoon, and when we got home the owner of the Rottweiler was at my house. She appologized profusely and said they decided to put the dog down. It made me feel a lot better that they had remorse for the situation, because I didn't feel that way on Friday. I am also glad it won't have the opportunity to hurt anyone in our neighborhood. It has to be quarantined for 10 days (in a kennel), and then it will be put down. So now I can take a normal route on my walks vs. cutting through other people's lawns. Everyone in our neighborhood is breathing a sigh of relief right now.

So, here are the pics from day 6. The bruising on my face is almost gone, most of what I have now is on my neck and chest.

Sunday, September 14, 2008

Day 5 post-op

Here are my day 5 pictures, the swelling is gradually going down and the bruising is almost gone (I have been using arnica gel on my face, so I really think that has helped):
I got very congested again today, everything felt really tight in my face. I wanted to hold off on taking the Afrin because it can cause a rebound effect if you take it more than 4 days in a row., so I took liquid sudafed and that seemed to really do the trick. The sudacare tablets also seem to help in the shower, and the rice socks to apply heat to my face. I have a humidifier in my room to keep things moist. I also went 9 hours today without my oxycodone, I am thinking maybe tomorrow I will try to only take the oxycodone at night, and liquid tylenol during the day, so I can start weening myself off the heavy pain meds. I do still have the fentanyl patch for pain. I took a walk today, I had to cut through some neighbors lawns to get out to the main road, since I didn't want to walk past the neighbors house with the dogs.
So, overall, recovery is still going pretty well, all things considered. The one thing that amazes me is how my lip incompetence has been eliminated when my lips are at rest. My lips are pretty swollen right now, but it is such a cool feeling not to have them open 7 mm.

Saturday, September 13, 2008

Day 4 pics

Here are today's pics, taken at around , the swelling is gradually going down, I can't say for sure if it was due to the MLD theray or not, but it certainly couldn't have hurt. You can also see the bruises settling in, above the bridge of my nose and around my jaw-line. I have taken Afrin once on Thursday, Friday, and Saturday since my nose has been so clogged, todays dose hopefully did the trick because I took it around 2 pm and I still haven't gotten the congestion back.

Regarding the whole dog attack issue, My mom took Shelbyto the vet right away. She had many stitches and a tube put into her back to drain the blood so it wouldn't abcess. here's a photo of the injuries she sustained. They had to shave her fur see how much damage was done, and to stitch her up.:

They didn't even appologize for the incident. I would have expected them to come over to our house afterwards to see how thing are going, but they never even do that. I did speak with the police, and they said that unfortunately there wasn't much they could do about it, since no body has reported any prior offenses with their dog. I asked the policeman if we had to wait until the dog attacks a human before anything will be done about it? He said that unfortunately dogs have more rights than humans in these kind of situations. This dog has chased several neighbors down the road before, and most people around here won't walk by their house because they are afraid of the dog (s).They are always outside and the and just don't seem to care. Even though they have an electric invisible fence, the dogs still somehow get out. On several ocations, the Rotweiler has gone after another neighbors dog, He was just able to pick him up in time before anything happened. The police officer said that he would go talk to them, so I wanted to hear whet they had to say before pressing charges. I didn't hear back from him today, so we called, and it appears we can't find out any iinformation before then. If the plice don't/can't do anything about it, most of our neighbors have agreed to sign a petition to get that dog out of here. People should not be petrified to go for a walk in fear that a dog may attack them. I noticed I was clenching last night, which worries me, because I don't want my jaw to pull apart everything that is fixed in place. clinching for me is many times induced by stress, So, now my mom is taken care of 2 patients.
Thanks again to everyone for your kind comments. I will respond to them when I am able to see/read better.
Oh - I almost forgot ... I stepped on the scale this morning, and I was 4 pounds lighter than yesterday, so I am still up 4 lbs from surgery, but anticipate hat will change over the next few days/weeks.
My clear liquid diet has consisted of ice water, apple juice, beef and chicken broth ad sprite. Luckily, I haven't been hungry up to this point, so I've been getting along frine on the clear liquid diet. I am constantly drinking so I know I am getting more than enough liquids, but calories are probably still on the low side. It's really hard to drink 1000 calories/day of only clear liquids.
I'll post again tomorrow with more pics, I hope i have better vision then so I can actually read when I am posting, as well as check out the updates you all have been posting.
Pain wise i am doing well, as long as I keep on top of the meds. My first appointment with my OS is next Thursday.

Day 3 pics

I have to keep my posts to a minimum tonight becaue my vision is so blurry (just for reading, I can see things well far away. The doctor says it is most likely from the anti n nausea patch.

The first 2 postsare from early in theday yesterday, before I did my MLS tratment.:

This second set of photos wastaken yeserday after my MLD treatment;

Friday, September 12, 2008

Day 3 ...

I had my MLD massage at 11 today, they focus on the whole body, not just the face. It felt really nice, I am supposed to be drinking even more fluids than I was to flush the toxins out of me., and take some short walks. My mom and I just went out for a walk with Shelby, our dog (my parents had "adopted" the dog from me several years ago when I lived in Mexico). Two houses down, the family there has a Great Dane, a Golden Retriever, and a Rotweiler. They have an electric fense, but it doesn't seem to be very effective alon their driveway. When the dogs saw us waling by, they cam running, and the Rotweiler attached Shelby! It was all my mom could do to get Shelby out of there, but he had already punctured her skin and did some kind of damage to her leg. So, my mom just left to take her to the vet. I was helpless because I wasn't about to get in the middle of a fight wiht a Rotweiller, as I couldn0t take any chances with my jaw. The owners of the house came out and said they would take care of any vet bills, but jeez! They need to keep that thing on a tight leash with a muzzle or put it down! I love animals, but now I am so afraid to walk by that house. I think I am going to have my husband call the police when he gets home. I really don't need to worry about my safety or those of anyone visiting me, and since we are on a dead end road, that is the only way I can go to take a wald.

Ill post more later on when thins settle down, I just am in a bit of a shock right now that this happenedd

Thursday, September 11, 2008

Princess Spud ...

What do you guys think? See a resemblance?
My swelling continues to go up ... just when I couldn't imagine it getting any more swollen. I made an appointment for MLD Therapy tomorrow, so we'll see how that goes. I think the long walk today wore me out, so I have been taking it very easy since then. I have switched from the ice packs to heat packs (rice socks), they feel good on the face but I really don't think they help with the swelling.
For those of you who have gone through orthognathic surgery, did you gain weight before you lost it? I just find this so incredibly odd. Yesterday I was 6 lbs heavier than when I left my house for the hospital, and I have gained another pound since yesterday! I am drinking lots and lots of liquids, but it just seems crazy I seem to be retaining so much water. My mom called my OS to make sure that was Ok, and it seems that it is, I just have not seen it happen to anyone yet.
Bruising is minimal, I have 2 dark dots on the bottom of my chin, but I am not sure if that will continue to progress as time goes by. I have been keeping arnica gel on it, so hopefully that is keeping the black and blue at bay.

Day 1 and 2 post-op pics

The first photos are in the hospital yesterday, day 1 post-op:

And here are today's pics (day 2 post-op) ... as you can see, I have LOTS of swelling. I have been keeping ice on my face at all times. I'm not sure if it is helping at all, but it feels good to have it on. After today I will switch to moist heat.
In the next one, I am trying to smile ...

And lastly, my side profile;

Do any of you remember the movie "Pure Luck" with Martin Short? That's who I feel like I look like right now, after he got stung by the bee and had an alergic reaction! I am going to make an appointment for MLD (Manual Lymphatic Drainage) for Saturday to see if that helps reduce some of the swelling. In a little while my mom and I will go for a walk ... it will be good to get outside and enjoy the fresh air a bit.

I am sorry if I have a lot of typos in my post-op posts ... looking around I can see fine, but I am seeing double when I look at my computer so I can't really tell if I make any errors when I am writing. I am guessing it is the oxycodone that is making my reading vision blurred.

Wednesday, September 10, 2008

Back at home!

I saw Dr. P this morning, he stopped into see me around 6 am. Everything went very well with the surgery, but again, he said everything was so incredibly tight that he had a hard time with it. The bones in my mandible broke very nice for him for the BSSO, but again he had some trouble with the movement because of the tightness of the skin. He then splinted my lower jaw to move onto the upper jaw surgery, which usually takes only a few minutes but it took him around 25 minutes just to get the splint in. The 18 mm is not how much he moved the actual bone, but it is how much of a movement will be percieved with the rotation. He ended up just doing a one piece LeForte I because he was worried about doing more pieces with my tissue being so tight, but that should not affect my outcome. I guess I started swelling up quite a bit even during the surgery. Today my swelling is really strong, I've been keeping ice on it constantly, I'm not sure if it's helping or not but I have nothing to loose.

Total, I have 8 plates and 43 screws. We took a picture of my swelling today, but I'll take another one tomorrow and post them then.

I am feeling pretty good as long as I keep on top of my pain meds. I have been taking in a lot of fluids, 64 oz. since I got back from the hospital around 2 this afternoon. I don't think I'll even need to use the zip.n-squeeze bags, or the sippy cup, as I pretty much have all of my feeling in my upper and lower lips. so I am just drinking from a plastic cup. It is a little numb and tingly on the sides of my mouth, but Dr. P said that's most likely from the stretching and that will come back quickly. I am very surprised at how little numbness I do have ... I was expecting much worse ... but Dr. P did say that my alveolar nurves in the mandible were very well protected so he didn't have to touch them or move them at all, which explains the lack of numbness.

I stepped on the scale and I weigh 6 lbs more than I did yesterday before going into the hospital! I am guessing it's from the IV and all of the solution they pump through your body, but I just thought that was strange. Has anyone else gained weight in the first few days?

Tuesday, September 9, 2008

Nose Tube is out!

Dr. P called again, and the nurse convinced him that my nose tube can come out! So, I have now been drinking water out of a cup. I really didn't think I'd be able to do that, since I thought my whole lip/chin area would be numb. Of couse, I have to be careful not to spill it all over me, but I don't think water ever tasted to good!!


So here we go ... the first picture is me in the "holding area", waiting ot go in for surgery ...

And this next one was taken about 2 hours afer surgery, once I got up to my room:

I still have the nose tube in, supposedly I am supposed to have it in until tomorrow. However, there is no new blood going into my stomach, and it appears that it all has been sucked out. Dr. P has called the hospital a few times to check in with the nurse who is taking care of me, and she is trying to convince him to let me take the nose tube out. I can't drink anything until it gets out of there, and my mouth is so dry! That is really my only discomfort ... I'm thirsty. Other than that, things are going very well. I got up to take a walk around 5, with the nurses help of course. Then I used the bathroom as long as I was up ... everything back to normal. I did get light headed by the end, though, so I just have to take it easy. I am so pleased with my progress so far (although I look like Mr. Potato Head, but that of course was expected).

Numbness is great. I have all my feeling in my chin, just a little tingly on the left side. I can feel my whole lower lip except it is tingly on the lower left side. Upper lip is mostly numb, but I have feeling in the middle. I am really doing so much better than expected. I would only classify my pain as a 2, if even that. I think I've used my morphine button about 3 times ... not too bad.

I have my handy-dandy jaw bra on now from Zip-n-Squeese, we just have to change out the ice quite frequently as it melts pretty fast.

I repeated to myself hundreds of times this morning "I am strong, I am healthy, I recover fast", and between that and the skill of my surgeon, I really feel like I have come through this with flying colors.

My mom cleared out my nose (the nostril with out the tube) with a q-tip and hydrogen peroxide, that felt really nice to get some of that gunk out of there. I am breathing through my nose very nicely.

So, that's where I'm at. I really don't think I could be any better than I am ... very pleaseed so far.

On the other side - less than 3 hours post-op!

Hi everyone! I made it to the other side! I am feeling pretty good, they told my mom and husband that they advanced my lower 18 mm, not sure about the upper.

The surgery lasted around 4 hours 40 minutes, I have my nose tube in still because they are worried about blood in my stomach. I am so thirsty, though, and I don't think I'll get anything to dink until the nose tube comes out. Pain is pretty good .. I've hit my pain clicker once so far (morphine drip). Everyone here has been so nice. The anesthesiologist told me before surgery that it was going to fell like someone drove a truck up my nose. Nice, huh?

I'll post some pics later, swelling is there but actually better than I expected. Dr. P apparantly said I was one of his more difficult cases, not because my mouth was so small but because my tissue was so tight.

Thanks, everyone, for thinking about me. So far, it's gone better than expected. The best news? 2 different nusrses asked why I wasn't going to the pedriatric until ... they thoght I was under 19!! Not to bad for a 34 year old :)

Monday, September 8, 2008

Thank You!!

I just wanted to THANK everyone for all of your well wishes! Less than 8 hours to go ... my hospital bag is packed ... and I'm as ready as I ever will be. I'll post as soon as I can on the other side. Thank you all again for the great tips, advice, and support.
I met Dr. P in his office this morning at 6:15. He refit me with the wax impression we did of my bite, and everything looked good. He then fit me once again with the face-bow, and had me once again look into the horizon. He explained that studies have shown that if a patient moves there head up and down several times, and is then asked to look into the horizon, there is only a couple degree variation, statistically a very accurate measurment. This time he had me look into my reflection so I could see my eyes, and we did it several times, and it appears that this may have been the problem, that I possibly was not holding my head completely "horizontal" when we originally did the face-bow. He has done many surgeries, and this is the first time this has happened. He was happy, however, that the error was with the face-bow, not the x-ray, because if it was with the x-ray we would have had to reschedule my surgery because they have to start over. With the face-bow, as long as they know what the true measurements are on the x-ray, they can work with it.

I mentioned to him that I had been sick but was getting over it. He said that I should see how I feel tomorrow, he wants my immune system to be at 100%, this surgery is hard enough to recover from as it is, and you don't want to add a compromised immune system into that mix. I think I'll be fine, I still have a bit of a cough and a little drainage, but it has made leaps and bounds every day.

I had a dream last night that my surgery was cancelled. Not because of the whole face-bow/x-ray issue, but other issues. I was at the hospital, and a ton of people showed up from my work to support me. Dr. P then came in and made an announcement to everyone that after further review, they could not fix my bite surgically, only orthodontically with a compromised result. Needless to say, I was crushed. Luckily, I woke up.

In other news ... it appears I won't need the genioplasty. So good news there ...

Less than 24 hours and I will be in surgery.

Sunday, September 7, 2008

An Unexpected Twist ...

So I just got home tonight, and had a message from my OS waiting for me. He said he has been working on my surgery for the last few days, and things just aren't matching up right, so he needs me to come in. I called him back, and it appears that there are some discrepancies between my x-rays and the face-bo measurements. So he needs to figure out where the error is. The problem is, he is at his remote office tomorrow about an hour from here, so we have to do it in his local office either early in the morning or around 6 pm. The latter will not work out too well because his office is near the stadium, and there is a Packer game tomorrow night (that means pure chaos... Packer traffic is crazy!!). I'd rather get this all sorted out in the morning, anyway ... otherwise I am going to be stressing about it until surgery. So, I will meet him at his office at 6:15 am tomorrow morning, and hopefully he can figure out quickly what the discrepancy is. Whatever I need to do ... it's my face ... I want things to turn out right!!!

48 hours and counting down ...

If all goes as planned, 48 hours from now I will be undergoing orthognathic surgery. I started to come down with a cold/sore throat on Thursday, and Friday I was feeling pretty rough. I couldn't stay home to fight it off because I have so much to get wrapped up at work. Yesterday, I stayed home all day and started to feel better, and today my congestion is much better, my throat a little sore but I am optimistic I am going to kick this. I am so frustrated I got sick, I haven't been sick with a cold or the flu since I started taking my pharmaceutical grade vitamins a year ago. I guess since I had to go off the vitamins 14 days before my surgery, and all of the stress I've had with work, my immune system was down. I don't want to have my surgery canceled because of this, I don't know how quickly they would be able to reschedule, and that would really screw things up. So, I am drinking a ton of juices and fluids, trying to flush this bug out of me.

I can't believe it's almost here!!

Monday, September 1, 2008

More pre-op photos ...

I realized that all the photos I've posted on my blog were from my OD's office, so I thought I'd post some that are more "natural". The photos below were taken at my best friends wedding at the begining of August. I have a tendency to jut my lower jaw forward when posing for a photo to mask my recessive chin, so it may not seem quite as bad as in the other photos I've posted, but you can none-the-less still see my mandibular deficiency ...

On another note ... if anyone has any more ideas for clear liquids i can drink post-op that will make me feel full, that have no particulates, please let me know!!

T minus 8 days ...

A week from tomorrow ... I will be undergoing orthognathic surgery. A lot of people have asked me if I am ready, and I guess I am as ready as I can be, at least for the parts I "can" prepare for. I have been researching and reading about this surgery for over a year now, so from a preparation standpoint, I don't know how I could be more prepared. Now we'll just have to see how I deal with it after the fact. But I know what to expect, so hopefully there will be very few surprises.

So, my "official" post-op supply list ... this is what I have bought thus far to get me through the first 1-2 weeks post-op, and in some cases beyond:

List of supplies pre and post op

1) Arnica Montana gel (to reduce bruising/swelling)
2) Bromelain tablets (pineapple extract) – reduce swelling
3) L-Glutamine
4) Aquaphor (for lips – found in baby section of pharmacy)
5) Zip n Squeeze bags for eating
6) Sippy Cups
7) Baby Spoons
8) Baster (another method of eating if I don’t get syringes w/catheter at the hospital)
9) Zip n Squeeze jaw wrap (“Cool-Jaw” Wrap) – can also be heated for when I move to moist heat
10) Protein Powder (soy and whey)
11) Boost/Ensure
12) Baby Toothbrush
13) Children’s Sudafed (Non drowsy)
14) Extra Strenth Tylenol (Adult Rapid Blast Liquid)
15) Waterpik (I had one already, can’t use until OS clears me)
16) Q-tips and hydrogen peroxide to clean out nose
17) Afrin (for nose congestion)
18) Saline Nasal Spray
19) Dry erase board
20) Small notebook for writing down meds and frequency, Larger notebook for communicating, pen
21) Hydrogen Peroxide for cleaning mouth, Biotene and salt water for rinsing mouth
22) SudaCare Shower Soothers
23) L-Glutamine
24) Baby suction (for sucking spit)
25) Magic Bullet
26) Pill Crusher
27) Humidifier (I already had one of these)
28) Flaxseed and Flaxseed oil
29) Fiber (in powdered form)
30) USANA vitamins (I have taken these for the last year and will resume as soon as cleared by my OS … I will crush them in pill crusher or coffee grinder)
31) Coromega (Omega-3 fishoil supplement in gel form)


1) Sprite
2) Apple Juice
3) Cranberry Juice
4) Kellogg’s K20 Protein Water
5) Gatorade (Orange, Grape, and Fruit Punch flavor)
6) Beef and Chicken Broth
7) Ensure and Boost for when I graduate from clear liquids (I bought chocolate, vanilla, and strawberry flavors)
8) Lean muscle milk from GNC (protein shakes)

… once I move on from clear liquids I will buy lots of frozen fruits (the seedless varieties) for smoothies, and blend regular food and soups.

I still need to pick up some more pillows for my bed to sleep upright. Other than that, I think I am pretty set, and maybe even excessive with everything I have bought. I have been searching for button up pijamas to bring to the hospital, but everything is so homely. If I can't find anything, I will just bring my robe, after all, I will only be in for one night.

Oh - and how could I forget! I picked up my post-op prescripions so here it goes:

One bottle of liquid Roxicet (generic of Percocet, which is oxycodone with acetaminophen)

4 bottles of liquid cleocin ped, which is the brand name for clindamycin, which is a lincomycin antibiotic used to treat bacterial infections. I believe my OS usually prescribes amoxicillin, however I am allergic to penicillin, which it is related to.

2 transderm patches -- these patches are placed on skin behind the ear every 72 hours to prevent nausea and vomiting

3 Fentanyl patches - Fentanyl is a narcotic, a member of the same group of drugs to which opium and morphine belong. It is said that it has an analgesic potency of 80 that of morphine. This narcotic analgesic is used to treat persistent moderate to severe chronic pain that requires around the clock administration and can not be relieved by non-steroidal analgesics (such as ibuprofen or naproxen), narcotic combinations analgesics (such as oxycodone or propoxyphene) or immediate-release opoids (such as morpine sulfate immediate release). The patch is to be applied to the skin every 72 hours, prefered placement is the chest, back, upper arm, or on the side of the stomach.

Last but not least, I will be receiving a PCA pump in the hospital post op, PCA stands for "Patient Controlled Anagesia". Dr. P said I probably shouldn't need it to much though, since I will have a patch on for pain, which I am guessing is the Fentanyl patch. That would make sense ... if the fentanyl is more potent than morphine ...

Dr. P also said I won't have to go back on the doxycycline post -op ... if it is causing me gastritis, it is not worth it. I have to say I am more than pleased with that decision.

2 more appointments to go next week, my pre-op physical and my pre-surgical evaluation.

Now I just need to get things in order at work. It seems like there are just a million things going on right now, and to top it all off, the assistant for our division resigned last Monday, and she reports to me. So now, I need to scramble to get someone hired by this Friday, and arrange for her training since I will not be there to assist. I am trying to have everything in order so I don't have to worry about anything work related during the first 2 weeks post-op, I have 5 more business days to get it all done so that is probably the biggest thing that is stressing me right now. In the end, I know it will all work out, or at least I will have done everything possible that is in my control so it does, so I just need to take a few deep breaths and relax ...

Surgical Hooks and Pre-op appointment with OS

Last Wednesday (Aug. 27), I got my surgical hooks put on at Dr. L's office. I only have 2 on the uppers and 2 on the lowers, so it's not too bad. I just keep lots of wax on one of the lower ones because it rubs and caused a canker sore, but that's to be expected. As most have said, the most annoying part is all the food that gets stuck in them, they are harder to keep debris free. I asked Dr. L about the 2 predictions. He said that the first prediction was too masculine, so they softened it, so my result will more similar to the 3rd prediction picture in my last post. The projected movements, he said, were around 3.8 mm on my upper jaw (advancement), and 15 mm mm for my lower jaw, and around 3.5 mm for my genio (also advancements). As I processed this information, the math wasn't coming out right, given I started out with a 6 mm overjet and was supposedly going to be around 7 mm when I was ready for surgery (2 mm is ideal).

Thursday (Aug 28), I had my pre-op appointment with Dr. P, my OS. I had my mom come along since my husband is out of town in Europe. I had molds done at my pre-op appointment with my OD, so I wasn't expecting any new ones with my OS, but I was wrong. We had to take more pictures and molds. I was pleasantly surprised that everything came out pretty easily at my OD's office, but the trays at my OS's office were metal and had small holes all over them, so the back of the trays would get caught on my back brackets. Needless-to-say, I was happy when that was all over. Apparently my OS makes his molds into some stone material, so he could not use my OD's molds which are plaster. Prior to that appointment, I had my teeth cleaned, so by this point my joints were quite sore.

My OS had bimaxillary jaw surgery last year for obstructive sleep apnea, and I hadn't seen him since he had his surgery. I asked him who did his surgery, and he said an OS in Santa Barbara, CA. I said "Dr. Arnett"? He said yes. I believe he had his surgery last October or November, and he still has some residual numbness in his upper and lower lip.

He marked several black dots down the front of my face with a Sharpie marker, and pulled out the face-bo to take some final measurements. He pulled out his ruler and measured my gummy smile (4 mm of gingival tissue show when I smile, 9 mm from gum to top of lip). Also, my midlines are about 2 mm to the left (and chin as well). He said that a trained eye can usually pick up on a deviated mid-line at about 3 mm, and a lay-person when it is about 5 mm off. I truly didn't realize I was even off ... since both mid-lines are deviated the same way so they "look" like they line up. I also have a cant to my lower jaw. This will all be fixed during the surgery.

He still isn't certain how many segments my LeForte I will be, he will be sitting down with Dr. L one more time before my surgery to discuss my case and finalize the movements. He said that they may not even do the genioplasty. I asked him if someone could call me before the surgery to let me know the exact measurements of the movements they would be making, which he agreed to. I also asked him about the numbers Dr. L had given me, as 15 mm seemed like a huge movement for the BSSO. He said that was the approximate distance that my jaw would move including the rotation/leveling of my plane angle, but not necessarily how much they would be actually moving my mandible. So that makes much more sense. I am hoping I will find out beforehand the exact movements of the actual bones, I don't know why I am so interested, I guess I have read so much and it seems like most talk in terms of the movements of the bones vs overall movement, so it is easier to compare to others that way. In any case, if between my lower jaw and genioplasty, the overall movement is 18.5 mm ... that is 3/4 of an inch which will be a dramatic change! As I said to my OD, function first, aesthetics second ... but I sure would like to come out of this looking good. I do have to say, though, I have implicit trust in my OS and OD, they both have such a comforting demeanor and work so well together, so I have no doubt everything will turn out OK.

I asked had several questions for Dr. P, most related to supplements and post-op eating. I have to be on clear liquids for one to two weeks post op. Clear means see-though, so no milk, ensure, shakes, carrot juice, etc. That limits me to things like Sprite, apple-juice, chicken broth and gatorade. He did say I can have cranberry juice ... he considers that clear. I am hoping my sutures heal quickly so I can move on from the clear liquids after the first week. One week seems do-able, but 2??? Yikes! He very conservative on post-op eating, from what I have seen from others. He is very worried about infection, so doesn't want to take the chance of any particulates getting in to the incision site. He also is very cautious about getting sick (meaning vomiting), he said he has not had a patient get sick in 1.5 years. Therefore, as long as I am on the clear liquids, no supplements (even grinding up my vitamins or using liquid vitamins), no protein powder, no bromelain, no added fiber. I am not sure if it is all because he is worried about vomiting, or if some may be because he is worried about the particulates causing infection, but in any case ... no ... not until I have graduated from clear liquids. Well, I tried ... I was just looking for ways I could feel a little more full while on the clear liquids. I did pick up some of that K20 Protein water by Kellogg’s ... that way I will get in 5 g protein and 5 g fiber with each drink and I am not adding any supplements ... hopefully those will help a little my first week. The one thing that he did clear for me to do post-op is MLD (Manual Lymph Drainage), which I was very pleased. For those who do not know, MLD is a very gentle massage, it is a therapeutic method that uses massage-like manipulations to stimulate lymph movement. Lymph is the plasma-like fluid that maintains the body’s fluid balance and removes bacteria. Lymphatic drainage is said to beneficially affect the nervous, immune and muscular systems. The treatment consists of light touch massage that accelerates its movement and circulation. Lymph Drainage Massage strengthens the immune system and is for post-surgical patients, and for people with edema and seasonal allergies. It helps expel toxins from your system and ultimately will help with the post-op swelling.