Sunday, September 28, 2008
Thursday, September 25, 2008
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
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
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
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.
Monday, September 15, 2008
Sunday, September 14, 2008
Saturday, September 13, 2008
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.:
This second set of photos wastaken yeserday after my MLD treatment;
Friday, September 12, 2008
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
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
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
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.
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
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
I can't believe it's almost here!!
Monday, September 1, 2008
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!!
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
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)
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
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)
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 ...
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.