Wednesday, October 31, 2007

Just in time for halloween!

I am a pumpkin head just in time for Halloween! Thanks to my lovely girlfriend and her zany dollar store adventures!

There are some new shots in my gallery for you. Beware!!!

Getting to the hospital was fine, and I wasn't as starving as I thought I'd be. They pretty much took me right in and it was much the same story as last time. I laid on a gurney with a warm blanket just before Dr T came by to have me sign my consent. He ended up doing Le Fort I advancement, maxillary vertical reduction, widening of the left side of the maxilla just in the back by one of my molars, tiny cheek bone grafts, BSSO setback, and genioplasty.

I definitely feel 3 times as swollen as I did after SARPE and I think I look it too. I have a splint in and I am banded shut. Surprisingly on day 1 my sinuses were clear. Not quite so lucky today but I suppose it could be worse.

Yesterday Kristy and Jonathan were kind enough to come by and see me. Don't you all think Dr T did an amazing job on her! Thanks for the bamboo, guys! You didn't have to do that and it was great to meet you in person despite my darkest hour!

I made sure to take the Sudafed and Otravin this time, I think that helped, but until Dr T cuts these elastics on Tuesday it will be a challenge to get crap out of my nose and throat. Eating with a syringe sucks too, literally, one freaking milliliter at a time!

I don't feel a lot of pain, more pressure from the swelling really. I'll take a bit of codeine tonight though to help me sleep. Hopefully my stomach can deal with that.

The floor I was on was much quieter this time and my roommate barely made a peep. So that was really nice.

Getting home today was really shaky. After all I hadn't eaten anything for 2 and a half days. I feel a bit better with a couple of meal replacements in me now. I'll try another one later tonight.

Overall I feel very tight. I can barely see my teeth and can't really see my new face yet due to the swelling. I did two hot compresses today, so hopefully that will help get things going. My mom said she thinks my chin will turn out a lot shorter though.

Dr T said he was happy with how things went and that it was pretty straightforward. I'm glad that he didn't have to do any further expansion in the center. The SARPE worked pretty much right on target.

All for now. I'm really wiped. Wish me luck for clear sinuses.

Sunday, October 28, 2007

The 11th Hour

Thanks everyone for your well wishes. The hour is near and I feel pretty good about everything. I had a nice relaxing weekend to help me wind down. My mom and my girlfriend are poised to help me out and I've pretty much finished doing all the little things I wanted to do before surgery day. My hooks haven't really bothered me much and I haven't even used any wax - just feels like I have more stuff in my mouth.

I check in to the hospital at 10:30am tomorrow (Monday) and I just hope I'm not too starved, not looking forward to that part.

I posted some pre-op shots in my gallery. Unfortunately I don't really have a way to update my blog with photos until I get back and I do it myself, sorry to make you all wait! My mom has her camera though so I will post everything as soon as I can.

See you all on the other side!

Thursday, October 25, 2007

Arrrg! The Return of Captain Hook!

You know you're ready for surgery when…

…you have 6 hooks on top and 5 on the bottom! I didn't realize he would have to take the wire out to put them on. As it turns out they are the same type of hooks he put on for the class II elastics; and for those two he just bent them on to the wire. So technically I was Captain Hook before I even realized it!

He made a small adjustment on one of my lower right pre-molars, and I asked him if he could tilt my left central incisor to try to close up the space a bit more. He explained that the space is due to gum recession and that because of the irregularity of the shape of my teeth I would likely need to get veneers to completely eradicate that space. Veneers are also a better and more permanent solution for my peg laterals (which are now bonded in case you forgot). Gum tissue can only fill in so much space. He cited a study in which gum tissue was shown to grow back if the teeth are augmented to the proper shape. I've had a feeling this would be needed, but veneers are $1000 each so I may be waiting a while to get those! Maybe I could do more bonding in the meantime if it's really bothering me. We'll see how things are once my braces are off.

I asked if he would be talking to Dr T before Monday - he said no. They've worked closely together for long enough that he knows what to expect from him and vice versa. My surgery is very routine for him and said they consult only when really special cases arise. Everything I've heard from both docs has been in sync so I'm fine with it. They both have a very good reputation. Dr W said it is really Dr T who calls the shots, which makes sense.

One of the really cool things about Dr W is that he knows how to do some cranial therapy and uses it for his surgical patients. I go back to see him the following Wednesday for 20 minutes of this and again 3 weeks later. I definitely need to go back to the cranial RMT following surgery too. I'm definitely sold and I would highly recommend it to any jaw surgery patient or even just for general relaxation.

I ate lunch avec les hooks. Not too much trouble, and my lips aren't bothering me too much right now. I do seem to have some irritation at the right corner of my mouth though. I think that appeared after getting the models done at Dr T's pre-op. Vaseline seems to be making it more bearable but I hope it clears up. We'll see how things are by Sunday, but I suppose it won't matter much after surgery.

You will notice that I changed my photo links. I ran into some trouble with my Flickr account so I copied everything to a new Picasa account. I will be posting all my post-op photos there.

Tuesday, October 23, 2007

Pre-op shenanigans 2007 Edition

Today was pre-op. My hospital appointment was for 8am and I got there well ahead of time. Thankfully I noticed on the info sheet that I had to go to the admitting room first. That went quickly but I discovered that they raised the prices of private and semi-private rooms by $10. $260 for private and $215 for semi-private. I requested a private room. After last time I think it's worth it. I think of it like a full service hotel. :o)

Everything with the nurse's interview went fine. Maureen is a chipper lady who used to actually do the post-op nursing with Dr T. I wish she could be there to look after me because she was very informed on this kind of surgery. I remember the nurses last time didn't seem to be very experienced with it, or at least that was my impression. Seems they had the wrong surgery time in the computer though. It said 12 noon but I'm sure Dr T's office told me 8am. So I'll confirm that today.

My blood work was done by a sweet old European lady who felt horrible for causing me any pain.

"Oh sweetheart, I'm so sorry. Just a little pin prick ok? Oh I'm so sorry!"

Hehehe! I told her I charge $50 per unit. She laughed.

We then went for an ECG. I'm amazed at how quickly the new machines take the readings. I brought the results back to Maureen and told her I had some pretty pictures for her to look at.

"Haha, yep, and they look really boring. You're good.".

Yay, no cardiac problems.

I then saw a guy from the anesthesiology team. He asked me a bunch of questions related to my interview and history. He listened to my heart and said it sounded fine. He then explained about the tubes they would be using, one in my trachea and one in my esophagus. The first one gets removed before I wake up when they are convinced I can breathe on my own. The second stays in a bit longer and gets removed in the recovery room. Same as last time. He said it would be uncomfortable. I remember that.

I'm not supposed to take any Advil from now till surgery. I'll ask Dr T about that as I definitely feel like I need it. Tylenol doesn't cut it.

Ok, of to Dr T's office soon…

…Ok, I'm back. It's definitely a blustery day out there! I arrived a bit early and was surprised not to see a madhouse of people in the waiting room. In fact there was only one other to start with. I got called in to do the paper work and paid my $2700 (ouch!). I also confirmed that my surgery time is now 12 noon, so that means I check in at the hospital at 10:30am. I'm really not happy about this only because it means I have to starve myself for 12 freakin hours! I am definitely going to try to stuff myself at 11:30pm on Sunday night!

After a second short wait it was time for x-rays; a panogram and cephalogram. They didn't give me a copy but I saw them on the viewer and can definitely see the disparity between the uppers and lowers, especially at the back molars.

A few minutes after that it was time to see Dr T. Most of the rest of the staff had gone home (or for lunch, I'm not sure which) and I was surprised that Dr T himself did my models! He also did a wax bite model and took some other measurements while sizing me up in various ways. I could hear the wheels turning in his head. Now that he has all my records he will study them to determine exactly what he needs to do, so I won't find out for sure until surgery day but it's definitely lefort, BSSO, cheek bone grafts and genioplasty. The question is just whether it will be a segmental lefort and whether he needs to widen my palette any further.

"You've done this a few times right?"

"Never. You're the first one."

"Ah, I'm the guinea pig then, ok."

"Actually I've been doing this for 30 years and have had over 4000 patients."

I can live with that!

He mentioned that he had just got back from Italy was still feeling a bit jet lagged. I told him to make sure he gets extra sleep for Monday.

"I don't need a lot of sleep really. Four to five hours and I'm good."


"Yeah, I did 3 cases on Monday and was feeling kinda tired, but nothing a can of Coke won't fix."

Haha! Just in case I needed proof that this guy was born to be a surgeon. And yes, he was totally kidding around here folks.

I will have a splint. Yes, my favourite! I wonder how it compares to the nasty RPE I had. Either way it sucks.

I will also be lightly banded for 6 weeks and will be able to remove them for eating and cleaning.

The hospital told me to stop taking Advil from now till surgery, and I definitely cannot live without that as my back gets really bad sometimes. I asked him if that was really necessary and he said that his only concern would be if I was taking huge doses of it. My usual two or three per day were fine by him. I will try to keep it minimal though.

Surgery typically takes him 2.5 hours. I told him that I often hear about it taking more like 5, but he said he has a great team in the OR and they've done thousands of cases. It really just depends on how experienced the surgeon is. I could go to a teaching hospital and have it take 10 hours if I wanted. No thanks. He also doesn't make any incisions on the outside of the cheeks like some surgeons do. He said he has enough room to get in there and put the screws in.

I asked for my post-op meds and he gladly wrote out a script for me. Same as last time: keflex and liquid codeine.

Overall he said things look good and he even remembered me from when he did SARPE on me. He was really happy with how that turned out. Me too.

Hooks on Thursday, agh!

Thursday, October 18, 2007

10 Days To Go!

So here I am, 10 days before my big face reconfiguration. I'm feeling somewhat smug about it lately. I'm so used to blocking it out of my mind; until now it's felt like an eternity away. I'm sure these ten days will go quickly. I still have pre-op, hooks, and lots of last minute madness at work to get through.

One thing that is freaking me out lately is something new that I learned, one of the possible complications of this surgery. Maxillary delayed union. It basically means that the upper jaw doesn't properly grow back together and in some cases a second surgery is needed to fix it.

I know, what are the chances, right? But it happens.

I suppose a ton of other things can go wrong too, like maybe I'll catch a superbug in the hospital.

Meh. I'll just have to roll with it.

I plan to take some pre-op photos this weekend, so I'll be posting those fer y'all.

I went out and got some True Mass. I figure it will be better than just soy protein like I had last time. I am also going to get some Vega and bromelain capsules to put in my shakes.

I think I'm ready. Err, well sorta.