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!


At 7:39 PM, Blogger Amy said...

Wow Graham! Great post, brought back memories (and that weird pre-surgery anxiety feeling). Sounds like everything is in order. I hate to state the obvious - yes, the splint sucks. The RPE sucked worse cause it was in longer, but basically they both suck. At least your not wired shut, so it means you can enjoy the pureed goodness of just about anything once you can remove your rubber bands :)

All joking aside, it's very exciting to see your here and will be checking back often as you get closer. You'll have to show off your new hardware in photo. Now you get to finally be Captain Hook ;)

At 11:50 PM, Blogger Brandyleigh35 said...

Hey Graham,
Funny but as I read your post I got that same exact feeling Amy was referring to. It was like a flood of pre-surgical anxiety! Then I remembered that I'm already done so I felt much better! LOL..

So sounds like your procedures are going to be quite extensive. Upper, lower, genio, cheek bone grafts,and a possible multi piece/additional expansion. Wow! I don't envy you!

It does sound like you are in good hands though, and its nice that he remembers your SARPE. The whole, I'm just another patient thing has been a bit disconcerting to me personally. He sounds like my doctor with 30 years of surgeries. I think that is good, and man 2.5 hours...that is smoking fast! Wow! and that is cool that he doesn't make outside incisions.

Hard to believe your day is almost here. Are you starting to get a bit nervous yet? I can tell you that I will for sure be checking in to see how you are doing. Be sure and post lots of pics! I can't wait to see your post surgery panoramic x ray! Those look soo cool with all the screws and plates.

I will check back in, as you get closer to the 29th.


At 1:25 PM, Blogger Kristy Clucas said...

Ditto on the anxiety, but thats prolly cuz i have the same surgeon, go Dr. T. Sounds like the exact same i went through, same pre-op, same surgery time, and same advice.
It really sucks that its 12, same me. I will give you one heads up though. Ull get there 10:30, check in downstairs again, then go up to 1st floor, get checked in again, get into your hospital attire, and honestly u wont wait much longer in the waiting area. I was in the hallway on my stretcher by 11:10....but then comes the worst part, they carry lunch right by you. At least they cover it, but i could smell the pizza, its aweful, specially when u havent eaten for 12 hours and u know you wont be eating for weeks after...so just a note...not to scare you but to prepare you! Wish you the best of luck, and know you are in good hands, I was!!!

At 2:15 PM, Blogger Chris K said...

You still might have a segmental lefort!? After all that expanding!? I don't like the sound of that at all. There's an old carpenter's adage, "Measure twice, cut once." Sounds like your OS knows what he's doing but isn't there a better way than doing it twice?

At 10:45 PM, Blogger Graham said...

Chris: SARPE doesn't always accomplish exactly what is hoped for. I remember my ortho not being completely satisfied with the amount of expansion we got out of it, but there comes a point where it's just not tolerable any longer. YMMV as they say. I don't think it's such a bad thing if my OS needs to expand more since it's a different way of doing it and not like I have to go through 3 weeks of expansion afterwards with the RPE, rather I get to start healing immediately. So we'll see. If it's needed then I'm all over it.

Brandy: Thanks for all the helpful info on your blog. Even I, believe it or not, stole some of your pre-op questions. :o)

Thanks for your comments everyone. I'm lucky to have you all following along with me after all this time. I know the wait has been frustrating for all of us!

At 9:15 AM, Blogger Michelle said...

Oh boy...TICK TOCK, TICK TOCK. Don't let the anxiety get the best of ya'! I know you are sooooo happy to be so close to getting this done with. I cant wait to see your updates and watch your progress.. Just know going in that you have tons of ORTHOGIANS right behind ya!!

At 12:02 PM, Anonymous mylene said...

Oooooh! Best of luck, Graham. You mut be there as I'm typing this. Fingers and toes crossed!

At 7:01 PM, Blogger Shontell said...


At 9:53 PM, Blogger Erin said...

Your pre-op sounds so thorough. Mine was 3 days prior to surgery and Stanford could be a little more organized... and I really wasn't told much of anything... I think I went along because I had already had four other surgeries there (on my wrists) and they hadn't killed me yet. ;)

Don't worry much about the splint. It's not THAT bad, really. How long are they keeping it in? Well I guess it depends on whether he ends up widening the palate. I may have only experienced the expander in my younger years, but I can tell you without a doubt that the splint was so much better. It doesn't stay in that long and most of the time you're distracted by all of the other recovery things.

You are going to rock the surgery, I just know it!


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