jaw surgery–three days after

I’ve made it to the other side and it feels so good. So much time that used to be clogged with worry over this surgery has now been freed up in my  mind that I don’t even know what to do with the extra energy.

I’ve made little comments  in a journal along the way, hoping to be able to relay some helpful information to those who may be undergoing a similar procedure in the future and are also freaking out. Reading others’ blogs was my number one source of information and comfort in the time leading up to surgery, and no doubt they will continue to help and encourage me in the future.

Day 0 was full of new experiences, since I had never been in a hospital as a patient before (even though I work in one), let alone for surgery. I arrived at 5:30am for surgery at 7:30am. The nurses, anesthesiologist, and doctor were all so comforting and caring as I was being prepped for surgery . I was really grateful for that. I got some great hospital socks out of the ordeal, too.

I tried to keep my mind off of it as best I could; after waiting so long for this much-anticipated surgery, the few minutes before going in felt surreal. Apparently I was supposed to have been given Versed before entering the operating room, but someone messed up somewhere along the line and I was totally cognizant as I was flipped over onto the metal operating table. There were so many people in there, including my doctor with a suspicious-looking toolbox that probably contained horrible things like bone saws and scalpels. The room looked like a morgue, but by the time I was thinking that I was already waking up in recovery, with a tight, itchy layer of Coband wrapped around my head.

My time in the hospital was actually pretty good. I’m sure having a pain pump full of Dilaudid helped. My birthmom stayed with me through surgery and my boyfriend stopped by, and I was able to talk (mostly) intelligibly with both. I had very little pain in my face, but I was exhausted, and I still am. I was able to drink water, apple juice, Ensure, and some cream of wheat through a syringe, also a better experience than I was expecting. It’s slopping and cumbersome, but possible with a little bit of patience. I was numb inside and outside the lower half of my face. I didn’t throw up after surgery, and haven’t really felt nauseated either. The IV in my elbow and splint my surgeon put in my mouth  bothered me more than the surgical sites. Another thing that bothered me was that anytime I’d drink something or try to talk, my mouth bled. I went through a box and a half of Kleenex that day. My throat hurt from being intubated. I’d still say the first day my pain was around a 2.

Items that helped me out in the hospital:

facial wipes

iPod, headphones

phone

Arnica salve for stretched and cracked lips

free-standing mirror to allow the use of two hands while drinking out of syringe

glasses and glasses case

deodorant

face lotion

face mist (mine is bougie and scented, but it could just be a bottle that mists water–very refreshing when you’re feeling hospital icky)

 

I brought some other stuff, including a change of clothes and a notebook, but I didn’t end up using anything other than what I’ve listed.

Day 0

day-0

Come at me, boys.

 

The next day, day 1 after surgery, all of the anesthetic had worn off, so I could feel my tongue and the inside of my mouth again, which is great for eating, but not so great for pain level. My pain went up to a 4 and I had slight nausea. My swelling had increased dramatically.  I got to leave the hospital that day, and it felt so good to take a shower and move around my house unencumbered by an IV pole or pulse oximeter.

I was prescribed Ibuprofen and Hydrocodone for pain, Scop patches and Promethazine for nausea, and steroids and antibiotics for swelling and healing. I got behind on my meds yesterday after sleeping through the alarms I set to take them, and my pain level got to a 5-6. I got better about managing my meds after that, so it’s back down to 3-4. My lower face is mostly just incredibly uncomfortable. The skin on my cheeks and chin is swelled so much it’s shiny, and I have intense bruising around my mouth and on my neck, which is a lovely shade of purplish blue right now.

Day 3

Tomorrow is my first post-op appointment with my surgeon, which should just be a quick check-up. I’m dying to get this splint out, but won’t for another few weeks. It’s a food trap and makes it hard to talk. I think things will vastly improve after that. I can’t imagine going back to work with this thing in my mouth.

I’ve been sleeping a ton since getting home, and I keep dreaming I’m chewing food. Last time it was a hot dog fresh off the grill. The dreams stem not so much from food cravings as from the fear I’ll mess my new face up. I’m not wired or rubberbanded shut, which kind of freaks me out. At this point, I don’t like exploring with my tongue in my mouth very much. It’s like a Martian landscape that used to be Earth, and it will take some getting used to.

 

 

 

 

jaw surgery–before

In two days I will have a Mandibular Bilateral Sagittal Split Osteotomy and Genioplasty Advancement. In other words, jaw surgery. When I originally found out I would need this surgery three years ago, the orthodontist thought I would also have to have my top jaw surgically corrected and possibly segmented into three pieces to widen my bite. Thank God my orthodontist here is a miracle-worker and has resolved my open bite and cross bite without surgical intervention. So the problems I have left are my lower jaw and chin.

HOW: The surgeon will make two diagonal cuts through my jaw on both sides in order to pull it forward 12 millimeters and screw it in place. That may not sound like a lot, but it is when you’re dealing with facial proportions and jaw placement. Secondly, he’ll cut through the tip of my chin and move that forward too, screwing it in place to give my face better proportion after the movement of my lower jaw.

jaw

The places marked in red will be cut and moved.

WHY: I’ve addressed this in previous posts, but I’ve had a cross bite, open bite, and significant overbite since puberty (for about 17 years now). I had two expanders and braces as a high schooler, but none of my bite issues were corrected. At first, just the open bite bothered me, but I was pain-free. As time passed, I started having increased muscle tension and discomfort, especially on the left side of my jaw and down my neck. I also chew farther back on my teeth than I should, meaning my molars are wearing down faster than they should. My open bite and overbite also affect how I speak, giving me a little lisp and making me thrust my jaw forward to enunciate, which is exhausting, especially when I’m teaching linguistics, when accuracy and being able to talk at length is vital.

I’m adding some before pictures to show some of the issues I’ve mentioned and to be able to compare them to after (assuming I make it).

Left to right: the day I got braces for the second time, teeth 10 months later right before surgery, profile from both sides before surgery

Did I mention I’m extremely nervous? Current list of worries:

  1. Being aware but paralyzed during surgery
  2. Throwing up after just getting my jaw broken
  3. Getting a blood clot
  4. Having to wear a splint in my mouth when I go back to work and not being able to talk
  5. Not having my jaw rubberbanded or wired shut, so my freshly-detached jaw is just flying free
  6. Waking up with an incredibly swollen, different face than I went to sleep with
  7. Having to swallow medication immediately after surgery (not a pill swallower to begin with)
  8. falling into a deep depression
  9. crying immediately after surgery and having difficulty breathing

Obviously some of these fears are more justified than others, but in my anxiety-ridden mind, they’re all equally devastating prospects. I picked up a journal I’ve dubbed my jaw journal, and on the front it says “It’s Gonna Be Okay” with inspirational quotes sprinkled throughout the pages. I thought this would be a good, uplifting exercise, focusing on positivity, but I just don’t think I’m cut out for it. Most quotes have my cross-outs or scribbles on them, like “fuck optimists” or “bullshit,” then my own version of uplifting quotes written in place of the originals. For instance,”If we had no winter, the spring would not be so pleasant.” Seeing as I live in Phoenix, I obviously don’t agree with that pithy sentiment. I replaced it with, “It’s the same sort of cold comfort when we look up into a clear sky and see that we are mere specks in the enormous universe. Our actions here on earth contribute, no doubt, to the evolution of civilization, but in such a minor and minuscule way that there is freedom in knowing that what you do doesn’t really matter, can’t matter, in the scheme of things.” That’s from Enchanted Islands by Allison Amend, which you should read, by the way.

So I guess, in a way, my journal idea is working, just not the way this journal intended. I’ve been brainstorming ways to wrap my mind around this, deal with the fear and pain, and with not eating food for six weeks. I think good books, journaling, sunshine, and watching good shows will go a long way. Everyone says watching comedies improves your mood, but I’ve found that watching the most fucked-up things I can find (stories about kidnappings, murders, the deep web, torture, craniofacial surgery way more severe than mine, stalkers etc.) helps me put things in perspective and take my mind off my comparatively-petty problems. Whatever works, right?

So, with my fridge stocked with liquids and my credit card charged with any and all things from Target I thought might make this process more comfortable, away we go.