Wednesday - Saturday Updates

Let's start with a few more photos.

Thursday - 2 days post surgery

Friday - 3 days post surgery

I mentioned previously that the recovery wasn't going as well as I had hoped it would. My main two problems have been sleeping in an inclined position (rather than on my side) and breathing issues.

Of the two, I'd have to say the one that had me the most worried was breathing. I had always had an open bite that resulted in my breathing through my mouth when I slept. And I've never had the best of times when breathing through my nose due to various reasons.

After the surgery I was heavily banded which prevented me from opening my mouth at all and, of course, the swelling was having an effect on how well I could breath. This led me Wednesday night to experience a slight panic attack when it felt like I wasn't getting enough air throughout the night. Nothing too much ... I didn't go running around looking for the scissors or anything to cut the bands. But I did spend a rather large percentage of my time just concentrating on getting full deep breaths through my nose for most of the night. And it wasn't an issue where the nasal passages were clogged ... they weren't. I had used Afrin earlier that day and had followed that up with Ocean's Nasal Spray closer to bed time. It just felt like I was laboring way too hard for each breath.

The other breathing issue that just occurred over the last day/night is that I'm creating a whole lot of saliva that requires me to constantly swallow throughout the night. At times this has caused me to startle awake thinking I was drowning. Not a pleasant sensation.

Other than that, though, things have been progressing along nicely. The swelling is starting to subside, I'm putting down more liquids each day (water, Boost, banana shakes) thanks to the Zip-N-Squeeze bags, and my energy levels are starting to slowly increase.

I may have pushed it too far yesterday though. I was getting a little bit stir crazy in the apartment and asked my Sister to drive me to my office so I could show off my swelling to my co-workers (they're Marines ... they like this kind of stuff). It's about a 30 minute drive each way with minimal walking (some stairs) inside the building. I'll tell you I could feel the swelling increase just from walking out and climbing into the car ... much less walking up the stairs at work. After we returned home I was done for the day.

Today (Saturda, 4 days post surgery) the swelling seems to be subsiding a bit. It does, however, increase throughout the day. And I'm turning a nice shade of yellow down my neck, past my collar bones, and onto my chest. I'll see if I can't get a good photo of that for later.

On the Other Side!

Well, the surgery's over and it's time to post a little update. While I didn't have an adverse reaction from the anethesia, it's not been as easy a recovery as I had hoped. Of course, it's only three days post-op so things can only get better from here on out.

My sister, Alice, flew out this past Saturday to stay with me for a bit. As it turns out, she had a gastrointestinal bug Sunday, Monday and Tuesday. She ended up sleeping much of that time and I tried not to catch what she had ... didn't want to get sick and have to cancel the operation. She ended up calling her Doctor and getting a prescription - seems to be all better now.

We stayed at a Marriott hotel about 13 miles from the hospital. I don't live too far from the hospital (about 35 to 40 miles) but I do live in the Northern Virginia / Washington, DC area and if you've ever been here then you know how the traffic can get. Doesn't matter what time of the day it is ... traffic is BAD. This worked out well as my show time was 5:30 am Tuesday morning for a 7:30 am surgery time.

Turns out there are 14 operating rooms in the hospital so the pre-surgery drill was in a "group" environment. All of us patients were there for different reasons and each of us had our own operating room staff (surgeons, anethesiologist, et cetera.) ... we were just kept in a central area until it was our turn to head into the operating room.

I completed all of the pre-surgery stuff with the anethesiologist and, before you know it, they had hooked up my IV drip with the stuff that calms you down -- that's some GOOD stuff! About 15 minutes later I was in the surgery room and the anethesiologist had the breathing mask over my face telling me to breathe deeply ... about four breaths later I was out. The last thing I remember was them pulling down my pajama bottoms for what I'm hoping was a catheter and then waking up in my hospital room. I don't remember the recovery room at all.

I guess I "woke up" for good right around 2:00 pm. From what I was told I was in surgery for about four hours (lower jaw surgery (BSSO) and chin augmentation (genioplasty)) and in the recovery room for about one and one half hours. They ended up "de-rotating" my lower jaw four to five millimeters to the right and back just a smidgen (my term) and augmenting my chin by bringing it out about eight millimeters. It's amazing, really, when you consider that all of this was done INSIDE my mouth with the exception of two tiny incisions (one on each side of my jaw) so they could place the titanium screws in the proper places.

The afternoon of the surgery I felt amazingly well ... really, really good. I found out later that I still had quite a bit of the anethesia in me as well as pain meds (morphine anyone) and steroids (for the swelling). I was drinking water like a fish and was able to go to the restroom on my own well before dark. I was able to speak relatively easily as my surgeons had not placed very strong bands on me after the surgery. Wednesday morning I had x-rays taken and tighter bands placed which have caused me a bit of discomfort (muscles really do have a "memory" and my lower jaw muscles want to try and get back into their previously "normal" position).

My sister showed up around 11:00 am on Wednesday, we picked up my medication, and I got home I think around 2:00 pm Wednesday afternoon. I'll go into "home time" in a later post. For now, below are some pictures from after the surgery while still at the hospital:

First Picture After Waking Up

The Swelling is Still Down

Using the Hospital Syringe for Drinking Water

That's it for now ... I'll post more tomorrow on what it's been like at home / away from the hospital.

Show Time

Just returned from one last teeth cleaning visit. That was a bit interesting considering all the metal I have in my mouth.

I confirmed the surgery time with the Hospital ... 7:30 am. That means I'll be checking in to the hospital at 5:30 am.

With that check-in time they just might not need to give me any anesthesia.

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Preoperative Instruction Sheet

Here's what my preoperative instruction sheet says:

-Wear comfortable clothing suitable to the type of surgery you are having.
-DO NOT bring any valuables or wear any jewelry.
-Please do not wear make-up, contact lenses, or fingernail polish.
-Please remove ALL body piercing.
-Dentures and eyeglasses must be removed before going to the Operating Room.

Females - If you have been given a urine specimen container, obtain a urine sample at home on the morning of your procedure and bring it with you to the Ambulatory Procedures Unit (APU)/Short Stay Unit (SSU). It will be collected when you check in at the APU Nurse's Station.

Children are to wear their pajamas and may bring a favorite toy.

MEDICATIONS - do not take any aspirin-containing or Motrin-like medication (including over-the-counter) for two weeks prior to and two weeks after your surgery unless otherwise directed by your physician. These medications include but are not limited to: Aspirin, Excedrin, bufferin, Anacin, Cama, Alka Seltzer, Motrin (Ibuprofen), Indocin, Tolectin, ClinorU (Sulindac), Naprosyn, Toradol, Advil, Nuprin, Aspergum, Vioxx, Naproxen, Celebrex, Diclofenac, mobic (Meloxicam), Bextra.

Do not take the following herbal products - Gingko biloba, Garlic, Ginger. These can prevent blood clots from forming and have been associated with prolonged bleeding.

Do not take Vitamin E supplements.

TYLENOL IS OK. IF ONE OF THE ABOVE MEDICATIONS OR HERBAL SUPPLEMENTS IS TAKEN, YOUR SURGERY MAY BE DELAYED OR CANCELLED.

DO NOT EAT anything solid after midnight on: 12 March.
DO NOT DRINK anything after midnight on: 12 March.

If ordered by your surgeon, you may drink clear liquids up to the time you check in at the APU. Once you check in nothing else may be taken by mouth except prescribed medications with sips of water. Clear liquids include water and coffee without milk.
Only drink the liquids on this list. Orange juice is NOT permitted.
DO NOT DRINK ANY ALCOHOLIC BEVERAGES WITHIN THE 24 HOURS PRIOR TO YOUR SURGERY!

Other items for consideration on your day of surgery (as applicable):
- Complete surgical scrubs as directed with Betadine/Hibiclens/Ivory/regular soap (the night before and the morning of surgery).
- If you require inhalers please bring them with you.
- If you utilize a CPAP machine please bring it with you.
- Bring a copy of your Advanced Directive, Living Will, Five Wishes, or Power of Attorney.

Meals on the Short Stay Unit (SSU) (Overnight Patients)

One you return to the SSU after your procedure, you will be offered the option to receive meals from the Nutrition Management Department via the National Naval Medical Center billing system.

Cost per meal: Breakfast - $1.70 Lunch - $3.30 Dinner - $3.30

Apple juice, ginger ale, gelatin, popsicles, broth, ice cream, and crackers will be available for in-between meal snacks. Your family may also bring you meals, as there are several fast food alternatives available in the hospital.

Holy Metal Batman!

In case you don't know, the surgeons will band my jaws shut using either wire ties or strong rubber bands. They'll do this with the help of "surgical hooks."

Yesterday I went to the Orthodontist to have the surgical hooks installed on my archwires. I had this idea that I'd get a couple of them on each side of the upper and lower jaws ... maybe eight in total.

Boy was I wrong!

I've got 18 of those things (nine on top and nine on the bottom) ... basically, one in the middle of each of the brackets. The good thing is that, at lease so far, they aren't bothering me in the slightest. Not even when I eat - a very nice surprise. In fact, my mouth doesn't feel any different at all with these things installed.

I did manage to get my shirt caught on the upper surgical hooks (don't ask me how). Had to go get a mirror to get it loose.

Yeah, I'm talented like that.

One week to go!

Okay, this time next week I'll either look like Brad Pitt or Rodney Dangerfield. I'm secretly hoping for Rodney because, let's face it, looking like Brad would just be too much pressure!

I've done a ton of research so I have a pretty good idea on what to expect. I'm not stressing ... actually looking forward to it being over. The only thing still up in the air is whether I'll be having upper and lower jaw surgery along with genioplasty or just the lower jaw surgery and genioplasty. I'll find out for sure this Friday when I get the surgical hooks.

I'm *NOT* looking forward to that.