Saturday, October 31, 2015

Day 2: Swelling Increasing - Happy Halloween!

Woke up around 7AM and still felt no pain at all. Today mostly consisted of drinking Ensure, getting used to the syringe, and being on my medication schedule. I took many naps throughout the day because the entire syringe process is quite exhausting! I also wasn't that hungry so I was tired and full quickly. It's Halloween today and I had my Halloween face ready - hahaha.

Day 2 of Double Jaw SurgeryA bit more swollen today and I can open my lips just fine. You can see the rubber bands
to shut my jaw.

 So happy I had my dad here to help! He was so great looking after me and setting up my liquid foods, refilling each time I was done, and then making sure my medicine was adhered to.
 
My dad syringing strawberry-flavored Ensure for breakfast.

Medications
So my medications are as follows and may be different from you:
  • chlorhexidine topical - 15 mL - taken 3x a day
    • It's a mouth wash to prevent bacteria in the mouth and it's refreshing. I took it after each breakfast/lunch/dinner meal by swishing it in my mouth for 30 secs and then spat it out.
  • clindamycin - 20 mL - taken 4x a day
    • It's an antibiotic to fight bacteria. I took it when I woke up, after breakfast/lunch/dinner.
  • methylPREDNISolone - dosage pill pack
    • These were the worst! They're a steroid to prevent inflammation. But they came in tablet form! I thought it was supposed to be all liquid. The dosage decreased 1 pill each day from Day 1 of 7 pills to Day 6 of 1 pill. Due to it being a tablet, we had to crush it up with a spoon and mix it with water to be injected into the syringe. The taste was gawd-awful! Can't wait to be done with this.
  • Zofran - helps alleviate nauseau - NEVER NEEDED TO TAKE IT
  • oxyCODONE liquid - to alleviate pain - NEVER NEEDED TO TAKE IT

Bath Time
I took my first bath today to get the hospital funk off me. I had a friend help bathe me, because it would have been weird for my dad to, at least for me. We just filled up the tub with water and poured some of the anti-bacterial Dial into the tub which bubbled up nice and smelled fresh. IT FELT AMAZING!!! I didn't want to leave the tub. haha. I poured water over my hair too to wash that. To clean my face, I used a wash cloth to gently cleanse it. I didn't want to douse my face with water, especially with my sutures on my cheeks and my stitch on my lip. I plan on bathing every day to feel amazing hahaha.

Symptoms
I mostly felt exhausted still today. Talking wasn't a problem and no pain.

Friday, October 30, 2015

Day 1: Discharged and Home


Day 1 of Double Jaw Surgery


Good morning! As you can see, still minimal swelling. My lips are definitely plump though! I woke up around 6AM and another cancer patient with the same symptoms was next to me again.

I'm not suctioning as often anymore and the saliva is clearing out and no longer bloody looking. I was visited by the doc at 7AM and was told that I can be discharged today after they see I can take down food, not feel nauseous, go to the bathroom on my own (I've had a catheter the entire time) and walk around.  My parents came back around 9AM and hung out until I was discharged.

They removed the catheter and I was able to urinate 4x on my own. I was cleared for a full liquid diet (not just clear liquids) and they brought me a really smooth pureed broccoli and cheddar soup, cranberry juice, and custard. The nurse showed me how to eat with the 20ml syringe and red catheter attached to it. Pretty simple and a little messy at first, haha. I also was able to walk around the ICU and completed a lap without any problems, just took it slow and steady with my rubber-bottomed socks. One thing of note, when I did actually get up, my left nostril leaked fluid and I had to hold a gauze up to it until it stopped. It leaked intermittently depending on my body position.

I was advised to fill all my prescriptions at the hospital because they'd be harder to find elsewhere due to the liquid form. Apparently the medication system went down for a few hours and it was hard to ring patients up for it. There was a lot of back and forth between the hospital employee and my parents to see when we can get those filled. A few hours later though, I changed back into the clothes I came in, took a bunch of syringes and gauzes with me, and off I went in my rollchair to get into the car!! That was about 2PM.

 Home and Exhausted
 Finally back in my apartment, my dad helped me into bed as he sorted through all the meds and paperwork.  I had a pillow wedge from a previous incident and kept it knowing that I'll need it for this surgery. The incline alone on the wedge wasn't big enough, so I added my curved memory foam pillow on top of it and I was elevated nicely.

Morning swelling vs home afternoon swelling. Pretty much the same and minimal. I knocked out.


I slept for most of the day and still drowsy. Just like the previous night, I woke up every couple hours but it wasn't bad.

Thursday, October 29, 2015

Day 0: Surgery Day!

Full disclosure: I'm writing these posts AFTER the titled day, because, let's keep it real, you'll be way too drugged up and tired to type up a coherent blog post. :) Don't try to be superwoman/man and live tweet/blog/post your experience.. just focus on resting.

My dad came into town last night to help me for the first few days post surgery and to drive me back home. I was instructed to not eat/drink/chew anything after midnight and take a shower with an anti-bacterial bath soap (Dial) the night before and morning of. No lotions, moisturizers, lip balm, and no contacts. Since my surgery was scheduled for 8am, we were asked to be at the Surgical Center by 6am to get checked in and get prepped.


Pre-Surgery
Once we arrived, we were promptly escorted to the Pre-Operative area, where I changed into a drape and gave my clothes and bag to my dad to keep with him. I was visited by my room nurse, anesthesia providers, and surgeon. They each asked me tons of questions to re-review my medical history and verified what I was here for. They also repeatedly asked if I had any allergies, which I have none of. Speaking of verifying, they will also ask you to verify your name and date of birth every single time a new member of their team comes to see you for security purposes.


First unsuccessful try - back to the drawing board.
The worst part of this prep process was starting my IV line. My veins are horrible and I always get poked several times before they find a good vein. This time was no different.

The first lady was not able to do it successfully with the standard needle size, so they brought in another lady who changed the needle to a smaller (kid) one, just so I can start getting the juice in my system. I expressed my concern to her about how I might not get the proper dosage of fluid since it's a smaller needle and she laughed. She said, "Oh, don't worry sweetie! I'll switch that needle as soon as you're under, at which point, you won't feel a thing anyway!" Funny and true.


All IV'd up! Ouch...
So stylish in my gown - anxious and ready!

Thanks to my daddy! Last pic with the old face :)
Post-Surgery - 5 hours later
Other blogs were saying they remember being rolled into the Operating Room and see all the instruments... I do not remember any of that. I must have been knocked out before I entered the room because the next thing I know I'm awoken from my anesthesia and lying in the PACU recovery area. I was a little out of it but was able to speak pretty well to the nurses, despite my jaws being banned together. My immediate feeling was no pain, tired, and a sore throat from the tube they inserted so I could breathe. I forget now, I'm not sure if it was saliva or mucous running to the back of my throat, but I had to use frequent suctioning of bloody saliva/mucous out of my mouth. It was a long clear tube, similar to the one at the dentist/ortho office where you close your lips around it to suck up the saliva. There was a nurse literally standing right in front of me the entire time for several hours, posting guard and making sure I was OK while she typed away on the medical laptop. She was the one who suctioning my mouth each time I raised my hand or made a noise to get her attention. Super sweet.

The surgery must have been completed around 1PM and I think I was able to see my parents a couple hours after that. The nurses placed a clipboard with paper on it and a pen so I could communicate - that proved to be helpful!

My scribbled questions and notes.
Lying in the PACU recovering right after surgery.
My parents and the entire staff was amazed how well the surgery went for me, in regards to very minimal swelling and no nausea and minimal pain. Like I said, I could talk a little bit, I could move my lips, I could feel my cheeks, my tounge, the roof of my mouth, and so on. Speaking of which, the roof of my mouth felt sooo... I don't know how to describe it, solid? It felt like a metal sheet was right behind it. Didn't hurt - just weird. I experienced ZERO nausea the rest of the night. I must not have a reaction to anesthesia because I didn't feel ill either after removing my wisdom teeth.

Moved to ICU (only because there was space)
I spent the following 5 hours after surgery napping here and there and suctioning my mouth. I think the hospital was really, really busy because I didn't get moved until 6:45PM. At that time, they rolled me into the ICU actually. Apparently that was the only place that had space because I wasn't in critical condition to need to be there. I shared rooms with a cancer patient who had just gone through radiation and she was complaining about her nausea and pain the entire night - I felt so bad for her. A curtain separated us and my parents came by again to check on me as I was settled in and then they left for the night.


I only experienced Pain Values of 3-4 before midnight, for which they gave me mild pain medicine. I felt pretty good otherwise. My nose was really stuffy and I kept wanting to blow my nose but they said not to. They placed the mask over me at low setting to give me some humidity and hopefully my nose wouldn't bother me so much. It sort of helped - if anything, the mask was a little uncomfortable because it pressed against my jawline. So I ended up taking it off in the middle of the night and just propped it right below my nose on my chest.

Sleeping was hard - I woke up every 2 hours to suction my mouth and the nurses came in periodically to take my vitals. The bed itself and my position was quite comfy though!

All in all - the day of surgery wasn't bad at all. Just uncomfortable with the clogged nose, sore throat, and constant suction I had to do.

Wednesday, October 28, 2015

T-1 Day: Prep time!

I am one good night's sleep away from my jaw being cut and moved to its rightful place!! Truth be told, it still hasn't hit me that the day has come. I've been waiting so long for this to happen. Right now my mind is completely occupied with work and making sure my colleagues have everything they need to take over my work while I'm out on leave. I hardly had any time to prep anyone because I just returned from a staycation to attend all my pre-surgical appointments and deal with a car accident I was involved with a couple months ago.

The majority of today I visited some of my work locations to say goodbye to my teams with my old face (it sounds weird, but it's true), cleaned my entire apartment so it's clean for my family and myself when I return, and stocked/packed supplies.

Alas, the day is near and I've been perusing a ton of blogs to see what I need to do in prep for surgery and what to expect. I never read any of them in full, only bits and pieces. With all the blog resources and my surgeon's recommendations, I was able to gather a list of items to get for my overnight stay and home recovery. Both lists are originally from Rox's Jaw Surgery and edited a little bit for me. I'll return to this post to edit what was useful after surgery.

My Hospital Supplies:
  • Loose fitting tee and PJ bottoms, thick socks, and underwear
  • Breathe Right Nasal Strips (sensitive skin)
  • Baby tooth brush
  • Baby wipes to clean my face
  • Sleep mask
  • Small flashlight to help clean nose
  • Aquaphor Lip Repair lip balm
  • Post-its and pen for family to write me notes if they left
  • Small pedestal mirror to use for syringing liquids
  • Soft tissues
  • Large ziplock bag to bring home used syringes
  • Extension cord for my cell charger
  • Thank You Cards for nurses
  • Couple magazines if I get bored and my journal
EDIT POST-SURGERY: I had a completely different experience it seems than others.. I did not use ANY of these supplies during my one night stay! I was way too out of it to even bother putting on a sleep mask, let alone be coherent enough to write thank you cards to all the 6+ nurses who took care of me in shifts (and how was I supposed to remember their names???). That doesn't mean that I needed some of these items when I got home, like the nasal strips, flashlight, pedestal mirror and lip balm in particular. 

My Home Recovery Supplies:
  • Heating pad for sore neck
  • Children's Advil
  • Ocean Nasal Spray
  • Hydrogen Peroxide
  • Alcohol-free mouthwash
  • Ensure drinks (all flavors and different types, i.e. Plus, Active)
  • Chicken broth
  • Tomato Soup
  • Gogurt
  • Greek Yogurt
  • Prune Juice for fiber
  • Apple Juice
  • Ginger Ale
  • 3 oz. Dixie cups to relearn how to drink
  • Pillow wedge (bought a long time ago at Bed, Bath & Beyond)
  • Large bolster for under the knees for comfort (bought from Amazon a while ago too)
The pillow wedge on the bottom coupled with my curved pillow on top to elevate me even higher. The round bolster is especially helpful too! It takes the pressure off your lower back by placing it right under your knees. I got the idea from years long of massages I've had. You'll sleep really well!

Tuesday, October 27, 2015

T-2 Days: Why I Chose Surgery

July 2012 right before braces

Before Double Jaw Surgery
My cheeks are sunken in and my underbite is evident.

Here I am - 2 days until THE day. I've seen about 6 surgeons (honestly, don't even remember) in the past 3 years until I finally found one that I was comfortable with and their team. Let me recap my journey thus far.


My Bite and Its Problems
I have a Class III Malocclusion (technical term for Underbite) since as long as I can remember. Not only did it make me self-conscious growing up in my early teens, looks wise, it grew more bothersome in more functional ways as I grew older.  I could never properly bite down on a slice of pizza, mozarella stick, burger/sandwhich, chicken wing, celery stick, etc. because my upper and lower front teeth were too far apart and didn't cut food.  This resulted in a messy/cheesy/stringy/awkward mess each time. I also started developing a SLIGHT lisp and I could see my spit shooting out of my mouth when I talked to people. All of these things are just embarrassing and annoying.

I finally decided to get my underbite corrected, especially since I worked for a great company with great benefits. My braces were "installed" in July 2012 and it was a hefty price tag because it's considered surgical braces, due to the more frequent visits and adjustments that have to be made to correct my bite. Generally, you're in braces for a year to align them as they should be for post-surgery, but I've had so many set backs because my teeth have been very stubborn. I tried many things during my orthodontic treatment:
  • 2 TAD screws (1 in each side of my upper gums)
  • PROPEL Accelerated treatment
  • 2 upper teeth extractions
It's been quite the rollercoaster - each year thinking that's the year, only to wait another year and so on.

I am so happy to have found a wonderful orthodontic team, who has been relentless and caring through this longer-than-expected process.  On top of that, my surgeon is A+! He is head of his department and specializes in both plastic surgery and orthognathic surgery (a great combo when you're looking to improve the functional with the aesthetic principles of correcting the jaw).

The Upcoming Procedure
The surgeon will perform a LeFort I Osteotomy and rescontructing my lower jaw with fixation. In layman's terms, 70% of the work will cutting my upper jaw and moving it forward, while the remaining 30% of the procedure will be cutting and shortening my lower jaw backward.


My sort-of profile before braces. 2012

One of my TADs screwed into my upper gums to anchor and provide more tension (Oct 2013)
Both my TADs removed!! (2 weeks prior to surgery - Oct 2015)

Profile from Summer 2014. It's been made worse with braces in prep for surgery. Normal.
I was pretty much used to smiling with my lips closed but it didn't really bother me
towards the end (open smile or not). haha.




Friday, October 16, 2015

Commence Countdown - 14 Days

Today marks exactly 2 weeks until my double jaw surgery to correct my underbite! Let that sink in real quick.... OK done. I decided to start a blog to document this major surgery and have something to keep me sane and occupied as I recover. Welcome to my journey!