Day 3: First post-op video!

Pain in Jaw: 5/10

Happy i'm Home!

Veg soup, syringe style!

Day 2: Overview

Pain in Jaw: 6/10

So I made it to the other side!
I'm currently 2 days post-op surgery and got discharged home today. I had mandibular advancement, maxillary impaction with genioplasty and as far as my surgeons were concerned, it went like clockwork!

I've attached some before and after photos below (If you click on them they come bigger). I love the side improvements but the front looks abit weird - but I guess that comes down to the swelling especially in my lips and nose, I cant close my mouth yet because I feel like a great big puffer fish. All in all, I totally wasn't prepared for this surgery, quiet a few times I've said I've regretted it but that's just down to me being a mard and not coping very well at the time, in a few weeks i'll be all singing and dancing I hope! (Or nearly!)

Eating is still a challenge and i'm just having to use really thin IV syringes for thick foods, or the purple enteral syringes with a straw for drinks etc. I was also a lot more dribbly today than usual, but I guess that's due to not having the suction at home. Once I got home I had a shower and some food and felt abit more human although I got abit teary later on as I couldn't breathe very good, my nose began to bleed again (it's still full with blood and im under strict instructions not to touch it) and i'm drooling lots!  I did manage quite a few undisturbed hours sleep, although I did wake up with really bad pain in my upper jaw, but the co-codamol knocked me straight out!


Before Front, Day of Surgery, Day 1 post-op, Day 2 post-op.

Before side, Day of Surgery, Day 1 post-op, Day 2 post-op.



Day 1: Pain, Pain, Pain!

Pain in Jaw: 8/10

The Syringes i'm using to eat and drink

I awoke about 6am in a lot of pain in the side of my right cheek, radiating up my skull and into my temple. Luckily and somehow I managed to have quite abit to drink, a wheetabix for breakfast, along with some mash and gravy for dinner with a yogurt for afterwards. I thought I was doing pretty well until my surgeon added an extra band in my mouth, closing this gap completely in order to bring my teeth to 'bite together' as I couldn't do it voluntary. Although he said that I looked fantastic considering i'd just had major surgery. Eating soon became an extremely frustrating challenge, although I did manage some soup and a ensure drink for tea. The day just dragged in general, my family came again and told me that my results looked amazing, and I realised how much I couldn't have done this without them by my side. I also came out in a burning hot read blotchy rash on my chest and arms, the nurses just put this down to being allergic to my antibiotics. Medication wise, I was on IV co-amoxiclav 3x daily, diclofenac 3x daily, and could take ibuprofen and co-codamol upto 4x daily as required. I also began to brush my teeth using a baby toothbrush and toothpaste, although I didn't poke around too much. 

Day 0: Surgery day has Arrived!

Pain in Jaw: 6/10

Update before hospital: So the day of surgery has finally arrived and i'm feeling pretty good! I managed to have about 4 hours sleep last night which is alot more than I expected me to have, it's 05.45 at the moment and we plan on leaving in 45 minutes - it's mad to think that it's all finally taking that big step further! The day i've been waiting for has finally arrived! I haven't eaten since last night (as advised) and i'm already starving, but I may aswell get used to it as I'm pretty sure i'll be feeling hunger an awful lot after surgery! Family are currently eating their breakfast around me - weetabix have never looked so good!

Update in Hospital: So I got to the hospital about 07.15 and unfortunately James or my mum were not allowed to stay with me, this distressed me instantly but I soon calmed down, and before I knew it I was being wheeled to theatre. 

I can't actually remember much of the 'put to sleep' process, I remember being cannulated and the anaesthetist giving me some sedating drugs, asking how I was doing before putting an oxygen mask over my face - the next thing I knew I was waking up, my surgeons and the recovery nurse were telling me that my operation has finished and to take nice deep breaths.


Visually I can just recall a very blurry image of my surgeon smiling at me. Instantly my hands were all over my face, I tried pulling my oxygen mask off, I vaguely remember the nurse telling me to leave the mask on and that it was ok. She then told me that she'd leave it on because I will still very sleepy and my sats were pretty low, I remember waking up with a really flemmy and chesty cough. About half an hour later I perked up, although my mouth felt like sandpaper and I was totally bewildered as to what had happened, I was in my own little world just watching everybody else. I was desperate for a drink but didn't bother asking for one, i'm not sure why, I think I was scared as to how I was actually going to drink. Two hours later I was moved from recovery to my ward, and everything went downhill from here. The moment I got in my bed I had a wave of nausea and I vomited blood all over my sheets and gown. I was sick after this about 5 times, every moment I tried to take a drink or move it came straight back up. My nurse wouldn't let me out of bed because he was convinced I was going to pass out, I needed some ibuprofen but told the nurse that I would just throw it straight back up. In addition, all dignity was lost going to the toilet infront of a male sat on a commode, but I really didn't care. Soon after my family came to visit me and I was sick another 4 times - I can't really remember much after this other than three of my surgeons coming back around me because my nose had started to bleed, them giving me some anti-sickness, bandage on my nose and having an awful nights sleep.

Day (-1): Surgery tomorrow!

So the day has finally come, Surgery is tomorrow!

At the moment, i'm feeling quite excited - I woke up in this kiddy-excitement mood and it's stuck so far. I met with my surgeons today, they both just went through everything again and checked that my wafers fit (I did ask what they were used for, but if i'm honest I completely zoned out - from what I gather they're just a guide to put my jaws in their new position!) The plan is still to have maxillary impaction (move the top jaw upwards), mandibular advancement (move the bottom forwards) and depending on how my jaw sits in it's new position, they may do my chin too (genioplasty), however they did tell me that they usually do this at a later date just because of the swelling. They reminded me that i'd be in safe hands, they'd look after me, and advised me to have one last good meal, and they'd see me tomorrow morning!

I have FINALLY done a video which is below (Sorry about the thumbnail, it's not very attractive!) - but a couple of things I've missed off, post-op wise I've been told that it's strictly a liquid diet for the first 4 weeks, and then a soft diet upto the 6 week mark. I'll be tightly banded when I wake up, however there is a chance they may wire me together, depending on how stable my jaws are sitting afterwards - but that's a play it by ear scenario! I've also done some before photos, but i'll add them when I have some after photos to compare them to!

For now, I'm going to enjoy my Easter Egg, and wait for nerves to kick in! (I should probably pack my hospital bag somewhere in this too :P)

Pre-op Steak!

So since i've found out about my surgery, my food countdown has begun. (Some people only do a week, but i've had every nice food going as much as I could for the past month!) Including; Endless maccie D's, nandos, chocolate, cookie dough from pizza hut, pizza and last night I went for my last pre-op steak with the boyfriend!

      

 

Surgery Plan

So just got back from my 'meeting and plan' with my surgeon - the last time i'll see him before the big day in 13 days! Before I went in I was so nervous, I couldn't sit still, and the 2 hour wait didn't help me either, I think it's because I'd changed surgeons last minute, and I wasn't sure what to expect from him, whether he was going to approach my surgery from the same angle as my previous surgeon, or whether he thought I was even ready for it! But he was beyond lovely and relaxed me instantly. From this only meeting, I have complete faith and trust in him, he made sure I was happy, and planned everything around what I wanted to change about my jaw, rather than him just telling me what he wanted to do instead!

So the surgery is so far still go ahead for the 28th March (fingers crossed it doesn't get cancelled) and here's what Mr. G is planning on doing; (apologies if this doesn't make sense, i've tried to remember as many details as I can!)

• Top Jaw (Maxillary Impaction); The main aim of moving this is to correct my gummy smile. He said that a 'normal' jaw/gum line will display about 4mm of teeth, but I've currently got around 13mm of teeth and gums. He did say that to make this look to the usual '4mm' he would have to move my top jaw upwards around 8mm, and this is a DRAMATIC move. He explained to me that long-term, this would make myself and my gummy smile look worse. Apparently, as you age, everything 'goes south' meaning that as my jaws drop, my gums would too. (He told me that this is what has happened to the olympic athlete whose name I can't remember when she had correction of her gummy smile). In addition to this, too big of a movement can make the rest of your face 'squash up' aging it somewhat - So instead he plans to just move my top jaw upwards about 4-5mm, in all honesty, this is still a pretty big move, and will still reduce my gummy smile a hell of alot - so i'm pleased about that! He did say that usually with maxillary impaction, it can alter the shape of your nose, making your nostrils flare slightly. However I have a thin nose, and he doesn't think this would look too much of an issue!

• Bottom Jaw (Mandibular Advancement): Simple plan to move this forward - I actually don't know the proposed measurements as he said it's something that he would have to look at during surgery, as by taking my top jaw upwards slightly, this would automatically move my bottom jaw forward, but I would still need surgery on it to move it forward that little bit more.

• Chin (Genioplasty): This is something which may not go ahead, again, it is something that he will decide while i'm in theater, depending on how my chin looks after the new changes to my jaws - although he did say that sometimes it is better to carry this out at a later stage, if I wanted it done. 

Post-op wise, he said that he doesn't wire together his patients, instead he will use plates and screws to hold my jaws in their new position, and i'll probably just have a few bands for support. I've been told that i'd be able to eat only soft foods for a couple of weeks, and I should keep talking to a bare minimum - he also told me that i'd be extremely swollen (word for word, i'm to 'imagine the worst swelling ever, and expect far worse than that'), but pain wise should be bareable with normal pain killers combined with some local anaesthetic he'll give me whilst i'm asleep! Surgery should take approximately 6 hours, and I should be in hospital for atleast 2-3 nights, depending on how things go! He did touch on the 30% risk of perm nerve damage, due to the nerve running through the lower jaw - however, I think the benefits of jaw surgery in itself outweigh the risk of nerve damage.

After he told me his plan, he spent time telling me exactly how he's going to achieve this, where hes going to cut, and where he is going to plate. I've added a couple of YouTube videos which explain this really well..

• Top Jaw (Maxillary Impaction);

• Bottom Jaw (Mandibular Advancement):

• Chin (Genioplasty):

I think if this post has highlighted the importance of anything; it's to make sure that you have a surgeon you can trust, and you feel comfortable with, even if it means waiting that bit longer, it does make all the difference!

Surgical Hooks On!

So just got back from having even more impressions and my  hooks put on, surgery is still go ahead on the 28th of March (providing there's no emergencies between now and then). I've got another appointment this Friday to meet my surgeon again,- to make sure I'm happy with everything they're going to do, and a final appointment on the 19th of March to get my wafer fit (some people call it a splint), and to sign consent forms!

The hooks are sitting well at the moment, I had visions of them tearing my gums up like the braces did, but I guess they're already pre-hardened to it now. They're just relatively annoying, and I can certainly feel that they're there! (Especially when my lip keeps getting stuck on them!) I've just been told to keep an eye on them, some movement is fine but they don't want them snapping off before surgery. From what i've been told, the hooks are used as a guide when they detatch your jaw, and to then lock them together while they plate and screw my jaw into the new place!

Surgery wise I feel OK! My moods do keep changing from excitement to nerves, but I guess this is normal. I just can't get my head around by how fast the surgery has come around. I'm more annoyed at the fact that I know i've got alot of post-op work to have done still. Before braces I had a broken tooth capped, and from having the braces, the force and movement has caused abit of nerve damage on the tooth under the cap, making it appear shorter than usual (you should be able to see it on the photo), so this will have to be replaced once all the braces are off! Although my family keep on telling me that it doesn't look nearly as bad as it does on the photos i've taken.
Compared to some people, I don't feel all that prepared - the most i've bought is a baby toothbrush and some tissues, but that's about it! So if somebody can give me a kick up the bum and tell me what to buy, that'd be great! Else i'll be panic buying in Asda the morning of my op!

I'll upload some 'proper' before and after pictures soon, and blog again on Friday!

Update: Just ate tea, food stuck in braces was bad enough, without the added drama of hooks too! :P
x

The Date..

I haven’t posted on here for a while, as nothing new has happened. I’d still been going for regular check-up’s with my orthodontist, and I had still been waiting for my date. My next scheduled apt is for the 12th of March, 2013, and by now i’d come to the conclusion that I wasn’t going to have a date for the op anytime soon, and i’d probably have to wait until after university has finished in September to even think about having it done. However, as of yesterday (22nd February, 2013) I FINALLY got my date!

It took me by surprise, as it certainly wasn’t expected. I’d just finished nights at work and I received a phone call from an unknown number. It was the secretary of my surgeon, asking if i’d be happy to change surgeons, and if I was happy, then I had a date - the 28th March 2013!

I took it instantly, as I haven’t really bonded with my current surgeon - I’ve only met him once, I thought what the hell! Excitement took over me instantly and I told everybody I knew, and that knew I was expecting an operation. I think it took most people by shock, fear has set into myself and everybody by now - but atleast the ball is finally moving!

Currently have a range of dates over the next 3 weeks to get my surgical hooks fitted, and to meet my surgeon to finalise everything. I'll update some before photos soon, front view and side on, and keeping fingers tightly crossed it doesn’t get rescheduled for another day!

A regular visit..

It’s 6 month since I’ve last had something to blog about, but I guess not a lot has happened during that time. Surgery-wise at the moment is still a waiting game, any day now my date could come with Mr Posty man through my letter box, but until then, I’ve been visiting my orthodontist every 6-8 weeks just for general check ups!

So yesterday (9^th October 2012), I went to see my orthodontist as I usually do, just for him to change my bands and make sure that I was doing ok in general.  As soon as I walked in his face lit up, he asked me if I’d had my date yet and how excited he was to see my finished results. As always, I answered with my ‘no date yet’ and I thought that was that. HOWEVER, his assistant (Dental nurse? Whatever she is) whilst I was being seen by my orthodontist went into another room to print a spreadsheet off. She then came back into the room and started talking about something that I assumed was ‘dental banter,’ until I realised that they were telling me how many people was on the  op list - there was 1, 2, 3 and then me. They both looked at me, grinning down at me while I was lieing in that stupid chair, telling me that I was 4^th on the operation list. I cannot contain my excitement now, as I’ve never been told how close I was, and I certainly didn’t expect to be this close! I had the biggest smile on my face imaginable!  Obviously, this is subject to change as you never know what emergencies may crop up, but non-emergency, maxillofacial wise, I AM 4^TH ON THE LIST. (Still excited, can you tell?) My orthodontist made me another appointment for the 4^th of December, and said that hopefully, by then, I will have received my date! Fingers crossed!!!

Clinic Appt'

So today was the day of my clinic appointment, I was told by my orthodontist that the clinic was to finalise everything that was going to happen to me, and to check that I was generally ready for surgery. I went in all smiles, convinced myself that the operation was going to happen soon, and i’d maybe get a date. However how wrong was I…

Before we get to the disappointing part, let’s talk about what is actually going to happen to me surgery wise. I met with both of my oral maxillo-facial surgeons, my current orthodontist, two registrars and an orthodontic nurse. We looked at my first ever moulds and x-rays and compared them to them as they stand now. My surgeon also showed me using the moulds what my teeth and jaw would likely to look like afterwards. It’s pleasing to say that already there has been a dramatic improvement, and i’m sure that the end result will look as fantastic as the moulds, it’s just getting there that seems to be the issue. :P
 

My surgeon explained that my Jaw is a pretty unique one, and can be improved in two ways;

• A) A fairly simple and straightforward operation, whereby my bottom jaw only would be moved forward and will be just a few hours operation.

or…

• B) Maxillary Impaction with Mandibular Advancement and Genioplasty Surgery- a larger scale version on what could be done, giving me an even better result. It would involve moving my top jaw around 5mm upwards, my bottom jaw forwards approx 5-6mm and, my chin-bone being cut and moved also. 

It was agreed that the second would be my better option and it’s main aims were to sort out my general positioning of my jaws, my inability to close my mouth, my gummy smile, my open bite and my lack of strong jaw bone and chin. 

They explained to me that after a potential 7-hour operation I’m likely to be in hospital for 3-5 days, after then I’d return home all ’battered and bruised.’ I’d then be seen by my surgeons once a week for 8 weeks, just to make sure that post-operative my Jaw and Chin remains ok. After the 8 weeks I’d be given back to the care of my orthodontist who will make any final adjustments and continue to monitor my post-op progress.

They also went onto talk about the possibility of relapse a few years post-op, where i’m very likely to get a slight open jaw after around 4 years, however they also pointed out that even after relapse, the improvements will still be 100% better than they are now, and the benefits outweigh the negative aspects. 

My disappointment comes to the wait. I’ve officially being put on the waiting list and marked as ready for my operation, it’s April now and I’ve been told that my operation would definitely be after August, and potentially into next year. However it remains a waiting game, and i’d only be told a month in advance of my surgery date. This is mainly due to emergency operations taking priority over myself which is understandable and to be expected, but still, the disappointment made me cry before I’d even left the room. 

Now I’ve accepted the facts, I’ve come to terms with the longer journey that  lies ahead of me. I’ve waited so long for my operation, and a couple more months really isn’t going to hurt!

Why am I undergoing surgery...

It was never noticed as I was younger, but it became obvious that as I grew up and my face took it’s shape that something wasn’t ‘quite right’ about it - I started to get quite a gummy smile, a weird looking jaw structure, and I was unable to close my mouth.

During 2002, (I was about 12 years old) I was told that one day I may potentially need either screws or surgery in order to correct the position of my jaws, but I’d have to continue to wait until my face fully grew before they could be sure. Until then however, they tried a number of braces in order to try and reduce the ‘mess’ all of which failed. As my face did grow, I developed an overbite, open bite and additionally a severely set back lower jaw. (At this time I also took a knock to my jaw which somehow made everything worse!)

It was during 2008 that it was confirmed i’d need surgery in order to correct the alignment of both of my jaws, however it was a choice. I didn’t HAVE to have the surgery, but I was told it would improve my appearance and my problems greatly. During this time I’d had a pre-op clinic appointment with my maxillofacial surgeons and the ortho-team who all confirmed what they intended to do with my jaw, the process that would happen, and what was to be expected in the next few years.

It was decided that I would have bimaxillary osteotomy, maxillary impaction, and Genioplasty. Not long after this, I did agree to surgery, consent was signed and I started on what feels like one of the BIGGEST commitments of my entire life.

In August 2009, I had permanent braces put on. The braces were used to align my teeth into the surgery position and will be used after surgery to wire both of my jaws together. It was estimated that i’d have them on for 6 months before I was operated on. HOWEVER, 2 and a half years later, (March 2012), I’ve only just been told that i’m pretty much ready for my operation (Have another clinic appt 11th April, to confirm everything!) and It’s today that i’ve started my blog! I had ENORMOUS complications at the start of having braces, all which have slowed down the whole process entirely. My teeth were also far too stubborn to move into their surgery position! 

Why i’m actually having the operation;

1. Correction of Discomfort. I desire to use all of my teeth to chew in a 'normal' position, not hit and miss, and with this, I want to be able to fit my jaws together into a correct position.
2. Due to the position of my jaw, It’s impossible to breathe through my nose, so it makes me a mouth breather. (Breathing through my nose makes me feel like i’m about to drop dead with a lack of oxygen.) People with a set back lower jaw also have an increased risk of sleep apneas
3. Correction of Physical apperance. I’m sure people who have the same problems as me can agree, the psychological effects of having a pretty messed up jaw are enormous. I know from personal experience I am incredibly paranoid and self-conscious about my appearance  especially side on when it’s most noticed. You see pictures and realise how gummy your smile is, or how weird your jaw is, and you just feel so unattractive. People can consider this as 'vein,' however, how I look at it, why shouldn't I be able to have a normal jaw structure like the majority of the population? There is no shame in wanting to feel good about yourself in every aspect of your life, jaws included!