Brandy's Braces, SARPE, Jaw Surgery Journal

This is my daily journal to my eventual perfect smile and Apnea free life. It logs my surgeries, and daily progress.

Tuesday, May 15, 2007

Wow! NO Splint OR Rubberbands for ME!!!

Today was my big pre-op appointment! Very interesting, and OMG quite shocking in a lot of ways. The Dr. started out taking another set of impressions. Ones he will be using for practice models. He then took a bite registration where he had me bite down at my normal closing location after loading my teeth with some nasty goo in a tube (which tasted awful by the way.) Once it was dry he had me pull my teeth apart and he pulled out this second type of impression materal. While he was doing all this he used some tye of measurement device to measure my face. It had these little inserts that go in my ears and acrossed my face, then something that set on my nose. Once finished with all this he let me clean up. Then it was question time.

How long will my surgery be? - About 5 hours, maybe more, maybe less, I won't know til I get in there for sure. Then you will be in recovery for about another 2 hours.

Will I have a Catheter? Yes, we use a catheter on anyone whose surgery goes over 3 hour. It won't get put in til after you are out though, and will be removed before you wake up so you won't even know you had it.

Will I have an NG tube? No NG tube, but you will have a breathing tube inserted after you are out. It too will be taken out before you wake up.

Will I have drainage tubes? Yes they will run from the inside of your incisions to a small collection bag on you chest. This is to keep the blood out of your system during the first 24 hours. I will come see you the next day and remove them.

What if I wake up during surgery, how will you know? - We do not paralyze you like some surgeries do. If you wake up and start moving around at all we will put you right back out. You will be able to move and trust me, if you do, I will notice!

How long will I be in the hospital? - Well it depends. You have to be able to take fluids in and keep them down, pee, and walk around. Once you can do all of those things you can go home. I would plan on 2 days in the hospital though. That is the standard amount of time. We will see how you are doing and if you want to go home sooner you can, but plan on two.

How will I keep my teeth clean? - Use a small baby toothbrush, you can use regular toothpaste, and will want to frequently rinse throughout the day with warm salt water. NO water piks! You need to wait til your stitches are completely healed before you use anything like that. I will let you know when it is ok to use that again.

When can I start biking/exercising again? - At about 2 weeks it should be fine, as long as you are feeling ok, and not still taking pain meds. If you feel up to it, and your not too weak or light headed then biking, or walking should be fine.

What post surgical meds will I be taking? - I will be giving you liquid Roxicet (demerol) for any pain, and liquid Cephalexin (antibiotic) that you will be taking for 7 days following surgery. Can I get these today so I can get them filled before next week? "that's what these are right here" (hands me the perscriptions) Wow, you are certainly on top of things around here! "laughing...we try to be"

Is it ok to take all my vitamins etc now and post surgery? - Yes that is fine, I do want you to quit taking everything you are taking now though, with the exception of the vitamin C. Vitamin C is the most important thing you can take right now. Most of these are fine as they are just vitamins, but there are a couple here I'm not really familiar with. I would hate for you to show up for surgery and have the anesthesologist say that he doesn't know what these are and that he needs to cancel the surgery til he can research it. The Arnica and Bromelain are fine afterwards also.

How long will I be on liquids before I can switch to soft food? Well really you won't have to be on liquids? We call it the fork smash diet...anything you can smash with a fork and swallow is fine, you just CAN'T chew ANYTHING with your teeth for 6 weeks.

So what about a splint? Will I have one of those? - Nope! No splint for you! I only use a fixed splint when I do a multiple piece Lefort. Since you will only be having a one piece I will use splints during my surgery to make sure I have everything where it supposed to be but I will be taking them out as soon as I get everything anchored and you will not have any splints in your mouth when you wake up.

WOW! I'm surprised, Well Ok...what about rubberbands, how will those work? - You won't have any rubberbands either. I use a new type of fixation. It is made out of a newer material that is actually stronger then titanium. Due to the fact that this material is stronger they can make the plates and screws smaller too. Once I have your rigid fixation placed and I take the splints out, your jaws aren't going anywhere. There is no reason to hold your jaw shut after that.

What about retraining my jaw? - There is nothing to retrain. Once its advanced and secured with the plates and screws it is not going to move back, it is locked into its new position.

So no splint? No rubberbands? NO NOTHING? - Nope....you will be able to open your mouth as soon as surgery is done. Your jaw joints will be a little stiff for a few days but other then that you will be able to access your mouth just like now. You just have to be careful not to bump you jaw, or chew anything for 6 weeks.

Well so if I won't be having rubberbands why do I need surgical hooks? - Good question! I use those during surgery to hold your splint and align things properly. So I need them for my stuff, but yeah, you don't really need them for anything other then that!

Will I have incisions in my cheeks? - I will make some very small incisions to get the screws into the lower jaw, however, what we do is we pull the skin up from underneath your jaw bones, make the incisions, then let the skin go back to its normal location. You will basically have two very small dots underneath your jaw bones that no one will be able to see. We put surgical tape over them and they don't leave scars. You will see two tiny spots though for a couple days though.

So may I ask how this surgery will change my appearance? - He pulls out my tracings...."I take artistic license with these. I don't use computer imaging, I like to do my own measurements. " He said that after you take all the measurements into account (the standard which doctors work off and is considered to be the norm) that 11 is considered balanced symmetry based on the measurements. He said that my measurements are at about 17 or 18 right now, but with the 3mm advancement on top, the 6 -7mm on the bottom, plus the chin advancement I will be at a perfect 11 when we finish. He said from the front it will not be much of a change, other then having a more prominent chin, but you will really see a difference in your profile. He said that some patients experience a slight up turn in their nose, but that he does a lot of stuff to prevent this from happening, and has never had anyone be unhappy with their results, or dislike their noses.

Can I continue to do nasal irrigation after surgery? - For the first couple of days you will experience some bleeding from your nose. You may use q-tips and saline or whatever is most comfortable for you to remove any buildup in or on your nose but you may not blow it at all! Hold off on using the nasal irrigation until I give you the go ahead to blow your nose again. Also, you may suck from the back of your throat to get stuff out, but just don't force any air out for awhile.

This was about it for questions, although they did tell me that I can call anytime between now and next Thursday if I think of any other questions. My pre-op labs appointment is next Tuesday. They told me to bring a copy of my EKG, they will do a pregnancy test, and draw my blood to check my platelet counts etc. I'm to arrive Thursday morning at 6:00am, and surgery is scheduled to begin at 7:30am. YIKES!

I'm so amazed that I won't have a splint or bands. Sorta freaks me out. I think I will ask if I can have some rubberbands just in case my jaw gets tired. Seems like some people have reported that they found the rubberbands comforting at times, that they sorta gave their jaws a break.

10 Comments:

  • At 7:00 AM, Blogger Mary said…

    Wow! Talk about thorough! This is a great Q&A for future patients as well. And lucky you, no splint, no rubber bands, sounds like you are in really good state-of-the-art hands. By the way, can you tell me what the supplement is for nerve regeneration. I know that I've asked before but I forgot. Can't wait til you post your post-surgery pics! Its going to be so cool! Mary

     
  • At 7:46 AM, Blogger mehitzel said…

    Hey, Brandy! It sounds like you had a great OS visit and are all set for your surgery. I agree with Mary, he sounds very up-to date on things, very confident, and very competent. I know that must give you a secure feeling going into this. Did you get the email I sent you the other day? Just wondering if it went through. I got my surgical hooks put on yesterday. Not too bad except the one right in the middle is really irritating the inside of my lip. Thank goodness for dental wax!

    Martha

     
  • At 9:20 AM, Blogger 57rdi said…

    Wow, as someone going on week six of splints-ville, I am certainly envious. It sounds like your surgeon is tops, Brandy. Good luck!

    -Vaughn

     
  • At 4:00 PM, Blogger Graham said…

    Wow, awesome post! Sounds like you pretty much have all the bases covered. I do worry about not having elastic bands for support though, Jen's experience is a good example of why. But at least you know already so you're prepared just in case.

    Where do the drainage tubes go? This is the first I've heard of anyone having them.

    For the breathing tube, after SARPE they took mine out in the recovery room. I didn't even realize it was in there until they told me they were going to remove it. It was an iky feeling but it's over quickly and my throat felt so much better once it was out.

    No splint! I'm jealous already! Makes sense though for a one-piece.

     
  • At 8:50 PM, Blogger Brandyleigh35 said…

    Hey Martha,
    YNo I never got your email. Try sending it again. The address is brandyleigh35@hotmail.com

    Vaughn, Yes I was so excited to find out that I don't have to have a splint. I have read your account as well as many others and the splint has been the worst part for many of my blog buddies. Glad yours is coming out soon though!

    Graham,
    Not sure if you will see this, I will post it on the blog too just in case. I know that the drainage tubes are used by many plastic surgeons, especially during face lifts. My friend had them last year with her BSSO (we have the same doctor) and she was very happy with her results. She felt the drainage tubes were helpful and said they were not painful at all. If they keep me from swallowing a ton of blood then I'm all for them. Mine will come from the inside of my jaws rather then those in this pic (see below), but this is what they look like, and the little collection pots that are attached to them. I'm sure they will make my post surgery pics just that much more attractive! LOL...
    http://ai.eecs.umich.edu/~mirror/FFS/FullBandage.jpg

    6 more days!

     
  • At 9:29 PM, Blogger mehitzel said…

    Hey, Brandy. I resent the emails. I had the address correct the first time. Do you think maybe they went to your junkmail or spam folder?

    Martha

     
  • At 9:59 PM, Blogger Brandyleigh35 said…

    Nah, I check it a lot, just to be sure. I got your new email this time and replied back.

    Brandy

     
  • At 9:10 PM, Blogger Mrs. Shanton said…

    Lllllllllllucky! It's not the splint that's so bad as the being wired shut and not being able to eat. You are so lucky that you won't have that.
    So, we want some pre- and post- pics, of the front and profile. Mkay?

     
  • At 10:37 PM, Blogger Brandyleigh35 said…

    Sure! Should I post them all together for comparison! LOL!

     
  • At 12:16 AM, Blogger Shontell said…

    Woo hooo on the "fork smash diet!" and woo hoo for not having those rubberbands or a splint. Sounds like you are ready to go!

     

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