11 Days Before Surgery

Doug sent me this yesterday, which was taken on the 20th of January, 2007, just 11 days before my surgery. He said, your nose and chin look so different now. Hmm. We shall see.

Daniel's Blog

Daniel had facial osteotomy on January 25th. He's one of the people I've been talking with from the Yahoo Support Group for orthognathic surgery patients. He started a new blog at metoposcopist.blogspot.com. High 5 Daniel! :)

Good Luck on the 8th, Kim!

Hey Kim, thanks for the comment. I wanted to write you back but I don't have your e-mail address. So here it goes:

1. Yes I do have a splint. I have a plastic piece between my upper and lower teeth.... my surgeon says he'll remove it on Monday.
2. No I'm not driving yet. Mostly because I've been on pain killers. I don't plan to drive in the next couple weeks... just to be on the safe side. If I had to, I defnitely could, though.
3. Yes in the past week I slept quite a lot. Dozed off a lot at the hospital. Since I've been home I sleep about 7, 8 hours at night, and maybe two more hours during the day. That's a lot for me - since I usually need only about 6 or 7 hours on average.
4. I felt reasonably well on the outing yesterday (stopped by a pho noodle house on the way home from my follow-up appointment, and had clear broth). It was a total of four hours, from the time we left the house (a friend drove me) to the time we came back. I felt exhausted, though, and fell asleep in the car. After we got home, I had to take another nap to recover from all the excitement.

What time is your surgery on the 8th? Get plenty of rest the night before and think positive thoughts. Relax your mind. Other tips:

1. Ask your husband to get a dry-erase board or notepads ready for when you wake up.
2. Drink as much fluids as you can post-op. I'm sure your nurse would tell you the same thing.
3. Do what your body tells you. If you're tired, get some rest. Don't push it. I think our bodies are pretty smart... so just listen to them. ;)
4. Have a good mindset. When people asked me if I felt nervous in the days leading up to my surgery, I always replied - "No. Why should I be nervous? My surgeon should be the one nervous. Hahaha." All you need to do is relax, let the meds kick in, and let your doctor and the anesthesiologist do their thing. Just another episode in the adventure that we call life. :)

I'm sure all will go well on Thursday! Take care Kim.

New Kid on the Block

Introducing the newest member of the Cabbage Patch Kids - yours truly. ;) The swelling has gone down quite a bit... and the bruises are shining through. I've had friends asking me if that's some kind of yellow healing creme on my face! Hahahaha. Um, no. Just old fashioned bruises.

Why I Did It - Medical, Not Cosmetic

As more friends of mine read my blog, I'm starting to get questions and comments such as "wow you made yourself look different". Yes, that is true. But I do want to clarify that while an improved physical appearance is certainly one of the benefits, it was not the primary reason why I decided to get orthognathic surgery.

In my medical chart, they'd stated that I had "...significant skeletal deformity. Class III.". What does that mean? In laymen's terms, it means that my upper jaw had a retrusion and my lower jaw had a protrusion (see photos of my natural bite above), which negatively impacted speech as well as chewing functionalities. I had a serious malocclusion, and excessive wear and tear on my teeth because the contact surfaces were abnormal. Over the years I'd noticed my lower teeth slowly advancing forward, to the point that it formed a gap between my upper and lower front teeth.

I'd asked my orthodontist and surgeon what would happen if I chose NOT to proceed with any treatment at all. They said my bite would continue to worsen, and my chewing less effective. Clear speech would become more of a struggle. Also, my jaw joint pains would likely become more frequent and severe (I used to get jaw joint pains whenever I felt tired).

So folks, these were the MEDICAL reasons why I chose surgery, and why they'd labeled me a Skeletal Deformity Class III. I'm glad these problems would go away now that surgery has been completed. And if I happen to look different as a result - icing on the cake! :)

God, all I can think about now is FOOD. :)

Progress

Slept through most of the night, woke up only twice. Breathing has become easier - not 100% there yet, but it didn't bother me enough to wake me up. :) Also, my nose isn't bloody anymore. Big improvement, considering how it's been bloody evern since the surgery. Also, the pain no longer becomes all-consuming as soon as the pain killer wears off after four hours. I tell myself not to take it unless I really NEED it. No point getting psychologically dependent on that stuff.

8 mm

6 mm off across my upper jaw. The lower jaw has been tilted differently so there goes another 2 or 3 mm. Net - Dr. Li says my face is now 8 to 9 mm shorter. That's about 1/3 of an inch! W h o a. Funny how our hands have memories. When I touch my face I could tell - without looking into the mirror - that there's less of a chin now and the slope of my nose has changed.

Over the Hump

The few minutes Dr. Li spent suctioning my nose felt like Nirvana. I hadn't been able to breathe that completely in almost a week. He cut off the super-strong rubber bands "wiring" my upper and lower jaws together, and replaced them with four little vertical ones, two on each side, leaving my front teeth exposed and free. He gave me some replacement rubber bands to take home, in case I needed them, and they were, very fittingly, named "bummers" on the envelope.

Dr. Li noted once again how he'd never seen anyone swelling up as much as I did throughout his entire practice. Hmm. I wonder if there's an award for that? ;) In any case, he said the swelling in my face, as well as in my sinuses, would gradually go down in another 10 days or so. I am now officially "over the hump". As far as the "before & after" picture I so eagerly showed him, he dismissed it with a smile - said it was too early to tell the exact differences. I got the sense that I should prepare to see the precise, and final results after the swelling disappeared. Come what may.

On the way home, Elaine treated me to two big bowls of beef broth at a pho noodle house. I triumphed with the giant syringe in hand, until, in a moment of over-enthusiasm, I over-extended the pipe, so the broth came dripping down on one end; and as I shoved it back into the tube instinctively, it quickly sprayed out the other end. It was like a one-two punch. You'd have to be there to appreciate the not-so-subtle humor of the situation. In any case, Elaine and I had quite a laugh about it.... and I'm sure this one will go down in history in its full glory. ;)

Grateful

Did a lot of research on orthognathic surgeries on Google this morning. One website caught my eye when they said that when you first find out from your orthodontist that 1. yes, something IS wrong with your jaws and 2. yes, there IS something you can do to fix it - it is an overwhelming feeling. Yet, we should thank God because lots of people live their entire lives knowing they have a problem, but can't articulate it, or find a solution for it. In that sense, I am very fortunate, indeed.

My dentists have always said I have "beautiful teeth". Ironic, isn't it, that I'd never felt proud of them? Not that I'd purse my lips in photos, but boy, I always knew, if there's one thing I could change about my physical appearance, my face would be it - the profile, especially. Wouldn't you say that's a pretty big deal? My FACE. Not my ankles, or my tummy, or my breasts. But, my face. Our faces are our IDs in this world. I am, yes, grateful, that things turned out the way they did and I was given the opportunity to make an improvement and boost my self-esteem. Thank you, God.

Support Group

I'd completely forgotten I'd joined this Yahoo Group for Orthognathic surgery patients and their families. It's very much alive, active, and informative. Check it out at http://health.groups.yahoo.com/group/orthognathicsurgerysupport/.

Miracle Formulas for Clearing Your Nasal Congestions

Serious nasal congestions would have to be my biggest complaint in all this misery. If you plan to undergo orthognathic surgery as well, OR if you catch a nasty cold next time, keep these things handy just in case:

• Vick's VaporRub - This stuff ROCKS! Dab a little under your nose, or better yet, mix a smear of Vick's with a glass of hot water and steam your face with it. It does WONDERS.
• Vapor Inhaler, nasal decongestant. It's levmetamfetamine. You can literally feel this stream of fresh air piercing through each of your nostrils. Much, much needed in times like this!
• Hot showers - the tried and true. Honestly, I had my doubts. And honestly, even though it does help, in my opinion it doesn't work as great/fast as the two above.

Day 6

Showered. I've been taking showers almost daily since the surgery. While in the beginning it made me dizzy to remain standing for more than minutes at a time, hot showers definitely do wonders in clearing up my nasal congestions. I feel alive again.

Elaine's picking me up in two hours go to see Dr. Li for a follow-up appointment. These are going to be weekly until mid-March.

Breathing Through A Wet Sponge

This has been such a long, long night. I'd fall asleep from absolute exhaustion, only to wake up from my ever-diminishing breathing capacities. Jaw "wired" (rubber-banded), with a serious nasal congestion. It's one of the worst feelings I've ever experienced. It's as if your world is closing in.... and you're trapped in the middle with less and less oxygen.... and the light just dims. I feel this cloud of congestion hoovering right up in my sinus, between my eyebrows. It's like - breathing through a wet sponge.

The nurses had suggested to sleep with my head elevated to help reduce the swelling in my face. I've "slept" all night sitting up in my bed, with lots of pillows propped up behind my back. It's not exactly pleasant, and while it didn't promote the swelling, it didn't reduce it much, either. Off I go to get more ice packs from the fridge.

A Walk in the Park

Literally. Doug and I took a slow walk in the park this afternoon to get some exercise. Laughing hurts at this point.... it pulls the gums in my upper jaw with such a strong force. I'll stick to drama for now. ;) If you click on the photo to enlarge it, you might be able to see the bruises forming on my lower jaw.

Turtle-Necks and Pony-Tails

The swelling isn't completely gone yet. But, I don't have anything on my dance card. I can wait.

In the meantime, I decided not to look like a patient anymore. Got out of the cozy bath robe, put on a long-sleeve t-shirt, jeans, and a puffy down vest to keep warm and match my puffy face. ;) Put my hair up in a pony-tail - which I used to hate, 'cause it highlighted my less-than-perfect profile. Now I love it! Plus, I just realized minutes ago that hey, now I can wear turtle-necks, too, without worrying about how they'd emphasize my prominent, over-sized chin. All these little details and constraints that I'd learned to accept and get used to.... no more!

1st Before & After

Click on the photo above to enlarge it. Before.... (before the braces even started, about a year ago), and after (this morning, as we left the hospital). My cheeks are still very puffy, but you can probably trace the new profile already. Bonus point? I lost 8 lbs in 4 days!

On the Other Side

After much jitter, and anxiety that the surgery might be postponed due to the cold I happened to catch just three days before, now on this day I proudly and safely stand on the other side. It's done! And might I add - fabulously done! Great job Dr. Li! Thank you so much.

The surgery proceeded as planned on January 31st. My friend Mark and I stayed at a hotel in Palo Alto the night before so that we didn't have to rush in the morning. At 8:15 am we reported to the Stanford Ambulatory Surgery Center 15 minutes early. Miraculously, my cold symptoms had lessened sufficiently. Even Mark, who'd spent 10 years as a medic in the US Navy, and worked as a nurse, was convinced that I should be ready to proceed. We did all the paperwork (one of the questions on the form was, in so many words - "in case of a medical emergency, would you choose to die gently, or be kept alive as a vegetable?". What a question for that early in the morning, huh?). Then I changed into a hospital gown and we waited in the pre-op area for almost two hours until Dr. Li and my anesthesiologist each came to check on me. The anesthesiologist I could barely remember. He'd called me the night before. That morning he showed up, listened to my lungs, checked my pulse, and said - ah, when it pounds that hard, you must be nervous! I'll give you something that will calm you down. Well, calm me down it did, alright! After he injected whatever it was into my veins, I barely stayed awake during the short trip from the waiting area to the operating room. The last thing I remember was Dr. Li asking me to scoot over to the operating table. I did, lied down, and blacked out promptly - after thinking "wow the operating room looked pretty crammed!", and "not as dark as I'd seen on TV!"

When I came to I was coughing/choking just a little. The first thing I sensed was Dr. Li calling my name and wiping my face, saying - "Kristen! You did very well! It went perfectly." Huh? What? That was it? How long ago was it? My thoughts had no lucidity. I felt extremely groggy and wanted to figure out how much time had lapsed before I regained conciousness. Four hours - it turned out that I'd been in surgery for four hours. They wheeled me to the ICU and kept me there for about an hour or so to make sure I remained stable. Then they wheeled me off to my private room where I stayed for three nights.

As they wheeled me to my room I heard Mark's voice nearby in the hallway and felt immediate relief. It helped so much to have a friend close by! I felt oddly energetic and stayed awake so we chatted for a while. Well, correction - he talked, and I motioned and listened. My jaws have been "wired" shut with rubber bands so I couldn't talk and risk moving my jaws prematurely. Mark bought me a notepad and a pen, AND a cute teddy bear with roses. :) At 8 pm he left when my friend Elaine arrived. She brought me tabloid magazines to help pass time and ease the pain. Elaine spent the night with me and slept in a chair - very uncomfortable! Plus, she woke up every time the nurse came in at night to give me pain killers and antibiotics. Poor thing!

In the morning Elaine left for work and I braved the day alone until Doug came at 5:30. Elaine had told me how "swollen" I'd looked before she took off, but I didn't appreciate the intensity until Dr. Li paid me a visit at 2 pm. As much of a veteran surgeon as he is, even HE chuckled when he saw my face. And after commenting on how I appeared to be more swollen than most people he'd treated, he broke into a polite, but hard-to-surpress laugh. Um, thanks! Oh well. I never fault a comical situation.... even if it's at my own expense. ;) On the flip side, Dr. Li reassured me that the surgery went just perfectly, and he was very happy with the results. That provided some great relief.... even though somehow I never doubted it would be a success.

The day shift wasn't exactly up to par, however. For instance, I'd press the nurse call button, they'd ask via the intercom - "What do you need?", and of course with my jaws wired I couldn't say anything except make noises - so they'd simply hang up on me, perhaps thinking it was a fluke. Argh! And all this happened even though I'd asked the nurse from the night before to make a note that I couldn't talk. It's funny in retrospect, sure, but at the time, it was infuriating. The only thing that brightened the day was the flower arrangement that Jackie sent me. She's such a sweet girl!

When Doug came that evening everything got easier. :) He was just such a great, caring friend! Well, a little groggy himself, perhaps. Because for some unfathomable reason, he'd thought he was taking me home that night! No way. I wasn't due for a discharge until Friday morning - and even that was delayed a day because of my condition. Silly Doug!!

However, he was a real trooper and stayed almost three full days through thick and thin - er, or maybe through gross (me, with a serious nasal congestion) and smelly (him, through three days of no showering). My friend Isabelle visited Thursday night and the three of us chatted for quite a while. She's the one that had recommended this surgery to me in the first place (she went through it herself about five or six years ago). We had a great time "partying" in my hospital room. As soon as she left, though, I felt the wind taken out of me and just crashed.

It was too much to see poor 6'4" Doug cram himself into two chairs and suffer through the long night. Luckily neither of us is overweight, so I invited him to share the tiny hospital bed with me. We managed not to crush it! Thursday night came and went without much ado.

Friday was a different story. After the quick shower in the morning, I felt dizzy and sick in the stomach, and had to lie down immediately after coming back to my room to let it pass. Dr. Li came to check on me again, and suctioned my nose because I began to have trouble breathing through it (and my jaws were "wired" shut!). Unfortunately that problem came back with a vengence at around 7 pm. Breathing became so unbelievably difficult, because my nose was terribly congested and my jaws wired shut, that I experienced my very first panic attack, and thought I was going to die. To be perfectly fair, the two nurses there were not very helpful. The student intern was alright. But the other one was patronizing, telling me that my oxygen intake was at 97% so there was no serious concern. How dare she!! Could she not see how much struggle I was going through just to get some air? I held Doug's hand and before I knew it, tears came running down my very puffy cheeks. Long story short, after about an hour of fear and struggle, my breathing became easier. But, I suspect it'd be a long time before I forget about this particular night.

At 2:30, or 3:30 in the morning neither Doug nor I could sleep so we took a stroll in the hospital instead. It was of course very quiet.... and even serene in a way. We looked through all the paintings on the walls.... and walked through the different corridors. I knew I was getting stronger because standing for an extended period of time didn't make me sick and dizzy anymore.

So this morning we packed and left for home! I had no idea how good it would feel to be home again. But it was definitely relaxing... and helped ease my breathing. How ironic that even though I had JAW surgery, my nosal congestion and breathing became the #1 issue and concern in the immediate recovery period.

I took some snapshots of my face. It is still very swollen.... but the swelling has gone down quite a bit. Spent some time doing before and after comparisons.... which you'll see very shortly!

Heading Home!

I am going home! Finally checking out after three nights at the hospital.

Posing with the Monkey

Face deflating just a bit. The skin didn't feel as tight and stretched as the night before. I could spare some to squeeze out a smile now. ;)

Comfort

Jackie sent the flowers, Mark gave me the teddy bear, and Doug brought the monkey. Thank God for friends!