Wednesday, May 27, 2015

Day 13

Today was another good day (as you can imagine). I drank a Boost for breakfast because I had to use one of my three hours to talk at the animal shelter. Since I'm getting my energy back, but can't quite go back to work yet, I decided to get some foster kittens. I've been fostering for a long time. All three of my cats were fosters that we decided to keep. I've probably had over 50 kittens altogether. I really have no idea. But anyway, I'll post some pictures of the two little guys later. Still trying to think of good names!

As for my meals today, I finished some leftover potato soup for lunch, and then I had my FAVORITE thing ever, potato pancakes for dinner! My family is Polish and my parents' recipe is awesome. I'm not sure if potato pancakes are considered to be as soft as scrambled eggs, but I had no problem mashing the pieces up with my tongue, which I assume is the point of the soft foods (no chewing). It's still tough to eat because I can only open my mouth about an inch, not even. I also have to look in a mirror while I'm eating because I have to be very careful. Also my bottom lip is still numb and I would definitely make a mess if I didn't watch what I was doing!

So I can feel my left cheek and bottom eyelids! That means the only numb spots I have left are my whole chin, my bottom lip, my right cheek (right next to my nose), and the right corner of my top lip. But with feeling comes pain. That's not to say the pain is bad or any worse than it's been, but I can definitely feel soreness in my bottom jaw. Also, the tension from the rubber bands that are holding my jaws shut is making my teeth sore. Overall I'd say the discomfort level is about a 3. Which is pretty amazing considering everything they did to my face! 

I feel the need to point out how much ice cream and milkshakes I haven't eaten. I really thought that I'd have like, a milkshake a day! But I wasn't really able to get any milkshake through my teeth during the first period of my recovery, not to mention the last thing I wanted was anything milk-based with all the protein shakes I was drinking. I know they don't actually contain milk but my stomach would beg to differ. And even the past two days, people have brought me ice cream and milkshakes but once I'm done my meal I don't have any time or room in my stomach to eat them! When you only have three brief chances to eat in a day, you are much more particular about what you eat in that small time slot!

Well, that's about all for today, here are my pictures!




Tuesday, May 26, 2015

DAY TWELVE!!!!!

Today was the big day! The day I've been desperately waiting for, well, twelve days! I had my second post op appointment today and I got to open my mouth for the first time since surgery! If you've ever seen Hocus Pocus, I felt like Billy the zombie when he cut the stitches that were holding his mouth shut and he coughed out dust and leaves! It was the craziest feeling. The best part was feeling my new airway. Obviously, it's been great breathing through my nose, but it was absolutely amazing breathing through my mouth! Every breath felt so easy and full and wonderful. As you can imagine, it's pretty tough to open my mouth because my jaw was just operated on and then sat shut for almost two weeks. It was kinda scary trying to open my jaw because it feels really unsteady. I still have a lot of healing to do, but I'm so happy with my progress.

At this point, my swelling has gone down a lot, but there's definitely still a good deal of it. Some swelling can remain for up to about 6 months, so I may not really see the finished product for a while, but honestly, I'm already really happy with the way I look. My gums aren't showing all the time, my nose isn't droopy, and I have a jawline! Did I mention I CAN BREATHE!?

Oh, the BEST part of today....I GOT TO EAT REAL FOOD! I've never been so excited for anything in my life. I'm now allowed to take my rubber bands off and take my splint out for one hour, three times a day for the next nine days to eat. My parents and my fiancé and I went out to Houlihan's right after my appointment so I could have potato soup. It was awesome. I had to pour out all the soup onto a plate and mash up all the potatoes and I was only able to finish half of the little bowl of soup, but it was such a relief. The hardest part of not being able to eat is knowing that you're not allowed to eat. As much as you want to, you physically aren't allowed to put a piece of food past your teeth. It's really great for seeing how much self control you have though! :P

The other interesting thing about my experience today was actually being able to talk! Let me tell you how fun it's been playing Charades with everyone for the past twelve days.... It's pretty funny at times, but now that I need to communicate things other than "pain medicine," "ice pack," and "water," it's starting to get really frustrating. I have too many things to say to keep writing them on my little white board. But anyway, my voice sounds pretty weird. Obviously my face is still swollen and things are still adjusting and settling. I have a little bit of a lisp at the moment but honestly it sounds cute. I reminded myself of my older brother when he was pre-pubescent and had a spreader in the roof of his mouth. Quite funny. :)

Here's my day twelve pictures and a video from the restaurant! It's a little hard to understand me, but gimme a break, I haven't talked in twelve days! :)





I'm finally starting to feel like myself. I'm getting my strength, energy, and morale back after a very trying twelve days. I'm excited to see where I go from here! :)

Day 6 through Day 11

So apparently I'm not quite as good at this blogging thing as I thought I'd be! Honestly, I've had absolutely zero energy and haven't been doing much of anything. I didn't even want to watch TV the first few days because I was so physically and emotionally exhausted. Showering was the biggest accomplishment of each day for the most part. Regardless, every day gets better.

Saturday (Day 9) was my first real outing since surgery. I went to my friend's son's 2nd birthday. I was only there for an hour and I was exhausted. Monday (Day 11) my fiancé took me to see a movie.

Here are some pictures from days 6-11:

Day 6:

 Day 7:

 Day 8:

 Day 9:

Day 10: Forgot to take pictures (oops)

Day 11:



Thursday, May 21, 2015

Day 5- First Post-Op Appointment

So Tuesday I had my first post-op appointment. Unfortunately, Dr. Lanzi was out of town so we had to drive a half hour to see his partner, Dr. Burke. It was a long day, but I made sure to get lots of nutrition in me so I was strong enough for the trip.

At the appointment, I got my chin strap removed, as well as the two little stitches. The stitches in my mouth are all dissolvable I believe...

I also got X-rays. (Unfortunately, I don't have pre-op ones to compare at the moment)



I have like 5 plates and 22 screws or something like that.

Day 4

This is the day I finally hit rock bottom. I hadn't been "eating" enough and it finally caught up to me. After napping for a few hours in the afternoon, I got up to go to the bathroom and we all thought my next stop was going to be the Emergency Room. While I was in the bathroom I started feeling really sick, and so my mom and Corey sat me down in the kitchen where I tried to pull myself together. My mom rubbed a cold washcloth across my face and body to try to cool me down. I knew I needed to lie down so I tried to get the living room, but I fainted on the way and they had to sit me down at the computer desk. When I FINALLY got back to my chair, I was able to lie back and proceeded to drink as much Boost as I could handle. I started feeling better from there, and we made sure I started getting as much nutrients as possible, even if I didn't want them. I actually don't have much of an appetite at all surprisingly. But I'm learning how to eat for nutrition, not for taste.


Day 3

Sunday funday. Not.

The days were just dragging by and I was trying desperately to sleep as best I could,

BUT. THE. CONGESTION.

Congestion is by far the worst part of the whole recovery. I cannot breathe through my mouth at all, which mind you, is how I've been breathing primarily for the past nineteen years. So the nose is all I got. They opened my nose up with surgery so that I can breathe better, but it's been so stuffy that all of my energy has been focused on trying to breathe. The one thing I can do that provides immediate relief in use Afrin nasal spray. It unswells the blood vessels in your nose that are causing congestion. Unfortunately, you're only allowed to use it every 10-12 hours. So when that wears off, some of the other things you can try are:

  • taking a steamy shower
  • using a vaporizer/humidifier
  • saline nasal spray (every 20 minutes)
  • trying to gently blow out some of the mucus (you're not really supposed to blow your nose for about 2 weeks)
It's also really frustrating not being able to spit out the mucus in my throat. You can't really "hock" properly when you're mouth is all banded shut, so you just have to swallow it. 

As you can see I have this fun chin strap thing on, whose purpose is to help reattach the muscles in my chin that were disconnected from the bone for the genioplasty. I also have two little stitches on the underside of either side of my lower jaw, where they had to make two tiny incisions to stick a little screw driver in there.

Day 2- Going Home

Day two, it was time to go home. I got to take another stroll around the hallways in the morning. Sue had changed my into my clothes the day before. So all they really had to do was take out my IV. Like I said, I was pretty out of it for the first few days, so I don't remember too much about that morning. They pushed me to the car in a wheel chair and we were on our way home.



It was time for me to inhabit the recliner where I've lived for the whole first week following surgery. It was also time for BOOST. All. the. time.
Nutrients are super important because you aren't eating anything and are no longer hooked up to fluids, so you can go downhill really fast.
I can only eat through a syringe, 2oz at a time. I stick the little beveled edge of the tube back into my cheek and slurp in the goodness. Its very dehumanizing and messy, but it's all ya get at this point.
Aside from Boost, I drink apple juice, water, and chicken broth.

My brother visited with my nephew Saturday night which really helped me take my mind off things for a little bit.



Day 1

The first day post-op was pretty hazy for me as well. Still, definitely not fun. I had nasoparyngeal airways (tubey things, as my mom called them) in both nostrils because there's no way I would've been able to breathe through my mouth, and they needed to make sure I could breathe through my nose. They took those out in the morning, as well as the catheter that I had in (weird). I had a few visitors come see me but I don't remember much.

The worst part of my stay was when I didn't have Nurse Sue. The other nurses weren't nearly as great as she was. In fact, when I was having a panic attack on Friday because I felt like a couldn't breathe, they said the monitors are showing that I'm getting enough oxygen and I just need to calm down. They did absolutely nothing. Not cool.

Friday night I was able to get up and go for a little walk around the hallways and told Sue about my wedding plans and showed her a picture of my dress. :)




Surgery Day

The day of surgery, we arrived at the hospital at 10:00 AM to prep for surgery at noon. I used the bathroom, got changed, and they started an IV. A few people, including my surgeon, stopped by to talk with me before surgery. I said goodbye to my loved ones and was on my way...


Five hours later, I woke up and the surgery was over. I was pretty out of it for the rest of the day, but it was NOT a good day. I felt very sick and swollen. There was blood in my stomach that I threw up in the middle of the night (all over myself). Fortunately, I was blessed to have my mom and Corey with me the whole time, as well as the best nurse ever, Nurse Sue. She was so awesome and took such good care of me.


When all was said and done, I'd had:
  • Arch bars put on
  • Lefort I Osteotomy (upper jaw surgery)
  • Bilateral Sagittal Split Osteotomy (lower jaw surgery)
  • Genioplasty (chin surgery)
  • Septoplasty and Turbinectomy

Wednesday, May 13, 2015

The End of an Era...

I never thought this day would come. Surgery was months away, and all of a sudden here I am, the night before surgery, preparing for my life to change forever. I've been so anxious and scared leading up to this point, but I managed to find peace today. I'm ready for this surgery.

Of course, the main reason I am getting this procedure is for my health, to ensure a lifetime of proper breathing and snore-less nights. But let's be honest...everyone that knows me knows that I have been self-conscious about my smile for a very long time. For years, I wished that I could change the way that I look, so I could just be confident and comfortable with my face and my smile. However, I don't regret waiting to get this surgery. The way I look, and more so my low self-esteem about the way I look, has made me the person that I am today. And for that, I am grateful.

I know that everyone will have their opinions about me having this surgery. But all I can say is, how often do you have the opportunity to change something that you really don't like about yourself? God has blessed me with this crazy and amazing opportunity, and I'm putting it in His hands. He aligned the stars for me in this situation, and I trust that everything is going to turn out the way it is supposed to.

So take a good look at this face, the face that I've had for the past twenty years, because tomorrow, it's going to change forever...for the better! :)


List of Things I Purchased for Recovery (Updated)

Here is the list of things I got for recovery:


  • Small humidifier/vaporizer with mask (to help me breathe and keep my mouth/lips moist)
  • Protein Shakes
  • Baby utensils (for when I start eating soft foods)
  • Non-alcoholic mouthwash
  • Bed Buddy ice/hot pack
  • Dry-Erase board (for communicating)
  • Sleep Mask (for sleeping in the hospital)
  • Tissues with Lotion
  • Nasal Decongestant
  • Saline Nose Spray
  • Face wipes
  • Baby toothbrushes
  • Baby washcloths (for my sensitive post-surgery face)
  • Aquaphor (to keep my lips/face moisturized)
  • Thank You cards (for all the people that are going to be taking care of me!)
I will update this post to let you know what I actually used and if there is anything else I wind up buying or wish I would've had!

Update:

So I wound up using pretty much everything I bought! The only thing I didn't wind up needing at all was the sleep mask. I had a private room and was on lots of medications so I was pretty much knocked out the whole time. The hospital gave me Saline spray and a nasal decongestant (like Afrin) so I didn't really need to buy them but I used my own Afrin spray anyway. The baby washcloths weren't really necessary, but I used them because I had them.

The things I used most were the protein shakes (obviously), my little handheld vaporizer, my Bed Buddy, and my dry erase board.

Saturday, May 9, 2015

Pre-Operative Appointment

Yesterday, I had my official pre-operative appointment with my surgeon. They took new x-rays and my surgeon took lots of measurements and notes. I also gave the surgeon my models, which he will use to perform a mock surgery on my jaws prior to real thing. Here are some more fun facts:

  • I have lip incompetence, which means my lips don't close at rest. It takes some effort to pull my lower lip up to my upper lip.
  • My jaws are crooked. My top jaw is higher on the right side than the left.
  • Because my top jaw is crooked, so is my bottom jaw. Because my bottom jaw is crooked, it pops on the right side.
  • My nose curves slightly to the right.
  • My right cheek is slightly weaker than my left.
  • My face is slightly concave because my top jaw grew long instead of outward. 
  • My face is disproportional:
    • Ideally your face has three equal sections: Forehead=nose=lower face.
    • My forehead and nose are just about equal, but my lower face is about 2cm longer.
Now....drum roll please...here is my official diagnosis:
  • Maxillary Hyperplasia
  • Maxillary Asymmetry
  • Angle's Class III (not really sure what this is)
  • Mandibular Hypoplasia
  • Macrogenia
  • Other Jaw Asymmetry
  • Dentofacial func. abnorm;unspec.
And my surgical procedures:
  • Maxillary LeFort I Osteotomy with graft
  • Mandibular Bilateral Sagittal Split Osteotomy
  • Mandibular Anterior Sliding Osteotomy
  • Two Oral Surgical Splints

Pre-Pre-Op Appointment

So after my consultation with Dr. Lanzi back in September, I thought I would need to get braces again for surgery to put my bite in some special position for surgery. After I met with my orthodontist and realized he'd just be tweaking the few minor imperfections that I have after not wearing my night retainers for the past five years, and that I would have to pay the full $4,000+ dollars for braces for practically no reason, I asked Dr. Lanzi (around October-November) if it was possible to do the surgery without braces. He reviewed my models and decided we could do the surgery with arch bars instead of braces. Arch bars are surgical braces that get put on right before surgery and stay on for 6-8 weeks after. The arch bars are used during surgery and during recovery to hold the jaws together.

I originally wanted to get the surgery done over my winter break, but because there were no dates available, I had to schedule it for May 14th, after the spring semester. Once my insurance was approved and my date was set (around February), I found out I wouldn't see Dr. Lanzi again until my pre-op, six days before my surgery. This just wouldn't do, considering I had a million bajillion questions and a boatload of anxiety that I was carrying around. So I made an appointment to see him in March so he could answer my questions:

Q: How exactly does one move a lower jaw up?
A: Three words: Bilateral Sagittal Split. Basically, the surgeon splits the lower half of your mandible from the upper half on either side and is able to reposition it forward and up that way. It's kind of hard to explain so you should Google it. :P

Q: How much of my upper jaw will be removed?
A: About 5mm (1/2 cm).

Q: How far forward will my jaws be moved?
A: About 3-5mm.

Q: Will my voice/singing be affected?
A: Not likely. (I'll probably be able to sing a little easier because of better air flow).

Q: What if I have an anxiety attack when I wake up? (I have anxiety problems.)
A: I'll be on anti-anxiety medicine when I wake up to keep me comfortable. I'll also have anti-anxiety meds for when I go home.

Q: Will my lips touch afterwards? (I have "lip incompetence" and my lips are about 11mm apart when my mouth is at rest.)
A: It will take some time for them to adjust to each other (plus all the swelling) but eventually, they should touch.

Q: Do I have a hyperactive upper lip, and will it be that way after surgery? (My lip moves up pretty far when I smile, so my smile looks more like a "here's a nice good look at all my teeth and gums" than a smile.)
A: Yes, I do have a hyperactive upper lip, and it most likely won't move as far after surgery.

Q: Will my gums still show?
A: Dr. Lanzi and I decided that a little bit of gums looks youthful and attractive so we're gonna leave a little bit of gums.

Q: Is there any chance of pain and migraines afterwards?
A: No. The surgery actually reduces/takes away likelihood of TMJ and migraines.

Q: Will I have full range of motion?
A: Yes, after I'm fully recovered.

Q: What is this "splint" I keep reading about?
A: The splint looks kind of like a mouthguard and it holds the bite in place.

Q: Are there any additional risks with using arch bars instead of braces?
A: No. I may have some gum inflammation, but that will go away when they come off.

Friday, May 8, 2015

A Little Bit o' Background...

For most of my life, my defining feature has been my gummy smile. For any of you that have a gummy smile, you probably know how hard it is to go through life, afraid to smile too big or laugh too hard. No doubt, showing a little bit of gums when you smile is youthful and attractive, but showing more gums than teeth just makes you feel very exposed and self-conscious. But you live on...

When I was twelve years old (in 7th grade), I got braces. I was SO excited because at that point, I hardly noticed my gummy smile past my crooked teeth!

Woof...Cute braid though!

It's hard to find pictures of me smiling big. This was the best
 I could do for the braces years (and the least painful).

I had braces for two years, and my teeth straightened right out. I also had a small overbite, which was also completely corrected by braces. During my treatment, we had asked my orthodontist if there was anything that could be done about my gummy smile. As soon as he mentioned removing a bone from my face, my parents immediately dismissed the idea. Unfortunately, I was too young to really understand the implications of jaw surgery and make a decision for myself. As nice as it would have been to have done this procedure before high school, this face is what made me who I am today. As grateful as I am for my current position in life, I'm ready to take a leap...

I'm not sure what inspired me to look into what it meant to "have a bone removed from my face." This past summer, specifically August 2014, I began researching jaw surgery. When I had a better understanding of what the surgery implied, I decided to make an appointment for a consultation with an Oral and Maxillofacial surgeon. I wanted two opinions, so I saw a surgeon with a great reputation, Dr. Silverstein, about an hour away. After a great appointment with him, I saw the surgeon that my orthodontist recommended. Because their opinions coincided, I decided to stick with the second surgeon, Dr. Lanzi, who is located much closer to me, who also happens to be the surgeon for the Philadelphia Flyers. Pretty cool.

During my appointment with Dr. Lanzi, we looked at my X-rays and learned that because of my overgrown upper jaw, my lower jaw is too low and too far back, which leaves me with an airway of only 4mm wide, instead of the average 11mm. Obviously a small airway can lead to various health issues, especially sleep apnea as an adult. For that reason, it was deemed medically necessary that I have this procedure done. My insurance company denied me the first time around, but approved the surgery after the appeal.

My surgery date is May 14th, 2015.
Days until surgery: 6
Anxiety level: 8

Why Make a Blog?

First and foremost, I want to establish why I've decided to create this blog. There are certain things in life that you really want to be prepared for, and yet, can never truly be ready for. Jaw surgery is one of those things. In anticipation of my surgery, I've spent hours and hours online, reading blogs and trying to find people who have been through what I'm about to go through. There are so many little details and implications of jaw surgery that you need to know in order to make the process go as smoothly as possible. Even after collecting all of the information that you can, completing all of the activities on your to-do list, and buying all of the stuff that you're going to need, you still probably won't feel ready. I've come to the conclusion that you can't ever truly feel ready for someone to cut into your face. I never found someone with quite the same situation that I have, so I can only hope that this blog will be a resource to people with situations similar to mine, to give them hope and optimism for their own journey.