Day 3: Saturday: Order of Congestion with Jaw Spams

So I forgot to mention this before, but one of the more annoying things besides the congestion is the jaw spams.  They hurt!  They also seem to come in waves.  I also started getting a little feeling in my face, more of a kinda tingling feeling.  I hope that means good news. 

So overnight, I slept in a chair next to my parents' room in case I needed their help in the night.  I am very dependent on them.  Part of it is that I am still a little weak (you wouldn't believe how much energy it takes to syringe your food so that you have enough to drink.  Trust me it's a lot.) and the other is that I was still using their bathroom to eat and take medication.  I was still dependent on the crutch of using a mirror to eat. 

My sleep overnight wasn't too bad.  I certainly slept better than the night before, but still not the greatest.  I would wake up and have trouble breathing.  I would have to drink some water, move around a little, and moisten my nasal cavities with saline spray.  This is when I discovered my second obstruction at 3 am.  It was again about the same size as the other.  The problem was all of the breathing I was doing through my nose at night had hardened it because I slept solid from about 11 to about 3.  So I had to gently keep moistening it, meanwhile breathing through my mouth because my nose couldn't provide enough air.  It was very scary.  I finally got it loose, and I can't tell you the relief I felt.  I was then able to blissfully go back to sleep, only waking occasionally when I had to go to the bathroom or drink some water.

My first meal today was, drumroll please, thinned ensure.  I was finding the regular ensure was still a little on the thick side, so I would thin it out with water.  After taking all of my medicine and putting lotion on my face and ointment on my lips and rinsing, a good portion of the morning was gone.  I tried doing some of the blog posts from earlier getting them up.  I had them written just not in the blog.  I didn't want them going up out of order so I wrote them in a text app on my phone and will commit them when I get time. 

This morning, I went outside to have some peace outside taking in the morning sun before it got too hot and humid.  It was pretty nice.  You can see in the picture that the dogs can tell that I am sick and are trying to comfort me and treat me kindly. 

I'm not really sure if I was comforting him or he was comforting me.  It is hard to tell.  One neat thing, you can't see it here but right in front of the chair is a hummingbird feeder.  There are a ton of hummingbirds that show up.  If another is there, you will sometimes even see them chase each other off.  I'm less happy about that part, but as soon as the greedy hummingbird leaves, the others come back.  You can see in the photo,  I still have my chin strap on.  I think that is keeping most of the swelling down.  My face is the biggest it has been but it still doesn't look as big as I was expecting.  That is definitely a good thing.  I then walked around a bit, getting some exercise. 

After third meal, my Mom took me on a drive.  It was really nice.  It was a pretty day and the drive was smooth.  On my drive home from the hospital we didn't think about it but we ended up using an older vehicle of my parents' that has a less smooth ride.  Today we used the newer vehicle and I could tell a difference.  Again drool and congestion were still an issue while I was driving.  In addition, I was having problems where my eyes kept tearing.  I don't know whether the light was too bright or what, but I kept having to gently dab my eyes to get rid of the tears.  After the drive, I can safely say that my bowels finally started working.  I can't tell you how worried I was about that.  I know it sounds gross, but constipation is no joke.  The last thing I want when I am already in pain is constipation which is what I was worried would happen. 

I also took my first shower today.  I can't tell you how good that felt.  It was so refreshing.  I had to be really careful not to get too high, but my parents hooked up a detachable shower head that they had so I could wash safely.  Apparently, showers are allowed, but not baths because of vasodilation where there is a risk after surgery that you could pass out when you stand up I guess.  Before this I had been using bath wipes which is better than nothing but doesn't really have the same feel as taking a shower.  I always still felt a little dirty. 

One nice thing is that I watched a movie before going to bed.  I was worried that it would be a little too much.  Earlier in the day, there was a movie that was really weird called Santa Jaws.  I don't even think you could call it a B level movie.  It was really, really bad.  The shark had a candy cane horn it would impale people with and a santa hat on his dorsal fin.  There were also Christmas lights wrapped around its body.  Like I said, it was weird.  I thought that it was just me and that maybe I was still under the influence of something because the whole thing didn't make sense.  Trying to follow it was making my head hurt.  I ended up turning it off.  When I turned to my Mom, who had watched a minute or two of it before I turned it off, commented how weird it was as well.  So it was a relief to know that it wasn't just me.  Anyways, back to the night movie.  It was really good.  About every hour or so I would have to pause it so that I could drink or go to the bathroom or clear mucus (I know that is gross, but that is a big problem for me.)  I really liked the movie that my brother got for me.  Here is another before bed photo set.

I don't know if you can tell, but the swelling is not even on the two sides.  The right side of my face is noticeably bigger than the other.  The only thing that I can think is that the second year resident told me that when she was doing the back suture, she accidentally popped off my crown on my back molar.  She gave me the crown, because she wasn't sure if they could reattach it.  

Day 2: Friday: I Didn't Know About Pain

Today was even worse than the day before.  I try to normally be an optimist, but today was terrible.  I slept very bad.  I was in pain most of the night.  I slept in my parents' bed to be near my Mom since she was so worried about me.  Before going to bed, I had taken some Tylenol with Codeine liquid and some Claritin.  Every couple hours, I would have to get up and go to the bathroom and could never really sleep that well.  I also couldn't sleep in any reclining position because then mucus would start sliding down my throat and I couldn't handle that.  When I finally woke for the last time, I had some breakfast of some ensure, some juice that I liberated from the hospital with me, along with my medications.

Here I am in the morning. Not too happy at this point.

I realized in the night, that I really wasn't getting much from the Tylenol so I decided to do without.  I took my Sudafed liquid, Ibuprofen, and antibiotic.  It was a ton of work.  By the end of eating and rinsing with chlorhexadine and putting on lip ointment, it was over an hour later.  I was still trying to work all of the kinks out of eating with a syringe.  It is a lot harder than it sounds.  Imagine not being able to open your jaws, you have sores at the tops of the gum line and in the very back so you can't poke back too far.  In addition, you can't feel your lips at all.  On top of that, there is also a splint on the roof of your mouth so your tongue has to slide further back to swallow.  It is really hard.  It seemed like all I did all day was eat, take medicine, and go to the bathroom.  In addition, I had the fun time of each time my head would move a little, a snot blood mix would come tumbling out of my nose.  I don't think I talked about that much before but because I had upper jaw surgery, they had to break into my sinus cavities.  Also, during the 6 hour surgery, I had a breathing tube go through my right nostril.  That means that the nostril was sore and bleed a lot.  I also had discharge from the sinus cavities as they empty.  Primarily, the blood was not fresh red, but maybe a shade or two darker.  I have to use this saline spray fairly often so that things don't dry out.

In addition, I read that congestion can be a problem which is why I'm taking the Sudafed and Claritin and using the saline rinse.  They were not kidding about the congestion.  I feel like a lead weight on my chest.  I also can't blow my nose at all because my sinus cavities are exposed.  I think I have to wait 2 weeks.  This next part is going to sound really gross so feel free to skip the bracketed part. ******************************************************************************
So because I can't blow my nose, I get these clumps of like tarry, glue-like obstructions that take residence in my nose.  They start to harden if I don't get them out fast enough or don't water them enough.  Somehow, I have to get these balls of glue out of my nose.  Unfortunately, the way I found out about this is when one took residence up there and I didn't know until suddenly it was hard to breathe.  It got really large, about the size of a small ball bearing.  Now try to imagine how hard it was for me to get out.  I have something that large up my nose, but I can't blow my nose.  It has the consistency of a glue ball yet I'm also worried to work too hard to get it because I have exposed sinuses.  It took about a half hour of work but I finally got it loose.  I'm not going to share a picture because it was that bad.  Also, it didn't come out in one piece.
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It sounds like I'm Darth Vader or an Emphysema patient when I breathe through my nose. I have to constantly battle the congestion.  All day, I'm drinking fluids to help keep things thin up there so I can breathe.  I know my family is worried about me today, because I haven't really been communicating much, but just making it through the day took everything out of me.

Head on profile as I am going to bed

Side profile

Day 1: Thursday: Day after Surgery

This is the day when things started to go worse.  Because I hadn't really slept that well, and I don't remember being told to do so, I hadn't really drunk a whole lot over the night.  Mostly they kept trying to get me to pee.  I've read it before that other people had a hard time urinating again after the surgery because it burns.  Let me tell you, they are not kidding.  It hurt so bad.  When I finally did manage to work through the pain, I was only able to go a tiny bit.  Really, since I hadn't drunk a whole lot, it would make sense that there wouldn't be much in my bladder.  I did drink a lot the day before so that I wouldn't be dehydrated afterwards.  The night nurse kept threatening to catheter me again if I didn't go some more.  When I finally was able to go a tiny bit more, she decided to do a bladder scan to see if I was faking.  Fortunately, I was in the clear as there was little in there.  The second year resident popped up after all this.  I don't really remember much about her visit.  Apparently, she told me to drink more liquid and to try pee standing up which the nurse wouldn't help me with.

The overarching issue that I had overnight was that I came off the pain meds from the surgery and was in a lot of pain.  Their solution was to give me oxycodone, liquid.  I had a hard time taking it because it was a liquid and I wasn't drinking yet.  The other issue is that they were trying to get me to drink laying down.  Of course I would choke!  The nurse finally gave me a shot of Toradol I think, but that seemed to at least dull the pain, but they said it was a one time thing.  Eventually, I was able to drink enough that when I needed the next dose of pain meds they gave me oxycodone liquid.  All that really did was make me sleepy.  I still felt the pain, I just couldn't do anything about it.  It was miserable.  This was around the point at which the resident showed up.  She might have also made a comment about my swelling but I'm not sure.  I do remember her saying that they would be doing my bands in the morning.

Finally, at about 5 am, a whole bunch of residents popped up in my room to watch the banding.  The fourth year resident and the second year resident slowly put the bands on my teeth while trying to get my drug addled mind to shift my jaw forward so they could lock it into position.  I got scolded by the senior resident for not drinking enough at this point.  That is all I remember about the visit.  Apparently, I found out later they said a whole bunch of other stuff, but I don't remember it and slept for the next three hours.  During that time, I guess I as slowly swelling like a balloon.  At about 8 am, they took me downstairs to do xrays and final band adjustments.  Downstairs in the oral surgery clinic they made sure that my jaws were in the right alignment.  Then I waited two hours in a side room for a transporter to take me upstairs.  I was miserable.  I got taken away before my mom could get to my room and no one seemed to be able to find me.  Eventually, someone came to take me upstairs and I finally made it back to my bed.  By this point, I was in a lot of pain and pretty out of it.  The nursing staff since I was in a neurology unit didn't really seem to know what to do with me.  The food that I kept getting was also too thick.  I got thick thick cream of broccoli soup and then another time I got some other soup that was too thick and chunky.  When I left the surgical area, I had an awesome head ice wrap that worked wonderfully.  When I left to go downstairs for xrays, someone tossed it in the trash because they thought it was dirty.  As soon as I got back upstairs, I kept asking for a new one.  I kept asking like every hour or two or every other time I saw the nurse saying, "Can I please have an ice wrap?  My surgeon says I am supposed to have one for the first 24 hours."  She would say yes and then never bring one.  I finally got one as I was leaving and couldn't really use it that much.

Here I am walking in the hallway trying to get some exercise and feel better.

Later on the female resident (I feel terrible I don't remember her name), showed up and asked why I was laying in bed, I should be moving around.  I would feel better, the swelling would be less, and I would be able to eat and drink better.  She also told me to eat in front of the mirror as that would help me position things better since I was numb from the nose down.  Apparently, she had explained this earlier, but I didn't remember anything anyone said overnight.  I started following her directions, needing help to get up initially, but I was finally able to drink enough liquid to satisfy the target.  For some reason, it seemed like the nurse didn't want to let me go.  Finally, the surgeon's office called my mom and asked how I was doing at home.  They seemed surprised that I still hadn't been released and worked to get me out.  It didn't help that when we finally got approval, I had a weird episode where I started getting cold and shivering.  I'm not sure what started it but it freaked her out enough she wanted to talk to the dr again and recommended that I stay another night.  I wanted to go home so badly.  Again, the dr intervened and was able to spring me out so I could go home.

Here I am attempting to use a syringe in front of the mirror.

The ride home was an adventure.  I was in quite a bit of pain and it was so long.  It lasted two excruciating hours.  It didn't help that we had to drive through the city so some of the roads were a little bumpy.  I felt every bump on that ride home.  Fortunately, the pain meds I got shortly before I left made me sleepy enough to make the time pass.  When I got home, my family's dogs were very excited to see me.  They knew something was wrong and they were overall very well behaved around me which surprised all of us.  At this point, I was surprised at how little swelling I had, but I was in so much pain.

The Big Day: Surgery!

I'm here waiting to be admitted into the hospital and I am so nervous.  My hands are sweating and I slept terrible last night.  I woke up at 3:30 and couldn't really get back to sleep.  Part of it is that I started getting hot and the rest was nerves.  The closest analogy I can come up with is like the last night before school starts.  I had to get up real early to rinse my mouth with this vile rinse that tastes terrible.  I also had to use it last night to prepare for the surgery.  In addition  to rinsing with that liquid, I had to first go to admissions where I waited for quite a while.  It reminded me a lot of going to the DMV.  No one wants to be there, yet everyone is forced to go.  There were so many people there at 5:30 am.  They even had tickets which would state which patient they were helping.

I look chipper in this picture amid the chaos in surgical admission.

My hands were sweating a little bit and I was wishing that I didn't have to do it.  I think I ended up waiting to be admitted for about an hour.  Then I had to go upstairs to the third floor to go to the surgical admissions where they had me dress into various gowns.  Surgical admissions was pure chaos.  I was supposed to be prepped for 730 am surgery but they didn't even start putting in the line for me until way past that.  I basically sat there for an hour until people started showing up close to the surgery time and then everyone came at once.  I saw the supervising anesthiologist, the nurse anestheiologist, and two resident anesthesiologists.  I also saw a fourth year surgical resident, a second year who I guess I was her case, and then the two surgeons.  The pure chaos there at the surgical admissions delayed my surgery by an hour and a half the surgeon said. 

I just remember being walked to the surgical room and just being terrified.  They knocked me out right as they were strapping me in.  Good thing I'm not claustrophobic or have a fear of being tied up.

Most of the rest is kinda hazy and my Mom had to help me with later.  Some I do remember.  I mostly remember waking up in recovery before going to my room and being hot.  I think I even asked for water but they wouldn't give me any.

I was really out of it here.  It was hard to find one with my eyes a

re open.

I don't really remember too much else. I do remember the surgeons coming in and saying they were surprised at how little swelling I had. I remember that distinctly, but it is hard to know where that happened. I thought it was in recovery while I was waiting to go to a room, but my Mom says it was not.  Eventually, someone came and got me and brought me upstairs where I spent the night.  I didn't know it at the time, but I was in the neurology wing.  One nice thing is that at this point I wasn't banded shut yet.  I wish I had taken advantage of that fact.  I was kinda coming in and out from the drugs  so most of the night is pretty blurry.  I do remember that my surgery was a 5 mm bilateral saggital split ramus ostestomy and LeFort I.  I think my Mom said that was another 5 mm.  Plus, I also had genioplasty at the same time.  I figured I was out anyways so might as well do it.  I now wish I hadn't as that added another 6 mm.  All in all, my jaw profile came forward 11 mm, and my upper jaw rotated at the back like 5 mm.  I don't remember a whole lot when he explained it but I do remember him saying that they had to cut through my sinuses and that they were rather full so a lot of congestion would be expected after the surgery.

Day Before Surgery

I am writing this the night before, but it will probably take me a couple days to post this online.  I am really nervous.  I feel like I had my last meal before my execution.  It was so good and I tried to savor the food as best as I could.  I had pulled pork with baked beans and french fries.  I'll try to include a picture of that up here as well.  What kinda complicated my eating was my surgical hooks. 

My last appetizer. Onion rings.

My last real meal for a very long time

Last night, I went to my orthodontist and he attached the hooks onto what seems like every available surface.  These things hurt!  They tear up my bottom lip on the inside.  The ones on top are not so bad because I can kinda rest my lip above them.  I have been judiciously applying wax on every hook from incisor to incisor on the bottom.  Like I said, my orthodontist put hooks between every bracket on the wire.  Paraphrasing his words, "I put a lot more hooks than you'll need for the surgery, but I figure it's better to give the surgeons more options in the surgery room.  Some will probably come off and the only one that that will impact will be you and that won't matter in a day or two because you won't feel anything."  He has a weird sense of humor.

These are the hooks.  Not the best picture but you can see they're everywhere.

Because my surgery time is so early, 7:30 am, I have to be there two hours early which meant my arrival was 5:30 am.  Ugh!  The hospital where the surgery is being done is 2 hours away on a good morning.  There was no way I was getting up well before 3 just so that I could sleep at home.  I think my Mom and I made the sound decision to get a room at a hotel near the hospital.  The hotel my Mom chose was super nice, and I wish that we had gotten here earlier so that we could really enjoy it.  We got in after eating at about 9 and after getting ready, it was about 10:15.  This bed is super soft and I have a feeling I will be sleeping really well.