Day 987 - 27 Days Post-Op

It's been 27 days?!? They're going by fast now!

I woke up this morning thinking about how I was one month ago today. In short - I was a wreck! The surgery was only three days away, I was scrambling around at work to finish stuff up, and I was nervous about what I was about to go through. Very nervous.

But, here I am a month later, a month later and feeling better and better each day. I'm pretty much eating everything now - even things that require a SMALL amount of chewing (i.e. last night I had a hamburger for the first time.....no bun obviously!.....the hamburger meat falls apart easily enough with some light chewing, so it was all good!). There is still a good amount of swelling inside the mouth, but I don't think the swelling is noticable any longer to an outsider. The numbness is still there - I've accepted the fact it will probably be like that for a few more months at least.

The one new thing I've noticed is a little discomfort in my left cheek when I bite into the splint. I'm going to ask about this the next time I go in for an appointment, but I'm speculating that I'm feeling this discomfort because I'm working some muscles in that cheek that simply have never been worked before! The left side of the jaw - as you know from my pre-op photos - has never been functional, and now all of a sudden it is theoretically perfectly functional.....so the muscles that control my bite are getting a workout they have never had before. Again, this is just me speculating! As long as it's nothing seriously WRONG with me, I'm sure it's fine whatever it is!

Nothing much else to report on. I do not see the surgeon again until next Wednesday. And the Wednesday after that is the day the splint is removed! Needless to say that I am looking forward to this!

I'm sorry about the pics.  I will get these online very shortly.

Take care all,
Paul

Day 979 - 19 Days Post-Op

I am probably the worst patient to wear a splint! I'm eating EVERYTHING I can get my hands on as long as it's small enough to fit! Hahaha. Eating so many solids means that things are no doubt getting lodged in that splint, but right now, I don't care! I'm loving the food! In just the past three days, I've had spaghetti and meat sauce three times, several bowls of meatball soup, chili, pancakes, toast, scrambled eggs, chicken, french fries (made soggy with gravy!), etc. Holy. I may weigh MORE now than I did three weeks ago! Hahaha. I definitely bought too many Boost's and Ensure's!

So my tone should convey that I'm in good spirits, which is kind of strange considering I'm going back to the office tomorrow! Honestly, my work has been very understanding and supportive of this process. I have been working from home for the last week and a half, and never once did I hear a complaint or anything in regards to the time away from work I was taking.

I'm still swollen, but it's going down. Stitches are starting to fall out of my mouth...kinda gross, but whatever! I also shaved my goatee off. I hated that thing. It was a weird feeling to shave an area of your face that's completely numb, but I felt MUCH better after. Ugh, how did I once have a goatee for five years????

Now that the swelling is fairly minimal, I can really get a good look at the actual teeth. Wow. They line up! Left side and right side line up with each other! No gaps. However, I'm still concerned I have a crossbite. The surgical hooks between my two front and bottom teeth do line up perfectly, but I'm concerned that the hooks themselves are not QUITE in the middle of the teeth. In fact, I think the top hook is skewed a little to the left, while the bottom is skewed a little to the right, creating a crossbite. That would SUCK if this was the case, but at this point, I can't do anything about it. I'm going to ask Dr Holmes about it again this week.

I spent the weekend away from home this weekend and went to see my parents for Mother's Day. It will be the last Mother's Day before my wife becomes a Mother herself, so I figured it would be a good opportunity to see her. I also got to spend time with my brother and sister. My sister's off to university next year. Hard to believe. I feel it wasn't THAT long ago that I went off to school. But it has been 11 years. We're all getting older. It's starting to get scary.

Anyway, I promise to post the post-op pics in the next couple of days. Twenty-two days left with this splint!! Woohoo!

Take care,
Paul

Day 973 - 13 Days Post-Op

So today marks the second post-op appointment with the surgeon. I have no reason to think things will go bad – I can tell I’m healing up day by day. Things are still more uncomfortable than comfortable, but there have been a few breakthroughs in the last few days. First, I’m off the morphine. I decided I didn’t really need it anymore. Instead, I’m just taking Advil when needed. Advil’s a good drug to have because it acts as an anti-inflammatory in addition to a painkiller, so be sure to have Advil if this is a surgery you’re going through! Second, I’m eating FOOD again. Okay, not all foods. Not even close to all foods. But I’m managing to eat soft foods such as pasta. As long as the pieces are small enough for me to swallow them whole, then that’s good enough for me! Most of the time, a small piece of pasta may get lodged in the splint, which is kind of annoying, but I have so far been successful at flushing out the splint after eating.

Cleaning my teeth is getting easier and easier. It generally takes up to 10 minutes to do, and every time I eat, I have to do it, so it takes a good portion of my day, but the food is worth it! I use a baby toothbrush with toothpaste, and then again with baking soda. I use the baking soda because a side-effect of the medicated mouthwash is stained teeth. My teeth are definitely not as clean as I normally would keep them – I use an electric toothbrush usually – but I’d say I’m doing a pretty good job so far.

Reintroducing food into my diet also means that the weight loss is probably going to stagnate for a while. Right now, I am at 12 pounds lost – which isn’t nearly as high as I thought it would be (good thing!). Still, those 12 pounds make me the lightest I’ve been since my third year of university (that was a bad year for me!). In the three years since having the SARPE, I am down nearly 45 pounds.

My pain has been managed pretty well. Like I mentioned, I am off the morphine, but continue with the Advil as needed. I will probably take a couple of them before leaving for the hospital for today’s appointment (I am on my own for today!). My left cheek, chin, upper jaw, and area of my nose between the two nostrils are the numb areas on my face. The left side of my face is still pretty swollen, but I think it’s going down every day. Overall, I think the recovery is going very well. So well in fact that I decided I was well enough to start working again. Luckily, my work affords me the ability to work from home – so I have been doing just that since this past Thursday. My plan is to continue to work from home this week, and then return to the office on Monday. Also, I did some socializing this past weekend. A friend of mine who I used to work with stopped by on Friday. She brought some soup with her, and I managed to talk for a few hours without being in too much pain. The day after, we went up to see my wife’s family (who I had already seen the week before, but still) for lunch. And finally, I capped off the night by seeing another friend of mine to watch the Mayweather/Cotto fight. While it is important to allow yourself adequate time to recover, I think it is important to try to get back to your normal daily activities as soon as you are able to, or at least some subset of those daily activities. I think it can help speed along the recovery process.

Anyway, again, I’m sure everything will go fine today, but I’ll be certain to update the blog again after today’s appointment! Four more weeks with this damn splint!!!

Take care,

Paul

Day 968 - 8 Days Post-Op

The first week post-op is done!

Now that it is, I can officially tell everyone that, overall, the week BEFORE the surgery was actually worse than the week AFTER the surgery. I was suffering from the anxiety of the surgery for the week leading up to it, and that takes a toll. Note that I'm comparing the WEEK before and after surgery. Had I been comparing, say, the two days before and after surgery, the post-op was worse since those first couple of days were rough.

I had one of the worst sleeps last night. I kept coughing and coughing....but it's hard to really let the coughs loose because of the broken jaw. I think I was just very very phlegmy (gross, I know), and I spent a good portion of the night coughing and coughing. Luckily, the movie Vertical Limit was on TV. I saw that movie in the theatres when I was in high school (one of my fonder high school memories actually!), and it's a great flick. Finally got to sleep around 3:30am, but was able to stay asleep until 9:00am.

I also decided that I'm now well enough to do some work from home. I have an office job, so it's not like I'm doing anything physically strenuous. I basically spent the morning catching up on my emails (not done yet actually), and letting people know I'd be working from home for the next little while. If the recovery keeps going this well, I think I'll be able ot get back into the office a week from Monday. I'm still fairly weak, which is keeping me away from the office right now. The weakness was re-confimed yesterday when I decided to take a walk to a Starbucks for a coffee. It's just over a kilometer away. I didn't even make it to the half-way point before turning around and walking home. Too much. Ah well. I'm going to go for another walk today, but only to get some air. I'm not going to try to make it all the way to that Starbucks just yet!

Not much else to update on. The swelling still persists but is receding and I THINK the bruising may  be receding as well (tough to tell - it could be just starting!). Hopefully this recedes a bit more by Monday.

I finally took a look at my post-op pictures....they ain't too pretty. In fact, I'm not too sure I want to post them. When I saw other people's pics, I'm not going to lie, they freaked me out a little bit....probably unnecessarily so. I certainly did not FEEL as bad as I looked, but still. I'll probably still post them, but I want to be clear that EVERYONE'S experience is different, and again, I didn't feel nearly as bad as it looks.

Take care all!

Paul

Day 966 - 6 Days Post-Op

Today is my first follow-up appointment with the surgeon. I think everything should check out fine. I have no signs of infection, been keeping up on my meds like clockwork, and generally LOOK a heck of a lot better. I'm still quite swollen (although the swelling in my lips has come way down), am experiencing some degree of pain (especially I approach my morphine dosage time!), am numb from pretty much under my eyes to my chin, am quite exhausted (probably lack of substance....still on clear liquids until hopefully after today's appointment; the Boost is chilling in the fridge already! Haha!), and the bruising is beginning to appear underneath the eyes, but I can tell I'm on the mend.

I guess the biggest milestone yesterday was being able to drink from a cup instead of using the syringe. It is probably faster for me to just use the syringe, but I figure that I may as well get back into the habits of daily functions as soon as possible. I was having a look at my old posts from after my SARPE, and it seems like I couldn't drink very efficiently for the first week there either. So far, I would say that the recoveries from SARPE and this jaw surgery have been quite similar. Again, I think I benefited mentally from having the SARPE. I had some idea of what to expect post-op.


Today's milestone, aside from hopefully graduating from clear liquids, is that I shaved for the first time since the surgery. Weird feeling since the face is mostly numb. In fact, I didn't even want to touch the area around my mouth, so I'm rocking a goatee right now for the first time in several years! Hahaha. We'll see what the wife thinks about it when she gets home from work.


A few other updates:
- Sleeping last night went GREAT. I slept all the way through from midnight until 6:00am (I take my meds on the 12's and 6's). Looking forward to much of the same tonight!
- Weight loss is now at 10 pounds. This should slow down if I can have other non-clear liquids.
- My mother-in-law brought me a chicken broth last night. When it's pretty much all you can have, you can REALLY tell the immense difference in taste between the Campbell's stuff and something that is homemade. It was very tasty.

So I guess that's about it until the appointment happens this afternoon. I will be sure to update the blog again then!

Take care,

Paul

UPDATE:
I just got back from the appointment with Dr. Holmes. He said everything looked great, and also gave the ok to start with pureed foods! Yes! This outing also served as a reminder of how fragile my jaw still is however. I slightly tripped over my feet on my way into the hospital (common occurrence for people who are 6'7"!) and felt the shock in my upper jaw. Later, as I was waiting for my appointment, my nose started to bleed! I'm not sure if the two events are related or not, but I have not had any nosebleeds all week while at home, and then all a sudden when I go out for the first time, I do. I think I just need to remind myself that I'm nowhere near 100% yet, and need to take things slower when I do go out.

My next appointment is in a week from now. Will update again then!

Day 964 - 97 Hours Post-Op (+ PHOTOS!!!!)

Well, I don't want to get ahead of myself here, but I think the swelling may have peaked. I was a little upset when it clearly did not peak last night. The swelling had in fact advanced under my eyes yesterday, making me wonder if this swelling would ever stop! I think it MAYBE has.....we'll see.

On a positive note, the nosebleeding has pretty much stopped. The annoying part is waiting for the clots to make their way down (I know that's gross). No signs of infection or anything like that.

Not a lot of sleep again last night, but I'm finding that I can get a few hours in during the day which has been helpful. I think I'm almost a little afraid to sleep at night time in case my airway is blocked, which I understand makes no sense (the swelling does not affect your airway....remember that the swelling pushes you OUTWARDS, not INWARDS).

Weight loss is pretty good still. It has now been nearly five days without eating anything, and I've only dropped five pounds (keep in mind that I weighed in at 235lbs pre-op....I'm 6'7"). On Tuesday, I will hopefully be given the green light for the non-clear liquids like purees and meal supplements. So I think the majority of whatever weight loss I incur will be over today and tomorrow.

Anyway, this post is long overdue, but I thought I would maybe share some of the pre-op photos. I am not yet looking at my post-op photos, so those will have to wait a few days yet, but I wanted to give you an idea of WHY I needed jaw surgery:


PROCESS START PHOTOS
These photos were taken three years ago prior to my SARPE:
http://paulsjawmakeover.blogspot.ca/2009/05/picture-post-1-prior-to-sarpe.html

Probably two immediate observations:
a. My teeth were crooked! Probably enough said. Not one straight tooth.
b. My upper jaw was narrow! The SARPE helped to correct that, but did not expand it completely obviously, because I underwent some further expansion in last week's surgery.

After SARPE, I have been wearing braces for the last 2.5 years to straighten the teeth out before the orthognathic surgery. To be perfectly honest, I was quite happy with my results prior to surgery, but obviously the way my jaw was aligned would still create problems for me down the line.


PRE-OPERATIVE PHOTOS
Here are some of these photos (taken the night before surgery):

Photo #1: Smile
Again, I was pretty happy with this, especially when you compare this to the photo from three years ago!! However, when you look a little bit closer, you will see the reasons the surgery was needed.

Photo #2: Closeup of Teeth
There were three main issues here that needed to be addressed. The first is the crossbite. As you can see, the upper midline is almost half a tooth right of my lower midline. The second is the 'gummy' smile. Again, this is not nearly as bad as I have seen in other cases, and I could have lived with it, but there is definitely some upper gum exposed. The third is how the upper law looks like it's kind of slanted down to the right. The mandibular (BSSO) part of the surgery would rotate my lower jaw in order to meet the upper. Because of how this was before, the teeth on the left side of my jaw never made contact with each other (see Photo #5 below).

By the way, if you are wondering what those hooks attached to the wires are, they are for the elastics used to hold your jaws together post-op and also to help the surgeons stabilize your jaw in a certain position during the surgery.

Photo #3: Roof of Mouth
This pic is included to show you how much expansion the SARPE achieved. Compared to three years ago, that's a LOT of expansion, but again, a little bit more was needed.

Photo #4: Profile
Again, this is a profile I could have very easily lived with, but you can see the need for that maxilla to be moved forward a little bit.

Photo #5: Left Jaws
This is a photo of the left side of my jaw. As you can see, none of those teeth make contact with each other when I bite down. In fact, only two teeth on my right side made contact. This could mean big trouble down the line in terms of decay of the teeth and all that due to over/under utilization.

Photo #6: Pre-Op
Just for kicks, here is a photo of me waiting in the recovery room prior to being called into the OR for surgery. I thought the headdress thing was kind of funny. At the very least, it helped to distract me!

Anyway, I am now at 97 hours post-op.....still not feeling great, but with each passing day now, I know things are going to start to feel a whole lot for the better.

Thanks for reading everyone. I will try my best to respond to any questions you have.

Take care,

Paul

Day 963 - 75 Hours Post-Op

Hi everyone,

Well, I'm on the other side of the operation! I knew these first few days would be rough, and I'm really hoping today is the peak of the discomfort. Consistent with other people's experiences, I'm not sure "pain" is the right word to describe what this is like. It's just extremely tight right now.

Anyway, while the pain meds are allowing me to sit here for a few minutes without the need to get up and move around, I figured I may as well start from this past Tuesday!

Tuesday, April 24 (day before surgery)
I went into the clinic for a 4:00pm appointment where they essentially told me everything they were going to do with me. In my particular case, it was a 3-piece Lefort 1 osteotomy for the maxilla, and a bilateral sagittal split osteotomy (BSSO) for the mandible. The maxilla was going to be moved UPWARDS a few millimeters, OUTWARDS a few millimeters and EXPANDED a few millimeters. The mandible was basically going to be ROTATED in order to meet the maxilla (my pre-op pics will show that the left side of my jaws did not meet), and brought BACK a couple of millimeters. There was also some talk about having a genioplasty due to the mandible going backwards, but after they did all their projections on my jaw, they determined it was not necessary. The last thing was for a couple of cheek implants. I never thought I needed this, but my cheeks are fairly flat, and the movement of the jaws would accentuate this flatness. The doc said something along the lines of, "You may not need them, but if you do, we may as well just put them in there." Turns out I didn't get them....more on that later.

Anyway, I went into this appointment extremely apprehensive - what am I about to put my body through? - but honestly, the resident surgeon who did this 'info session' did a very good job at explaining everything clearly, laying out the potential complications and expectations honestly. I felt much better leaving that appointment than I did going into it. In fact, I even managed to sleep that night. I was one day away from having a functional jaw for the first time in my life.

Wednesday, April 25 (day of surgery)
My wife and I woke up around 5:00am. There's something weird about your alarm going off on "big days". I was mentally ready to go and pretty much in a, "Lets get this over with," state of mind.

We arrived at the hospital for 6:00am. I was brought immediately into the OR waiting room for my 8:00am surgery. Aside from having to change into the gown and all that, I required a tightly taped towel around my head. The normal old operating room headdress would simply not do for this surgery.

After meeting with a couple of nurses, and the two resident surgeons who prepped me, I met with the  anesthetist . I have a history of coming out nauseous from anesthesia, and being sick after jaw surgery is not an appetizing prospect. However, when I had my SARPE three years ago, I was completely fine coming out of it. The anesthetist had a look at my chart from that SARPE and said that I was pumped so full of anti-nausea's during the procedure that there was no way I'd be sick. Makes sense! He said they'd be doing the same thing again. Made me feel a bit better.

Then came the call. The OR was ready for me. I walked towards the OR with one of the nurses after saying a quick bye and I love you to my wife and baby-on-the-way. First thing I noticed: Same OR as the SARPE - Operating Room #10. This must be the OR used for all jaw surgeries. I walked in, and started shaking right away. It is nerve wracking, but hey, if you aren't even a little scared about being put under for invasive operations, I don't think that's normal!! I lied down on the table, and the team quickly got my IV going. While this was happening, Dr. Holmes came into the room. I was still shaking at this point. One of the nurses told me to just pretend I was lying on a beach in Florida. That actually helped a bit! What helped even more however was when the anti-anxiety meds did their magic and calmed me right down! After this, they put the mask on me. I knew this would be it. I recall falling asleep. It took a good two or three good breaths, with my eyes getting heavier and heavier after each one. I was out.....

.....and then before you know it, I wasn't! It's 4:00pm, and I'm now in the recovery room. I remember thinking, "Ok, it's over. You did it." right away, but not much else after that. My wife came down to recovery because I had to stay for four hours. My jaw has cause some mild sleep apnea issues, and such patients are required to be monitored a little bit longer in the recovery room. In addition however, I lost quite a bit of blood in the OR - 1600 cc's! I did NOT require a blood transfusion, but the loss meant that my blood pressure and heart rate were quite elevated following the surgery. I also recall that my oxygen levels were down, so they put an oxygen mask over my nose and mouth which apparently helped out.

My head and cheeks were completely wrapped in a pressure bandage. That night, I could tell I looked kind of like a mummy through my reflection in the window, but I refused to look at myself in a mirror. I was afraid to see what was on the other side!

Around 9:00pm, I was wheeled up to the room. My only bout with nausea was when I shifted from the stretcher into my bed. They quickly administered Gravol however, and I was fine.

The first night, as expected, was rough. My famous bloody nose from last time couldn't stay away, and was draining pretty much all night. Moustache dressings - which would catch the blood drip from my nose - were applied pretty much on the hour. I was also bleeding/drooling heavily from the mouth. Not to mention that I had to wear that oxygen mask the entire time!! It was annoying to say the least. However, my wife was there the whole time.....something I am so grateful for. Also, we had a great overnight nurse who came quickly with every ring. But overall, that first night was bad. There's not much you can do aside from count the minutes until the sun comes up. Night seemed to last forever. At one point, I think I was slept for 25-30 minutes continuously, but it didn't get better than that.

Luckily, the sun always comes up.....eventually!!!


Thursday, April 26 (1 day post-op)
The junior resident stopped by at 7:00am to tell us that everything went great and as expected. This was a huge relief. The pressure bandage was then removed a couple hours later when the senior resident stopped by to pretty much tell me the same thing.

I managed to get onto my feet and walk around a little bit, which is big since the movement has the dual benefit of helping with the after-effects of the anesthesia, and also with minimizing the swelling (although right now, I can't imagine myself much MORE swollened!).

I went down to the clinic in the afternoon for my panoramic x-ray. I caught a glimpse of it on my way out.....lots of metal in there! Hahaha. When I have the exact hardware they put in there, I'll let you know, but for sure there are four plates in the maxilla and two in the mandible. Again, the residents said that everything looked great!

Due to the blood loss during the procedure, they had to monitor my hemoglobin throughout the day via blood tests. The bad news about the amount of blood loss is more swelling. However, one day post-op, I was still doing ok in this regard - the steroids they give you help with that! He mentioned that my scarring from the SARPE contributed to the bleeding. I guess things were just that much tougher to move around.

And that brings me to the cheek implants. The surgeon decided that due to the blood loss, and the fact that it was decided I didn't absolutely NEED them, he just wanted to end the surgery and leave it at that. I can't really argue with that - whatever he thought is good with me!

I didn't get much sleep on this night again (and not only because the Ottawa Senators had just lost game #7! Grrrrr.....ah well, they played an exciting game), but I would walk back and forth to the ice machine, get back into bed, try watching a little TV, maybe drowse off for a bit, then do it again. Again, you end up just waiting for the sun to come up. My wife went home on this night to get some real uninterrupted sleep in our own bed. She came back early though - right at 6:00am.

At this point, I still had not looked at myself in the mirror. My parents were scheduled to come down on Friday, and I wasn't sure what their reaction would be. The swelling has definitely been in a constant state of growth since coming out of the procedure. I'm told that it generally peaks at around 72 hours post-op, and I came out at 4:00pm on Wednesday, so I'm counting the hours from there. As I sit here, I'm at 75 hours.....and I really hope it has peaked!!


Friday, April 27 (2 days post-op)
My parents and sister arrived at around 10:00am. We needed my parents on this day because my wife had an appointment with her OBGYN RE: baby. So her plan was to pick up my prescriptions (since I would probably be going home on this day), go home and have a nap, go to her appointment, and then come back to bring me home. Apparently, getting the prescriptions was a little adventurous, but she got all four of them (antibiotics, painkiller, mouth rinse, another painkiller). Her adventures cost her some precious nap time though.

My painkillers were running good while my parents were there. And again, my swelling was not yet peaked, so they generally understood what I was saying! Overall, they were expecting me to be much much worse than I was (probably because I made this clear with them beforehand.....I wasn't going to be a pretty site!).

I was discharged at around 5:00pm, before my wife's appointment was done, so my parents brought me home in the joy of a Toronto Friday-afternoon rush hour. They stayed another hour or two after my wife got home, and then took off.

My nosebleeds had finally begun to clot on this night. It's still annoying though. I can't breathe anything through my nostrils because of how plugged they are. Hopefully this clears out soon! We also bought a cold-air humidifier which is supposed to help with this. It does, although I'm not sure it helped any more than marginally.

It was also my best night of sleeping. I probably got a total of five hours in, off and on. I think half of this is just due to exhaustion.

My diet is limited to strictly clear liquids until my next appointment on Tuesday afternoon, at which point I can hopefully graduate to some more 'full' liquids like Ensure or Boost. There's only some many combinations of beef broth, chicken broth, tea (no milk though!), fruit punch, apple juice, and water that you can have! However, it's not like I'm FEELING hungry, you know? When your body physically can't eat, it will hold off on that feeling of starvation for as long as possible. Because I've been good on the liquid intake so far, my weight loss has not been dramatic. I'm anticipating that to change over the next couple of days as the swelling goes down but diet stays the same.

Oy, I can feel that I'm getting kind of tired writing this, so I think I may stop for the night. Again, I am past that 72-hour post-op mark, which supposedly is the peak of the swelling. I'm really hoping so!

If I'm up to it, I will post the pre-op pics tonight.

Take care everyone,

Paul

Day 957 - Clock is Ticking.......

I'm not so sure I've ever been more afraid than I am right now.

I have spent the last couple of days searching around the net, and wow, I am realizing this surgery is quite invasive and serious. My latest concern now is BREATHING. I hear that breathing is a challenge, which makes me feel claustrophobic. I'm a pretty heavy-breather already.

The common string amongst everything I have read is to expect a week of hell.

I'm really trying to keep the end-goal in mind here, but today am questioning if it's worth it.

Day 952 - The Day Has Arrived

Ladies and Gentlemen, this is the MAIN EVENT of the evening. Introducing first, the challenger. Hailing from Toronto, Ontario, Canada, this man went in for an orthodontic consult in June 2008, and now, after six tooth extractions, a SARPE that required a half-inch of expansion, a retainer, and three years of braces, he is finally ready for the final fight. PAULLLLLLL KENNEDYYYYYYY!

Ok, so apparently the stress is getting to me a little bit! Hahaha!

But seriously, I am going in for my orthognathic surgery next Wednesday, April 25; just over 3 years since my SARPE. I didn't know how I would react when I was told I was booked. To be honest, I thought I'd be scared like I was with SARPE, but as serious as this one is (more on that in a minute!) compared to SARPE, I was more EXCITED that anything to get the news. I am still apprehensive of course, but am excited to finally have this over with.

The timing could not have been any better, literally. Had the surgery not been able to happen this month, I made it clear I wouldn't go through with it. Not because I'm sick of the wait, I mean, teeth are teeth and it takes time to move them. It is because my wife is pregnant with our first child! She is due in early September, and so I wanted to make sure she would not be dealing with a jaw surgery patient so late in the pregnancy. Wouldn't be fair on her. I let my intentions be knows to my new orthodontic student at the clinic (Joanie had graduated last spring), Heather Ford, and I think she really went to bat for me and got me in there. The program held up its end by getting me in for April, and now I will be holding up mine!

The baby news has really just capped what has been a CRAZY three year period since the SARPE. In between the SARPE and the orthognathic surgery next week, we have bought our first home, I have switched jobs (twice), gotten married (once! Hahaha!), received my Fellowship in the Society of Actuaries (a seven year process which is the topic of my other blog FYI!), and have a baby on the way! Wow. But I digress.....

The surgery itself sounds....intense to say the least. Although I have not officially been briefed yet (they leave this until the night before surgery!), I know this will involve a 3-piece Le Fort maxillary expansion - because obviously the 16.75mm SARPE wasn't enough!!!! - a lift of the maxilla a little bit to show a little less gum when smiling, and some slicing and dicing of the mandible to fix the crossbite and get the jaws lined up properly. Oy. All in all, the procedure is supposed to last 6-8 hours. I report to the hospital at 6:00am the day of, and will be put out at around 8:00am. I kind of like the idea actually - no one wants to wait around all day for their surgery to start.

So I've been spending the last few days pigging out. Based on the fact that I lost 30lbs with SARPE, I'm expecting to lose at least 40lbs with this one. The good news is that I am overweight by about 20lbs (I am 6'7", 240lbs currently), but the additional 20 would put me at a weight I haven't been since being a scrawny basketball player in high school!

I am thinking I am more comfortable (at least so far) with the idea of this surgery because I have done SARPE already. I realize this surgery is SO much more serious than SARPE, but do I realize I will be a bloody, swollen wreck? Yes. Do I realize I will be eating with a syringe? Yes. Do I realize the weight loss will be significant? Yes. Barring any complications, I do have some idea how this will go down.

Anyway, as I did before, I will post some photos of my "before" surgery, and will keep a close eye on my progress post-op. And since I will be off of work, with not much else to do, I'm sure I'll be updating the blog regularly over the next little while. My plan right now is to partially return to work after two weeks by working from home a few hours a day, and then return to the office after the third week. I think it's a realistic goal, but I understand that everyone's situation is different. We'll see!

If anyone out there has undergone the 3-piece Le Fort, drop me a line. I'd love to read about your experience with it!

I'm definitely a wreck right now, but again, it's exciting to being so close to having this over with!

Wish me luck!

Take care everyone!!