So I thought since I have been trolling these forums for a few months now I'd add my exeperience so far to the collection.
Background:
I wore braces for 7 years starting around grade 5 and had them on till Grade 11. At this point I was so sick of wearing them that I broke them all off myself. The orthodontist really mucked up, and my midline had deviated, my lower teeth were still crowded, and I still had an overbite after losing 4 permanent teeth! Around this time I went in for a consult to another Orthodontist and they said the case had been mismanaged and now that I was done growing I only had surgical options to correct my bite. I consulted a surgeon and he himself didn't seem to keen to do it, as back in Pakistan OMF Surgeons only really do trauma cases regularly. My TMJ had started to lock and pop over the years so the surgeon gave me a few exercises to help with this.
Fast forward another 6-7 years. I had just graduated from college and my TMJ problem had deteriorated over the years that anyone could feel the mandible pop (you could actually see it happen when I opened my mouth) and you could hear it sitting next to me if I was chewing on something tough. I decided to get an orthodontic consult here in Montreal and was told that I will need braces again with Surgery to correct the Overbite. Midline may be fixed with upper jaw surgery but the orthodontist didnt recommend it. I saw the surgeon and he too agreed, and at the consult said he would need to remove my impacted 3rd molars too.
I agreed to the treatment plan. July 2010 I got braces again, and soon after my surgeon removed my third molars. Surgery was initially supposed to be in the summer of 2011. By the time summer came the OR was booked up, and my teeth weren't ready so they planned to do it at the end of the year. The late was later confirmed for December 1st.
At the preop visits to the surgeon we discussed the midline, and in between I did my own research, and the surgeon didn't seem too keen on doing a Lefort 1 just for the midline, and after reading into the procedure extensively and remembering the cadavers from my college anatomy classes, the whole maxillary downfracture and risk of fracturing the lateral pterygoid plates seemed unnecessary for a deviated midline. I spoke to my orthodontist he said he will try after surgery using elastics to correct it.
Day of Surgery, Dec 1st 2011:
The hospital called and said I can't eat after midnight. So I had friends over and we ATE like nuts. Had a good steak and plenty of water and went to bed. Next morning I had to be in the hospital at 6:45AM!
I woke up, did the preop shower they asked me to take, and went in. They put us in a waiting room, and a few minutes later called me for last minute vitals and some questions about allergies and medications taken today. I was then told to go into another room and put on the gown and these tights. It was really awkward wearing tights for the first time in my life, beign a guy and all....I was really cracking up. I looked like something out of a comedy show. All this took around an hour and a half. Then I waited another 45 minutes till they called my name and put me on a bed to take me downstairs. I was expecting to have some nerves at this point but oddly I didn't.
Downstairs outside the OR I met the anaesthetist, resp techs, OMF resident, a nurse or two. At this point I was asked by the resp tech for consent to start an IV, and I said sure. The senior resp tech let the junior one have a go at it and I thought to myself "whatever, how is he supposed to learn if he doesn't do it". So he started to try and insert it and had a few issues, and it started to hurt. Mind you I have very prominent veins in my arm so it wasn't my anatomy that was the issue! After 3 failed attempts and some really sharp bouts of pain I told the Surgical resident next to me loudly, "so my friends call me abusive, and I'm starting to reach my threshold now..". At this point the senior resp tech came in and did it and it was over. I overheard the surgical resident ordering some tools for surgery and heard him say pineapple, which turns out to be a type of burr. They asked me about medicine allergies so we had a long discussion about my sensitivity to various antibiotics and came to an agreement. Then they took me into the OR, and SADLY I didnt get to see the fancy saws and all. I asked the surgical resident if I will be banded shut he said depends on the fixations. Then they gave me was a oxygen mask and said "We are giving you oxygen, breathe deeply." I did for a few minutes. And then they lifted the mask to look at me, so I raised my eyebrows back at the anaesthetist. She asked me to keep breathing.
Next thing I remember is waking up in the PAICU, not groggy just tired. I immediately tried to open my mouth and YAYY I wasn't banded shut and had some movement, and two elastics on both sides. I didn't feel like going back to sleep and was getting bored so I asked for some books, so they gave me some fashion magazines in FRENCH (This is the montreal general hospital). So I just flipped pages looking at pictures as I speak very little french. I passed out and next thing I remember is my surgeon who I hadnt seen all morning calling me out on reading already. He said surgery went very well, they advanced my lower jaw by 5mm, and that my "entourage" aka my mom and girlfriend are waiting for me so he will help me go to my room. He spoke to some nurse and soon I was taken up to my room.
This is probably the worst part of the entire experience as I was very disappointed by the nursing staff at the hospital, save one nurse. They were rude, did not answer questions, did not inform me of things (thankfully I had trolled these blogs enough to know a lot), had not put my name for food at the cafeteria. Just terrible. But I did get excited that I was given a clicker for morphine. So me being me, I just started to click it whenever I remembered to do so. Boy was it bliss! I didn't really even need it. Later on my mom told me the surgeon told her that I bled very little during surgery. Infact I was expecting to bleed some and suck some blood out using the tube they gave after surgery, but I didnt even use it once. I think I bled for longer after having my wisdom teeth removed!
The next morning another resident came and they took x-rays, and I was discharged soon after. There was an issue with no breakfast, again MGH #NURSESFAIL.
At home things have been good. The blessing for me was that I could open my mouth just enough to shove pills in, otherwise I would have had to open the capsules of antibiotics and mix them in water. Also I was getting so nauseous on liquid childrens advil. BLEKH. Tasted like idk what! It was supposed to be grape :o. So yeah I switched to normal OTC 200mg advil and took 3 every 6 hours (I was prescribed 600mg). I was also given Ratio-Oxycodone (oxy+tylenol), sadly not as blissful as morphine was, just knocks you out. Anyway so the only real inconvenience was tying the icepack around my face, and the effing syringe getting stuck. The hospital only gave me 2. So a few days later we got 10 more from the pharmacy surprisingly cheap! I could drink from a cup from the first day but thicker liquids were hard to manage. So the syringe was needed.
I had my 1 week post op two days ago. I have yellow bruises from my neck down to my chest. And apart from that things are good. Most of the swelling is gone surprisingly (I'll put up pictures later). Stitches are loose and should be falling out soon. I am still on a pureed diet though sadly. I can move to soft foods when they will remove the two elastics I have, and I will have to wear them only at night.
As for numbness I am still numb from the lip down to the chin on the right side, the area innervated by the right mental nerve. The surgeon said since it is always tingling it should recover soon. He was pretty shocked at how fast the swelling has gone down, and says things are goign really well.
Food tips from my end:
Metamucil with water/milk/smoothies!
Muscle Juice (Weight gain protein + carb mix)- mix in two scoops with each smoothy easy calories as you get 1020 calories with 4 scoops and a complete dose of amino acids of each kind, helps with healiing!).
Anyway that's about it....Hope it helps someone at some point as other people's experiences have helped me.
PS. I'd recommend my surgeon to everyone. Great guy, great staff!
