Pre-op video

Pre-Op Appointment

Last Friday I had my pre-op appointment with the surgeon. The orthodontists had implied that the surgeon might still decide that my mouth wasn't ready for surgery, but the surgeon said it was definitely a go--it wasn't even a question for him. So the surgery is on! The only thing that could derail it now is if I were to get sick. The last day or two I started to feel a bit iffy, so I slept extra and took loads of vitamins and today I'm feeling better. C'mon body, just a few more days!

At the appointment we did a number of things:

• took two molds of the upper and lower jaws
• did measurements with the face bow
• took x-rays from all sides
• took pictures from all sides (including one where I put a stick in my mouth, in case my jaw was slanted)
• got a prescription for steroids to take the night before
• answered all my questions
• got blood drawn (hematocrit and hemoglobin)

The surgeon doesn't think any of the alternative medicines for pain would really work. He also says most people get by with ibuprofen and Tylenol. So my current plan is to do what I can to not take any stronger medications after I'm home. He says it's a pump-n-dump situation for 24 hours after taking anything stronger. I'm not happy about this. We'll have to see how it goes.

They are not going to be doing huge changes to my jaws--maybe 5 mm at most in any one direction.

He says right from the start I'm going to be on a 'no chew' diet, and this will last 4-6 weeks. He says there's no restriction on using a straw. I probably won't have to use a splint, either. So it sounds like if I'm able I'll be able to eat a wide variety of things rather quickly.

On Monday I went to get my surgical hooks put in. My orthodontists have their main office in a town that's 25 miles away, and each week they come to my town as a satellite office. The disadvantages of this model became apparent as they discovered that they did not have enough surgical hooks to completely wire me up. Oops! So the end result is I'm going to stop by their main office after an unrelated appointment in the Big City (an hour away), and one of the orthodontists is going to come in special to put the surgical hooks on. I feel a bit bad about making her come in on an off day, but it's not my fault they were out of hooks!

A few more things bought

Last night I bought a baby toothbrush, and some prune juice. Just about everyone recommends the baby toothbrush for post-surgery cleaning, and many have mentioned constipation due to the pain medications. Well now I'm prepared on both fronts!

In the next day or two I'm going to try napping in one of our recliners to see if I need a neck pillow, and which one I'm going to use during my recovery.

Waking up is hard to do

In honor of my impending surgery, my father-in-law forwarded me this video made by five Minnesotan anesthesologists.

Via http://nottotallyrad.blogspot.com/2009/11/waking-up-is-hard-to-do.html

Liquid vitamins

After stocking up on regular vitamins I remembered/realized that I probably wouldn't be able to get a pill into my mouth for at least the first week post-surgery, and that I didn't really relish the idea of getting them in there chopped up (let alone asking someone to chop it!). So I picked up some liquid vitamins. I got the Centrum liquid multi-vitamin, and some Emergen-C Immune Defense formula. The box says it is a "Ruby lemon honey flavored fizzy drink mix."

On the different jaw surgery blogs I've read, there's a wide range of practices from doing nothing special to having acupuncture or lymph massage. Everyone takes different vitamins.

My family doctor just wants me to take extra vitamin C after the surgery. Dr. John Berardi has an article about healing after sports injuries, and he recommends Vitamins A and C, and copper and zinc, along with fish oil.

This is what I'm going to do, and it will have to be good enough:

Immediately post-surgery (before I can swallow pills):

• two doses of the liquid multivitamin
• one dose of the Emergen-c Immune Defense
• one tablespoon of fish oil

Once I can swallow pills, up to a month after the surgery:

• Vitamin A
• Vitamin C
• Vitamin D
• Two multivitamins

I might try to find copper somewhere in the big city this weekend. I already have my fish oil which I take every day.

Medications and breastfeeding

I am still nursing my fifteen month old son, and plan to continue doing so for the time being. This then poses a bit of a problem because I'm going to be in the hospital for at least a day after the surgery is complete. After that, I have to consider how any medications I take my impact him.

I don't plan to have my son brought to the hospital post-surgery, so it doesn't really matter what anesthesia is used--it will be out of my system by the time I feel well enough to pump. But after that point, I'd like to pump and save the milk rather than dumping it (breast milk has been called liquid gold), and resume nursing my son without any problems.

Here is a link that summarizes the different pain medications and their safety levels for breastfeeding (and pregnancy): http://kellymom.com/health/meds/pain-meds.html

I'm bringing a print-out of this to my surgery consult on the 15th. Though I'm hopeful that stronger pain medications may not be necessary since a number of blogs I've read have only used Tylenol or ibuprofen.

In the meantime I've started pumping so that my son will have milk while I'm in the hospital. I really don't like pumping--I feel like such a cow! But I'm making measurable progress, so that eases the sting a little bit. Every day and a half or so I put away another 4 oz bag of milk into the freezer. However, I don't know how much he's going to drink, since I can't measure how much he consumes when he's nursing. I'm going to just keep going and probably have too much.

A few preparations

Currently I'm mostly killing time until my appointment on the 15th with the oral surgeon. At that point he'll do molds, give a final okay on going ahead with the surgery, and answer a lot of my questions. One thing I don't know is how long I'm going to be on a liquid diet.

I'm also thinking about requesting a tooth implant for a molar I had removed. That molar being destroyed was one of the things that convinced me to go ahead with this surgery. When I talked with the oral surgeon the first time (prior to having the molar removed), they said that most people don't mind having that tooth gone. But I am finding that I'm only chewing on one side because of the missing tooth. And if I'm going to spend all this money on fixing up my mouth, why not make it perfect? I don't want to have to favor one side of my mouth just to save a few bucks.

Every day I notice the muscle strain in my jaw. It's likely a combination of being more aware of the problem because of being more educated, and the muscles having a problem with the new position of my teeth from the braces. I am amused when I realize that different teeth touch at different points of the day, like my muscles are getting tired of holding onto one position.

I'm starting to buy things to prepare. This is extra motivation to push the surgeon to go ahead with the surgery :-) Things I have already:

• whiteboard - for writing if/when I can't talk
• two boxes (24 12 oz bottles) of Myoplex chocolate nutritional shake
• one pack (6 8 oz bottles) of Equate strawberry nutritional shake
• one pack (6 8 oz bottles) of Equate vanilla nutritional shake
• one bottle (64 oz) white grapefruit juice
• one bottle (64 oz) V-8 Splash Smoothie
• vitamin D
• vitamin A
• vitamin C
• multivitamins
• new bottle of Carlson's Finest fish oil
• powdered greens

I'm worried that I won't be able to get vitamins into my mouth at first. I guess I can try crushing them now and see how it goes.

My husband wants me to try sleeping in the recliners now so we know which one to bring downstairs and if I need to get some special or extra pillows. I had been planning to do that this weekend while my in-laws were away, but it looks like they're going to be staying. I'll have to work some nap time in soon to try them out, instead.