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.

Chat with my orthodontist

The orthodontists (I work with a father/daughter team) wanted me to come in for an X-ray today. Apparently the surgery wasn't as certain in their minds, because it's happened rather rapidly. If they had their druthers, it probably wouldn't happen for another six months, but since the timing works very well for us, and they don't see any contraindications, they said, "Let's go for it!" Their basic conclusion after looking at me today is, "We think it will work. Let's see what the surgeon says at the pre-surgery appointment." Way to inspire confidence! :-) The pre-surgery meeting is October 15th.

Chat with my family doctor

Yesterday I had a chat with my family doctor, one of the topics being preparing and recovering from the surgery. He doesn't want me to do anything differently leading up to the surgery as far as supplements go (I'm taking a general multivitamin). I'm already doing pretty well on nutrition, so it's just a matter of eating well in terms of fruits and veggies and having a good diet in general.

I have a problem with seasonal depression, and most people have a depressive crash a couple weeks after this surgery. The stress of a liquid diet, the trauma of surgery, and the pace of recovery just send people into a bad spot. Every year I try to go without medication for as long as possible, and this year I had high hopes that I could make it with a very improved diet and other measures. But the doctor thinks it would be best if I just started medication a week before surgery (if I don't end up starting before that because of my symptoms), to prep for the post-surgery crash. I'm still going to be doing measures like supplementing vitamin D and having a very strong natural light lamp.

After the surgery the doctor would like me to supplement extra vitamin C, and continue with as good a diet as I can.

Pictures

Front, not smiling, not trying to hold my lips together (ie, natural position).

Front, smiling. Gummy smile.

Left profile.

Right profile.

Teeth close-up, showing open bite (I could not get them closer together than this).

Some terms defined

In my last post I posted the letter my surgeon wrote to my insurance company. It used a lot of medical-ese terms that I'm going to define and clarify here.

mandibular - lower jaw

maxillary - upper jaw

hyperplasia - overgrowth

Class III dentoskeletal deformity - This basically means that my jaw grew wrong such that I'm left with an underbite--my bottom jaw is too far forward.

maxillary vertical hyperplasia - This is the 'gummy' smile previously mentioned. This also means, "cannot create a lip seal without mentalis strain"--ie, my lips don't close unless I work on doing it, so they are almost always open.

maxillary transverse deficiency - This means my upper jaw is too narrow for my lower jaw. I can attest to this one because if my teeth are together I can feel the bottom of my upper tee

th with my tongue--they stick out into my mouth.

mandibular sagittal hyperplasia - This means my bottom jaw is too far forward.

osteotomy - A surgical operation whereby a bone is cut to shorten, lengthen, or change its alignment.

LeFort I osteotomy - Le Fort was a surgeon who pioneered these surgeries. The LeFort I surgery is a horizontal cut in the bone along the top jaw. See the pretty graphic of a skull for a visual.

mandibular osteotomy setback - This basically means they are going to cut out a chunk of my bottom jaw and move the front part backwards.