Day 4

Post surgery folk, help me out. This breathing thing is starting to freak me out a tad - at one point last night I had panicked myself into thinking I might drown in my own snot. Obviously, I didn't, and by some miracle I slept for over 5 hours straight, but this morning I'm still feeling uncomfortable.

Breathing through the mouth, of course, not on option - though it was one I employed a bit too much last night and ended up with some crazy jaw strain/pain. My left nostril is still swollen to all eternity and barely passable when I'm NOT bleeding from there (which I still am, off and on). So pretty much, my trusty right nostril is pulling overtime and getting tired.

I've got a humidifier going and that really helps (though heats up the room and it's HOT here in the pacific northwest right now). I've tried q-tips dipped in hydrogen peroxide/water... I have Afrin, but can only use it twice a day. Any suggestions?

Other than that whole debacle, things are doing pretty well. I got in a little bit over my head with pain last night - I'm starting to realize that once it really starts to hurt it's almost impossible to get it to come down. Just have to keep on pain meds. My jaw bra is helping - and I think just as much as for support and compression than the ice.

I'm getting funny twinges, already. My favorite is the vibrating sensation - it literally feels like a small little portion of my face is vibrating like mad - but then I throw my hand up there to figure it out, and nothing's actually happening. Just nerves regenerating, doing their thing. I'm really, really numb still - pretty much my entire face from the eyeballs downward. I have weird pockets where I can feel as the drool passes them by, but that's about it.

Finally took a shower this morning - it was kind of a production as Nick and I had to tape up the hip (which is it's own spectacular bruise that none of you will ever see, but it's fantastic!) dressing and get my weak butt into the shower, but I sure feel better now that it's over.

And, naptime...

Day 4 pictures:

Surgery Day!

We had a fantastic surgery day thanks to the amazing, amazing staff at Swedish Hospital in Seattle. No kidding - I was never really nervous! We had to be there around 8:45, and managed to arrive there at the exact time as my mom, who was coming from Shelton. I checked in and spent maybe 10 minutes in the waiting room before being taken back to pre-op (sans mommy, but with Nick).

Had to do the pee-in-the-cup pregnancy test and change into my lovely hospital gown, pants, and robe, and slippers. We didn't have to wait terribly long for a nurse to come over and ask me the same million questions I was asked in my pre-surgery interview. She was really cheerful and reassuring, could answer every question I had.

She then had us shipped off to the surgery waiting room, where they started the IV (not a SINGLE problem, despite being dehydrated!). They had comfy recliners for the patients (there are pictures, no worries), and Dr. Lee and her resident Dr. Kelley came over and talked to us, and the anesthesiologist talked to us. Dr. Lee and the anesthesiologist were concerned about my nose - apparently it wasn't really wide enough for me to get sufficient air through it OR for them to get the breathing tube down without lots of bleeding... so Dr. Lee said she was going to widen it. I'm not sure if that meant just on the inside of my nasal passages, or if it'll show on the outside, as well. Either way, I'm grateful for it now as breathing isn't really all that comfortable WITH the wider nose. :)

After a while of waiting, they came over, put my hair into the net, let me kiss Nick goodbye and we were on our way to the surgery room. The room was a lot smaller than I expected, but there were lots of scary looking tools and huge lights and it was FREEZING. We're talking, downright cold as a meat locker! It felt kind of good because I was a little warm from the waiting room, but then they put a "hot air dryer" blanket on me and another blanket above that. I remember staring at the lights, and then nothing - they didn't even warn me that I was going under!! (Hah!)

So... the next thing I remember is pretty funny. It was dark (my eyes were closed but I wasn't really aware of this at the time), and I was trying to figure out why they were taking my blood pressure on both legs instead of my arms... which led me to think... wait... do I have arms?... which led me to think, "Hey! My eyes are closed!" So I opened them and the recovery nurses put my glasses back on. The "blood pressure" things on my legs were really there to keep clots from forming. They kept asking me to breathe because apparently I wasn't getting enough oxygen even with the oxygen going straight into my nose. I drifted in and out and was coughing a lot - I wasn't really aware enough to use the suction tube yet so they were helping me off and on. I don't remember being wheeled up to my room but I do remember having to scoot over from my operating-room bed to my hospital-room bed because my hip hurt for the first time when I had to move it and it shocked me.

My mom and Nick came in just a few minutes later and I was out of it for the next few hours - my grandparents stopped by and Heidi and Fred stopped by, which I remember but I don't really remember what I "said" to them (HURRAY white board!! I would have been really frustrated without it). I was REALLY shocked and scared to be still bleeding - I had a big cough and blood went EVERYWHERE - all over my gown, the bed, my whiteboard, the table... it was a little too much like a slasher-flick-horror movie for my taste. But then the nurse gave me a rag to cough into, so it wasn't so scary the next few times. I kept having to clean out my nose because it would get clogged up with all the dried blood.

I had a rough night - I kept choking on something HUGE in my throat (probably a blood clot) and I was gagging and coughing. The ice that they were keeping on my head felt really heavy and the cold HURT my joints. Whenever they would change out my ice my pain level would take a turn for the worse. I never slept for more than an hour at a time, and it seemed like the night took forever to pass. I was really lucky in that Nick could stay with me the whole night - they even brought him in a cot to sleep on.

That night I was already up to go to the bathroom with Nick's help (the hip was pretty miserable) and I could kind of drink from a cup. The next morning I got to pick from a "clear liquids" diet menu and got some chicken broth. My surgeon and her resident stopped by again to say how well the surgery went, and to explain my post-op medications and all that. There were a few fiascos getting the medication (the hospital didn't have liquid oxycodone so they filled a pill version.. but hello?! so we had to wait for a different prescription to come over for the demerol.

Post op meds:

• Hydroxyzine (Atarax) for nausea
  
• Demerol for pain
  
• Liquid motrin/ tylenol for pain


• Peridex rinse
  
• xephalexin (Keflex) for anti-biotic.
  

Okay, I'm completely worn out from all the typing. Naptime :) That's about all I can remember.

the good and the bad - early day 3

I have to say that this surgery (so far) has been easier than expected. I have the normal goods and bads...

Goods:

• I slept for almost 4 hours in a row last night in my comfy chair. This is so far superior to that awful hospital bed propped up with pillows.
  
• My throat is feeling a little better this morning.


• I am feeling less "out of it" than I was yesterday


• My pain is being controlled by motrin!


• I have not thrown up, or even FELT like throwing up yet! Hurray, doctors :)

Bads:

• Breathing is not as easy as I would like it to be. This is a new development as my swelling has taken (yet another, hopefully the last?) turn for the worst - my left side is much more swollen than my right, and it's kind of pushing over my nasal passage on that side. I don't feel like I'm choking or anything, just don't quite feel comfortable and don't quite feel like I'm getting enough air. But don't worry, Kate... my lips aren't blue :)


• This swelling is hardcore uncomfortable! I kind of feel like my face is made of silly putty that's been stretched a little too far.


• I'm hungry (duh). Now that I'm off of the clear-liquid stuff I drank a nice glass of muscle milk and it actually took the edge off, but I'm still hungry!
  
• Eating takes WAY too much energy. Before I can actually stave off any hunger, I'm too worn out to continue eating. Blegh!


• I really can't stand the taste of the pain meds - they're all so cloying I feel like I'm choking every time I take them. I found that the infant motrin you only have to take 7.5ml of it to get the 500 mg they want, instead of the 30ml in the kid's motrin - I'm sure it will cost more, but at this point I'm not sure I care.
  

So, it's not too bad. Had a really rough go of it last night around 10ish because Nick and I accidently got my pain meds (demerol) mixed up with my anti-nausea medication... so instead of taking a normal (5ml) dose of pain meds, I took a not-even half dose of my anti-nausea medication (which is supposed to be 12.5ml). Oops! Woke up in CONSIDERABLE pain, but I took tylenol at the same time.

Instead of making this a mile-long post, I'll post another post on my hospital day :)

Day 3 pictures:

I'm home! (Day 2)

I'll post more about yesterday later tonight or tomorrow sometime (I'm feeling a bit spaced out), but right now I'm feeling pretty good. The only complaints I have are the hip from the bone graft (ow!) and my throat is really, really sore.

I'm pretty positive that my lefort (upper jaw) was only a 1-piece because I don't have a splint (though, it's SO WEIRD to feel the roof of my mouth with my mostly-numb tongue without feeling ANYTHING on the roof-of-the-mouth side). I did have the genioplasty (if you look in that picture of me right after surgery, there's a funny sign that my surgeon wrote "do not touch chin"... cracked me up. I also had the lower jaw surgery - and everything went much quicker than expected - no problems at all. I'm banded really tightly shut, but only in the front so I can squirt food in the sides.

I'm home, loving the ice, dozing off a lot, and watching my face morph into something truly amazing - the bruising is already getting dark and I am SWOLLEN! Can't wait to show you guys pictures.

Thanks for all the support. Love you guys!

Day 2 pics:

Pictures

Here's a picture of Steph after her surgery and after the half marathon on Saturday. Two GREAT accomplishments! (Though technically, it was her doctor who did the surgery but Stephanie has to deal with the aftermath. =))

Update from Steph via Heidi!

The surgery went well and lasted only three hours. She unfortunetly had to get a hip graft which is (at the moment) the most painful aspect. She's not quite sure where the graft went. And worst of all, she will not be running any half marathons with me anytime soon! She had her upper jaw, lower jaw and chin all done. Best of all, she's feeling pretty good! Mainly because she's quite numb. Hopefully, that will continue as she gets home and the happy drugs wear off. =)

I'll post some pictures when I get home and have my camera cord.

off to the hospital...

Well, my bags are packed, I'm ready to go... I'm standing here, outside your door... I hate to wake you up to say goodbye....

I'm leaving (in a car, not a jetplane)! :) Still not nervous, but Nick is betting it hits when we hit the parking lot. Here are some "before" pictures from last night before I went to bed:

And...Pre-surgery photos: Surgical Hooks and teeth pictures

See you on the other side!

the day after tomorrow...

I'll be on the other side! My surgery is scheduled for 11am on Wednesday. I had my pre-op phone interview with Swedish Hospital this afternoon, and it sounds like my surgery will only be 3-4 hours? Sweetness.

The bad news? My computer wasn't able to be fixed yesterday so our friend has to wipe it completely clean and re-install the operating system on it. So not only am I running Safari for all internet access on a PC, but I can't upload any pictures from my camera (among many, many other things). I have great ER bruise pictures, surgical hook pictures, my post-half-marathon picture, and of course will be taking the obligatory pre-op photos - I just won't be able to upload any photos until after next weekend, when our friend can come over and fix it. I'll add photos as soon as I can, though. And my friend Heidi will (hopefully) be updating my blog after I come out of surgery since I won't be out of the hospital until Thursday sometime.

I feel like I'm forgetting something major in the big scheme of things. I'm not sure what it could be so I'm not concerning myself TOO much, but it's slightly unnerving. Maybe it's nerves - I'm still not very nervous, though feel like I should be.

busy times

Half marathon was this morning - CHECK! While I had a giant migraine during a good share of it and therefore ran slower than I wanted to (boo), I still completed it and feel really good about that.

Nick and I went shopping in a major way - we got a new recliner that is possibly the most comfortable chair I've ever sat in - it's a la-z-boy and they really are superior chairs. We visited their store first, left because of the high prices and spent the day sitting in chairs (I felt like goldilocks... too soft... too hard... too tall... too short... not enough support... too much support) that were uncomfortable, only to return to the la-z-boy store and purchase one.

Other stuff on the shopping list?

• Baby toothbrush
• Hand-held mirror
• Humidifier
• Button up PJs for the hospital
• Liquid (infant) tylenol and ibuprofen
• Sippy cup
• Baby spoon
• Aquaphor
• Dry erase board
• Baby bulb syringe
• Afrin
• Puke pail
• Neck pillow
• Hydrogen peroxide
• Food strainer

Plus, I got a liquid, high-quality multivitamin, plus arnica montana, bromelain, and traumeel. I'm a little wary about using these directly after surgery because my stomach doesn't always react well to vitamins and supplements and since I bought them fairly last minute it was already beyond the 2-week no-vitamin-or-aspirin cutoff time.

I didn't buy a lot of food - some organic chicken broth, muscle milk, gatorade, and tea. I found a pretty great protein drink (as protein drinks go). It's called Isopure. It's got 40 grams of protein per 20 oz, and it's got no sugar (which I'm trying to avoid, as sugar can cause inflammation). I figure that as I decide I want something or something sounds good, my mom or Nick can go out for me - I didn't want to buy a lot of food and then not eat it. I might buy some cranberry juice or other juices.

Surgical hooks are on and annoying (got them on last Tuesday). Had my appointment with Dr. Lee (surgeon) and found out that she might not do the segmental Lefort - she may just do a 1-piece. I have the possibility for a bone graft out of my hip depending on how bones look when she's in there. I don't know the words for the surgeries - but she's impacting my upper jaw (gummy smile) and evening it out (correcting open bite). She's bringing my lower jaw forward (to fix the overbite) and making my chin match with a genioplasty. I have the terms in my surgery folder, but it's in the living room and I'm too lazy to get it right now. I'll update that later.

I'm a bit sad because I had a whole list of questions but she kind of did the "talk to me about my surgery" while we were doing the molds and the facial measurement (face-bow?) stuff. And I had left my purse and questions with Nick in the waiting room, because I thought we'd go into an office to talk. But nothing major. I know about the recovery and what it looks like with her, I know my risks (AHHHHH!), and I know the benefits.

More updates later. I'm not feeling all that nervous yet, but I think it's because it's all so surreal right now. It was such a battle to get here, and now it's actually happening.

Oh! And I found an ice pack / jaw bra online. Thanks to everyone for your searching and well-wishes. :)

HELP!

Does anyone out there (post surgery) have a cool-jaw wrap they'd be willing to sell me? I got my order in from Zip-N-Squeeze today and apparently they are backordered - and it's really a product that I think I need with all of my jaw joint issues causing migraines and stuff.

I'd be willing to pay you the $10.50 for the wrap and all the other fees like the box and shipping and handling... Anyone?

countdown pt. II

Just over a month ago I was in love with my countdown clock - I spent a good minute watching the seconds tick by towards my paid-for-mostly-in-full surgery.

But now? It kind of seems like that clock is laughing at me, reminding me of all of the million things I have to do before I'll be ready. (As if I could be actually ready for this). But the migraines aren't stopping - though the new anti-nausea medication actually stops them in their tracks - so there's no way I'm stopping now.

This week is a busy one - today is shopping and brainstorming soups with my amazing mother-in-law, tomorrow is helping my friend in her classroom and getting hooks on at Dr. Molen's office, Wednesday is the husband's birthday and I work at Starbucks, Thursday pre-op appointment with Dr. Lee and I'm picking up my marathon packet in Seattle, and Saturday is the half-marathon. So pretty much between now and my "last meal" event at my favorite brew pub, I've got 3 days to myself.

It's all coming so quickly.

inquiring minds want to know part deux

Alright, I warned you: Part Two of the "Inquiring Minds..." series. Answer as you will (this will really help me!) And if you've already answered these ahead of time (overachievers!), feel free to ignore me.

1. What are questions you asked your surgeon at your pre-op appointment?
2. What are foods you stocked ahead of time (other than soup, my MIL has that covered and then some) that were easy to "eat" right after surgery? Anything that you would NOT recommend?
3. What are the products you bought for jaw surgery? (Stuff). I need to make a list!

Thanks, guys. This means a lot to me. School is out in just a day and a half, and after that it's just 14 recliner-shopping, food-stocking, list-making, apartment-cleaning, half-marathon-running, migraine-avoiding days until surgery. I have great pictures of all of the IV bruises I've collected in the ER last week, but my computer is acting up and I can't upload pictures. I'll make sure to have that fixed before surgery :)

Part three... coming soon to a theatre near you.

so get this...

I was in the ER again last night around 11:30pm. The waiting room was empty but we waited for almost an hour before I got called into triage. You wouldn't believe the stupid guy I got to deal with. He asked about my migraines. He asked all the normal questions (is it a "normal" migraine, how long have you had it, what have you taken today, etc). We then got to the fact that it was my 3rd visit in 4 days and he was shocked. Okay, that's fine. Be shocked. But then he started asking questions about my jaw and the jaw surgery - and how exactly did I know the migraines were jaw related and not an aneurism or something?

I explained that when my jaw hurts, I get migraines. When I do things like play the clarinet and eat and chew and talk, it gets aggravated and turns into migraines. He asked if I had done any of those things today - I replied that yes, I had in fact played my clarinet, eaten, and talked today... to which he responded... "you need to take care of yourself. You can't do things like play the clarinet - after all, would you feel sorry for a lung cancer patient that smoked a pack of cigarettes before asking us to "fix her up?""

Umm.. excuse me, jerkface!?! And the worst part? It wasn't even my clarinet playing OR eating that gave me the migraine - it was the drive home in the dark with all of the headlights facing at me.

I'm still ticked beyond belief.

I love the ER, and the ER loves me

The migraines took an unexpected turn for the worse this week. I was at school throwing up on Wednesday on field day (yuck), so right after I went home we went to the ER. Spent 6 hours and could only get my pain down to a 3 or 4 (out of 10). The "big guns" narcotics just aren't working for me - in fact, they seem to be making everything worse.

On Thursday I had the massive migraine all day while bowling and skating with the 8th graders at my school - came home, napped, thought I was feeling better, and then Nick accidently moved my arm that was pressing into my face. Seriously, that's all it takes anymore - I almost puked immediately, I couldn't move, finally fell asleep with my hands pressed to my jaw in complete agony.

This morning, woke up, thought about going to the ER but I don't have any more sick days and since the husband is home but not working we're a little short on cash - but it did me no good. I got to school and the pain was so bad I couldn't form complete sentences so another teacher drove me home and Nick drove me straight to the ER where we spent only 4 hours. With lots of narcotics that don't make it better.

My hand (from the IV on Wednesday) has a giant bruise. My arm is a GIANT bruise because the poor nurse today was new and I have hard veins to find anyway... she had to root around in there a lot to find the vein. OW!

I don't know what I'm going to do, or how I'm going to survive the next two and a half weeks. I went to my regular doctor this afternoon and she just kind of said "well, good luck! Jaw surgery is in 2 and a half weeks!"

Great. Lord, help me. I don't know if I can do this.

time flies...

...when jaw surgery is only 3 weeks away.  3 weeks from now I will be coming out of surgery and I'll join the rest of you on the 'other side.'  I'm becoming terrified!  This is so scary now that it's coming up so fast.  Luckily I'm running a lot (half marathon in 2.5 weeks), I'm working a lot (7 more school days), and I'm playing my clarinet a lot (2 more concerts).  This weekend I'm hanging out with the mother-in-law who is hopefully making me lots of soup for the recovery bit.  

The jaw hurts like CRAZY and I've had what seems like a trillion migraines in the past few weeks but everything seems a little better now that surgery is on the horizon.   

It's all coming so fast :(  I'm scared. 

inquiring minds want to know...

I just had a freak-out moment when I realized that no, jaw surgery is NOT a million light years away anymore. And yes, it really is happening... in 33 days. And wait, I should start thinking about all of that STUFF that jaw surgery patients can't live with out. Because really, when you think about ordering after payday on the 1st of the month and waiting for things to come in the mail (and my UPS and USPS guys refuse to leave stuff on my porch, telling me to come pick it up during business hours - which are 8am to 3pm, when I work 7am to 3:05pm... I've been working on getting a package of music games for 2 weeks now... And since Nick is no longer here to pick stuff up for me I'm a bit outta luck)...

(Did I just rant about my mailmen on my tooth blog? I really have lost my mind. Back to the regular scheduled programming...)

All of you lucky patients on the dubious other side (and anyone else who has an opinion). Answer me these:

1) Zip and Squeeze Bags: Worth it? Not worth it?
2) ZnS Cool Jaw Wrap: Worth it? Not worth it?
3) What are products that I should think about buying NOW (other than a recliner, I'm working on that this weekend)?
4) Do I need a recliner? I am looking into both purchasing one and also possibly leasing one.

I think that's it... for now. In a few weeks, expect another post titled "inquiring minds part II" about questions for the surgeon and foods and other STUFF that I can get at the grocery store. Maybe it's a good thing all of my buddies are beating me to the operating table ;)

Love you guys!

orthodontist today

It was an uneventful orthodontist appointment today. I did lose the springs on bottom, and while I never thought I'd say this - my braces feel so small now! Playing the clarinet will be much more comfortable now (and my insane wax usage ought to level off). I'm in the same wire as I have been for the past few adjustments, and it'll be the wire I have surgery in.

He did mention that when he emailed Dr. Lee she wasn't specific in fixing the height of my bite (ie the gummy smile thing). He told me to make sure to remind her of this in our pre-surgical appointment (although, this seems WAY too close to my actual surgery... yikes). I must remember to ask her about this, though, as it's pretty important to me. I figure if I'm going through all of the dual jaw surgery thing, I might as well come out with a nice smile.

Anyway, pictures finally: Check out the [lack of] gaps on the bottom!

by the numbers

Days until surgery: 40! (tomorrow will be 39!!!)
Days until my half marathon: 37
Days until the husband is home: 25 (ish).
Days until school is out: 18 (actual school days, not including weekends)
Number of migraines in the last two weeks: 8
Miles in my race last weekend: 7.5
Days until my next orthodontist appointment: 5
Performances/Concerts/Field Trips in the past two weeks: 5

I have to say, I am quite jealous of all of the swollen lips, puffed up faces, sawed-apart jawbones, and perfect bites of the past few weeks. I am SO happy for everyone, especially Kate and Aimee and Aimee (ananda devika)... it seems like we all started orthoblogging around the same time, and now they're all "fixed"! But tomorrow that countdown clock rolls on into the 30s, which I can't complain about. I'll follow you guys to the 'other side' soon enough!

I still haven't called my benefits coordinator about what exactly is covered. I'll do it next week. Somehow it's fallen off of the radar with all of the relief still goin' on. :)

officially approved!

May 12, 2009

Dear Mrs. Sheppard:

The Board of Trustees of TSP heard your appeal requesting coverage for orthognathic surgery at their May 7, 2009 meeting.

The board has approved the appeal and I will contact Regence Blue Shield to let them know that the trust will pay for that coverage.

Sincerely,
MP

Still need to call about what exactly is covered, but I think that will be on next Monday. I'm violently vomiting everything I eat, but don't have time to make it to the ER - I performed in a concert on Monday (with my left eye closed because it was too blurry to see out of), conducted a concert last night, had band contest all day today, conducting a concert tomorrow night, and have orchestra concert on Friday. If this is still happening on Friday you can bet your butt I'll be in the ER after school.

Unless my head just explodes on my shoulders before them. Seems like it's about to happen - I'm amazed that one little head (big head?) can hold this much PAIN.

countdown begins

I like to stare at my countdown clock lately. It makes me feel strangely peaceful. It's funny - I can't say that I ever thought I would be joyful looking at a countdown to someone sawing apart and re-arranging bones in my FACE.

The surgery is going to be wretched, the recovery process long and difficult, and I will hate every minute I'm not able to sleep or eat or drink or talk or chew or move. I'll want to cry when I see my swollen face and I'll be scared about my nose changing or whether or not I'll like my face once the swelling goes down.

But at the end of it all, I will be able to chew steak. I will be able to eat a gummy candy and not get a 3 day migraine. I won't have this terrible jaw pain and all of these constant, aching migraines.

The migraine that I am currently getting (will probably be full blown tomorrow, great timing with one performance of my own and 4 for my students) doesn't seem as bad because I know that in 51 days I might not ever have a migraine again. (Probably not, but you never know!).

Hurray!! I'm on cloud 9. STILL.