Jaw Surgery

As it’s coming up to 3 months since my surgery, I thought I’d write a quick blog on the experience as a whole.

A lot has happened since my operation. Christmas has been and gone, a new year is upon us, and I’ve spent two weeks in Kenya as part of my Masters degree. I’ll admit I was more nervous for the latter than I was even for my surgery, but I had the absolute time of my life and I’m already planning to go back.

The first week after the surgery was hard, physically and mentally. The first two or three days were undoubtedly the worst – Sunday and Monday, after the operation on the Friday, were rock bottom. I was thankful I knew that would be the case though. There is comfort to be had in knowing that you are at rock bottom and that things will improve from then on.

OLYMPUS DIGITAL CAMERA

 

 

 

 

 

This was me only two days after the surgery. Swelling is not obvious from that angle but from my eyes down was swollen like a balloon, and completely and utterly numb. Like an idiot, I gave my dad free rein with my camera. He took pics of me right after I got back on to the ward after the surgery. I don’t remember that, I wasn’t fully aware of things, drugged up on morphine and still only just round from the anaesthetic.

OLYMPUS DIGITAL CAMERA

 

 

 

 

 

The stuff round my head is ice to soothe the swelling and in this shot I still have the drains in – they didn’t get taken out until 6am the next morning. At which point they took the morphine away, which made me sad.

So as you can see, the first few days were rough. It didn’t help that I was on awful drugs. I couldn’t chew or open my jaw much, so I was on soluble paracetamol and ibuprofen syrup, as well as antibiotics which had to be ground up into a kind of chalky paste. All three of those, apart from tasting utterly utterly disgusting, made me feel unbearably nauseous, to the point where I was willing to go without pain meds [which I still really needed at that point, although the ice did a lot of good, but swelling hurts more than you expect it to] just so I wouldn’t have to take them. My parents had to all but force them down my throat with a syringe and it was miserable.

After Tuesday, things started to look up. My dad called the doctors and after a lot of faffing about, got me some anti-nausea meds. I managed to swallow an ordinary paracetamol tablet, which meant I could stop with the horrid pain meds from the hospital.

I had my first post-op check up on the Wednesday, and managed to get dressed and go to the hospital without anything disastrous happening. The consultant was lovely and gave me more confidence to be able to eat actual food. I felt quite a bit better that afternoon, and had a bath in the early evening, around 7.30pm.

That was a mistake.

My mum stayed with me while I was in the bath – being only 5 days post-op, I wasn’t really able to wash my own hair or anything and needed help getting out and stuff. Which was a good thing, because I got out of the bath, and immediately felt bad. I told mum I needed to sit down, plonked myself in the chair, and didn’t feel any better.

Next thing I know, mum is screaming in my ear for my dad to come upstairs. I’d passed out, and only about 30 seconds after my dad arrived, off I went again. So dad went off to call 999 and mum had to calm me down – passing out for an unknown reason is terrifying and I still didn’t feel great, black dots in the vision, sweating and white noise in your ears does that to you. Mum and dad thought I might be suffering from low blood sugar, so they brought some lemonade up and started spooning that into me quickly. The woman on the other end of the 999 call wasn’t pleased about that but it did me good, woke me up a bit.

Then they decided I need paramedics and next thing I know an ambulance turns up, which freaked me out, because I was already reasonably stressed out by the situation and I’d never had to be treated by paramedics before and that’s scary and only happens to people who are really sick.

But the paramedics were lovely, the woman in particular – I dealt with her most because I didn’t have an awful lot of clothes on and so the man stayed outside in the hall with dad. She was very calming and they can do all sorts of tests, they did ECGs and took my blood pressure and blood sugar.

But the decision was I needed to go to A&E. Which again freaked me out – going in ambulance?! To A&E?! But you know, 5 days post-op is still pretty dangerous and apparently I was distressingly pale and clammy so off I went. Fortunately they didn’t blue light me. Dad stayed behind to get food [he is diabetic] and I had to sit in the ambulance and try not to be sick. I get travel sick and facing backwards on a trolleybed is not conducive to feeling great.

A&E seemed to be okay. I had needles poked in me again – the nurse couldn’t find my vein – and they all asked questions I could hardly answer cos I could still hardly talk from the numbness and swelling – the first day in hospital was a nightmare because my bag had got lost and I couldn’t talk at all and when my dad arrived and went to find my bag, with the pen and notepad in, it was wonderful – I could communicate again!

Anyway they moved me out of triage into the treatment area and I kind of realised – gonna be a wait here. So I settled on the new trolleybed. But space was kind of cramped and a nurse asked me if I could hop off the bed and go and sit down in the waiting bit. I didn’t feel fabulous but I agreed. Halfway across the room I started to feel bad again. My parents rushed me to the chairs, and it was like a parting of the waves – my dad called out that I needed to sit down quickly and people quickly got out of the way. I still didn’t feel good once I’d sat down and my dad went and asked a nurse for help, getting told that they were busy with a patient and couldn’t help. And then I fainted again. Which was kind of useful, because my dad just bellowed ‘We need some help here, now!’ and I came round to about 5 or 6 doctors and nurses around me, trying to stop me falling onto the floor and get me onto a trolley bed.

Fainting in A&E, whilst not recommended, is useful. At that point they have seen you lose consciousness and you get bumped up the waiting list. I got put back on a trolleybed and given my own bay to lie and wait in. Someone took my blood pressure. After not very long an A&E doctor came and assessed me, and then whacked me on fluids. They called the on-call doctor down from the department which did the operation, and he was super lovely and spoke to us for ages about the operation and everything. The fainting was a simple vasovagal attack – in other words, through lack of fluid from not eating and drinking much, the hot bath, and being upright sent my blood pressure crashing through the floor.

They kept me in A&E til 1.30am, until they saw that I could walk a lap of the hall without passing out and my blood pressure was more normal. The next few days were mostly taken up by boredom, because after that I wasn’t allowed off the sofa without supervision – the A&E doc had advised that I was quite likely to pass out again, and so I wasn’t allowed anywhere alone. I felt quite a lot better by this point, in terms of swelling and pain, and I was off all the nasty meds, so I was HUNGRY, and I quickly started climbing the walls.

OLYMPUS DIGITAL CAMERA

 

 

 

 

 

I look reasonably cheerful here but I was losing my sanity with boredom and fed up of dribbling everything I ate/drank all down myself because my lips were numb.

And here are the all-important before and afters. Because this is, after all, what it’s all been for.

OLYMPUS DIGITAL CAMERAOLYMPUS DIGITAL CAMERA

 

 

 

 

 

Before

 

20141126_200856 20141126_201352After

Three weeks on…..

As per my last post, on Friday 14th of November I had an operation known as a bimaxillary osteotomy, or double orthognathic corrective surgery – in layman’s terms, surgery to completely realign both my jaws, so that the bottom jaw bites behind my top jaw, as it is supposed to, and as it does with the majority of the population.

This surgery was the climax of 3 and a half years of braces and over 5 years on waiting lists. I thought at some point I was supposed to be having the surgery in the summer of 2013 but that didn’t work out. I could have had it in summer 2014 but the only date available was the date after I graduated, 300 miles away. So. November 14th was the date and by the time it got to November 13th, it’s safe to say I was bricking it. I hadn’t really thought about the surgery in the run-up to it. I’m at university 300 miles away, and getting time off for this op was complicated – first of all emailing all the lecturers involved, sorting out extensions, making sure I get all the work done that I need. Then the not insignificant task of booking a train home, packing, actually getting the train home – that was a hell of a journey, which started with a broken lift in my apartment block, featured me breaking my (extremely heavy) suitcase so that the handle wouldn’t retract anymore, and ended with me losing my parents at my home station cause they went to the wrong platform, I assumed they were late and went out to the car park to wait, and we must have crossed while I was in lift and they took the stairs.

The surgery is big surgery. If anyone is reading this blog because they are about to go through it, don’t let anyone tell you it’s like having your wisdom teeth out. I did that last year. Quick whiff of anaesthetic, out for 15-20 mins max, home three hours later. Orthognathic surgery is a big deal, and if you’re going to have it you need to take at least two weeks off work/school/uni, preferably 3-4.

My surgeon left the hospital in the summer because he got promoted so I only met the surgeon who was going to do the operation a couple of weeks before the surgery. Surgeons, as a rule, are incredible people. They wake up in the morning knowing that they are going to cut someone open and poke about at their insides. You can’t go to work a bit tired, as a surgeon, because you couldn’t get to sleep. You can’t have a heavy night drinking before operating because you will probably kill someone. My new surgeon was no different. And three weeks [and one day, if we’re being picky] I’m starting to get back to normal and despite the nightmare of the first few days, the ambulance ride to A&E, and the being confined to the sofa for far too long, I have to say…it’s so nice to look in a mirror and feel like I look normal [except for, you know, all the swelling]. My face is balanced out now. I don’t feel horror every time I look at me. I feel like I have the right face now.

Today is the day.

So this is it. D-day.

In a little under 1 hour I will be leaving to go to hospital to have the surgery which will be the climax of 3 and a half years of braces and many more years of orthodontics, x-rays, and waiting lists.

I’m scared.

I’m excited too. And there’s no turning back now.

No going back now…

Today I had my final set of appointments before I go in to hospital in just over two weeks to have my jaw broken and pinned together and six metal plates stuck in my face. By which I mean get orthognathic surgery.

It feels a bit weird, saying bye to the people who I’ve seen every 6-8 weeks over the last 3 and a half years and knowing that the next time I see them I’ll have a different face, pretty much. It’ll still be my face, but it’ll look pretty different.

Pre-op was a long process complicated by address issues. It was kinda nice to go to the main hospital though. My appointments are in an outpatient bit, we don’t see much hospital stuff happening. And I quite like hospitals. I always have. I wanted to be a doctor until I hated chemistry at A-level. Although it’s exceptionally easy to get lost in hospitals, especially since I am always distracted by the signs. They are populated with such interesting destinations as ‘cardiac catheter unit’ and ‘intensive care unit’ and I am fascinated by them.

Anyway, the pre-op assessment. Endless questions about how I am, family history of illness, do I know what’s going to happen, this is where you have to come, this is when, you can’t eat anything after 6.30am on the day of the surgery…I got given reams of paper, leaflets about what I can eat afterwards – whatever I like as long as it is totally totally liquid. No lumps at all. Otherwise my jaw could bend. Nice image, that. Blood was taken, height and weight measured, blood pressure and heart rate taken.

I have pretty much the perfect BMI scoring so they would prefer me to not really lose much weight after the operation – which could happen as it’s kinda hard to get all the nutrition if you can only eat liquid – so they’ve pretty much given me the go ahead to eat whatever I like for the next two weeks, all the kinds of stuff we’re normally supposed to shun, to try and build a little buffer. So that’s kinda cool.

And then I had to go up to see the treatment team. Which I was not looking forward to, as yesterday I developed a mouthful of painful ulcers. But they had to try out the surgery splints to make sure everything would be okay for the operation. They have little casts and models of my jaws and teeth and what they will look like at the end, in a big fancy hospital box with my name all over it and important surgery things in bags of sterilising solution. It all feels very important.

Suddenly it feels more real than it has done up to now. Apart from all the ulcers. When I am at uni I don’t much think about it. The work is starting to kick in and I have too much else to think about. But now I have to think about getting to hospital, plan when to arrive and stuff. They told me about the aftercare, all the pills I will be sent home with, the morphine drip, the ward that I spend the night on that’s in between an ordinary ward and ICU. This is happening, in 15 days.

No going back now.

Masters and…stuff.

I started my Masters degree this week! Well, last week technically. Well, actually we don’t *technically* start til next week. Last week was full of inductions and stuff. This week was split in two, as was this year’s cohort, so we could each do a 2 and a half day first aid course to prepare us for…well, life, I suppose. It gets a bit complicated trying to explain it to people. ‘So how are you finding your course so far then?’ ‘Well, we haven’t actually started yet…well we have…oh never mind.’

It’s…strange. It’s very odd to be in the same place (I did my undergraduate degree here, ergo I have been here for three years already) but with completely different people. By far the majority of people from the undergraduate degree have moved on to pastures new. There can’t be more than ten of us coming a back for the Masters. And it’s odd. I’m used to being able to call up friends, arrange to meet, go to events, and see certain people, pretty much whenever I like, because they live in the same town as me. Now they have scattered to all corners of the globe and whilst I have come back to familiar surroundings, it feels very off-kilter. No more running into familiar faces around campus.

I do have an advantage though. If I am finding it bizarre, me, who knows my way around and knows all the staff and where the lecture theatres are and where to go for the best chips in town and if you go down that path you’ll get there in half the time, then the people who are coming here for the first time must be feeling ten times worse. Three years down the road from being a fresher, the new kid in town, the youngest in the place, and I honestly can’t imagine how I did it. It’s terrifying. A new place, new people, a completely clean slate. I don’t think I’d be able to cope as well now, but then I suppose that’s the benefit of youth. And when you’re a fresher, so is everyone else. Everyone is new, no-one knows anyone and everyone is in the same boat.

So I’ve just finished two and a half days of first aid training, after being bored for the three days prior to that, having no work and nothing really to do. My knees are wrecked from two and a half days kneeling next to ‘casualties’ checking for vital signs and bleeding out and why the heck is this person unconscious and unresponsive?! and using CPR dummies and putting people in the recovery position over and over and over. Interesting way to break the ice, that. ‘Hey, nice to meet you. Now I’m going to poke you everywhere.’ And when I say everywhere, I mean everywhere. The protocol calls for, if no circulation issues are found, a head-to-toe body search to try and discover the cause of unconsciousness. Which requires running your hands over the skull, looking behind the ears, looking in the eyes feeling the brow, nose, jaw, collarbones, sternum and ribs, and prodding the stomach in four places, then feeling the kidneys. Next up the legs and arms – you have to feel everywhere, basically, except for the groin. I imagine this is not a problem in an actual, real-life emergency. But when it’s someone who is still conscious, and merely pretending otherwise, and someone you have only just met and will be coursemates with for the next year – bit awkward.

I have a kitchen of my own, which is nice. I have one room and one en-suite. So I don’t even have to go through a door to get to the kitchen. It’s right there! It’s lovely, even if the fridge is a bit noisy, and I have a balcony and a double bed and it’s all rather fab. And despite living 5 miles further out from campus than for the last two years, I only have to leave my flat 15 minutes earlier than I did last year. Which is cracking, if you’re like me and hate early mornings.

Finished Uni – Now What?

I have finished my degree! Had my last exam on Thursday, spent Friday packing, and Saturday travelling home. It’s so lovely to be home. So lovely.

As students will be finishing uni up and down the country and facing the transition into ‘the real world’, we all have to come up with some kind of answer to the question ‘What are you going to do now?’

It is a bit of learning curve. For the past 21 years, we have been buffeted from pre-school to primary school to secondary school, and then perhaps to A-Levels, and those of us finishing degrees, on to uni. It almost feels as though we have been blindly stumbling along a pre-planned path, and now we’ve reached the end of that path and have to figure out how we’re going to pay the bills and put food on the table. It is a slightly daunting prospect.

For some students, the inevitable will be delayed by embarking on a Masters degree. Masters undoubtedly make you more employable. They also cost a lot. Others will get a job. Others will travel. Some will go on and use their degree to begin education in a different area. I have friends going on to Medical School and Vet School. Others will volunteer, or go into internships. Some will get jobs that are related to their sector of preference. Some will get jobs that are utterly unrelated because of a need for money. Some will get married. The issue of funding is relevant to all these. With government grants and loans no longer and option, the money has to come from somewhere.

Everyone is also faced again with the slightly odd situation of people with whom you have become very good friends, and shared formative experiences with, will all disperse to various corners of the country, and sometimes, various corners of the world. Having spent three years together in a small town (in my case), suddenly you will never see some of them again. It is a slightly dizzying prospect, a time of huge change. Three years tucked up in a little insular world of studying, partying, lectures, exams, essays, trying to wrangle finding a house and living together, which sometimes goes well, and sometimes not, forming new relationships, some of which may last a lifetime, and suddenly we are flung, blinking, into the chaos that is the world, with all of its crowds, it’s rushing, a whirlwind of decisions to make, numerous balls to juggle with.

Everything is about to change.

Are you ready?

A date has been set…ish.

Been meaning to write this blog post for ages. Of course I would finally get round to it the evening before my first final exam at university. I suppose I ought to be going over my references again at this point. Most of the information is in my head but trying to make references – names, dates, studies – stick is more difficult than you’d expect, and I’m slightly frazzled because I have yet to either look up, or remember, any of what are known as ‘outside reading’ – references you can slip in that you didn’t cover in lectures. Maybe that is my job for after I’ve written this post. 2 for each of 5 topics shouldn’t ought to be too hard to find, or remember, but again, you’d be surprised. Due to various slightly devastating events I have to do immensely well in tomorrow’s exam to do well in the module.

Anyway. I have had braces for 3 years, and 1 month precisely (today being 6th May 2014). 3 years is a long time to have wire glued to your teeth. And believe me, it hurts. Not 24/7. Mostly it’s fine. But the wire doesn’t just sit there. It tugs your teeth about in your mouth, straightens them, neatens them. So every time you have the wire adjusted, it is accompanied by horrible aching at every touch to your teeth, for several days.

And then of course, having metal rubbing against the inside of your mouth is not a lot of fun, and tends to cause many ulcers. These, too, are particularly prevalent in the first few days and weeks after an adjustment, until the inside of your cheeks harden off, as it were (they don’t literally harden. They just toughen against the irritation). This causes something of a double whammy – achy teeth and a sore mouth. And I’ve had these braces for three years.

The reason I have braces? My bottom jaw is too far forward, and my top jaw too far back, as seen here:

OLYMPUS DIGITAL CAMERA

This does not necessarily cause huge medical issues. But it does make eating flat things difficult, and it looks horrible. I have no cheekbones (apart from having a flat face anyway) and my bottom jaw and lip stick out much too far. Most people I encounter exclaim that they haven’t noticed. Whether they are just being polite or not, I can never quite work out. But whatever other people think – I hate it. And I’ve been waiting for the operation for ages. I thought it was going to be last summer, but that was miscommunication with the hospital. Then I thought it would be this summer. But my teeth are not ready, there is no slot, etc etc.

I had my wisdom teeth out in preparation last April. And this April, I saw the surgeon again, and finally got a date set. Sort of. It’s very provisional, and unfortunately my surgeon has a promotion, and will be leaving, so it depends on the replacement as to whether it will happen on that date. But it should be sometime in November.

This makes things rather awkward. Last week I was accepted onto the Masters programme I had applied for at this university. So if everything goes ahead as planned I’m going to have to have some serious talks with the professor. The reason for it being November, and not, say, December, which would minimise time missed and give me time to recover over Christmas, is that on the Masters programme, a field trip to Kenya is scheduled for early January, and I need substantial time after the operation to recover and be ready for this.

I will need 6 weeks of taking it easy. 2 weeks of heavily taking it easy. They will breaking my bottom jaw and taking a bit out, breaking my top jaw and moving it all forward. 6 metal plates. They are also going to remove a strip from my top jaw, so that when I smile, less gum is visible, and this here doesn’t happen.

OLYMPUS DIGITAL CAMERA

I will go in on a Friday morning, spend Friday night in what is Intensive Care in everything but the name, with specialised nurses who are specifically trained. Then I should go home on the Saturday, bar any complications. But as you can imagine, with a broken jaw, I won’t be able to eat properly. Liquid food, soft food, anything that doesn’t need chewing, that will be the order of the day. The surgeon warned me to expect to lose 10% of my body weight. This and the enforced diet will leave me with little energy, and so… go out in the morning? Spend the afternoon asleep on the settee. I think I may have to prepare a stack of films and boxsets.

But even though I am 3 years+ into my orthognathic surgery journey, I thought I’d develop this blog into sort of tracking what happens, as we near the business end of the journey, and things start happening. For a long time now I’ve just been going to and fro to the hospital whilst they change this wire and adjust that module to make my teeth straighter. Not the easiest, when I’m at university 6 hours away from the hospital I’m having my treatment at, and I have appointments mostly every 6-8 weeks. But I’ve got through. Anyway, I shall be updating now after appointments (and in between, if I have other things to say. I won’t strictly be blogging about hospitals). I hope that people who are about to begin the process, or are in the same shoes as me, find it. I guess that’s what I’m aiming for with this. Because let’s be honest, when I started the process, easily 4 or 5 years ago, I was given a DVD to watch, to help me understand what to expect. It had interviews on with people that had gone through it. And the one that has always stuck in my mind is this one woman, who said, of waking up from the jaw surgery:

“I woke up, and I felt like my face had been run over by a steam roller”

I won’t lie. That’s…not the most reassuring thing I could have heard. Maybe it’s true, I don’t know. I’ll have to wait and see.