Going Under the Knife

A year ago, on April Fool's Day 2015, I had an appointment with an orthodontist to talk about getting braces to fix my teeth, which were getting more and more crooked each year.  I had braces for 5 years as a kid, but my orthodontist was super old and basically admitted that he couldn't get my bite just right and was retiring and we were moving so he just took them off, gave me an upper retainer only and sent me on my merry way.  At the appointment, after taking x-rays and examining my bite, the orthodontist explained that the only way to fix my teeth was to do old-school metal braces (I had been hoping for Invisalign) and surgery where my jaw would have to be broken and reset to correct my bite.

Then he showed me a simulation video of how and where the jaw would be broken and moved around.  And I started bawling and freaking out.  Then I went home and scheduled two more consultations with different orthodontists for a second and third opinion.

Long story short, they all said the same thing:  I had a "severe skeletal Class II malocclusion with a transverse deficiency problem."  Basically a terrible cross-bite and overbite that could be corrected only through surgical intervention, not just braces.  Because of my bad bite, my left joint in my jaw is "severely worn down from the open bite trauma" (this is all from a letter from the orthodontist I went with to my oral surgeons discussing treatment).

I got my braces on in May, which I blogged about back then.  It was all mostly funny ha-ha and the surgery was a far-off concept until a couple of months ago when we finally set a date for the procedure and started ramping things up with my treatment and meeting with the surgeons to prepare.

This Friday - April Fool's Day 2016, exactly 1 year from that first consultation about getting braces - I will be going in to have a 4-hour surgery where my jaw will be broken in 5 places, then plated with metal plates, screwed into a new position and wired shut for almost 2 weeks.  It's not going to be fun.

While I am wired shut, I won't be able to eat anything other than liquids.  And not even regular smoothies or milkshakes, which are supposedly too thick to get past my teeth.  We are talking chicken broth and apple juice that can trickle between my teeth because even if I COULD suck from a straw (which I won't be able to), I couldn't get a straw, even a small one.  At the class preparing me (and Paul) for the surgery, they said that we can try smoothies or shakes but first need to put them through a fine mesh strainer and I should be able to consume the resulting liquid.  So, yeah, that's going to be fun.  Also, no blowing my nose, sneezing through my nose, picking up anything more than 5 pounds or any kind of exercise for at least 6 weeks so I don't open up a wound or break sutures inside my nose or mouth.  Oh, and the vomiting blood and nose-bleeds that are side effects of the surgery for the first week.  It won't be pretty.

Once the wires come off, I will still have a splint in my mouth (sort of like a mouth guard that keeps my upper jaw in place but allows me to move the lower jaw) and at that point I should be able to move up to things like yogurt, applesauce, and anything soft enough to mush but not chew for another 4-6 weeks until the splint comes off and some bone has started forming between the broken sections of jaw.

The nurse explained that most people don't complain of pain after the surgery so much as feeling really uncomfortable.  All the incisions are on the inside of my mouth and they remove the nerves in the upper and lower jaws and set them to the side while they operate, then tuck them back inside when they are done.  Apparently doing that paralyzes or numbs them like when you get a cavity filled at the dentist.  Except instead of the numbness wearing off after one afternoon, it takes anywhere from 2 weeks to 3 months (or longer) for the numbness (which will be my entire face below my eyes) to go away.

The other big part of the discomfort is from the swelling, which is pretty extreme for most people.  I will have to wear an ice pack that surrounds my face non-stop for the first 72 hours, and then 30 minutes of every hour for the next week after that to keep the swelling to a minimum.  And even at that, when they showed us pictures of patients who have been through the surgery before and documented their progress day-by-day, the swelling by day 5 is painful just to look out.  After that it is supposed to start subsiding and by 9 months after the surgery (sometimes 12), I should look how I am going to look for the rest of my life because all of the swelling will be gone.  I'm not exactly looking forward to looking like a chubby bunny for the next 9 months.

I hope it is worth it.  A big motivating factor for doing this now is that our insurance covers the entire procedure and all I have to pay is a $20 co-pay, which is amazing.  Each of the three orthodontists I consulted with said "please tell me you have Kaiser?" when they realized surgery would be necessary because of how good they are with the amount of coverage for this.  Also, I knew my teeth were just going to keep getting worse and worse and this would eventually result in more pain (it already feels pretty terrible) and they say the older you are the harder it is to recover from surgery.  But I'm worried about not being able to care for the girls, not being able to talk normally, what it will be like to throw up with my jaws wired shut (a major concern and one that we talked quite a bit about in the prep class), the recovery time, how I will look afterwards (both in the near and far terms) and so much more.  Thankfully my parents are coming to stay with us and take care of me and the girls and Paul while I am out of commission.

Wish me luck.

First Date Night of 2014

One of my New Year's Resolutions is for us to go on dates at least twice a month.  I tried to schedule a date night swap with our friends for this past Tuesday/Wednesday but it didn't work out because they had other obligations.  But I REALLY wanted a date night, so I guess I resorted to drastic measures.

As I was chopping cilantro for the chicken flautas that I was making for dinner, I accidentally sliced into my thumb.  It all happened so fast that I didn't register the pain at first.  I have knicked myself and even sliced a little bit here and there over the years, but this... well, I pretty much went about 3/4 of the way through my thumb a little less than an inch from the tip.  It was gruesome.

Clara was watching "The Little Mermaid" and I didn't scream or cry out or anything.  I just quickly doused it under cold water to rinse off the first welling of blood, then realized just the extent of what I had done and grabbed a clean white dish towel from the drawer and laid down on the kitchen floor trying to draw deep breaths and keep it together so I wouldn't pass out.  Because I have totally passed out from blood, needles, and pain in the past.  I don't swoon or anything - it isn't romantic by any stretch of the imagination.  I am more of the eyes-roll-back-in-the-head-and-I-topple variety of fainter.  It's kind of one of those embarrassing things about myself that I don't usually share.

Thank goodness for cell phones because I had mine on the kitchen floor there with me and I called Paul while I lay there feeling beads of sweat form and drip from my forehead and down my neck (part of the whole passing out thing for me) and clutching my cloth-covered hand like the little chunk of semi-detached thumb on the top was going to drop off, hoping he was already on his way home from work.  When he answered I sort of stammered out what I had done but must not have been very coherent because he asked me to elaborate at which point I lost my temper and sort of bellowed at him to stop asking me questions and just come home.  Then I called my friend Christine who lives around and the corner (and with whom we normally do our date night swap), praying she would answer.  She did and she rushed over with her two kids in tow and loaded Clara into her car then gathered my wallet, purse, and shoes for me since I pretty much just stayed put on the kitchen floor pretending I was somewhere else and that I hadn't just done what I had just done. 

Christine made me feel better by telling me on the drive to the hospital that she had gone to the emergency room just a month before because of a bad splinter.  This was my first trip to an ER, ever, and I was pretty anxious, but I told her to just drop me off at the entrance and then take the kids home because nobody had had dinner and Clara had a bad cold and besides, I didn't want anybody there with me anyway.  And I knew it wasn't the most convenient timing for her anyway since her husband had things going on that night with work and church responsibilities that had made it so date night was a no-go for the week. 

Sure enough, as soon as I walked up to the intake desk and had to remove my dishtowel from my thumb to show them what I had done, I lost it and started wailing.  It was SO embarrassing and I am so glad Clara didn't get to see it or she would have been traumatized for sure.  I don't know if it really looked terrible (I couldn't bring myself to look at it) or if I was just freaking out the other people in the waiting room because they took me right back and checked me in without having me sign anything.  Very impressive service with zero wait time.  Way to go Kaiser Permanente Hospital.  The guy who helped me (I don't know if he was a nurse or a doctor or what) tried to put the dishtowel back over my thumb for me and I snapped and sobbed at him "DON'T TOUCH IT!!!" like some sort of hideous swamp creature.  He actually laughed. 

I would like to point out that I am THE WORST patient in the entire world.

Anyway, after that I shut my eyes tight and didn't open them again until an hour later when everything was over.  They told me that they were going to have to clean out the wound and I went ballistic when they sprayed a tiny bit of saline solution in it.  So then somebody (not sure who was really involved at this point because eyes were closed - there was a girl and a guy and at least the girl was a doctor for sure, maybe the guy too) had the brilliant idea to go ahead and numb my thumb BEFORE cleaning it since they were going to have to numb it later anyway for stitches or whatever.  I don't know why numbing or knocking somebody out isn't the first thing on ER protocol because it only makes sense to me. 

I knew that numbing my thumb would require a painful shot and I was full-on hyperventilating and full-body shaking when they came in to do it.  Fortunately, the shot went into the fleshy mound of my palm at the base of my thumb rather than into the thumb pad itself (which I had been worrying about).  I was told it would take 15 minutes for my thumb to lose all sensation, which turned out to be pretty accurate because they went back to work on it around 7 1/2 minutes (they told me how long it had been) and I started sobbing uncontrollably all over again (versus the pathetic keening I had settled into) because I could still feel them lifting open the wound to squirt saline solution into it.  They decided it would be better to wait the full 15 minutes before working on it any more. 

Paul showed up after I had been there for about half an hour and came in and tried to stroke my hair.  I kept my eyes closed but barked at him not to touch me (seriously, I mentioned I am the worst patient ever, right?).  He chuckled and stood off to the side while everything was finished up and at one point I thought to mention that he should take some pictures on his camera.  Because of course I would need photos.  He laughed and said that he was already doing it and I just hadn't noticed because my eyes were screwed shut still. 

The doctor(s) decided that the wound could be closed with superglue stitches or whatever that stuff is so that they didn't have to use traditional stitches which I would have to go back for to have removed.  So once everything was irrigated they sealed it up and Paul and I had about 20 or 30 minutes to just sit there while the glue dried and chat.  Paul texted Christine to let her know the update and she said that Clara was eating dinner and Johannes didn't end up having to go to the meeting that had originally made date night impossible so we should take our time and stop and get ice cream on the way home or something.  So when everything was finished we stopped by In-N-Out for burgers and fries (I was craving salt like crazy - is that a symptom of shock or something?). 

All in all, we had dinner, conversation, time alone with each other, and sort of an activity/entertainment.  We laughed, we cried, we went home.  So I guess the first date night of 2014 was a success.