Answers And Decisions

Had my consult with Dr. Gunson on Friday.  First, I will say you get what you pay for with these guys.  In this whole process, I don't think I've ever had so much undivided attention and attention to detail given.  It just really blew my mind.  I don't think any of my appointments have been more than 10 minutes with my surgeon.  My orthodontist is always pretty rushed too.  For what it's worth, I know they are busy doctors, but somehow this guy in Santa Barbara manages to schedule his stuff to where you get his time and you are not rushed.  My appointment was close to 3 hours total.  I got all my questions answered and more.  My head is still spinning from all of it, but it feels so good to finally have my brain wrapped around exactly what is wrong with me and a little more understanding of what went wrong.

Seems like the issues I'm having post op are worse than what I even thought.  I thought most of my issues were confined to my top jaw and that it was off in every direction possible. I was right about the every direction possible, but what blew my mind is how far off my bottom jaw is off.  It's also canted, but yawed and twisted so bad that the buldge I have on my left side -- you know, that one my surgeon said was just swelling/infection and a hematoma from me ripping a stitch the first week post op?  Yeah, not so much.  My jaw is yawed so significantly that the bone is basically sticking out more on that side and causing that lump/bulge. This is not a hematoma that will go away.  This is a permanent disfiguring of my face now.  This was probably the most disturbing news that I got in the appointment. I guess I was just surprised because even though I've wondered in the past if that bulge on that side was really the jaw or not, I just talked myself into believing it was a hematoma and extra swelling that would eventually go away. 

Right side sitting interior to that center line. Left side sitting outside that line. You can even see the fuller face on my left vs. how sunken in it is on my right.

The other surprising bit of information (well, not super surprising since I also suspected this and didn't want to believe it) is my top jaw is moved too far forward.  I've been having trouble closing my lips and again kept telling myself it was residual swelling that needed to go down.  My top jaw is too far forward and making my top lip and area between the lip and nose way too full, making it hard to close.  This is also causing some of the chin dimples and mentalis strain in my lower lip and chin.  Otherwise, everything is about what I thought-- midlines shifted over to the right (my bottom too), canted to the right, and in general everything is just sitting right except for the yaw in the bottom jaw to the left.  No wonder everything has felt so screwed up on me!

So, what do I do now?  Dr. Gunson drafted up a surgical plan.  This system he uses gives all the numbers.  I don't quite know what I'm looking at, but this is what he comes up with:

He suggested my top jaw be taken a smidge back and seated center.  Bottom jaw gets moved a smidge forward and centered with a small genioplasty on my chin to balance out my face.  I forgot to mention that in new news-- Gunson suggests a small genio on me.  I am not sure it's something I would do since it's purely for cosmetic reasons, but I'm also not 100% opposed either.  I would have to think about it for sure.  Now the bad news-- as much as I would love to get my work done with this doctor, the price tag without the genio is 68K.  With the genio, around 73K.  I would also need to be out of work for two months and find temporary housing down in Santa Barbara during the first part of my recovery.  I'd then need to plan on being down there once a month for the rest of the year after that for check ups.  I really wish money wasn't a factor, because hands down I would get the work done with this doc.  He has the time for me and I feel like he would get it right.  I'm thinking about approaching the administration board at Kaiser and asking them to cover the revision since the first one was their mistake and I've now lost faith that the doctors here will do it right a second time.  Not so much just because they don't have the skills, but they honestly do not have the same time this doctor in Santa Barbara has.  Kaiser is like a factory.  In and out, treat em' and street em'.  I don't want to go back to that.  This is not just my face.  It's my skull and jaw bones.  I want this right so I'm not living with messed up bones for the rest of my life.  Have a lot of decisions to make now, and I don't even know where to begin.

Newest xray and joint scans-- can see bone filling in along my lower jaw cuts, and Dr. Gunson said my joints are in really great shape (thank goodness!).

On a totally different note-- got home from the trip down to Santa Barbara in one piece, but both of us woke up the next morning with mild food poisoning!  No beuno!!  We both shared food at a local fish and chip shop and both of us were pretty sick.  Had to take another day off of work today since, even though we're not curled up on the bathroom floors puking our guts up, we're now just totally drained.  Might try to get some soup in later, but for now we're good with gatorade and saltines.  Seems I just can't catch a break lately!!