It's kind of surreal being in this posture again. A week pre op, getting my final photos, xrays, scans, blood tests, etc done. Running around to a ton of appointments, picking my parents up from the airport (my mom is staying the month with me again to help out), eating everything I can while I can. Totally dejavu, but at the same time not. There are definitely differences this time. One of them is having a detailed surgical plan in hand. Finally....the thing I wanted so badly the first time through, I finally have. It took a bit of weight off my shoulders. Not that I doubted my surgeon was going to give it to me, but it's this nagging thing in the back of my head because of what happened the first time.
I had a long appointment with my surgeon yesterday to go over some things. He basically breezed through the paperwork advising me of the risks because I already knew them, and the booklet on liquid diet nutrition because I've already done it. Instead he concentrated on the numbers and the plan. He presented some images of his mock surgery from all of my 3d scans and molds. I guess some of my anxiety is this ridiculous feeling like I couldn't be fixed. That what I had after the first surgery was so bad that I would be screwed. So, to see it fixed on paper....it was amazing. And relieving! To see what I currently have vs. what it looks like to be fixed. What a huge difference! Just seeing how asymmetric I am now compared to the straight proposed finished product. No wonder why my face/jaw is so strained the last two years! No wonder I have had a constant migraine the last two years! There is so much torque on my joints. I could feel how my jaws were sitting immediately after the first surgery, which is why I doubted that ortho was ever going to fix it and that I was immediately a surgical case. Seeing how yawed/twisted/skewed in these scans at least makes me feel better knowing I was right with exactly how I felt my jaws sitting. That I am so twisted and torqued that I am not a whiny baby for complaining about how awful things have felt the last 2 years through this.
On to the fun stuff. The first picture is a start/intermediate/final image. Top is what I am starting with. Middle is what I expect to look like after the top jaw is fixed. Bottom is the final result after he finishes up with correcting the bottom jaw. I harp a lot on how off my top jaw is, but looking at that middle image of the intermediate projection really shows how absolutely screwed up my bottom jaw is. It's just as canted and twisted, like Dr. Gunson told me from day 1 of my revision consult journey. The view from under my chin in the second picture is crazy with regards to the lower jaw. You can really see how yawed out to my left I am. And I'm basically in a cross bite with the way the two jaws are sitting, which is exactly how I felt and described it to my ortho a few weeks post op after the first surgery. My surgeon is still not making any promises, but he's hoping centering everything as best he can in the yaw/cant/midline position, it will help the bowed out left side of my face. I also got all of the measurements. It's a lot to take in, but in general my midlines are being shifted back over a few mm where they were before my first surgery, upper jaw being moved back 2.5mm (which is still not as far back as it was before my first surgery, but we don't have much room to move it back further), lower jaw forward more about 3mm, and everything untwisted and cants leveled out. Surgeon thinks my nose will be less upturned and shouldn't see a bunch more widening. Phew...good. Speaking of the nose....that was the one piece of not so great news. I've always had issues getting air in to my nose. It felt worse on my left side after surgery, but like my ear issues after surgery, it's never something high on my complaint list to talk to my surgeon about and thought I would see an ENT later on about it all. After the scans and taking a look up my nose, surgeon said I am pretty significantly deviated on the left. Never thought to try this, but I blow out air one nostril at a time, and sure enough barely any coming out of my left, and full amount from my right. So, he's going to try to do what he can while he's in there, but I'll probably need to fix the deviated septum when we're done. Goody. And the other bad news I was worried about is the bone grafting and bone loss. I do have some, but not an amount that is completely unexpected after all the work I've done. They're going to bring in grafting material in case they need it, but for now we're hoping I don't.
With the bad, came a little bit of good news. I am NOT banded tightly shut the entire 6 weeks! Since they are not going to do widening of the top jaw, I am tightly banded the first week, a little looser the the 2-3 weeks, and hopefully by the end of the month I can be in the lingering band configuration that allows me to easily take them off to eat and clean. Like the ones my ortho had me in after being unwired last time. The splint will be wired to my top jaw for 3 weeks, which sucks, but hopefully being able to open a little bit to get a baby spoon in or the nozzle of my condiment squeeze bottle to eat from will be a huge win despite the splint being in still. So, this is HUGE news. I was so anxious about being wired tightly shut with the splint for the entire 6 weeks. Don't get me wrong, this is still going to be rough, but now I know it won't be any rougher than what I went through last time. So, here's to liquids/purees for about 3 weeks, and then soft chew by the end of the month hopefully!! Yay!!!
Anywho...here are the pictures of the plans. Just a week to go. Tons of prep left to do still, so it won't be a super relaxing week. Everybody out in jaw surgery land or friends/family reading, start sending your good vibes. I'm going to need them. Seems like I have endless bad luck with all of this.
I had a long appointment with my surgeon yesterday to go over some things. He basically breezed through the paperwork advising me of the risks because I already knew them, and the booklet on liquid diet nutrition because I've already done it. Instead he concentrated on the numbers and the plan. He presented some images of his mock surgery from all of my 3d scans and molds. I guess some of my anxiety is this ridiculous feeling like I couldn't be fixed. That what I had after the first surgery was so bad that I would be screwed. So, to see it fixed on paper....it was amazing. And relieving! To see what I currently have vs. what it looks like to be fixed. What a huge difference! Just seeing how asymmetric I am now compared to the straight proposed finished product. No wonder why my face/jaw is so strained the last two years! No wonder I have had a constant migraine the last two years! There is so much torque on my joints. I could feel how my jaws were sitting immediately after the first surgery, which is why I doubted that ortho was ever going to fix it and that I was immediately a surgical case. Seeing how yawed/twisted/skewed in these scans at least makes me feel better knowing I was right with exactly how I felt my jaws sitting. That I am so twisted and torqued that I am not a whiny baby for complaining about how awful things have felt the last 2 years through this.
On to the fun stuff. The first picture is a start/intermediate/final image. Top is what I am starting with. Middle is what I expect to look like after the top jaw is fixed. Bottom is the final result after he finishes up with correcting the bottom jaw. I harp a lot on how off my top jaw is, but looking at that middle image of the intermediate projection really shows how absolutely screwed up my bottom jaw is. It's just as canted and twisted, like Dr. Gunson told me from day 1 of my revision consult journey. The view from under my chin in the second picture is crazy with regards to the lower jaw. You can really see how yawed out to my left I am. And I'm basically in a cross bite with the way the two jaws are sitting, which is exactly how I felt and described it to my ortho a few weeks post op after the first surgery. My surgeon is still not making any promises, but he's hoping centering everything as best he can in the yaw/cant/midline position, it will help the bowed out left side of my face. I also got all of the measurements. It's a lot to take in, but in general my midlines are being shifted back over a few mm where they were before my first surgery, upper jaw being moved back 2.5mm (which is still not as far back as it was before my first surgery, but we don't have much room to move it back further), lower jaw forward more about 3mm, and everything untwisted and cants leveled out. Surgeon thinks my nose will be less upturned and shouldn't see a bunch more widening. Phew...good. Speaking of the nose....that was the one piece of not so great news. I've always had issues getting air in to my nose. It felt worse on my left side after surgery, but like my ear issues after surgery, it's never something high on my complaint list to talk to my surgeon about and thought I would see an ENT later on about it all. After the scans and taking a look up my nose, surgeon said I am pretty significantly deviated on the left. Never thought to try this, but I blow out air one nostril at a time, and sure enough barely any coming out of my left, and full amount from my right. So, he's going to try to do what he can while he's in there, but I'll probably need to fix the deviated septum when we're done. Goody. And the other bad news I was worried about is the bone grafting and bone loss. I do have some, but not an amount that is completely unexpected after all the work I've done. They're going to bring in grafting material in case they need it, but for now we're hoping I don't.
With the bad, came a little bit of good news. I am NOT banded tightly shut the entire 6 weeks! Since they are not going to do widening of the top jaw, I am tightly banded the first week, a little looser the the 2-3 weeks, and hopefully by the end of the month I can be in the lingering band configuration that allows me to easily take them off to eat and clean. Like the ones my ortho had me in after being unwired last time. The splint will be wired to my top jaw for 3 weeks, which sucks, but hopefully being able to open a little bit to get a baby spoon in or the nozzle of my condiment squeeze bottle to eat from will be a huge win despite the splint being in still. So, this is HUGE news. I was so anxious about being wired tightly shut with the splint for the entire 6 weeks. Don't get me wrong, this is still going to be rough, but now I know it won't be any rougher than what I went through last time. So, here's to liquids/purees for about 3 weeks, and then soft chew by the end of the month hopefully!! Yay!!!
Anywho...here are the pictures of the plans. Just a week to go. Tons of prep left to do still, so it won't be a super relaxing week. Everybody out in jaw surgery land or friends/family reading, start sending your good vibes. I'm going to need them. Seems like I have endless bad luck with all of this.
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