Surgery is 26 hours away...

[Tom2]

Sunday morning right now I think.

I just slept about 3 hours straight.    New record post op!

I m not missing food as much as I thought at this stage.  Odd.   I have been able to walk, brush my teeth and live in a state of mind a little more normal.   

The pain is weird.   First, I'm refusing narcotics due to what the impact they seemed to have had on me. 

I'm managing to get by on Tylenol.   Sometimes I feel an ice pick going into my skull, sometimes it's like a metallic worm like screw working it's way through my teeth.   the lower jaw is an exhausting constant pressure that tires me out.   A few sharp hmm pains have almost made me run to the narcotics but that has been limited.

My throat is sore and it's just not fair to have to deal with that on top of everything else.   its lilt the sore throat is the straw to break the camel's back.

I've been able to brush the fronts of my teeth.    I feel tingly in many areas.    I can move my lips a bit.   I feel nothing in my lower lip or front of chin.

Emotions.  Right now I would not have put myself through this if I had known what I was facing.  The mouth splint is evil.   What if the results suck?  What if they are disappointing.   What if I end up worse.

I'll ask doctor for more details on surgery time.

Apparently, after the surgery, I was not waking up and at a certain point they considered it safer to keep me under and maintain my airway than to have me crash in the middle of the night.     So , I stay under till about 8:30 the next day.     I remember the breaththing tubes coming out and puking.    I remember the Cath thing coming out.     I remember being restrained in the bed.

I'm going to try to get some more rest now.    A day of getting fluids, eating Fluids, taking meds and mouthcare is coming an. I need some energy to face it.

[Nataliepryor]

Wow, that sounds very full on. Hope you are able to rest and things improve after the first week.

[molestrip]

Sounds awful. Is that a function of the surgery length? I've met many people who said it wasn't that big a deal. There's a guy in my office who had it done in 1990 even. Is it about expectations? Or just normal variation between individuals?

Also, what makes the splint so evil? Is it any different than, say, a mouthguard?

[PloskoPlus]

Sounds awful. Is that a function of the surgery length? I've met many people who said it wasn't that big a deal. There's a guy in my office who had it done in 1990 even. Is it about expectations? Or just normal variation between individuals?

Also, what makes the splint so evil? Is it any different than, say, a mouthguard?

My upper jaw surgery was only 1.5 hours long.  I lost no weight, had no pain.  No dietary restrictions after 4 weeks... But my upper lip is still partially numb after 6 months. This is really starting to grate on me.  IOW, your mileage may vary.

[terry947]

plosko what do you mean grate on me? its starting to bother you?

[PloskoPlus]

plosko what do you mean grate on me? its starting to bother you?

All surgery guides mention lower lip numbness as a potential permanent sensory change.   Upper lip numbness is supposed to be temporary and is therefore hardly mentioned.  I've had mine for 6 months, expecting it to resolve "any day now".  But the longer something is like this, the more likely it is to remain so.  I do think it's connected to the altered sensation in my palate and numbness in my teeth and gums.  Those can take as long as a year to resolve.

BTW, don't let this dissuade you from surgery.  You need it (and you're are young).

[molestrip]

@PloskoPlus Did the surgeon tell you how this happened? I know they need to cut through all the nerves feeding the palate and upper teeth. My understanding is the upper lip and cheeks are simply a side effect of inflammation. Did you have cheek work done too? It seems to heal really well, I've never heard of permanent numbness there. My local surgeon said 3 years for it to fully heal. I read one case of lasting numbness in the incisors but even then it could have come back later. Everyone's nerves are different though. Is it impacting you functionally? Can you live with it?

I just saw this article today about potential treatment, no shortage of crap like this that goes nowhere and won't help if the nerve is unreached, embedded in a mandible for example lol. Some in the Paleo community believe in intermittent fasting for accelerating nerve repair too.

This is the main reason I was interested in Dr Alfaro's technique. Smaller incision to the soft tissue maxilla means less likely to have permanent nerve damage. But then I realized that the incision is in the area most likely to have permanent numbness. Still, I think it's really cool. He only published the paper a few years ago but I wish surgeons here were familiar with it. They all seem to know each other, maybe they do it and we just don't know.

[PloskoPlus]

@PloskoPlus Did the surgeon tell you how this happened? I know they need to cut through all the nerves feeding the palate and upper teeth. My understanding is the upper lip and cheeks are simply a side effect of inflammation. Did you have cheek work done too? It seems to heal really well, I've never heard of permanent numbness there. My local surgeon said 3 years for it to fully heal. I read one case of lasting numbness in the incisors but even then it could have come back later. Everyone's nerves are different though.

Local nerve branches are cut.  It's unavoidable.  No cheeks.  Well, OK, apparently my plates are right under the cheekbones.  My right side was also more recessed pre-op and that's the one with the most numbness/paraesthesia. Also my jaw had to be narrowed at the back because it would not have fit my lower as it came forward (I guess that childhood palatal expander did its work).

Is it impacting you functionally? Can you live with it?

People can lose limbs and live.  I wouldn't even call it numbness.  More like semi-numbness, altered sensation.  My lip and front teeth (especially on the right) get this very tight and tired feeling after talking a lot or swimming.  Like the lip is sutured or something (technically it was, VY plasty and all that).  I can feel "sparks" in the lip when I touch the area next to my nostril.
It will probably come back (I hope). It's more annoying than anything.  But psychologically I think I won't be over the surgery until the lip comes back.  I guess I'm one of those "80% achieved" cases.  (Though some have said my result is very good.  Top 10%.  I dunno about that).

I just saw this article today about potential treatment, no shortage of crap like this that goes nowhere and won't help if the nerve is unreached, embedded in a mandible for example lol. Some in the Paleo community believe in intermittent fasting for accelerating nerve repair too.

For the record, I eat little in general and very little carbs in particular.  Not paleo diet, more like "don't want to be fat" diet.

This is the main reason I was interested in Dr Alfaro's technique. Smaller incision to the soft tissue maxilla means less likely to have permanent nerve damage. But then I realized that the incision is in the area most likely to have permanent numbness. Still, I think it's really cool. He only published the paper a few years ago but I wish surgeons here were familiar with it. They all seem to know each other, maybe they do it and we just don't know.

Why is not more widespread then?

[Tom2]

Good Tuesday Morning.

I'll be having a follow up with the doctor today so we'll see what happens there.

The Mouth Splint.

It covers the top of your mouth.   Your tongue has limited space to move and you feel it when you swallow.   I've always had a gag reflex that worked overtime so between that and how it limits speaking, eating and general comfort - I find it one of the worst parts of the surgery.

I have a sore throat and that's just extra crap I don't need right now.

Just in general - pain hasn't been the problem.    I had some issues after the surgery that were more narcotic related than anything about what I had done.

My focus now is to get the mouth splint out (I can't work with it in), get nutrition in (Again  - damn mouth splint) and hopefully see a return to feeling in my nose and lower lip/chin area.

My breathing is feeling better - much improved.   Appearances also seem to be improving but we'll see more about that as the swelling goes down.   From what I can tell, my side profile has changed. 

I was in braces prior to the surgery so that aspect will continue and hopefully end by year's end.

[molestrip]

People can lose limbs and live.  I wouldn't even call it numbness.  More like semi-numbness, altered sensation.  My lip and front teeth (especially on the right) get this very tight and tired feeling after talking a lot or swimming.  Like the lip is sutured or something (technically it was, VY plasty and all that).  I can feel "sparks" in the lip when I touch the area next to my nostril.

Semi-numbness doesn't sound so terrible. The sparks? Like allodynia? That could be a pain. Sleep on your side and it keeps you up.

For the record, I eat little in general and very little carbs in particular.  Not paleo diet, more like "don't want to be fat" diet.

This. Good for jaw surgery recovery. No cavities. Supposedly, low carb helps nerves regenerate too.

Why is not more widespread then?

Paper was just published in 2012. Maybe other surgeons are using it, who knows. But they're also averse to trying new things. Who wants to be the first patient? Dr Alfaro has to train them personally I think. Why do you think so few surgeons still do CCW rotations? Even many of Dr W's fellows don't seem to do it.

[Tom2]

12 days post op.


Improvements to things like breathing, sleeping, drinking and just in general existing each of these days has gotten much better.

I lose 25 pounds a little too quickly but have put some of that back on as drinking has gotten easier and I'm doing better with the diet and planning.

I still hate the mouth splint.

[LoveofScotch]

Hey Tom2,

Hope you're doing progressively better and better!

Can I ask if you lost 25 pounds in only 12 days?

Take care, and happy healing

[Tom2]

Hey.

Yea, I'm healing.  I don;t know that I would say that I am feeling better.

Honestly, at this point, if I could go back in time and not do the surgery - I would.  Maybe time will change that.

I did lose about 25 pounds in about 9-12 days - I can't remember right now.     My wife was freaked out.  I was very active and on top of that I always had a fast metabolism to boot.   I consumed a lot of calories and then suddenly...nada.    I've stabilized my weight for the most part but my energy levels are off and I feel weak.     

Good news in the stupid evil splint in my mouth is slated to come out in a couple days.   Then I should be able to eat mashed potatoes and the like.  I need that bad.

I also need some feeling back in my face and I 'd like to be able to close my mouth which I am concerned my lips won't be touching.

I'm hoping I didn't trade one set of problems for another for the price of missing work, discomfort and surgery....

[LoveofScotch]

Hey Tom2,

So glad you're healing, but I'm sorry you're not really feeling any better.

Hang in there, and I hope having the splint out makes a world of difference for the better!

If you're looking to increase the caloric value of mashed potatoes...using only heavy cream tastes like an oil slick, but I think half and half tastes really good. Also butter. Or ghee, or REFINED coconut oil (it doesn't taste like coconut, I promise). I'm obviously not a doctor, but assuming you don't have any issues with high blood pressure, your kidneys, etc.--a hefty does of salt in the potatoes might make you feel a little less weak.

Take care, Tom2.

[NStich]

Hey Tom2, great to hear from you.  Please keep us posted on the post op appointment and let us know when you lose that splint.  I bet that is going to make a huge difference.  I have been eating scrambled eggs and that seems to be a great nutritional option for me.  I know I have been craving protein.

Your lip issue may all be related to swelling and the splint.  How is your swelling?

Peace and healing, Nancy