Blood & Stuff

Pre-op planning was going too smoothly, some things were bound to crop up.

I went for my pre-admissions testing today (taking a blood sample HURT. I have a pretty high pain tolerance so I don’t really know why a little needle hurt so much! The actual prick didn’t hurt, but when they extracted the blood I could actually feel it leaving me. I don’t know it was really weird.) I was supposed to get my autologous blood donation done, but my blood test results had a couple of problems. My Prothrombin Time (PT), which is a test that measures how long it takes blood to clot, was higher than norm. This means that my blood takes longer to clot than the normal person, which might be a problem since blood loss during jaw surgery is a pretty major concern. Blood sodium levels are slightly low too.

I’m going back to the hospital on the 31st to do another blood test, and see a haematologist if the results persist. A family friend who studied medicine suggested that I eat more dark, leafy vegetables and soy products to increase my Vitamin K intake, which is supposed to help blood clot. Those two foods happen to the very things I always avoid!!!

Hope all will turn out well in the end. The last thing I want is for the surgery to be postponed!

FINAL Appointment with my Surgeon

Yesterday’s 2-hour appointment with my surgeon was veryyyyy eventful. She spent an hour informing my mother and me about the exact procedures involved and explaining the recovery process, and another hour measuring my face.

Basically, I am diagnosed with a ‘dentofacial deformity’ (how blunt), specifically a Class III Malocclusion. My surgery will involve Lefort I + bilateral sagittal split osteotomy (BSSO) + KIV genioplasty. That is surgeon-speak for double jaw surgery with a possibility of chin advancement if the surgeon decides during the surgery that it is necessary. The surgery is planned to be five hours, although with all the pre- and post-op preparations, I will be in the operating ward for a total of around eight hours.

Risks & Complications

She was very thorough in going through every single risk and assessing the possibility of things going wrong. These include:

  1. My body rejecting the blood that is given to me
  2. Severe blood loss
  3. Tiny foreign instruments getting left behind in the open wound (when the tip of the instruments break off, or if a surgical hook falls out)
  4. Damaging some facial nerve that will result in a lopsided smile
  5. Something going wrong on the day after the surgery such that I need to go for a second surgery
  6. Developing an infection
  7. Permanent residual numbness
  8. Relapse

In short, many many many things could go wrong.

The first 5 are highly unlikely, but the last 3 are definitely valid concerns. Apparently 10% of patients are left with permanent numbness (not total numbness, but more like a degraded sense of feeling in some spots on their chin/lips), and the risk generally rises with age. I’m less worried about that, and more anxious about the possibility of relapse, which can be as high as 50%, especially when the jaw movement is large. My movement is quite significant, so there is a higher probability of relapse. Thankfully, my surgeon stresses that the degree of relapse in most cases is negligible, and in all likelihood I will not go back to an underbite.

Fingers crossed that Murphy’s Law won’t apply to me and it will all be smooth sailing!

Recovery Timeline

  • I will spend an hour or two under intensive monitoring. The first night will be in the high dependency unit.
  • I will probably be able to check out after the first or second night if nothing goes wrong and I am comfortable with my progress. Swelling will peak on the second day.
  • Week 1: Liquid diet. This includes Ensure, juice, melted ice cream, yoghurt, strained soup, etc. Elastic bands everywhere!
  • Week 2-6: Soft food, no chew diet. If I’m not wrong, by this point there will only be one elastic band on either side of my mouth.
  • Week 4: Splint is removed
  • Week 6 onwards: Slow transition back to normality

Post-Surgical Changes

Besides being able to tear food properly and comfortably close my lips, and having improved pronunciation, my surgeon also talked about the aesthetic changes that the surgery will bring. She emphasised that this isn’t a cosmetic surgery, although it does have a cosmetic effect.

My front teeth will become much more prominent, and my profile will become convex instead of concave. There will be ‘more support’ at the mid-section of my face, where my cheeks are, so my cheek bones will become more prominent and I will probably become ‘chubbier’. My nose will be ‘lifted’, so it will become more upturned, and the base will be slightly larger. She warned me in a very serious tone that I will look girlier. I don’t know why she sounded so grave about it, really. I’m female after all, I wouldn’t mind looking girlier!

After that, she spent an hour measuring every aspect of my face. It was pretty funnily awkward to keep still and stare straight into the eyes of my surgeon as she appraised every single aspect of my facial appearance. She was very verbal about her evaluations, and some of her comments were quite amusing:

“Your eyes are very symmetrical. That’s really good, the eyes are the window to the soul.”

“Hm. Your lower midline seems to be a little off. Just a little. Actually if I tilt my head a little I wouldn’t notice it at all.”

“Your lower jaw is really long! That’s great, then you won’t get a double chin when we push the lower jaw back.”

“I think you are going to look like that woman.” *Points at model on the dental implant poster* “But don’t quote me on it.” (Sorry doc.)

She was pretty optimistic about my post-op aesthetic changes, and told me that I might need to get a new passport done. Before that appointment, I was honestly not expecting my facial changes to be very drastic, because a couple of people I know from school went for the operation and they don’t really look dramatically different. I still don’t want to expect much, because I reckon it’ll be pretty disappointing if I’m expecting significant change but I hardly get any, and aesthetics isn’t my main reason for the surgery anyway.

My surgeon sent me away with the line: “See you on the 9th of January.” Yes, the next time I see her will be on my op day! Which is just a little more than a month away. Everything is in her hands now. The only things left for me to do between now and then are an autologous blood donation on Boxing Day and just a bit more waiting.

Gosh it’s crazy how close it is.

Last Pre-op Ortho Appointment

Quick update! I had an appointment on 28 Nov. Thought it wouldn’t be much so I wasn’t intending to blog about it, but my surgeon ended up having me go for some necessary pre-op stuff so I thought I’d just put it down before I forget.

My dentist removed my power chains and put in this metallic wire thing around my brackets to prevent my teeth from moving anymore. Unfortunately a few days before the appointment, my power chain snapped in several places so I now have a slight gap between my central and lateral incisor. ): On a more optimistic note, I officially have no more pre-op orthodontic appointments! Pretty wonderful if you ask me.

After that, I had X-rays taken, and lots of photographs. The coolest bit was the 3D facial modeling system! Had my photo taken and a 3D model of my face was constructed on a computer. I had to do it multiple times (about 10) to get it right, because apparently the lights weren’t reaching some parts under my chin, presumably because I have a really steep jaw line that blocked the light from that area.

They are using the 3D model to make post-op projections. I really hope I get to see it before my surgery, it would be pretty awesome.

Ah, that’s about it for that day. It was a pretty long appointment, took about 2-3 hours. Hopefully that cuts some time from the appointment with my surgeon on the 5th of December.

MY A LEVELS ARE OVER I am so happy!!!!!!!!!!!!!