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My Double Jaw Surgery: Surgery Day

It was an early appointment, so my mom spent the night to help with the kids, and my husband and I got going to the surgery center before dawn. This was an out-patient center not connected with a hospital, but I was going under a general anesthesia, and was being intubated through the nose.

We met with the surgeon and anesthesiologist prior to going to the OR, and I confirmed with them both that they were okay with me taking a high dose of arnica, in a pill called SinEcch. This is something that I use with my patients that are undergoing procedures where I expect swelling and bruising to be higher than normal.

Going under a general anesthetic is a fascinating experience. The times I have been under are the only times I've ever experienced a complete lack of the passage of time. One minute you feel great from the Versed they piped into your veins, the next minute you wake up in recovery and feel as though it was the very next second. It feels like what I imagine time travel to be like. The last thing I remember thinking while in the OR was being grateful that I am finally getting this done and that I'll be able to sleep better soon.

When I woke up I immediately felt as though I had local anesthetic all over my face, which to be fair, they had indeed given me a boatload of to help with the intraoperative bleeding and to help with the post-operative pain. However I could already feel the pressure from the swelling and the pain in the areas that weren't still numb. They loaded me up with some IV pain meds, and I promptly felt nauseated, go figure. So they then loaded me up with anti-nausea meds and I promptly slept for several hours. When I was back in the land of the conscious, the surgeon stopped by and told me that everything went great, and the procedure only lasted about 1.5 hours which was about 30 minutes faster than anticipated. I took that as a good sign - that means it was more simple than anticipated and in dental surgery it is generally recognized that the shorter the surgery, the less chance of post-operative complications. So far so good, now if I could just get the balance of pain and nausea under control.

I was home about 5 hours after the actual surgery started. It was a rough wheelchair ride to the car, not a fun car ride home, and even tougher getting from the car into the house. I was extremely nauseated by this time and and actually vomited an ample amount of blood, which was good to clear out of my stomach, since it was likely what was causing the nausea at this point anyway. I slowly and painfully got situated into the hospital bed that was set up in my super dark bedroom, and I spent the rest of the day drifting in and out of consciousness. When awake, I was still dealing with the nausea, and couldn't imagine taking any more pain meds for fear of vomiting again. I hadn't anticipated the complete lack of jaw movement, and could barely sip a bit of water, much less get any pills down. So my husband crushed some ibuprofen, mixed it with a bit of bone broth, and slowly and painfully injected it into my mouth using a syringe. Between the trauma to my throat from the intubation tube, and the difficulty in moving my tongue, it was quite difficult to even get this small amount of fluid down. Every swallow spiked my pain level to around a 9. I had grand of plans of drinking lots of bone broth and taking lots of supplements to help with healing, but I hadn't anticipated how difficult these small tasks would be.

At the surgery center they informed me that moderate bleeding is not uncommon after the procedure and not to worry. Again, this plays a large role in the post-operative nausea, since it so difficult to try to expectorate anything at this point. For me, the bleeding stopped that evening.

One of the advantages of going through this surgery as a dentist, is that I have a dental laser, called the Millenium MVP-7, which is used to treat periodontal disease in a procedure called LANAP (Laser Assisted New Attachment Procedure) that I became certified to perform in 2012. An off-label use of the Nd:YAG laser is that it can be used for biostimulation. This is a setting where the energy is absorbed into the body, but the tip of the laser fiber is not in direct contact with the body - it is typically 1-3 inches away from the surface. The energy is absorbed higher in areas with inflammation, and it is quite obvious that this is the case when using the laser, as you'll find that you can be working in a "normal" area and feel warmth from the laser tip only when you get it fairly close to your skin, but that when over an an inflamed area, the energy quickly feels hot and you need to back the tip of the laser fiber further away from your skin. We had set the laser up next to my hospital bed, and my husband was able to laser my face a few times that day.

I felt so weak that I could not walk without assistance. I made it my mission to try to do 2 things that first day: Sleep and ice. The sleep part came and went, but I stayed in bed pretty much the whole day. I kept ice compresses on my head day and night, except for when they got too painful to have on. As long as they stayed cold they generally felt good, but these gel packs don't stay cold all that long. I did try making an ice bath in a large bowl, and this was the best relief I found. However it is difficult to breath, and I tried putting a straw between my lips and breathing through that, but I couldn't keep my lips together enough to create a seal. I woke my poor husband up several times in the middle of the night to refresh my ice packs and get me more meds. My stomach finally felt up for trying to add a narcotic into the mix in the middle of the night, so we started slow with just a half a tab of norco. That helped and I spent that day and night drifting in and out of consciousness.

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