first twenty four hours ... long report

[Guest guest]

a few people seem to be wondering what the first twenty four hours are like, so

I'll just

share tidbits of mine with you.

Firstly, my surgery took about 7 hours, so i'm told. (Upper split into three

sections with

slight advancement and tilt, lower advancement of almost 10 mm, and genioplasty)

Of

course, I don't remember a bit of it, and anesthesia is timeless, so you

basically go to

sleep and then wake up and have no idea how much time has passed. We started a

little

after 1pm, and finished later in the evening.

I had no ice packs on my face when I woke up, nor did I have ice at any point in

the

hospital. I had brought my own homemade ice packs made with maxi pads soaked in

strong comfrey tea and then frozen, and they felt good, but I was so out of it,

I didn't

really use them that much. I did have a tube in one nostril to pump blood out

from my

stomach, and I had a nebulizer/cool steamer on my face to help breathe and keep

things

moist. I remember my nostrils being surprisingly clear, breathing was no problem

at all.

Also, there was no pain, and minimal swelling. Remember, you are on an IV and

they are

pumping you full of painkillers, antibiotics, and sudafed, so you really don't

feel much.

Antibiotics and saline with dextrose came through the IV, and sudafed and

tylenol were

taken orally every 4 hours with a syrine with IV tubing at the end instead of a

needle, so

you could shoot everything right down your throat. I am still using these

contraptions

now, 5 days post op.

That first night, sleep was fitful, on and off. I barely remember being wheeled

into my

room, memories are kind of patchy. What woke me up a few hours later was the

sensation

of the tube in my throat. The tube didn't bother my nose at all, but it felt a

little weird in

my throat when I swallowed and I remember watching the clock constantly because

I

really wanted them to take it out and they kept saying " tomorrow morning " .

They'd come

in every 4 hours for the meds and to take my vital signs, and I kept asking.

Finally at 6:30

AM, when they said " tomorrow morning " , I said " It IS tomorrow morning, please

take it out "

so they did. It was a strange sensation, and it made me retch a little bit, but

I was so glad

to have it out.

My surgeon's required me to hire a private nurse for the first night, for a 12

hour shift

until 7am. She sat in a chair by my bed, awake, all night long, and I don't

remember

requiring her services too too much, but when I did need her for anything, she

was right

there. This was helpful, considering that the regular nurses at the hospital

have lots of

people to attend to, and even though they were great, sometimes it took them a

few

minutes to come in after I pressed the nurse button in the room (eg, when my IV

bag was

empty and needed replacing).

I also had a catheter in, which was removed shortly after the nose tube. There

was no pain

associated with this, and I had no " accidents " without it ... just got myself up

out of bed,

unplugged the IV, and wheeled everything over to the bathroom when I needed to.

I was

definitely VERY DIZZY for the first several days. Not sure if this was

anesthesia, pain meds,

lack of food, or some combo thereof. Whenever I stood up too fast, I felt like I

was going

to fall over, and sometimes even turning my head too fast in bed would make me

spin.

For breakfast, they brought me chicken broth, tea, and jello around 7:30am. I

had no

appetite for anything, and the IV was keeping me hydrated, so I ate nothing just

yet. By

lunchtime, I realized i really needed to try to eat something to help with the

dizziness, so I

had all of the broth, which was actually quite yummy at that point, My husband

was in the

hospital with me the whole time (2 days, we left by 3pm on my 2nd day post op),

and he

snuck me in a Stonyfield Farms vanilla yogurt smoothie which tasted SOOOOO

GOOOOD at

that point. I knew I needed more protein than just the broth, and I'm not good

at keeping

secrets or lying, so I told the nurse what I was doing. She said that even

though

instructions were that I should have clear liquids only, if I was tolerating the

smoothie, it

should be just fine. I drank about half of it, and just didn't have room for any

more.

They gave me a sodium chloride rinse for my mouth, since I couldn't brush, and I

used it

frequently. I tend to be a little neurotic about my oral hygeine, and when my

mouth feels

scummy, I get cranky. They also gave me peroxide, but I never really used it.

The surgeon came to visit me at 1pm the day after surgery, and he was totally

amazed

that a) I had no bruising, I had very little swelling, and c) I was up and

about and

smiling. He said if I kept this up, I wouldn't need to stay the requisite 3 days

in the

hospital (which I didn't). I asked him about the peroxide, he said don't bother

with it. I also

asked him about the splint ... I am not wired shut, but rather have titanium

plates and pins

in my bones, and a surgical splint wired to my upper teeth for 5 weeks. He said

the splint

acts as a guide for my lower teeth, and once it's off, if there is any shifting,

it can be fixed

by my orthodontist, since the braces are still on. I will also need a little bit

of restorative

dentistry (ie, shaving down some teeth, adding bonding to others) to reshape

them to

perfectly fit my new bite, since there was some wear in my old bite.

He kept a piece of silk tape below my lower lip, about 6 inches long, and taped

on slightly

curving upward and gave me some to take home and change as needed. He said that

because the incisions are on the inside of the gum, and because of the numbness,

I need

the tape to support my lower lip otherwise it may heal with a slight droop

downward. I

change it daily, because it does tend to get a little scummy when I drool soup

or juice on

it.

He also gave me triamcinolone acetonide ointment in a petroleum jelly base to

keep my

lips constantly moist. I did find after a few days though that my lips were

peeling horribly,

and that I had nasty white stuff in the corners which one of the nurses said was

" mildew " .

Once I got home, I started looking for alternatives ... I tend to be a natural

kind of girl, and

putting a petroleum based product on my lips daily just didn't seem right. So

far, the best

thing I've found is olive oil from the kitchen, though it tends to dry rather

quickly.

However, the texture of my lips is much better with it, less peeling, and no

nasty stuff in

the corners. When I have my first post op visit later this morning, I'll ask him

for other

alternatives.

I am not allowed to blow my nose, because the upper surgery was done through the

sinus

cavities. instead, i have various nose sprays to loosen things up, and I am then

supposed

to sniff them up and spit them out. This is rather nasty, but luckily, the

sudafed is keeping

me fairly clear to begin with, so I don't have much extra stuff in there.

I started walking around the day after surgery, in the afternoon. I unplugged

the IV from

the wall, and toted it around with me, up and down the halls of the hospital. I

had my iPod

and listened to gentle music the first day post op, cranking it up and dancing

in the halls

the second day post op. I did buy a set of surgical support CDs from

www.hemi-sync.com

and I do think they helped with my overall level of relaxation. I listend to the

pre=op CD

while in the waiting room before surgery, and they let me take the iPod in so I

could listen

to the intraop CD while they were working on me. Since the surgery was 7 hours

and I only

have 3-4 hours of battery time, i'm sure it ended at some point, but at least i

listened to

some. Then, I started listening to the post-op CD as soon as I was lucid enough

in my

hospital room. There are 3 more CDs: Recuperation, Energy Walk, and Surf, which

is my

favorite. It is just the sound of ocean waves, with an occasional seagull in the

background.

Something about the way it is recorded is supposed to level out your theta brain

waves,

reducing your blood pressure and need for drugs, and increasing your level of

relaxation. I

thought they were great.

I also had one session of manual lymph drainage massage before the surgery, and

now 5

days post op I am seeking someone to do another session. MLD is supposed to help

move

the lymphatic fluid around the lymphatic system and reduce swelling. Being in

the US, this

is not covered by insurance unless you go to a physical therapist for it, not a

massage

therapist. I also think my one session preop helped me have so little swelling

now. I don't

want anyone to touch my face, because where it is not numb, there is a little

bit of pain,

but the lymphatic system includes the neck, chest, underarms, and other parts of

the

head, so I think I can still benefit from it.

Oh, one more thing about the pain: if you take your meds, it's totally

manageable. Again,

I'm a natural sort of girl and I'm not really into taking drugs if I can avoid

it, but during my

recovery, I understand that I totally need them. My doc prescribed me tylenol

with codeine,

which just wasn't doing the job. I mean, it took some of the pain away, but the

codeine left

me soooo drowsy and dizzy, I was just laying around on it. My husband called the

doc on

the 3rd day post op (my full day back home), and told him it just wasn't cutting

it. He said

that when he had had his wisdom teeth out, he had been prescribed Vicodin, and

he

requested it for me. I was hesitant at first, because of all the hype about

addiction, but MY

GOD what a difference it made! With tylenol, after 1.5 hours, I'd be watching

the clock

waiting for 4 hours so I could have my next dose. Also, as I told you, I was so

drowsy and

out of it because of the codeine. The Vicodin totally removes all the pain

altogether, and

actually gives me a little bit of energy. Of course, as soon as I don't need it,

I don't want it,

but in the meantime, it is a lifesaver. So make sure your doc prescribes you

something

strong enough ... remember, you've had bone and flesh cut! This is serious

stuff!

One warning though: my dreams are TOTALLY CRAZY! It's got to be the drugs. They

are so

vivid, and so weird! Also, I find myself dreaming about my mouth, because it

feels so

weird. Last night, I dreamed that I was eating cooked celery, all stringy, and

that I was

trying to pull it out of my gums and teeth, and that I was pulling my sutures

out instead.

Yikes! I was so happy to wake up and realize it was just a dream!

OK, I think that's about all of it. Hope this wasn't too long, and that it helps

those of you

looking for details. I'll keep you all posted on how my first post op appt goes

later today.

Best of luck to all!!!!!!

Jen