Checkups galore and hip stitches taken out (maxillofacial)

Busy day today. Had to go for two appointments in different hospitals.

I had my orthodontic appointment in the morning with Mr S.
I went with my boyfriend to this app.

Mr S had a look around my mouth again and was generally pleased.
He said he won't go to cut the stitches near the back of my mouth as it would be a bit uncomfortable for me as my lips would be pulled around.

He asked me about the whole experience so far and said he'd like it if I wrote down all the good and bad things that have happened to me throughout my operation and stay in hospital. He said this will help future patients as the sheet they gave me are all from previous patients suggestions.

He then asked if I preferred having my lower jaw done in this way (ie cut, no plates used and wired shut for 6 weeks) compared to the other method.

I said I prefer this way as I was told the other way has a higher risk of losing feeling to lip, tongue, chin etc even though I wouldn't be wired up.

He said it's interesting as all the patients he has asked have preferred being wired-up.

I told him my hip stitches were coming out this afternoon.
He wants to see me again after his holiday, so they said two weeks, although the appointment I got is actually in three weeks!

So in the afternoon I went to see Mr O with my Dad.
I was nervous about this app because of my stitches being taken out even though I've been told by lots of people not to worry. I'm a worrier!

We got there and waited a while then got called in by the guy on the surgical team (whose name I really need to find out!)

Mr O asked how I was and had a look inside my mouth. He said the top of my mouth has healed up well where it was cut.

He then asked if it was okay for a young student dentist to have a look, I said sure and they showed the student how my teeth are all wired up and explained what they did.

Mr O then went out of the room and the guy from the surgical team and a nurse told me they were going to remove my stitches.

He put some alcohol on the dressing first to remove that without pulling my skin too much. Then cut the bead higher on my hip and pulled the rest out from the lower end. I made a face and the nurse asked if I was okay. I said "Yeah, I just thought it would hurt". It didn't hurt at all!

The guy told me he's not removing the lil dressing strips on my scar and said they'll come off when I have a shower etc.

Mr O then came back into the room and said my swelling was going down well but my upper swelling would take it's time.

My Dad commented on how we have been taking photos every day to see the swelling progress. Mr O said he'd like to see the progress from our photos, hehe.

I asked him about a lighter mark on the corner of my lip, he had a look and said it looks like pigmentation. I said some skin came off from there after the operation. He said it should go away, I also asked about a raised vein caused by the drip and he said that should go too.

Next app is in two weeks.

No more painkillers! (maxillofacial)

I went to see Mr O my surgeon.

He was pleased with my progress and had a quick look inside my mouth.
He said the stitches on my hip can come out next week. I made a face and my Dad commented that I've been very worried as I thought the stitches were coming out today.

Mr O said "It won't hurt, it'll be like a tickle, they'll just cut one bead and pull the rest through, even you can pull it if you like"
I was thinking, no thanks, lol.

He asked about my numbness and whether I've been having any feeling, I said now and again I get itches on my upper lip and pins and needles sometimes. He said that's good as it means I'm starting to get some feeling back.

The sooner, the better I say.. I'm finding it annoying as my nose still leaks and I can't feel it. I have to always have a tissue with me, hehe.

We asked for some new dressings for my hip as everytime I shower I need to change it as it gets wet. Next app is for next week.

NB: I have now stopped taking painkillers as I'm no longer in so much pain.

Mouth stitches cut (some of them)

I went to see Mr S today. When Nicky came to get me she commented my swelling had already gone down since my last app 4 days ago.

Mr S asked "So do you want me to cut the stitches or just have a look?"
I said "Have a look" lol, I'm not very brave!

So he had a look at my stitches and cut the ones at the top of my mouth. The also removed a cut that were hanging loose.

He then asked how it felt, I couldn't really feel much difference as my top lip is still numb but he told me it should feel better as I can move my mouth a bit more now without it feeling restrained.

He asked how I was getting on generally and said I'm making good progress.
He wants to see me again next week before he goes on holiday.

Silly bruises

I went to have my appointment with Mr S my orthodontist.

I was the first appointment in the afternoon.

When Nicky the nurse came to get me, she commented that I wasn't as swollen as she thought I would be.

Mr S had a quick look at my teeth checking the wires, then used a mirror to gently have a look at my stitches at the top of my mouth and around the sides.

He said he usually cuts them as can take a while to dissolve and that he'll give me that option.

He was generally pleased and asked to take some photos of me.
He said it's always nice to see patients on the other side and doing the final run.

I have another appointment next week on Tues.

NB: Bruising on my arms is still there and now I also have a raised vein from the main drip I had when I had my operation. The vein hurts when pressed.
Another vein near the wrist is painful too, my boyfriend said it looks like I have bruising around the vein. Normally you can't see my veins, but this is making it show up clearly.

Day 3 - freedom!

I slept better last night. Had the usual meds etc.
When I got up I actually went and sat in my chair and generally moved around. I was still limping. I wasn't using the sucker anymore as I was comfortable swallowing my spit now.

The doctors came and saw me in the morning and asked how I was and the guy from the surgical team asked if I wanted to go home today. I said 'Can I?'

He thought I was well enough to go home and that I was progressing well.

So later on the nurses came and cleaned my room etc and gave me some fresh milkshake and water. I had my meds and had water and milkshake now and again and read a book.

I was now keeping a log of my water intake and my milkshake intake.

Another nurse came and cleaned up my nose and changed the bolster.
She said I can get changed now.
I was a bit confused so I pressed the button after pondering for a long time and I asked the guy who came to my room about it. He said I can put my normal clothes on.

So I got my clothes out out of my bag and got changed, it felt weird being out of the hospital gown, my jeans rubbed my stitches a bit as they sat right over my hip so I reasoned I'd change into some joggers when I get home. I wasn't sure if I could remove my stockings so I went to ask and they said yes so I removed them. They were really tight and I can see how the nurse struggled putting them on my legs in the first place.

My boyfriend turned up at 10am.

I told him I was going home today so he thought he'd come earlier as I might need to vacate my room as someone else may need it. I also showed him my log and he was pleased I was drinking more.

I started packing my stuff up with my boyfriends help and then a few mins later the doctor came and asked if I could leave the room as it was needed. So I grabbed my stuff and we went to the TV room to wait.

When my Dad turned up, he found us in the TV room and wasn't happy I'd been chucked out of my room. I was happily still syringing my milkshake etc.

Later a nurse came and spoke to us, they got me my meds etc and fresh dressings for my stitches and nose. They gave us lots of meal drinks and build-up and also some syringes. They also gave me an appointment with the Maxillofacial clinic on the 23rd July (one week today).

Then off we went home, I sat on the sofa at home and relaxed, happy to be home. I changed into my joggers later and found them more comfy then my jeans.

I had a few visitors.

I was taking my medicine with the syringe, but soon found I can drink from a glass.

I now have lovely colourful bruises from all the places the nurses and doctors took or tried to take drips. They are purple and green in colour. They hurt when they are pressed.

Day 2 - more drips

I didn't really sleep very well the first night as I still kept having to use the sucker to get rid of blood/spit build-up in my mouth.

At about 6am, the nurse came to administer meds through my new drip. This one hurt a lot like the old one and the nurse said this one would also need removing too. She didn't finish giving me the meds because of the pain.

She came back and removed the drip a few mins later.

Later a doctor came and looked for new veins on my arms, he got me to pump my arms and open and close my hands to raise veins up. He tried one spot at the back of my right hand. This didn't go in properly so he took it out again. He then tried one lower on my right arm, this also wasn't any good so it was removed again.
He then asked to look at my left arm and tried one on my lower arm. This also didn't work so he gave up.

At this point, I have 5 points drips have tried to inserted!

Later in the morning, two doctors came to see how I was getting on and said they were going to remove the tubes from my nose.
I wasn't looking forward to that!
First they removed the smaller tube, then they went to remove the longer tube which one of the doctors said would be uncomfortable as it was in the stomach. It turned out not to be too bad.
They told me I'll still be leaking blood and plasma from my nose as my sinuses are full of blood.

Once they had gone, a nurse came and cleaned up my nose as it had lots of dried blood in and around the nostrils. She then applied a bolster (sterile dressing under my nose) for the leakage and got me to sit in the chair. She tidied up the bed.

The nurse later a jug of iced water.

My Dad turned up at half 10 to see me and my boyfriend came at eleven. They both said I looked better now I no longer had the tubes.

To be honest I felt better too as most of the blood in my stomach had gone, so I no longer felt ill and it was mainly saliva I had now sucking from my mouth.

Later the nurse came with my painkillers to take by syringe and told my Dad and my boyfriend that I had to go to the clinic for a checkup and that a porter would take me but they could accompany me.

Now when I wanted a wee I was expected to walk to the toilet. I was limping because of my hip but managed to walk to the loo with my Dad with much determination.

The light in the first toilet wasn't working, so a nurse showed me a different one.

When I went back to my room, I started to slowly take my medicine.
The soluble paracetamol was the worst tasting.
he anti-biotics tasted like banana and the stronger painkiller tasted like orange.

When it was nearly time to go the the clinic, the nurse said that a porter wasn't coming and gave a wheelchair for them to take me down to the Maxillofacial clinic in.
When I sat on the wheelchair, the nurse put a blanket over my legs to cover me up more snugly. I still had my dressing gown on.

I felt self-conscious as my boyfriend pushed my wheelchair and my Dad led the way. I felt like people were looking at me.

When we got to the Maxillofacial, we were taken to a room called the "recovery room" to wait. There were lots of people waiting and they looked at me, swollen face and all as I was wheeled past.

We waited for a while and a lady came and asked me to walk next door to be x-rayed. I slowly limped next door and then the lady asked if I had any jewelery on etc. For the first x-ray (front view of teeth), she asked me to keep my mouth closed for the x-ray which I found funny as I couldn't move it.
For the next x-ray (side view of teeth), she asked me to keep my back teeth closed, (again wondering how they think I can actually move my teeth!).

After that was done, I limped back to wait with my Dad and boyfriend again.
We were then called and got seen by Mr O my surgeon who asked me how I was feeling etc. He had the x-ray photo up and it showed I have 4 metal plates on my top jaw.
He asked if my lower lip was numb, I said no, I could just about talk. I said my top lip is numb. He was pleased with this as usually when lower jaw surgery is performed, there is numbness in the lower jaw, but I don't have any. He told me the nerve was stretched in my upper jaw and so it could take a while for it to recover.
He said the swelling will go down gradually.

We then went back up to the ward where I had some water and later some milkshake.
I wasn't really hungry or thirsty. A food selection list had been left in my room for me to choose food for Wed and Thurs. I looked at the list and there was nothing suitable for someone who's wired up.

Later my Dad left to go and get my Mum.
My Mum and Dad came back later and kept me company until they left at 9.30pm.

The nurse came in at about 10pm and asked when my boyfriend would be leaving, he said in a few mins, she said he can stay for a lil longer, but not too long. She asked me how much water etc I'd been having, she wasn't pleased when she realised I hadn't been drinking much, once she had gone, my boyfriend said we'll keep a log of how much water I have tomorrow and try and increase it.

Later my boyfriend went and the nurse came in a while later with more meds.
I had the meds and went to sleep.

Operation day!

On my operation day, I got up early in the morning, (I was nil-by-mouth from 12am in the morning) and got ready to go.

My Dad drove me there and my boyfriend met us there.

I got to Leicester Royal Infirmary at 7.15.
We had to be there for admission at 7.30.

After we met my boyfriend, we went to the admission ward and sat and waited.

First a nurse came and saw me and after confirming my name, address, DOB etc, asked me questions about my health. She also took my blood pressure and read my temperature from my ear.

Later the anaesthetist came to see me and after confirming my name, address, DOB etc, she asked me some questions. She asked for me to explain in my own words what they are doing today. I said I am having jaw surgery, she said okay, that's fine, she also asked if it would be okay to use a suppository painkiller up my back passage.

I hesitantly agreed, then I asked if I could have numbing cream applied to my wrists as I hate needles (it should stop me from feeling the needle going in) and she said I can have it later after I have showered.
My Dad questioned this as I'm only having surgery to my face, but they said everyone has to shower with a special gel to stop the spread of MRSA.

Then a guy from the surgical team came and saw me and explained to me what they were going to do.
He said I was second in line, (eek!) and should go down about half 9.
He talked me through what they would do again and said my hip will be the most sore compared to my face. He said I'll have stitches and a scar.
He asked which hip, I didn't know so he said the right hip as the monitoring equipment is on the left so it's easier for them.

He said I should be in theatre for 2 hours and then in recovery for a few hours so should be back at my ward for 4pm.

The nurse came back about 9 and said it's time for me to shower, she asked if I had a dressing gown, I said yes, so I grabbed my dressing gown and slippers and followed her to get showered.

She supplied me with a bag for my belongings, a hospital gown, towel and showed me how to use the shower room. She said I need to use the gel all over, but I can leave my hair. She showed the shower control saying this way is for cold, and this way is for luke warm, it doesn't get hot.

I asked if I need to remove my bra, she said yes and I asked if I needed to remove my pants explaining about the suppository painkiller. She said she'd get me some paper pants.

She said once I've showered put the hospital gown on and my slippers and dressing gown.

After she'd given me the paper pants and gone, I locked the door and turned the shower on, it was cold not luke warm.
I washed myself as quickly as I could, it was a bit hard doing my back as my hair wasn't tied up. I struggled using one hand to hold my hair, and one to rub my back, then switched hands.
After I was done I dried myself off with the towel and got dressed into the hospital gown and paper pants.
I couldn't do the back of the gown up so rang the bell for help and a nurse came and tied it up for me. I put on my dressing gown, picked up my belongings and went to wait again shivering because of the cold shower.

Later the nurse came again to put the numbing cream called EMLA on my arms. She applied two patches to the top of my hands, and two on my wrists. She also put some stockings on my legs, these are to stop blood clots from developing and are similar to flight socks.

About 10 mins later they said it was time for me to go down, so my Dad, my boyfriend and I went down with the nurse to the waiting bit for the surgery.

We waited a few mins there and then a nurse came and took me away to talk to. She just asked for me to confirm my details again and whether I was ready.
I said kinda, then we went back, got my Dad and my boyfriend and I hugged them both as it was time for me to go.

They left and I went to the bit before you go into the operating theatre.
I was told to remove my slippers and dressing gown and get on the bed.

My surgeon Mr O said hello and asked how I was, he did a quick check of my teeth, he asked which hip, I said right (as advised by the guy on the team earlier).
There was a whole team around the bed, a nurse got me to lie down and loosened the ties on the back of my hospital gown.
She then attached the monitoring equipment to my chest.
The anaesthetist came and said hello then she got an assistant to remove the cream from my arms.

They then put the drip in on my left hand (it hurt! it wasn't numbed at all) and talked to me about what I do etc to try and relax me.

She asked if I was feeling sleepy, I said yes and I remember slow blinking and opening and closing one eye for a while and then I was gone.

Next thing I remember is the anaesthetist calling my name and me taking a while to gain consciousness in the recovery room.

My mouth was all wired up and I could feel I was swollen.
I also had two tubes in my nose (one in each nostril).
One went into my stomach, The other was to allow the suction pipe to get to my throat.
I wondered where my boyfriend and Dad were.

I was in recovery from about 2 - 7pm!!
All I can remember is waking up and choking on my blood and spit.
I had an oxygen mask on which kept steaming up my glasses so I left them off.
I also had a dressing on my right hip covering up my stitches.

They managed to work out that sucking the blood out straight from my stomach helped sometimes, but I also needed blood sucking from my mouth too.
I was also given a pen and paper to communicate with them when I needed to.

I had a nurse left in charge of me, but she wasn't always there.
I slept most of the time I was there in between waking up and coughing up blood.
I remember once waking up and coughing lots of blood out which I was spitting out as I didn't want to swallow it and it dripped all on my hospital gown, down my chest and settled to dry on my stomach. I was looking at other nurses around, but none of them came to help me and I felt helpless.

Later when they decided it was time to get rid of me, they came and cleaned me up. They didn't do a great job though as they didn't clean up the dry blood on my stomach.
They did give me a new gown though and cleaned up my face.

Two nurses came from my new ward and took my bed up to the ward where my anxious parents and boyfriend were waiting.

I got to spend some time with them and it was nice to see them. My mum had come to the hospital from work and they were all worried sick as I wasn't out of recovery for a long time.

The first night wasn't great.
I kept coughing up more blood from my stomach and my parents and boyfriend were worried. They kept holding me up.

The nurses later came to clean me up (after asking my parents and boyfriend to vacate the room).

I tried to tell them about the dry blood on my stomach and after a few attempts at speaking I showed them and accidentally exposed myself as the paper pants had been cut on the right side so they could take some bone and so I wasn't covered up.

Two nurses gave me a bed bath. (The younger nurse joked with me "it's like preparing for old age" as she could probably see I was embarrassed).
They took the pants off me and gave me a hospital nightie instead of a hospital gown.

Later I told the nurse I needed a wee and she asked if I wanted a bed pan or commode.
I said bed pan, she brought it back for me but I couldn't use it as I'm bladder shy so she got the commode. The commode is basically a wheelchair with a removable seat which has a hole and bed pan set in the centre.

I got helped onto it (because of my hip) and while I was on it they changed my bed sheets.

When I was done I got back into bed and my parents and boyfriend came back into the room to sit with me.

Later the nurse came to give me painkillers in my drip and when she was putting it in she could see it was causing me pain. She said it would have to be removed and a new one put in.

At 11pm my parents and boyfriend were asked to leave and they didn't want to go as they knew I hated drips etc. My Mum was reluctant to go as she was worried about me over night.

By this time I had my own sucker tool so I could suck out blood/spit buildup from my mouth myself.

They reluctantly left and my Dad and my boyfriend (they both have the week off) said they'd be in around 11 when visiting hours start.

After they went I had a nurse come and try to find a vein for a new drip, she put a new one on my right hand.

Forgot to add that during the night (before and after my parents and boyfriend left), the nurses kept checking my blood pressure and temperature regularly and I eventually got rid of the oxygen mask so I could put my glasses on and see!

I then went to sleep (or at least tried to...)

Photos my boyfriend took will follow soon..

Pre-operative assessment

I went for my pre-op to the Leiceser Royal Infirmary's (LRI) Maxillofacial department.

First I got called in for an x-ray.

When I went back to wait to be called again, my boyfriend told me another nurse had called me and that he'd told her I was having x-rays taken.

After a while I got called again and the nurse asked me questions to fill in some forms. I had my blood pressure, height and weight checked.

Then I went to speak to someone else who had the consent form for me to sign. The x-ray taken earlier was already up and he had had a chance to look at it.
He went through the risks etc with me, then he had a quick look in my mouth and took notes.

He basically told me everything I knew, my top jaw will be brought forward and lowered, a hip graft is needed to fill the gap when the jaw is lowered.
The bottom jaw will be taken back.

He also told me how they do it.
The top jaw is broken clean and once moved is fixed with metal plates and screws. A slice of bone is taken from my hip and put in.
The bottom jaw is cut in straight vertical lines at the back and then moved back.
Because of the awkwardness of the operation all done from inside my mouth, they can't use metal plates to heal it, so the only way for my bottom jaw to heal is to wire my teeth shut as soon as I'm out of the operation!

He explained that they used to do bottom jaw operations differently and that that way had a 1 in 10 chance of patients having permanent lose of feeling to the chin, cheeks, lips, tongue etc.

The way they are doing it only has a 1 in 3 chance of lose of feeling.

I asked if they will cut from the outside of my face and he said they will only cut inside the mouth so I will have no scars.

He asked if I had a preference to which hip they remove bone from.
I said I don't. He said as I am having bone taken fro my hip I won't be able to walk properly for a few days.

After that I was just asked to go to the Blood Test Centre to have blood taken before I left the hospital and I would be done.

So my boyfriend and I went to the Blood Test Centre. We saw that there was an hour wait. My boyfriend got the number (they call numbers out so we know who's next) and we got a bite to eat and waited.

After just over an hour, my number got called and I had blood taken.
After that I went back to work.

Admission date changed

Today I finally managed to confirm my pre-op which is on Mon 3rd July.

I rang for over a week trying to confirm as it says if you don't confirm your operation will get cancelled.

When I rang up the lady said since you have a pre-op where they will get all the info from you, you don't need to come in on the 13th for your admission, you can come in on the morning of the operation.
She said it'll save me from just waiting around.

I'm much happier being admitted on the morning as I think I would have worried too much staying in hospital overnight and probs wouldn't have slept very well.

She said she'll sent me a letter to confirm.

Hooks and measurements galore!

At this appointment I had a lot done.

First Mr S wanted to remove my wires, so he set about the lengthy task of trying to open my stubborn brackets.

Nicky the nurse got sent to get a water jet to help unclog my brackets.
The first jet wasn't very good and Mr S wasn't very happy with it.
So they experimented on me with a new spray which was much more powerful.
It vibrated the brackets open as it was so powerful!

He used it with warm water which felt much better then cold water.
The ony bad thing was all the spray that went on my face as it was very powerful!

Mr S asked how it felt from my point of view and whether it had caused discomfort.
I said it was fine.

Once the brackets were open, Mr S marked on the wires the gaps between the brackets and then removed the wires.
This felt weird as my false tooth is attached to my top wire so I had my gap back.

Mr S then attached hooks for my operation onto the wires he had earlier marked.

Once he'd finished that, he closed my brackets up (without the wires in) and prepared me for some molds/impressions.

I needed to have 3 sets done. Mr S said this is so the surgeon Mr O can cut them up and play around with them to figure out what the best way to move my jaw is.

After the impressions were done, he then got me to bite on a piece of wax to show my bite, then he got another piece of wax which I bit and he attached it to an appliance which measures how my jaw is held together.

It looks kinda like this.. (<< see link)

After that I rinsed and Mr S reopened my brackets to put the wires with the hooks attached back in.

He then gave me a small mirror to hold in my mouth on each side while he took photos.

Nicky then handed me a mirror and damp cloth so I could clean my face up.

Mr S then wished me well and said he's looking forward to seeing me after the operation. They also gave me an appointment for the 18th, 4 days after my operation.
Nicky said that as I'll be groggy I will always be the first one in.
She said if I'm not up to it, I can ring or get someone else to ring to cancel it.

Photos of new wiring and hooks: (click images to see close-ups)


Open bite


Closed bite


Top


Bottom


Left


Right


Hooks in detail!