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!

Pre-op cancelled

Today while I was at work, I had an answerphone message on my mobile.

I listened to it at lunchtime and found out that it was the Maxillofacial waiiting list calling me.

I rang them back and the lady told me my pre- op appointment for tomorrow is not on as they don't hsve a clinic day on Thursdays.

She said she's changing it to the Monday and will send me a letter to confirm.

All is well!

This was the first time I went my bus to my appointment, it took nearly an hour!

My boyfriend wasn't able to take me but met me there.
Luckily he told them I was running late.

The first thing Mr S asked was if I had any problems, e.g. broken brackets etc.

He said the last thing you need at this point is anything delaying my surgery.

He set about having a look at my teeth, but had problems with the chair and tool controls, so he said to Nicky his nurse to grap a torch as he wanted to get me sorted and could cancel any other appointments.

Mr S eventually got the controls working, then changed my elastic ligatures.
(He missed a few though :o(
I still have some emerald green looking ones, oh well...)

Just when I thought I was done, he said hold on, got some lip separators out and tried to find the correct size.

After three pairs he found some small enough for my mouth, got me to hold them in position and he took photos of my teeth.

Appointment over, I'll see them in July for my hour long appointment for measurements etc. Joy!

Operation date is set!

I got my operation date through the post today.
I was a bit annoyed to receive it just 2 days before my 25th birthday, but oh well... it made me all nervous.

The admission date for my operation is Sunday July 13th at 2pm at the Leicester Royal Infirmary.
The operation is scheduled on the following day.

It says on the letter:
PLEASE CONFIRM THAT YOU HAVE RECEIVED THIS LETTER IMMEDIATELY AS FAILURE TO DO SO MAY RESULT IN THE CANCELLATION OF YOUR OPERATION.

That made me even more nervous!

It also has a date for my pre-operative assessment (June 26th 10am)

I also need to ring up on the day of my admission to confirm a bed is available!
Shouldn't they keep one for me as they know I'll be coming in? Hmm...

So I confirmed both my operation and pre-operative assessment and got that sorted.
Now i've just got to wait.

I also received my orthodontist appointment for the measurements etc needed before my operation. That's on July 3rd.

Joint Clinic

I was accompanied by my Dad and my boyfriend to this appointment.

There was the surgeon Mr O, My orthodontist Mr S and his nurse Nicky and someone else with the surgeon present.

I sat on the dental chair in the middle and felt like I was on show!
Well there was 6 other people excluding myself in the room.

Anyway I basically got asked questions about why I want the surgery etc and Mr O also told what they will do in the operation.

My top and bottom jaws will both be moved.
My bottom jaw will be moved back and my top jaw will be moved down and forwards.
At the moment although my top front teeth are straight, you can't see them when I talk, so moving the jaw down will make the teeth visible.

Mr O said although it doesn't matter too much now as I'm young enough, it will make me look as though I haven't got my top dentures in when I'm older!

I think he meant figuratively about the dentures as if I'm having this much work done hopefully my teeth will last!

As the top jaw is being moved down, I will also be having a hip graft where they'll take bone from the inside of the hip bone.
It's taken from the inside so when the bone grows back lumpy it won't show externally, I'll just have a scar.
The bone taken from my hip will be used to fill the gap left when lowering the top jaw.

I'll get surgery my date through the post and they think it should be around mid July.

Nicky then told me I'll need an orthodontics appointment around 3 weeks before my operation so they can take measurements etc.

Scary stuff!