Friday, September 30, 2011

Lefort osteotomy poster child?

I am a little over 24 hours post-surgery.  The name of the exact surgery I had, was a lefort osteotomy.  Exact definition via google -- The Le Fort I osteotomy involves separating the maxilla and the palate from the skull above the roots of the upper teeth through an incision inside the upper lip. The maxilla is fixed in its new position with titanium screws and plates. Surgery time is around three hours.

Anyway, I wanted to go ahead and document my whole day and night, so that I don't forget anything.  Yesterday was literally the longest day of my life.

I worked until 10pm the night before my surgery. When I arrived home, my amazing mom had sushi waiting on me. YUM!  I had to scarf it down since I couldn't eat or drink past midnight.

I had to be at the hospital at 7:30am.  Needless to say, I didn't sleep too much the night before.  My mom picked me up at 6:45, and we were on our way.  It was foggy and misting off and on while driving to the hospital.  Pretty much how I felt about the upcoming day.  I was very, very nervous (understatement)!!

Driving towards downtown B-ham

As we were walking into the hospital, I started crying and didn't stop until I was wheeled back for surgery.  When we arrived, I checked in at admitting then went and sat in the waiting room.  I had no idea how long I was going to have to wait, but within 15 minutes, they had called me back by myself.  I needed my mom with me but had to be a big girl and go on my own.  Tears still flowing, I had to give a urine sample and get changed into the world's worst operating gown.  It was all plastic.  I was a hot, sweaty mess; I literally had sweat beads rolling off my body.  I was really nervous about getting my IV.  In the past, I've been stuck up to 5 times trying to find a vein.  The first nurse gave me some numbing medicine in a vein on the top of my left hand.  It felt like a bee sting.  She then stuck the needle in my hand.  She said she wasn't sure if it would work.  She started to let the IV fluid in and my hand immediately filled with fluid... she didn't get the vein.  I was laying on my back crying like a big baby.  It hurt so bad.  She went and got a second nurse.  That nurse gave me the numbing medicine then stuck the needle in the top of my right hand.  Once again, it didn't work.  They finally went and got the nurse anesthetist, and he got my IV started.  I guess third times a charm.  It was so bad though.  I had myself all worked up.  The worst part... the needles they used were HUGE.  I figured they used a 28 or 29 gauge needle.  Oh no! These people aren't messing around.  I was stuck THREE times with an 18 gauge needle. I was hysterical.  I couldn't even breathe through my nose, I had cried so much.  My mom finally got to come back and I was still being dramatic.  The CRNA gave me some 'I don't care medicine,' which I think was ativan.  They then started to wheel back into surgery, and I don't remember anything after that.

After two hours of surgery, I was taken to the recovery room.  I don't know how long it took before I woke up, but when I did I immediately felt the worst nausea.  They gave me zofran and wheeled me to my room.  My mom and dad were there waiting on me.  I was in and out of sleep pretty much most of the afternoon.  I remember my nurse being so nice and so helpful.  I had a huge contraption around my head that had ice cold water flowing through it to help reduce swelling.  There was literally a cooler filled with ice and water sitting next to my bed that was pulled through tubes to my face.  I also had some plastic thing over my mouth blowing oxygen to my mouth and nose.  They said it was to help me breathe, but it was really cold and I felt like it was just making my lips really chapped. 
**The rest of the pictures are so scary, but I don't want to not post them!

SCARY, enough said!

The respiratory doctor and nurses checked my oxygen levels a couple times, and it was 100% every time, so my nurse told me I could take the thing over my mouth off.  Thank goodness.  It was so bulky and uncomfortable.  Once it was off, per my request, my mom started loading chap stick on my HUGE lips.  I read that your lips get chapped easily, and I did not want that to happen to me.  The corners of my lips were also cracked where the doctor had stretched my mouth to work, so mom put polysporin on the bad spots.


I was intubated through my nose, so my nose was swollen and my nostrils were bloody.  I couldn't breathe out of it at all, so my mouth was opened wide.  It was also wide open because I couldn't shut my lips.  Clearly, they were HUGEE! My entire face, except for my forehead, was (and still is) NUMB.  I'm drooling like crazy.  While I was at the hospital, they gave my a little tube with a suction on it. It was a Godsent.  It didn't leave my side until I walked out the hospital doors at 6:30 the next morning!

Me with my suction tube.  A little later, a little less swollen.

I still hadn't eaten, so I decided around 6ish that night to try to drink a little bit of water.  The hospital provided me with a 60ml syringe with a small tube attached so that you can get liquid in your mouth.  My mom would fill the syringe up, and I would drink 5-10ml at a time.  I could only swallow if I was leaning back.  If I was sitting up, everything would just fall out of my mouth.  The water tasted horrible, so I finally switched to apple juice.  I've never been a big fan of it, but I was drinking it like a champ last night! 

My nausea had still not subsided, and I thought it was because I was so hungry.  Around 7:30pm, I got a new nurse who wasn't the nicest.  I still hadn't gotten any pain medicine and it was time for my second dose of my steroid for swelling, so she gave me morphine and decadron at the same time through an IV push instead of letting them drip into my IV slowly.  Literally within 10 seconds of her pushing those into my IV, my arm starting stinging, and I was throwing up.  Fortunately, mom got the pan to me before I threw up, so I didn't make a mess.  But omygoodness! It was horrible.  I threw up lots and lots of dark blood.  It tasted disgusting but I felt soo much better.  The morphine made my feel really dizzy, and I didn't like it at all.  I'll never take it again.  I tried to go back to sleep, but I was having to lay down at no less than a 45 degree angle and the hospital bed was the most uncomfortable bed I've ever slept in.  The mattress was really soft and it was killing my back.  I kept getting up and down because my back hurt so much.  My mom didn't sleep at all, and I didn't sleep but for maybe an hour or two from 10pm until we left a 6:30 that next morning. The overnight, not so nice nurse came in at 4:45am, gave me a dose of toradol for my pain then mom and I just watched tv.  She came back in around 5:30am to give me my final dose of ancef (antibiotic) through an IV drip.  I was supposed to get an IM shot of medrol in my hip, but I'm terrified of needles so I refused the shot.  Another reason I refused it was because my nurse told me she was scared to give shots! NOT something you want to hear before she's about to stick you with a 23 gauge needle (I asked!).  After I refused that shot, I had to get one more dose of decadron.  [warning.. maybe a little bit of TMI!] She gave it to me in an IV push and my vagina felt like it was on fire and leaking.  I didn't know how to act so I was just moving around a lot trying to get the proper words out of my mouth to explain what was going on. After 30 seconds or so, the pain went away and then my nurse told me that was common. Yet another failure on her part.  I felt like she really put me through some hardships.  Every time I asked her if something hurt or how something would feel, she always had the same answer, "Everyone's different, so I can't really say." I just wanted an answer to prepare myself, but obviously I didn't get anything from her!!! Needless to say, when it was time to leave, mom and I couldn't get out of the hospital fast enough! Right before I left, my nurse did tell me how good I looked.  She said most patients who have the same procedure I had look and act a million times worse than I did.  She said I was a lefort osteotomy poster child.

Once we got home, I walked in the door and literally sat down and let my mom feed me an Ensure chocolate shake. I wanted to cry it was so good and so filling.  I was so hungry.  I took some medicine with my mom's help, brushed my teeth with peridex, then mom and I both crashed for a good three hours.  We got up, I took more medicine, which tastes horrible btw, then drank another Ensure.  My swelling has gone down a lot, but my lips are still huge.  I am also still completely numb.  I can talk, but I'm pretty hard to understand.  I'm just ready for everything to go back to normal, but I know I've got a long road ahead of me.  I'm typically a pretty good patient and can handle pain pretty well.  I would rate my pain level no more than a 3 right now.  The worst thing is the drooling! I wish I still had my suction thing with me!

At home with a full belly! Ready to take a big nap!

My amazing best friend sent me flowers this morning.  Thank you so much CARLA! I love you so much! I seriously don't know who I'd be if she wasn't a part of my life!

Super cute fall flowers from Carla, Marsh & Sullivan!
THANK YOU SO MUCH!

I foresee lots of Ensure, sleep, drooling, medicine, chap stick, pajamas, and text messaging in my near future!!

This post is long, random and all over the place, but I wanted to write down everything from my surgery day.  It was such a long day.  I said if I knew then what I know now, I'm not sure if I would have had surgery.  Now that I'm at home, I'm so much happier.  We'll see if my opinion changes.  I'm just ready for my big lips to go down!!

Tomorrow my post won't be near as long!
Until then..
ashley :-O

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