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    Sagittal Split Jaw Surgery
    [Originally posted on 3 Nov. 2008, when this blog was still over at weblog.nl]
     

    I said I'd do a follow up post about the lower jaw surgery, when my jaw was back to slightly-different-than-normal. It's been that way for a while, and I'm finally getting to that post :D.

    So: no more swelling. The orthodontist has been busy getting my teeth to fit on top of each other perfectly for a while not, with lots of little elastic bands. Personally I think it won't work until they adjust my braces a bit too, because I can feel where my teeth are not aligned quite right and so won't come any closer on top of each other anymore, but I've mentioned it and they don't listen that much, so I'll let them figure it out on their own: insurance is paying for it all.

    Pictures of me pre-, and a series of post-surgery can be found in the gallery section of this forum: http://seedthecommunity.org/, you just need to register to be able to view them.

    The day of the surgery: I went in, they sedated me (I went out like a light), I woke up in the recovery room. I was wide awake almost as soon as I started waking up, no confusion or saying stupid stuff, though I was dizzy and it was hard to move. They helped me sit up (adjusted the bed for me so I was almost upright) and I had to spit out lots of blood (At first I had asked to be rolled on my side, but figured out right away that that was no good). Then they rode me back to my room (I was on my own bed already, whee!), and gave me this little cardboard bowl and lots of tissues, for when I needed to spit out more blood. Then they gave me an icepack that was tied around my head in such a way that all the ice was around my jaws. There was a glass of ice cold water on the stand next to my bed, and they gave us pitchers of it to refill our glass, and told us to drink as much of it as we could. I got an IV with fluids and something to stop the swelling, and I got two kinds of painkillers as a suppository. They worked well, but I wasn't in much pain to begin with. I kept on spitting out lots and lots of blood, it was kind of noticeable. It turned out it had nothing to do with the jaw surgery, but with one of the upper wisdom teeth they had pulled while they were busy anyway. One of them kept bleeding. That was OK, nothing had to be done to stop it unless I was still bleeding like that by the next evening. My head swelled up like a balloon, gradually. Despite all the preventative measures.

    So, I spent the night in hospital because they do that just to make sure. The next morning I was still bleeding ridiculously much, but it stopped during the day and by the time I got to go home in the afternoon, it was as good as over. They asked me if I wanted one last time of painkiller-suppositories, but I refused because they had a nasty effect that I won't go into so everyone can keep their food down. I went home by bus, and I hardly got any weird stares :).

    I had to brush my teeth as best I could with a tiny children's toothbrush and special toothpaste. I also got a mouthwash that did all the actual cleaning, because brushing your teeth after that is just very hard, but it was important to practise right away to keep everything somewhat supple and because it would help the swelling go down faster. Then I had to wash my mouth out with something else after using the mouthwash each time, to counter the stains that the mouthwash tends to leave on people's teeth.

    I used simple paracetamol as painkillers for a day or three, that was all that was necessary. People recommended ibuprofen, but that doesn't work on me at all (I tried, no effect whatsoever). The worst of the swelling went down in a week or two, but the rest of it took its time to go away.

    I had to eat liquid foods for the first week, and soft, pureed foods for 4 weeks after that. I did not like this, but I survived. I have not developed an aversion to yogurt, against all odds.

    After this type of surgery, you have a numb spot on your chin because they have to cut through the nerve on both sides of the jaw. This spot usually disappears in some weeks, or in some months. For some people, it never quite disappears, for others, it will always feel a little different, though not numb. It's now some two months after the surgery for me, I think... The numb spot has very, very slowly gotten smaller. Now it's a very small area on the right side of the pointy bit of my chin. It's not totally numb, but still just slightly numb and it tingles when I touch it. It also sometimes gives weird sensations on its own (they say these things are good because it means the nerve is still alive and giving sensations, and thus probably recovering). I don't mind. They said I'd get used to it, and I didn't trust that because professionals tend to say that and it's been untrue before, but this time they were right (though I suppose it might be the case that not everyone can get used to it).

    In brief:

    • My face looks slightly different now.
    • It will take another 8 months or so before I can lose the braces.
    • My chin is still extremely slowly regaining feeling.
    • I swell easily after surgery.
    • All of the swelling went away eventually.
    • There wasn't a lot of bruising for me after the surgery.
    • My teeth hurt when I chew now because they're being pressured in different places than they were used to before the surgery.

    Tips:

    • Don't panic when you bleed a lot after this type of surgery.
    • You can refuse pain medication if you want to (and probably a lot more).
    • Try to brush your teeth with a tiny and soft toothbrush from day one.
    • Don't panic when you start bleeding a bit again after brushing your teeth for the first week or so.
    • Use an old stocking to make your own icepack to bind around your jaw (it's in the pictures on the site I linked to).
    • Prepare ice cubes for your homemade icepack in advance.
    • Sleep sitting up until the worst of the swelling dies down (Or at least elevated), this seems to help the swelling go down faster.
    • Take 'before' and 'after' pictures of your own face so you can preserve the difference (You and people around you will forget eventually that you used to look slightly different). Also handy for those who don't recognise their own face to begin with.
    • Make sure you have equipment in your home to puree/mash your food.
    • Don't eat hot foods for the first two weeks (I mean as in temperature, but staying away from heavily spiced foods might be a good idea too. I ate my usually warm foods less than lukewarm).
    • Ice cold water or other drinks help the swelling go down.

    If I forgot anything I'll add it later.

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