My Clearance Meeting

August 3, 2016

Today is a wonderful day! I have been cleared to do anything and eat anything. Most importantly to me I have been cleared to play soccer right in time for when my season is starting. At the appointment Dr. Gollehon reaffirmed to me that my surgery went extraordinarily well. I will get to see him one more time after I am finished with my Invisalign. His assistant took the leftover stitches out that were already falling out. To celebrate, my mom took me out to eat sushi because that has been what I have been craving for a long time. Until the doctor said, "Okay," my mom did not let me eat it because she was concerned about the rawness of sushi and germs in my mouth.

My July Summer

In July:
My mom celebrated her birthday two weeks after my surgery. Here is a picture of how I looked two weeks after surgery:

My family goes on an annual to trip to a lake in up-state New York. We are in a house that is surrounded by woods and a lake. Usually I enjoy skiing, tubing, swimming, and other water-filled fun. This year I was not able to go into the water because of my jaw surgery. I was not allowed to get water up my nose because I had to protect my sinus cavity from getting bacteria in it. During the surgery they cut into my sinus cavity leaving it easily susceptible during the healing process. Additionally, the doctor said it would extremely painful if I got water up my nose so I had to avoid putting my head under water even in a swimming pool for the whole summer. Instead I did an excessive amount of reading and finished both my summer reading books. I still enjoyed the trip because it is a nice place to get away and relax but it was not as fun because I could not get in the water. My family played some games and of course I slept a lot. Instead of getting exercise from being in the water, my family and I did kayaking and running. I was still on my special diet but my mom cooked foods I could eat. Also, I ate a ton of Jello, Pudding, and Lasagna.

The next week I went to the beach. Another place where the water is fun to play in. Because of my jaw surgery I avoided the beaches and pools and did a lot of running. I really got into running at the beach because it was so flat. I did not run on the beach but on the sidewalk at the resort. I spent time with family and felt like I could eat anything. My mom still limited me to my doctor-dictated diet of foods that I only had to chew a little. I was sick of Jello and pudding so I gave it to my cousins. I really enjoyed breakfast foods like eggs and grits.

My point in telling you this is that even though my vacations were all near water areas that I was not able to participate in, I still found other ways to be active and enjoy my vacations.

My Dr. Appointment a week after my surgery

Wednesday June 29, 2016

I had a great meeting with Dr. Gollehon. He said that everything looked great and that my surgery went extraordinarily well. I did not lose a lot of blood like some can. He even told me I could start running as long as I was careful not to fall on my face. Good news, he said I could stop wearing my bands all day. I only have to wear them at night until my orthodontist tells me differently. I have been having to do salt water rinses of my mouth several times a day and avoid getting anything on the stitches' site. I am to keep this up, but I do not have to be as careful of the stitches' site. Also, he said I can start gently flossing in about 2 weeks. Right now I can transition from the pediatric toothbrush they gave me to a regular toothbrush as long as I am super careful. I have been taking Dimetapp around the clock since the surgery but he said I can stop using it unless I begin to get congested or a cold. He recommended I heat and gently massage my face for 5 to 10 minutes 3 times a day. As far as food goes I have a few more days of liquid diet but soon I can move to foods that are soft chewing like scrambled eggs and lasagna. I am super excited to chew a bit because I feel like I could do it right now although I know I should not. I will see my orthodontist in a week. 

A Week After My Surgery

Tuesday June 28, 2016

Today I woke up a 7:00 for my meds than fell back asleep and didn’t wake up until 11:00, just in time for my meds again. I have been waking up late even though I go to bed a 11:00 or so every night. I guess my body just needs a lot of sleep to heal. A lovely lady from church came and gave me a chocolate milkshake from Cookout. My  mom made spaghetti for me and ground it up a ton to the consistency of apple sauce, I know it looks gross but trust me it was delicious. I have really missed "real" food! I started working on a 4000 word Extended Essay I have to write this summer. Also, mom and I watched Hamlet, the movie, one of the many versions. We are about to go on a walk. I feel great. My upper lip and bottom of my nose are still numb and a little swollen. During the movie I put heat on my face and rubbed it a bit. I can’t really tell a difference when I do it but that is what the doctor told me to do. Often I have weird tingly and itchy feelings in my cheeks and face but my dad just says that is the numbness wearing off. I go to the doctor tomorrow and I am hoping for good news! He may say I do not have to wear the bands any more which would be great as they are just a pain!

My mom made me blended Spaghetti. 

Day 6 After the Surgery

Monday June 27, 2016

I was woken up at 7:00 for my meds. Then I woke up at 10:30 and had half of a Carnation Instant Breakfast. Friends from soccer brought me a smoothie and stayed for a short visit. I was able to talk for a little.  I finally left the house for a car ride going on a few errands with my dad. I stayed in the car the whole time but I got a chocolate milkshake from Chick-fil-A and ate it with a spoon. I can now start putting heat on my face. I wrote thank you letters to all the people that gave me smoothies, flowers, and other gifts.

Day 5 After the Surgery

Sunday June 26, 2016

Today I woke up feeling better than yesterday numbness-wise because I can start to feel and see the bottom of my cheeks. This little change makes a big difference to me in how I look. Unfortunately, I was just really tired. After breakfast, I have slept most of the day. Perhaps I did too much yesterday. I tried to play a game but during the game I felt hot so my parents thought I might have a fever or something. My mom gave me liquid Advil but accidentally thought she over dosed me. Having to take all my medicine in liquid form makes the dosages confusing as they are labelled for children's body weights.  Also, I checked my temperature and it was fine. This afternoon, I cleaned my room. I sat on the floor and sorted all the papers from school. Before bed, I watched the Copa Finals and went to sleep.

Day 4 After the Surgery

Saturday June 25, 2016

Today was a good day. I woke up at 9:30 and drank some Carnation Instant Breakfast.  It tasted great. My face feels so much better than yesterday. I could tell that overnight my face made huge improvements. I still feel numb in my nose, upper lip and upper parts of my cheeks. So far there is not much pain. It only hurts a little when I yawn and laugh because I feel like I am stretching stitches or something. I have lost 6 pounds due to my liquid diet. My lips are very chapped so I have to apply vaseline on them. I went on a walk around the block (my first outing and exercise) and I read. I ate some Go-Gurt and applesauce for lunch. Transitioning from a clear liquid diet to liquids has greatly expanded my options. This makes me very happy! I watched Les Miserables. My friend came to visit before she went to camp. It reminded me of fun opportunities I have had to skip this summer. I had to take this terrible medicine that is supposed to make me poop. Mixing it in a smoothie was better than mixing it with water. It is extremely bitter and slightly burns my throat. I talked on the phone and I only took one short nap in the afternoon. Tomorrow I may or may not go to church I have not decided because I am self-conscious of my facial swelling.  

Day 3 After the Surgery

Friday June 24, 2016

My face is still pretty numb and I am very swollen. I do not feel that well.  I am constantly icing my face hoping this swelling will go away soon! I had many visitors today.  My friend, her mom and my church youth leaders came. I feel bad because I cannot smile or anything and I do not really like to talk at this point. Hopefully my visitors understand that I would laugh at their jokes but it hurts my upper lip area a lot. I think when I laugh it stretches the stitches. Allowing people to see me in my pitiful looking state has helped me recover because I need interaction with more than my parents to keep my spirits up. I am self-conscious of how I look but I know that the people who visit me are expecting me to look bad so it does not bother me and I know I will only look like this for a short period of time. I did finally take a shower and wash my hair and change clothes. It felt good.  The water on my face felt very weird because I could feel it in certain places but in others I could not feel it at all yet I knew it was there.  In the evening my grandparents came. I had to stay up to take my meds at 11:00 p.m. but then I went straight to bed and did not wake till morning.

Day 2 after the Surgery

Thursday June 23, 2016

Today a group of friends came to visit and we watched a movie because I was not really up for talking much. I am very swollen and today was probably the worst day for me. I am on so many meds. All I do is sleep, take medicine and ice my face a lot. I like small icepacks because they fit on my upper lip area without covering my nose. I had to learn how to put the rubber bands on my teeth by myself. Until you get the hang of it, it is really hard and kind of frustrating. My mom had to hold my mouth open for me at first. All I can say is, it takes practice!

The Day After Surgery

Wednesday June 22, 2016

I woke up and was wheeled out to the car around 8:00 a.m. I had apple juice for breakfast. We went to the doctor where they took pictures of my jaw.  They brushed my teeth and showed me how to put the bands on my brackets which would help my jaw muscles relearn how to hold my jaw in the new location. They said everything went perfectly. The visit was short. I went home and I slept a lot. Every time I went to watch TV I fell asleep. I felt really miserable because I was uncomfortable. My face did not hurt it just felt really swollen. I was also still on medicine which added to my tiredness and "blah" feeling. I did not do much talking. 

My perspective of the day of the Surgery

Tuesday June 21, 2016

Morning of Surgery

Wow, so the day has actually arrived! It is crazy because I have waited literally more than a year knowing this day would come. Unfortunatley, I woke up early at 7:30 and I don’t have to leave the house until 11:15 so I have time to kill. I have read a bit and finished watching a movie but my focus on other things is low while I try to keep myself occupied. I painted my nails red for good luck so hopefully I am allowed to have my nails painted. I am going to have my mom braid my hair in two pig tails and then I am wearing my favorite sweatpants and sweat jacket. I am nervous and I feel like I am getting tingling in my arms... it is kind of weird. Also, I have sneezed a lot this morning. But all in all life is good and I am ready to get this surgery done! I keep reminding myself as long as I am asleep I will be fine. Anyway, I do not have too much too say so wish me the best of luck and I will update the blog as soon as possible! Oh and my mom will take many pictures of me so everyone can see what I look like through the whole process. :) 

At home before surgery.

In the pre-op room, I changed into surgery clothes (gown, robe, underwear, and socks), they gave me a warm blanket and I sat in a comfy chair. I had a really nice nurse and my parents asked questions and signed papers.  I got a needle in my arm (numbing needle hurt the most but did feel actual IV). The anesthesiologist came in to introduce himself. He was very friendly and comforting. Two nurses introduced themselves to me and one nurse came in because she had a granddaughter that was adopted from China, too. Finally, Dr. Gollehon came in, logged into surgery computer and answered our questions.

A nice man walked me to the surgical room. In the surgery room, they connected a wire to my arm. I laid down and looked at the giant lights above. I told a lady nurse I really wanted to make sure I was asleep before the surgery started. She said "Don't worry that's my job and I won't get paid if I don't." She said she would start the medicine and I totally do not remember anything else,  I was completely out. Next thing I do remember is waking up in the recovery room.

After Surgery

When I woke up from my anesthesia in recovery I could not stop whining and crying because I was in a lot of pain.  My throat was so dry it hurt. Also, the ice packs were placed around my lower jaw, but it was my upper jaw and nose area that needed the ice. When I was more awake I was rolled to my overnight room where my parents met me. It is very nice, the bed is so comfortable and can be moved to elevate my head. I slept a bunch and eventually after the morphine kicked in the pain just became discomfort. My face feels super numb and fat.  My dad and I are watching soccer on TV. I got a small nose bleed in my left nostril after using nose drops. I will be using nose drops and other medicines to keep from getting a cold and having sinus issues during my recovery.  I have a leg vibrator machine that feels good. It encourages my blood circulation and was in the surgical room, too. I am taking fluids. At this stage, I must try to drink water through a syringe. The nurses are recording how much I take to ensure I stay hydrated. The water makes my throat feel so much better.  I am able to drink much more water than they even expected me to drink. I got medicine for my lips to keep the swelling down. My nurse is so nice like all the other nurses. When I move my head just a little I get super dizzy and get a headache feeling.

Pre Surgery Jitters

Sunday June 19, 2016

My surgery is in 2 days. I am a little nervous at this point but mostly ready to get it over with. I think I will miss solid food a lot. My main concern is reminding and ensuring myself that I will definitely be asleep during the surgery.  I know that I will, but I am still concerned about waking up during surgery or something crazy happening where I am able to feel pain.  Other than that, I want to do my summer reading and watch a lot of movies. 

Two days before the surgery.

Monday Night June 20, 2016

Hello. So it is 11:30 p.m. the night before my surgery. I have 29 minutes left to eat/drink. I went out to dinner with my friends for a “last meal” of solid food for a while. Of course we had pizza and cheesecake. We took some pictures too which was pretty fun! I learned my surgery is at 1:30 p.m. That means I will have to arrive around 12:00 p.m. which means I have to leave the house at around 11:15 a.m. because I live in Greensboro and the surgical center is in High Point. How am I feeling you might ask? Well I feel pretty okay, I feel like I should be stuffing my face because I will not be able to eat/drink for a while, but for some reason this one time I do not feel hungry or have any desire to eat. I am drinking a lot of water though. The doctor said it was important to stay hydrated. Also, I took two cleaning pills tonight and I will have to take one tomorrow morning too. They are tiny, minuscule, like if I was not wearing my glasses or contacts I could not see them probably unless I got really close. Anyway, tomorrow I am going to wear my favorite sweatpants and a zip up sweat jacket. Zip up because I do not want to have to pull anything over my head. Also, I am going stay up later because I want to sleep as long as possible in the morning so I do not think about food. I did some singing tonight because I probably will not be able to do that for a while. I am a terrible singer, but it is a lot of fun for me to annoy/ sing in front of my parents. So I am getting a little more nervous as I think about what they are going to do but I am just reminding myself that I will be completely asleep and will not even feel a thing. I am taking a lot of photos though because my face will never look the same as it has these last 17 years. Hopefully only a small part of my life and this surgery will make my face what it will look like for hopefully a long time. Okay now I am rambling, so a summary is I feel pretty good. I am going to watch Friends tonight and other Netflix shows because that is what I like to do to distract myself. Wish me luck tomorrow!! Woop Woop. Ready to get this over with so I can watch sad movies and drink apple juice. Oh and the USA men's soccer team plays tomorrow against Argentina so good luck to them! U-S-A, U-S-A! Yes, I am chanting this in my head. Okay. Goodnight :) 

My friends and I the night before my surgery.

Prep Meetings with my doctors

1st Jaw Surgery meeting with Dr. Gollohan in May

During the first meeting with Dr. Gollohan we talked about the basic details of the surgery.  I had my wisdom teeth extracted by him 1 1/2 years prior so I felt comfortable talking to him immediately. I asked him the exact process of what he was going to do during surgery. He asked me if I wanted to know the gory details and I said yes so he told me. He said he was going to make cuts above my upper gum to separate my skin from the bone. Although it did gross me out, I was glad I knew and I reminded myself that I would be asleep while it happened. Then, he showed my parents how my nose was misaligned and how doing the surgery would actually align my nose with my mouth. While the topic was serious, Dr. Gollohan's demeanor was friendly and casual making me feel more comfortable. I appreciated becoming more knowledgable about my upcoming surgery. 

June 8, 2016 (2:30-3:30) - My last pre- surgery meeting with Dr. Gollohan

During my pre-surgery meeting my parents signed a contract and consent form detailing everything that could possible go wrong because I was 17 they would have to sign it for me. The nurse took 2 top impressions and 2 bottom impressions to make a cast for the final position of  my teeth. The composite goo tasted bad and was uncomfortable but not painful.  I got a pediatric toothbrush and small tube of toothpaste to use after surgery.  Its bristles were more gentle and its small size would ease brushing as I will have limited ability to open my swollen jaw and I will have bands on my teeth to navigate around. Then, the nurse took my blood pressure and gave my mom a recipe booklet for soft foods. I, also, got prescriptions antibiotics to take before surgery to prevent germs from creating infections during surgery and prescriptions for liquid medicine after surgery for pain.

When Dr. Gollohan came in he made the point to emphasize that I was the patient and he would answer my questions first, then my parents. He told me exactly what would happen on the day of my surgery and the overnight in the day surgery recovery center. I learned the surgery will last 1.5-2 hrs. The process would include going to a day surgery center where nurses would check my vital signs and get me changed into a hospital gown for surgery.  Dr. Gollohan will be available to answer any last questions. Then, I would go to the surgical theater where I will get comfortable and they will put me to sleep. Before I know it I will be waking up in the recovery room. I can only stay in hospital for 23 hours and 59 minutes for insurance reasons.  A parent will be allowed to stay overnight with me and will be provided a meal. The next day I would go to Dr. Gollohan's office for a 1-day post surgery check.  This visit will include showing me how to put rubber bands on the buttons and brackets to help guide my jaw into relearning where to close. My orthodontist will place the little buttons and brackets on my teeth the week before surgery.  I will come back a week later, a month later, and then when I am done with Invisalign.

After Dr. Gollohan described the whole process in detail, he said I would be numb in my face for about 6 months but the numbness will recede over time. I will be on a clear liquid diet for the first 48 hours after surgery, then 2 weeks of liquids food including smoothies and milkshakes, followed by another 2 weeks of food textured like scrambled eggs, and finally 2 weeks of food the texture of soft spaghetti. If all goes well, he will then give me approval to eat whatever I want that does not cause me pain.

Dr. Gollohan told us some history of LeFort 1 surgery. He said it was named after a French man named Lefort, who lived in the 1800's. He dropped heads from high buildings to study how bones in the face broke. The places where they broke is where they make cuts for surgery now because those are the weakest and easiest areas to cut. So the areas Dr.Gollohan will cut are based on the areas that broke when Lefort dropped the heads. I thought that was pretty crazy but also totally ingenious. 

At end my parents made payments, figured out the insurance, and got information about the surgical center. 

Orthodontist puts on buttons and brackets pre-surgery

A week and a day before my surgery my orthodontist put the buttons and brackets on my teeth, an un-painful process. After the hooks were on, they felt like what I thought braces would feel like. The buttons and brackets were extremely annoying and painful afterwards  because they were rubbing against the inside of my mouth creating sores. Luckily, after a day my mouth got adjusted to them and they do not bother me anymore. So life is good! Then the orthodontist took a bunch of photos of my teeth from all angles. Pretty simple and uneventful. My orthodontist told me I would see him two weeks after the surgery. Right now I can open my mouth wide enough that he can stick two of his fingers in it, but after the surgery until the swelling subsides I will only be able to open my mouth wide enough for him to insert one finger.

Introduction

Hello! My name is Annesleigh, this is a blog about my experience of having upper jaw surgery during the summer as a rising senior in high school.

This long process (5 years and counting) started when I was in 7th grade (December 2011) and I went to the orthodontist for the first time expecting to have the typical braces to straighten my teeth. The first orthodontist I consulted quickly told my parents that I was a special case and would need much more than braces, including surgery. This alarming news caught my family off-guard, so we got 2 other opinions. The orthodontists presented different options  and timetables for treatment. My parents chose the orthodontist who took the conservative approach of waiting until I was fully grown to see what I needed because he said growing could change my situation.  The problem he saw was that I had an underbite and a misalignment of my jaw, not simply a misalignment of my teeth. He did not want to do anything that would be purposeless or detrimental to what would ultimately be advised as I was still growing. We agreed he would monitor my progress. In addition, he wanted to use a pallet expander on my upper jaw immediately (early 2012) and then use a retainer to hold my teeth in place while we waited for me to finish growing.

In May 2014, my orthodontist referred me to Dr. Gollehon for an initial consultation concerning potential jaw surgery and my need for wisdom teeth extraction. My parents and I watched a video about jaw surgery and met with Dr. Gollehon for an hour as he discussed what he thought I might need, established a general timetable for us and advised us about potential medical fees. At this point, he was uncertain as to whether I would require surgery on only one jaw or both.  He said that I would need to get my wisdom teeth removed at least one year prior to jaw surgery to allow for complete healing. Additionally, he indicated that jaw surgery needed to wait until I was fully grown and it was preferable to have when one was a young adult and not wait for major health issues to occur first. He said I did not have to have the surgery prior to college. So we were in a wait mode, but my parents felt one constructive step we could take at that time was to have my wisdom teeth extracted.

In August of 2014 I had my wisdom teeth removed by Dr. Gollehon.  I continued to see the orthodontist for regular monitoring of my growth and changes. In January 2015, my orthodontist determined it was time to talk about my family's plans for addressing my orthodontic issues. Now, I had to make a decision about whether I wanted to do the surgery or not because my choice would dictate what, if anything, the orthodontist did at that time. There were many factors I had to take into consideration. Ultimately, my parents determined that surgery was necessary to prevent health risks in the future such as potential TMJ (temporomandibular joint dysfunction, pain and compromised movement of the jaw joint and the surrounding muscles), misalignment of teeth causing unnatural wear on teeth and compromise to their health, and eating challenges as my molars did not meet. But, that choice lead to additional decisions. I had to decide when I would  have the surgery.  My options were to have surgery the summer before my senior year in high school,  one summer during college  or wait until I graduated college. We chose to do the surgery while I was still a high school student, when my parents could best care for me and I could take ample time to recover without losing out on career preparing opportunities. I wanted to avoid any schedule limitations in college which might hinder study abroad or internship opportunities.  Additionally, as I expected to go to an out-of-state college, timing later could be difficult, especially with the pre-surgery and post-surgery orthodonture.  When I intended to have surgery also impacted the orthodontist's schedule for preparing my teeth for surgery.  The orthodontist said I needed to allow 15 months for braces to move my teeth into the best position for surgery.  Ironically, pre-surgery orthodonture would make my teeth even more misaligned so that when surgery adjusted my jaw, my teeth would then be in alignment needing only minimal adjustments. The good news was that he could accomplish this pre-surgery effect with Invisalign if I wanted. If I had chose to do the surgery later then I would not want my braces now because I would not want to have even more severely misaligned teeth for such a long time.

We had to make some quick decisions in the early part of 2015 so that I could be ready for surgery in the summer of 2016. Invisalign has been just like having retainers and the worst part about them was taking them out to eat because I like to eat a lot. I appreciated the appearance of Invisilign over traditional braces. For 15 months I went regularly to the orthodontist to check my teeth and receive my new Invisalign trays. During this time, my anxiety about the jaw surgery was minimal. However, in April 2016, I had my first pre-surgery meeting with Dr. Gollehon and my anxiety about the surgery began. Although Dr Gollehon's reassuring and confident demeanor helped ease my nervousness, however, having the pre-surgery meeting meant it was really going to happen.

In my blog I am going to share the before, during, and after detailed experience of my jaw surgery. The most challenging time was the first week. After a week, the challenge became eating because my diet was limited and as they say you always want what you cannot have. The aim of this blog is for my shared experience to help relieve anxiety for those anticipating surgery, to aid by sharing advice, and to help people know what to expect if they are deciding whether to have the surgery.