Good insurance is a must....

Got my surgery bill today and have never received such a thick envelope from the hospital.

Amount pending with Insurance: $56,462.80
Amount you owe: $300.00

Definatly gives me a reason not to complain about this HMO. Though its amazing what things cost in hospitals. While I don't fully understand the breakdown, they do like to charge for every little thing.

3 week update

Went to the doctor today and discovered that my jaws arn't opening as far as they should so its time to force the..er..excercise them.

Doc taped 8 depressors together. My wife is supposed to insert them into my mouth to stretch the jaws and I'm supposed to hold that position for 10 seconds. Then over the next week, she is supposed to gradually add another 8 depressors so that 16 can fit.

It also turns out that my bite is off, so the arch bars wont be coming off at 6 weeks and after I get the opening corrected I will be tightly banded for awhile. Thats gonna leave me out of work a little longer :( If it wasn't for the 40 minute commute, I am physically able to be back at work right now. The other thing keeping me from work is the fact that I work at a hotel and have a lot of guest interaction and answering of phones. My speech is improving, especially without the bands, but knowing that they are coming back would keep me from being able to do my duties.

Other then that, everything is going good. Been sleeping through the night, slept 10 hours last night and woke up feeling great! My stamina is just about back and swelling is 98% gone. My lips still feel a bit swollen and my chin is still covered with strange sensations.

With the bands off, been able to eat better foods. Ate a couple of bowls of Rice-A-Roni, Cheseburger Macroni, and a broken up Wendy's burger. Noodles slide down easy and hamburger is easy enough to break up with my tongue. Definatly not looking forward to pulling the blender back out.

Bands off

Just got back from my 2 week doctors apointment and he removed the rubber bands! Though he stressed that I should not chew and stay on the liquid diet. Said removing them was for therapy and that by talking I will work out the jaws.

Though I will admit, part of me is afraid to open them. It feels wierd! And due to my overbite, I have yet to get it open far enough to get a spoon through, something I shall work on later so more applesauce gets in my mouth and not on my shirt.

Next apointment is a week from today.

2 week update

The Good:

- Sleeping much better. Last night I slept for 10 hours! After all the napping I have been doing, this was a much needed nights rest.

- Pretty much off my pain meds. I use them occasionally at night to help me go to sleep.

- Been getting creative and able to suck down soft foods.

- Able to drink out of a cup! Found a method of putting the glass right under my overbite and 'slurping' the liquid in.

- Able to close my lips. This was a big feat! Helps with the slurping.

- Swelling just about gone.

- Stamina coming back. Feel like I could do anything.

- Am able to smile :)

- Drooling is just about gone!!!!!!!

The bad:

- Nose still numb to the touch

- Lips still swollen, feel like a fish.

- Chin numb to the touch and is constantly tingling. While the tingling is good, it does get annoying.

- A good bit of my food gets on my shirt. Bad for me, good for the dogs.

- There are times during the day where I have to stop and and take a deep breath..almost gasping. Just seems like I run out of breath at certain points during the day. Scares my wife and mother.

- Still have occasional drainage problems.

- Anxious to get back to real foods!

The ugly:

Well, not ugly just...ughhh. I am glad rubber bands were used instead of having my jaw wired, but lately its as if I can feel the rubber bands. My jaw just hangs there anoyingly. I know I can't move it and yet I want to. Its kind of like holding your arm up for an extended length of time, eventually it gets heavy and kind of hurts and you just have to put it down. I would say my jaw feels like that. I have moved my teeth just barely, but one time I accidentally moved them forward and it caused a sharp pain in my cheek. Thats something I wont be doing again.
----------

While I can't wait to get these arch bars and bands off, I have to say I would do the surgery again. Sleep is definatly much better and I am enjoying not having to use the CPAP. I have my next doctors apointment on Thursday and I will try to get pics of the before and after X-Rays to show the difference this surgery has made. Part of me is looking forward to the post-op sleep test so I can see what the results are.

The only concern I have is in Oxygen saturation. That was the only problem I had post-op and my out of breath moments make me wonder if thats completly gone.

Updated Pics

Kind of able to crack a smile now :)

Day 10 Doctors Visit

Went and saw the surgon today. He took an X-Ray to show me the difference in my airway, definatly looks impressive! He checked all the hardware and said everything seemed to be looking ok and set another apointment for next Thursday.

What I am upset about, however, is that the bands wont be coming off for another 2-4 weeks. He said he will make that decision next week. That means pure liquid diet for much longer then I had anticipated. Gone are the drams of spooning in mashed potatoes and the gooey insides of a taco and replaced is the fact of more straining liquid through my teeth.

Time to get creative :)

Other then that, everything is going great. I am off the antibiotics, I am definatly sleeping better, wife says snoring is about gone, and I havn't used the CPAP!!!!!!!!!!!

Days 8 & 9

Getting better sleep! Starting to sleep longer through the night and my naps are starting to feel better. Will be finished with my antibiotics tommorrow and will be getting off the pain meds soon.

Was having problems with a broke stitch so I went to my PCP on Wed who took the stitches out of my bottom lip. Might get a bit of a talking to by the surgeon for that one, but I feel it was the right thing to do. That broke stitch opened a sore every time I tried to clean my teeth and it bled a lot. It hasn't done that now that the stitch is out.

Also getting hungry and long for the day I can use a small spoon for soft chew foods! Having the teeth banded together feel wierd! Lately its like I am instinctively trying to open or close my mouth which puts a little pressure on the bands. If I understood the surgeon correctly, I have another week before they get cut, so its something thats gonna be driving me crazy for awhile. Gonna have to find some distractions.

Days 6 & 7

Day 6 went real well. Walked around the house and ate real good. But, I developed some coughing fits due to drainage and I think the wires are cutting my inner lips creating excess drainage. Due to that, Day 7 knocked me down. I was in bed all day, could barely get up and didn't eat much at all. Took my medicine, drank water, and swallowed down what little I could. Contacted the doctors office for advice.

Fortunatly, that has passed and I am feeling much better now.

Sleeping is till tough. I tend to sleep in 2-3 hour increments waking for a few moments before going back to sleep. There are times I awake with pain in the right side of my mouth, but most of the wakings are due to drainage and breathing. The CPAP machine has gotten me used to breathing through my nose, and with that blocked with drainage, I am finding it more difficult to breath through my mouth. Part of that is due to the wires and not being able to open my mouth.

Overall I think the swelling is going down and the strange sensations arn't as intense as they were a few days ago. My only concern is my nose as it appears one nostril is a lot smaller then the other one. Hopefully that will change when the swelling leaves.

Been playing around with moving my lips and can do a semi-smile. Though, the other day something felt wierd in my chin as I was doing it so don't know if I will continue that excercise.

Now for some updated pics. Need to shave, but not sure if I should or how it would do around the swelling.

Day 5

I seemed to hit a wall yesterday. Didn't feel like getting out of bed and struggled with fluid intake. Still not getting much sleep due to fear of drainage, its more of an odd and annoying sensation I am fighting to not try and blow my nose. Ultimatly its a lot of weird sensations. Tingling is a constant with the swelling, stitches feel wierd when I touch them with my tongue, my lips are so puffed up and cracked that its hard to keep them moist, and the few times I twitch or jerk due to something I can feel the pulling of the bands and wires.

Its hard to see regular food around the house because broth is getting old real fast. But I know that every moment I endure is a moment closer to full recovery. Right now I am counting down to 2 days. The 21st and 24th. The surgon gave my wife tools to pull the stitches next tuesday, something I can't wait to have done. The 24th is my first doctors apointment after the surgery, and to be honest I'm not sure what will happen, I am just hoping for good news.

I'm starting to get used to the taste of the pain medications and can now take them with less water. I also bought some liquid vitamins as I havn't been drinking as much Ensure as I should. To think, I thought the pills were bad, this stuff will take some getting used to.

Do I regret the surgery? I'll give a better answer in a couple of weeks, but I can say I don't know if I could go through cosmetic surgery. Like most of life, you can't come out with the finished product but must live through bumpy ride to get to your destination.

Day 4

Day 4 started off real good. Spent a lot of time sitting in front of the computer because I am tired of laying down. Ensure, Chicken Broth, Malt O meal, and water make up most of my diet. Though sprite tastes good from time to time.

Though snoring is popping back up. Kind of hard to doze during the day because I keep waking myself up afraid of the outcome of snoring as drainage is still an issue. Sleep didn't go very well last night. Layed down about 1am and woke up at 3:30 with some pain in my right side. Took some tylenol stuff then dreamt about being drugged up for the rest of the night. Been waking with a very dry mouth and trying to find the best way to avoid that.

Head home

Day 3 after the surgery I am allowed to go home. Go see the surgeon where he cleans my mouth and my nose then signs the release papers. First night home goes ok. Able to sleep in a 4 hour stint and a 2 hour stint, though dreams are very wierd. Probably shouldn't have had the tv on "legally blonde" when I was dozing.

Still having some coughing/drainage problems but it seems to be getting better. Able to eat though I must say that liquid medicine really tastes aweful. Fortunatly, I had had my wife with me and she has been a real lifesaver. Unfortunatly, she goes back to work tommorrow.

I am typing these last few posts while still groggy, so I might have to do a revision post to fill in many details I am probably missing.

Moved to my own room

Morning after spending time in the ICU, they decided to move me to my room. One word of advice, if you have a semi-private room then you need to ask for someone who doesn't snore and talk in their sleep! Sure didn't help recovery.

Still had some breathing problems, but that is easily taken care of with the face mask. Nasal bandage removed and the nurses came by much less then in ICU. Had to start taking care of myslef more often. It is very hard to call a nurse when you can't speak.

Drinking sprite and water and able to get some broth down. Had a little sprite/lime jellow "smoothie" which really felt good on the dry throat. Fortunatly, have no problem with one aspect of going to the restroom. Still having difficulty sleeping and having some coughing/drainage problems.

Day of Surgery

Reported to the hospital at 6:00 am where they did all the IV and connections. Roled me into the OR by 7:30. I remember scooting over onto the OR table and next thing I know they are tyring to wake me up in the recovery room. I was having trouble with oxygen saturation and they fitted a bi-pap machine to help me breath. Was real groggy and don't remember much. They were going to send me to a room but with the saturation problem, they decided to send me to ICU instead.

One fun thing about ICU is you can't sleep! But the nurses are awesome! Take care of every need, though the face mask they put on me was cold!! The face mask replaced the bi-pap and not only helped me to breath but also provided moisture. The cold air was probably good on the swelling, but when it hit the wires and arch bars it felt like I had popsicles in my mouth.

Pre-Op

Currently in the middle of my Pre-Op day. Finished with the surgeon and waiting for the next set of apointments.

Surgeon took molds of my mouth and described the procedure in greater detail. The surgery will take 7 hours. He will be moving my jaws forward 8mm and my chin forward 10mm which will result in a 18mm increase of my airway, which is currently 3mm.

I was shown before and after X-Rays of a previous patient, and the difference was awesome! Definatly looking forward to getting this thing over with and hopefully to be off the CPAP machine.

Before Pictures

Its time to grace..er..scare you with my pictures :)

What is MMA?

Maxillomandibular Advancement, also called Bi-Max, can be performed to alleviate Obstructive Sleep Apnea.

Other Articles:

Chest Journal on MMA and results

American Sleep Apnea Association on Surgery

Blog Up

I will be documenting the process of my MMA surgery and recovery here. Pre-Op is set for February 6th with the surgery set for February 14th (wife loved that one!).

The procedure will be performed at Scott and White Hospital by Dr Read.

Check back for updates.