2 weeks and change

Friends, lovers, and the disabled!

So, I am done with my 2 week follow-up. They think I'm looking great (I argued that a bit) and said the numbness isn't unusual and is to be expected. Basically, I'll be numb for at least 6 months to a year, possibly forever in a few spots. I was expecting most of it to heal quickly and then have a few trouble spots long-term, but evidently the healing is more linear than I expected.

My swelling is still going down, the edema is most noticeable in my lips and nose still, but it will resolve in a couple more weeks they expect.

My bite and lower jaw were starting to pull back a bit, so they gave me some bands I'm supposed to wear to help solidify that whole deal. It was very minor, like 1mm or so, but I could tell the difference and I was worried about it so I asked for something. They said they pretty much give bands to everyone, that's why they keep the huge metal brackets on.

Speaking of which, I'll be getting the brackets off in 4 weeks, which will be a very good day (despite the painful removal process). So, Oct 2nd is the day to look forward to, I suppose. The metal wires cut my mouth up quite a bit, so as the numbness wears off that'll only get worse.

I have been progressing in terms of what I can eat these days--I was able to slowly down pop-tarts as well as a microwave pizza. I might try real pizza again soon. I also did a TV dinner, Salisbury steak, which was a bit tough but edible. I'm starting to think hamburger meat might work for me, since it's so crumbly-wumbly.

Anyway, here are some pictures from this morning, they are selfies in the bathroom, something I have fastidiously avoided in the past. However, my spouse's inability to accompany me to California this time left me wanting in terms of suitable photographers.

Food porn? Hardly, that's Dinty Moore Beef Stew blended into a pasty-soupy mix. It was palatable I suppose, but not ideal. I also tried blending a 5-layer burrito from Taco Bell but the texture really got to me.

1.5 Weeks Out

SORRRYYYYYY.....


I haven't posted in an age, I know. I have been rather listless, so gathering the energy to post something has been beyond my grasp. However, at the behest of my father, who always knows best, I'll give you all (and future Alex (hi future Alex!)) something to read so you can be up-to-date.

Firstly, I'm off my pain meds at this point. The tough part hasn't been the pain, I almost wish it was sometimes. The annoying part so far is the numbness, inability to eat, and obtrusiveness of the wires and brackets in my mouth.

The swelling has gone down in a lot of areas, but the numbness has largely remains. It affects my right side much more than my left side. My lower lip completely numb, my upper lip less so.

My bite isn't perfect, if I am lying down for a while I start to get an underbite, and it slightly pulls right. These are things they'll be adjusting with bands in the coming weeks I'm sure.

Eating is tedious. Lots of liquids, very few solids. However, I have found a few solids I can ingest, such as String Cheese or really soggy vegetables. I just mush them up and suck them while my tongue pushes the food against the roof of my mouth. I'm starting to explore additional options in the quest to not go crazy.

Here's a pic from a few days ago, I accidentally deleted the forward facing one (though it's still on Alia's phone), but here's profile.

And here are photos from today. My allergies are really acting up today, which has led to congestion and red-eyes, but c'est le vie.

Picture Dump! 

Don't be distressed that I look so miserable in these pics---even though I am a bit, I am also trying to not smile or anything in pictures for consistency.

Right before the surgery, app. 4:40am Tuesday

That evening, obviously post surgery. 

Some mouth shots....honestly I'm sparing you the worst views.

Thursday evening

Friday Morning

First pics

 I had that head wrap for the first day after surgery....

Got it removed the 2nd day, still swollen lips!

Surgery Day(s)!

Ok, so I'm back from the hospital, but I'll start at the beginning.

We had a show time of 500am Tuesday, the 20th. We got there on time, no issues, over night bags packed and whatnot. They dressed me in gowns and got all my crap in place. The first tech failed to stick me with an IV twice, they then got another, better tech, who failed once and then got me the 4th time. So, that wasn't a great start, but I figured I was going to be going through a lot more painful stuff later so I could probably handle a few IV sticks.

Once that was finally done, we played the waiting game (and hungry hungry hippos) for a while until Alia and I parted paths and they took me to the OR waiting area. There was a bit of a delay getting me started, I guess my docs had an elephant walk inspection thing that the randomly selected room of the day has to go through right before surgery. Either way, it wasn't a huge deal. The docs were all very nice and I had a good time even though it took a bit extra to get going. I vaguely remember them carting me into the OR and a few of those things, but that's about the time my memory went blank.

[By the way, not really part of the narrative but I can't describe to you how much that frustrates me--the inability to not remember what happened. I had a pretty decent memory and I rely on it a lot, so to know that I was cogent and talkative but I had no idea what happened. What's worse is that I hardly remember anything the rest of the day, even after surgery. Oh well.]

This would be a good time for Alia to describe what happened during surgery from her perspective:

"They took Alex to anesthesia around 6:00 am and showed me to the operation waiting room. It was completely empty. I took a seat and waited for an hour. Then a few more hours. After four or five hours went by I was beginning to feel restless, to say the least. People began filtering in and out; evidently Alex's procedure was much longer than many of the operations taking place that day. At 8 hours I was downright nervous. Finally, around 3:00 pm (around 9 hours later), two of the surgeons appeared and called my name. The informed me that the operation was a success and that Alex was resting now. They explained that he lost a lot of blood (mostly out his nose) but didn't require a transfusion. He had elastic bands holding his teeth together but they didn't wire his jaw shut. I would notice metal plating on his upper and lower gums, but those would be removed later. They were pleased that they were able to shift the bones a full 1 cm forward, and cautioned me that the aesthetic difference would be very noticeable, but they thought it would be 'flattering'. He also had stitches on both sides of his face where the incisions were made. I thanked them and anxiously waited for another hour until they wheeled my droopy/drooly hubby by and into the ICU (The IMCU was full). The post-op edema was evident, but what really blew me away was the size of his lips! They were huge! Ah well--all the better to kiss me with (once he became coherent enough to give consent, of course). "

Yeah, so I don't remember a ton of what happened in the ICU. I was there pretty much all night I think, I mostly just remember vomiting blood fairly often. That was definitely the worst part of this entire thing--I had quite a bit of blood all over my sinuses and my throat and nose and all sorts of other cavities I didn't know I possessed. So, puking that out was productive but very painful and unpleasant. I slept off and on that night, while Alia slept at the hotel. Later, I was moved to the intermediate ICU and that's where I stayed for the rest of time. Honestly, I was just bored at this point. I starting drinking fluids for the first time for breakfast Wednesday morning, apple and grape juice and some chicken broth. I had the same stuff but beef broth for lunch. I was anxious to leave by that morning but we had a lot of delays getting out with just stuff getting lost in the mess of stuff, ie waiting for the Oral docs to give the go ahead for me to leave, but then my ICU nurses thinking I needed to do more things. Also, all my meds took a while and that was what we were waiting on for a long time.

My heart rate was also fairly high for a while, inexplicably, but I think I'm fine at this point. But, I know that was a concern for a bit for the nurses.

Around 5pm Wednesday, I was officially discharged. While I have had some xrays after the operation, I don't have a personal copy yet (though I'll ask for them on Friday) and I can show you all the screws and plates then.

In sum, the first 12 hrs after the operation have been the worst. After I got most of the blood out of the system, the nausea went way down and I definitely improved. Day 2 was really mostly boring, Alia and I just had to sit around forever. Now I've been back at the hotel, drinking juices, etc. I can't open my mouth at all, I have the rubber bands holding my teeth together, so I can't swallow anything. That makes pain meds a huge pain (pun!) cause we have to grind them up and drink them, which is wholly an unpleasant experience. To be honest, the pain hasn't been THAT bad. Though my face aches, it isn't too severe as long as I don't put any pressure on it. Though, the oddest things, like twisting my head or leaning it down can hurt quite a bit until it gets settled. Yawning also hurts, when my body tries to do it.

I'll post pictures after I decide if I feel like showing you all how gross I look right now. Vanity of vanities, all is vanity.

Last night of food

So. Tonight is my last night of freedom. I'm not going to lie, I've eaten a lot of junk food the last week or so, bit of gluttony, in preparation of the liquids only diet for the next month or two.

I have a show time of 5am at the hospital. I'll get prepped, sit around, interviewed, all that jazz. Then, I'll start getting the fun drug cocktail the nice anesthetists. After that I'll pretty much be out of it for the rest of the day.

The surgery will probably take 4-6 hours. Poor Alia will have to just sit around for a while--hopefully she'll find some fun things to do. School starts up soon so maybe she can have a blast getting ready for that!

I have to stay the night tomorrow at the hospital. I don't know how much freedom I'll have to write or whatnot. I hope there's wifi for Alia, and if I'm conscious maybe I'll be online myself doing interwebs things.

Alia will post updates for me, maybe some pictures. I'll look gross, just be ready for that.

Dorky video of MMA

If you want a very basic overview of an MMA procedure, here you go! The lady looks like a fish pre-op, so I guess it's a big improvement for her!

https://www.youtube.com/watch?v=5RLUYeY3Hlo

Do Alexs dream of sleepless sheep?

Here's how it all began:

Many years ago, there was a man (my father) and a woman (my mother) and they had me. Fast forward to later, and my father had pretty severe Obstructive Sleep Apnea (OSA). Apnea, meaning without oxygen/breathing, along with hypopnea, or low oxygen (I shouldn't have to explain this, you should know these etymological prefixes), are events that can occur while sleeping. Your body, for a period of time, will have reduced to no oxygen flow to your brain and other organs.

Now, sleep is pretty important, and so is breathing, and neither of those things happen as much as they should when you have OSA. Your body actually kinda spazzes out when you have an event, and releases hormones and stuff to arouse (hey hey!) you, similar to flight and fight mechanisms. So, if sleep was like the movie Inception (the first of many Inception analogies I'm sure), every time you start to get to a lower stage of sleep and have an event, your body wakes up. I don't usually become conscious, but my body is no longer sleeping for a moment, if that makes sense. So, what they call sleep architecture, or the percentages of sleep in different stages required for productive sleep time, gets destroyed like Tokyo with Godzilla.

Now, that's the problem. You may ask yourself ('self??'), what is to be done? Well, the best way in terms of preventing any episodes is to otomy your trachea, straight up hole in the throat. But, that isn't really a common response, unless its seriously a life-threatening, you are dying type of thing.

Another first response for most people is to stop being super fat. Most patients with OSA are obese and they have such a preponderance of soft tissue that they stop breathing. Losing weight is a very effective form of treatment for the obese. Fortunately, that isn't my problem.

Most people just use a CPAP, aka a continuous positive air pressure device. That is a mask that basically blows room air down your nose while you sleep. It creates a vortex in your airway that prevents it from collapsing and voila, you breath better. However, it sucks, figuratively. The mask is really irritating, you have to wear it for the rest of your life, e v e r y   s i n g l e   n i g h t. Total turn on, huh?

One solution I was using for a while was an oral appliance that pulls your lower jaw forward. That was technically effective for me, which is why I determined the surgery would be a good fit. It's a clear plastic retainer that you put over both lower and upper teeth with bands that pull the lower teeth forward, and it hurt like the dickens, reminiscent of charles. I'd wake up with loose teeth and a messed up bite, and it just didn't seem like a good permanent treatment.

However, it showed me that opening my airway a bit was effective in stopping my OSA. So, the next step was just to make it permanent, and that was through an MMA (maxillomandibular advancement).

Surgery Wha?

So, here's the story from A(lex) to Z(zzzs). Those of you who don't know, which is probably most people, I'm getting a major surgery Tuesday, 20 Aug. That's in two days. I've been looking and considering it for quite some time and I've seen other blogs that have helped me prepare for everything. So, I figured I could make a blog that would help other people, as well as possibly keep me sane in the coming weeks of insanity.

The procedure is called a maxillomandibular advancement, formerly known as a bi-max (they used to call the mandible the lower maxilla, hence bi, or two maxillas), occasionally known as orthognathic surgery. They are going to cut my upper and lower jaw bones, behind my teeth and under my nose, and pull both forward. The goal is a 1 cm, though if you can get somewhere about 7 mm that usually is enough. I'll go into more gruesome detail later, but that is the gist.

Am I nervous? Yeah, of course, absolutely. But, I know it is a good decision for me. I'll talk about them later but I think it is the best long term solution for me.

So, this is my outlet and warning and forewarning for the poor fools getting this procedure in the future. Also, a chance to let my friends and family know whats up with me, especially since it will alter my face and appearance and they might think I had a Tara Reid-esque plastic surgery mishap. I'll be swollen for months, I'll be drinking liquids for months, I'll be bleeding and bruised and sleeping upright and all sorts of garbage for months. But, hopefully, I'll be sleeping through some of it.