orthognathic surgery,janell smith,jaw surgery,lower jaw surgery,over bit,overjet,the quest for less character, character blog, braces, adult braces,mandibular advancement, jaw The quest for less character: 10/01/11

Oct 1, 2011

Pre-Op Event!

Yes!  It was an event.

Let me start by saying that I TOTALLY don't mind working with student doctors.  I mean, we all have to learn somewhere right?

The line up at Dr. T's office is this:  Dr. Tiwana is the director of the Maxo-Facial program at UTSW in Dallas. He will be doing the actually surgery with only assistance from a resident doctor. At his office, he has a resident doctor that assists him with everything, does a lot of the leg work in the office, like photos, measurements, impressions, etc.  He is Dr. Simpson. He is AWESOME!  So smart, and informative. He is still such a new doctor, and hasn't had the opportunity to lose his bedside manor yet. lol.  I love me some Dr. Simpson.

So yesterday I arrived at Dr. T's office for an 830 appt.  They got me right back and Dr. Simpson came in to start doing my work up. He took new photos of me to start. He is very comical about taking photos.  Very OCD. Every photo has to be at exactly the right angle, at exactly the right focus, in exactly the right light, and goodness don't even think about blinking.  He has to have the PERFECT photos, and not just one, but at least 3 of every shot. I told him if things didn't work out as a doctor he could always rely on his photo hobby for a living.

So he then started going over all the paperwork, the procedure, the risks, the possible outcomes etc.  This was the FIRST time I had heard ANYTHING about the possibility of doing the chin movement.  He called it something other than "genioplasty" because he said that if it was an "Osteotomy" it wouldn't raise the "cosmetic" flag with the insurance company. He said he didn't think I was going to need it, but just in case, he wanted me to consent to it prior to surgery.

He then started doing things like measuring the distance from my top lip to the top of my teeth when I smile, and the distance of my top lip from the bottom of my top teeth when I am not smiling.  Do you have ANY idea how hard it is to relax your face with your mouth open when someone is telling you NOT to smile? 
Not easy!  I felt like basset hound trying to keep my cheeks relaxed and saggy.

He then said, I'm going to call in Dr. X, (I'm calling him Dr. X because I can't remember his name), so I can show him how to do the facial symmetry analysis. The two of them then proceeded to analyze every angle, every contour, every measurement of my face. It was a bit awkward to have two men right in my face having a very robust conversation about my face.  LOL!  Just a bit surreal.

But, the end result was that it was for sure that my top jaw was perfect! Everything is lined up, not too gummy, not too little gummy, no cant... etc.

They did keep going back and forth about my chin though. Dr. Simpson would say, "I think the advancement will take care of the deficiency, but you could argue that there is a fold that indicates the need..."  and then he would say, "Well I can see how that might need to move a bit more forward," and then say, "I think that it will be fine."  *sigh*  I guess I will see if I wake up with a new chin or not when I have surgery. It IS after all, Dr. Tiwana's final decision.

I went and had X rays taken and was then back for the impressions.
Ahhhh,.  Those lovely dental impressions that we all love so much.  First, Dr. Simpson pulled out what looked like a caulking gun. I had never seen that before. He said he going to squeeze stuff all over my bottom teeth and then have me bite down. I was TOTALLY expecting this to be the nastiest thing ever, but surprisingly enough, there was no taste.  It was perfectly fine.  So I thought, I can do this, this is no big deal.

Next came out the impression trays and the icky, ucky impression plaster.  I know its not technically plaster but I'm forgetting what its really called. These impressions are a bit more tricky with braces on because the plaster gets caught on the brackets. It seemed as if Dr. S. put a little too much of the plaster on the tray because as he was holding it in place it was oozing out the back and onto the back of my tongue which made me start gagging.  SO EMBARRASSING! Dr. S said, "Let's get her a napkin!"  and then said, "Its okay if you need to drool, this is a Drool-Safe zone!"  and I thought, DROOL?!  I'm about to puke!  Is this a PUKE SAFE zone?  LOL.  I managed to breathe through it and get to the end, only to have the plaster not want to come off my brackets. I felt like my teeth were going to be ripped out one by one and he was trying to pry the molding off my teeth. So much so, that when they did finally get it off, it tore. So, Dr. Simpson said, I'm going to let Dr. X do this again and I need to run to the next room and start another workup.

I immediately thought, NO!  Don't leave me Dr. Simpson! But as quickly as I thought that he was gone.

So I was left with Dr. X and his very VERY green, timid, non-confident self. Don't get me wrong, he was very sweet, just not very experienced with what he was doing.

Mold #2... Stuck worse than the first one, and caused Dr. X to panic a little bit because he couldn't get it off. You can imagine what was going through my mind, as he's prying and pulling and he himself is panicking. Finally he was able to get it off, only to have it tear again.

So on to mold #3, and we're not even to my bottom teeth yet.  *sigh.  All I can do is just pray for patience and try to relax.  It had to be done and they had to get it right.

Try #3 worked, THANK YOU GOD!

The bottom took 2 tries and we were done.  Goodness sakes! When he was done, I had "plaster" all over my face, all over my shirt, and even down my neck.  It was CRAZY!  I have to say that I did have to giggle a little bit last night as I found some on the inside of my ear when I was brushing my teeth.  LOL..  Bless his heart!

About the time I thought I was done, Dr. T came in and mentioned that he wasn't happy with the angle on my xrays, so he wanted those redone. Um, did I mention my surgeon was a perfectionist?  HA!

Finally got the xrays done and I was off to Zale for hospital pre-op.

After about an hour wait, I got back with the Nurse to realize I didn't get any preop orders from Dr. T's office. Had to wait another half hour for her to get the orders faxed over so she could complete my preop testing.  Nothing exciting, urine, blood and vitals. Gave me my instructions, time to be there, and I was off.

Whew!  Glad that is behind me.  One more pre-op appt with my ortho on Thursay to get my surgical hooks placed on my wire.

As for today, I have lots of baking to do.  My oldest son is turning 20 on Tuesday and we are celebrating tomorrow with ginormous steaks and Italian cream cake!

Also have 2 cakes to makes for work.  Great way to pass the time.

I really thought these last 2 weeks would drag but it seems to not be the case.  This last week FLEW!

Our countdown is in single digits now so it will be here way before we know it.

Next stop.........