Bilateral saggital split ramus osteotomy and Lefort 1 maxillary advancement: a TR

[Dr. Send]

Reading the thread about givers and takers, I decided to step up and contribute this TR of sorts (although it can hardly be considered "quality content").

About six weeks ago I went under the knife to correct what they euphemistically call a "malocclusion," which is a nice way of saying that I had a hideous Beavis-like jaw which was slowly fucking up my teeth. Most people would probably say "ahh, fuck it," but being the high-roller I am I decided to go whole hog and drop 14 grand to have it corrected.

Here's a photo that demonstrates the extent of the problem. I've included a photo of Beavis for ease of comparison.


Originally the surgeon just wanted to move my upper jaw forward, but I told him to eat shit and went to a different surgeon who offered to move both jaws for an extra $4000. My kind of surgeon. (On an unrelated note, my orthodontist leaked some incriminating info about this guy - apparently he was building a house on a piece of beach front property out in the islands somewhere, so he could fly away in his private floatplane for some R and R, and it burned to the ground just before it was finished. So did he give up? No way! He just signed a check and started again from scratch. This is the same guy who was buying a house in the ritzy West Side and would only sign the deed if an engineer gave him the go-ahead to build a giant hottub on the roof.)

In a nutshell, the surgery involves sawing a big gash in my skull just above my gum line, moving the upper jaw forward a little and screwing it into place with some titanium plates; then cutting my lower jaw back around where the wisdom teeth would be and telescoping the bone backward a bit, then screwing that back into place. Here's a link if you don't get queasy easily: GAAAAAAAA! GROSS!

Anyway, to make a long story short, I was nervous as hell going into pre-op. I've never had surgery before (except my wisdom teeth, but that hardly counts), and previews for the movie Awake had been playing on TV all week before the surgery, opportunely coinciding with a couple of articles in the Globe about "anesthetic awareness" where you are awake and can feel everything but you can't move any of your muscles. Fuckin spooky shit. I sat down in the big 12 Monkeys-style chair and gulped down a cup full of random pills as someone poked an IV into my arm. Someone came in and told me that the last surgery was going long so it would be a while. As the random pills started to take effect (apparently something in there was supposed to "relax" me), I jonesed for a cheeseburger. After two or three hours of jonesing and being nervous, I was called into the OR. I thought the pre-op chair was creepy, but laying down in the table in the OR while a bunch of med students arranged big trays of knives and needles and scalpels and scissors pretty much took the cake.

Creepy:


The anesthesiologist came in and asked me how I was feeling. "Freaked out" was my reply. She offered something to help me relax. "Heck yes" was my reply. She hooked something up to the IV and I was rapidly overcome with a feeling of awesomeness. I was staring at the big lights on the ceiling and I noticed everything get kind of soft and wavy. I figured it was a good sign.

Then I woke up looking like this:


My jaw was clamped shut and my nose was stuffed up with dried blood boogers, which made it extremely hard to breathe, on top of which, the lower half of my face including the inside of my mouth was stone numb, and I couldn't control my tongue enough to get out of the way. Someone sitting beside me asked how I was doing, and I told her that ahh gouhlhgnd brhgehtlthe! ihles hahglrd dhe brhgehtlthe!!! She didn't seem to care. Someone came along and stuck a needle into my leg, and made a remark about how thick my skin was. After an hour or so of drifting in and out of consciousness, someone said I was ready to go upstairs, and wheeled me around for a while. We ended up in a scene out of ER, a tiny ward room full of patients with concerned-looking, teary-eyed family members clustered around their beds. People were coming and going; nurses were yelling instructions and taking my temperature; at one point I saw my family off in the distance. A group of people surrounded my bed and told me I had to switch beds - it turns out I was still on a gurney. I laboriously transferred myself to the new bed, then someone wheeled me back into the hallway.

"What's going on?"


I ended up in a big room with four beds but no other patients. Sweet. My family came in and admired my new face and took some celebratory pictures. Things were looking up. But then it happened: I felt a big piss coming on with rapidly increasing urgency. I mumbled to my mom and she rushed off to get the middle-aged ward nurse. "You have to pee?" she said; "I'll get the funnel."

She came back in with a plastic oil jug and instructed me to whip out my member and insert it into the opening. I motioned for everyone to get the hell out of my area, and did as I was told, but nothing was coming out. The pressure of the situation was getting to me. After a couple minutes of straining and trying to relax my CG muscles, the nurse came back in. "Are you done?" she asked. I mumbled something in reply. "Is your penis not in the funnel?" She came closer. I tried to tell her it was a simple case of stage fright - "ihlsh jhuslst shtleadghse fhrahldt!" She came closer. "Shtleadghse fhrahldt!!!!" She seemed to get the message, and after a couple more minutes I managed to open the floodgates and let it out like a glorious golden pressure valve.

I only used the funnel once more before I learned to walk to the bathroom by myself. The rest of the night was spent alternately getting up to pee (those saline drips are damn hydrating!), getting my vitals tested, and waking up in a claustrophobic panic thinking I was suffocating to death. Once the stomach tube came out, things got marginally better.

I left the next morning, and the fun was pretty much over. I traded in my morphine drip for a foul-tasting elixir of tylenol and codeine, along with a delicious banana-flavoured penicillin liquid.

On day three I got to shower and take off my bandages:

I wasn't really as pissed off as I look, it was just a lot of work every time I got out of bed to do anything, showering especially.

The difference from the before picture is clear in the profile:


By day six, the day I learned how to drink out of a glass, the Butthead resemblance had definitely taken precedence:


And now here I am six weeks later, super good-looking! Thanks, Mac Photobooth!:


That about wraps up this TR. My lower lip is still numb and I can't totally chew, but as of today I'm allowed to start lifting heavy things. The worst part about this surgery (obviously) is the timing: I'm missing out on some seriously fat, unstable Whistler snowpack. Soon, Dr. Send. Soon.

[MrZach]

Ummmm...whoa [/Beavis]

[Smacky]

Wow. Definitely a new breed of TR's. Good to hear everything went smoothly. Whenever I go under anesthesia, I always react badly; glad to hear that didn't happen to you.

[rideit]

Frozen wants your leftover meds.

[lifts4turns]

My orthodontist purposed a similar surgery. I told him to rot in hell. Your TR confirms that I made the right choice.


On a more serious note, I bet your glad its over, congratulations on surviving it and heres hoping you get lotsa chiclets with your new face.

[timvwcom]

I was going to make a comment earlier, but I was so astonished at your fortitude I just sat here with my mouth open!!!

(Also, revisiting and seeing that final pic again... good choice, there is something kinda "other worldly" about that photo. Cool, cool, cool...)

[Tourette Dude]

DUDE! You need to use this as a passport photo!!









Seriously though, surgeon did a great job! Good luck.

[DirkaDirkaJack]

that shit was so funny i had a lot of trouble reading due to the tears from crying. oh man, that write up was epic! best TR i have seen in a while

[DirkaDirkaJack]

...double post....

[skibuminwyo]

dude.... fuckin ouch!

[irul&ublo]

It would have been a lot easier just to have Chuck Norris punch you in the face.


BTW....I thinking not Butthead, but: