Tuesday, August 20, 2013

Pre Surgery Appointment with Dr. Gunson

Yesterday morning I had my Pre Surgery Appointment with Dr. Gunson. New surgical impressions for models were taken at the beginning of the appointment to compare with the progress models Dr. Way (my orthodontist) had taken 2 weeks ago. Normally getting impressions done is no big deal, I'm very used to getting them. (Impressions for braces, impressions for splint therapy, impressions for splint therapy again, impressions for braces again, impressions for surgery….. considering that for each of these, multiple impressions were taken I’ve had my fair share done). The impressions today however were slightly... annoying. First of all, they put this weird grainy feeling pasty stuff all over my teeth. (And for any pre surgery patients reading this, hopefully they put it only on your teeth because that stuff does NOT, and I repeat does not, taste good). Another thing that made them annoying was that the impression material is extra runny, so they had to really manipulate my lips to have them rest properly over the impression tray. Keep in mind that the assistant’s gloves are completely COVERED in the grainy paste, so that went just about everywhere on my face. Also I don’t know if I have special magic braces that make it hard to get impressions taken off of them, or if my buddy Amaris over at Dr. Way’s is just a pro (Amaris is the awesome Senior Technician who has been in charge of handling my orthodontia ), but these things would not come off. The first impression even got ruined because a big chunk was so stuck in my brackets that it just ripped right off!
After the impressions were done I got to try to clean myself up. That whole process took about 15 minutes alone because the paste was dried on my cheeks, chin, and lips and on and in my nose. Dried paste, in my nose...Boy was that fun to get out. It brought back memories of when I stuck a big wad of play dough up my nose when I was little and let it dry. Needless to say I never did that again.  
Then I had to use a metal pick to dig the impression material out of my braces. Again, I don't know if it is just my braces but that stuff was not going to come out without a fight.... Several and I mean like 15+, gum stabs and scratches later I got it out enough to rotate using a tooth brush and the pick. My spit was a lovely red color after that.
I should probably warn all you readers now; if you don’t like blood, and are squeamish you might want to look away. Be prepared for the post-surgery pictures because I’m not going to hold anything back!   
After I finished ripping the impression material out of my braces Dr. Gunson took a wax bite impression. To do this he heated the wax tray, wiggled my jaw around until it was in the "natural position", and had me bite down hard. We did that twice. Next we moved to the Pre Surgery pictures. They took pictures with the bite impression both in and out, so they could see the difference in how my jaw rotates to close. Pictures were taken from the front, both sides, and looking over the shoulder. After the pictures were all done, Dr. Gunson put little stickers on my face. I honestly don't really know what the stickers do, but they had a bump in the middle that I am assuming have some sort of electrode that he uses to track my face in scans. I wore those stickers while they took a facial scan. Good news, my joints look great!!!! YAY!
 After all of the medical history forms, records, impressions and images were taken we sat down with Dr. Gunson’s assistant to discuss Post Op care. She gave us the basic power point run down of what to expect; swelling, bruising, bleeding, nausea, sore throat, what have you….  She also went more into detail about how my parents are supposed to care for me, or should I say my mom :P Sorry dad, but you are not allowed near my face. The assistant also told me that some of the medications they give you during surgery can make it seem like you are PMSing.... so if I get irritated and grumpy for a few days, I'll just blame it on the medication ;) Goodbye filter that keeps me from saying everything that I am thinking.
 I finished the appointment reviewing the surgery plans in detail with Dr. Gunson. My lower jaw (Mandible) will be dislocated, cut, and moved down and out. He will do this to both sides of my mandible, resulting in the first two bone "fractures". Because the facial nerves that supply feeling to your lower lip and chin area exist the mandible so close to where the bone is cut, there is a greater chance of nerve damage in this area. So there’s a small chance that these are my last few days feeling my face, at least the same way that I do now. Awesome right?! After the lower jaw has been cut it will be moved to its new position and secured in place. Then Dr. Gunson will cut the upper jaw (Maxilla) above the gum line, and below the nose. A "Y" shaped cut will also be made on my hard palate separating my maxilla into three separate movable segments. All three segments will be positioned separately moving my maxilla up and out from its original position. At some point the mandible and maxilla are placed back into their original positions, and then once again moved to their new positions. After Dr. Gunson is positive that the bones are exactly where they need to be, he will put the final plates in to secure them into place. To re-position my mandible back into the temporomandibular joint he has to blindly feel the bone back into the socket. He performs three separate tests on the joint to make sure that it is properly fitted in the socket. There is however, a slight chance that these tests will fail and the joints will not be returned properly into the socket. This would cause the surgery to be a failure, resulting in improper alignment of the moved bones and the joint. Fingers and toes are crossed that this won't happen.
There are a few other complications that are likely to happen as well. Because the blood flow to the teeth is compromised, particularly the front upper and lower teeth, they can be left with discoloration. To correct this I would need to get a type of root canal where they bleach the tooth from the inside. Dr. Gunson told me that this isn't like your typical root canal, and that it doesn't hurt as badly as normal ones but.... I don't see how they could bleach the inside of your tooth without it hurting. As someone who has never even had a cavity the idea of a root canal sounds about as scary as this surgery! Yes I am aware that I am dramatic. But I don't like pain, any pain. 
Any who back to the surgery… So now you’ve heard the run down and what they are doing, and what I am expecting. I will attach some pictures that I hope give you visual learners (Hey you’re like me! Go visual learners) a better idea of what I am talking about. 















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