The Biltmore Surgical Center requested that I check-in at 7:00 AM even though my surgery wouldn’t take place until 9:00 AM. They had me sign a bunch of consent forms and that’s when I noticed everything said 1-piece LeFort I instead of 3-piece LeFort I. They double-checked with Dr. Day and updated the consent forms before I signed them. My fiancé called me right before the nurse came to get me, so I got to wish him good luck on his rocket launch one last time. My mom and I were taken from the waiting area to a small examination room where the nurse took my weight and temperature. Then we walked over to their “pre-op” area, which was a large circular room with a bunch of curtains that sectioned off hospital beds. I changed into a hospital gown, put a blue hairnet on over my hair, and got under the covers. I hate needles, so the nurse who put in my IV distracted me by talking about how her son is getting married in the Spring, just like me. She put an identification sticker on my overnight bag and asked me if there was anything valuable inside (like an iPad or Kindle) before having me sign a patient belongings inventory form. After that, it was just a waiting game because I still had another hour before my surgery.
During that time, my jaw surgeon, Dr. Day, stopped by to say hello. Apparently he had another surgery right before mine. I wondered how he was going to finish in time, but he said he was only going to be operating on their lower jaw, so it would be quick. He joked, “I’ll be all warmed up for you,” which I thought was funny. After he left, the nurse hooked me up to a heart monitor and blood pressure cuff. I honestly thought I wasn’t that nervous, so I was surprised to hear how fast my heart was beating.
The anesthesiologist finally came over and asked me a few questions about my medical history. He also asked me which nostril I could breathe out of better. I told him my left nostril was stuffed up but I could breathe out of my right nostril pretty well. I didn’t know if that meant he would put the breathing tube down the right or left side. He injected something into my IV that was supposed to “calm me down” and then they wheeled me out of the pre-op area. I remember saying “I feel drunk” as they wheeled me down the hallway. The last thing I remember is them asking me to scootch over from the gurney to the operating table and talking about my succulents (we are growing a bunch of succulents in our backyard to use as our wedding centerpieces). I don’t remember anything else – no mask or counting backwards.
I also don’t remember waking up from the anesthesia. My sister said when I woke up I was mostly just concerned about my fake eyelashes (go figure). I wear individual lashes that I apply with clear glue. They usually last about a week. I debated taking them off before the surgery, but the woman at my pre-op appointment said it was fine to leave them on. I don’t think she realized they weren’t the permanent kind, and apparently they taped down my eyelids during the surgery, so when they peeled off the tape most of my fake eyelashes went with it! Another funny anesthesia story is I kept trying to use sign language. I took four semesters in college, but I don’t really remember much of it other than fingerspelling. My sister said I was fingerspelling to the nurses and they had to keep telling me they didn’t know how to sign, haha.
Looking back, my two biggest regrets were not eating better yesterday (I felt super weak because I didn’t have many calories in me), and I wish I slept more than two hours the night before (I didn’t realize the recovery area would be so LOUD and bright during the day – it was impossible to sleep). I also wish I had known that my throat and the inside of my mouth would be swollen. Everyone’s blogs always focus on the outside swelling, not the inside swelling. At one point, I had a mini-panic attack because I couldn’t swallow. I think one of the reasons I was having trouble swallowing (besides the fact that I had a breathing tube down my throat for 2 hours) was that I was struggling to swallow large blood clots; I just didn’t know it at the time. My day nurse (Nurse Vicky) had to calm me down and kept telling me my swollen throat was normal. She added a steroid (Decadron) to my IV line to help with the swelling. But I didn’t stop worrying until my night nurse (Nurse Nancy) called it a “sore throat.” For some reason, something clicked and I realized: “yeah, this is just like having a bad sore throat” and I stopped worrying about it after that.
Dr. Day came by at some point and said he did me a “favor” during surgery – he sawed down the bones that were growing out of my top gums. I told my sister to show him the pointy bone growing out of her bottom jaw and he called us “bone growers.” He told her to cancel her appointment and come see him instead. He also asked if I got his email – he took a picture of my profile right after they took the breathing tube out and sent it to me. The email said: “I’m very pleased with how things went.”
After that, I mostly slept on and off with ice packs covering my face. They put one around my head/chin (called a “jaw bra”) and another over my eyes/nose. Whoever designed them is an idiot because they have sharp edges and the eye pack doesn’t really reach your upper cheeks, which is the part of your face that actually needs ice. At first, when Nurse Vicky wrapped a new jaw bra around me, it hurt SO bad on my right side because I have a big bruise there. But now I realize you have to pull it tight because after you stick down the Velcro, it loosens up. Maybe my fiancé can design something better when he gets home. He’s an aerospace engineer so he’s basically MacGyver.
Oh yeah, remember how I was worried I would start crying tears of pride if I watched my fiancé’s rocket launch? (Crying is really bad after you just had jaw surgery). Well, I ended up missing the launch because the Wi-Fi in the hospital wasn’t that great. My mom and sister had the NASA live stream pulled up on their iPhones before 4:45 PM, but I guess it skipped ahead to the rocket already flying in space. I was so upset I missed it that I started crying out of anger, which was really dumb. I think the anesthesia was making me more emotional than normal.
The girl next to me was throwing up like crazy and I remember feeling proud of myself for not getting nauseous. I asked Nurse Vicky if she could take me to the bathroom. She said the night nurse was coming on soon, so I would have to wait for her to take me. I sat up in bed for the first time, right as Nurse Nancy walked in and started to introduce herself, and I think sitting up triggered my nausea because all of a sudden I was projectile vomiting blood all over my lap. It was probably scarier for my mom and sister than it was for me because I already knew from my blog research that throwing up blood was normal (they have a suction tube running during surgery, but they can’t get everything). Plus, it felt SOOO good to get all of that blood out of my stomach! I ended up throwing up again after going to the restroom for the second time – I threw up into a blue bag while leaning over the bathroom sink and the blood that came up was much more coagulated. Nurse Nancy cheered me on as I struggled to cough up a massive blood clot. I didn’t see it, but she said it was huge.
We asked Nurse Nancy when my mom and sister had to leave. I was under the impression they would be kicked out at 8:00 PM, but she said they could stay as long as they liked. She gave me Propofol, but I was having trouble falling asleep because restless legs syndrome kicked in, so my mom massaged my legs to help me relax. The Propofol started to work just as my mom and sister were leaving and I FINALLY fell asleep. The only problem was I woke up SOOO many times to pee. I swear it was like once every hour and a half. Nurse Nancy said it was because the IV drip was putting so much saline through me, and it was a good thing too because I was flushing the anesthesia out of my system. I believe her because my urine smelled AWFUL… like medicine.
At 3:30 AM I woke up again because I had to pee and that’s when we realized my call button had been unplugged the whole time! Nurse Nancy felt really bad about that. She said, “I was wondering why you just kept yelling for me instead of using your call button.” I drank cranberry juice for the first time through a syringe. She wanted me to try to drink it out of a cup and I was like “no way that is happening, my bottom lip is completely numb.” After she left, I started to feel around my face with my fingers for the first time. I had sensation on my nose, the area under my eyes, and my upper lip, but my bottom lip and the middle of my chin were totally numb. I couldn’t tell if the sides of my face were numb because the jaw bra was in the way. I was really surprised I could feel that much.
Nurse Nancy ended up disconnecting my saline drip so I wouldn’t keep waking up to pee. I asked her to write down my medications – I’m not sure why. According to her, I took antibiotics at 4:00 PM and midnight, and steroids at 5:00 PM and 1:00 AM. I brought a bunch of supplies in my overnight bag, but I didn’t even go into it once, although at one point I considered getting out my eye mask to block the light, but I remember being too tired to try.
The following paragraphs are from the perspective of my caregiver (my mom):
The morning of Mckenzie’s procedure seemed to go very swiftly, but the rest of the day felt eons long. A nursing assistant took me back to the PACU (post-anesthesia care unit) after her surgery, and she was pretty out of it, although apparently they had her back there for an hour after Dr. Day had finished. It took most of the rest of the day for her to seem like herself again (she was quite groggy due to the anesthesia). I felt like she really only “came to” an hour or two before we left at 8:00 PM. She was well tended by the staff, and was her very sweet, unassertive, undemanding self, even amidst obvious discomfort and anxiousness. She didn’t ask for much of anything, and didn’t complain either, especially compared to some of the other patients around us, behind the other curtains. A number of them seemed to be Dr. Day’s other oral surgery patients.
It is extremely hard to see a loved one suffering, especially when you feel powerless to help, so I attempted to be as attentive as possible to her needs, even though sometimes it was hard to tell what she was trying to convey (not that she couldn’t speak – but the anesthesia had her a bit loopy). I was so anxious about how she was feeling that I literally left her side for a total of MAYBE five minutes the entire time, and that was just to go to the restroom. If the staff wasn’t immediately available for, say, lifting her bed up a bit, or assisting her to the ladies room, I would stand outside her curtained-off area to grab their attention. It was wonderful that her younger sibling, Shannon, was able to work only half-day and join us (she also brought me a little something to eat for lunch). It helped to have another caregiver there for psychological support, even though both of us felt pretty useless. Shannon says the only thing she feels she did the whole time was put on Mckenzie’s socks, and hand her a notebook and Sharpie. I felt the same. I’m certainly not a medical professional, so therefore about the only thing I could contribute was braiding her long blonde hair to get it out of the way, massaging her legs and feet when she felt like she had restless legs, and handing her the suction device when it got lost in her covers.
Honestly, if I could give one bit of advice to caregivers, I would suggesting reading a bunch of blogs like this one, well ahead of time. Naturally, everyone’s situation isn’t identical, but the basics are the same, and there are some helpful tips out there.
Below are the Day 0 pictures that my sister took. You can see how my ice packs pretty much covered my entire face. I probably didn’t need the nose guard because my bloody noses were so far back that all of the blood was draining into my stomach, not out my nose. In the last picture, I was returning to my bed after being taken to the bathroom in a wheelchair.