Appointment with surgeon

Surgery is one week from today! Eeeek!

I had my pre-op appointment with my surgeon yesterday and things didn't go exactly as I expected. I assumed that he would just review my bite again, show me some models of my teeth, give me his surgical plan, and answer any last questions. However, he started off by saying that he's been contemplating my case all week and trying to decide whether I need double jaw surgery or whether I can get away with just the upper jaw, and he wanted to wait until he could measure my bite again before making a final decision. The reason he's hesitant to do the lower jaw is because I had previous jaw joint issues and having lower jaw surgery can increase the risk of reactivating the degenerative joint disease. It also increases the risk of permanent numbness so it's better to avoid it if possible.

First he started off by measuring my overjet and comparing this to the same measurement taken from the models and x-ray, all the while with a perplexed look on his face (this is never a good thing!). After a couple of minutes he explained that he was getting three different numbers and that he'd like to take another x-ray, making sure my lower jaw was as far back as possible for it. He said it's crucial that these measurements are taken with my jaw in its "relaxed" position because this is the most natural position for the jaw joints and it's also the position that my jaw will be in during surgery, without conscious posturing or muscle tension. I hope my head doesn't begin to glow in the dark from all these x-rays!

After the x-ray was printed my surgeon spent about 10 minutes in silence tracing features of the x-ray onto tracing paper, cutting the paper into sections, and positioning them relative to each other. This was rather awkward, but extremely fascinating! He was so focussed that I could almost hear the wheels whirring in his head. He then took a new wax bite, several times to make sure it was accurate, and determined that the mounted models he had were a bit "off" and that he wanted to fix and remount them. He said it's very important to have accurate models because they're used to make the splint.

So, after all this, his conclusion was most likely double jaw surgery plus genioplasty, but he's going to remount the models, talk to my orthodontist about the treatment plan, and get me to come back either tomorrow or Friday afternoon for his final decision and more details. I'm not sure if I'm more nervous now or less! I was surprised to hear that the models weren't perfect, but it was reassuring to see how accurate he wants everything to be (it looked to me like there was only about 1/2 mm difference between the new x-ray and the original!) and how much thought he's putting into my case. I guess it's better to catch inconsistencies now rather than later in the OR!

To finish off the meeting my surgeon went over what to expect in the first couple of weeks after surgery, most of which I already knew from reading blogs (blogs are awesome!). One piece of advice he gave which I've never heard anyone else mention is to carry around a small pair of scissors for the first couple of weeks after surgery, just in case I throw up and I have to quickly cut the bands off to prevent choking. Hopefully this never happens! He said most people have no problems if they throw up, they just lean forward and let it leak out through their teeth since it's all liquid. Eew.

Well, I should learn more details soon and will post again when that happens. Hopefully I'm not boring anyone with all these details! I just want to keep a record of everything that happens so that I don't forget anything!