Archive for the ‘surgery’ Category

Today I have my second surgery to remove the titanium mesh installed during the first surgery. The mesh was put in place to give the bone a space to grow into. It has since dehisced (uncovered itself) on both the buccal (cheek) and lingual (tongue) sides. The lingual dehiscence is the most pronounced. My body has regrown gum tissue on the underside of at least this part of the mesh. Here are photos before I go to get this removed today. The black stain on my teeth is due to the chlorhexidine gluconate mouth wash I’ve been using to keep things clean and sterile.


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WARNING: This particular post contains surgical photos, depicting blood, body tissues, bone, etc. If you are squeamish, don’t view this full article.


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Day 4 After Surgery

Photos from day 4 after surgery. The swelling is quite “remarkable”. There is also “poofyness” around my collar bone. Apparently this is a well-known effect of the INFUSE and the swelling takes about a week to go away.


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This is the second day post surgery. The swelling isn’t too bad, but they’ve been giving me 2 steroids via IV.

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After Surgery

Today I woke up after surgery. I spent most of yesterday asleep, drifting in and out of sleep. They’re been controlling the pain fairly well, although there is swelling. I have a scopolamine patch behind my right eye, cephalosporins on IV, dilaudid on IV as a PCA (with 10 minute self-administration interval), pepsid injection and some other anti-nausea drug. And some vicodine which I took in liquid form with breakfast.

This what I looked like when I woke up this morning around 730A.

This is the 60 mL syringe with flexible tubing that I’m using to feed myself.

This is me trying to hold my lips open so you can see my teeth. My lips are hard to control and the lower left lip and part of my chin are numb, because the inferior alveolar nerve (IAN) had to be removed to remove the ameloblastoma. It was pulled out using the “pull out” approach described by Dr. Marx in his book (see the earlier post that I’m holding the book up in).

I can feel a little bit of pressure in that part of my lip. Each side of the jaw has its own IAN, and they go through the bone and come out of the bones around the canine. There is a bit of cross over on each side, so the left innervates part of the right side and vice versa. Maybe that’s how I feel pressume? Another odd thing though is that earlier today the left lower lip and chin just below it was itching, but scratching did no good! A phantom itch? Weird.

I went back to sleep after this and work up around 1015A. This is what I had for my breakfast around 1030A this morning. I had a smooth (banana and strawberry I think), chicken broth and a glass of apple juice. All given to myself with the syringe with tubing, put to the back of the right side of my mouth (opposite). I tried to put my tongue over the left side as to not contaminate it. I rinse with peridex (chlorhexidine) after eating anyways.

And this is my IV in my left arm. It hurt going in first yesterday and there was some pinkness around the entry point, but is doesn’t bother me now.

And this is what the incision looks like with the gauss off. Doesn’t hurt just poofy.

This afternoon, I had a little blood spillage as well. This kinda freaked me out, but the nurse told me it wasn’t anything to worry about.

The braces I had on were wired shut. The front 4 teeth by default don’t have tabs. The ortho put K-hooks on the canines. Then the hooks and tab on the brackets were used to wire my jaw shut.

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Surgery Today

Today is surgery day. Arrive at the hospital 1.5 hours before, surgery at 1030a. Updates (and photos, unfortunately from my netbook since I left the camera on my desk at home) will follow.

The scopolamine patch that I put behind my ear (per my surgeon’s request) isn’t making me too loopy. Apparently it makes some people incredibly loopy. I’m a bit hungry, although strangely enough although I didn’t each much of a dinner later night, the hunger isn’t too bad. Neither the thirst. Before the midnight shutoff for all food and water, I had about 32 oz of water, just to make sure I didn’t dehydrate.

I tried to stay up a bit so I’d be a bit tired, but I’m actually a bit more chipper than I’d care to be.

Tried to clean my mouth as best as possible, without overdoing it, to reduce the bacterial load/plaque that could come back to infect the graft.

Here we go, trying not to think about the details.

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Today, my (former and I guess now current) orthodontist put braces back on my teeth. These will be on 3-6 months. This hurts the gums less than surgical arch board, helps preserve the alignment of the teeth and will let the surgeon get better closure. Also, the arch bars would have required a band on the #20, which would have been a conduit shuttling bacteria straight in to the bone graft.

Notice the back 2 molars are lacking a bracket (the #18 and #19). These will be removed with that part of the mandible, so they don’t need a bracket. That would probably just cause them to catch on the gum on the way out.

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