Pre-op Appointment with my awesome surgeon

Dear Mom;

Sorry I haven't written lately. Things have been going really well. I’m trying start tying up all my loose-ends at work in preparation for the 6 ½ weeks off I’ll be taking…….IN LESS THAN 2 WEEKS!!!!

I was shocked to hear about the tornado yous guys had, and was relieved to hear that nobody was seriously injured. I bet it especially scared the be-jeebas out of Jane, since it hit so close to her house.

There really wasn’t that much to report up until recently, but yesterday was doublely-wubbuly eventful, what with my pre-op appointment with Dr KL and my teeth cleaning at Dr N’s! …and since you’re my mom, I knew you'd want to know all the gorey details, so all I gotta say is “watch what you wish for”!

So, I got up early yesterday (Thursday), shaved off my moustache and beard, (which sort-of disguises my "chin deficit".....awwww...) and left at 7, in order to make my 8 a.m. pre-op appointment with Dr KL. in Palo Alto. The whole experience at Dr KL's office is fantastic. The office is a beautiful facility, and the staff (Linda the receptionist, Juanita, the lady who handles all the insurance stuff, and Daisy the technician) are just the best. You would love them. They are all as nice as can be and very well-organized….but first things first:
After signing a couple of consent forms and giving Linda the biggest check I’ve ever written (gulk!), Daisy led me in to the room where I got a panoramic x-ray and some other type of x-ray, using a different machine. Then she took molds of my teeth. First the lower and then the upper. After all that stuff was done, Dr KL came in looking chipper and ready to explain everything, and answer my barrage of questions.
For starters, he brought in his "display skull" to show me exactly what he will be doing with my upper jaw, and lower jaw. Wow! The reality of it all is finally starting to set in.
He started by telling me that the anesthesiologist will be calling me the night before the surgery (not sure why, but great!). Since my surgery is at 7:30 in the morning, I have to get there at 5:30, which means Paulie and I will have to leave SF by 4:30 and get up at 3:45. (Yawn!)
As usual, no food before midnight. Got that.
The first thing he’ll do in the 5+ hour surgery is attach the arch bars, (but I think they are positioned higher than these on the link) and he explained how they will be attached to my teeth with wire by weaving the wire through my teeth, as opposed to using screws in my jaw to secure them)
After the arch bars are in place, and my teeth are tightly clamped together, he will “liberate (i.e. break-out the “buzz-saw” and “go-to-town” on) my upper and lower jaw, together from where they are. The upper jaw will be cut free first (sorry no video…I asked!) and then the lower jaw will be cut (i.e. “sliced” at an angle, in order for the bone to be able to fuse together). There will be a small incision on the (outside) lower part of either cheek in order for the good doc to sink a couple of screws in my lower jaw at just the right angle. Those will be the only external incisions, and the scars will end up being virtually unnoticable. Cool beans!
He will be doing what is technically called a “counter-clockwise rotation” moving my upper jaw forward 8-9 millimeters and the lower jaw about 12, meaning he’ll drop the back down just a little bit, to enable the lower teeth to move forward a few millimeters farther than the upper.
Then comes the genioglossus. I asked him why he usually chooses the genioglossus over the genioplasty and he said there are different reasons for doing each. He said he would determine which of the 2 procedures is best for me when he is in there, getting a better look. I trust he will do the right thing!

I mentioned to him that first and foremost, I want to be able to breathe better when I sleep, but I hope that asthetically, I will end up with a nice strong chin. He assured me I will be pleased with the outcome.
I also asked him about a possible chin implant, but he said that won’t be necessary and not a very good idea at that. Why? He showed me an x-ray of a patient with one who experienced “bone resorption”. Meaning, the patient had an implant that (over time) actually ate away at the chin bone….(euuuuu!)…so he removed it and did a genioplasty on the patient. Okay, okay! No chin implant already……;-)
So, since he will be moving my upper and lower jaws in unicin, my bite should remain relatively the same, meaning no braces for a third time. There will be numbness at first, but over several months, most of the feeling in my chin, pallet and teeth should (knock on wood) return.

Next, came the battery of questions from me:

Q1: What is the plan for pain management?
A. After a short discussion about my allergy to codine and the fact that vicadin sometimes doesn’t work well, he prescribed something else he thinks will work. He also gave me a keflex prescription to thwart away any infections - which he said was highly unlikely.

Q2: Does my bloodwork and EKG look okay, and will I have to bank my blood?
A: Yes to the bloodwork and EKG, and no to the banking blood.

Q3: Will he be addressing my deviated septum?
A: Possibly, depending on how high up in my nose it is. If it is low enough, yes. If not, no.

Q4: Will you take out my adnoids? (which by the way, I was shocked to hear they were still there because I was under the impression they were removed back when I had my UPPP surgery. ...but I hear they sometimes grow back, so I can't be sure what really happened)
A: No. Not at this time. He doesn’t want to complicate things and do too much.

Q5: What about that stupid stone in my salivary gland (that showed up in my x-ray)?
A: Nope. He said it might be a good idea to have the salivary gland and stone removed along with the adnoids… later.

I wish I would have asked him that if I promised to pee right before they put me under, could I skip the catheter….but I figured I already knew the answer to *that*.

Finally, he took a couple of pics of my teeth and smile, the appointment came to a finish, and on my way out, who do you think I saw? My buddy Learian!!! It's a small world, ain't it? As always, it was awesome seeing she and her hubbsband.
I had Daisy take a pic of me and the good doc, but my stupid camera always zaps the last pic when you take the SD card out of the camera ,(which happened to be the one with Dr.KL.. ANNOYING!) so I guess I’ll have to wait for the next photo-op.Which reminds me: I took some pics myself for you to check out, because in 2 weeks, your kid ain't gonna look quite the same any more. (awwww) I'll post those in a little while.

After that, it was back in the trusty Scion (I love that car!) and back up to The City to see my awesome dentist of 15+ years, Dr N. (I love ha!) to get my teeth cleaned...although she didn't actually have the honors..it was the new dental hygenist Zora. I wanted to get my "pearly off-whites" as clean as possible now, since they will probably be very grungy for awhile after the MMA and GA. Lovely! Looking forward to THAT! ;-) My 6 month cleaning was supposed to be in September, but I figured that I probably won't be able to open my mouth far enough to have it done then. Not a big fan of the teeth cleaning experience in general, though. That's because of the receding gums I was gifted with after my last round (as you recall, there have been two) of braces. Apparently my teeth moved too quickly and it caused my gums to recede. However, I managed to make it through all the scraping and polishing, so that was one more thing to strike off my "to-do" list.

Oh! And I also called Comcast to dump Showtime (now that Weeds is done) and signed up for Logo, so we can get the TV new series "Sordid Lives", which is based on my favorite movie of all time! It should be a hoot!!

So, there you have it. A day in the life of one of Americas Next MMA patients.

who loves ya, mama?!?
xoxo: Pinsk