Checkups

We just finished our first round of post-op checkups.  We saw my oral & maxillofacial surgeon Dr P on Saturday, then my plastic & reconstructive surgeon Dr A today.

They continue to be amazed at how well I am healing.  And pretty impressed with their handiwork too.  I have definitely grown fond of my little medical team.

Dr P had a look inside my mouth at the fibula flap.  He’s happy with how it’s healing, very happy in fact.

Nevertheless, the wiring of my jaw needs to stay on for the regulation six weeks post-op.  That’s another four weeks.  I’m looking forward to getting it removed, but happy to wait out the wiring to make sure the jaw sets just right.  Removal of the wiring requires day surgery under general anaesthetic.  He assured us he wired it well and oh do I believe him.

He will see us again next Saturday.  In the meantime, he referred us for a CT scan and OPG this week.

When we saw Dr A today, he also had a look inside my mouth at my fibula flap.  All good.  What he really wanted to look at, however, was his fine needlework on my left leg (from the fibulectomy) and neck (from the neck dissection).

He removed the long line of steri-strips from my leg, as well as the few remaining on my neck.  The linear incision on my leg is not entirely healed so there was a little bleeding.  Nurse, he cried.

Before the nurse took me away to do a few bits and pieces Dr A requested, we asked him a few questions.

How long will I stay on crutches, we asked.  He’ll reassess the left leg at four weeks post-op and, all going well, I may be able to put some light weight on it.  At six weeks post-op, I may be able to move to one crutch.  At eight weeks post-op, I could be walking – gingerly – on my own.

What should I do now for pain relief?  We are almost out of oxynorm and panadeine is ok during the day, but does not cut the mustard at night.  He prescribed dissolvable panadeine forte but, as Darren discovered when he tried to fill the script a little while later, that doesn’t exist.  Instead, I’m now on a double dose of ‘painstop for children’.  Oh yeah.  It describes itself as an analgesic syrup with antihistamine.  Just for night-time when the pain is at its worst.

Can I have debulking surgery yet?  He got the joke and laughed.  You may remember he said not to bother asking for debulking surgery at three months post-op because he’ll tell me to wait until six months when the flap has settled properly.

At that point, he sent us on our merry way while he went to deal with real problems.  We’ll see him again in two weeks time.

Our merry way led next door to the nurse.  She cleaned and redressed the left leg wound.  Then she set about the torture section of proceedings.

Some layers of skin around the tracheostomy wound are healing faster than others and showing what they call granulation.  It’s an aesthetic issue.  It just means the scar needs a bit of love and care to look its best as it heals.  That love and care comes in the form of liquid nitrogen.  When painted on, the liquid nitrogen burns off the top layer of skin to form a scab.  This eventually peels off to reveal healthier looking scar tissue.  As it turned out, I couldn’t even feel it.

That, however, brought us to the torture section of proceedings.  The nurse had to remove the sutures that had held together my dissected neck.  Some sections of my neck are entirely numb; others are not.  Those weren’t difficult to identify as she cut the suture and then pulled it out with tweezers.  Ouch.  That done, the nurse cleaned it all up and taped my dissected neck back up with steri-strips.  It is  a lot more comfortable with the sutures removed.

Unfortunately, my neck skin is red raw and irritated from the dressing changes.  She applied a simple gauze dressing to let the skin air and repair.  Paw paw ointment should do the job, she said, or bio-oil.  Try just to wash my face and neck with a washer, she advised, and just shower from the neck down.  That way I won’t need a waterproof dressing to prevent water going down my trachey hole.  If need be, I can put on the water proof dressings but otherwise I’m happy to give my poor skin time to repair.

With that, she sent us on our way.  We need to come back to see her for more wound maintenance next Monday.

The last stop today was for my first post-op medical imaging, ordered by Dr P on Saturday.  He’ll go through with us what the CT scan and OPG actually mean next Saturday, but the pictures were so pretty I couldn’t help but share…

Here is the OPG.  In the middle, you can see the oh so attractive wiring on my teeth.  The image is reversed, so the void where the teeth used to be is on the bottom right on the image.  The bike chain look-a-like is the titanium plate holding my jaw together as the fibula flap heals to form my new jaw.

OPG 15 August 2011.jpg

The scans envelope also contained this cool 3D reconstruction.  Again, the image is reversed.  It’s the left side of my face that’s funky.  That is one fine jaw, right there.

3D reconstruction 15 August 2011.jpg

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