I had my first follow-up appointment with my surgeon yesterday, and have a few things to share from that. Wow, traveling not so many miles and a short appointment took it out of me! (Thankfully Lorraine was driving.)
Everyone in the office was very supportive; saying how great I looked, considering. My surgeon’s partner, who took part in the surgery, also stopped by. He said something that I found most helpful: that in this period (first two weeks after surgery) is when people struggle the most, including wondering whether they should have undergone the procedure in the first place. That thought had crossed my mind (and I was not allowing it free reign), so it was comforting for me to hear that it’s not uncommon to think that.
My surgeon says that I’m doing very well in my recovery; ahead of the curve in some ways. We were able to address several questions that Lorraine and I had. As we talk about the work that was done, my surgeon is making distinctions between things that we know about the surgery and recovery so far, and things we are not going to know for a time. I’ll report on some of those below.
There has been some degree of improvement in my breathing during sleep. My surgeon was able to do quite a large advancement of my mandible and maxilla, of 1 centimeter. He was prepared for a shorter advancement if needed, and had splints ready for a shorter length. I am not sure what besides how well the pharyngeal flap tolerated the advancement was a determining factor for the length of advancement. But the results do mean that my airway at the back of my throat was opened up substantially. With my surgeon’s approval, I have experimented very lightly with my CPAP at lowest pressure, and I know that there has been an improvement in my sleep apnea. It is too early to tell what the results were, but indications so far are positive.
We don’t know what my long-term results will be in chin-area sensations (paresthesia - “pins and needles” and related pain or lack of sensation). My surgeon said that the nerves there were intact during/after the surgery, but notes that 100% of patients coming out of orthognathic surgery (and genioplasty in my case) experience numbness in the chin area. Roughly 85% recover, and that recovery takes a long time, so for me it is far too early to tell what my results will be.
Meanwhile, yes, I am experiencing numbness and a “pins and needles” feeling, in an area that roughly matches a “Van Dyke”-style beard and moustache, plus around my nose. I have left that area unshaved. The first time I shaved after surgery I was very uncomfortable. Though I can see that I’m cutting hair instead of flesh with my razor, being numb I can’t feel it. I decided to let it grow, and I’ve never had this much facial hair in my life! On the down side, the Van Dyke combined with the facial swelling makes me look something like Jon Lovitz’ smarmy character in The Wedding Singer. Well, it’s interesting as a departure… and not likely long-term.
We know that there has been an improvement in my breathing in my nose. Thursday evening (after the Wednesday surgery) when I saw my surgeon in the ICU, I commented that my breathing in my right nostril felt easier than I can ever remember it being in my life. Yesterday my surgeon reminded us that my swelling was really just beginning on Thursday, had been increasing for several days, and has since been interfering with that easy nose-breathing. That matches my experience, though I am also excited to say that even in spite of the swelling I have experienced moments of easy nose-breathing which are a very different experience than my past.
We don’t know what changes have been effected in my speech. My surgeon was encouraged by hearing my speech Thursday in the ICU. My speaking was fairly clear and not a lot changed from when I had spoken to him pre-surgery. However, again the swelling plays a role in hiding the long-term results for my speech. My surgeon noted that when one is congested, it is easier to make closure between the palate (or pharyngeal flap) and the tongue. So, my congestion from the surgery may be hiding hypernasality that will emerge in the longer term when the swelling goes down.
We talked about medications and the eating-via-syringe that I’ve been doing, and my surgeon reminded me that “Healing requires nutrition” – a very important reminder for me.
We also stopped at a favorite Indian fast-food restaurant and got me some chicken tikka masala; we’ll figure out how to get that into me sometime soon.
Dr. Adam Burdick has been a professional musician for over two decades. Teaching, conducting, and performing in various music genres, he is also a perpetual student with interest in a wide range of topics. He loves to ponder and share his discoveries with anyone interested!