Rachel's Surgery

So what exactly what did they do to Rachel?? 

I can tell you in simple terms they repositioned her upper jaw and moved it forward to match her lower jaw. 

However, I found a video on YouTube that shows exactly what they did to Rachel. There are several videos of actual surgery footage, but I found a computer generated medical video that is less gruesome. 

After watching this video, it helped me better understand exactly what, and how, they did Rachel's surgery.

For a larger view, select the "full screen" mode 

once you have started to play the video.

Oral Splint

Rachel came out of surgery with a splint in her mouth. This is what it looks like. 

Throughout the day she is supposed to be putting her teeth into the grooves in the splint to train her jaw the new resting position. 

When we asked at the time of hospital discharge how long the is in, the resident said a couple of weeks. Rachel is hoping that because Dr. Martin said at her post op appointment this past Monday that she is ahead of the game, that perhaps he will remove it next week. She is hoping that is the case!!  

Feeling Stir Crazy

Other than an outing for a smoothie on Sunday afternoon and her Post Op appointment on Monday, and our drive to Chick Fil A yesterday, Rachel's been pretty much home and resting the last week. She's going a little stir crazy. 

Rachel was for anything at this point, even if it meant going to Hobby Lobby and Target. Of course lunch was involved.

She started off with wearing a mask, but soon decided it was just too hot and took it off. She's wearing a little bit of makeup today, swelling down some more,  and really looks good!

Post Op - 1 Week Since Surgery

It's hard to believe that Rachel had her surgery 1 week ago today. One week of recovery under her belt and one week closer to things getting back to normal for her. 

She's pretty tired of protein shakes, applesauce, mashed potatoes, and yogurt at this point. She can have macaroni and cheese and really anything that doesn't involve chewing. Basically things she can squish on the roof of her mouth. This morning we tried chicken dinos, just for something different and for some substance in her stomach. I cut them up into the smallest of bites so that she could just squish them and then swallow. It worked out great, only problem is because she eats so slowly right now, the pieces got cold and hard before she could eat them all. Next time we will only cook a dino or two at a time. 

Around lunch time we went to Starbucks for a chocolate chip frrppacino and to Chick Fil A for french fries. We figured she could break the fries into the tiniest of pieces and eat those. I got chicken strips and was able to tear them into small pieces for her and she loved that.

Enjoying her frappacino with her baby spoon (NO straws allowed).

Her pain is starting to lesson. When I ask her what her pain is, today it's been a 2. She's more irritated and ready to have the splint removed. We're still giving over the counter Advil and Tylenol as needed for pain/major discomfort. She has some numbness to her lips, which they say could take a couple of weeks to come back. Swelling is starting to lesson as far as I can see. My parents saw her yesterday and said the swelling was down quite a bit since they saw her on Thursday.  When you see her everyday like we do, you aren't so quick to notice any difference. 

Before surgery and 1 week Post Op. 

It wasn't until I put these two pictures side by side that I could see just how different her face looks at this point - only 1 week out! There's still swelling. But what a difference in her nose, and the amount of space between her upper lip and her nose. It looks like Dr. Martin made her face longer, but I know he didn't. It's amazing just how much a jaw deformity can shape ones face. And how fixing it can redefine the face! 

Post Op - Day 6 and a Post Op Appointment

Rachel is now 6 Days Post Op. 

Last night was her best night yet. She slept through the night. Still sleeping in the recliner, in an upright position to keep the swelling down. She's not been sleeping well the last several nights, and I was willing to try anything, and then it came to me to try some lavender oil and that worked!!! It's amazing how much better you feel when you get a good night's sleep. 

We had our first Post Op Appointment with Dr. Martin this morning and she's doing really well! Dr. Martin said she's actually ahead of the game and is farther along than most patients. He wasn't too impressed with her swelling, apparently it can get pretty bad. He looked inside her mouth and at her bite into the splint. Everything was great. He answered my list of questions and they took pictures and we return for another appointment next week. 

Rachel's very self conscious about how swollen her face is, so she wore a mask into the doctors office, and a the grocery store on our way home. It's one thing to post and share pictures on her blog, but another to be out in public and have people possibly stare at you. 

Post Op - Day 4

Another day of recovery and things are still going well. 

Rachel slept a little bit better last night, going back and forth from the recliner we moved into her room, to her bed. Swelling is still there, nothing too impressive. No bruising. 

We are managing her pain with just over the counter Advil and Tylenol. We have just a few more doses of the pain narcotic left that I am saving for when things are really hurting. But she only every says her pain is at a 3-4-5 on a scale of 10. We learned when she was little, that she has a VERY high tolerance for pain. And it's proving to be that way still. 

I took this picture this evening out in the sunlight. Rachel tries to avoid the sunlight right now to avoid any possibility in sneezing!! 

We've spent today lounging about watching movies and just relaxing, and in between Rachel's been trying to write an essay that's due tomorrow night (she's in summer online courses). 

** picture posted with Rachel's permission

Post Op - Day 3

Rachel had a bit of a restless night, some pain, swelling was bothersome. 

But she's doing well today, starting to talk better, more understandable. Still really swollen. Eating soft foods and drinking well. She's in good spirits. 

Her "good" pain med won't make it many more doses, and since it's Friday and the weekend is upon us, I called our Plastic Surgeon's office to see about a refill. They suggested stacking Advil and Tylenol now and saving the "good" stuff for when the pain is really bad. So that's what we will do. 

Post Op - Day 2 Evening Update

After spending two very long days at the hospital, it was nice to have a relaxing afternoon.  The girls and I lounged about watching television. 

I wanted to share this picture, a side by side comparison. I did one just a few hours after surgery and the results we saw then were simply amazing. So I'm going to be doing a few of these in the weeks to come. The top is before surgery, the bottom was taken this evening, a little over 48 hours Post Op. 

Look at the difference in her chin!!!! For years, she hasn't really liked her chin, as it's so pointed and stuck out (some of it is the Fraser genetics). We knew her chin would be pulled in a bit, but the difference is amazing!! Same with her nose. This surgery has made her nose perkier!! It will be interesting to see how her face looks as the swelling subsides and everything settles down, which could take weeks.

Her face is pretty swollen this afternoon. No bruising. 

Gramma and Papa made us dinner tonight and brought it over, it was soooo good and it was so nice to have a home cooked meal. Gramma made Rachel pudding, which she is very excited about. 

Looking forward to hopefully a good nights rest for everyone. Rachel needs some good sleep and uninterrupted rest. So thankful to be home. 

** pictures posted with Rachel's permission

Post Op - Day 2 She's Home!

Steven and I wanted to be at the hospital when the doctors did their rounds this morning. So we got to the hospital around 6:15am. Visiting hours don't start until 9:00am, so we had to be sneaky and go in through Urgent Care and work our way through the halls. We made it all the way into Rachel's room before we got stopped. 😂 Only one of us could sit bedside until the doctors came, and at that point the other could be texted to come  and talk to the doctors. 

The Plastic Surgeon Resident came at 7:00 and looked in Rachel's mouth and after answering some questions, was going to recommend discharge. We walked out of the hospital just after 9:00am. 

So we are home! She was happy to take a shower! Into clean comfy clothes and is doing really well. Pain is manageable. Swelling about the same as last night, and is drinking and eating soft foods. First Post Op appointment is Monday morning. 

Post Op - Day 1 Evening

It's been a long day of waiting and anticipating a possible late afternoon/evening discharge. 

Rachel has been doing all the things that had been set out for her to accomplish (pain managed, drinking/eating, up and about walking). However, in the last hour, after speaking to the Plastic Surgery Resident, they want to keep Rachel for one more night of observation for possible "respiratory distress." 

So it's one more night in the hospital, thankfully she has a good roommate, which makes it a little easier. 

She's doing really well! Her pain has been pretty minimal considering (4-5 on a scale of 10). She's up and about without any help, walking the halls, drinking a ton, doing everything she can to recover quickly. 

Here is a picture from this evening, about 18 hours after surgery. We expect the swelling tomorrow to increase, as it usually does 2-3 days after surgery. But she's doing good!!! 

* picture posted with Rachel's permission

Post Op: Day 1 - Morning

 Rachel had a good night. She slept off and on. Pain is under control. Got unhooked from the IV in the night. Up and walking on her own. And is in her own comfy clothes rather than a hospital gown!

The Plastic Surgery Resident came by.  She said Rachel looks good, and is doing good, and really doesn't see why she couldn't go home today, but will need to talk to Dr. Martin. She'll be back this afternoon. 

Todays goal: drink, eat some soft foods, up and walking, and keeping pain under control. 

* Picture posted with Rachel's permission

Surgery Day: Finally in a Room

 Seven hours after surgery ending, she is finally in a room. 

The post op nurses were very attentive and took such great care of Rachel. Steven, Hannah, and I took turns switching out and keeping her company. 

She is experiencing some nausea and vomiting this time around with anesthesia. So she's getting meds for that. We are also very actively trying to make sure they stay ahead on her pain control. 

One of the things Rachel noticed this afternoon was how perky her nose became. Now we can't unsee just how different her nose looks. Will be interesting to see how much her face changes in the coming weeks. 

Because Rachel was stable, and a non emergent case, she was transported to a smaller hospital (same hospital organization, just a small surgical hospital down the street). She went via a medical transport so a nurse could monitor her the mile trip. I was able to accompany her. 

Upon arrival, she did experience more nausea and vomiting and was time for some pain meds. She is sleeping and resting comfortably now. 

She is in a room with three beds, but scored the window bed with french doors that open out to a little patio. Tomorrow we will get her up and out in the sunshine. Dr. Martin says being upright is good for keeping the swelling down. 

Visiting hours end at 9:00pm. So we both will head home then. It will be the first time we leave her unattended following any surgery. Things are different when your kid is now 18 and considered a legal adult. But we've made sure to let the night nurses to please check on her frequently in regards to her pain. 

Thank You everyone who has been checking in on Rachel today via her blog, through Facebook, and through texts. We truly appreciate all the love and support. 

We will continue with updates tomorrow. 

** picture posted with Rachel's permission

Surgery Day: In Recovery

We finally got to see Rachel in recovery around 1:00pm. 

My first glance at her from straight on was there was nothing different about her. But once I saw her profile from the side, the difference was amazing!!!! Her lips finally meet and touch, something they've never done. 

As I sat at her bedside, looking at her, praying and thanking the Lord for answered prayer for everything going so well thus far, I couldn't help but think of the different faces we've loved through the years. 

The first time, was when she was born. She had a very wide cleft lip and we fell in love with that face, as it was the one we knew for 4 1/2 months, until her lip was repaired in January 2005. 

The second face was the one we've known and loved all these years since that lip repair. Extreme underbite and all, it's the face we've looked at for 18 years.

And now, this third time, is that her profile has changed drastically, lips matching and touching for the first time in her life.  And while I'd only been looking at it this new profile briefly, swelling already starting to set in, I already love this new face just as much as the others. 

* picture posted with Rachel's permission

Surgery Day: Surgery is Complete

Surgery is complete!!

We had been told surgery would be 4-5 hours, but it was just shy of 3 hours!

Dr. Martin came and spoke to us and let us know that surgery went well, went as expected. He extracted two wisdom teeth and her new jaw position fits nicely in the splint she has in her mouth. Swelling will get really bad in a day or two and then will be good around Day 10 post op. 

Getting up and about and sitting in a chair later today will help start the recovery process. It'll be important for her to drink and stay hydrated and keep her pain under control. 

She's in recovery and it'll be an hour or two before we can see her.

Surgery Day: Ready and Waiting

Rachel was first on Dr. Martin's schedule for today, she had a 7:15 surgery time.

She had such a wonderful and caring nurse that took care of her prior to heading off to surgery. After all the prep work and charting was done and we were just waiting for the doctors to make their appearance, the nurse said she liked to pray with her patients, and asked if she could pray with Rachel. What a blessing that was!! 

Surgery will be about 4-5 hours. And then time in recovery. Then she will be admitted to a patient room. 

There are three things that will determine when Rachel will be discharged:

1) The ability to drink, take liquids

2) She's up and moving about

3) Her pain control and her ability to take oral pain meds

For sure she's here at least for tonight, but if all goes well, perhaps she'll go home late tomorrow afternoon/evening. 

They wheeled Rachel off just before 7:15am. 

One of the hardest things ever as a parent is watching as they roll your child off to surgery, this was our 7th time of doing that. They only allowed one of us with her at a time in the holding area. I was the one with her as they took her away, but this was by far the easiest "wheel off" for me. 

Will update as the day goes on....

Rachel's Guestbook

 We would love to know who's checking in on Rachel. 

Would you please consider signing the Guestbook. 

The LeFort Osteotomy

The surgery Rachel will be having is called a "LeFort Osteotomy".

This is a corrective jaw surgery (orthographic surgery) that involves repositioning the upper jaw (the maxilla). The surgery realigns the jaw and teeth for optimal function. It is used to correct a wide range of dental - facial deformities, and in Rachel's case, those born with a cleft lip. 

There are three types of a LeFort Osteotomy. Rachel is scheduled for the Level 1, which is the most common for treating jaw misalignment and cleft lip and palate. It allows the upper jaw to be easily repositioned to reshape the face and improve ones bite.

She is expected to be in the hospital 1-2 days, all depending on how she is doing. The main thing is making sure she can drink in order to stay hydrated and avoid the risk of dehydration. Once home, she will be on a liquid only diet for 2 weeks. We have protein shakes, chocolate milk, some gatorades, and apple juice, and chicken broth readily on hand. After that, she'll be on a soft food diet for 4-6 weeks.

Before Pictures

Rachel's profile will change pretty drastically with this surgery. Therefore we wanted to take some "before surgery pictures". These pictures were taken last week. 

Looking straight on, we don't think there will be much difference, however, maybe we could see a change in her nose perkiness. It will be hard to tell exactly what will look different until all the swelling subsides, which Dr. Martin says could take up to 6 months.

Where we will notice the biggest difference in Rachel's facial appearance is her side profiles. In each of these pictures, you can clearly see that Rachel's lower jaw extends out much further than her upper jaw. 

In people who were born with clefts, the middle of their faces don't grow completely, therefore Rachel's upper jaw does not match her lower jaw. This surgery is going to correct this. 

Rachel's excited to have this surgery done. As she's gotten older, she dislikes how much her chin sticks out, some of it is due to her cleft and her upper jaw not having grown, the other part is simply genetics - she has her fathers pointy chin, it runs in the family! 

Surgery is a Go!

Rachel is scheduled to have her jaw surgery on June 20, 2023. 

We have had this date for 6 months. 

Ten days ago, the surgery scheduler called to tell me that our insurance company had denied approval as it was deemed "not medically necessary". Additional records, measurements, scans, pictures, etc, were submitted. Appeals filed. Another prior authorization submitted. 

We moved forward in trusting the Lord and having faith that all this would work out and we would receive insurance approval. 

Rachel had a pre-op appointment with Dr. Garcia on Wednesday. And she had a pre-op appointment with Dr. Martin this morning, as well as a Pre Admitting Appointment where they went over all of her medical history and took blood. 

Long story short, we received word this afternoon that our insurance has re-reviewed Rachel's records and this surgery is indeed medically necessary, and they have given the approval for surgery!! 

Surgery is a go! And it's happening this Tuesday!! Thank You Lord!