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!

A Day of Appointments

Today was a very full day of appointments. Rachel and I left the house about 7:30 and did not get home until 5:00pm!!

First appointment was with our dentist, Dr. Hoffer, for a crown on a tooth that is transposed in her mouth and was going to impact her new jaw alignment based on molds that had been taken. The crown took just over 2 1/2 hours, but when it was all said and done, Dr Hoffer did an amazing job on the crown and it should work out perfectly.  

SideNote: I absolutely love our dentist!! He's gentle, kind, very knowledgable, and up to date on the latest and greatest dental techniques. His wife is a pediatric dentist whom the girls went to for many years! 

After her crown was down, she switched chairs and had a routine cleaning. After almost 4 hours at the dentist office, it was lunch at Chick Fil A, and a trip into Home Goods and Walmart. 

Next appointment was out in Beaumont, with Dr Carter, Rachel's orthodontist. Thankfully they have a CT Scan machine in office that takes the scans that Dr Martin needs for planning out surgery. So new CT scans, new molds, a new bracket on the crowned tooth, and new wires and rubber bands. 

Everything is stabilized for no additional movement prior to surgery and we won't see the Orthodontist again until the week before surgery. 

A trip through the McDonalds drive thru for a McFlurry and then on the road home. Getting home just before 5:00pm. It was a very long day. Rachel's  mouth is sore. But everything was necessary to keep on track with surgery in a month. 

CT Scans

 I received the results of Rachel's CT Scans she had earlier in the week. It's interesting to see all the measurements and recommendations for the jaw alignment. Even more interesting to see her actual scans. 

Preparing for Surgery

For months, we have been on a very rigid and strict timeline in making sure Rachel's surgery stays on track for Mid June. Lining up orthodontist and plastic surgeon appointments when she's home on break or long weekend has been very challenging. Today was no different, we had two appointments this morning in anticipation of Rachel's surgery next month. 

The morning started out with a maxillofacial CT Scan at Loma Linda. Dr Martin will use these scans to digitally align and plan out her jaw alignment. This was a quick appointment. Rachel was actually in and out before her appointment time! 

Next appointment this morning was with Dr. Garcia, the orthodontist. This appointment kind of knocked the wind out of sails. 

Turns out Rachel needs a crown on a tooth that in a previous mold, would interfere with her new jaw alignment. No one had called and told us that in the last five weeks since her last Ortho visit. 

Dr. Garcia removed the bracket from the tooth in question in hopes we could get an appointment for a crown. Once we get the crown, all new CT scans will need to be taken, as well as new molds. This mornings scans she had are invalid at this point. 

We stopped by our dentist's office on our way home to talk to the scheduler in person about the urgency of getting an appointment for a crown. Our dentist is currently out of town, but we were able to get an appointment for 2 weeks from now. Which works out perfectly for us, as we leave for a week at WDW early tomorrow morning.

 

Freshman Year of College - FINSIHED!

We did a turn around trip to Phoenix today to move Rachel's big things into storage for the summer and then bring her home for the next 4 months. 

It's hard to believe her Freshman year is done. That year went by quickly! She had a very successful year, becoming independent and maneuvering through difficult roommate situations and landed herself on the Dean's list with straight A's. She has two weeks break and then online summer courses begin!

Orthodontist Appointment

It is extremely hard to get Orthodontist appointments coordinated with the times that Rachel is home from college. Rachel hadn't been seen since the days leading up to her leaving for college. 

We were fortunate enough to have an appointment this morning, which worked out well with Rachel heading back to college tomorrow morning.

New molds were taken. New wires were attached and and new rubber bands were placed. We are moving forward in anticipation of her June Surgery. 

Next Ortho Appointment will be when she's home on Spring Break in March. 

Surgery is Scheduled!

Rachel had an appointment with Dr. Martin today. It was pretty much an appointment to keep us from falling through the cracks and on target for a summer surgery. 

Well, Rachel's on target and surgery has been scheduled!  

Rachel will be having her next surgery on June 21, 2023!!

This surgery will be her 5th surgery related to her birth defect. It will also be her biggest surgery, as Dr. Martin will move and realign her upper jaw and line up her lower jaw. 

Off to College and Turning 18!

Rachel's wanted to go to Grand Canyon University ever since her older sister started attending there! She's been looking forward to this adventure for the last several months!

There are advantages to going to the same school your older sister just graduated from - aside from knowing your way around the campus, the majority of Hannah's apartment belongings were passed on - a couch, entertainment center, television, dishes, pots and pans, and a lot of other things that make setting up a bedroom at college nice and comfortable.

We spent two days moving Rachel in to her apartment on campus, getting her room all set up, and doing odds and ends the next day, out to breakfast for her birthday, grocery shopping, final tweaks needed on electronics from Dad, etc. 

We went to dinner at one of our favorite restaurants for her 18th birthday. As hard as we tried to be in celebratory moods, it was difficult  as we knew when dinner was over, we'd be taking her back to the campus and saying our goodbyes. 

We are so very proud of her decision to go away to college and have that experience. Looking forward to all the Lord has in store for her in this new adventure! 

Appointment with Dr. Martin

Rachel's been in her second set of braces for almost 2 years (coming up this month!) in anticipation of getting things moved and in position for her next big surgery, which we knew would be around the time she was 17-18 or there about depending on her facial growth. 

Today, we saw Dr. Martin, Rachel's plastic surgeon. We saw him last in November 2019, where he sent us back to Dr. Garcia, her orthodontist for baseline X-rays and a return appointment for 6 months later. We had an appointment scheduled to see Dr. Martin in May 2020, but it was cancelled due to the COVID outbreak and was never rescheduled.

Here it is, a little over 2 years after we were supposed to return. It was a good appointment. Good to touch base and have her looked at. 

Rachel is where she should be (growth wise) for moving forward with surgery. Dr. Martin thinks just by looking at her, and her bite, that he might be able to get away with just repositioning her upper jaw, and not the top AND bottom as some cleft kids have. Of course he won't know for sure until he gets CT Scans and puts it all into the computer for graphing and calculating. But overall this was great news!!

The problem - Rachel leaves for college in 8 weeks. There is no way Dr. Martin can get her on the surgery schedule and done and recovered in 8 weeks. So our hope/plan is to have surgery next May/June when Rachel is home for summer after her first year away at college. We just need to check with Dr. Garcia to make sure it's okay she sits in braces for another 11 months until then. 

Profile pictures were taken today for her medical records. We have a video appointment in a couple of weeks with Dr. Martin after he checks in with Dr. Garcia.