I'm Isabel's mom, and she asked me to post an update on today's events.
Our day started in the wee hours of the morning; we had to check in at the hospital (30 minutes away) at 6:00 a.m. Geh. But the hospital is in a more rural area, and the smell of hay and cows on the journey had restorative powers.
As we were signing the many forms and filling out paperwork, we found out Isabel's surgeon's middle name is Gustaf. Somehow knowing that gave me more confidence in his abilities. After Isabel got in her glorious surgical gown (photos forthcoming), they administered her IV, which wasn't easy. Apparently Isabel has disappearing veins; in fact, after surgery the IV had magically switched from the right to the left arm, so the surgical team must have had additional problems.
She was then wheeled into the holding room, where we met her anesthesiology team and the nurse who would be assisting. Everyone was kind, but once they made her don her lunchlady surgical cap and hideous tan polyester surgery socks, the nerves set in and she got a little teary. Seriously, those socks would make a Navy Seal weep. Deep breaths, I kept telling her. Deep breaths. They sent me packing to the waiting room (since my "deep breaths" mantra wasn't of any help whatsoever), and her surgery got underway about 7:30 a.m.
Three things I learned about Mountain View Hospital in Payson, Utah, while I was waiting: 1) it has pleasant courtyards, with plants, fountains, and shady pergolas, where you can read Alan Bradley mysteries in comfort; 2) the hospital gift shop carries a large selection of shoe horns ("I'm so sorry about your appendectomy. Here's a shoe horn."); 3) the cafeteria closes at 6:00 p.m., although I didn't learn that until I went down to eat some dinner at 7:00 p.m.
About 9:30 a.m. a lovely nurse came out to tell me things were going well and it would be another two to three hours. At about 12:30 p.m., the surgeon emerged. He told me the five-hour (!) surgery had gone well––that the whole team was "ecstatic" with the outcome. They widened the upper jaw, tilted and rotated it, and shortened it a bit so her smile will be a little less "gummy." (These are not the technical terms, I know, but as a nervous mom, this is what I heard.) They then moved the lower jaw forward about 9.5 millimeters and moved the chin with a genioplasty about 6 additional millimeters. Sometimes noses tend to widen with this surgery, but he somehow stitched her nose in place to minimize any widening. (Isabel's nose is so cute, it would be a shame to mess with it.) All of the incisions were done from inside the mouth.
The surgeon will check in on Isabel late tonight and will look at her again first thing in the morning. When she's discharged (hopefully tomorrow morning sometime), we're supposed to head over to his office for x-rays and post-op instructions on elastics, mouth/teeth cleaning, etc.
Isabel spent most of the afternoon conscious but in a pretty hazy state. Her first coherent directive to me was to REMOVE THE TAN SOCKS (communicated through caveman grunts and violent gestures toward her feet). The nurses gave her doses of morphine for the pain, ibuprofin to help with the swelling, an antibiotic of some kind to prevent infection, and nasal saline spray to help keep her air passages clear. She was bleeding for about 5 hours after surgery, but the nurses kept a suction tube close so that we could suction most of the blood away and she wouldn't have to swallow it. After about the 5-hour mark, we were suctioning mostly saliva. She had a few nosebleeds, but she's prone to them anyway (and being intubated and cut and stitched doesn't help). She also either got something in her eye or her eye got scratched somehow during surgery. That may have been the most annoying/painful thing about the ordeal. The nurses got some eye drops to try to flush it out, but they didn't help much.
Her swelling has been pretty moderate so far. Her upper lip is quite swollen, especially on one side, but I think she looks amazingly good. I realize swelling will peak three to four days after surgery, but we're hoping the trend will continue for minimal swelling and bruising. We've been faithfully switching her in and out of her "jaw bra" ice packs every 20 minutes, on doctor's orders.
Isabel felt nauseated really only once––the first time she tried to get up and use the bathroom––but she never did throw up. The hospital didn't have any feeding syringes, but they rigged up one with a large syringe and some tubing. She was able to drink a little bit of nectar for dinner but didn't feel like eating or drinking much else.
Because her jaws are "wired" shut with the elastics, she has had to communicate via grunts, gestures, and a whiteboard her grandma gave her. Isabel knows ASL, but the rest of us don't, so her attempts to communicate with legitimate ASL signs have been futile. She subtly rolls her eyes, secretly thinking we're all imbeciles.
Isabel's dad is out of town, and she has younger siblings at home, so I had to leave her at the hospital at about 8:45 p.m. She'll be on her own with the nurses tonight. I'll drive back through the pre-dawn air, redolent of cows and hay, to meet with the surgeon again tomorrow morning.
Photos are forthcoming! I'm just a blogging novice who doesn't know how to upload them.
