Wednesday, February 23, 2011
Wednesday, February 23rd, 2011
This morning I had my second follow up appointment with Dr Morales. Last night my parents didn't turn, they had planned on having Michelle turn on her shift. When Mommy got ready to leave for work, Michelle said she couldn't find the screwdriver and wondered if Mommy knew where it was - which she didn't. When Daddy came down to sign Michelle out he also didn't know where the screwdriver was. He proceeded to look around for it but couldn't find it and he was convinced I had hidden it somewhere.
Mommy, Daddy, Grandma and I met up at Primary Children's at 10:00 for my appointment. Dr Morales was running about an hour behind but as I waited I perked up a little and was happily playing when he came in to the room.
Daddy explained that I had not had any pin turning since Tuesday morning because the screwdriver was MIA. Dr Morales looked me over while I cried and kicked. He decided that my bottom jaw was already bigger than my top jaw so he figured I had a little jaw to grow into. So after three weeks he announced that the pin turning was over. I signed "all done", smiled and clapped at the news.
Dr Morales wants to see me back in three weeks but prior to the appointment he wants me to have an xray done of my mandible to see how well the bone is solidifying. We also scheduled April 19th as the date to finally remove the hardware. He said that it should just be an outpatient procedure and unless there are any serious issues I would be able to go home the same day!
Although the worst part of this jaw distraction is now over, Mommy wanted to talk a little more about the pain. Dr Morales said it was possible to put a catheter in the jaw for a drip of pain medicine but because it is another wound site it is another place for possible infection so that is not his first option. He explained that in the first 10 days after the surgery the bone isn't healing as quickly and so it is not surprising that I didn't have as much pain in the beginning. It so happens that at the same time that the bone starts to heal more rapidly which makes it more difficult to turn and also more painful - I was getting turned twice instead of once which would have compounded the pain.
It's possible that next time around, we might want to turn more rapidly in the beginning when the pain is not so intense and then turn more slowly the second half of the distraction.
Although there is no way to know now how many distractions I will need over the course of my lifetime or how soon the next one might be - it's pretty clear that this won't be the last. Daddy asked whether Dr Morales also thought my jaw wasn't quite symmetrical. Dr Morales could see that as well but told us that the jaw distraction is not a very precise surgery. Once I had finished my last jaw distraction for growth (probably in my teen years) then there would be a final surgery where the jaw would be broken and moved to the appropriate place and then screws and plates would hold it in that position going forward.
The last thing I wanted to hear about was future surgeries so I was glad when the discussion was to an end and I could go home with Grandma. The rest of the day Grandma substituted regular Tylenol for the Tylenol with codeine and I wasn't complaining. My parents are hoping that is a sign of the weeks to come until I can finally get the distractors removed.
BTW - Mommy found my screwdriver tonight in the cushions of the chair that I have been sleeping in most nights. Daddy still thinks I hid it there on purpose!
Peyton Nicole Smith