I checked out of the hospital about 1:20 PM this afternoon. :) :) :)
!'m a little woozy and my jaw hurts... >:( I had a right side mandible resection and reconstruction.
For the curious here follows a blow by blow description. Prior to this resect ans rebuild the lower right molars had to be pulled. Later, in a year or so I'll have molar implants,
First though, why was this procedure necessary? I had a keratocystic odontogenic tumor. It has been a recurring problem since 1976. Previous "solutions" involved drilling a hole and then scraping the bad thing out. That used to buy about 10 years before it came back.
I last had that performed in 2007. Several x-rays since that time showed the bone was regenerating. However this February the CT scan showed it back and very large. The keratocystic odontogenic tumor is a benign type. It destroys the bone from the inside out. It's not a solid mass like we think of when we hear the word tumor. It is more like a fluid or gel filled balloon. Pressure build us inside it and the slow outward push makes the bone itself recede.
So yesterday the first thing that was done was to obtain some marrow from my hip bone.
Next they made an incision from about the center of the mandible (jawbone) to near my ear. This is in the under the jaw area. The mandible was exposed and a titanium repair strap trial fitted. This strap was pre-shaped last week sometime. The CT scan was used to make a 1:1 scale model of my mandible. The model was used to shape the titanium strap. The strap it self was about 8 MM wide and about 17 CM in length. It's l-shaped with the sort arm extending up the ramus (the back part of the mandible that goes up to the 'hinge' point.
So the strap was fitted and pilot holes drilled for the screws that hold the plate to the bone. The screws were fitted as well. Then all the hardware removed. The offending section was resected, medical lingo for cut out. Then the plate was screwed back into place to get things correctly aligned. Cadaver mandible bone was then carved to fit the space where my bone was removed. Screws also are holding that bone in place. The new insert had been hollowed out. Once in place it was packed with the bone marrow.
To complete the task, muscle and other tissue was put back where it was and the incision sewn.. While they were opening up the tissues around the bone they had to be careful to try their darndest to not mess with the nerves that run along there. The entire operating room process took 6 hours.
The titanium parts total up to about $1200; the screws were something $80 each.
Glad you made it through alright. I had been wondering most of yesterday and today how it went. Did it necessitate your jaw to be immobilized for any period of time? Thank goodness it didn't affect your typing fingers. Make sure you get your rest. Although it may not appear to effect you that much any operation is stressful regardless of the procedure and your body needs to adjust to the change.
Congrats Don, glad to hear things went well! Here's to a speedy and pain-free recovery!
No immobilization. t's sore enough though that I don't move it much.
Glad to see you made it thru.
Rest up and you'll be better than ever soon. :)
1:20 PM this afternoon? Wow!!! You seem pretty coherent to me!
Speedy recovery . . . And good luck to you . . . :)
/
That's great Don! Good to hear. :)
No more MRI's for you! And you'll have to walk s-l-o-w-l-y through the detectors in the airport if you fly anywhere or you'll set them off!
Glad to hear it went well. Dental/mouth work is about my least favorite kind of work to have done. I think I'd rather have a proctology exam before that.... :o
Handsome me. [crz]
The hand grenade is a painkiller dispenser for the hip area the marrow was taken from.
(https://i133.photobucket.com/albums/q75/djmillerbucket/oddnends3/P1020212.jpg)
Glad to hear you're home and doing well :)
Welcome Back Don w*
Glad all went well for you Mt Don. [cool]
sparks
Glad to see you back Don!
Bruce
Don, it's great to see you back again so quickly, best of luck with the healing process.
It's a good thing I'm a nice guy or I might make some wisecrack about wearing a fanny pack on your head.....but that might make you laugh which would be an unkind thing to do.
By the way, you know what kind of nuts and bolts folks we are here, got any pictures of those $80 screws, and does your hospital buy stuff from the same suppliers that sell parts to the military?
Once again, your wisdom is one of the reasons this is such a good forum.
John
Looks real painful.
Hope you heal quickly and have no further problems with it.
Glad everything went well and you're recovering.
Nice to see they let you out, Don. Hope all continues to go well.
I took a break from work as I was working about 70 miles from my son's in LA so still out of town.
Quote from: OkieJohn2 on April 16, 2010, 05:25:14 AM
By the way, you know what kind of nuts and bolts folks we are here, got any pictures of those $80 screws
Here's what the strap looks like...
(http://www.china-implants.com/products/titanium_bone_plates/cbyl2_0_07.jpg)
These are typical for the screws...
(http://product-image.tradeindia.com/00075085/b/0/Locking-Head-Screws-Titanium.jpg)
No pictures of the goods they used on me.
Cool - self drilling fasteners... a favorite of mine.
Welcome back Bionic Man :D :D :D
I wonder way they didn't just use galvaized plumbers tape?
(https://www.plumbersstock.com/images/products/large/00291269.jpg)
Don, I read this earlier this morning and was all set to reply when out of nowhere the guttering guys showed up a full hour and a half early, so I got distracted and didn't get around to replying. Glad to hear it went well and hope you recover from the fanny pack on your head and the hand grenade on the pocket soon. :) Sounds like a major ordeal, so it is good to see you looking so perky so soon afterwards!! Really glad you're back!
Well, we went into the doctors office at 7:45 this AM. He says it's coming along, not too much swelling. It hurts though. He refilled the grenade.
No real food for a couple weeks. And I have no desire right now. I feel somewhat hungry, but there is no way I'm putting anything tougher than Jello in my mouth right now.
How are you hanging in there? Getting any sleep?
Does the stainless plumber's strap stay in place, or does it eventually get removed?
Still praying that recovery goes fast and well!
-f-
Sleeping last night at home was better than the night in the hospital. Almost bedtime already.
The titanium strap and 11 screws stay there from here on. At this mornings meeting with the surgeon I confirmed the number of screws at 11.
They use a small reciprocating saw to cut the mandible section out.
(http://bone-saws.salvin.com/images/products/enlarged/RECIP-SAW.jpg)
$1100
Nice tool!
Wow Don, those are pretty nifty screws, and eighty bucks each seems to be a bargain when you consider some hospitals charge twenty bucks each for a tylenol.
Ace Ortho Care .....Ace Hardware....Hmm
Bruce
Just popping in to send you my best wishes as well, MD! You have many friends, and you're in our prayers... Sounds like a really rough time for you. The whole thing sends chills down my neck... and jaw...
Quote from: firefox on April 17, 2010, 10:13:14 PM
Ace Ortho Care .....Ace Hardware....Hmm
Bruce
At least it's Ace and not Acme, you would think that Wiley Coyote would have wised up and switced vendors by now.
$1100 actually seems pretty cheap for a surgical grade sawzall.
Don,
Hope you have a very speedy recovery with minimal pain. ;D
CHUCK
Glad to hear you are back Don! I went Jeepin for you this weekend :D
Quote from: OlJarhead on April 19, 2010, 12:21:56 PM
I went Jeepin for you this weekend :D
Great! Where were you when they cut into me?
Quote from: MountainDon on April 19, 2010, 01:36:24 PM
Quote from: OlJarhead on April 19, 2010, 12:21:56 PM
I went Jeepin for you this weekend :D
Great! Where were you when they cut into me?
Not sure but it was Saturday that I took the Jeep around our place on the ATV trail :) Did you see the video I posted here for ya?
24 Staples In My Butt!!!!
Whoa! The spot where they took marrow from my hip is more like a neighborhood! Big long L-shaped incision. 24 staples to close it! No wonder that had it's own little painkiller dispenser hooked up with a mini IV. That's gone as of this afternoon.
More on the technology front. The titanium strap and screws in the mandible are rated as MRI and CT safe.