Guest guest Posted April 17, 2011 Report Share Posted April 17, 2011 Hi, ! Great to hear from you again! You're another very longterm Bandster who has done well. I don't know of anyone who has had your particular jaw surgery, but I do know of two in 8 yrs who have broken jaws in accidents, and had their jaws wired for a couple months of healing. One was pretty much at goal, and did just fine. The other was soon after banding, and was not able to eat solid protein, of course, and basically put her band loss on hold for 3 months until she was un-wire - then did well over the next 2 years. The lady near goal maintained her weight just fine. It's still the total calories per day that count - Figure the daily calories that you're consuming now to maintain your ideal 170-180, add about 500/day for the needs of healing, and that should allow you to maintain your weight. You may need to tweak a little as the weeks go on. The most intensive calorie needs for healing will be in the first 2 weeks or so, then will taper off. I'd suggest a good Protein mix from a Health Food store, rather than Ensure which is protein deficient and high-calorie (it's really meant for seniors having trouble maintaining weight). There are lots of choices, so talk to them about your needs and try different ones. Supplement it with nutritious blended soups, ice cream, and juices. THis sounds like a fairly involved surgery, and some docs would want an unfill. I personally would disagree, since your fill is not a big one, you've done great with NO vomiting, and are a very experienced Bandster by now. There may be a small chance of vomiting, but it's very small. Anti-nausea meds can be used. And even if you do vomit once or twice, it's extremely unlikely it will cause band problems - your band is exceptionally well-healed into place by now, and there is lots of good scar tissue holding it very securely. You are wise to have the NG placement under fluoro, as it will be a larger sized one if it is to be used for feeding for 6 weeks. You'll know to flush it well with water after every use, to be sure it doesn't clog up. I always believe in messing with a fill as LITTLE as possible, and I do not see a good reason to mess with YOURS now. The fill can always be reduced if you really need it, after the surgery. If your oral surgeon has not discussed ways to achieve good oral/teeth care during the wired-shut time, consult your regular dentist. THis will be important, as you won't be able to get a toothbrush in there. Good luck! I think you'll do just great - just as with your Band!Please let us know how you are.. Sandy > > Next month, I'm having double jaw surgery (after a year of braces to straighten my teeth first) to correct my underbite. This involves cutting both jaws, moving the lower one back and upper one forward, and then using small screws to pin the jaws in the new alignment. I will have a splint between my jaws to hold them in that perfect alignment, and my jaws will be wired with the splint in place for 6 > weeks. I'll be on a liquid diet, using a feeding tube or syringe > that fits through a small opening in that splint. > > Since the surgery requires insertion of a naso-gastric (NG) tube, I have arranged that the NG tube be placed under fluoroscopy so that no damage is done to my band or pouch. > > I only have a loose fill of about 2.5 cc's in a 9-cc Swedish band, and have more or less maintained a 170 to 180 lb weight loss for almost 7 years. Since I was banded in September, 2003, I have never vomited or had any notable band complications. > > And it is barfing that now has me concerned. I gather some people do vomit dried blood after this surgery. (The jaws are highly vascularised, and bleeding or oozing is normal for at least the first week. I may not bleed that much,since my hematologist will give me desmospressin (DDAVP) in my intravenous to help clots form, and tranexamic acid (Cyklokapron) for 10 days post-op to help clots stay > in place.) Also, since I will not be able to chew, I am worried > that if I don't use my blender thoroughly enough, a little chunk of solid food may get swallowed. (Mostly I'll drink Ensure meal replacement shakes, but also have smoothies, tomato soup, etc.) > > Some people lose a few pounds a week while their jaws are wired. > > So: should I get a defill before this jaw surgery, or keep my fill intact as I did with 8 of my 9 post-band surgeries? (I got a partial defill during my beltline lipectomy.) > > Also: anyone else have double jaw surgery as a bandster? Any tips? > > Thanks, > in Canada. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 2011 Report Share Posted April 19, 2011 Hi , I recently had to have hernia repair & band replacement. I had to do the 2 week starvation diet again. Instead of going on Meditrim as last time, I decided to go on a drug store shake. I wanted to use Slim Fast, but my dietician suggested diabetic Boost. It has the most protein- 16 grams I think. It is not quite as tasty but I out them in the freezer for a few minites & they taste fine to me. I am just finishing 3 weeks of nothing but diatetic Boost. Good luck with your surgery. Charline in NB Canada > > Next month, I'm having double jaw surgery (after a year of braces to straighten my teeth first) to correct my underbite. This involves cutting both jaws, moving the lower one back and upper one forward, and then using small screws to pin the jaws in the new alignment. I will have a splint between my jaws to hold them in that perfect alignment, and my jaws will be wired with the splint in place for 6 > weeks. I'll be on a liquid diet, using a feeding tube or syringe > that fits through a small opening in that splint. > > Since the surgery requires insertion of a naso-gastric (NG) tube, I have arranged that the NG tube be placed under fluoroscopy so that no damage is done to my band or pouch. > > I only have a loose fill of about 2.5 cc's in a 9-cc Swedish band, and have more or less maintained a 170 to 180 lb weight loss for almost 7 years. Since I was banded in September, 2003, I have never vomited or had any notable band complications. > > And it is barfing that now has me concerned. I gather some people do vomit dried blood after this surgery. (The jaws are highly vascularised, and bleeding or oozing is normal for at least the first week. I may not bleed that much,since my hematologist will give me desmospressin (DDAVP) in my intravenous to help clots form, and tranexamic acid (Cyklokapron) for 10 days post-op to help clots stay > in place.) Also, since I will not be able to chew, I am worried > that if I don't use my blender thoroughly enough, a little chunk of solid food may get swallowed. (Mostly I'll drink Ensure meal replacement shakes, but also have smoothies, tomato soup, etc.) > > Some people lose a few pounds a week while their jaws are wired. > > So: should I get a defill before this jaw surgery, or keep my fill intact as I did with 8 of my 9 post-band surgeries? (I got a partial defill during my beltline lipectomy.) > > Also: anyone else have double jaw surgery as a bandster? Any tips? > > Thanks, > in Canada. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 2011 Report Share Posted April 23, 2011 Hey Sandy! Thanks for replying so thoroughly. I appreciate your help! Just to clarify one point, the NG tube will only stay in while I'm in the ICU the first night. (I forgot to ask my oral surgeon why I need one at all -- can you guess?) I will be consuming my liquid diet using a 60-cc syringe with a rubber hose fitted to it, that will be inserted through the splint (which in turn will be wired to both my jaws for 6 weeks). Of course, maintaining acceptable oral hygiene will be a challenge, since all I can do is use a child's small toothbrush to clean the outer surfaces of my teeth, and then rinse with mouthwash. (An adult toothbrush would be too big to get around my swollen cheeks and gums. One new question: any idea how I can " force " myself to sleep on my back during my recovery? I am a lifelong side sleeper, and that would put my swollen, very tender wired jaws right on my pillow. My only idea is to sleep in a recliner (say, a lift chair version of a La-Z Boy?), since then there is physically no room to roll over on my side. The bonus would be improved drainage of blood, lymph fluid, mucous etc. from my mouth and nose. But do you know of any technique to make yourself sleep on your back in a regular bed? My only idea is to have an 8-inch-thick dense foam pad cut in two, and sleep with half on each side of my body. Thanks again, . ....> You are wise to have the NG placement under fluoro, as it will be a larger sized one if it is to be used for feeding for 6 weeks. You'll know to flush it well with water after every use, to be sure it doesn't clog up. ... > > If your oral surgeon has not discussed ways to achieve good oral/teeth care during the wired-shut time, consult your regular dentist. THis will be important, as you won't be able to get a toothbrush in there. > > Good luck! I think you'll do just great - just as with your Band!Please let us know how you are.. > > Sandy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 2011 Report Share Posted April 23, 2011 Hi Charline, I will check out the Diabetic Boost. The High Protein version does have 15 g of protein, as compared to 10 g for the Regular Boost. I had a nice visit to New Brunswick two summers ago, and enjoyed Saint , but got deluged with rain at Fundy National Park and had to escape with my wet tent after just one night! Thanks, . ... I wanted to use Slim Fast, but my dietician suggested diabetic Boost. It has the most protein- 16 grams I think. It is not quite as tasty but I out them in the freezer for a few minites & they taste fine to me. I am just finishing 3 weeks of nothing but diatetic Boost. Good luck with your surgery. > Charline in NB Canada Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 2011 Report Share Posted April 23, 2011 Hey, ! The NG will be used to drain fluids during the surgery and first night. There will be some bleeding that you may swallow, so they are commonly used with any head/neck surgery. As far as sleeping - I think a recliner is the best bet, and you can practice with it before surgery. There is benefit from having your head raised anyway - it will help reduce swelling and allow easy drainage. A good recliner will lay you back enough that you're not far from flat anyway. No need for the " lift " kind of recliner. Another option, if you want to be in your own bed, is the large solid foam wedges geared for people who need their heads raised for sleeping for cardiac reasons. These are available in any medical supply store or on the Net. The 10 inch one here looks ideal: (I don't think the 7 inch one is enough) http://www.colonialmedical.com/product.php?productid=17222 I'd suggest starting to sleep with the wedge now, to get used to it. I think it won't be hard, and it will soon feel odd withOUT it. Good luck! Sandy > ...> You are wise to have the NG placement under fluoro, as it will be a larger sized one if it is to be used for feeding for 6 weeks. You'll know to flush it well with water after every use, to be sure it doesn't clog up. ... > > > > If your oral surgeon has not discussed ways to achieve good oral/teeth care during the wired-shut time, consult your regular dentist. THis will be important, as you won't be able to get a toothbrush in there. > > > > Good luck! I think you'll do just great - just as with your Band!Please let us know how you are.. > > > > Sandy > Quote Link to comment Share on other sites More sharing options...
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