In mid-2017, I met with my surgeon at Kaiser, Dr. Andrew Kleinberger, as arranged by the Multi-Specialty Transitions Clinic. We worked out what I needed for my facial appearance in the way of surgical changes. A CT scan of my head was arranged to gather data the doctor would need in guiding his work.
The doctor broke down the needed work, totaling some 14 hours of surgery, to be done in two parts. The first stage, involving bone and cartilage work from forehead to jaw was about 8 hours worth, and the second portion, adjusting soft tissues to match the new bone structure and making some changes to alter the throat cartilage was estimated at about 6 hours of surgery time. The two surgeries would be at least a year apart to allow adequate recovery and healing of the bone before shifting the soft tissue.
The first surgery was done in late August of 2018, and is documented here.
The second stage surgery was performed on March 9, 2020.
We arrived at Kaiser Oakland at 6 AM for checkin and preop stuff. I was quickly tagged and after a few minutes was back in the pre-op area to be weighed, measured, plumbed and wired for surgery. I was in the usual little hospital bed, the Gown of Embarassment donned and ready in just a few minutes. They had that lovely warm air blanked already running and hot, which felt very good indeed.
Because of the time I would be on the OR table, special pads were placed on my rear and shins, something new to me. The usual EKG wires were placed, and an IV run into my left hand. Blood pressure was through the roof initially, so I spent a little time in breath meditation to bring this under control.
Laurie was brought back to help me relax a bit, and we chatted about nothing in particular, she trying mostly to reassure me all would be well.
Dr Kathy Brandstetter came by about 7:30, along with a newer doctor on the team, to place guide marks for surgery on my neck and face. Both had excellent bedside manners, quite reassuring. They explained that Dr. Kleinberger was a little late and I would see him in surgery.
My anesthesiologist came by, and we discussed what would be done, the broad sequence of events, IV + oxygen + gas, intubation once I was well sedated, and that the tube would be removed post-op, likely before I would be able to remember. We discussed nausea control and whether or not the anti-nausea patch would be a good idea. Oh, I got the patch, unlike the first round, and it worked very well!
At 8 AM I was rolled away, saying good bye to Laurie until I was done. I had the easy job and would be asleep. Laurie got to sit in the waiting area watching the status board for color changes next to my tracking number.
I was rolled into OR6, still wide awake. “Good morning, Dr. Kleinberger!” Three surgeons (one in training), anesthesiologist, scrub nurse, assisting nurses, all circulating around me! I was shifted onto the surgery table, positioned, armrests attached and my arms lightly fastened down. My head was on a foam doughnut and chux pad, giving me a great view of the upside-down anesthesiologist and some huge adjustable surgery lights.
The recorder started, all present checked in. “Michelle, do you you understand what we are about to do?” “Yes, sir. Rhytidectomy and chondrolaryngioplasty.” Basically, a lower facelift and trach shave, as we had discussed a few years ago. The other stations gave their reports.
“We are ready to begin.” The anesthesiologist placed the mask and started the oxygen feed. The doctor mentioned that he would not intubate until after the chondrolaryngioplasty. (They need to use probes to verify that the incision on the cartilage would not impact the attachment point of the vocal folds.) Position would be shifted 180 degrees after the chondrolaryngioplasty.
The smell of the gas suddenly changed. The room gently spun and faded from view.
I woke in the recovery area about 4 PM. I felt more than a little spacey, and was thoroughly bandaged up.
At some point we were rolled upstairs to the 11th floor. I was placed in my room, met the staff, told I would be on a liquid diet, and was asked to watch a couple of videos on fall safety and the hospital stay.
After a few hours they had me out of the bed, and with the aid of a walker made a lap of the floor. I managed to demonstrate bladder function to their satisfaction, so I was not catheterized (Yay!), and drank my juice and water.
Laurie would be sleeping in my room with me,k a great comfort. I drifted off after being given two Tylenol for pain control. I woke just about midnight as the night nurse came in to start an antibiotic IV going. Pain was ramping up, and I was given 5 mg oxycodone. This got me to sleep more easily, although the BP checks at 2AM and 5AM woke me again.
About 7:30 two other doctors on the ‘head and neck’ surgery team came by on their rounds and changed the dressings, showing me how to tend to this. The dietician came by for my breakfast order... cream of rice or cream of wheat... Decisions, decisions...
The discharge orders were in by 8:30 and a Percocet prescription was ordered for me. Laurie went down to pick this up. By 10:30 I was getting dressed, and Laurie went to get the car while I waited for the nurse to take out the IV line and the escort to roll me out of the building in the usual transport chair.
It all went smoothly, and I was home by 11:30. Oh, breakfast never showed, but Laurie and I had some steel cut oats once home.
The first two days I used a Percocet every 6 hours just to ensure I was comfortable. The third morning I switched to one 325 mg Tylenol and stayed with that a few days, just taking a Percocet at bedtime.
I’m back to eating solid food, and the soreness in the jawline and throat congestion from probes and intubation is almost gone.
I’m just waiting for a little bruising and swelling to fade away.
I think I’ll be happy with the result.
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