Monday I had my 34th surgery and I woke up to some of the greatest pain I've ever woke up to in all my surgeries. My mouth hurt like a son of a bitch and it was a different kind of pain. I knew plans had changed in the OR with regards to my mouth cause this pain did not feel like z-plasty's. This felt like something else. Then there was the pain in the sides of my neck, or the top of my shoulders, however you decide to look at the placement of the releases and then the pain in my donor site below my right knee. I could barely open my mouth to speak to the nurse who was taking care of me in the recovery room it was so swollen and hurt so bad.
Once they felt they had my pain fairly under control as much as they could there, they released me to be taken back to my room over at the OBC. Of course as I come out of the recovery room, my mama's waiting for me in the surgical waiting room and comes out when they call her name. She takes my hand to give it a squeeze that says "I love you, honey" and follows us as she has done time and time and time again. As soon as I'm in my room and as soon as my nurse has asked what I need and leaves to go get it leaving me and my mom alone, I ask for a mirror.And I'm in horror when I see the reflection in the mirror because staring back at me is the Joker from Batman. My doctor has cut open the sides of my mouth to open it up. There were no z-plasty's in site as he said he was gonna do just before I went in for surgery. Evidently he changed the plan after I was knocked out to a plan we had discussed a long time ago. But I wasn't mad about that because I trust my doctor to do what is best and if he takes a look at my mouth after I'm under and decides that there needs to be a change in the plan, I trust he will make the right decision and go through with the right plan because we have been working together as doctor and patient for almost four years now and he knows me, he know my body and how it reacts. But I do look terrible and am anxious to talk to him and discuss what he did exactly.
Trying to control my pain after surgery is a feat in itself. Nurses are nervous to give me the amount of pain medicine as is prescribed for me. Usually my doctor puts me on Dilaudid PO and a Dilaudid IV but I'm taken by surprise when the nurse breaks out the Fentanyl for my IV meds. I'm even more surprised at how much my doctor has prescribed for me seeing as how he has a history of being nervous with pain meds as well. Now, let me pain you a picture. Fentanyl is about a 100 times more powerful than morphine. And Fentanyl is often what they give you to keep you asleep in a medically induced coma. To keep you asleep and out of pain in a medically induced coma, they usually put 100-150mcgs of Fentanyl in a person's IV. Well, I've been prescribed up to 200mcgs of Fentanyl. And I'm not being put into a medically induced coma where a breathing machine will monitor my breathing and keep me breathing if needed. So all the nurses are incredibly nervous to give me the 200mcgs but on the night after my first surgery when I was in such excruciating pain from my foot, the nurse was giving me the 200mcgs of Fentanyl and I was having no problems. I wasn't falling into deep sleep. I wasn't slurring my speech. My respiratory wasn't depressed. I was doing fine. So as you can see, my tolerance level for pain meds is so very high. After my second surgery I was in excruciating pain again only this time it didn't have to do with my foot. So my doctor orders a Fentanyl PCA for me that was close to the equivalent of getting 200mcgs of Fentanyl every hour as I was getting before plus 8mg of Dilaudid PO every 3 hours. That should take care of me and so far it's done well.
(My "Joker" mouth one day after surgery. A lot of the swelling has gone down)
(Left side release after second part of surgery and one day after)
(Right side release after second surgery and one day after)