Orbital Floor Surgery, Take Two

As I said in my last entry, I am now at home recoupering from what is hopefully my last surgery to correct the damage from November. I’ll go through a quick walk through of yesterday. I woke up around 10am and basically just tried to kill some time until I was supposed to be at the hospital. I was originally going to take a cab down there at around 12:30pm, but it was such a nice day out that I decided to just walk the whole distance myself. Surprisingly, it only took me a half hour.

Once I got there, everyone was immediately friendly. Even though I had to answer a pile more questions that I had already answered before, it didn’t really bother me as things were finally about to be finished. Everyone was on time thankfully, and at 1:15pm I found myself getting changed in the Jim Patterson Pavilion at VGH. And let me say — VGH, at least the new areas that I was in, is a far nicer hospital than St. Pauls. It just seems far more modern and inviting than St. Pauls, and it was almost comforting haing out there. Oh and this time, I didn’t strip naked in front of the nurse, so I learned my lesson.

My actual surgery was scheduled for 3:15, and thankfully this time I brought a real novel to help pass the time. Over at St. Paul’s, I spent most of the time waiting for surgery in a really uncomfortable recliner wearing a surgery gown, but at VGH I had a full bed in a semi-private room, which was really nice. While I was reading, a nurse came over and covered me with blankets, which was a nice gesture that made me feel right at home. I could have almost slept, but people kept coming by and doing various things (such as put in my IV, go over my history, put those little tags on my wrists, etc).

Finally my surgeon comes in and talks to me about everything. He asked me to put my head back as he examined my eyes once more. He said he went over my CT scan, and said my fracture went really far back into my eye socket, more than normal. So instead of trying to correct it using the implant that was in my eye, he would take it out and start over. Another thing he said is that in his opinion, my eye wasn’t just vertical misaligned, but also misaligned front-to-back (which an eye doctor said wasn’t the case a few months ago). And even though he talked to my other plastic surgeon and the eye doctor, he disagreed with them and said just looking at me it was apparent to him, and that he was going to correct it (so maybe having the best guy in the province is a good thing).

So, the plan was to raise my eye a few millimeters, and also bring it forward slightly by sliding the implant pretty far back into my eye socket (you can go about 4cm back before you hit the optic nerve).

Next I met the anesthesiologist who, like his St Paul’s counterpart, was a really nice guy. He was surprised I hadn’t had any food or water for breakfast since my surgery wasn’t until 3pm, but he was happy I hadn’t since it made his job easier. But at that point, since I hadn’t had anything to drink in about 18 hours, I was completely dehydrated, enough that they hooked up a saline IV to make me feel better. They were so busy at the hospital that the anesthesiologist offered to wheel me into the OR himself instead of an orderly, which is probably something that doesn’t happen very often at any hospital (since anesthesiologists are pretty far up the totem pole). We actually had lot of fun since he didn’t really know how to drive my stretcher and we kept whacking into things.

The OR seemed a bit less high-tech than the one at St Paul’s, but that didn’t worry me. They started stripping me nearly naked, hooking up tubes, etc, and pretty soon I had the first cocktail injected into my IV to help relax me. At that point I was pretty out of it, just sort of passively aware of people getting ready around me. Next, I was asked to think of somewhere I really wanted to be, somewhere warm and happy. Next thing I knew, I woke up in recovery.

At this point, after checking my eyesight and verifying I still had two eyes, I really wished I had a camera. As I looked forward from my bed, in pain, I realized I had a sweeping 180 degree view of the entire downtown core from my bed, and it was really pretty. It took about 10 minutes for someone to notice I was awake, and once they did notice, my surgeon came over to talk to me. He said they replaced the implant, but that I had quite a bit of scar tissue that had formed in my eye socket. So, once I was back on my feet, I was going to have to work at eye exercises to break it all down. But, he seemed happy with the surgery.

It’s a bit disappointing (in general) that the doctors talk to you as soon as you come to, because to be honest, I don’t really remember much of that conversation. It’s hard enough to keep your eyes open at that point. They are really busy though (my surgeon is in Prince George today doing surgery), so I understand they don’t have much time, but it would be nice if someone wrote some of that down for you for when you have your senses back again.

I was in more pain than last time, and in general, felt like complete shit. I’m not sure if they kept me under longer or what they did differently, but surgery kicked my ass in a big way this time. I had to get them to give me three separate injections of pain killers to stop the pain in my eye socket and put me at ease. Plus, I was so nauseous that they hooked up a bag of gravol for my IV so I wouldn’t barf.

About an hour later they moved me back into the peri-operative area where my dad was finally allowed to come hang out with me. I was really out of it at this point, and didn’t even really feel up to talking. But he just sat next to me, putting his hand on my knee from time to time to let me know he was there. They gave me a couple T3s at this point to help with the pain. At this point, based on my last surgery, I would have gotten up and gone home, but I didn’t really feel like I could talk, let alone walk, so I just stayed for 45 minutes to an hour longer until I felt like I could at least hop into a wheel chair.

I spent the night back at home, chatting with my dad and listening to music. We put on Pan’s Labyrinth to watch, but after about ten minutes I realized it was a lost cause, and we turned it off so I could pass out and go to sleep.

My dad and I were both really impressed with the hospital staff at VGH. Everyone went out of there way to be friendly, and even crack the odd joke or two. Those little gestures make all the difference when you’re stripped naked, and sitting there worrying about your pending surgery. We stopped on our way out to thank the nursing staff personally for making it easy on everyone, and it was a nice experience based on everything I have been through in the last six months (see, I don’t hate all you medical people).

So, here we are. The surgery disrupted my infraorbital nerve, which means my entire left side of my face (my left cheek, nose, lip and gums) is completely numb again. If you held a lit cigarette against it, I’m sure I wouldn’t flinch. This happened with my last surgery, and hopefully over the next few weeks it will slowly come back in a series of pins and needle sensations as nerves start going active again.

The incision is a bit different this time, and it looks like they didn’t recreate the old one exactly (perhaps on purpose so they could see more inside of there), which will mean I have two scars instead of one, but oh well. Instead of having steri-strips on my wound, this time they just covered it with polysporin and left it exposed, which is a bit weird since last night it was dripping a bit of blood and creeped me out. However, they say it heals better this way. The vertical position of my eye seems better, but I’m trying not to get my hopes up so early in the recovery, since the swelling and everything distorts how everything looks for a while. The double vision is about the same, but it actually hurts to look in those areas now, where before it didn’t. Which actually makes me happy, since I think it means those muscles are no longer trapped on anything, and are free to move again (but sore from scar tissue and lack of use). But he said hopefully the double vision will resolve slowly over the next few months, if all goes well.

Here’s a shot from this morning comparing the result (on the right) with a before shot taken about a week ago.

At least to me it looks quite a bit better, excluding that big bloody gash under my eye. Next Thursday I’ll get the stitches out, and will get to clean everything properly and see what it really looks like.

Once again, thanks for all the support. Hopefully I’m on my way to having all of this behind me.