MQ (male 31) – San Francisco, California
Date of maxillomandibular advancement – October 14, 2009
The Bottom Line, First:
Undergoing Maxillomandibular advancement (MMA) surgery with Dr. Li was one of the best decisions I’ve made in my life. Only seven weeks removed from the operating room and I’m sleeping extremely well. I feel rested for the first time in ages; as a result, I’m thinking much more clearly, I have more energy and my mood has improved dramatically. Of course, now that I have a bit of perspective, it’s tempting to bemoan all that time and opportunity lost to unhealthy sleep through the years. With my severe sleep apnea a thing of the past, though, I’m just too excited about what lies ahead to worry about what could have been.
I was diagnosed with sleep apnea in 2005. I struggled with CPAP for years before being re-evaluated by the Stanford Sleep Disorders Clinic in 2009. There, sleep studies revealed a Respiratory Disturbance Index (RDI) of 46.4, meriting a diagnosis of severe sleep apnea. My prescribed treatment was CPAP at a pressure of 15 cm of water. Unfortunately, my anatomy once again conspired against CPAP narrow breathing passages made it a struggle to exhale against the high air pressure coming in from the machine. When, and if, I fell asleep, I would wake up shortly with air streaming out of my mouth or abdominal cramping from swallowing too much air. Given my profile and inability to tolerate CPAP, the Stanford Sleep Disorders Clinic referred me to Dr. Li.
Dr. Li’s reputation as a world class surgeon is matched by his bedside manner. He took the time to thoroughly evaluate my condition and familiarize me with all available options. Any question my wife and I may have had regarding the various procedures was answered with detail and consideration. Given my history and profile, it made sense to proceed with MMA surgery (in addition to correcting a deviated septum in my nose).
Day of the Surgery:
The morning of the surgery I was both nervous and excited, as was to be expected. The staff at Stanford Hospital, as well as the anesthesiologist and Dr. Li, ensured that everything progressed smoothly from checking in to recording my vital signs to wheeling me into the operating room. Once I was moved to the operating room, it wasn’t long until I was under anesthesia. After that, my first solid memories are of the intensive care unit (ICU), where I spent the night after surgery.
The staff at Stanford is fantastic. I don’t imagine it’s ever fun to stay at a hospital, but the staff’s attentiveness and familiarity with the procedure made my two days as pleasant as one could hope. The first night I spent at the ICU, where they made sure I was comfortable and recovering well from the surgery. For the most part, it was a blur of waking, sleeping and something in between. The second day I was moved to the general hospital, where I stretched my legs for the first time and began familiarizing myself with a liquid diet. There was some pain, as well as a little discomfort (my mouth was banded together), but overall it wasn’t bad. Mostly, I felt tired, thankful the operation had gone well and eager to continue the recovery process at home. Dr. Li visited each day to check on my progress and I was cleared to return home my third morning in the hospital.
The First Week:
The first week after the operation wasn’t a whole lot of fun. The minutes and hours seemed to crawl by, and I imagined that the coming few weeks would be some of the longest I could remember since childhood (I’m happy to say that wasn’t the case: after the sixth or seventh day, routine took over and time seemed to accelerate). Pain was not a major issue for me; however, post-surgery nasal congestion made my first few days home less than pleasant. Combine a closed mouth, a prohibition on sneezing and post-surgery nasal discharge (blood and mucus drain from the sinuses during the first days post-operation) and you have yourself an uncomfortable time. Even though I stopped by Dr. Li’s office immediately after leaving the hospital to have my nose drained, I found myself very congested the next morning, which happened to be a Saturday. My wife called Dr. Li, and he very kindly met us at his office just to clear my nose.
Fatigue and a bit of malaise set in after a few days. As Dr. Li noted, I had, after all, just undergone surgery. Neither condition lasted long, however. Looking back, I’m pretty amazed at how quickly I recovered the first couple days I pictured an eternity sleeping in a easy chair with my mouth banded shut and suddenly it’s seven weeks later, I’m eating soft foods and sleeping like I never thought possible.
Random Tips and Observations on Recovery:
It’s particularly important in the first week or so to remember that you will be feeling much better soon.
I did not experience a great deal of jaw or facial pain some discomfort and a little pressure from time-to-time, but it was not bad. Aside from the nasal congestion of the first few days, the most uncomfortable thing I experienced was an inflamed Eustachian tube on the right side of my face. Brushing my teeth or drinking occasionally triggered a sensation similar to descending (or diving) quickly and being unable to equalize pressure in my ear. This was painful, but I soon learned to mitigate the unpleasantness by clearing my ears, swallowing or gently repositioning my teeth. As Dr. Li foretold, the inflammation decreased and the incidents became fewer and farther in between; finally disappearing altogether.
Keep breathing passages moist. Showering a couple times a day early on and sleeping near a cool-air humidifier really helped with my nasal congestion.
It helps to read about other people’s experiences with MMA surgery there are a lot of blogs out there with interesting insight on what to expect.
Get outside and walk around, if only down the block. It really makes you feel better.
Aesthetics think giant chipmunk for the first 7-10 days. As the swelling began to recede, I got a sense of my post-surgery appearance. With a stronger jaw and chin, I do look a little different I’ll give all the credit to Dr. Li’as my wife even thinks it’s an improvement. You can definitely tell Dr. Li is a skilled cosmetic surgeon.
You’re not alone. Dr. Li and his incredible staff were always available if my wife or I had a question.
Life changing. I’d go through the process ten times over to be where I am today, and I’m only seven weeks out. Thank you, Dr. Li, for giving me a new lease on life.