Pre-surgery note

Tomorrow.
Tomorrow is the day.
Tomorrow it will all change.
Tomorrow I will get my life back.

My surgery - the right TMJ eminectomy - is scheduled for tomorrow, at 08:30am.

On August 6th, I received a phone call from the Dental Hospital confirming the new date for my surgery. Since then, it has been extremely hard for me to rest, to sleep, to concentrate or focus on anything. Hence no new posts lately. My apologies.

Two days ago I had the pre-clerking appointment, in which all the pre-op medical exams were done. The surgery and recovery period were explained in detail and discussed once again with Mr. C. and his team of surgeons. After three hours of consultation, I signed the surgery consent form confirming I understand the procedure and was informed of all possible side effects.

The eminectomy procedure is exactly as I described on my post The surgery explained. However, contrary to Dr. P. C.'s* judgement, Mr. C. has no intention of removing the disc and replace it by a graft, even if it shows signs of severe damage. According to Mr. C., a damaged disc still provides a better joint functioning than any graft, and it must be kept for as long as possible.
In Mr. C.'s opinion, removing the eminence is already intervening too much on such complex joint. He will do his best to minimise the surgery's impact on the joint by avoiding touching the disc. However, if during TMJ function testing the disc fails to return to its position above the condyle on its own, Mr. C. will put it manually and secure the disc with a few stitches to avoid further disc anterior displacement. But this procedure is only done as a last resource.
From the discussions we had, Mr. C. seems to be a very sensible surgeon. I am so glad that he avoids disc replacements at all costs.
As for side effects, my lower jaw will shift slightly to the right side upon mouth opening. I already have this offset, and I consider this a minor thing when compared to the pain and discomfort I have to live with at the moment. Because some branches of the trigeminal nerve have to be moved out of the way to have access to the joint, there is also the chance of paralysis of the portions that control cheek and forehead movement. However, this paralysis is only temporary, and the nerve recovers after a few weeks/months. Also, I will leave the surgery theatre with a new hair cut - a lateral head shave, which is quite fashionable these days.

The surgery is planned to last one hour in total. I will stay at the hospital overnight in observation, with a drain placed in front of the ear to remove excessive blood and avoid swelling. I will come back home on the following day (Tuesday, August 14th), for a week of post-op pain and swelling. The only medication I will need to take is tramadol (for the pain), since antibiotics and anti-inflammatories will be injected straight into the joint. According to what I was told, I will be able to open my mouth fully straight after the surgery, but due to the natural swelling, on the first week it will be quite difficult. A week after, I will return to the Dental Hospital to remove the stitches and for an overall check.
Obviously I won't be able to start eating normally straight away. I will be on a liquid diet for the first days, slowly introducing soft foods as I feel the TMJ improving. They are confidant that my pain will reduce significantly, being the post-op pain much more bearable than what I have now.

I am extremely nervous and anxious for tomorrow.
I am sure I have another sleepless night ahead of me.
But be calm, little heart - the end is near.

Tomorrow I will have my life back.

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I will do my best to keep you all updated regarding my surgery and during recovery.
Once again, thank you all for your love, kind words, and support.

*Dr. P. C. - the oral-maxillofacial surgeon I went to see for a third opinion in April 2012.