Cleft Lip and Palate News Thoughts

The Wisdom Extracted alongside Four Wisdom Teeth

Wisdom teeth. Enough said - even the most elite athlete can be taken down by wisdom teeth pain. Unfortunately for cleft patients, wisdom teeth causing problems is an all too familiar occurrence - and I was no exception.

As those who know me are well aware, I am undergoing orthodontics in preparation for my final orthognathic surgeries to bring my top jaw in line with my bottom jaw, and my wisdom teeth weren’t about to go without a fight. Now I could very easily write an article all about the procedure of having one’s wisdom teeth removed, but that is something that you will either be familiar with or could easily find elsewhere on the internet, so instead I have chosen to write about what I learnt about the hospital system in 2013 during this experience in the hope that it may help alleviate some other people’s fears and anxieties surrounding going into hospital for surgery.

Amazingly, I had managed to avoid having any surgeries under a general anaesthetic since 2001, when I was a child, and so having to go in again for a general was something that scared me a bit as it had been a long time since the last time, and all I remember from 2001 was being incredibly sick in hospital after my operation vomiting up blood which I had swallowed during the operation. But I learnt the best way to deal with these anxieties. For me, my biggest anxiety is needles, which may seem rather irrational given all the other procedures I have had, but nevertheless, it is an anxiety that I have (we all have our own fears I guess!) Before any elective procedure that involves a general anaesthetic in New Zealand (and many other countries) you will have a preadmission appointment at the hospital. The purpose of this is to determine how fit and well you are so that they can be sure that you receive the best treatment. You will be seen by an anaesthetist, a house doctor and a nurse who will check your heart with a stethoscope, and check your breathing, blood pressure etc. It will also feel like a game of 20 questions where they ask many questions about your health and medical history (as if you won’t have answered enough questions on the paper forms already!) but my biggest piece of advice here is to use the opportunity to ask questions for yourself – everybody is there to help you – so if you are scared of needles for example, there is something they can do about that. The other helpful piece of advice that I can impart to you comes from my good friend Ellen McKee, and that is to not worry about something that hasn’t happened yet. Simple yet solid advice when you think about it – so for someone who is scared of needles for example, no point worrying about that seasonal flu jab for the whole week before, because for that entire week before, you are absolutely fine – there’s no need to think about it until it actually happens.

Before going in for any general anaesthetic, you will have to ‘fast’ (i.e. not eat) to ensure that the anaesthetic is effective and doesn’t make you particularly sick. The length of time that you will fast for beforehand will vary depending on a range of factors so be sure to follow the instructions given to you, and be sure to keep drinking right up to the time where they say that you can’t drink any more fluids – you may be waiting for a long time at the hospital and you don’t want to be dehydrated. For this procedure, as I was scheduled for the morning of Monday 17 June, I was able to eat until midnight the night before and then continue to have clear fluids (water, tea without milk etc.) until 08:30.

On The Day

After a night of fairly broken sleep I woke up, had a shower and went to have breakfast and then noticed my signs that I had put on the fridge door and cupboard doors saying ‘DO NOT EAT!’ so settled for a glass of water instead. It was a freezing Christchurch winter morning and bucketing down with rain so was sure to dress up warmly and then headed into hospital.

After navigating the labyrinth of corridors, I eventually arrived at the DOSA (Day of Surgery Admissions) area. I checked in, in much the same way that you would if you were going to get on a plane, and then went to wait my boarding call in the waiting room.

I was pleased to have thought to charge my iPod and bring it along with me as I figured (and was correct) that I could be waiting here for a while. Kelly Clarkson’s song ’(What Doesn’t Kill You Makes You) Stronger’ came on while I was sitting here, and whilst one only needs to meet someone with a progressively degenerative condition to realise that this sentiment is BS, at the time it was a very reassuring song to hear (and the sentiment is generally very true for us clefties who do get stronger with every procedure we go through). Eventually one of the DOSA nurses came through and ushered me through to a room to go through everything with me, make sure that I was still willing to go through with the procedure and to put EMLA cream on my hands to help with putting the IV needle in (as an aside, everyone you see on the day will keep asking you what procedure you are having – this isn’t a trivia quiz to see how much Googling you have done about your op, it is so that they make sure they are doing the right thing and providing the right treatment, so this is not the time to crack a joke about being there to have a limb amputated).

Once all this paperwork was complete, they put a band on my wrist to remind them who I am once I am unconscious and can’t speak for myself and was sent back out to the waiting room to await my ’10 minute call’ from theatre. I was also handed a gown and a pair of the sexiest stockings ever to get changed into when the 10 minute call came up. After a while, the nurse called me over and took me quietly to a room to get changed and wait so that we wouldn’t be rushed when the 10 minute call came up. She closed the curtain as I tried to figure out how on earth to put the gown on. I quickly concluded that the gown has a gaping hole at the back which leaves nothing to the imagination, I may have been in hospital, but I wasn’t going to be so undignified that I was going to walk around with my bum out with stockings to my knees, so made the decision to keep my boxer shorts on – I would strongly advise you do the same.

Once I got changed the nurse told me that she was going to bring me a ‘cuddly’ to keep me warm. I had no idea what this was – was it a teddy bear? A person? Well it turns out that it is a regular blanket. I was also told upon delivery of my ‘cuddly’ that the machine that warms the cuddlies was broken, and so my cuddly was presented at room temperature. Funnily enough, I still felt ridiculously hot! The nurse tucked me into a chair restrained by my cuddly and I awaited the call from theatre.


Sitting wrapped up in my ‘cuddly’ and in the hospital gown awaiting my call from theatre

Going to Theatre

I remember looking at the clock and realising that my concept of 20 minutes and the hospital’s concept of 20 minutes were quite different. Eventually, an orderly came along with a bed and I climbed in. Alongside the ward nurse, the orderly went through some final paperwork before getting clearance to wheel me down to theatre. Lieing in a bed getting pushed around the hospital corridors is a rather odd feeling. I was being pushed backwards and I remember seeing white light after white light on the ceiling, and wondered whether people who have a near death experience and report ‘seeing the light’, are in fact seeing these hospital lights on the ceiling and in their semi-conscious state perhaps are not registering what they are actually seeing. I also remember lots of hospital staff walking past the bed and many of them would look down at the bed and smile. We seemed to go past many sets of double doors and the orderly told me that each set of doors was an operating theatre. Eventually the bed turned into a set of double doors with the number ‘5’ on them, and I was quickly introduced to another anaesthetist who put electrodes on my chest so that they could monitor my breathing once I was asleep. The orderly explained at this point that he had had his wisdom teeth out when he was younger and that it had been a long four hour ordeal, the anaesthetist quickly butted in at this point and said ‘yes, but yours won’t take nearly that long’. My surgeon then walked in to the room at this point and told me what would be happening before walking through another set of double doors.

Once I had all my electrodes installed on my body, the other anaesthetist came in and said ‘okay, we are going to walk you in’ which actually translates to ‘you are going to walk over to the other bed now’. I remember him telling me to be careful not to slip on the floor and then quickly followed it up with ‘but there shouldn’t be anything slippery’ right as I noticed a big red stain on the floor right next to the bed.

I hopped onto the operating bed and was quickly hooked up to various machines which all made lots of beeping noises. I saw one of the big screens had the time on it and it was 12:51pm, which affirmed to me that the hospital and I also had a different idea on the concept of ‘morning’. The anaesthetists gave me a mask which they put over my face and told me to breathe it in and that it would smell like what it would smell like to sniff petrol. The anaesthetists were very good at putting me at ease throughout this part of the procedure, the machines started beeping which they quickly told me was normal. They told me that just at the point that I felt like there was no way the gas was going to work, that it would start working. They were right. After about 30-45 seconds of breathing in the gas, I felt like nothing was happening, and then all of a sudden, everything around me started becoming fainter. The last thing I remember them telling me is that ‘In a minute you are going to wake up in recovery’. I knew that there were people there standing over me looking at me and I could hear them talking but it sounded like they were underwater and I had no idea what they were saying. I saw little black spots in my field of vision, getting bigger and bigger and then I don’t remember anything else.

Waking Up In Recovery

My next memory is of opening my eyes to see completely different surroundings and find an oxygen mask on my face, a canulla in my right hand and a recovery nurse looking right back at me. He smiled and said ‘The time is 1:30, the operation is over’. The clock said ’13:43’ so I wondered if my concept and the hospital’s concept of 1.30 differed or whether I dozed off for 13 minutes and have no recollection of it. The nurse picked up a jar from the end of the bed, held it up to me and said ‘Here are your chompers!’ and sure enough, inside it were the four cretins that had caused so much trouble and unsurprisingly – they were huge! He then took my oxygen mask off and told me that we were going to try breathing without it. He then asked me if I wanted a lemonade ice-block, but funnily enough, I didn’t feel like eating yet even if I had been able to.

He left me alone for a bit and came back a little bit concerned because I was shaking seemingly uncontrollably, he asked if I wanted a blanket (finally a word that made sense to me!) and I nodded, and stopped shaking very soon after. I drifted back off to sleep for another half hour or so and when I next woke up, I had a proper look at my surroundings and found it to be one of the strangest places I had ever found myself in – unconscious people being wheeled in every few minutes, and I remember seeing one very young child being wheeled in and thinking that would’ve been me 20 years ago and how wrong it seemed for such a young child to be in that place.

After I had been awake and stable for a while, the nurse from DOSA was called and came to collect me and wheeled me back to the ward.

Back In The Ward

Going back to the ward is the first step towards going home. Once back in the ward, I was given my own room and told just to rest for a bit longer. The nurse went and found my iPod for me to listen to. She also got me a cup of water with a straw, but both my lips, chin and tongue were numb from having had local anaesthetic as well as the general, so much as I wanted to drink, to my complete frustration, I was unable to suck on the straw and any attempt to drink the water without a straw just served to moisten the top of my gown.


Back in the ward

About an hour later my mum and youngest brother arrived back at the ward. I was feeling rather okay at this stage and had managed not to vomit this time from the anaesthetic which was a relief! My nurse went off duty and another one came on who got me some ice-cream which I really wanted to consume but despite my best efforts, due to the numbness and swelling, the closest I managed to get the ice cream to my mouth was on my chin! So despite being 22 years old, it was back to being spoon-fed by mum – an awkward experience for both of us!

The nurse was keen to get me moving again, and so I slowly got up and then quickly realised that my lack of control of my mouth was directly correlating with me drooling blood all over the gown and floor. I figured out how to control that by tilting my head back.

After a bit more rest, I had the canulla taken out of my hand, got to put my clothes back on, was given a bag of pills, some paperwork, a jar of teeth and was sent back home to recover, after having experienced a good practice run for the more major orthognathic surgeries coming up in the next 12 months or so.


Resting back in the ward


Getting up – sporting the sexy stockings

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