Monday, January 7, 2019

LaForte with jaw impaction and placement of Red II halo

Colton’s Journey
(LeFort I osteotomy and placement of Red II halo device)

This is the journal of my son, Colton's experience through surgery/halo placement to
removal, February - May 2018, and follow-ups after removal through January 2019.
Hoping that his experience and this journal can help others who may be preparing for
a similar journey.

History
Colton was born with a cleft lip and palate. He has had MANY surgeries from the first pulling
his lip together until now. These surgeries will be 21 & 22.... In the summer of 2015, he had a
mid-face advancement in which his top jaw was extended nearly an inch, at the time we
were hoping to get close alignment.

Unfortunately due to the major misalignment of his upper and lower jaws, and some
complications afterward in which his cleft fell, he was not left with the results we hoped. We
discussed options with his surgeon and three others, the conclusion was that the only way to
get the results he wanted would be to have additional surgery and use the Red ll to guide the
growth of the jaw to a more normal fit.

After the consultations were complete, Colton decided he did not want to go through with the
surgery and months of wearing the halo. Fast forward about two years...in the fall of 2017,
Colton expressed that he wanted to go ahead with the surgery. In his words, "I hate how it
looks and I want people to stop staring at me." It broke my heart to hear him say this, and the
thought of the surgery and extensive recovery made me anxious. I knew though, that if he felt
he was ready, we would totally support him and make it happen. He is pretty strong-minded,
so when he makes up his mind to do something, he means it!

October 2
Preparing for surgery:
Dr. Mount had the representative from the company bring in a RED device (rigid external
distraction) so Colton could see it and get an idea of what it would be like. It is made of titanium
and super light, so that is one "plus." Also, it isn't as big or cumbersome as we (at least I) had
in mind.

She also had several CTs completed and a 3-dimensional model was made of Colton's head.
This would be used to help determine and guide what would be done in surgery. Considering
he already had his mid-face advanced bringing the top jaw out, the model clearly showed
how much more he had to go.






Before Photos:
Alignment of teeth is off both top to bottom and side to side, he also has the huge “gummy”
smile which Dr. Mount said she can reduce.  Because of the alignment, he has to pull his lips
together to keep them shut, hoping this will be improved as well.











February 21, 2018
Day of Surgery:


We headed to the hospital around 6 a.m. so Colton would be there by 7:15 for pre-op
preparations.  Getting prepped was the usual pre-surgery routine. Dr. Mount came in and
explained the procedure which would entail impacting his upper jaw (palate and bottom of nasal
cavity), removing tissue and moving it up, then installing the halo device (Red II) to his upper
jaw and anchoring with screws to the side of his head.    







Surgery was supposed to last about 2 ⅓ hours.  Colton went into surgery at about 8:30,
he was projected to be done around 11:30.  An hour in we got the notification that surgery had
started and all was fine. Around 11:00 we received another message that surgery was
progressing and Colton was doing fine.  




Noon came and went, and surgery continued.  We received another notice around 12:30 that
things continued to progress and Colton was doing fine.  Finally around 2:00, the surgeon
came to find us in the waiting room and let us know that Colton was in recovery.  She was very
excited and said that based on what she had done and how things looked already, Colton
would be pleased with the results.  


A short time later we headed back into recovery.  His face was swollen (though not near
as swollen as it was coming out of the LeFort surgery), and his nose was bleeding off and on.
The vision of the wires coming through Colton’s upper lip was hard to grasp at first, it took me
a bit of time before I could look at it closely.  The halo was also attached so tightly to the top of
his head that it pushed the skin up and made folds above the halo, again not the picture we
had in our heads prior to surgery. Colton was still out and having trouble coming out
of anesthesia, his oxygen stats kept dipping and his breathing was very shallow.  The nurse
put an oxygen cannula near his nose. Due to the surgery he couldn’t have it
put in his nose or mouth. The steady flow of oxygen helped keep his stats up and he
went in and out, talking to us occasionally. It took well over an hour before he was ready to
head to a room.


When we arrived at the room, he was in a lot of pain.  His nose keep bleeding, not excessively,
but enough to need to be continually cleaned off.  It ran whenever he moved. They told us
that this would eventually dissipate. We started taping a piece of gauze under his nose to
help stop the dripping...he didn’t like it, but it worked.


The first night was like the usual when you are in the hospital...lots of pain and not a lot of sleep.  He
also had to sleep with the bed propped up which was not fun either.
Side note: Have a recliner since sleeping flat with the halo is off limits, we were told he has to
be at a 30 degree or higher angle when sleeping.   We had to purchase a recliner since we
didn’t have one!




February 22
The second day the reality of it all starts sinking in...realizing that this “thing” is attached to
his head and there’s nothing he can do about it.   Pain was an issue as the IV med hits hard,
but wears off quickly. We kept encouraging him to drink so he could take an oral med which
would last longer.  By mid-afternoon he was able to do this and it helped sustain pain relief.
The constant dripping (bleeding) of his nose was really driving him nuts.


By evening he wanted to get out of the room so we took a trip in the wheelchair.  It was a good
diversion. We even went down to first floor and he played the piano for a little while.  He
got quite the stares from people as we went through the hall...these would be the first of many.  
Later in the evening we found out he was being moved to the adult side of the hospital.
We were bummed because the rooms are much nicer on the children’s side and they check
in on you a lot more but…there were other young kids who were really ill and needed the rooms,
so off we went.






Interestingly, when we got to adult side we not only got stares from the other patients and
visitors, we got them from the nurses too...several told us they had never seen a halo device like
his before.  I stayed the night and was glad I did as they didn’t know things like - he can’t have a
straw, and he can’t have a smoothie with berry seeds, and he can’t blow his nose. It was a
long, rough night in the new small room!


February 23
Early in the a.m. nurses came in and said Colton could go home that afternoon. I was
somewhat nervous as I wasn't sure if I was ready to handle all of this at home yet. At the
same time, I knew it would be a relief to get him home where he would at least be more
comfortable in his own space.

I never expected the drive home to be an issue, but it was. We had to stop two times for a
break because the bumps from the road were causing a lot of pain. Even with pillows for extra
support and driving as slow as I could he still said he was in a lot of pain. Our normal hour drive
home took over two hours. When he got home I parked him in the recliner, gave him a pain
pill and let him sleep the rest of the afternoon.


February 24-March 1
Monday nose stops bleeding

First week discoveries:
-Have lots of dixie cups ready - regular sized cups, plastic cups, water bottles - nothing else fits
been the metal “post” in the center and the lips..

-A travel neck pillow (U-shaped, like for flying) works great for sleeping in order to keep the
head from turning to the side..

-Get up in the night to give pain meds / ibuprofen...it is super important to control the pain.  
I created a chart to keep track of meds - helped a lot since my husband and I did a lot of
tag-teaming between middle of the night and early a.m.

-Be prepared to sleep on the couch - Colton felt very insecure about getting up and wanted
one of us to be around when he woke up in the night.

-Head pins are very sore - clean daily with peroxide and keep antibiotic cream on them.

-Long q-tips from the hospital are handy for putting on antibiotic cream etc.

-Ask your doctor for prescription pain cream (Lidocaine) to rub on on head and lips etc.


-Protein drinks are great for taking meds - gets some nutrition in when they don’t feel like eating.


-Button down shirts are life-savers.  Henleys don’t work (yet) because the whole head is so
painful.  Zip-up sweatshirts needed too.

-Colton has a vision impairment which made getting around with the halo on difficult...
not sure if / how it would affect others with no visual impairment, but we had to move some
things in the house and mark a couple door frames...it really interfered with his depth perception.
He had a hard time figuring out how far away he was from cupboards etc. when he was
walking around the house.




March 2
First follow-up appointment with surgeon.  She said everything looked good. She explained that
we would be starting the turns to move the top jaw out.  She completed the first set -
two full turns per day on each side - it is supposed to move 1mm a day over 12 days.  
Colton sat for the turns in front of about 6 people watching. His forehead was beading up
with sweat, but he said he felt o.k. I struggled watching…  


March 3
More tips:
-Stemless champagne glasses fit well behind the bar...better than dixie cups.

-Roast pans full of vegetables on the weekend - use them to add to soups or create your own

soups. (Lucky for us Colton loves cooking so he created lots of homemade soups, often using
our ingredients from supper e.g. taco meat, rice, cheese... barbecue, potatoes, carrots...he was
pretty creative!)  Making his own soups helped fill Colton’s time and gave him some control of
 his eating.

-Buy  different bases - chicken, beef.. You can also get coconut and almond milk which are great for making cream soups in the blender. 

-Keep ibuprofen with you wherever you go… and pain cream!




-Be prepared that your child may not want to go anywhere… or have people around.

-Be cognizant of how frustrating it is for them to watch others eat “real” food… we tried to make meals and eat when he was resting downstairs, and ate a lot of suppers of toast or something small so we wouldn’t eat in front of him!

-A syringe or small spray bottle works great for applying peroxide on the screw and pin sites when in the shower or tub.   I would apply, let it soak, help
wash his hair then apply again to make sure all the soap is out.
Then after he got dressed I would apply antibiotic ointment and
pain cream.  






March 4
Amazing how much change already from one week of turning!  The gummy look has been
eliminated, Dr. Mount took out about one centimeter of tissue during surgery.






March 9
Appointment with surgeon, things are looking good so far.  We can begin to see the movement.
We have to continue turning every day.  Again, Colton handled the appointment well -
no complaints. He’s being really strong.  At home he’s up and down. Some days good,
some days really rough - both with pain and dealing with it mentally...


March 12
The screw sites on his head are oozing, bleeding on and off,  and he has lots of pain.
We contacted Dr. Mount because we were really concerned about how they look.  They had
us take pictures and send them so Dr. Mount could look at them (she is out of town).
Her assistant contacted us later in the day and said this was “normal.”  We knew they could get
sore, but weren’t expecting this to be normal. We will continue to be diligent with using peroxide
and antibiotic cream! Ugh!


March 15
Thursday
Weekly appointment with our surgeon’s assistant.  She said things continue to look good.
We need to continue making turns nightly.  We need to go back to Dr. Mount on Monday
because we have turned enough that the wire and end posts are all the way extended.  
Dr. Mount will have to unhook the wires and re-adjust them so the turning can continue, it’s too
bad because he is within just a few millimeters of moving the top out all the way.


March 19
Appointment with Dr. Mount to fix the wires in the front.  We have turned them enough that the
“arms” are all the way to the end.  Dr. Mount had to undo the wires in front, adjust the arms, and
hook everything back up.  Colton said that it wasn’t painful, he could just feel the tugging.
Good thing is that by doing this she moved the arms in closer to his lips and they don’t stick
out the other side nearly as far, will definitely help with running into things or getting stuff caught
on them.




March 20
O.K., so the pain of yesterday’s movement has kicked in.  Colton is not feeling well today, didn’t
want to do anything except lay around, play video games and sleep.  He is not a happy person.
Hopefully it won’t last long... back on pain med and ibuprofen.



March 21
Pain is better today.  Still on a pain med, but much more tolerable.  He decided he wanted to
have a one month “celebration” of having the halo.  He chose going to Dairy Queen for an
Oreo blizzard. He said he thought the cold would make his mouth feel good.  Today he also
discovered that one of the wires from his braces was sticking out the end and poking the inside
of his cheek, one more thing to deal with…





















March 23
Went back to Dr. Mount today, completed an adjustment to the side and front (out).  Then we
had to go to Dr. Allen (orthodontist) to get the wire cut that was sticking out inside his mouth.  
That was a quick and easy fix, thank goodness.


March 25 - 28
Both rough days, lots of pain again.  I’m sure due to moving both side and front at his
appointment and continuing to do more turns to the front at home.  We continue turning daily.
He doesn’t want to do much of anything...it is starting to get to him again. He’s bummed and
depressed.  Hoping this week will be the last week of turning. We need to get him to the
hardening phase, which will hopefully not be painful. Also need to get him back to school so
he has some purpose.


March 29
Almost done turning..one more to go today, HOPING we won’t have to do any more...


March 30
Feeling really good today, first time in awhile.  Spent almost 2 hours at the Y...riding bike, lifting
weights and playing in the Loft.  Weighed in - down 14 pounds so far, In the
afternoon we went to Wisconsin Dells.  We played glow in dark mini golf and some arcade
games. We were going to stop a Panera for some soup, but Colton didn’t want to go in
the restaurant to eat.  Ended up getting a drink at Starbucks then drove home and
he made himself some soup. I think it would be hard to go in there and see all the other
food and know you can’t have any…









March 31
Slept in, then went to the Y again today.  Good to see him wanting to do other things and get
out of the house some.  Later in the day he started to get sore again, more in the front this time.  
He kept complaining that his front teeth were hurting...he said hurts a lot to smile and yawn.


April 1
Easter Sunday...Colton did not want to go to church (hasn’t gone yet).  He said he doesn’t feel
comfortable going with the halo on. He was excited about getting together with Aunt Sue,
Uncle John, Sam (favorite cousin) and boyfriend Ty though! :)   Having to "blenderize"
scalloped potatoes, ham and vegetables and having to sit at the table watching everyone else
“eat” their dinner pretty much sucked... (though it was nice of Aunt Sue for making a meal
that would easily turn into potato & ham soup).  Dessert was apple or cherry pie, everyone
joined in with a shake on the side... and Uncle John made Colton an apple pie shake.
Note: remember to bring the Ninja blender when you go to other people’s houses to eat,
and a glass that fits is helpful too (Aunt Sue saved the day with her champagne glasses!)


April 2
Colton was up at 5 a.m.,  He decided to go along to the Y with me to workout.  Came back,
took a pain pill and went back to bed until noon!  Does not take much to wear him out….
Check up with surgeon this afternoon.  Hoping that the turns will be done.


Nope... not that lucky.  She said everything looks EXCELLENT, but...it still needs to move out
a bit more, so three more turns this week then back on Friday for another check.  
So again, HOPING that Friday will be the end of the turning. Interesting fact learned today --
after the turning is done and he is in the holding (hardening) phase, she will use rubber
bands attached inside to move laterally.  Good news is that Dr. Mount said she doesn’t think
she will have to do anything to his bottom jaw (e.g. break or split) to make it align,
all can be done with moving the top.


April 6
UGH!  Dr. Mount said he needs another week of turns, every other day.  Colton pretty much has
had it… I told Dr. Mount I wasn’t sure if he could do any more.  She told Colton he was 99%
there and could leave it if he chose. She wanted him to take it a little over where it needs
to be in case the tissue retracts after he gets the halo off, however, she acknowledged
that lots of people live with an underbite, so it is o.k. either way.  Colton held it together
through the appointment, however as soon as Dr. Mount and Dr. Nora left the room he broke
down in tears. He is so torn...he wants to doit to completion, but is so frustrated
and tired of the pain he’s not sure if he can do it.

April 7, 8, 9
Not good days..pain & being torn about doing turns.  We left it up to Colton...it weighed heavily
on his mind, you could tell he wanted to finish, to do it “right,” yet was so tired of the
halo that he just wanted to stop so the hardening could begin.  


Saturday night he announced that he was going to do more turns and did the first ones himself.  
He went ahead and did another turn on Monday.

April 10
Received a message back from Dr. Mount today that he could use a spoon as long as he
doesn't suck or slurp the food off.  You would have thought he won the lottery by the way
he cheered. I think it verified that he had made a baby step toward the end.   
Did his last turn today, he’s done three since we came home from Friday’s appointment.
He decided he wanted to try to move it out a little more, but didn’t want to take all week so
he did them three days in a row…


April 11-13
Up and down days.  Didn’t do a lot. Pretty frustrated because he is home alone more.  Now
that he is feeling some better and able to do more on his own we are spending more time at
work. It has to be really boring...there’s only so much to do.  We are setting up plans for him
to go back to school, at least during the day. Looks like he can start back on the 16th.
He says he misses his friends one minute and that he doesn’t want to go back the next minute.  
It’s got to be worrisome not knowing how people are going to react.


April 14
Having some pain today.  He says it’s a bad headache, feels like a lot of pressure in front
around his forehead.  


April 16
Didn’t go back to school today.  We had a snow / ice storm overnight, roads were questionable
and schools around home had a late start. We will stop tomorrow on our way to the
hospital instead.


April 17
Back to Dr. Mount so see what the next steps will bring.  She is very pleased with how
everything looks. Next step is adding rubber bands on the right side, Colton will wear them
nightly.  The goal is to pull the right side down to even out the top and bottom (make them
closer to parallel). It has to be moved slow with light rubber bands to make sure it grows and
heals properly.  Dr. Allen (Orthodontist) will monitor the movement as well. Colton will go to
his office on Friday then back to Dr. Mount the next Friday. IF they can’t align the top and
bottom enough this way, the other option is to do surgery on his lower mandible - basically
breaking it in a couple spots to tip it and make it fit.  This would be up to Colton down the road.


Good news of the day is that Colton can start eating some soft foods - he is super excited!  
Basically, he can have really soft cooked pasta, cooked vegetables, refried beans things that
are a little more solid and have a little more texture, but he still can’t “chew” them, just
has to mash it with his tongue.  Regardless, it’s a little prize for the day and an indication that he
is on the downhill side.


Rough night late night..Colton was seriously anxious about going back to school and got himself
pretty upset.  He’s a worrier, so lots of thoughts going through his head...also it’s been pretty
comfortable here at home, so the thought of heading back to school all day is daunting.  
Stress that this adds isn’t easy sometimes…









April 18
Survived the day at school..even getting up at 6:30 a.m. (when he’s been used to sleeping in
LATE.  All and all he said it went well. Teachers and friends were glad to see him. I don’t
think he was too excited with the pureed lunch they served him though...


April 20
First trip to the orthodontist today.  Dr. Allen added a rubber band stretching from the top teeth
on the right side to the bottom teeth on the left side.  It is supposed to slowly draw the jaw
down on the right side to hopefully get it parallel with the bottom. It is really annoying more
than anything...he’s hoping he only has to wear it at night...waiting to hear from Dr. Mount for
the final word on this.  


On the good side, he was super happy about the movement of Colton’s top jaw.  He spent a lot
of time looking at it, almost in disbelief of how much has changed in this short time.  He told
Colton that he would be able to help line everything up even better once the halo is off and the
bone is healed.


Got home and decided to shear off eight weeks of beard!



April 21 - 25
First day or so the rubber band didn’t seem so bad, however by the third day Colton’s cheek
was really swollen / hard and that side of his mouth was very sore again.  It was so sore that
we had him stop wearing the rubber band on Wednesday. You could see that in the few days,
it pulled that side down a lot, it looks very close to being parallel with the bottom already.


One problem is that the area where the wires come out under his nose are really bothering him,
and he’s having trouble leaving it alone.  Probably because it dries and cracks and get sore
because he has a stuffy nose (the usual this time of year). Wiping his nose compounds the
problem in that he bumps the area and sometimes makes it bleed.  If all else fails we will have
to tape his “mustache” of gauze back on...which he did NOT like before.


April 27
Back to Dr. Mount for a check up.  Her assistant, MaryKay was there today, she hadn’t seen
Colton in about a month and was amazed at how everything looked.  Dr. Mount was super
happy with his progress as well. She said we could start a countdown - 3 to 4 more weeks!
This week he can leave everything alone, next week he will need to wear the rubber band
again for a few days.  She is scheduling a CT for the week of May 21st and if the bone looks
good, she will take the halo off the next week.  Keeping our fingers crossed that all goes
as planned so he has it off before his birthday (June 2nd).

May 1
Good to see him starting to venture out a lot more.  We went to Fox Valley Technical College
to meet his advisor and sign up for fall classes. Rode his bike down to his sister’s soccer game
this week and had a little fun with Benny the Beaver. I am proud of how strong he is and gets
himself through going places like this where virtually everyone stares at him and he tries to
explain why he is wearing that thing…and of top of that is the whole eating thing.  It’s hard
when traveling, you have to plan out where you are going to eat or take something along...




May 4
Saw Dr. Mount and Dr. Allen today.  Both are happy where things are at. Dr. Mount says he
needs to wear the rubber bands just 4 nights to pull the right side down a little more, and then
he will be done with movement with the halo.  Dr. Allen said he thinks he can get the remaining
cross-bite lined up with continued orthodontic work after the halo comes off.


May 5 - 6
By Saturday night, the swelling is back and cheek is hurting again, though doesn’t seem quite
as bad as the last time.  Trying to keep Colton distracted with other things..he has very little
patience left and gets frustrated quite easily. Sometimes he won’t eat or do anything.  The
area around the wires on his face are dry and cracking and itchy making it hard to keep his
hands off of them. Ugh...this can’t be done soon enough!

May 7
Monday took us on a trip to Fox Valley Technical College for a meeting with Colton's counselor
to talk about scheduling his classes for fall. A great distraction and something to look forward
to. He handled the trip well, including walking around campus and having all those people
checking out his devise!



May 8
Back to Dr. Mount.  Rubber bands DONE. Now we wait.  Back on the 18th for a check-up.
CT scheduled for the 24th.  Tentative surgery dates 29th or 1st...checking on Dr. Mount’s
schedule and they will tentatively schedule a date for take off!

May 13
Mother's Day photo...



May 17
Colton decided to ask his friend Cassie to go to the prom with him at school.  Again, amazed that he will do these things!    He had a good time, even leading the whole group during the "Locomotion" dance with a train around the room.   He did end up having me take them home before the end of the night because he was getting sore and tired, but overall had a good time.


May 18
Check-up with Dr. Mount.  All still looks good. Continuing in holding pattern.  Bit of good news -
Colton gets to start using a straw (until the take off surgery).  Planning on surgery on the 29th.
May have to stay one night over in the hospital. She will have to do some pretty good sized
incisions inside to remove the wires, also will do a little plastic surgery on the outside to reduce
scarring from the wires. (These are really starting to look bad and continue to really bother
Colton.)  


After removal surgery, he will need to stay home the rest of the week, but can most likely return
to school the next week (which will be his last week).  He will also continue on a soft diet as the
incisions and repairs heal… slowly graduating back to a normal diet.


May 19
His dad’s birthday - made him a cheesecake (cause he can eat it too :)



May 21
THREE MONTHS!  It’s been a long three months.  We all can’t wait for Colton to get this thing
off.  It’s just getting to be plain annoying for everyone! He has become so frustrated and it’s
messing with him emotionally…he is at the point where he is pretty much uptight and crabby
all the time.  There isn’t much that makes him happy...and that’s wearing on all of us. Now that
school is ending and summer is near, we are looking forward to grilling out, going for bike rides,
hanging in the pool...all things Colton can’t take part in yet.  He is close though... Looking
forward to the CT this week - hoping all looks GOOD!


May 24
And the CT says…. YES!  Dr. Mount will take the halo off on TUESDAY!  Just a few more days!
She said the bone growth looks good.  She will check for hardness when she does surgery.
If it’s too soft, she will put a plate in to help protect it, but hoping she doesn’t have to do this.  
Before going into surgery she will dismantle part of the halo so the anesthesiologist doesn’t
have to work around this. He will be awake, but will get a med so he’s more relaxed.  During
the procedure she will also do plastic surgery on the outside where the wires go through his
skin, hoping to help limit any scarring. Surgery will be about 2 hours...a bed is “reserved,” but
he might not have to stay overnight.  Among the many reasons to be excited...Colton says he
can’t wait to sleep in his own bed again!



May 27
Terrible, rough day.  Colton was been super edgy and moody since he got up.  He gets mad
and blows up over even little things now. The quiet lazy Sunday we were hoping for turned out
to be a pretty ugly stressful day for all of us.  Maya and I even left for a couple hours after
supper. Again, Tuesday cannot come soon enough.


May 28
Last day with the halo.  He is really stressed today.  He’s worrying about the surgery, as he well
knows the pain that always comes with it. hoping it isn’t too bad and that the relief of having it
off helps him get through the pain and on to a quick recovery.  We have to be at the hospital
at 10:30 tomorrow. Leaving home around 9:30. I don’t think I’ve ever actually looked forward
to a surgery, but #22 is going to be life changing for all of us.



Screenshot of the countdown App on Colton’s phone:



May 29
Tuesday - Take off day.  Colton woke up pretty stressed about the surgery.  On the way to the
hospital he talked about his other surgeries and how he hopes this is his last one… time will tell
on that.  Once we got to his room to get ready for surgery he put on his game face as he always
does. He’s always so brave and just takes everything in stride, and even manages to have a
little fun.  All the doctors and nurses comment to me about how strong he is…

(We can really notice in the pictures that his top jaw is moved forward so much his lips seem
to be stretching... Dr. Mount had said this would happen because once the device is off, the
jaw will retract back some, so she takes it beyond where it needs to be.)

Dr. Mount comes in and it’s hugs and silly comments between them as usual.  Then she
explains how he’ll go back to the OR and she’ll loosen the device and they they’ll put his IV
in and put him to sleep for the surgery. She offered him a med to help him relax before
she starts working on the device, but he says he’ll be o.k. without it. We all gave
our hugs and off he went. Around noon (a little over an hour later) we got a message
that Colton was just going into surgery.






About an hour into surgery we received a call from a nurse, she said a nurse in surgery was
exposed to Colton’s blood and we had to give permission for an HIV test of his blood.  Haven’t
ever had that call before. I was relieved to hear that though, because I kinda freaked at first
when I got the call…


Around 2:30 we got a message that they were finishing up and Colton would soon head to
recovery.  About a half hour later Dr. Mount came out and said he was done and heading to
recovery. She said it took longer because she had to put plates in the front due to the new
bone being spongy yet.  (We are back liquids again…)

Coming out of surgery, Dr. Mount tells us that she had to put plates in the front of his upper jaw.
We are disappointed to hear this as we were hoping he wouldn’t have to have them put in. (The
real fear is that eventually there will need to be another surgery to take them out as they move
or shift as the bone grows... and as we have learned from experience with the mid-face
advancement.) . She said she had done some plastic surgery where the pins went in, and feels
that it will look really good when it heals.  She was very happy with everything and excited
for Colton.

Shortly after we went back to recovery to see Colton...so excited to see him with the halo
GONE!  After about an hour, they decided to take him to a room and have him stay overnight.
He was not too excited about staying overnight, and even less excited when he came to the
realization that he was now going back to a liquid diet.  We ordered up some soup, apple juice
and a protein drink. Ugh..  Colton’s aunt and uncle came by to visit. Uncle John tried his
hardest, and got a few smiles out of Colton and took him for a wheelchair ride.  We left him
there for the night, with Brent planning to go back early in the a.m. On the way out, I heard the
nurse saying she would get him some pudding, I hope that makes him a little happy.







May 30
Brent went to pick up Colton at the hospital this morning.  He was not in a good mood at all.
Pain from surgery starting to kick in.  Hoping being at home and getting some good rest will
help. He came home and parked himself in the recliner.  He could sleep in his bed now with
his head propped on a couple pillows, but I think he’s a little scared too...it’s been so long.  
By evening he was moving around and starting to feel a little better. Still NOT happy about
having to be back on liquids.

That night he sent a message to Dr. Mount asking if she kept the halo for him as promised
(he’s not sure whether he is going to try to destroy it somehow or use it like a trophy).  
She said it is being sterilized and that she will get it to him! :) He’s hoping to
get his 3D head model as well. We joked that he should stick a lightbulb in it and
make it a table lamp...




June 1
Haircut day!  Thank goodness...3 months with no haircut, except for some chopping that I did
around the pins when it was bugging him.  His hair was starting to look pretty bad. As a
surprise I got him in with his old favorite hairstylist (she moved to a new place).  He was super
excited and she was awesome working around his sores left from the pins. He looks so
different. It’s really hitting home now how much this has changed not just his alignment, but
his facial appearance.




June 2
Today is Colton’s 21st birthday.  We invited his best friend and his girlfriend over for dinner.  
He really wanted to have Mexican food but he still can’t chew anything…  I made chicken
tortilla soup and Jasmine made him refried beans as a compromise.  Luckily it’s a beautiful
day and we all hung out in the pool for awhile before supper.  About half way through supper
Colton started saying he wasn’t feeling well. He started having bad stomach cramps and
didn’t really even want to eat his ice cream birthday cake… We thought maybe what was
really going on was that he was upset about not being able to eat and celebrate his birthday
like he wanted.  Unfortunately it kept getting worse and by bedtime he had a low-grade fever.






June 3
Colton is still not feeling good.  He still has bad cramps. We did some research last night and
think he’s having a reaction to the antibiotic.  I called the on call doctor at the hospital and
discussed his symptoms. She said that’s what it sounds like and he should stop the antibiotic
because of the fear of developing C-diff.  Ugh… he had that once when he was little and ended
up in the hospital nearly a week. Hopefully we stopped it soon enough, Back to the doctor
tomorrow for post-op and we’ll see what they say.


June 4 -
Good news is Colton is starting to feel better, so hoping it isn’t manifesting into anything.  Bad
news is Dr. Mount is sick so he appointment is cancelled. Talked to the nurses again, and
everyone says to leave him off the antibiotic.  They are scheduling us for an appointment
tomorrow.


June 5
Colton is feeling much better this morning, so that’s a relief.  Dr. Mount says everything is
looking good. He can move up to some soft foods again.  NO biting using his front teeth and
nothing chewy, hard, or crunchy in the back. It’s a step forward at least.   He is heading back
to school for the week. At least he’ll be able to find some things to eat. He’s excited about
finishing the last week with his friends.  


June 6 - June 8
The cook at school was really helpful in providing soft foods for Colton to eat, so that helped
him feel better as he finished up his last week there. Back at home it was much easier because
he could make his own meals.   He had his first burger, but did NOT like cutting it with a knife
and fork, anything that he can’t eat the “normal” way, he avoids (e.g. pizza, sandwiches, burgers
etc.). For his graduation celebration we went to Olive Garden, the pasta was perfect.



June 9 - July 4
After a couple weeks, he says his teeth are feeling good for chewing.  He says that he can
chew things much better than he ever could before because his teeth are lining up now.  
His speech is starting to sound better as he gets used to having his teeth actually at the front
of his mouth.  I think this is going to take some time before he is really clear. If I make him
slow down and repeat carefully, he can get the sounds out pretty clear, it takes time and
concentration.


It is really hard to get used to seeing him with a real, full, teeth-filled smile.  Whenever we run
into people they say he has a great smile. He seems really proud and has a different sense
of confidence.


July 5
One month follow - up appointment today with Dr. Mount.  Colton is hoping to get the “all clear”
for eating from her.  He’s also hoping to get his halo and head model. :)


Well, he’s closer.. He has the o.k. to bite soft foods with his front teeth, and can eat chew most
foods with his back teeth, except anything hard or really chewy.  She would like him to wear
rubber bands for a while to move the cross-bite over and get the top and bottom all lined up.
She’s going to talk to Dr. Allen, his orthodontist and determine what the plan of action would
be and then let Colton decide.  It definitely makes sense to finish this last step and get
everything completely aligned, however I can see why he might say he just wants to be done…

July 9
Colton goes back to WCBVI to work for the summer.  He is working at the Janesville Police
Department and loving it.  Also enjoying his friends and the activities at the center.

He did decide to go ahead with the rubber bands, so begins wearing them every night.


July 22-29
Everybody takes the week off for a family vacation in Antigua.  We scheduled vacation at the end of July because Dr. Mount said by that time Colton could have the go ahead to be back to a regular diet and eating what he wants.  The only thing left is wearing the rubber bands each night, but compared to everything else, that isn’t too bad. We all had a great time relaxing on the beach and enjoying lots of great food!




August 6
Back to Dr. Allen for a check-up.  He says Colton should continue to wear the rubber bands every night.  He will wear them about 6 more months and see how much movement he can get.


August 8
Appointment with Dr. Plumb, Colton’s regular doctor.  She hasn’t seen him since shortly after getting the halo on.  She is amazed at the difference in Colton’s appearance and is excited for him.


August 10
Road trip to Fox Valley Tech College today - Colton has his fitting for his culinary uniform for school.  He is really excited (and nervous) about school starting a a few weeks. So glad he had the halo done and can go ahead with the extra confidence he has gained from the surgery.


August 18
Move in day at Tech Village!  School starts on August 21st and Colton will begin his lifelong goal of going to culinary school!


August 12
Appointment with Dr. Allen.  He called me back to the examination room to tell me that he thinks Colton’s teeth have moved as much as they can to the side.  (Though he doesn’t have “perfect” alignment, it is much better than it was before). He says we will leave the braces on and continue a bit longer with the rubber bands.  We set up an appointment for early January to get the braces OFF! This should be the end of braces for Colton -- this was the FOURTH time he has had them. He has been seeing Dr. Allen since he was 8 years old!  The next visit will be the last of many, many trips to the west side of Madison for appointments!


January 7
Braces came off today! This part of the journey is over. He will need to see the dentist for some bonding of his top teeth and a periodontist to trim some of the gum line, these procedures will make his teeth/smile look more symmetrical. He says he is "free!"


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