Monday, January 21, 2013

Wed Jan 16- Facial Bones Set

How's that 'stache?! James on Jan 23, '13
 These are CT scans of James' face. To tell what it's supposed to look like, look at the undamaged left side of the image. That is the right side of his face. Then, compare it to the other side. Where it doesn't match is most likely a fracture. These are just the obvious ones I saw.

This is the frontal view of James' eye sockets. His L socket is on the R side of the image.

Here are his facial sinuses, behind his cheeks.
Here is the sinus above & between his eyebrows.

Well I wanted to let you all know what we were told after his big long facial surgery. This was the surgery to repair the fractures in his sinuses and his eye socket reconstruction. They did not do anything to his damaged eye in this surgery.

He was taken back to the OR hours early, because the plastics team's morning surgery with someone else was cancelled. That was a blessing for James because he didn't have to wait forever, stressing about the first surgery he'd been aware of since he got his appendix out as an immortal teenager.

The team switched out to a new team in the middle of surgery. It was so long, I don't know how the DRs do it. Oh wait, he told me: "they pay me tens of dollars."

Both of the plastics DRs are about 35 years old. One is the shy-smiling, soft-faced dream of any Jewish mother any where. The other is an underfed, kind-eyed, scraggly-faced guy (nearly identical to the dad from the video "swagger wagon").

We had trusted James into the hands of others many times, so, strangely, we got a lot of work done during his surgery. Michelle man-handled insurance people and I recorded stuff for y'all. We ate crappy expensive cafeteria food. Periodically, the phone rang and we had a quick update from OR, telling us that James was doing well.

My MIL & SIL came up to the hospital with Joseph so I could nurse the poor dude who refuses to look twice at a bottle. My friend picked him up that afternoon. We spent the day in the cafeteria, cluttering up a table near a power outlet.

After 3pm, they called and said they should be done around 4, but that if they weren't done by 5 pm, that that didn't mean anything bad happened. After 6 pm they said they were wrapping up and if we wanted to see the surgeons, we should make our way to the ICU waiting room. An hour later we were lifting our heads every time the door opened. Finally our two young DRs came in looking as fresh as daisies- really. Here's the notes I took:
  • 6 plates of varying size, each 3 mm thick. 
  • Screws are 3mm across the head and the twisty shaft is only 1.5 mm across. 
  • They used facial (mathematical) landmarks to know where everything should go, instead of just comparing the left to the right side. 
  • It could be 4 days till the swelling even peaks. 
  • If this was the only thing he had done, it would be 3-4 weeks till he returned to work. 
  • They did not have to harvest bone from his hip to recreate the cheekbone, because they used chips from the facial fractures. (I guess the plates take the place of the chips they "harvested." 
  • They seemed to describe a network of scaffolding (pins or something) to recreate the eye's orbital floor.
  • They undid the stitches from the cut on his eyebrow (where whatever punctured his eye entered his face, is my guess) and accessed his facial bones that way as well as the zig-zag incision on his scalp.
  • They closed his good (R) eye during surgery with a stitch although why they couldn't simply tape it is beyond me. 
  • They found a piece of glass under his left eyelid. 
  • They stitched the left eye closed with a sort of anchor under the bottom lashes and through the upper lid and taped the long string tail to his forehead (and on the tape we had a nurse write "Do Not Open Eye" because she made like she was going to open it to put ointment in it!)


  1. when they stitched my knee closed after surgery to repair my broken patella, they stitched a long bit of...string...up into my thigh and taped it down. not sure why, but it grossed me out for 2 weeks after the ordeal. just left it hanging there out of my bandage. reminded of that after your last 'note'. dr's do weird shit, no?

  2. So you say he looks the same? When do bandages come off? Is there alot of swelling? I like the picture.

  3. Wow! James you are destined for great things!!

  4. that first picture is of him today, Jan 23. I'd say he looks the same. No bandages.

  5. He looks the same - you guys apparently had some skilled surgeons. BTW - please tell James Dear for me, that this was a chance to make improvements and I am proud he took advantage of it and had that magnificent stache implanted. Kevin W in CA

  6. I love the medical technology and expertise that these Drs have accomplished! James looks the same and whats' more is he now has a scar on his eyebrow, just like his older step-brother (Jason - may he RIP), even more to be bring us closer (I know it sounds kinda weird, but I notice the small things that remind me of Jason now).
    What enormous blessings are blooming for you and James and your beautiful family. I'm glad you are writing this blog to keep track and name them. Anxiously trying to get the next visit lined up.
    Love to all!

  7. Tracy he looks great :)