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1. • CommentAuthormareli17
   • CommentTimeApr 14th 2009

    
   My daughter is having orthognathic surgery in Seattle in a few monthsDoes anyone know if Dr. Bloomquist is good. I have heard that this is all he does and that he is very good.
   We are traveling from Montana. We originally were going to go to Dr. Craig Jonov in Seattle. No one seems to know him when I call dentists and orthodontists in Seattle.
   Does anyone have any experience with Jonov? Please I need help finding the right Doctor. It is so hard to know who is good. Thanks.
2. • CommentAuthorMeryaten
   • CommentTimeApr 15th 2009 edited

    
   My orthodontist would recommend to me only either Dr. Audia in Bellevue, WA, or Dr. Bloomquist.
   
   I had my BSSO (lower jaw advancement) done by Dr. Bloomquist and am extremely happy with my results. I also know two others who had their surgeries with him and have been happy.
   
   The one slight negative I will put forward is that you do have to be proactive about asking your questions. It's not that he is unwilling to answer - he gave me good answers in response to every question I had, and they were numerous - but more that he doesn't actively volunteer a lot of info. So write down a list of questions to take in with you to the consultation, and stick to your guns to get them all answered to your satisfaction :)
   
   He's a nice guy though - don't get me wrong :)
3. • CommentAuthormareli17
   • CommentTimeApr 16th 2009

    
   Thank you so much for writing about Dr. Bloomquist. I guess we will go with him as I it appears he has a good reputation. I have heard that this is his expertise and that this is all he does?
   My daughter has an asymmetric jaw ....one side has grown more and she has a cross bite. We were in a car accident 5 years ago and she lost her four front teeth and so it is important, they say, if she wants implants, to have a correct bite. She also will have other problems if it is not corrected. She is 17. We live in Montana and we are trying to figure out if she will be okay to travel in the car 8 hours a few days after surgery....what do you think? I am trying to prepare myself for it, she seems to not want to think about it .....I am afraid she will be in a lot of pain. Do the meds manage the pain? I have so many questions and this site has been helpful in answering some of those questions. I just hope it goes well and that is why I would like the best doctor possible. Thank you so much.
4. • CommentAuthorMeryaten
   • CommentTimeApr 16th 2009

    
   I don't know if it is all he does, but it is certain that he does a heck of a lot of this type of work. During the busier months, I was told (by one of the OR nurses) that he will operate on four orthognathic cases a day, three days of the week. And he's been doing this work for years. He remains actively involved in research too, so I'd be pretty confident that he stays up to date on the field. In only reported in my previous posting about the fols from whom I had heard first-hand that they were happy with his work. However, through one of them, and through other folks at work, I heard of multiple others who were similarly happy. Of course, nothing is a guarantee, but among the folks with whom I communicated I heard no negatives.
   
   Travel? At the time I was planning this surgery, I asked Dr. B. how soon I would be able to fly, since I was anticipating needing to travel to Europe a matter of weeks post-op. He assured me I could fly as soon as I wanted. In the event, the trip didn't happen. However, I know a couple of folks who travelled to Costa Rica to have their surgeries done, and these ladies both travelled home within a week or so of their surgeries.
   
   Pain? Hard to predict, as everyone's experience is different. However, Dr. B. sends patients home with liquid Demerol, which should be able to keep it under control if she is in any pain. (I was lucky - I experienced no pain at all, and amazingly no numbness)
   
   I don't blame your daughter for not wanting to think about it. As my own surgery approached, I reached a point where I wanted to put it as far as possible to the back of my mind. My partner wanted to talk about it and make extensive preparations, but I was more inclined to do the minimum possible and trust to living close by lots of grocery stores ;)
5. • CommentAuthormareli17
   • CommentTimeApr 20th 2009

    
   Thank you very much for answering my questions. I was also wondering how long a person is on the liquid diet and when do they get to eat soft foods? What are some ideas for the liquid diet? Did you not feel like eating due to pain and swelling for quite a while? Also did you take any liquid vitamins or protein powder? Thanks.....we live about 9 miles from a store so I will need to be more prepared and it is a small town so options are limited.
6. • CommentAuthorMeryaten
   • CommentTimeApr 20th 2009 edited

    
   Dietary management post-op varies a lot from one doctor to another. Where one doctor might restrict the patient to liquids/purees for several weeks, another may permit a patient who has had the same procedure (with a similar outcome) to eat anything that can be smashed up enough with a fork to be swallowed without really chewing, and a third might push the same patient to resume soft chew foods quite quickly. Dr. Bloomquist encourages his patients to resume soft-chew foods within a week of surgery. When I say soft chew, think in terms of starting off with slightly over-cooked pasta, and moving up from there.
   
   My first few days post-op, my diet consisted of ready-made soups (the type that are sold from the chiller case in grocery stores, rather than canned or in a carton) that I pureed and ate using Zip-N-Squeeze bags (which need to be ordered online) fibre-fortified smoothies (Safeway home brand), and some puddings (these I ate with a baby spoon). I rotated soup flavours to try to help keep a good balance of nutrients; I did not bother with any vitamin supplements. I also made sure to drink plenty of water. Odd as it may sound, even though I had full sensation (which was very lucky) I still preferred to use a disposable (paper) cup the first few days, but then started using a glass again. I was back to soft chew in under the week, as instructed.
   
   Regarding Zip-N-Squeeze bags - several folks have been experiencing troubles with their orders direct from the ZNS site, so using a secondary vendor such as the dinner through a straw site might be advisable. Don't over-buy - the bags can be washed in hot soapy water and reused several times. But do be sure to get the extra large size pureed food bags.
   
   I was lucky to experience no pain. I stopped using Demerol during the day time after my first day at home (took it then only at bed time to help sleep_ and quit it completely the fifth day after surgery. The swelling was considerable the first few days, but peaked fairly soon, then started to come down steadily. I'd not say that it in any way diminished my appetite. I think the biggest factor would have been a temptation just to lie around, since the anesthesia will tend to make one weary. However, I listened to Dr. B's instructions and made sure not to lie a-bed - I got out and about for a walk every day except the first day after surgery (and that day I was just plain exhausted, as I'd barely slept the night at hospital).
   
   I am a firm believer that moderate activity, such as walking, and drinking plenty of water help minimise swelling and bruising, and help clear them up fast. Of course, diligent use of ice packs during the first 48 - 72 hours is a massive help too. The ZNS site has a fantastic jaw wrap that is far superior to what they offer at hospital. But do buy some extra gel "ice" packs - I had three pais altogether, so I could cycle them from face to freezer and keep a good chill going. After the first 72 hours, ice won't help with swelling, but can still be used for comfort. At this point the patient is usually allowed to use warm packs - no need to buy anything special - you can tie something like rice or lentils in a sock and warm that in the microwave.
   
   Do give some thought about sleeping arrangements, as sleeping partially upright is a huge help and comfort at first. It was actually a few weeks before I felt comfy lying with my face on its side (even though I'd been cleared to do so rather sooner) so since I cannot abide sleeping on my bad in bed, I stayed propped up. We opted just to use the recliner in the living room, with plenty of pillows to prop knees, elbows, etc., so as to make things just as perfectly comfortable as can be. Other options include buying a special pillow (people have found them on Amazon), mounding pillows, propping the upper part of the matress with pillows beneath it, or raising the whole head of the bed with bricks (or such).
   
   Other minor advice:
   take some ZNS bags to hospital and ask for food if she is able to eat (encourage her)
   make sure the top for the wear-home outfit buttons up
   take a book or some magazines (something very light) to hospital, and also have plenty of such at home; comedy DVDs are great at home too
   a MP3 player is nice for the hospital stay
   consider taking a laptop to hospital if you use Dr. B as Swedish does have wireless patients can use
   Dr. B recommends rinsing with a mixture of equal parts hydrogen peroxide and water post-op, so have a bottle at home
   if you don't use Dr. B and the doc you use doesn't supply one, get a baby toothbrush
7. • CommentAuthormareli17
   • CommentTimeApr 22nd 2009

    
   Thank you for all of the information. I feel better when I am prepared. I had thought that after this surgery you could only have liquids for 6 weeks. Is it still difficult to get much food down? How much weight did you loose? When you went on walks did you leave the ice wraps on? I am assuming you leave the wraps for the 72 hours to get the most benefit. We are going with Dr. Bloomquist and we will go to Seattle next week to meet with him. Did you have any problem with talking after the surgery?
   
   You are so lucky to have had no pain. It seems from others that some people have lots of pain and discomfort. My daughter is having lower jaw surgery so I do not know if that means any less pain. I agree with you about the walking and I just hope I can get her up and about, teenagers can be a bit stubborn. If the doctor says it that will help. She has just gotten a job with the science lab in our town. She hopes to go back to work a week and a half after her surgery.....do you think that is realistic? How long before your swelling went down substantially?
   Thank you for mentioning the pillow. I will look for something as I do not think regular bed pillows will keep her propped up enough. Do you think I can get the zns ice wrap in time or do you think there is a delay like with the bags?
   Also did it take you awhile to get used to your new bite?
   Thank you for all the information it is really helping me.
8. • CommentAuthorpushead
   • CommentTimeApr 22nd 2009

    
   With my recent experience of a two jaw surgery and sapre I only took pain meds for 3 days. The first day was whatever the hospital gave me in my iv the second two days I crushed some loritabs every 3 hours becuase I could not stand the taste of the liquid stuff. Almost all of my swelling was gone within 7 days. I could have easily gone back to work after 2 weeks but I enjoyed the paid vacation for 6. Getting used to my new bite is still taking place. I am 90 days into it and still not even close to adapted to it. I figured out the other day why I was ending up with a large mouthfull of food after each bite. I am still eating for my original bite which would would have normaly barley netted any food. But a 13MM overbite will do that to you. I still have trouble bitting through hamburgers and stuff but I am getting better every day.
9. • CommentAuthorMeryaten
   • CommentTimeApr 22nd 2009

    
   Honestly, I did not lose an ounce (more's the pity! ;)) A full tub of the Safeway Signature soups I was consuming would give me in the ballpark of 900 Cal., one of the fibre fortified smoothies (which I would usually dilute with some full fat milk) would add another 300 (plus the milk), then a pudding cup would probably give an additional 200 or so. Bearing in mind I was not very active, this was plenty over those few days. But if her metabolism is faster (she's a youngster, after all) then it's easy to go up from here on calories without adding a lot of extra food. Think about making your own fruit smoothies and using full fat milk, or half & half; you could even add protein powder to these. Think about using Boost or Ensure drinks - the Boost Plus and Ensure Plus drinks offer even more calories, are high protein, and of course should be nutritionally balanced. If dairy is a problem at all, don't forget about soy or rice milk.
   
   As I said, some doctors do indeed mandate liquids/purees only for several weeks posty-op, but if you use Dr. Bloomquist, I'd not expect this to be the case. For quite some years now his post-op regimen has been to push patients to resume chewing within the first week. (This includes patients who had both upper and lower jaw surgery too, not just the lower jaw only) I started to take my soup unpureed on the fifth day after the surgery (having been scolded at my post-op follow-up appointment for not having resumed chewing yet! ;)) and on the sixth day worked my way (extremely slowly! LOL) through a full portion of "Nonna's Pasta" (baked penne pasta in a creamy tomato, five-cheese sauce) which was honestly I think a bit more challenging than the "slightly overcooked pasta" that was suggested! I did stick largely to softer chew meals for some time following that (lots of pasta, gnocchi, flaky fish - salmon's great here - mashed potatoes, baked potatoes minus the skin, scrambled eggs, and so forth) although it was just under two weeks post-op when I was able to chow cheerfully through a plate of "Brown Ale Chicken" (grilled chicken breast in a brown ale and mushroom sauce, served over cheddar mashed potatoes, with a seasonal veggie) at my local Rock Bottom - again I asked for the veggies to be slightly overcooked, and managed fine - restaurants, you will find, are usually willing to try to accomodate if you explain the situation. Oh, and taking your own silverware with you when eating out can be a good idea initially, since it can take a while to regain enough ROM (range of motion) in the mouth to use some of the regular stuff at restaurants. (Hence, as well, my suggestion to have baby spoons available for the first few days).
   
   My swelling peaked early and started to go down quite rapidly. For most people it seems to peak around the third day, and within one to two weeks most folks look pretty normal - maybe a little puffy, or appearing as if a few pounds heavier to those who really know them, but nothing extreme at all. Mine actually peaked on the day after surgery, and started to go down from there. By the eigthth day post-op I was looking pretty darn presentable (and therefore went to a beer tasting :)) If you use Dr. B. and will be in Swedish overnight, I can tell you that you'll need to be proactive about asking them to freshen up the ice in the ice packs. But I firmly believe that, along with Dr. B's skill, and the fact that I guzzled water and also (as Dr. B. himself put it) got up and about rather then lying a-bed, being diligent about the ice really helped my swelling go down fast, and helped minimise the bruising that followed. If that isn't incentive enough to get your gal up and out of bed, stubborn teenager or not, I am not sure what is! ;) And yes, those first days I did indeed keep on the ice wrap when I went for a walk - you'll see from the link below, the nicer ones sold online are quite sleek, with small gel-packs that sit snugly in pockets - nice for when you're out and about. My other ice packs were just cheapie ones from Rite Aid, that did not fit in the pouches, but the wrap could still hold them in place when I was lounging around at home.
   
   (cont. in next post)
10. • CommentAuthorMeryaten
    • CommentTimeApr 22nd 2009

     
    Regarding pain - I know more people (by quite a margin) who have reported little to no significant pain, and I know one lady who was sent home from hospital with nothing stronger than Tylenol to manage any pain - she did fine, I am happy to say. Please don't dwell on the possibility too much. Yes, there may be pain, but she'll have the right medications, and it can certainly be managed in by far the majority of cases. But it's also possible she'll enjoy a pain-free experience. Whilst we're at it, I'll say that mood matters - try not to baby her and treat her as an invalid. I sat chatting to a lady when I was waiting for my post-op check-up - she and I were laughing and joking, and sharing our opinion of how well we felt, and how much easier it had been then we'd ever imagined; across the waiting room were two extremely woeful-looking teens, their mothers solicitously patting their shoulders, and murmuring what I'd assume to be words of sympathy and encouragement... I know she's your baby, but try to encourage her to be up-beat, rather than going over the top on sympathy. I'm not saying not to listen when she feels bad, but just encourage her to be positive - it truly does help. That's also why some comedy DVDs, and light reading are great for at home too (though I confess, there was a time or too I laughed/smiled enough the facial muscles felt a little uncomfy for a moment - but I think it helped me regain ROM faster anyway :))- anything to distract, and to lift the mood - and that applies more so if she should feel any pain, or be unhappy about he swelling. That's another thing too - never let her dwell on the swelling or bruising - it's huge to remember this a very temporary part of the experience, and should not be something that she should allow to upset her. Try to encourage her to laugh it off. A few of us who've been through this joked about it quite a lot, especially when anyone happened to stare :)
    
    Speaking was not much problem post-op for me, although some people find it tougher. The first night I was tight-banded so it was harder, and the nurses had trouble understanding me over the intercom, but after that it was fine. (Dr. B. discourages use of pen/paper or whiteboards, btw) The day after the surgery, I spoke on the phone for over a half hour to my aging mum over in the UK, and that was fine.
    
    It's surprising how weary you can be following something like this, even though Dr. B. gets people in and out of surgery fast (less time under anesthetic seems to equate to a faster bounce-back, as a rough rule of thumb) I tried to do some work email maybe four days post-op, and found myself exhausted in very short order. However, just one week later I was back to working part-time, from home, and by the end of that week I was back to full time. My surgery was a Friday, so I spent the next two weeks at home (working, as I said 6+ hours/day the second of those weeks) and went back to the office the next Monday (which means more than 40 hrs/week for me). As long as her job is not very physical, she could probably be OK on teh timescale you suggest, but she'll likely be more tired than usual by evening.
    
    My advancement was not a very large one, so I didn't really experience much trouble with the bite. My advice there is to take things slowly and carefully at first and it should be fine. Another thing to keep in mind too is that the swelling does take many weeks to recede completely, and until then the results should be considered a work in progress. Some people do initially get very discouraged but find that in the end the results are what they hoped for. Also, realise that for some people, waking up with a new face can be quite jarring, having lived with the "old" face for so long. Some people take it entirely in stride, but some others do get quite disctressed. Be prepared. She _will_ still look like herself, but it can just be a bit of a shock to some patients - and it is often true that the patient sees more, or rather focuses more on, the difference than some of their friends and family.
    
    Products:
    This is an example of the sort of pillow some folks have used: http://www.amazon.com/Bed-Rest-Pillow-%252d-Tan/dp/B000M8GZHW/ref=sr_1_1?ie=UTF8&s=home-garden&qid=1240426949&sr=8-1
    This site seems to be the originator of the jaw wrap that the ZNS people sell, so might be an alternate source: http://cooljaw.com/
    This site has the bags: http://www.dinnerthroughastraw.net/products.htm#bags - I know of a few folks who have had luck ordering here.
    I may be worrying overly much, but I've just heard of too many people having trouble with ZNS not fulfilling orders, or not fulfilling them in a timely manner, and not responding to emails or phone messages. It may be more of an issue with folks who are overseas, but I called and left about five messages trying to chase an order for a lady who lives in the UK, and they never responded to my messages.
    
    (cont. one more time)
11. • CommentAuthorMeryaten
    • CommentTimeApr 22nd 2009

     
    And one other thing you may want to have to hand is a nice new sharp pair of scissors or nail clippers, and a pair of tweezers, in case she gets any long, dangly stitches later, as they start to come out. They can be a devil for getting caught on food, the toothbrush, etc., and it's not nice (eye-watering! ;)) when they get tugged!
12. • CommentAuthormareli17
    • CommentTimeApr 30th 2009

     
    We met with Dr. Bloomquist yesterday in Seattle. He seemed good. He has recommended that she have both upper and lower jaw surgery. We had not heard this from the other two docs we had seen but it made sense once he had described it. She has under bite, cross bite, chin needs work and then she also has breathing issues that he said would be helped by the surgery to the upper jaw. What will we have to expect with surgery on both lower and upper jaw do you know? Will it be more recovery? Thank you.
13. • CommentAuthormareli17
    • CommentTimeMay 28th 2009

     
    Meryaten can you tell me if you had any problems with the woman in the financial part of Dr. Bloomquists. We are having a horrible time with her. Thank you please write me back!!
14. • CommentAuthorrodstohogs
    • CommentTimeNov 10th 2009

     
    Im planning touse Dr. Bloomquist for both upper and lower jaws. Trying to read as much as I can about him to make sure he is the right choice.. After meeting him and his staff I was not that impressed. They are not very friendly though that may just be to appear professional I dont know.. From what I have read he is good at what he does however I have also read what a pain his staff is and how uncaring he seems.. I did get that impression however I can deal with that if he is good at what he does. From what I have read I do have concerns with him doing as many as 4 surgeries a day and being to tired to focus on me. I wonder if he would be to tired, or if he is to old and if it is just a job to him. He didnt come off as a very happy man LOL I will keep doing my own research and will post any findings I may have and also keep those interested up to date with my case and progress.. So far Im just trying to figure out how to pay for it. Its about $15,000 so far and my insurance didnt cover it.. they did tell me at the office that premera blue cross will pay for it so I switched to that insurance in hope that they will cover it.
15. • CommentAuthorla
    • CommentTimeNov 11th 2009

     
    he has done my surgery around a month ago and it was great .. the staff were friendly I'm surprised it was not the case with you. maybe he did not spend a lot of time during the pre-op visit but he was really nice .. doing a lot of surgeries make the surgeon very experienced (skills he can only learn from practice) .. hope your surgery goes well :)
    
    I will post a thread about my experience hope it helps you ,,
16. • CommentAuthorhpnotiqjosh
    • CommentTimeDec 26th 2009

     
    I had the surgery with Dr. Bloomquist on Nov 20th and its week 5. He was really good. My healing is pretty fast compared to others that I have researched (through blogs) and I had both a top and bottom procedure done. I can almost eat normally. He doesn't tell you much but he knows ALOT. So if you have questions he will answer them fully but he won't voluntarilly give you all the information. I mean this is pretty much the main thing he does.
    
    I'm glad I went with him. Great experience so far.
17. • CommentAuthorcheylani
    • CommentTimeMar 10th 2010

     
    i am having double jaw surgery and have been recomended to Dr. bloomquist by my ortho and ive heard good things. i have an underbite where my upper jaw is too small and they plan to move it forward and my lower jaw back to have them meet.
    
    i am more than a little nervous as i am 17 and have never had major surgery let alone on my face.
    has any one had this done???
    
    im planing to go to seattle to have a consultation with Dr. B but any information would greatly help.
    
    how long do u think i would have to stay in seattle for?
    how long does the swelling usually last and do u still feel like yourself afterward?
    how safe is the procedure?
    and any other helpfull hints would greatly be appreciated!!
    
    THANK YOU :)