If he's having a mandiblectomy... and the teeth are being removed with the jaw.. then that's fine. HBO helps with the healing of the area by bringing 02 into the area to promote healing - which is often compromised by rads. Removal of the teeth from a radiated jaw that is going to stay in the mouth is bad news at the best of times so if they are removing teeth from anywhere else that isn't being reconstructed - it could cause more necrosis of the jaw and possibly an even bigger surgery later.

Is he being treated at a CCC? Whenever I hear a variance in normal treatment I usually ask this because CCC's tend to stick to what is most effective and what works. I am not sure, but by the sounds of it he only had radiation and chemo for his palate, which is not common place. Usually (from what I have read here) they remove the palate or part of the palate and may then follow up with rads. Again with the tongue, neck dissection etc... normally an experienced ENT, will go in do one surgery remove all effected areas, and even clean nodes just to be on the safe side - then do rads and chemo if necessary.

Mind you that is done and over with and now you are facing another daunting surgery - I just bring it up because maybe you should get a second opinion at a CCC if you are not at one. They may still give you the same surgical option - but may do some things differently.

Though their main concern right now is probably cancer - not the potential for jaw necrosis, it should be taken into consideration to prevent what may possibly lead to another surgery.

Maybe your reaction this time is based in fear perhaps not of the surgery (though it is quite involved) but the fact that this is a third recurrence and that in and of itself is terrifying. It's kind of like running a marathon and hoping to get in front of the lead runner but slowly falling behind.

With regards to having guests. you state your inlaws are not in great health. As a parent I would understand their need or desire to be there. If this is possible without making more work for you then I would let them come. However if they are staying with you and need to be cared for - I would maybe see if he has a sibling who would be willing to come and support them while they visit, you clearly have enough on your plate. If they are capable of caring for themselves then it may be a help to have them there. As christine stated the first few days out of surgery can be rocky. This surgery in particular can have a few setbacks particularly with his history of prior treatment. Maybe if they can do a day shift of sitting with him and you can go in after work, and save your vacation time for when he is released. Run this by him and them and see. By all means take the time off the first few days of course, but his stay may be fairly long and usually its the first few days where the most can go wrong - after that it's just healing time. Once he's out of the woods, then saving your vacation time for when he's home may be best. Home care is very dependent on your insurance and what your government allots for (I'm canadian - we have a certain amount of homecare available to us via the government). Call them explain the situation and see what they can do for you. I doubt they would provide a long term in home nursing service. But they may allow a few visits daily to change dressings, help with feeds, and do any other nursing care needed.

As for having people in your home - i hear you - there is a certain amount of responsibility to having someone there. I would suggest determining based on who offers. You know what your friends and family are like. If you get an offer from someone who is fairly self sufficient and really will be more of a help than not, then let them join you... otherwise keep their visits confined to the hospital. It will help break up a long day for your hubby.

best of luck... and welcome. (ps a trache SUCKS!) he will need something to communicate with... pen/paper, ipad, tablet, computer... something. Until he can speak again. hugs and take care.