Day 45: One miler

Just for y'all, a sweaty gym selfie! ;)

I have tried to run a handful of times since the Doc cleared me, however running has been painful. With every step I can feel the swelling bouncing in my cheeks and the pressure builds up my jaw and then into my cheekbones gradually building up the pain scale.  Earlier this week I pushed myself to do just 5 minutes on the treadmill. I had to really push myself to make it that long and I felt more sore afterwards.

So today I decided to up my run to 6 mins, but a good song came on and I was able to keep going for 1 mile (11-12 mins)! Compared to how easy it was to run multiple miles before surgery one (slow) mile is nothing, but compared to how agonizing running was earlier this week... I feel accomplished! I feel like it was another milestone forward, which really cheered me up after having a particularly a sore and high pain day yesterday (the new wires, chains, & rubber band placements beat me up!)

Day 43: I'm back...

Because the surgeon was so kind as to take the splint out yesterday, today I got to go back to the Orthodontist.  I think these 6 weeks is (at least close to) my longest gap in orthodontist visits since I started with him 2.5 years ago!

I was really relieved to hear Dr R. say that everything looks good, I mean I picked my maxillofacial surgeon pretty much on his recommendation alone!  He said that he thinks I have about 6 months of work to be done and then I'll get my braces out! I'm super excited, but I know that my "6 month" splint took me 9 months, so I won't mark a date on my calendar, but it is still exciting to hear that there's a chance I'll have my braces off in the fall!

So first visit post-op, the orthodontist fixed the bracket that was broken during surgery (by the way the ceramic brackets do NOT come off easy!), he changed the wires and added a chain on both the upper and lower teeth (the silvery looking bands that go around each of the brackets in the picture), he also changed the band placement from how I've been wearing them.  The rubber bands definitely add more pressure and make it harder to open my mouth = harder to speak.  I do get to take off the rubber bands to eat, stretch, and to brush my teeth. Which reminds me I was able to floss today! Oh my goodness, until you go through this process you have no idea the joy involved in flossing your teeth and getting that true clean feeling.  For those of you out there not having this surgery, do me a favor and give your teeth a little extra TLC tonight and try to appreciate how easy it is to do things like opening your mouth wide enough to be able to brush and floss even those back molars easily. Then take a moment and appreciate just how clean it all feels... :)

Day 42: 6 Weeks Post-Op

I just so happened to have my 6 week appointment exactly 6 weeks after my surgery and *drum roll*...  He took out the splint! Oh my goodness it is such a relief. So I don't know if I ever really showed you guys, but it was like a retainer, but wired into the roof the of my mouth. How was it wired?  It was wired through my gums in about 6 places around my upper teeth (see pic of one of the wires in the front).

So Dr M cut the wires and pulled them out. It was a little painful, but really at this point what is a little more pain in my mouth?  I was going to take a picture of the splint, but after he cut the wires and pulled it down I swear it contained some kind of toxic remains (Dr. M did warn me). Apparently little bits of everything I've managed to eat in the last 6 weeks had lodged themselves inside... *gag.*  I'm assuming Dr. M threw it into a HAZMAT trash can while I was rinsing out my mouth.
Anyways the roof of my mouth is a little cut up and sore right now, but it feels so FREE!!!! My tongue can move around again and I even feel like I can breathe easier!

Dr. M was in a little bit of a rush today, but I was told that I have absolutely NO RESTRICTIONS anymore. I can lift/run/swim/ even play soccer right now if I want to! I can eat hard foods as soon as I can tolerate them.  The only thing I cannot do is actively stretch my mouth open, I need to continue passively stretching it. He seemed a little concerned at how limited my opening is and really emphasized that I need to work on it, passively.

Here is me at 6 weeks...much better than those early days right? I'm still going to hold out hope until the 3 month mark that the left side will slim down a bit more though.

Day 38: Rubber Bands

Pain: 3/10; Spasms 1



It might look like a snear, but it is
 meant to be a smile!

Yesterday was the first day I didn't have those crazy muscle spasms (pain =10/10) along my masseters.  The spasms have been gradually decreasing in number this week and I managed without the muscle relaxant at night for the last 2 nights.  The last time I saw Dr. M said he wanted to see me back in the 6oz bands (instead of the 3oz) once the spasms disappeared and of course I'm pathetically desperate to please my surgeon (and truly petrified that he will hold me back on any potential progress)! Consequently, last night I decided to risk putting back in the 6oz. rubber bands. Its about noon and so far its been manageable. I've only had 1 spasm on the left side. The larger bands go on different teeth which makes them more visible to others (they look like fangs in my pic). They also really resist my opening my mouth so I feel like I am mumbling a bit more today because of this, but such is the life of someone recovering from jaw surgery.

On a positive note I successfully made it 30mins on the Elliptical yesterday. I was certainly tired, but I did not have an increase in pain in my face from the jolting of all the movement! I also started lightly weight lifting again. I feel so weak starting back up, but that's what happens when a person does no exercise for 5 weeks!

Day 37: Chopsticks

There are so many pizza commercials on TV!  I swear they must be increasing the number of them just to torture me!!! Oh the day I can bite into a slice of pizza...well that will be a truly magical day! :)

So with my goal of pizza in mind (some days its the small things). I am really trying to start moving my jaw a little more.  I am still on a no chewing diet, but "no chewing" has expanding to scrambled eggs for breakfast and oatmeal for lunch with protein shakes and yogurt in there to ensure I am getting enough nutrients. The only exceptions are the baby food Puffs and mini marshmallows that I use practice chewing at the end of my meals.  I can't mange that many pieces of either before I get tired; also I think I am chewing on the insides of my cheeks as much as I am the food (the insides are still numb and my body can't tell the difference between itself and food).  But I figure the only way I am going to get these muscles stronger is if I use them, so I'm trying.

I eat mainly with either drinking or using those espresso paddles I found on amazon.com but it is really hard to balance a semi-solid food like eggs on the little bitty surface. So I tried something a little different this morning and I ate my scrambled eggs with chopsticks!  I've never been particularly good with chopsticks, but normally I can manage to eat sushi without (completely) embarrassing myself.  They worked! Well I should say that they worked really well for the bigger pieces, which actually sped up my eating time this morning, since I didn't have to keep cutting up pieces smaller until I could place them on the paddles.  I had some difficulty when I got to just the small pieces, but maybe its just a chopstick skill I can develop?  Either way I'm treating it like a small victory and I am picking up another pair of chopsticks on my way home from work!


Feeling a little extra swollen today; Can you tell?

Day 35: 5 Weeks!

5 weeks ago I had a surgery that has dominated a large portion of my life for the last few years. Today is then one step closer to putting it all behind me as I am officially off my weight lifting precautions!  I had planned to head straight to the gym after work today and (starting back at square one) start strengthening again.  Unfortunately the weather had other plans and Virginia is in a state-of-emergency as of yesterday, which shut down the gym, (but did give me a snow day! :) So for exercise I shoveled off the porch...exhausting!

Overall I am not seeing much day-to-day changes, but...  The muscle spasms really only happen now toward the end of my day after I've done a lot of talking. I do still have a steady 4/10 ache along my mandible and under my nose, but it is now mostly relieved with Aleve. I feel more swollen and stiff in the morning particularly around my mouth and nose, but I think it goes down somewhat as I move my face muscles throughout the day. I'm still trying not to really judge my facial appearance until I reach the 3 month mark to let some more of the lymphedema go away.  Hmmm..what else?  Not much change in the numbness, but nerves regenerate at 1mm/day so I may have awhile yet, before I feel a change.
I think that's it for my update.  I'm still working on food (no chew diet still) and vertical mouth opening (I'm up to 1.5mm) and I'm still really hoping the surgeon takes the splint out next week!!

Definitely dressed for a day-off :)  You can see the the left side is still more
swollen when compared to the right side.

Many Thanks!

I know I have been talking about a lot of the frustrations that come with this surgery, but I wanted to take a moment and say thank you for many of the good things that have already happened.

A special big big thanks to my husband and sister for taking care of me those first weeks and making sure I took my medications and managed to get some nutrition.

Thank you to those of you who have helped with equipment to make sure I got said nutrition. So without naming names...

• I can not imagine going these 4.5 weeks without my Vitamix blender!
• The loan of a juicer allowed for a real nice variety in my diet!
• The loan of an immersion blender has been priceless for when I've picked up soups that did not turn out to be quite as blended as advertised (it works so quickly!)
• Those extra syringes that were provided were well used, even after I re-learned how to drink from a cup! 

Thank you to all of my supporters. Those of you who visited me in the hospital, those of you who have stopped by my house to keep me company (especially when I couldn't speak back!), and those of you who have sent cards and text messages. I can see how loneliness and depression could take a real hold on someone going through this, but thankfully I have never felt that alone through this process.

If you are about to go through this surgery I really recommend you ask your community to help support you during those first weeks. It is very easy to feel isolated, and the pain meds & inactivity are not exactly mood boosters! 

I am so grateful to my "community" both near and far! <3 <3 <3

Day 30: What is this "chewing"?

So last night I attempted to chew a lump in my mashed potatoes. I positioned the lump between my teeth and tried to close my teeth together aaand nothing happened! My teeth hit the lump and stopped. I really tried to close my teeth together and I felt the masseters (muscles) cramping, but the lump remained. I was defeated by a mashed potato lump!

Never fear, you can't keep me down for long! So today I made yet another purchase from the baby aisle... Puffs!

Designed for "crawlers" (that's right I'm not even at "walking" level yet!).

So how did it go?  Well I needed a second for the puff to soften, and it did require a surprising amount of effort and concentration, but I was able to bite through a snack puff for a 7 month old! Woo!  After about 4 puffs I was tired, but it was still one more (baby!) step forward!

Day 28: Good Hygiene

One of the things Dr. M commented on yesterday was that I had good hygiene.  *pats myself on the back*  But seriously! I asked him, how can I possibly have good hygiene?   The insides of my teeth haven't seen a toothbrush in 4 weeks!  Never mind "daily flossing!"  He laughed and said it was normal and I was doing fine. 

I do brush the outsides of my teeth several times a day with the smallest baby toothbrush I could find (it has Snoopy on it! :) and I use mouthwash like it is going out of style!  But I am constantly worried that I have bad breath and that the fuzziness on the insides of my teeth is going to take over...

Why am I telling you about all this loveliness? So that you can maybe appreciate just a slight bit of the joy I felt today when I brushed my teeth with the elastics off.  I could open my mouth (just 1 cm) and some of the bristles reached the inside of my upper teeth...oooh cleanliness! The bottom teeth were jealous, but when I tried to angle the bristles over the lower teeth my jaw cramped up and said that was enough of that! So only a few teeth got just slightly cleaner, but it made me feel so good for a moment.  I bet you've never thought that brushing and flossing were a privilege!

Day 27: 4 week appointment!

It feels incrementally slow that I am only 4 weeks post-op, but everything (the pain) is still so acute at moments that I am surprised that it has already been 4 weeks.

• Dr. M is still happy with the alignment and the bite. (yay! nothing has shifted!)
• He is concerned about the muscle spasms I am still having along both my masseters. He wants me to give it a few more days and if I am still having those sharp 9/10 pains he wants to prescribe a topical compound analgesic vs. the muscle relaxers (that I can't take because I am working).  He also left the 3oz rubber bands on for now, although he said he would really like to get me back on the 6ozs once the muscle spasms stop!
• All the pain around my upper lip and nose is normal.  I didn't realize it before, but he actually cut my nasal spine during the surgery. (see the purple area in the picture)
• Good News: I can start taking off the bands and passively stretching my mouth open vertically a few times through the day. The goal is to be able to fit 2 fingers-width between my teeth by 8 weeks.
• Better News: I can take off the bands to eat!!!  (Now this is not an immediate food gratification moment as I still can't really open my mouth wide and I have no jaw strength to chew, but it does mean that I am on the path toward semi-solid food!) 
• Even Better News: If everything keeps progressing, he will take the splint out in 2 weeks!!!

Below you can see my 4-week post-op selfies.  I feel like my jawline is stronger than it was pre-op and my cheekbones have definitely re-emerged.  I do still have some swelling under my eyes, around my nose and upper lip.  As you can tell my smile is still awkward, that's partially from the swelling, partially from the current nerve paralysis (similar to Botox), and partly because I am just awkward ;)

Day 25: Spoons

By now you all have an idea how I am struggling with food and feeding myself.  Monday will make 4 weeks of a liquid diet and I have so far manged to keep my weight loss to 14 lbs.  I have started to use a calorie counter to count up my calories and make sure I am eating enough....a complete reversal of what I was doing 3 years ago! With working this week I have only managed to eat about 800 calories a day. This is not a healthy a number for any adult, never mind one who is trying to heal nice strong bones!  I know this, but it is a struggle to eat when I can only consume thinner liquids through a cup or straw and moderately thick liquids with the use of a syringe. (Not to mention how nothing liquified looks appetizing!)

But today I received an order from amazon.com that marks a win in my eating column!  I have tried to find spoons that would enable me to fit something between the small opening I can make in my mouth  without much success (see previous entry on Eggs).  A normal teaspoon is too wide and too deep to fit into my mouth.  The first baby spoons I bought were coated in rubber making them too deep to fit into the opening.  The toddler spoons I bought were shallow, but too wide to fit between the bands on my teeth.  So I spent some time scouring amazon.com for something that might work.  I couldn't find any simplified baby spoons (crazy!), so I thought of gellato spoons (these you can order in packs of 500 and will ship in 4-5 weeks...too late for me, but might work for someone who thought ahead!) and from there I found Espresso Paddles! The product reviewers actually commented that they were even smaller in person...perfect!  You can see in the picture below that they really are small and shallow, not much too them at all.  BUT with those "paddles" I just ate some hummus and then a little mashed avocado! Both hummus and avocado were sticky enough that I could turn the paddle upside-down in my mouth so that I could drop the food into/use my tongue to eat (remember I have a splint covering the roof of my mouth immediately behind my teeth).  Its still slow going, but oh to eat something semi-solid!

Paddle, Baby Spoon, Toddler Spoon, & Normal Teaspoon

Monday is my 4-week follow-up with Dr. M. and I have a couple of hopes:
#1 Is that I am healing up appropriately (obviously)
#2  I am really hoping he lets me take these bands off for at least a few hours per day to eat (I'm really all about the food)

Day 25

#3 I'm also curious to hear what he says about the swelling around the middle of my face and when it typically resolves.  I no longer see a complete stranger when I look in the mirror, but I still look funny to myself and I feel just a bit surprised when I catch my own reflection and it's not quite right to me.

Day 23: Eggs!

I was a little desperate for solid food this morning so I thought I would give scrambled eggs a try.  Have you ever fed a baby who has just transitioned from milk to food?  They have no idea how to get food into their mouths from the spoon and haven't coordinating opening lips & gums -> closing  -> swallowing.  Well that's about how I looked this morning!  I even had a mirror so that I could aim for the tiny opening my teeth could make, but most of the eggs ended up mashed on the outside of my braces, all over my lips, and of course on the floor. (My dog loved the food on the floor and I think he may have actually eaten more of the eggs than I did.)  Of the little bit that I managed to get inside my mouth, I swallowed it whole, no chewing yet (!).  Overall I probably ate somewhere between 0.5 -1 whole egg and it took me about 25 mins to manage that much! So it wasn't much a nutritional win and it made my jaw really sore to fight against those rubber bands for that long, but I feel like it was a psychological win.  I won't try that again for a few days at least, but it made me feel better knowing that I could manage a little something semi-solid.

I am still making it through the work week.  One of the hardest things is still the amount of talking I do. I knew I talked a lot, but I REALLY talk a lot.  I am so happy when I get 5 mins between patients and can just sit and be quiet.   I am also finding it difficult to eat at work.  I have been drinking about 3 protein shakes throughout the day, but I always feel hungry.  Yesterday I brought in a pre-blended soup and sat in one of our back treatment rooms and syringed it into my mouth (that's something no one wants to see or hear!).  I felt a little more satisfied, but unfortunately having that time and space is not always an option.  One more day until the weekend!

Day 21: The Sneezing!

It is only noon and I am already talked out today!  I wish I knew sign language (actually that is on my bucket list to learn), but still I have 6 more hours to go before I have the option to NOT talk. Oh my aching jaw bones!!

Someone asked me how sneezing was so I thought I'd share it here.  I have been taking my allergy pills religiously since the surgery so that it wouldn't be a real issue, but this weekend I forgot to take my pill and I had my first sneeze, followed by another and another...   I am "allowed" to sneeze only if I place my finger between my teeth and sneeze through my mouth. This is to prevent any back pressure from blowing a stitch into my sinuses. Well I didn't know I was going to sneeze the first time, so I didn't prop my jaw apart and it made me anxious that something got messed up somewhere inside of there.  (everything seems ok) And I have sneezed since then, one sneeze at a time is really no big deal.  Multiple sneezes however, cause my jaw muscles to cramp up and it actually takes me about a hot minute to recover. So needless to say I've been better about taking my allergy pill!

Day 21!

Day 20: Back to Work

I'm not going to lie to you, I was pretty apprehensive about returning to work today. I mean, I still talk funny, I smile weird, I feel like I don't look like myself, and I have very low endurance to activity. Also important to consider is my job typical involves being on my feet 8-9 hrs, doing actual sports exercises, and talking to kids and their parents. I absolutely love my job and today was the very first time I was dreading going in.
 

Day 20: Left side still swollen.

But I made it through!  I did take advantage of our hot packs every chance I had and I tried to rest a few minutes whenever I could. I am grateful that I have a supportive work team that did their best to mitigate my workload today, but it was still a hard and exhausting day.  The good news is that most of the kids understood me, but I did feel bad for my one evaluation today, normally I do a lot more talking and explaining, but today I kept it as short as possible. Despite trying to keep my talking to a minimum, this was probably the most conversation I've had since my surgery and my jaw is screaming at me right now. I walked in my door tonight and immediately took a muscle relaxer pill, hopefully it kicks in soon and I'll drift off to sleep.  I suspect, as exhausted as I feel through my whole body, that I am going to have my first great night's sleep tonight in 3 weeks!

As a side note: I am so grateful to Dr. M for making me take that 3rd week off. I can't imagine doing all that I did today with where I was at health-wise a week ago.  If anyone out there is having this surgery, seriously consider taking off as much time as your surgeon recommends!