2 years after

2 years ago I woke after my jaw surgery, woozy, in pain, and unsure of how I would heal or if all the buildup and struggle would be worth it.  Those next few month, weren’t easy (see my old posts for details), but here I am 2 years later. . .

 

It has been a busy couple years, so I’d love to say I forgot all about this surgery and put it all behind me, but I do still feel the effects. I continue to be migraine free…its amazing!!  I do still have a numb lower lip and if I forget sometime I’ll drool a little out of the left side (but most people are too polite to point it out :-P ).  I can chew just about anything I want!! Appearance-wise I don’t really see much of a difference pre-surgery and today, except for when I’ll catch a half-profile view of myself in a mirror and feel that I look different somehow, but it is hard to put my finger on what exactly. The physical jaw pain is better, still there, but so much better!  I only wear metal retainers a few nights a week… I still shudder at the thought of braces.

Are you considering this surgery?  Would I recommend that you do it?  That’s entirely up to you and your dental/medical team. It was a tough journey that I would not recommend you take lightly.

Would I do it again? … It’d be very challenging to convince me to go through all of that for a second round. But I’m glad I did it the once.  I do believe that it was worth every step of it to have the results that I have now.  I was in a lot of chronic pain and now I’m not.  I hopefully have many years ahead of me now full of eating, talking, laughing, and eating  J


Here are my pre-surgery and 2 years post- surgery comparison shots...




Top: pre surgery 1/2015. Bottom: 2 years later 1/2017

And that’s it for me... I’m signing off of this blog.  Feel free to comment or message me privately if you have any questions!!!

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 18: KT tape & Eating

So my friend and fellow PT stopped by for a visit yesterday and did some KT-tape to assist the lymphatic drainage from my face. (The theory is that it helps decrease the swelling by improving drainage)

It was great to have a visitor and really helped with my ever increasing cabin fever. I have left the house for short excursions, but the last couple of days the pain has been worse so I haven't been able to do much without a hot or ice pack on hand.  

I have gotten more proficient with drinking from a cup and a little bit more with using a straw. I do still use the syringe for thicker soups since I can't pour them into my mouth easily. I am REALLY missing solid foods and am completely over all my liquid meals.  By the way there are way too many pizza commercials on TV, I think they are just trying to torture me!  

For some perspective, here is a pic of how far I can open my mouth. This is a Tylenol capsule for scale, so as you can see there is no fitting a spoon in there. And unfortunately for just the short time to take this picture both my masseter muscles painfully cramped up, so there's no tolerance for the repetition needed for actual eating yet. :(  

Day 13: Part II- Follow-up appmt

Dr. M. instructed me to wait until Monday to return to work.  I have a little mixed feelings about it.  I feel like I must have messed up somewhere that my recovery is taking longer than I wanted it to.   But to be honest, I’m also a little relieved since my face is still swollen, my speech is so impaired, and I’m so tired all the time…  (He did seem surprised at how swollen I still am... he told me that I look like Cindy-Lou Who)

I also told him about the sharp muscle spasms. He wrote me a prescription for a non-narcotic pain medicine, decreased the resistance on my rubber bands (from 6 oz to 3 oz), and told me that if it is not better in a few days he’ll write me a prescription for a muscle relaxant.

Otherwise, he is still happy with my bite and how quickly the bruising is fading.  

Left profile shot; you can see a more defined jaw line!

He also told me that I can start chewing soft foods any time I want!  I think he meant this as a little joke since my teeth can only open mere millimeters apart and there is not a chance of anything non-liquid fitting between them.  But it is nice to know that I have his clearance as soon as I think its worth an attempt.  In the meantime I have some blended (to a lovely liquid consistency) chili con carne for dinner… you know your’re jealous!

Day 9

Today was another rough one, I didn't see much progress and I just felt exhausted all day.  My jaw really, really aches. Just a constant, gnawing ache that isn't relieved with warmed up facecloths or cold ice packs. Looking down to work on my puzzle or read just increases the pressure in my face and makes it all the worse. Tom also seemed to have more trouble understanding me today, maybe I was mumbling more from the effort? But because of all this, I called work today and told them that I would not be ready to return at my exact 2 week date of this coming Tuesday, but that I will still shoot for the end of next week.  They knew this was a possibility, but I still feel like I let them down. I know it is silly in that I can't control how quickly I heal, but never the less I know that they will now need to scramble to cover my patient load and I hate inconveniencing others.

One bright spot in my day was my sweet husband who spent time with me and made me an amazing peanut butter ice cream milkshake (with some protein powder thrown in) for lots of calories!

Day 8: Fatigue

So I think I overdid with moving around yesterday.  I really didn't feel like I did much, but Tom says that I was puttering around too much and then we went for a walk on the beach (oh the salt air was wonderful!). Either way I am absolutely wiped today. I just feel fatigued down to my bones and even with a long nap, I still feel unsteady on my feet.

Crockpot-beer-cheese-soup

Some of it I'm sure is the abrupt change in diet. I've officially lost 10 lbs. already.  I have not had much of an appetite, which I'm blaming on the narcotics because I cannot remember ever not having a an appetite. OR second theory is that maybe its a lack of appetite because there is no cheese in my diet.  So I've decided to rectify it by making cheese soup for dinner... I just wish I could make (eat) the pretzel rolls too!

I do have some good news though!  I would like to announce the re-emergence of my right cheek bone!  The left side is still pretty swollen, but the left was always my more painful (and longer) side so I imagine there was a little more surgical work done there.

Yea for cheekbones! 

Day 6: Surgeon Visit

 I had my 6 day follow-up appointment with the Surgeon today.  And I asked a few more questions about what he did for the operation.

• My mandible was brought forward 9.98mm 
• My maxillae was brought forward between 4-6mm on each side and the cant was corrected.
• The longer ramus was cut and angled to shorten the impact in the TMJ and correct the asymmetry.

Of course I wont be able to visualize these changes myself until the swelling goes down, but, overall Dr. M. was happy with the progress!  My midlines look a little off to me but he says that anything under a millimeter is negligible and they are less of landmark than the fact that my cuspids are lined up perfectly!!

Metal Mouth!!!

What else was there... oh I (only!) have two rubber bands that need to stay on my teeth all the time (this will help guide the jaw as it heals).  I was imaging a complex mesh-work of bands that clamped my teeth tight, but it is not that bad...

He told me that I need to switch from icing all the time to hot packs to assist the lymphatic drainage.
I also asked about using a straw, since it seems to be a huge no-no for many similar surgeries (negative pressure tearing up stitches), but he says that it is completely safe for me to use a straw.  I was so excited that we went straight to Tropical Smoothie from our appointment.  I stuck the straw into the smoothie aannndd nothing happened, my lips are too swollen to form a seal around the straw...ggrrr!

Overall

Pain: I ran out of pain meds before my appointment today and it increased to a 7/10 :(

Nausea: 0/10 (haven't taken a anti-emetic pill for 36 hrs!)

Exhaustion: pretty high

Main Frustrations: Drooling, numbness, fatigue, slow eating

Fresh juiced breakfast!

Day 4: Hopefully the worst swellling

 The surgeon says that day 4-5 is the worst and its all better from here * Fingers crossed* as I'm not sure if my swollen face could actually contain any more fluid.  The pressure on my jaw is terrible.  The sinus pressure is also rough, my nose keeps stuffing up which is frustrating because I cannot really blow my nose or risk breaking loose a blood clot.  A steamy shower followed by Q-tips dipped in rubbing alcohol is all I can do to clean out my nose and does provide some relief. 

I drank from a cup this morning! I used a paper Dixie cup and probably spilled equal parts down my chin versus down my throat, but it is a start! Drinking from a cup should help increase my calorie count and we know that calories = strength. So its a step forward!

As far as sensation, my nose and upper lip feel numb, but I can still feel touch/pressure/pain.  My lower lip and chin are completely absent to sensation, but the surgeon says that there is a good chance that those sensory nerves should grow back. Motor nerves all appear to be intact, but truthfully it's hard to move much with the swelling.

Day 4 Swelling

As far as entertainment, thanks everyone for asking, but the medications are making it difficult to concentrate on even a 20 min cartoon before I fall asleep. So I haven't even had the chance to get bored yet!

Update:

Also I had to add this comparison pic of me the day before my surgery and me today. I feel like the swelling makes me look 10 years younger! Yay for no wrinkles?!?

Day 3:Ducky

Well I looked into the mirror today and saw a troll looking back at me.  Instead, Tom (the cutest person ever) swears I look like Ducky from the Land Before Time with my duck-billed lips.  Ducky is far cuter than a troll so I'll take it.   Today and tomorrow are suppose to be the worst swelling days. I hope so, I'm not sure where any more fluid can go in my head. As it is. I feel like my head weighs 50lbs and I could use a chin rest.

I managed to eat some yogurt today, maybe 20 oz.  Beside broth it was the first semi-solid food I've eaten since Monday. But it took so much effort! I had to take a nap afterward.  I also managed a shower again today.  I'm trying to get back into a "normal" pattern, but there really isnt anything normal about any of this...

Day 2: home

Came home from the hospital  about 10:00 last night. Tom and my sister scrambled to get me all set up and ensconced  in the rocking chair. Warm blankets on the feet, ice packs on the face, humidifier next to my head. 

It's about noon now and I think I've been awake for a total of 60mins. I did manage to take a short shower. The steam felt wonderful and I found some random tape left over from the surgery so despite my appearance I was feeling a little better. But I still took another 3hour nap, until the pain killers wore off again and here I am. 

I plan to drink a little milk and fluids now.. Yea nutrition! Then take another nap until it's time to go to the Surgeon's office for my first follow up.

Day 2 picture: swollen up with ice packs

Pain 7/10

Nausea 2/10

Overall Discomfort 8/10

 

T-1: Eeeek!

I woke up at 06:00 this morning in a panic that today was the day of my surgery and I had missed my 05:30 check-in time!  Unfortunately, this does not bode well for a restful night of sleep tonight!

Obviously I am nervous about tomorrow, so I just used about half of my lunch break to run a couple miles and knock out a quick ab-workout.  Endorphins vs Cortisol aaand...GO!   I have no idea when the next time is that I will be able to go for a run.  I know that I am restricted to lifting < 24lbs for 4-5weeks so not sure how that will translate to ground reaction/impact forces...  Regardless, I'm sure I will have some major re-conditioning work ahead of me once I'm cleared!

Also I ate just about EVERYTHING yesterday.  My friends & family brought the most food I think I have seen anywhere!  I feasted until I was sick and then ate some more!  I really ought to step on a scale before surgery tomorrow just to have a baseline #.  I think I've succeeded on putting on between 5-7 lbs since early December which should make the 10% body weight loss less obvious :)

T-2: Party Time!

Today is going to be an awesome day!

Last night before bed my phone white-screened, As I was falling asleep I was trying to plot out a time to make it to the AT&T store, but this morning I plugged it into my computer and it turned on. HUZZAH! (I'm backing it up right now!)

Today is also going to be an awesome day because today, I am hosting a food binge party!  My dear friends are coming over and bringing the one food/dish that they would miss the most if they could not eat solid foods. So its a funny twist on a potluck, but this way I  have no food regrets and even more importantly I get to party with my friends.  ( I think it might be awhile after this!) I'm so excited to see everyone!

(update)
How can a girl possible be upset about what's ahead when she has awesome friends like this right now? :)

T-3: Getting all Pretty

3 days, oh boy!

I can't describe the mix of emotions I am feeling except to say just about every definition of anxiety covers it.  I am anxious to get this over with and move on with my life.  I am nervous about the recovery and the difficulties I will have over the next 6 months.  I am frustrated at the lack of control I will have in the next 2 weeks. I am excited to have an improved jaw/mouth and leave much of my chronic pain nothing but a distant memory.  I am exhausted, as the worrying is actually waking me up in the middle of the night and doesn't let me go back to sleep. Finally I am still hopeful that many of the blogs I have read exaggerated the difficulty of recovery and I will skate through this like its nothing.

But tonight, I get an amazing date night with my fabulous husband.  We received (incredible!) tickets to a musical for tonight as a Christmas present. So I am getting all dressed up and feeling as pretty as possible, for what will probably be the last time in awhile... and I am hoping that my husband can hold on to that image when he's taking care of the drooling, sloppy mess I'm about to become.

T-5: Hooks!

I feel like I need to start with a quote from Captain Hook, but I couldn't find the perfect one, so on to my status update...

I started my morning headed to the hospital (it was an eerie foreshadow of next week).  Where I submitted several vials of blood for testing to clear me for anesthesia and I guess to gain final clearance for surgery... hope my blood tests well!    

Then it was straight to the orthodontist. Dr. R and his amazing technician Hope were awesome as usual.  They both did their best to put me at ease and reassure me that it was not really going to be as bad as all that.  Well, at least they were honest and told me that it wasn't going to be a fun experience, but that it was something that I was not going to regret.  Dr. R told me that he has never had anyone come back from this surgery (with my surgeon) and regret the results.  He did say that some people have even told him it wasn't as bad as having their wisdom teeth pulled. (yea right!)
They then added the surgical hooks on to my wires for the rubber bands.. Why you ask, did they add more metal onto my teeth to jab into my cheeks and cut up the inside of my mouth just days before my surgery?  Well as the surgeon will not actually hardwire me shut after the operation, these are used instead to put lots of rubber bands on all these tiny hooks and keep me from opening my mouth too wide and screwing up all the surgeon's hard work.


Up close picture of my teeth, you can see the hooks.
They are the extra bit of metal posts between each of the teeth.

And that is hopefully it for the pre-op doctor visits!  My remaining plan is to continue eating as much as I feel like for the next few days. I do feel a smidge guilty about this with my work colleagues on their New Years Resolution diets eating itty bitty salads for lunch while I scarf pizza in front of them...whoops!

T-6 : Pre-Op Surgeon Visit

So Tom & I met with my surgeon today. I forgot just how laid back he was about everything!  He's been doing maxillofacial surgery for about 35 years and he pretty much told me that this was a "routine"  surgery. (ha!) But he definitely calmed me down on some of my worries. 

I have probably read about 15 blogs from other people who have had double jaw surgery so I had a big list of questions and concerns from some of their rough patches with their surgeries & recoveries. And to many things that were so urgent and awful to [other people in] their blogs, my surgeon said "no problem." Some of them were...

• "So I can't drink out of straw?" - Sure you can.
• "So I can't blow my nose?" - Sure you can, just keep your mouth open when you blow your nose, sneeze or cough.
• "How swollen will I get?'  - I'll be able to tell you after the surgery, but it will increase after your leave the hospital. 
• "When will I be able to talk." -As soon as you wake up after surgery.
• "When will I be able to run again?" -As soon as you can tolerate it.
• "Will I have one of those awful splints wired into my mouth?" - Yes, but it isn't that invasive.  (I'm not sure about this one though, a lot of other people who had this surgery said this was the worst part and their best day when it came out.)

He also gave me a super fun looking book called Dinner Through a Straw; A Handbook for Maxillary Trauma.  I'll let you know if there are any good highlights! 

 

And then one of my biggest worries about this appointment...he then showed me a computer rendition of what my facial profile will/might look like after the swelling goes down.  And I have to say it  was AWFUL! It made me look like a Bulldog. (which as Tom gleefully pointed out is technically my high school mascot, making me already a bulldog...it was a well timed joke and cut off my anxiety).  So I'm choosing to pretend that I never saw that terrible picture and we'll just see what comes out at the end of all of this!

Tomorrow I get my pre-op labs done for the hospital and then go to the orthodontist for the last time before surgery to get my surgical hooks applied to my braces...more wires! It feels like its all happening so fast all of a sudden!

T-7 Days

This morning I woke up with pain in my left jaw from stress clenching my teeth all night.  I am definitely getting nervous about this operation.  (Actually I am not all that nervous about the operation itself, I'll be happily sedated for that portion!) I'm really getting worried about the recovery process and how rough the next 6 months- 1 year will be for my mouth/face/life.

I will meet with the surgeon for my pre-op appointment tomorrow.  Tom will be coming with me so that he can get all my post-op instructions and details on how he can/ will need to take care of me.  I truly have the best, most supportive husband, but it is downright terrifying to me to think that I will be completely dependent on others for 1-2 weeks.

Tomorrow the surgeon will go into detail of exactly how many times and in how many places will be breaking my jaw and realigning it to correct all its imbalances.  I have a good idea of what to expect, but I will find out in gross detail just how extensive this will be.  Also he promised me a computer simulation of what my face will look like post-surgery.  I have to admit this is pretty intimidating!  I try not to be vain, but its so weird to think that the face that has stared back at me in the mirror for 32 years will be different. I'm trying to believe that I'll still look largely like me, this isn't after all a cosmetic surgery, and the doc did promise to make everything look as aesthetically pleasing as possible. However it is a huge unknown and I'm a little nervous to see that image on the screen. 

So to sum it up, I have a empty pit in the middle of my stomach, when I think about tomorrow's appointment.... Wish me luck!



I'm still not very good with the selfies, but in case I forget later here are a couple "before" pics. 1/6/2015

1 month before surgery!!!

So my surgery date is set... January 13, 2015!

I have my final surgical wires on my braces.
The Surgeon is taking all my pre-surgical  X-rays, MRI, molds, etc next week.
I have requested my time off of work.
My wonderful and very supportive husband has requested time off of work to take care of me in my invalid state.
My mother-in-law bought me the most amazing Vitamix blender to ensure I will have adequate nutrition (and my old hand-me-down blender is headed to the donation pile)
Now I just need to stock up on smoothie making materials, Ensure, Chicken Broth, and all the other recommendations from random internet blogs of people who have gone through this (why are they all in England or Canada, where are the Americans?!?)

I'm nervous, recovery sounds awful, but I'm still keeping all the positives firmly in mind (my future self had better thank me for this!) 
Including:

• Teeth that actually touch (oh the foods I'll be able to eat!!)
• No tension headaches from poorly aligned teeth (maybe I'll be smarter if my head doesn't always hurt!)
• Improved breathing (decreased risk for sleep apnea which decreases my risk for a heart attack!!!) 
• but mostly I'm just excited about the food I'll get to eat!  I could make a list longer than this post of food I've missed and will be able to eat again without grinding or rending my fool like the half-bovine creature I feel like I am now.

I'll post again right before the surgery and try to post daily here afterward in case anyone wants to follow along in my recovery with me.

Until then I hope everyone has a wonderful holiday!

Braces Adjustment

February 2014

I had my braces adjusted on Monday.  The Orthodontist popped off and reapplied a couple brackets and upped the wire strength on the bottom teeth.  Not too bad actually.  I'm back to eating soft foods, but not baby food... Thank goodness!

But every time I go back to the orthodontist or tell someone new why I have braces in my 30's, I start the whole anxiety spiral over the surgery all over again.  Its not just that I have a black hole in my calendar between September and January where I can't make plans (which IS really annoying!). Its more the thought of someone cutting up my face terrifies me and that I am voluntarily letting them.  Sure its for quality life, decreasing chronic pain, and ensuring that I have good nutrition by being able to chew food in the future... however this surgery is not like an emergency appendectomy where the doctors go to work and I am not sitting around anticipating it for 2 years.  

So as a habit, after I start getting anxious I scour the web to find someone who had had this same procedure and how they survived/thrived with it.  Most of the videos on youtube.com  that I find are done by ~17 yr old girls in the UK who had a severe under-bite, which is close to what I'm expecting but not quite my problem or my recovery path.  I found this one (below) today.  

The video is designed by an Australian surgeon, but the video is of a girl who has very, very similar bite occlusion and jaw pain as I do. And the positive results she seems to of found are reassuring. It reminds me as to the reasons that I am torturing myself (and draining my bank account)!  So if anyone reading this is wondering why I am doing all this work and willing putting up with all this discomfort check out the video:

PS. It also inspires me to do a video blog.  Don't worry I won't torture you all this far out, but I'll probably record a few pre- and post- surgery videos.

Hello from snowy Virginia!

Hello from snowy Virginia!

Sorry I haven't written in a few months. My orthodontist decided not to change my wires in December which has actually lead to a wonderful 15- weeks of no changes to my mouth. Well any relative changes... I have noticed that my teeth have gotten straighter on the bottom and I am starting to get some gaps between a few teeth on the top.   Not hillbilly gaps yet, but I believe I will get there before this stage is done!

The headaches are starting to return a bit, I never thought for a minute I would miss that chunk of plastic splint, but I guess I didn't appreciate it enough until I had my first 3-day migraine in a year.  Too bad it wasn't a permanent fix!

But truly the best part in the last 15 months has been these past 3 weeks, my teeth have really dialed down on the soreness and I have been able to chew many more foods that have been challenging for the past year.  My front teeth still do not touch (and I don't expect them too until after the surgery) so there is no biting into a sandwich, but I've really been able to chew again with my back right teeth.  I've even been able to eat lettuce/salads and pizza this week!  Unfortunately its back to the orthodontist in another week, so I plan to eat everything under the sun in case the teeth sensitivity flare up again.  But I'm hopeful that maybe it was just so awful because it was the initial 6 months of braces and that the rest of this year will be a cakewalk...well that is until THE surgery.

2nd wire change for braces

5 November 2013

I just had my second wire change for my braces yesterday. And wow am I hurting today!  I know I was sore after the last one, but it still caught me off guard today.  I forget what gauge wire I am up to, but I was told that I am at a "medium level, the level at which they do most of the work."  And being the obsessive planner that I am, I asked again (like every time)...so how far out from surgery am I looking?  He told me that it is now looking like next fall at the earliest :(  which is fine, I believe in my orthodontist, I trust his outcomes, but I want this process over with! and he had told me upfront that it will likely be 1.5 years with braces before the surgery, but I did have the pipe-dream that I could graduate in May and get the surgery over with before I started a new job.

Anyways, my suggestions for the pain of a braces adjustment?  Take your pain medications regularly and on time. Ice packs. Take the day off after your get them adjusted (if possible! I say this as I head back to class). Definitely brush with Sensodyne toothpaste. And use your blender!  Your teeth are going to hurt so bad that you don't want them to come in contact with each other at all = no chew foods.