Day 51: Pterygoids

I bought myself some Chester's Cheese Puffcorn as a treat. I found this stuff because they make a butter flavor that tastes almost (but not quite) like popcorn without the kernels, so I've been eating bags of it to subdue my popcorn cravings while I have braces on, but I have not eaten any since surgery.  So I opened the bag gleefully anticipating a soft/dissolving food I can "munch on" only to discover that I cannot yet open my mouth wide enough to eat the puffcorn...boo. (Never fear I just broke up the puffs with my hands first before shoving it into my face ;)

Because of yet another reminder that I can't eat properly, I then spent a little extra time working on my jaw before locking it back down with the rubber bands.  In particular I spent some time working on my lateral pterygoid muscles.  I know this is a muscle most people without TMJ difficulties or Jaw surgery may never have heard of so help out here is an antomical picture:

The muscles lie under the masseters, which is the more well known muscle for jaw opening, but the pterygoids are workhorses!  After surgery all the muscles of the jaw end up getting shortened and tightening up and these are particularly hard to reach! So for those of you inclined to try it out, here is how you reach the lateral pterygoid to massage it/ "release it" like you would at a masseuse for a tight back muscle. You know you are on the right spot if it feels sore and you start drooling ;)

Full jaw opening is considered 40-50mm as you measure from the edge of the bottom teeth to the edge of the top teeth.  My vertical opening today after stretching and massaging was 22mm!  It is slow progress, but it is still progress!

Its a funny angle, but I think its where I look the most different
 with my jaw line!

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 15: A Straw!

Today I was able to successfully use a straw! It was easier with a mirror, but I was able to purse my lips enough to form a seal around the straw.  In the end, it isn't super convenient yet because as soon as I get the beverage into my mouth it abruptly runs into my teeth.  I do not have quite the motor control yet to hold my teeth apart (the slightly apart the rubber bands allow) and still form a seal around the straw, but its a step forward!  By the way, I am doing my facial exercises multiple times a day and they are getting progressively less painful.  The muscles are still stiff and reluctant to move, but it is getting a little better every day.

To further progress my return to real life, I went to the gym today. Don't worry, I just sat my butt down in a recumbent bike for 20 mins. AND felt exhausted afterwards! I always tell my post-op patients that muscle atrophy and aerobic deconditioning are normal following surgery and rest, but it is really difficult to accept when I'm on the other side. I am still a little shocked at the effort it took me to reach the 20 min mark...I was running several miles just 3 weeks ago!

Day 15. You can see my left cheekbone!

Below, I marked where I have numbness and sensation loss.  The yellow is coming back the quickest and feels like its just dulled sensation now.  The Orange is all pins and needles to the lightest touch. The Red is completely absent to light & firm pressure and hot/cold sensation, which is part of the reason why drinking from a cup is difficult!

Day 10: Almost a Smile

I decided not to let today get the best of me so I woke up, showered, put some mascara on, and did not put my hair in a ponytail.  Tom and I were going to try to see a movie (figured it would be a relaxed outing), but we missed the movie showing so we just walked around the bookstore a bit. I still tired more quickly than I hoped for, but it was nice to get outside of the house.

almost a smile!

It is so bizarre to have lost proprioception and sensation in my lips.  They feel like they are ice-cold all the time, when really it is just numbness.  I've been working on my face exercises and have found that if I slow down and focus on my lips I can enunciate a little better. And along with slightly improved speech, I was working in the mirror and found that I could almost smile.  The left side of my face is still rather swollen though which makes most of my facial expressions odd and...lumpy? Regardless of the proper adjective I'm afraid that I may still scare the kids at work...

Status Update:
Pain: 6/10 (trying to take as little narcotics as possible)
Nausea: gone!
Drooling: improving with muscle control
Eating: still just through syringes and with small sips from dixie cups
Fatigue: High
 

Day 7: Pucker, Purse, & Scrunch

Starting my "exercise regime" today per MD I should be doing these multiple times per hour.

• Pucker : kissy-face
• Purse : pulling lips as far back as possible
• Scrunch : scrunching my face and nose centrally as much as possible.

Have you ever worn a mud mask on your face?  It starts off feeling like that, like my skin is stiff and it is that discomfort/ borderline painful to begin to move. Then the underlying musculature starts to yell. If I hadn't had such an intensive anatomy course I probably would not really remember facial muscles, but I swear I can feel each individual one as it starts to contract.  The upper lip  and nose muscles are actually the most painful, so I'm nerding out a little trying to figure out if it is the levator anguli oris, the levator labii superioris, or the levator labii superioris alaeque nasi (spelled that one without looking Dr. Swanson, boo-yah!)

A little bit of Grey's Anatomy for your enjoyment.

On another progress note, I also slept in my own bed last night!  I was still propped up and had a giant pillow buffer between me and my husband (out of both our fears to keep my head elevated and out of harms way). Unfortunately, I still only slept for 4 hours increments (still waking up as soon as the pain meds start to wear off :-/), but psyche -wise it made me feel a little more myself to be in a real bed after a week of sleeping in the reclining chair in the middle of the living room.