Day 108: 32mm!

Sorry, there hasn't been much to post about. Progress has slowed down in most areas, which is good because that means that life has been returning to some what normal!

I am still seeing a Physical Therapist and we are still working on those tight bands of tissue I have on either side of the inside of my mouth.  She says that she's seen scar tissue like this before, but not quite this bad.  It feels like they are guitar strings that you could strum going from the back upper corner of my mouth down to the lower corner. Some days I wish I could just pop them, because I feel like those bands are the only thing keeping my mouth from fully opening.  I have been at nearly 30mm for several weeks now, but finally yesterday after a lot of manual work my opening went to 32mm! (that's about 2.5 fingers width) I am just so excited to break that 30mm mark, because now I know that progress can be made!

My diet is slowing improving.  I am now eating chicken nuggets, saltines, and some breads. I still struggle with harder foods (nuts are still far in the future for me) and thinner foods (like spaghetti and lettuce) as I can't quite seem to bite them well enough. But overall I am back to my pre-surgery soft food diet (like the days after I would get my braces tightened) so its really not bad.

The pain has really gone down dramatically.  I can almost go a whole day without thinking about my jaw at all! The braces and rubber bands are now the largest inconvenience as I am very much over needing to take them off and re-apply my rubber bands every time I want to eat a small snack.  

The lower lip and chin are still numb, but I haven't given up hope that the nerves will grow back *fingers crossed* It wouldn't matter quite as much, but when I do a lot of talking I still feel like I am drooling a lot, which frankly isn't very attractive or professional!

Look you can see my uvula again ;)

3 Months

It feels very odd to say that I had my jaw surgery 3 Months ago.  I have certainly come a long way in terms of healing,  but it doesn't seem that the operation was that long ago as it is still a very relevant part of my daily life. I mean, I still think of my jaw/mouth multiple times throughout the day.  Be it in regards to pain, stiffness,  or difficulty with functional things like talking and eating.
I'm not trying to complain!  I knew going in that this was not going to be a surgery with a rapid recovery. But I also know that everyone around me must be sick of hearing about it by now! :)

So improvements... 

• I'm now eating cut up small bites of ground hamburger so red meat has been added back into my diet (!) 
• I'm seeing a physical therapist to help with jaw movement, after last week's session I opened to almost 30 mm (!) [Goal 40-50mm] 
• Talking feels much improved.  Although with work days longer than 8 hrs I still find myself fatiguing and avoiding long conversations. 
• The swelling is pretty much gone from my face. I feel like from straight on the right and left cheek/jaw are no more asymmetrical than they were before surgery. My nose is a little broader, but that's just vanity...maybe I'm breathing better and don't even realize it ;)

Of course I feel like when I can finally get my braces off, then it will feel like it is really all behind me. The Orthodontist says hopefully September *fingers crossed*

April ( &  January 

Day 81: Getting some Help

Has it really been 81 days since surgery??  Well this week brought several positives as far as healing.

• Have you heard of dry needling?  It is a modality administered within Physical Therapy for trigger point and muscle spasm relief.  (You have to be certified to do this!) Essentially it is the use of an acupuncture needle to go into the muscle belly to help release the trigger point and to stimulate the body's natural healing.  A friend of mine did a couple sessions of dry needling to each of my masseters, which has brought some pain relief!
• I also was able to find a Physical therapist to help me with some manual therapy to regain my jaw opening. I saw her a few days ago for the evaluation and was a bit surprised to find out how much my neck has actually tightened up through this whole processes. You know when you haven't realized that you are twisting your whole body around while driving to check your blind spot until someone asks you about it? :) Turns out that has been a contributor to all the muscle tightness around my mouth/jaw.  She did a little bit of gentle manual therapy work and gave me some new exercises to work on as it turns out I was being WAY to aggressive trying to force my jaw opening and I was actually doing more damage than good (which is why healthcare providers really should not "treat" themselves, but always find a skilled practitioner).
• No news on the food front. I'm still managing a soft food diet, but it is really so much better than squeezing liquids into my mouth with a syringe that I can't complain!

Its also hard to be upset about anything when the sun is shining and it feels like spring is finally here!  I see the Orthodontist again in a couple days, so I should have another update soon!

10 weeks

10 weeks out from surgery and some days are great and others feel like I'm rehabbing slowly.

I saw Dr. M for another follow-up this week. He said that he is pleased with how everything is healing despite only looking at the soft tissues and my bite.  I was surprised that no x-rays were taken, but he says my bite is consistent indicating that nothing is shifting. He was a bit disappointed in my opening, but I was expecting that as I have been working hard, but been unable to regain vertical opening on my own. 

Dr. M says that he sends about 25% of his patients to physical therapy to help out with this. So it's not unusual, but I'd be curious to know if that 25% fits in with the # adults that need this surgery  (versus the number of teenagers that seem to be the typical population for this surgery).  Unfortunately I have been having some difficulty finding a TMJ specialized PT that will take my insurance within driving distance...which has been frustrating, but I have a few people looking out for me so *fingers crossed* 

Anyways after 3 weeks of working really hard I can open my teeth apart 26mm, the goal for Tuesday was ~36mm. This is 80% of the ultimate goal of 48mm, which is what I had before surgery (normal opening is 40-50mm) so I still have some work ahead of me.

No real change in diet in the last couple of weeks.  I am still eating softened foods, some times I can manage really softened chicken, other times (like today) I can't seem to do anything with the chicken in my soup but spit it back out. But on the positive side, pancakes and soft fish are now on the menu!

Most of the swelling is gone, I might see a little more change over the next 2 weeks, but my face is about where it will be.  Everything I read says not to get too worried about anything until 6 months out, but Dr. M says 3 months, so... On the positive my nose is looking less crooked!

And here's a comparison of now to before surgery.... Can you spot the differences?  It could be so easy to slip into a bad pattern of obsessing over specific features. I'm really trying to just let it be, I don't think I've every looked at my face this much in my life! Oh such vanity!

Day 65: A Few Steps Back

So the last few days have been...rough.  I tell my patients all the time that healing is not always strictly linear, there will be good days and bad days. Unfortunately my last few days have been bad days. Remember how I said that the muscles spasms were growing fewer and weaker? Well they started back up on Monday with a dull cramping pain that was pretty easy to ignore, but by Wednesday the spasms were no longer dull but were so sharp they took my breathe away, again.
 I don't know why the pain has come back with such force. I have started eating more foods and I have also been more aggressively stretching to gain that vertical opening that I have fallen below the curve on so maybe with those two combined factors I've irritated the muscles into full rebellion? Wednesday I came home from work took the muscle relaxer and went straight to bed. Thursday I switched out my rubber bands from the 6oz weight down to the 3oz weights. Hopefully a couple days at the 3 oz bands won't slow my orthodontic work too much, but it was one of the few things I could think to do to diminish the pain.  Taking Alleve is helping, but does not stop pain.
Anyways I see Dr. M again in 3 days, so by the law of Doctor's Visits I should wake up pain free that morning, right?

And on a positive note, I am Finally having a little success with vertical opening!  I added a popsicle stick to my stack today and reached 30mm of passive opening!! (40-50mm is "normal") Still some work to do, but I was stuck at 22mm for a  couple weeks, so its nice to have some progress!

Day 62: More Soup

With the amount of soup I consume I wonder if I should really start watching my sodium levels or even my BPA chemical levels from all the cans?
The goods news is that I am no longer blending my soups, but actually eating them as they come out of the can!  Today's lunch was Campbell's Homestyle Italian Wedding Soup... you know the one with the tiny meatballs? The meatballs are so soft you probably don't even need to chew them, but I did! Of course chewing just tangles the food all up in the braces. Also since my cheeks are still numb I tend to pack the food into my upper and lower cheeks (like a hamster) without realizing it, so I need to stop every so often and remove the food and then sometimes when I brush my teeth afterwards I think I rinse out almost as much food as I managed to eat! (you really wanted to know that didn't you? ;-)

But I am eating much more with the softened cereals, cake-like foods, and even sliced cheese (so happy I can eat cheese again...although it'll be an overnight re-gaining of 5 lbs!)

Day 58: 2 miles!

This is just a really quick update. I'm frustrated with the lack of progress I'm making on my vertical jaw opening [only 3mm in 2 weeks :( ] So I called Dr. M to get a prescription for physical therapy, but he's out of town for the week so I'm going to have to wait a few more days before I can get some outside help. But I'm ready to ask for help!

Now on a positive note... I ran for 2 miles tonight!! The pain did increase with the jolting, but I was able to make it!  My face looked a little more swollen after. ..worth it!