Weeks 8-10

Time is starting to go much quicker as the recovery gets a little easier, but my no means is it completely done. This surgery is a long-term commitment with over a year and a half in braces, an extensive recovery time, and braces afterwards, but it’s definitely worth it. To summarize what’s been going on:

 

Week 8: For weeks 4-8, I struggled with a post-op infection around the plates and screws in the jaw. This meant slower healing, more swelling, and pain. I was on 2 strong antibiotics for 4 weeks. The antibiotics weren’t all that fun as they left me feeling totally wiped out. I was also kept on the no-chew restrictions while we waited to see if that infection would go away for the hardware would have to come out. Keep in mind, that this infection was not preventable by anything I did. Though I practiced strict hygiene around the stitches, this is an infection that was likely introduced during the surgery and laid under there “brewing” for the first month. The goal in the extensive antibiotics was to hopefully knock the infection, or at the very least keep it from spreading. If it worsened or wouldn’t go away, I’d have to have a surgery to remove all the hardware. Luckily, at my 8 week appointment I was given the all-clear. Though it’s not always likely, I’d actually beaten the infection and was allowed to begin chewing soft foods. This was happy news,but once again I left the appointment with a bittersweet sadness because it was one more step to this adventure being over. I was told to use ice, heat, and massage to work on getting my mouth to open wider. I currently can barely fit two fingers in there when it’s opened as wide as I can. I was also released back to my orthodontist to continue my treatment. I ate some pasta, scrambled eggs, and mostly anything as long as it was cut up into small enough pieces. 

week8

 

Week 9: First appointment at the orthodontist since surgery. The staff at my orthodontist’s office will be more people that I will miss when this is all over! They are incredibly supportive and were thrilled with my results. I found out later when I ran into a doctor retired from the same practice, that though they try not to show it, surgery cases are especially exciting and interesting for them. Apparently I was the talk of the town for the last few months. 😉 The best part of this appointment was getting the surgical wires and hooks removed. Before surgery, a thicker wire had been placed so that it could withstand the pressures of the surgery and bands placed on it. I also had those 13 “hooks” in there. Though I was pretty much used to all of that, it was nice to get some of that metal out of my mouth. I now wear my bands further back in my mouth instead of over the canines. It takes quite a bit of practice to be able to get those properly placed. It was frustrating because they often came off the hooks or snapped. The nerves continue to be a problem. They seem to vary between pins and needles feeling, to burning, to weird temperature extremes. It’s all good news because it means they weren’t permanently damaged, but very tough to ignore in the meantime! 

Photo on 7-30-14 at 10.32 AM #4

 

Week 10: After struggling with the bands over my molars for a week, I went back to the orthodontist for a simple fix. They bent out the hooks a little bit more and now the bands hold pretty well. The swelling is finally all gone. I’m even able to sleep on just one or two pillows at night and not wake up all puffy! It’s almost strange to sleep normally again and has taken some getting used to. There is less and less numbness in my lower lip and chin, but I continue to have problems with nerve pain. I go back to the surgeon for one last check up before school starts and will find out then if there are any restrictions to my eating as well as if anything can be done for the nerves. The last week was rough because the typical tightness and tenderness with adjusting the molars at the orthodontist, coupled with the nerve issues meant more pain than I’d had in a long time and even more time being unable to chew normally. It took about 5 days after my adjustment to feel okay chewing again. It is getting a little frustrating because my back molars still do not line up for me to chew easily. I have to trust they will get there eventually but after the ordeal of surgery, it would be nice if everything was all set and ready. But if I’ve learned nothing else, I’ve learned patience! At times, I wonder if I should have went ahead and done a genioplasty. This is a procedure to align, reshape the chin. It is strictly cosmetic and would have been another $1000 out of pocket, but sometimes I think my chin is still off center though it’s not as noticable as before. However, like many jaw surgery patiences, it becomes too easy to scrutinize and obsess over details that are most likely undetectable to other people and also insignificant. The chin does not affect my ability to chew or speak properly and is definitely a minor issue in the grand scheme of things! I supposed it’s better to not have added more hardware and recovering time to my face. For my next update, I’m hoping to have more before/after pictures ready because those are some of my favorite. Until next time, it’s massages, heat, and soft chewing!

Week10

 

 

 

 

 

My Favorite Things- Jaw Surgery Edition

It’s been 8 weeks already since my surgery. I really can’t believe it. I have some followers who are fellow jaw surgery patients, so I thought I’d share a list of the items I found important to get my through the first months of recovery. Most ideas aren’t my own but came from other blogs or the advice of my surgeon, but I thought I’d collect them all in one place.

 

 DSCF9699

 

1.) By far the best purchase I made was in this wonderful travel pillow. It was and still is my favorite thing and much more helpful than I first thought. I had it with me in the hospital and almost continuously for weeks. The U-shape really helps support the head since jaw surgery patients must remain upright during the healing phase. As a side-sleeper, this is the only way I could accomplish that. I also found that it was necessary in the car to keep the seat belt from causing pain to my tender neck and chest-something I wouldn’t have considered to be an issue before. Another great way I used it was to help hold my ice packs in place. This particular one is great because one side is really soft and warm and the other is a stretchy, smooth, cooler material. The side with the smooth material felt great around the stitches and stayed cool. This one came from Amazon. 

http://www.amazon.com/Samsonite-Luggage-Magic-Pillow-Print/

 

2.) Large syringe- these came from the hospital and were the quickest way to eat for awhile. It may be annoying, and you may feel like an orphaned baby animal, but with numb and swollen lips, sipping drinks/liquid food from a cup or spoon can take forever and be messy. Loading a large syringe makes things much quicker. This is especially important if whatever you’re eating isn’t the most pleasant thing to you. A favorite thing I used the syringe for was to get protein by mixing broth into canned baby food meat until it was nice and liquified and could be drawn into the syringe. 

 

3.) This book:

dinner

I got this for free from the surgeon at pre-op and it ended up being the absolute best for recipes. I tried lots of different things in there and didn’t really find any that I didn’t like. I notice it’s on Amazon but really expensive, so it must be out of print. Perhaps a search on eBay or elsewhere on the internet would get you this book. It’s definitely worth the time and money. 

 

4.) Baby food/fruit in a pouch- similar to the idea of a syringe. Sometimes I was just too tired to do much food preparation so having these handy pouches was a lifesaver. Just open them up and squeeze them into the small spaces between front teeth or in the back. I was especially liking these when I’d have to get up at 4 or 5 AM to take medications. I couldn’t take the antibiotics or painkillers on an empty stomach so it was easy to grab one of these, quickly eat it, take the pills and get back to sleep.

 

5.) Dishtowels and paper towels- Eating was (and still is, sometimes) very messy. I used dish towels like a bib, laid across my neck and kept paper towels handy to wipe up my chin and lips. There is no way I’d have any clothes left if I hadn’t! 

 

6.) Wide necked/V neck shirts- For about 3-4 weeks, I couldn’t wear any shirts with smaller openings for the head. My face and neck were so swollen and sore that the pressure of putting on clothes with a tight opening was too much. I wore the same 4-5 shirts for weeks but it didn’t really matter. I didn’t go anywhere and was quite comfortable.

 

7.) Homemade icepacks- we made our own ice packs and they were so much better than most others you could buy. In the hospital I had bags filled with ice chips/ice cubes but found that it was painful if the hard edges got pushed into some areas of my face. At home I had the Cool Jaw ice wrap that I’d been using to treat my TMJ leading up to surgery. The Cool Jaw is nice because you don’t have to hold it and has been useful lately, but in the first few weeks when such a large area needed iced, the packs just weren’t big enough. 

http://www.amazon.com/Soft-Stretch-Packs-Cool-Jaw/

A simple internet search for homemade ice gel pack will get you recipes we used. These used rubbing alcohol and dish soap. They get nice and cold but don’t freeze solid so they fit around the face nicely. Best advice I can give is to put at least 2-3 good quality freezer bags around them as they can leak after awhile. I then wrapped mine in a thin pillow case to use. You may wear yours out and have to remake them, but they are worth it since they are so much more comfortable than the regular ice or the store-bought ones.

 

8.) Lip care- Vaseline and Blistex are essential from the time you wake up from surgery. I used Blistex on the corners of my mouth that were raw/open from being stretched so far and for so long during the surgery. I used Vaseline for the stretched skin across my lips for the weeks after as everything swelled up. Still, 8 weeks later, my lips require a lot of chapstick or vaseline as they are still puffy and dried out/sore most of the time. 

 

9.) Face wipes- besides cleaning food off my face, I really wanted to keep my skin healthy and clean but found that leaning over the sink to wash my face or splashing it with hot water in the shower was painful and difficult so I got some moisturizing facial wipes. These can be found near the make-up removers in most stores. I really like the mositurizing ones because in one step I could clean my face and get lotion on there and only have to touch it once. Just be careful around any external stitches.

 

10.) Hair detangler- This goes back to comfort. For me, and pressure or pulling on my head made my jaw hurt so spraying a leave-in conditioner or detangler spray made brushing and pulling back my hair much easier. Again, not a necessity but made me much more comfortable. 

 

11. ) Rubber-tipped baby spoons- Once I was able to open my mouth a little more, I could eat things like Jello, pudding, or soup. These tiny spoons were so much better than regular spoons and the soft tips make them flexible and easy to fit in small spaces with little discomfort and less spilling out of the mouth. Plus they come in fun colors!

http://www.amazon.com/Munchkin-Pack-Soft-Tip-Infant-Spoon

 

12.) Small container/basket- I’d recommend getting a small basket or box to keep things close by. Even though I only traveled from the couch to bed and back and forth with the random doctor appointment, it was nice to keep all the things I’d need nearby so I didn’t have to get up and search for them and I could keep my table as clear as possible. I kept my lip treatments, some paper towels, extra elastic bands from the surgeon, etc. in there so that I’d never have to go searching for something.

 

13.) Anything you find fun/relaxing- After a few days when I had some energy, I played Nintendo Wii or worked on puzzles. It was something besides watching TV or reading to keep the mind going and made me feel productive even though I was just lying around. 

 

14.) Not shown is the best investment I made: A Nutri-bullet blender. Yes, it is expensive but well worth it. Not all blenders are created equal and a good quality blender is essential. This blender is very powerful and will practically liquify anything you put in there. I also love that it is single serving and you can eat/drink right out of the container you blended it in. This saves on dishes and clean-up time as well. I also have a Ninja blender system that is expensive, but worth the investment. It blends through about anything and has a food processor. The only drawback to the Ninja over the Nutribullet is that the pitcher is larger so it works better if you are blending larger quantities like multiple servings of soup. 

http://www.amazon.com/Nutri-Bullet

http://www.amazon.com/Ninja-Kitchen-System

 

 

Still the Same

Haven’t updated in awhile because there haven’t been too many changes. The swelling due to the suspected infection comes and goes and I’m totally drained of energy. Then again, my body is really working to fight this off, which I appreciate.

The infection was diagnosed 2 weeks ago and I started penicillin. It didn’t get better very quickly so I called back and said I was still puffy and feeling some pain in places around the plates and screws. They called in a second antibiotic, Flagyl. The antibiotics work on two different kinds of bacteria/germs so we can cover all our bases. The goal was to keep everything under control until 5 days later when I could have the plates and screws removed. The appointment was set for Monday, which was right after the long holiday weekend.

Luckily for me, the antibiotics kicked in and the swelling and pain went away pretty quickly. The problem was that with the office closed, I couldn’t get a hold of them to cancel the hardware removal surgery that was scheduled for 7:15 AM Monday. Since I had a follow up appointment anyway and needed to go, I just kept the appointment and hoped and prayed they’d agree to let me keep the plates and screws.

Once I got there, they were prepared to do the surgery. I was hooked up to monitors and prepared for anesthesia when the doctor came in and I told him I really didn’t want to do the surgery so soon if I didn’t have to. Lucky for me he agreed. What a relief! At only 5 weeks past surgery at that point, taking out the hardware would have left the jaw pretty unstable. He explained that no matter how sterile the OR was, sometimes things get in there during surgery and kind of sit and “cook” for a month or so. Which explains why the infection didn’t show up until 4 weeks after surgery.

It can slow down healing, so I’m still on a no-chew diet and wearing bands 24/7 but it’s worth it to still have the safety of the hardware in there and not have had to go through more surgery, even if it’s minor in comparison to the first surgery.

The plan is to stay on both antibiotics until this coming Wednesday and then stop. Hopefully, the infection is gone rather than just subdued. I have an appointment the following Wednesday, which gives the infection time to show itself if it will come back. He told me that when we have these post-op infections, the antibiotics will sometimes take care of it. But many times, that hardware will continue to harbor infections and have to be removed.

It’s been harder and harder to force myself to eat, however. I get hungry but am so tired as well as bored with the same food that I can’t find motivation to get up and go through the trouble of making the food. So, unfortunately, I’m not getting the nutrition I need which isn’t helping recovery.

I’ve gradually taken away pillows at night so I’m sleeping on only two pillows instead of the 8-10 I had at the beginning! It’s great. One thing I’ll have to ask about at the next appointment is if I can do anything about clenching my teeth at night. I wake up feeling extra stiff and my teeth are tingly. I think the bands/stress are causing me to put extra pressure on those teeth without realizing it which can cause the TMJ to come back as well as slow down progress in my healing. Hoping for a simple answer!

There’s a few pictures from the last 10 days below. You can see how the swelling on the sides/my lips changes day by day.

 

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Day 32

For every few steps forward, I seem to take one back. It appears that I’ve either pushed myself too much and/or developed an infection. A word of warning to all other jaw surgery patients: take it easy and definitely take good care of yourself and your oral hygiene. Despite brushing my teeth and using my prescription mouthwash, the surgeon believes there’s an infection. I have not confirmed it because I didn’t call until mid afternoon on Friday and I couldn’t have made it to his office before they closed. I had a sudden increase in swelling, much more pain, and my lip swelled up all over again. So far I haven’t had a fever, but have been much more exhausted than ever. It’s clear that my body is fighting off something. Between the pain and fatigue, I’m finding it difficult to eat. Both the physical act of trying to open my once-again painful jaws as well as the exhausting nature of preparing food are big deterrents in getting enough nutrition, which is likely compounding my problem. The surgeon called in some high dose antibiotics on Friday and instructed me to take them right away and to get into his office first thing tomorrow (Monday) morning to be checked out and probably have some xrays done to be sure the infection isn’t too deep or affecting the healing of the jaw. I also got bumped in the face by my puppy last night and have had pain from that so am hoping and praying those xrays come back still on track. One of my biggest fears is I will end up one of the few unfortunate ones who has to have a second surgery to correct the jaw if it doesn’t heal correctly. Of course, I made it through once, I would make it through again if I have to! The picture is from today and the swelling is kind of down right now though you can clearly see that one side (the left) is puffier than the other. The profile shows a little bit of the bulge that’s still there about halfway back my jaw. The swelling is right over the plate and goes down into my neck a bit. It’s also burning off and on which is another bad sign. Thank goodness for Penicillin!

#2 #3

 

4 Weeks- June 25th

First off, my apologies for not having updated for quite some time but the last two weeks have been… eventful…for many reasons-good and bad.

First off, I can say that the swelling really began to decrease and to decrease quickly after about halfway through the second week. The swelling mostly seemed to follow the numbness in that as the swelling decreased, my nerves began to wake back up and feeilng came back. This is not always a pleasant thing as it often felt like pins and needles for days. Other times, like if I didn’t stay right on schedule with my pain medicine it felt like very sharp pain. The best way I can describe it is that it felt like someone was driving an ice pick straight into my jaw, right about where the breaks are! Definitely not pleasant, but staying on top of medications is key in reducing that discomfort. Speaking of pain medications, I was able to successfully taper off the percocet during this time and switch over to Motrin instead. Now, I had to take about double or triple the doses of Motrin in weeks 2 and 3, but it was much better than dealing with the side effects of the percocet.

18 Days After Surgery:

18 days

Eating continues to be a challenge through this time period, some days allowing me to eat more “solid” food than others. I find that the swelling, pain, and mobility can change from day to day which effects what I can eat. However, at my 3 week check-up, I was advised to try to begin to eat soft foods instead of just liquids. Remember, I can’t open my mouth much more than a fingertip-wide and under no circumstances can I chew. So I have to shove small pieces of things in there and kind of mush them against the roof of mouth in order to be able to eat/swallow them. It’s messy and time consuming so somethings I just revert back to liquid things I can drink. But I’ve managed to eat tiny pieces of hot dog this way, scrambled eggs, spaghetti-os, fries, and very soft cookies. I’ve also been more brave in what I’m willing to blend. Even the thought of things I’ve eaten/drank right now make me gag, but when you are hungry and with people eating these things you can get past the texture rather quickly. I blended a piece of pizza, a junior cheeseburger from Wendy’s, and a taco. All looked disgusting but were much more satisfying than soup!

I continue to sleep propped up on many pillows as I find that lying flat, or even on one side results in waking up more swollen and tender on that side. Sometimes the pain will wake me up in the night if I have slipped over to one side or slid down the pillow and end up lying more flat. Apparently the time spend sleeping propped up like this varies from patient to patient, but I’m hoping that by 6 weeks post-op I can once again lie flat and get a better night’s sleep! However, I’ve recently suffered a set back to that, which I will explain later.

 

One thing I will touch on briefly, because  it is important and has been a part of this is what some people consider something to be embarrassed about or hidden. Without going into detail I can tell you that my blog updates stopped when they did because at about exactly 2 weeks after surgery, the mental and emotional side effects of everything hit me and hit me hard. Mental health is something people in our culture are often too ashamed or embarrassed to talk about, but it is real for many of us and can be especially real for patients having surgery such as this. A large part of my sadness and anxiety was due to the fact that this surgery was over. While I was relieved and pleased with the outcome, it is almost like a loss I had to grieve. Jaw surgery is a unique experience in that patients have perhaps years to prepare for the surgery. It is both elective and necessary to improve quality of life. It requires months or years of braces and planning. It’s a huge event and life-changing. The final weeks leading up to it are busy and there comes a time when adrenaline kicks in. I never really got nervous, just excited and ready for the adventure it would become. But then it was over. I was so busy planning and in adrenaline mode- I hadn’t taken the time to let it really sink in that it was happening. I wanted to be able to experience it all- the good, the bad, and the ugly and I felt like I didn’t. This is especially so because I was given a pre-anesthesia drug called Versed. I was told it was a light sedative to calm my nerves. I didn’t think I needed it but was urged by the nurse to do so. What I did not know was that it would pretty much erase every memory from the last 20-30 minutes before surgery, and she never told me when she was adding it to my IV. I felt cheated out of really being able to experience and remember this. Did I really need to put myself through seeing the OR and my doctor again? The scary tools and instruments? Probably not. But then again, I think it would have provided the “closure” so to speak that I needed. This was a huge factor in the letdown period at about 2 weeks after.

This feeling about the pre-op drugs, the strange reaction I remember having (before Versed) in which the doctor and nurse proudly brought me my models and I couldn’t think of anything to say (when I really wanted to be happy, excited, and ask questions), as well as anxiety over the other changes coming in my life led to a very bad time. I was the poster child for what we could call a mini-breakdown. Calls into doctors and my surgeon helped explain some of what was going on. Turns out that on top of all those feelings to deal with, the cocktail of powerful drugs and anesthesia can also trigger these reactions. The surgeon also explained that while we may seem to be coping well (and I thought I was!), the subconscious part of our brain can have a hard time processing everything that’s happened to us. In my case that was the trauma of the surgery, the exhaustion of recovery, and trying to recognize the new face in the mirror as my own. While the physical changes are positive, they can be confusing us and we don’t even know it! Thanks to a strong support system of my family and friends, following my surgeon’s advice to speak to a counselor, and just giving myself time I’ve been able to recover from this. Though there are still days where the sadness that this huge chapter of my life is over, I’ve been able to slowly move on. Here’s a good shot of how much my bite has improved. The first picture is about 2 months before surgery, the second was 3 weeks after surgery!

Photo on 5-8-14 at 4.56 PM #3bite2

Speaking of moving on, I can tell you that other things in life began to fall into place at totally the wrong time…but I had to go with the flow. I’d been searching for a house to buy for months and it timed just right that I ended up closing on my home and moving at 3 weeks post-op. It’s absolutely crazy and I don’t recommend it, but it happened and we got through. One of the bigger challenges (aside from being exhausted and sore) is that I am to under no circumstances do any heavy lifting. Though the surgical site is the jaw, we often clench or teeth or strain the muscles in our face when lifting. This has the potential to pull stitches loose or even causes shifting in the places where the bones are not yet fused. As the surgeon explained “you need to remember-your jaw is still broken and only held in place by the screws and plates”. The restrictions on lifting and physical activity remain in place until my xrays show that the spaces where the breaks are have begun to fill in with solid, new bone.

Again, my support system of family and friends were able to sacrifice their own time to get me moved from my first place- a tiny one bedroom apartment I’d outgrown that was 20-25 minutes from pretty much everything into my very own home with space and only 5 minutes from most places I go. It wasn’t the best timing but it all worked out! I even had lots of help painting because I just don’t have the strength or energy to do much and I can’t bend over or look up for very long without feeling pain. Because of the mental/emotional issues I experienced at that time, I hadn’t stayed in the apartment for about a week before I moved. My last night there had passed without ceremony or closure which is sad, but perhaps a blessing. I moved on the afternoon of June 18th, even driving the U-haul myself. I found it ironic that exactly 21 days before I’d been lying on an operating table with my bones being sawed and shaved. Who ever would have thought?

uhaul

I am now mostly settled into my new home and unpacking boxes little by little. I get tired very easily and after a week of stress and too much activity of moving, I’m learning to take it easy and listen to my body. The surgeon said that when people heal from surgeries like this, we need about 2-3x the amount of caloric energy. The jaw surgery is challenging because on a liquid diet, it can be extremely difficult to even get a normal day’s amount of calories and nutrients. So having a huge event, like moving so soon after surgery is not something I’d recommend, but in my case, was unavoidable.

Because I’m a bit of an overachiever and planner, I also got a puppy in the first week in my new house! Again, not the best of timing as far as surgery recovery but since I’m a teacher and the school year gets busy, I wanted to get a puppy in the early summer to get training out of the way before school starts. So, my choices were to do it now or wait another year. So I went for it and it’s been pretty good. Pets are therapy too, right?

 

Willow

 

 

At exactly four weeks after surgery, the before and after pictures are wonderful to look at. Can see the external results of the years of treatment and it feels great. A few days ago was the first that I was actually able to pull back my cheek and check out the inside of my mouth. Let’s just say it has a little ways to go yet to look healthy. It still looks pretty much like Frankenstein with thick, white stitches stretching from just past each canine tooth, all the way to the back of mouth on both sides, all sewn into the gums right under the teeth. I tried to get a picture…but it just wouldn’t turn out. Perhaps that’s better left to the imagination anyway… 😉

3 Weeks After Surgery: The day I closed on my house and the first day I attempted to wear makeup. Which is not something that was all pleasant as my cheeks and jawline are still very tender!

abc1

 

4 Weeks After Surgery: Again, the only day that week I wore makeup because it still hurts to put on and scrub off but gives me a better idea of what my day-t0-day “look” will be.

abc2

abc3

 

Days 11-13

The last few days have actually been a little harder than that first week. I’m still very sleepy and in more pain than I had been. I’ve had a few visitors and left the apartment a bit to go grocery shopping and yesterday to go to my mom’s to be outside and to go to my nephew’s ball game. It was nice to be out and about a bit but also really tiring. 

The mornings are by far the worst time of day, I think because I don’t sleep very well due to pain and the discomfort of what I call my pillow fortress. I typically sleep in one pillow on my side, so sleeping propped up on my back feels quite unnatural to me. I found out the hard way that I need to keep pillows along the sides of me as well to keep me from falling over while I’m sleeping. I woke up one morning having slid off the side of the pillow fortress. The pain was throbbing on that side of my face and it had swelled to almost twice the size of the other side. Learned the hard way about that one. This is my pillow fortress and it also involves heat pads or ice on the sides of my face too. It’s almost claustrophobic!

Image

 

Eating continues to be a struggle. Between the swelling at the front of my mouth and the numbness, I still find it simplest to put the most liquid foods in the big syringe and shoot into my mouth. Saves time and napkins. For thicker things, the baby spoons are still best. Sadly, my big syringe is no longer working so well. This makes me quite sad! The recipe book I got from the surgeon has been very helpful. The things in there aren’t nearly as bad as what they may sound. I’ve been getting more and more adventurous and yesterday made a liquid omelet from fried bacon, scrambled eggs, cheese, and milk. My Nutribullet made it nice and smooth and it tasted just like a good omelet. I’ve also enjoyed a sweet potato pudding, liquid beef stroganoff, melon mint soup, and a corn pudding. I’m eating a lot of Jello and pudding cups as well. I typically really aim to keep my food as natural and “clean” as possible, but have had to give that up for a few months in order to just get food in me, especially when I’m here alone. With only having about 4 hours of the day in which I feel halfway like myself, there’s not time to be cooking and stressing. I don’t plan to eat out for a little bit longer. The picture below details my struggle… it’s actually humorous to me. But no socially acceptable. I truly have no idea when my face looks like that. I just figure the culprit are being totally numb combined with the swelling creating little control over my bottom lip as well as all the internal swelling with the very small opening just scraping off anything that’s on the bottom of the spoon! The result is not glamorous, but is a little funny… 

Image

 

Other things from the last few days:

Pain-no longer taking prescription pain killers has been an adjustment. Tapering off the percocet at the same time as bits of feeling come back to the back of my mouth has resulted in some pain. As swelling begins to diminish and the nerves begin to wake up I’m faced with more discomfort. It’s manageable but makes me even more tired and grouchy. The worst pain is on the right side. It’s a sharp pain that starts around the site of the break and goes to the joint/ear area. It comes and goes but when it’s around it’s almost unbearable. After putting up with it for 2 days, I called the nurse at the surgeon’s office. (By the way, she’s awesome!) She said it’s to be expected. The pain is similar to a dry socket (one of the most painful conditions people can have after dental procedures…or ever and also something I experienced ten years ago with the removal of my wisdom teeth). The nerves that have been previously pinched by swelling and moved around during surgery are really acting up. It sends shooting pains up to that area just behind the ear. There is also pressure on the joints right behind the ear which can lead to more pain. Unfortunately there’s not much that can be done. At times I also have muscle pain that is caused by the muscles beginning to reattach to the bone. Remember those were also peeled back during the procedure.

Numbness- There is less numbness now, most of which is still at the front of my mouth and my chin. I have a variety of sensations including the typical pins and needles, sometimes a feeling of dampness or itchiness, sometimes a very sharp prick in a certain spot (like being poked with something), and the weirdest of all-a sense of a spider web substance being across the tip of my tongue. Very odd!

There’s been lots of changes in just three days, most notably in the swelling:

Day 11-Still limited movement of my mouth due to being numb and all the swelling inside getting caught on my braces

ImageImage

 

Day 12- Getting a little better

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Day 13-Much improvement all around. At least visibly. Pain was increasing!

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Days 8-10

I haven’t updated lately for two main reasons: there hasn’t been much changed and I’ve simply been WAY too tired. I think it’s finally catching up with me. My body is no longer running on adrenaline or on high doses of steroids and fatigue has set in. I’ve never slept so much in my entire life. mornings are the worse. I basically can’t function until at least 11 AM, despite getting up at 5 for Percocet, 7 for Motrin and antibiotics and breakfast. I muster just enough energy to trudge to the kitchen, find the simplest food possible take my meds and go back to bed. I had much more energy a week ago than I do now. I typically struggle to even stay awake enough to feed myself in the morning, perk up a little bit with a shower around noon and have 3-4 good hours before I need to nap again. 

It’s also been a little more rough the last few days because of having more pain than I did in the beginning. Again, I’m taking less painkillers and there is starting to be a little more feeling coming into my mouth so I feel a variety of things I hadn’t before. There’s times of the aching pain, sometimes sharp, in the joints of my jaws. I have sometimes sharp pains right under the screws/plates which is where the breaks are. The muscles are very tense which can lead to a different kind of pain. Sometimes the stitches inside start to pull a bit. Now, the pain comes and goes and can be tamed with the percocet and Motrin, but it’s definitely more noticeable now.

I also learned the hard way about how important it is to stay propped up when sleeping. In all the sleeping I’m doing, there’s times I wake up not where I intended to be, or I fell asleep unintentionally and my head wasn’t as upright as it should be. whichever side I’m on ends up twice as puffy as the other and the pain can be searing. Going to add even more pillows to my fortress tonight to help keep me from rolling over in my sleep! Lying flat and on my side in a few weeks will be absolutely amazing, I’m sure.

I’m beginning to get cravings for food other than my liquid/baby food diet which is extremely frustrating but I’m learning how to deal with. Watching TV is a way NOT to deal with it. You have no idea how many commercials are about food until you’re hungry and unable to eat anything satisfying! I’ve been watching movies or TV series on Hulu instead. 

I have been able to work on a puzzle which has been a fun way to pass the time and I consider it an accomplishment that I was able to finish it without the cats losing any pieces for me! Miracles do happen. Suppose tomorrow I will put it away and start a different one. But for now I like to admire my work. 🙂

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It hasn’t been too bad being home alone and taking care of myself, though it can feel a little confining to not have the ability to go anywhere, but I’m looking at this time as a “staycation” and enjoying relaxing a bit before life picks up in a few weeks and I go back to a crazy schedule. If this experience has taught me anything, it’s that I really do need to diligently schedule in “nothingness” like this in which I don’t have to be anywhere or talk to anyone and can just enjoy doing quiet things at home with my pets. The only times I really wish I had help have been when I’m too exhausted to even get up but have to in order to eat or take meds. The other time was when I gave myself a bit of a scare. I woke up from a nap and my leg had been curled under me. I didn’t know it was asleep until I’d take about 3 steps and it pretty much felt like it was giving out on me/bending backwards (or however you describe that sensation). I was dizzy and still exhausted so it caught me way off balance and I nearly fell into the door of the refrigerator. Not good!

The swelling remains relatively the same. It doesn’t look so bad on the outside, but I can definitely tell there’s a huge amount on the inside. My bottom lip is very swollen on the inside. It actually kind of spills over the tops of my bottom teeth onto my tongue. Very strange sensation. The inner cheeks are still so swollen that my braces actually become embedded into them (add that to the list of things that cause pain!). I know it will go down with time. I’m actually pretty grateful that I don’t look worse than I do. I look more like I had my wisdom teeth out than that I had extensive jaw surgery. 

Here are pictures from the last few days. Don’t mind the zombie look- I feel totally drained. I also don’t smile too much because it hurts and is awkward with all the swelling in my mouth!

 

Day 8

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Day 9

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Day 10

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Day 7 (June 3rd)

Today was a good day, pain and swelling wise, at least to start out with. Not a good night’s sleep as I was still up every 3-4 hours to take pills, get comfortable, etc. The struggles with the ice continued! I wish I had a good solution to the issue of getting all angles of my face iced at one time, but so far, I’ve only come up with only mediocre results. Icing the face is a multi-step production that typically ends up with my in my ice fortress that looks something like this: 

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The most useful ice advice I have come up with so far is to ice as often as possible, but to create your own ice packs or buy packs that remain as gel/liquid as possible. Some areas of my face have been very tender from early on, and ice cubes or even crushed ice really hurt. I found numerous recipes online for homemade ice packs that overall, have worked quite well and were relatively inexpensive to make. A google search of homemade ice gel pack will turn up multiple recipes. I found that the ones with Dawn dish soap turned out better than the ones with just alcohol and water. They look like this and are slipped into a pillow case when I’m using them. The liquid nature of them helps them form to my face without poking into the tender areas under my jaw. 

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The biggest issue we have dealt with is that they leak if under too much pressure. I highly recommend that they are double bagged with both bags duct taped around the top to seal it off. I think tomorrow I’ll try putting my gel ice bags in the bags we got from the hospital to see if they stay on my face better than trying to push them to the sides with pillows, etc. 

I enjoyed being able to go up to the school for the last day of school to pop in for a visit. People were very surprised to see me up and walking around and looking relatively well so soon after surgery, and at that time I felt great. The end of the year is always bittersweet for me. I think that all good teachers form somewhat of an attachment to their students, but since I have no children of my own I think the bond is a little bit deeper. It can be difficult to send them on their way. It’s nothing like a parent’s empty-nest, but probably a little bit similar. I spend 9 months caring for them, trying to reach their needs, being a teacher, mentor, stand-in parent, counselor, and nurse. I want each one to feel cared for and special but have to wonder if I did enough. But no matter the answer, you let them go and the relationship is never quite the same. But it’s what’s supposed to happen. I prepare them for the next year and look for them to go and be successful. I’ve now had around 330 little birdies fly the nest and I’ll survive it again. There’s a new flock coming in about 2.5 months anyway and the cycle will repeat itself. So with those feelings there every year, I’m glad I got the closure of going up to visit my kids, give them end-of year gifts and hugs and be on my way. I think the kids liked it too. I even took our class pet for one last visit. I love seeing the interaction between kids and animals. Some kids just connect so well with an animal.

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By the time I got home I was pretty tired and feeling sick from the car ride, but I did find that I was able to actually smile for the first time since last week. It’s painful and awkward so I don’t plan to do it often, but it’s possible and lets me see the aesthetic results of this procedure and makes me excited to try out the functional results of teeth that work. 

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I took a nap for a little bit in the afternoon which was quite nice and welcomed. Spent more time just being lazy because I can tell my body is becoming even more exhausted from this whole ordeal. More meals with the syringe and baby food. 

The pain level is a bit more. This is likely due to attempting to cut back on the percocet. I just am not liking the side effects- the somewhat dizzy feeling,  as well as the digestive issues. Seems I was a bit premature in doing so as the pain came back. 

The numbness remains a huge issue as well as the sometimes painful muscle spasms along the jaw line. The biggest issue as the day went on was that the swelling became much more pronounced from the time I took the pictures around noon and the time evening came. The bottom lip has become very large again which is making eating and drinking even more difficult and speaking nearly impossible. The only explanation I have is that the steroids are not drastically cut back, per the instructions on the package. The steroids really did a great job with the swelling when I was on the full dose, so I suppose a little relapse is to be expected. Just really annoying!

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Day 6 (June 2nd)

Woke up in the morning to find that my pillow fortress had been invaded by one of the fuzziest pillows I own! Glad he made himself comfortable and was looking out for me through the night. Silly boy! 

 

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Today was a big day as it was my first follow up appointment with the surgeon. I was still nervous about that right side that started feeling differently when I had the ice banded too tight, so was ready to go get some peace of mind about that. Would still like to get solid sleep but I’m up every 2-3 hours when pain wakes me up, or my neck aches from being propped up or it’s time for a pain pill. Speaking of pain, I haven’t addressed that too much but so far the pain is not what I’d expect.

-In the first few days, the most pain I had was from the oxygen tube. The pain in my throat was excruciating as it felt very, very raw. The worst sore throat I’ve ever had and as someone with chronic reflux/sinus issues, that’s saying something. 

-If I get behind on my pain pills, the pain is more of a dull achey pain at first which reminds me that I need to take the pills. It’s not nearly as sharp or painful as you may expect. Once in awhile it feels like the roots of my teeth are tense or aching as well. 

-There is a certain level of extreme pressure/tension in the muscles that I’m starting to feel on top of the aches from deep in the bones. Feels like cramps, or painful spasms at times. Luckily this comes and goes and ice seems to help.

-Earaches-have slight earaches in both ears. There is lots of pressure and swelling pushing on the inner ear, so this is to be expected and goes away with the pain killers.

-The last “pain” I have ranges from tingling, to burning, to stabbing in my chin and lower lap. The nerves were handled a lot during the surgery and are constantly under pressure from the swelling so they pretty much go haywire from time to time. 

 

One highlight of the day was finally getting all my beautiful flowers from coworkers and my small group at church. They certainly brightened my morning. I look forward to using the big planter at my new house in a few weeks.

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Early afternoon Mom came to pick me up to take me to the surgeon. The worst part of the whole thing was the car ride. Riding in the car makes me especially sick to my stomach and it’s about 55 minutes each way to get to his office. I’ve tried tapering off the nausea prescription and have been successful so I decided to chance it and go the natural route and took my peppermint essential oils. I do think they helped, but I took one of the vomit bags from the hospital just in case. The travel pillow was also crucial. It keeps my head propped up in the car and keeps the seat belt from cutting into tender parts of my neck. I was also starting to feel pretty loopy from the medications. Motion didn’t help and I know I wasn’t acting quite right by the time we made it to the waiting room. but we made it and that’s all that counts. Is it wrong I was kind of hoping my bruised appearance and big lips and bad speech maybe scared the teenagers sitting there waiting for what was probably simple wisdom teeth? 😉

The appointment was pretty simple and quick.

-I was greeted by a nurse who asked about pain levels, what I’m eating, concerns, etc.

-My favorite surgical nurse came in and sat down to talk awhile. She was very kind and understanding. She said things were looking really good for only being 5 days out from surgery. I told her about the most miserable moments on the way to the ER on Thursday and she said “We try to tell people it’s miserable but there’s no way to prepare people for this, but it sounds like you’re doing a good job.” Well…thank you! I also apologized to her for any ungrateful behavior at the hospital since I’m pretty sure the last time I saw her my nerves were fried and there was something in my IV…

-The surgeon came in to see me, looked briefly in my mouth and felt around. Repeated everything the nurse said, that the swelling and bruising is normal and expected and right on track. He told me again how pleased he is with the results-that the bite in the front is wonderful and he got the jaw rotated the way he needed to. He told me again about how he had to carefully and meticulously work around the nerves embedded in the jaw bone before he could shave off the parts he needed to. 

-I had x-rays taken to check on things. Those were very strange to look at and I hope I can get a copy to post here some time. We saw the screws on the right side and the plate and screw on the left side. Also saw the clean breaks in the jaw. There is still space between the pieces (hence the hardware). With healing the spaces will fill in with new bone.

-Got my stitches removed from the sides of my face. A week ago, the thought of stitches would have made me queasy, but I’m at a point where I didn’t even flinch. Just have to keep ointment on those spots all the time and they shouldn’t scar too much.

-Also switched out the elastics and got a bag to take home in case they start breaking. 

-Got permission to being tapering off some of the pain killers as long as the pain is manageable. I’m so ready to be done with some of the side effects of those pills.

-Same routine-sleeping propped up, liquid diet, ice/heat until I go back in 2 weeks.

 

Ride home wasn’t as nauseating as the ride there and when I got home I had some help. My wonderful grandma came and brought me even more flowers. I just love them.

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One of the best parts is she said the purple ones will root eventually and I can plan them. It was very thoughtful of her and I loved having her visit me. She even helped me get my end-of-year gifts to my students ready so I could pass them out. We also got my air conditioner is which is a relief. I continue to need help in all the extra house-work things. I can get my own ice and food, remember my meds, etc. but all the extra cleaning, laundry and dishes feel impossible.

Had another incident of the psychological effects of the painkillers and steroids. I had experimented with tearing off tiny slivers of breadstick, dipping them in butter sauce and sucking on them to get the taste. I was able to swallow the bread and it was nice to get the taste of pizza. It was fine until one piece went to the other side of my molars and I became panicked because it got stuck up on the stitches for a little bit. Felt like it was embedded in my cheek. It set off a panic/anxiety attack that had me pacing the floor for at leat 45 minutes and unable to calm down. While getting food stuck in stitches isn’t a good thing, it really wasn’t that big a deal but the side effects of the medications make it seem that way. A little warm water in a syringe, swishing around and it’s been fine. Another day done!

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Day 5 (June 1st)

Today had me feeling about the same as the last 2 days. Not as horrible as you’d think, but still pretty drained of energy. That’s okay though, my body has been through some big things over the last week. I got some good sleep last night. 3-4 straight hours of sleep is a huge accomplishment at this point. I often wake up to get ice packs off of me or rearrange myself on the many, many pillows I use to keep myself from lying too flat. The issue in getting back to sleep isn’t necessarily the pain or discomfort but that it’s now getting hot and humid in the apartment and I’m sharing my bedroom with my classroom pets-2 gerbils who seem to think 3 AM is the perfect time for high-octane races on their gerbil wheels. And then the trains… but nonetheless I eventually got back to sleep and woke up to find that the bruising has started. Not in the places you’d think, but mostly on my neck and chest but I suppose the bruising patterns are further proof of the issue I had in my throat on day 2.

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The same old cycle of pills, liquids, and ice continued through the day. It feels like one big blur of medicine. I can’t stress again how important the schedule on the dry erase board has been. There’s no way I’d keep on track without that! The other new thing is the sensations that come and go from my chin. It’s like the feeling you get when your foot falls asleep when you sit on the couch too long. Except it’s twice as intense and doesn’t respond to any amount of touch or movement. It’s typically not painful, just really irritating. Once in awhile it starts to burn or itch but then it goes away. It’s just something to put up with and is actually welcomed. One of the biggest risks in this surgery is permanent nerve damage so having sensations like that is a good sign that those nerves weren’t damaged while the surgeon moved them around or from being pushed on by the swelling.

I’m getting much better at eating. The two most useful things to have on hand for this surgery have been a giant syringe and baby spoons. While it is possible to sip out of a cup, it ends up being quite messy since I have little control over my lips and they are so numb. The syringe is the quickest way to get food in my stomach. It easily sucks up two of my favorite meals- smoothies with my Juice Plus complete protein powder and my other protein mix of baby food meat and broth. Good, quick, and mostly clean ways to feel full. The next best thing is that baby spoon. I have very minimal openings in my teeth so getting a regular spoon in there is next to impossible and painful. These are soft and flexible and I find if I fit them all the way in and turn them upside down I can get MOST of the contents in my mouth. But nobody’s perfect. 😉 Again, I’m grateful to have this option for feeding myself. Some people have bands across the front of the teeth as well meaning no openings or worse yet, are totally wired shut. This allows me to get thicker liquids in. But this is what my gourmet meals looks like: syringe, smoothie, baby spoon, a dish towel bib, water, and pills. Dessert is all the lip care in the blue bin.

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Another big event of the day was getting outside and going for a walk. It was only a total of 4 blocks but it felt great to be out in the sunshine, to get my mail, etc. I will say though, that it was exhausting and I needed a nap very soon after! But exercise is supposed to help the circulation as well as some of the…ummm…digestive side effects of narcotics… that’s all we’ll say on that. The best part was being outside. It kills me to sit inside this time of year! Get me out!

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Mom continued to take care of housework, my garden, and my cats which was a huge help. The battles with the ice packs continued today and I’ll post about that if I ever figure out a system that works. Another good friend came to keep me company which was quite helpful for morale. We even went on my first outing to a public place-we went to get ice cream. At first I was worried about seeing people I knew, especially students, but then I realized… I just didn’t care that much. Luckily I planned ahead and took my own baby spoon. It was a little challenging to place my order since I couldn’t speak clearly and I had to order extra napkins, which came in handy. I chose a seat facing away from most people since I knew that eating would be…messy. Which it was, but with some help as well as feeling ice cream drip onto my legs from my face, I was able to finish most of my small cup of soft serve before it melted. And the worries of people staring at me were mostly unfounded. I did hear a few people comment on my appearance, but it actually sounded like they had good guesses about what I was going through because I heard snippets of conversation that included “broken bones”, “braces”, and “stitches on the cheeks.”. If they weren’t talking about me, it was a huge coincidence. But really, I didn’t care as much as I thought I would. I was exhausted by the end of they day and probably over did it, but we’ll see what I feel like tomorrow before we judge that.

P.S. Here’s a before and after comparison of my bite! Just imagine what the really important teeth at the back look like! I will be able to chew better than ever!

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