Debracing postponed

So I was supposed to get my braces off yesterday but it's been postponed until at least January. My last appointment (2 weeks ago) was supposed to involve getting impressions taken for the bonded retainers, but I pointed out a small space that had opened up between my two front teeth after the last adjustment. It was small but it extended from the gumline to about 2/3 of the way down my teeth, and it bugged me! My orthodontist said it was due to the shape of the teeth so he did some IPR (shaving of the enamel) between them, and then he also had to do some between the four bottom front teeth because once the space closed I would be biting too heavily in the front. It didn't hurt but it was rather unnerving! It felt like I was going to end up with peg teeth! haha. The spaces were small and have already closed with powerchains. I'm really glad I pointed it out because that space would have haunted me if I hadn't mentioned it. Plus, I had some "black triangle" spaces between the bottom front teeth which seemed to get worse after surgery (maybe because I forcefully sucked liquids through them while being banded shut? Or the lack of flossing? Or just the nature of the surgery?) and the IPR helped to decrease their size. What's another few weeks with braces after going through jaw surgery, right? :) My next appointment isn't until Dec 27, and hopefully the appointment after that is debracing day! I'm ready to get these things off and do some thorough cleaning and teeth whitening.

I'm now 7 months post-op and I have full feeling in my face again (yay!) and no tingling anywhere except when I touch a tiny part of my upper lip above the right corner of my mouth. I still have sections of my teeth and gums that are numb, and some are still very sensitive to touch. There are two teeth in particular that make me cringe when flossing because the gums are so sensitive it's painful!

The amount I can open my mouth (almost 3 fingers) hasn't changed in a few months now, but I think it's within the "normal" range. I could open pretty far before surgery (4+ fingers!) but my jaw would also pop when opening wide, so part of the extra range was probably due to some joint dislocation. It no longer pops which is great! So much more comfortable. Sometimes I have some pain and stiffness around the plate on the right side of my lower jaw after chewing or clenching, but this usually goes away quickly. I asked my surgeon about this at the last appointment and he said that he didn't think it warranted anything drastic right now (ie. plate removal) but I should go easy on the chewing if it flares up. Hopefully it'll just go away with time. I used to have some random stabbing pains under the right side of my nose when I smiled wide but that's stopped now.

My lips are finally feeling more relaxed when I close them. I think getting the braces off will really help too. I can almost follow the "lips together, teeth apart" rule that's supposed to be so beneficial for TMJ problems but which I could never do properly before.

5 month update

I had another ortho appointment today, exactly 5 months since surgery, and I got some exciting news! My braces are coming off December 4! Wow, I wasn't expecting it to happen so soon! I can't wait until I can brush and floss properly again! What am I going to do with all the extra time I'll save cleaning my teeth? Haha.

It may seem pathetic but I'm actually a little sad that this journey is coming to an end. It's been an amazing (and terrifying!) phase of my life that I dedicated a lot of energy and emotion to. I think it's not unreasonable to have a short mourning period! The braces have also become a sort of security blanket for me. If I feel that a tooth is "off" somehow then my OD can fix it, but once the braces are gone I'm going to have to accept my teeth the way they are, and hope that they don't move! This makes me a bit paranoid. I know that perfection is impossible, but is near-perfection too much to ask for after what I've been through? :)

At my last ortho appointment I was told to wear elastics in a box configuration around the back 4 molars on each side. This was to bring them a bit closer together since there was some space between the top and bottom outer edges. I wore them full time for about 3 weeks but then I started to have joint pain and was afraid that they were going to trigger joint problems again! So I quit wearing them and it took about a week before my joints felt better. I figured it's better to have happy joints than perfect teeth. I mentioned this to my OD today and he said that joint pain can sometimes happen while wearing elastics because the jaw muscles are constantly trying to fight against them. He checked how the molars look and apparently they've settled nicely so there's no need to wear them any more. Good riddance! I still have to wear elastics in the front at night though, but for some reason I never had joint pain from these elastics. Maybe because they're farther from the joint itself?

Good luck to everyone having surgery soon! Remember to take it easy and have lots of patience with the result. I'm still seeing subtle changes in my face at 5 months, with some days being more swollen than others. In the end I'm sure you won't regret it. I definitely don't!

I never would have allowed this angle before surgery!

Surgery supply list

With all the fall surgeries coming up I'd like to share my own surgery supply list. Most of these items, if not all, have been mentioned numerous times in other peoples' lists but I'd like to provide my own for completion's sake (I've been wanting to do this for months!) and to reiterate which items I found the most helpful.

Surgery essentials:

• jaw bra
• Definitely a must-have! I got mine from the hospital. It secured with velcro and had plastic-lined pockets to hold ice cubes or small ice packs
• small scissors
• If you're banded shut, keep these close at all times in order to quickly cut the elastics if you're choking and can't breathe. The hospital staff even kept a pair by my bed in case of emergencies. Thankfully I never had to use them
• humidifier
• I had two going at once during the first couple of nights home
• recliner chair
• It's recommended that you sleep upright for at least the first week after surgery to limit swelling and to help with breathing. A recliner was the only way I could make this work
• vaseline/lip balm
• Essential since you can't lick your lips or rub them together! I found that my lips fared better if I varied the types of lip balm I used rather than sticking to just one type
• saline rinse
• 1 tsp salt to 2 cups warm water 
• I made a new batch every day and kept it in a jug by the sink
• Q-tips
• For cleaning out the gunk in your nose and keeping it clear. I liked to dip them in saline solution first so that they didn't dry out the inside of my nose
• high-powered blender
• If you're banded shut, food has to be liquified enough to suck through your teeth!
• feeding syringes (60 ml)
• Got these from the hospital. Make sure you have at least two: one for food and water, and one for saline rinse, though a separate water syringe is also nice to have. Extras are good to have on hand in case one breaks or gets stuck, which is inevitable
• sippy cups
• For when you get sick of syringes
• baby spoons
• For when you're finally allowed to open your mouth!
• medicine syringe (10 ml)
• Small syringe that I got at the pharmacy with my post-op meds. Easier to keep the dosage accurate and keeps medication and food separate
• children's (liquid) Tylenol, Advil, or Motrin
• For when the heavy duty pain killers are no longer needed. Bubblegum flavor was my favorite!
• liquid vitamin B supplement
• Supposed to help with nerve regeneration
• high protein ready-to-drink liquids
• Quick and easy for when you're starving (eg. high protein Ensure, Boost, Bolthouse Farms)
• face cloths
• Used for staying clean when eating and/or drooling. Paper towel is rough on the skin and you'd use a lot of it
• baby toothbrush
• Smaller than a regular toothbrush and has softer bristles so it won't irritate your gums which you probably won't be able to feel
• heating pad
• Feels good on tight jaw muscles and helps to reduce swelling once ice is no longer effective
• notepad and pen
• Trying to talk hurts your face, and chances are no one's going to understand your mumbling anyway

Day 100!

Wow, 100 days since surgery! It seems like such a long time ago that I was fretting about surgery and preparing for the long recovery!

I can almost open to 3 finger widths now which is enough to comfortably eat most foods like burgers and hot dogs. I think I'm still getting used to the new positions of my jaws because sometimes I end up hitting my lower teeth or lip with my fork on the way to my mouth. Not very graceful. :) I also find that my cheeks, especially the area along both sides of my lower jaw, feel stiff and swollen almost immediately after chewing. The swelling isn't something anyone else would notice but I can definitely feel an increased tightness there.

Some of my teeth are still completely numb, including the front teeth on top and bottom, while others are continuing to regain feeling. I find the feeling is coming back quicker on the right side, especially on the top, and the left is taking longer. Most of my gums are still numb but there are patches of tingling. I wanted to start using my electric toothbrush again but I find it really uncomfortable to brush, even with a regular toothbrush. It seems like the teeth and gums that have partial feeling are hypersensitive. I wonder how long that's going to last?

This is a strange aside, but I've noticed that the decreased feeling in parts of my gums and palate really affects the taste of some foods, especially dry foods like cookies, chips, and bread. The texture of these foods must really contribute to their taste. I just don't find them as yummy and satisfying as I did before surgery, and I don't crave these foods as much as I did. Plus, most of these foods require a fair amount of chewing so that's also an added deterrent. I didn't think that I'd ever want to see soup again after this surgery but I appreciate soup a lot more now!

The issue with my front teeth scraping together seems to be fixing itself with the elastics which is great! It feels so awesome to bite and have all my teeth touch at the same time. I find that I'm absentmindedly biting together just for the fun of it!

Day 69: Bye bye hooks

I haven't posted in a while because there hasn't been anything new happening with my teeth and jaws in the past few weeks, but today was an exciting day. I had my first ortho adjustment since surgery and the surgery hooks are no more! It feels so great to get them out, and it's so much easier to brush and floss properly without them! However, the great feeling of getting the hooks out was offset by the unfortunate news that I now have to wear some snazzy elastics 24/7 to "settle" my bite. There's only one on either side of my mouth, each in a triangle configuration, and they're pretty light relative to the ones the surgeon gave me to wear (at least I can open my mouth with them!) so it's not too bad, but it was still unwelcome news. I guess as long as they do their job properly then I'm okay with them.

I've noticed that my bottom front teeth often tend to "scrape" the backs of my top front teeth while eating and talking and I wasn't sure if this was normal or not (my front teeth haven't touched correctly in a long time!) so I asked my orthodontist about it. He said that my surgeon most likely overcorrected my bite a little bit in anticipation of some relapse as my teeth and joints settle. He said that if it doesn't correct itself within a few months then it can be easily corrected with braces. What a relief because it's rather annoying!

I'm becoming more and more comfortable and confident with my new face and bite and this has motivated me to make another big change by cutting my hair short! I've always wanted to make a drastic change with my hair but I've always been too afraid and therefore have stayed really conservative with my haircuts. Plus, I didn't think that many hairstyles looked good on me with my long face and lack of a jaw line. Well, I figured now's the time to make the change! After adjusting to permanent changes in my face, making a temporary change with my hair seems like much less of a big deal! And I really love how it turned out! It also feels really great to get the hair off my neck in the hot summer weather. I have no regrets!

I'm also finding it easier to close my lips together, especially with the removal of the surgical hooks. It still takes some effort and it doesn't feel or look completely natural yet but there's improvement!

Day 42: 6 weeks

Things are still going well and I now have permission to eat just about anything that I can fit into my mouth and feel comfortable chewing! I don't think I'll be tackling a burger anytime soon but it's nice to know that I won't hurt my jaw if I try it. I'm still not allowed to eat hard or crunchy foods like raw veggies, pizza crusts, and pretzles, and my surgeon said that I should avoid these foods for a year! Technically I'm not supposed to eat these foods with braces anyway, so at least I won't have to worry about breaking any brackets. ;) In total I lost 9 pounds after surgery and I've finally started to gain some of the weight back this past week. I'm assuming this trend will continue as I experiment with new solid foods, but hopefully not too quickly!

I can now open my mouth about 2 finger widths and can brush with a regular toothbrush rather than a baby toothbrush. I can also floss all my teeth now too, though it's still a little painful to reach the molars. Last week I suddenly got most of the feeling back in my lower teeth as well, so it doesn't feel so strange to chew things anymore. Thank goodness, because chewing on numb teeth was getting extremely irritating! Most of my upper teeth are still numb, along with my gums, but I really only notice this when I'm brushing. The feeling continues to return to my lips and chin, and now I get an uncomfortable intense tingle when I touch the right side of my chin. It's almost like the feeling you get when you hit your funny bone, though it doesn't last as long. I prefer this to numbness though because at least I know there's progress!

There's a small bump on the tongue side of my gums near my bottom right molars. I had visions of it being the pointy end of a screw, so I asked my surgeon about it yesterday during my appointment and he didn't seem too concerned. He said the screws aren't long enough to reach all the way through the jaw bone, though some people complain of small bumps along the gums after surgery for some reason (maybe swelling near the screws?). He examined it and said he didn't think it warranted an x-ray just yet, though if it's still bothering me at my next appointment (in 1 month) then he'll take an x-ray and make sure everything is still where it's supposed to be. I noticed it right away after surgery and it doesn't seem to be getting any bigger, it's just more noticeable now because the swelling has decreased and I keep rubbing it with my tongue while eating. It's not painful so hopefully it's nothing and I don't need to have any plates or screws removed!

I went back to work full time last week (day 33) and all I can say is that I'm so glad I took the whole month off! I was exhausted after my first day back, even though my work is computer based and doesn't require very much talking or physical activity. I felt much better during my second day back, but I found I needed to take more Advil for sore jaw joints and muscles at the end of the day. My jaw seems to be doing much better this week so that's a good sign.

My face hasn't changed a whole lot in the last 2 weeks. Some days I feel more swollen than others, but at least the bruising is completely gone now!

Day 28: Soft food

Wow, it's been 4 weeks since surgery already! Things keep improving steadily and yesterday I was given the all-clear by my surgeon to start chewing soft foods such as scrambled eggs, pasta, and chopped meat with gravy. I should be thrilled about this (food tastes much better when you can chew it rather than suck and swallow!), but I'm finding it rather challenging to chew. My jaw muscles get sore quickly, and my jaw doesn't move side to side or front to back very well yet so only a limited up and down action is possible. It's also difficult to tell how hard I'm chewing because most of my teeth are numb, as well as sections of the inside of my lips. Last night at dinner I didn't realize I was chewing the inside of my bottom lip until a particularily large chomp, and now my lip is swollen and I have a blood blister. I also find that a lot of the food I chew ends up stuck in the brackets and between my teeth and cheeks where my tongue can't reach. My tongue seems so much shorter now than before surgery! I can't properly lick my teeth or lips, but it's probably because my jaw doesn't move well enough yet to allow full range of motion. It also may seem "shorter" now because my upper and lower jaws were moved forward so I can't stick my tongue out as far. Not a huge deal in the big scheme of things I suppose. :)

I only need to wear elastics for 12 hours per day now, from evening to morning. This is great news because I've been having soreness in my right jaw joint while wearing the elastics during the day. I told my surgeon about this and he said this was common and should improve quickly, but given my joint history I should take Advil or Motrin 3 times per day as an anti-inflammatory even if I don't necessarily need it for pain. Sounds good to me because my teeth tend to hurt after chewing too and this will definitely help!

My orthodontist checked my bite again yesterday without the splint and he said things couldn't look any better at this point! There are some teeth that need fine-tuning, but he said my bite looks great now and I had great surgical results. This made me so happy! I asked how many more months of braces were needed and he said he keeps everyone in braces for a minimum of 6 months after surgery. This is to make sure that things settle properly and are stable before the braces come off. He said I probably won't need to be in braces any longer than this, but given my joint history and the fact that there's some remodelling of the joints after surgery (especially lower jaw surgery) which can change your bite and can sometimes reinitiate joint degereration, he wants to make sure things are stable before debanding.

I've been having some bad acne in the last couple of weeks that's finally starting to clear up. My surgeon said that it's probably due to the steroid medication or modified diet (more carbs than usual), or both. The nurse at the hospital who gave me the steroid shot said that it lasts for about 6 weeks, so hopefully my skin is clear again within the next two weeks.

I still have some swelling in several areas of my face, but the most noticeable to me is the swelling on either side of my nose and in my upper lip which is still restricting lip closure and movement. I think lip mobility has definitely improved since starting the lip exercises, and now that I'm allowed to talk without elastics I think it'll improve even more quickly, but my surgeon said it could take several months before this swelling is completely gone. The bruising is finally gone from my neck, but I still have small stubborn yellow-green patches on either side of my chin. More patience is needed!

Lips relaxed

Lips forced closed

Day 21: Splint is out!

Today was my 3rd post-op visit with my surgeon and he removed the splint! It feels so great to have more room in my mouth and to finally talk coherently! I'm still wearing two heavy elastics on either side of my mouth, but now I'm allowed to remove them 4 times per day for about an hour to eat and brush. Still no chewing allowed, but I took advantage of my new freedom as soon as I got home by eating some greek yogurt (with a spoon!) and it was awesome! For dinner I ate mashed beef stroganoff and mashed potatoes and it was great, but by the time I was finished my jaw muscles were really stiff and sore and it felt good to put the elastics back on and give them a rest.

It feels really strange to bite because I can only feel about one third of my teeth, so it doesn't feel like I'm biting correctly even though I am. I keep checking in the mirror to see if my teeth are still in the right place, haha. My surgeon is really pleased with my bite and he was joking with me that I should go to my orthodontist today and get my braces removed... of course this isn't possible, but it makes me wonder how much more orthodontic work there still is to be done. I'm not too anxious about it because the braces don't really bother me, and I'd rather have my teeth as perfect as possible when they're removed than to rush things, but it's nice to know that everything is looking great. I can feel with my tongue that a couple of my molars are a bit "off" on one side compared to the other so I'm assuming this will be corrected.

My surgeon also removed most of the remaining stitches in my gums and this has really helped to improve lip mobility while talking and smiling. A couple of the stitches were a bit painful while they were being removed, and there were a couple of disconcerting tugs, but overall it wasn't too bad.

I also noticed that I have a small chip on the edge of my front tooth. I was surprised when I saw it, but then I remembered that I had a filling there when I was a child after I hit my front teeth on a brick fireplace. It must have broken off during surgery or when the splint was removed. It's not very noticeable but I think I'll have it filled again after the braces come off. I don't think my jaw could handle being held open wide enough or long enough to fix it in the next couple of months. My surgeon said that the bones are still pliable and I'm not allowed to do any jaw exercises yet, but he suggested an exercise to strengthen the lip muscles. He told me to take a large button and tie string to it, then put it behind my lips and pull gently on the string while pursing my lips and trying to keep the button in my mouth. Apparently this helps to stretch the muscles, which tend to "shrink" after surgery and lack of use. I will have to try it and see if I can feel an improvement.

Day 15: 2nd post-op visit with surgeon

Today I opened my mouth for the first time since surgery! I had the second post-op visit with my surgeon and he removed the elastics and let me brush my teeth. It was the strangest feeling to open my mouth for the first time. When he removed the last elastic my jaw muscles just quivered and I was afraid to move anything! I had mental images of my lower jaw just falling off, haha. But then my surgeon told me to open and close my mouth a few times and I could feel my teeth fitting perfectly into the splint when I closed. He said everything looked great! Then he gave me some time to brush my teeth.

I ended up brushing my teeth for half an hour! It was awesome. I could open my mouth about one thumb width which was just wide enough to brush the tongue side of my teeth too. I was most looking forward to brushing my tongue but I could only open wide enough to reach the front half of it without gagging. The back half of my tongue remains reminiscient of a yellow shag carpet. Eew.

After I finished brushing and rinsing my surgeon put some elastics back on again but this time only two on either side, though they're strong enough that I can't open my mouth. My cheeks feel so much happier without the latticework of elastics pressing against them. He said the elastics I have now will weaken in a couple of days but I shouldn't try to resist them and to keep my teeth closed in the splint. Apparently it takes 10 days for the bones to start fusing after surgery and I need to wait a little longer before I can begin jaw exercises to improve my range of motion. The incisions have healed enough though that I can start doing some lip exercises like puckering to improve facial stiffness, as long as it doesn't cause any pain.

My next appointment is scheduled for May 23, exactly 3 weeks since surgery. This is a big day because I'll be getting the splint out! Only 6 more days of liquids! I'm so excited to begin experimenting with "no chew" foods!

Day 14: Two weeks!

Today marks two weeks since surgery! The time has flown by surprisingly fast and at the same time agonizingly slowly. The last couple of days I've felt particularily frustrated with the lack of food texture and inability to speak properly. I have to constantly remind myself that these things are temporary otherwise I start feeling sorry for myself. I've also spent way too much time overanalyzing my face and obsessing with the daily changes that I see, and it's not healthy! I'm really pleased with the results so far but of course there are things that I'm anxious about. The biggest of these is that my lips still don't close naturally at rest. I know I still have the splint and elastics in my mouth, and the swelling can take months to completely go away, but closing my lips naturally was one of the things I was most looking forward to after surgery. I need to stop analyzing and let my face "settle" further before I make any judgements. I also need to focus on the fact that this surgery was to correct my bite, and it just happened to cause significant changes in my face too. Because I'm not allowed to use my teeth yet, I think I've been focussing too much on appearance. I can't wait until I can chew solid food again and really try out my new bite!

A couple of really good friends spent the afternoon playing games and watching movies with me and it was so nice! Thanks ladies! It really helped me to get my mind off of things. They also understood most of my mumbling too which was great!

Tomorrow is my second post-op appointment with my surgeon. The plan is to take the elastics off and let me brush my teeth! I'm so excited to brush my tongue! It has felt nasty and slimy for over a week now. Too bad the elastics have to go back on after though, but hopefully not for long!

Day 13: Ortho checkup

Today was my first post-op ortho appointment. It seems like just a few days ago that I booked it but it's been over 1 month! At the time of booking, I found it so strange to think of coming back to the ortho office and finally being on the "other side" after months of planning. It was a little strange today, but in a good way. All the receptionists and assistants had nothing but positive comments for me about my new profile and how well I'm healing. It made me feel great! Though it also made me feel a little bit like a circus sideshow while they crowded around and inspected me, haha. I can't complain though. I have to take all the attention and sympathy that I can get before my surgery is old news to everyone!

The actual check by my OD was very short, maybe 2 minutes max. He just checked that my teeth were now in proper alignment and that the splint and elastics were still in place. He said everything looks great and he'd like to see me again for another quick check after the splint is removed. That should be in a little over a week unless plans change. I was also told to book my next ortho appointment for 6 to 7 weeks from now, during which I'll have the archwire changed and surgical hooks removed. It'll be nice to get back to simple braces again!

I can now feel the cuts on either side of my lower jaw, and a couple of the screws under my eyes. So weird! I'm assuming the bone grows over these screws eventually so that they become less noticeable, and the notches in my jaw fill in. It's amazing what the human body can adapt to!

Day 12: Sleeping breakthrough

Since coming home from the hospital I've been sleeping in an electric reclining chair that I borrowed from my aunt and uncle. It's actually pretty comfortable, especially if I use a stiff pillow to lean my head against while reclining, and I think it's really helped with the swelling. However, I've had some insomnia since surgery. It takes me a really long time to fall asleep, and once I do fall asleep I tend to wake up again 45 minutes later. This happens all night every night and it's getting so frustrating! It's probably lingering effects from anesthetic and medication, but a few days ago I tried sleeping propped up in bed with about 6 pillows to see if that helped... and it didn't. All I got was a stuffy, swollen nose which made it difficult to breathe, and my arm fell asleep.

Last night I tried sleeping in bed again, this time with only 3 pillows under my head because I have less swelling, and it helped! It still took me quite a while to fall asleep but I slept 4 hours before waking up again! At first I was really scared to squish my face, but I used a soft pillow and sleeping on my side wasn't a problem. I had asked my surgeon about how long I should sleep upright and he said that it was more important for recovery to get a good night's sleep, whether that's in a recliner or in bed, rather than force myself to sleep upright. He said that after the first week the swelling is less critical and I can sleep laying down if it's comfortable. I did notice that my face was more swollen when I woke up this morning and there was more pressure in my sinuses, but I'll take a little swelling over exhaustion any day.

My teeth have felt really itchy today, more so on the right side of my face than on the left. It's very similar to the itchy feeling that you get in your teeth once the pain subsides after an ortho adjustment. There's also a throbbing tingling pain through the right side of my chin which extends up into my lip and lower teeth, and I feel like I'm constantly drooling on that side even though there's nothing there. This part of my lip and chin have the least feeling so I'm assuming it's all part of the healing process and the beginning of nerve repair.

I've also made it 24 hours now without pain medication! I was taking liquid Tylenol or Advil primarily to relieve muscle tension and pain, but my jaw muscles have finally relaxed and I haven't needed to take any today. Yay! I'm sure my liver is very happy about that.

Here is a picture of my splint and elastics. No wonder I can't open my mouth! The front elastic was originally double wrapped around the front hooks but it broke 1 day after coming home. I was given extras so I replaced it, but I didn't have the heart to twist it like the surgeon did so I just put two on instead. They've started to turn yellow and brittle from food or air or sunlight so I think I'll replace them again before my first post-op ortho appointment tomorrow.

Day 11: Happy Mother's Day mom!

I just want to say thank you to my mom on Mother's Day. She's been working selflessly since surgery to tend to my needs and wants and I really appreciate it! It's so important to have support during times like these, and having my mom by my side during recovery has reminded me of how much I love her and depend on her. She has worn many hats during the last 11 days including nurse, chef, and counsellor, and I couldn't have made it this far without her. Happy Mother's Day mom!

The food at this morning's Mother's Day brunch looked delicious, though I'm happy to report that I successfully kept my solid food cravings at bay. I brought lots of filling liquids that I sipped to keep my blood sugar up, and I spent the rest of my time averting my eyes and just pretending the food wasn't there. Out of sight, out of mind!

The only food item that really started getting to me was the sausage. It's a taste that just can't be replicated in the blender and still look appetizing. It also smelled amazing with my improved sense of smell! When I got home I was still thinking of ways to get that "fatty, savoury" taste so I melted 2 tbsp of butter into a cup of chicken broth. It was so delicious and satisfying! I definitely won't be losing any more weight on this liquid diet.

My smile is looking more like a proper smile, except for the scary elastics that tended to frighten the children at brunch this morning. I can also feel a little more definition in my cheeks today!

Day 10: Life again!

My aunt has a saying about recovering from surgery: "After day 10 there's life again!" I've made it to day 10! And I think that the bulk of my physical recovery is over. Now there's just some fine-tuning to be done.

The swelling continues to improve daily, though the improvement is less and less noticeable in pictures. Also, my yellow-green bruise has started to change color and fade. Now it just looks like there's dirt on my neck and I need a shower! I know there is still a long way to go, but I have become a little bit anxious to see my final result. I will have to learn more patience! Only one baby step at a time.

Tomorrow I plan on attending a Mother's Day brunch at my cousin's house. Though I won't actually be participating in the brunch (I'll be bringing my sippy cups!) it'll be nice to have an extended change of scenery. It'll be my first real social outing after surgery and since no one I've attempted to talk to so far has been able to understand my incoherent mumbling, I have a feeling that me and my clipboard will be attached at the hip!

Day 9: Baby steps

Several small things happened today that I would consider to be baby steps along the road to recovery. The first is that I went for a half hour walk outside and I didn't feel tired! It was rather windy though and I felt chillier than I think I would have been if I was eating and sleeping normally, but it was nice to feel properly active again.

Also, I can now reach all of my teeth with a baby toothbrush! The swelling and stitches make everything feel very tight so I have to be careful about getting the toothbrush under my cheeks, but brushing helps to get more gunk out than rinsing alone.

As I was rinsing last night I decided to have a proper look at the stitches now that the swelling is subsiding, and what I saw made me anxious! I noticed that there was a "hole" in the line of stitches inside my bottom lip, like one of the stitches had popped out and my lip wasn't attached to my gums at that spot! Of course this made me paranoid (what if it doesn't heal properly!) so this morning I had my mom call the surgeon's office and ask about it. She explained the situation to one of the nurses on the phone and he said that this was perfectly normal. The dissolvable stitches start coming out 5-7 days post-op and the suture line can separate, but this is supposed to happen! He said as long as the "hole" looks dark underneath then it has properly clotted and will heal together with time. He emphasized using salt water rinses for 6-8 weeks after surgery (this is much longer than I thought!) to prevent any infection and to encourage more stitches to dissolve. Phew, I thought I had injured myself somehow but apparently having small "holes" is normal.

I also reached a small eating milestone: I drank from a cup! I have enough lip mobility now for this to be possible, though it's not very comfortable. It still takes a little bit too much effort to make it worthwhile, and it's messy so I only attempted it with water; however, I discovered a great alternative for thin liquids: the sippy cup! The syringe is starting to irritate the insides of my cheeks so I tried using one of my niece's sippy cups and it worked surprisingly well! The spout is thicker than the rim of a regular cup which makes it easier to seal your lips around, and the liquid pours out slowly enough that dribbling is limited and the choking hazard is decreased. I ended up drinking my dinner (cheesy potato soup) via sippy cup and I felt almost normal. The only drawback is that I have to tip my head backwards to get the liquid in and this makes my face and neck feel very tight, but not painful.

My attempt at a smile

Day 8: Hospital recap

My trip to the surgeon's office yesterday really tuckered me out! And today I've been feeling tired again. After my surgeon suggested that I may be anemic from blood loss and it can take up to 1 month for the body to replenish red blood cells, I've been looking for tasty ways of getting more iron in my diet. I've been blending spinach into soups, and today I made a fairly yummy molasses coffee drink: 1 cup whole milk, 1 tbsp blackstrap molasses, 1 tbsp peanut butter, 2 tsp Nutella, and 1/4 cup coffee.

I decided that the bulk of today's post will be a recap of my stay in the hospital. I found this topic to be one of the most interesting ones to read about on other people's blogs, and I want to write down what I remember about my own hospital experience before I forget!

I arrived at the hospital at 8:30am on the day of surgery and found out that my surgery was booked for 11:25am. They gave me a gown to change into, and once a bed in the pre-surgery room was available they got me hooked up to an IV (this was actually the part I dreaded the most!).

Waiting for a bed

IV line put in (this is after I recovered from my near-fainting episode!)

Once it was time for surgery a porter wheeled me to another "holding" room where I said my goodbyes and I waited to go into the OR. The room was really cold and it didn't help that I was nervous too, so a nurse brought me a warmed up blanket which felt really nice! While waiting, I signed some consent forms, put a hair cap on, and met the OR nurse and the anesthesiologist who were both very nice. The anesthesiologist explained about having to put a breathing tube through the nose and when I woke up my throat would be a little sore. He also asked if I had one nostril that was easier to breathe through. I answered the right one, and he said he'd probably use that one if it was larger, but he would see which was easier to get the tube down once in the OR. I asked the nurse if I could use the washroom one last time before surgery and she said I could, but I'd have a catheter put in anyways because the surgery was too long to go without one. I thought I could escape that part! But I guess not.

I wasn't wheeled to the OR until about 12:30pm because they were running behind, and on my way I met the surgeon in the hall. He said the anesthesiologist for my surgery was really good and I had nothing to worry about. He also said some other things, and some words of encouragement, but I honestly can't remember any details because nothing was registering! I was so nervous!

Once in the OR I was asked to transfer from the gurney to the operating table, making sure my robe wasn't tied in the back or caught under my body. This was slightly awkward because I was completely naked underneath. I was introduced to another nurse who was going to be attending the surgery, and then the anesthesiologist said he was going to give me some IV drugs to make me relaxed. I instantly had blurry vision and my brain went fuzzy, and I was getting all ready to count backwards once he said he was administering the anesthetic, but I never had a chance! I was out.

Surgery was over at 4:30pm, and I woke up in the recovery room some time before 5pm. My surgeon appeared and said everything went well and that he ended up doing double jaw surgery. I think I nodded and tried to smile and then he said some more things that I didn't fully comprehend in my drugged stupor. I was wheeled to my room at 5:30pm and I remember feeling very dizzy in the elevator and thinking "now I know why the hospital elevators move so slowly!" I shared a room with three other people during my stay, one of which was a young guy who broke his jaw in a fight and required surgery to fix it. I overheard his surgeon advising him not to take any street drugs or marijuana during recovery because it would slow the healing process, haha.

My parents and some relatives came to see me after I was more fully awake. I don't think the nurse was too pleased with them taking pictures but she didn't know I had asked for them!

I wore an ice wrap on my head (which felt awesome!), a mask with humidified oxygen, a blood pressure cuff and pulse oximeter, and later the nurse put compression stockings on my legs to prevent blood clots. I had access to a suction tube to get rid of drool and blood in my mouth, a nurse's call button, and a push button for morphine. Needless to say it was quite the ordeal going to the washroom for the first time. I needed help to get unhooked from everything (later I learned to do it myself) and I was rather dizzy so I clutched my IV pole like an invalid. This may be way too much information, but I didn't know how much having a catheter affects your ability to go to the washroom! It burned for the first day and a half whenever I went, and it trickled so slowly that it took ages to finish!

Even though I was given antinausea meds, I threw up twice the first night after surgery...all blood. Thankfully I didn't actually feel sick until a few seconds before it happened, and it was over with relatively quickly. The first time it happened though I couldn't find the nurse's call button right away because I was sitting on it, so there I was leaning over a bowl that I was clutching with one hand, letting the blood slowly drain through my teeth, and searching desperately with the other hand to find the call button. It was a good thirty seconds before I found it, but after that the nurse came quickly and cleaned me up. To add to the amusement, as I was leaning over the bowl the ice wrap slipped off my head and fell in, and then I puked on it. It really takes a special person to be a nurse!

By the next day I was feeling much better, despite a few nosebleeds (just blood draining from my sinuses), and had more visits from relatives. My surgeon came to see me in the morning and told me everything looked good. I also learned how to properly feed myself and rinse my mouth. The nurse kept asking when I wanted to have a shower. Apparently it's good to get moving as soon as possible after surgery, and a shower also helps to clear your airway, but I had absolutely no desire for showering. It took enough effort just to get to the washroom! And I could breathe quite well already, so I just asked for a towel to wash my face instead.

Day 1

Learning how to eat with a syringe

The second day after surgery I was discharged after another visit from my surgeon, getting a steroid shot in my hip to limit the swelling, and collecting some supplies (ice wraps, syringes, nasal decongestant, and saline solution). I was happy to go home and finally move around without dragging an IV pole, though I was sad to see the morphine pump go. It had become my friend. :) On the way home my parents picked up my prescriptions (liquid Tylenol with codeine, antibiotic (this later became my enemy), antibacterial mouth rinse, and Dimetapp) and I looked forward to getting a good night's sleep. And that ends my hospital adventure! (until the ER on day 4, but that's another story).

Going home!

Day 7: First post-op visit

It's been one week since surgery! The dreaded first week is over and today I had my first post-op visit with my surgeon. He checked everything out and said that things are looking good. Here's a summary of the questions I had for him:

Q) I've noticed that I still have some lip incompetence. Will my lips naturally meet once the swelling subsides and the splint comes out?
A) We'll see. There are several factors that could be affecting lip closure: splint (once this comes out my bite will close further by about 1 mm), elastics, surgical wire and hooks, and swelling (this is a big one). The upper jaw was impacted 4 mm and the amount of tooth I now show is good. Showing a little more tooth than average is considered "youthful." Things will keep settling as time goes by and the soft tissue adapts to the new bone structure.

Q) I can sometimes hear creaking and cracking sounds when I tense or relax my jaw muscles. This was more common right after surgery than it is now. What is this?
A) I'm not sure what causes the strange sounds that people hear after surgery. It could be creaking bands or splint, but not sure. Very common though and nothing to worry about.

Q) When I mumble I can feel the vibration in my teeth and into my sinuses. Is this normal?
A) Probably just sound bouncing around in the mouth. Again, very common to feel strange things after surgery and it's not a concern.

Q) My eyesight seems worse after surgery. What could this be from? Anesthetic? Medication?
A) I've never heard this question before. This type of surgery shouldn't directly affect eyesight. Remember that your body is working hard to heal and you're lacking energy and sleep, and you're probably a little anemic from blood loss. This can take a toll on the body and can cause eye muscle strain and fatigue. (I also asked my aunt this same question. She's an RN and she said that eyesight can be affected by low fluid levels in the body. Even though I'm getting adequate nutrition I could still be dehydrated and I should increase my water intake.)

Q) My jaw muscles still seem tight or clenched a lot of the time. Will they eventually relax? Or will they tend to pull my jaw back into its previous postured position once the elastics are removed?
A) Eventually the muscles and soft tissues quit fighting and accept their new positions. It just takes some time. The chance of relapse from this issue is much less common now with the use of plates and screws to fix the bones into place.

I also had a new x-ray taken and I got to see all the hardware in my head for the first time! So cool! When I feel my face I can definitely feel the ridges on either side of my chin, but there's too much swelling to feel the other cuts or screws and I don't want to poke around too much.

I've lost 6 pounds this last week, probably mostly fluid because I haven't been starving. I've actually been eating quite a lot and have gotten quite good at feeding myself with the syringe. I can now drink a cup of liquid in about 10 minutes, and my tongue is raw in the places where the liquid flows through my teeth. I'm even developing a blister on my thumb where it pushes on the syringe end. Haha.

The swelling seems to have decreased a lot in the last couple of days. Sound has been muffled since surgery (I'm assuming from swelling near the ears) but yesterday and today I've noticed that this has begun to improve too. Certain sounds such as the doorbell and microwave were lower in pitch right after surgery but now they're starting to sound normal again. I've also had some popping in the ears when swallowing, very similar to the sensation of ear popping in an airplane or after a bad cold, and with each pop the sound gets a little louder. I think using the heating pad on my face during the last couple of days has helped to decrease the swelling, and it also feels really nice on tense jaw muscles.

Day 6: Feeling, seeing, and breathing

I'm doing much better today! I've been getting a lot of my energy back and I decided to have a bath. First I was planning on showering but once I started running the water I became light-headed and decided a bath would be the smarter option.

I've been assessing the sensation in my face since waking up in the hospital and I realize that I have a surprising amount of feeling. I thought my whole lower face was going to be numb for a long time, but once the local anesthetic wore off I noticed that I have full feeling in the lower left quarter of my face as well as the middle of my upper lip and tip of my nose. I also have partial feeling in my cheeks, nostrils, and above the corners of my mouth. The only spot that is relatively devoid of sensation is the right half of my lower lip and the section of chin underneath that; however, when I brush my finger against it I feel it tighten and tingle. That's a good sign!

I've also noticed that I find it easier to breathe through my nose now than before surgery. I asked my surgeon about this in the hospital and he said that this is one of the benefits of having upper jaw surgery. It often creates more surface area in the nose and widens the airway. I find I can smell better too! I could never rely on my sense of smell before, but now everything has a distinct smell! I thought this might just be the effect of the nasal decongestent I've been using but I haven't used any today and things are the same! There are candles in the house that I wasn't able to smell before but now the scent is very strong! This is exciting.

One more thing I've noticed that's less positive is my eyesight. Everything seems blurrier now. I've caught myself searching for my glasses only to find that they're already on my face. Maybe this is just a lingering effect of the anesthetic? Or from pain medication? I've been trying to use more regular liquid Tylenol rather than Tylenol 3 for pain management because the codeine in it makes me dizzy and drowsy. I had some yesterday before going to bed because my jaw was hurting a little more than usual but when I woke up in the middle of the night I felt extremely disoriented and I couldn't get my eyes to focus. It's like each eye was doing it's own thing and I had to stumble to the bathroom by hugging the wall. The effects wore off in a couple of hours. Maybe my eyesight will improve once all the medication leaves my body, or I'll just have to go get new glasses.

Day 5: Liquids went in and liquids came out

The last two nights were some of the worst nights of my life. I got severe diarrhea from the antibiotic I was on. It started out with gurgling and general uneasiness in my stomach about half way through day 3, which I attributed to the liquid diet, but symptoms slowly progressed to full scale watery diarrhea and intestinal pain by yesterday morning. I only slept about 2 hours during the night on Saturday because every time I'd relax and almost fall asleep I had to jump up and go to the bathroom!

Yesterday morning my mom called the oral surgeon on call at the hospital (since it was outside of regular office hours) and told him what was happening. I had a feeling it was the antibiotic (I've had diarrhea from antibiotics in the past but never like this!) but I didn't want to stop taking it and risk infection. He confirmed that it was probably from the antibiotic so he prescribed a different antibiotic that's supposed to combat the effects, and I was to force myself to drink at least 2 litres of fluids. The new antibiotic didn't come in liquid form so I had to crush it and mix it with juice which tasted awful. I almost vomited a few times because it was so bitter and I already felt ill.

The surgeon said that if I wasn't improving by yesterday evening that I'd have to go to the hospital and receive IV fluids. I waited and nothing improved, even with the forced fluid intake, and by 7 pm I started vomiting and couldn't keep anything down so I went to the hospital. The 5 hour wait in emergency was horrible, 4 hours of which I spent on the toilet or laying on the floor in the washroom. When I was finally called in they gave me a shot of anti-nausea medication in my hip, pain medication through IV, and 2 litres of IV fluids. This seriously saved my life! They sent me home this morning at about 5 am with some more anti-nausea medication which, thankfully, I haven't had to use, and the diarrhea is now much better.

I've been feeling a little bit weak today, like I regressed to day 2 status, but without the nausea I'm eating well and improving quickly. Again a big thank you to everyone who has been encouraging me and giving me tips, as well as calling and emailing and dropping by to see how I've been doing. It's only uphill from here!

Here are some pictures from day 4, before I went to the hospital.

And here are some pictures from today. The bruising has definitely shown up now on my cheeks and neck! Other than that, there isn't much change between yesterday and today except that I look even more exhausted.

Day 3: Home again!

I made it! Surgery went well. I ended up having double jaw surgery, with the upper jaw moved up 4 mm and forward 4 mm, lower jaw moved forward 4-5 mm (the surgeon didn't give me the exact measurement when he came to see me), and the chin moved forward 4 mm.

Technically I came home from the hospital yesterday, but I was so exhausted I just ate a little bit and iced my poor face and fell asleep. I ended up sleeping 5 hours straight last night before I woke up for more pain meds (liquid Tylenol 3) and then fell asleep for 3 hours more. It felt so good, but the energy doesn't last long when you can't eat properly. I've tried a couple of soups and smoothies since I got home but I find that the little chalky particles (eg. from protein powder and ground up food in the blender) get clogged in the splint and between the teeth and stop the fluid from getting to the back of my throat. So I've mostly been living on water, chicken broth, homo milk, juice, and meal replacements. Not the most healthy diet but hopefully once the swelling subsides I'll be able to get more in there. Also, my palate is extremely swollen so there's hardly any room for my tongue, let alone food, and swallowing is a struggle. Oh, fun and games.

So much to say and so little energy... I will have to give more details later. Now I need a nap.
Here are some pictures from today.

 

Surgery tomorrow!

After a full year of planning, my surgery is almost here! The hospital called today and told me to arrive at 8:30am tomorrow. I'm terrified and excited and anxious and emotional all at the same time, but I'm ready to get this over with. I'm sick of constantly thinking about jaw surgery and getting jitters in the pit of my stomach.

Below are some "before" photos. I've been feeling rather sentimental about my face for the last few weeks, but looking at pictures of myself reminds me of all the aesthetic benefits of surgery that I can look forward to. One thing to note is that my teeth are touching in all of these pictures, even the last two where my face is relaxed. I think being able to close my mouth without forcing my lips to touch is one of the things I'm most looking forward to after surgery! Plus, it's good for me to remember the main reason for why I'm having jaw surgery in the first place: to fix my bite and save my molars!

A big thank you to everyone who has wished me well, and to friends and relatives who are praying for me! See you on the other side!