Saturday, April 28, 2012

Week 5 pics

I got a call from my boss yesterday.  They got my leave approved and I return on the 1st.  My checkbook is so relieved!  I'm still super dependent on my my Ibuprofen and Tylenol for pain relief.  Sometimes I still need a Vicodin at night.  But it's all pain in my right TMJ.  If it weren't for this darn joint problem, I'd be mostly pain free.  But, it's getting better, so I'm not trying to whine about it. 

Not too excited about my looks yet, I'm hoping there's A LOT of healing ahead.  I feel like my face is cartoonish, resembling Droopy dog.  The flipped up nose and long space between my nose and upper lip are the things which concern me most, but maybe it won't look so bad in 6 months.  Not liking the jowls either, but I had a bit of that pre-op too.  That can go away easily with liposuction if I still hate it in a year.  I'll try not to focus on my looks for a while, because the OS said it will be 6-12 months to see the final result.  Some pics from today...

Where oh where has my upper lip gone?  Where oh where can it beee??!  (singing)

Droopy dog reincarnated...

This is as wide as I can open right now.  The right TMJ is the painful one, but the left has limited range of motion. 

Looks really wonky to me, hoping it will all straighten out

Wednesday, April 25, 2012

Weeks 4 & 5- phantom cobwebs and bee stings

Right around the 4 week mark, the cloud lifted.  I woke up one day and didn't feel like I'd been hit by a truck.  Everyday after, the pain became noticeably less.  And within a few days I was down to half a Vicodin ES plus 500 mg Tylenol twice daily.  Please keep in mind, if you are reading my blog preop, most people don't experience the pain I have.  Most people are totally numb through most of it.  I had very little nerve damage, partially due to luck but mostly due to a fantastic, experienced surgical team.  But, that means I have more pain early on.  I'm okay with that, it will serve me better in the long run.  I also had quite a bit of joint damage, particularly in my right TMJ, prior to surgery.  That is because I delayed my surgery for so many years.  Most of my post-operative pain has revolved around that right TMJ, which is expected to heal.  My suggestion is to do the surgery before you end up with so much joint damage in the first place (hind sight is 20/20).

Right around the same time, I hit a wall with food.  I thought I might vomit at the mere sight of one more bowl of soup or mush.  My daily regimen of gruel was dragging me down.  I just NEEDED some real food.  One day I had made Mara a lazy dinner of chicken nuggets, tater tots, and canned green beans (homemade meals have been scarce lately).  I looked at my can of soup and decided to not blend it and see what happened.  So I mashed the chicken and carrots with my fork and swallowed bits of them mixed with broth and whole grains of rice.  I just didn't care anymore.  Then I thought, if could swallow rice whole, then I can swallow other things whole if I cut them up to the size of a grain of rice.  So, I commenced to dicing up a chicken nugget into 1mm cubes.  I then dipped each tiny piece into ketchup and swallowed it whole, one by one.  Forty-five minutes later, I had eaten 2 entire chicken nuggets, 5 green beans and 2 tater tots!  I felt vindicated, despite the pain it put me in.  The next few days I continued to swallow tiny bits of real food and my energy really started to kick up.

The process of nerve regeneration is quite fascinating to me.  The areas where I have more numbness are my cheeks, nose and upper lip.  They feel tight, heavy, mask-like and falsely sticky.  Over the last two week though, I feel the numbness slowly melting away from my upper eyelids downward.  As the nerves come back to life, they fire intensely or incorrectly.  This gives me weird sensations of phantom runny noses,  cobwebs on the cheek, and bee stings on my lip.  Shocking as they are every time, I'm grateful for them because it reminds me I am healing a little more every day.

Monday, at around 4.5 weeks, I had my splint removed.  It was planned to be on for 6  weeks, but because my bite was so off and I couldn't close my teeth without moving my left inner cheek out of the way, the OS wanted to take the splint off to evaluate the situation better.  He said everything looked good even though only my left canines touched.  They took more x-rays and handed them to me with a note for the OD.  I snuck a peak on the way to OD, wow, just crazy!  I have a total of 6 plates, 32 screws and 2 pins!  Add all that to the plate and 6 screws in my wrist from a quad riding accident and I think I am officially  THE BIONIC CHIC!   I want a tee-shirt or something :)

The OD said everything looked good too.  He didn't seem the least bit concerned about the sideways jaw.  He said jaw surgery isn't an exact science and there are usually discrepancies which need corrected with orthodontics post-op.  I personally don't quite understand why it can't be put back together perfectly, but perhaps my expectations are too high.  So, the wicked band made an unwelcome come-back that day.  Looks like I'm stuck with it 24/7 for the next 4 weeks at minimum.  It's going to pull my jaw back to the right and square it up as the joint swelling decreases.  Well, that's the game plan anyhow.  Fingers crossed, 'cuz this bad boy HURTS.  It better be worth it.  They removed all my surgical hooks, wires and bands then let me brush and floss.  I asked if they had a wire pot brush and some bleach I could brush with.  My mouth felt that gross. Then I got new wires, bands, an two new hooks for the wicked band.  AAAHHHH, all clean.  After that, I made Keir take me to Bob Evans for some pancakes and eggs.  Wow, real food with a real fork.  Good riddance splint.

The last few days have been good.  I can now speak without spitting and drink without drooling.  Eating more foods, feeling less pain, and becoming more active happens slowly but surely.  Mara told me, "Mommy, you can talk like a big girl now.  Good Job!"  I just love her so much.  She has made me smile through the pain and get out of bed when I didn't think I could.  She makes me pretend cakes and soups to "help me feel better" and kisses my  "boo-boo face" with the sweetest little smile.  In the beginning she said, "see what happens when you don't brush your teef Mommy? You get cabities and the doctor has to cut your bones!"  So stinkin cute!  I'll post pics tomorrow, just don't feel like putting on any make up today.  I'm packing up boxes of clothes and shoes that Mara has outgrown to send off to a dear friend and her little girl.  And that just does not require mascara :)

Saturday, April 14, 2012

Day 23- grasping for optimism

Sorry I haven't posted all week.  I've been a bit down in the dumps.  I'll do my best to minimize this airing of grievances.  Tuesday morning I woke up to a gusher of a nose bleed.  I didn't know a nose could bleed so profusely without having met the business end of an upper extremity.  I could not get the bleeding to stop.  So, I call the surgeon and they say come right away to the office.  That was fun, getting dressed one-handed (other hand pinching my nose with a dish towel), and getting my 3 year old out the door for school.  Although, Keir did most of the work.  By the time we made it to the office my nose had stopped bleeding.  That was probably an hour and a half.  OS says it may have been the motrin I was taking regularly in between my Vicodin.  He had told me to take it, and I was.  I've taken large amounts of NSAID's for many years due to my back problems and never had any complications, but perhaps this was too soon after surgery to resume.  So, he said no work on Tuesday or Wednesday and I may return on Thursday. 

Thursday I go to work only to have another craptastic day.  Got screwed over by a co-worker, then subsequently told that I was being relocated to another office which would add an hour drive each way to my commute.  So,  I'm barely able to do my job now, which is local.  Now, I'm to drive an hour plus to work, learn a new job, talk way more that I would have to at this office, then commute an hour plus home each day.  Can I drive that far while still taking pain pills?  I'm thinking not!  SHIT!  I could barely process all this because of the pain, so, I went home and cried some more.

Friday I wake up to more bleeding and so much pain I just want to chop my head off.  Why is my pain getting worse instead of better?  And why is my freagin mandible so far off the left?!  I've had it.  I feel like the OS isn't listening to me,  I can't take this pain anymore, and I obviously can't work when I'm spewing blood everywhere.  So, it's an understatement to say that I went back to work too early.  I'm a tough cookie. I've had chronic pain (and I mean PAIN) since I was 14.  I have never taken narcotics for it, I take my NSAID's, I get my injections, I shake it off, and I get on with life.  I limp down the halls at work, cry in the bathroom when it gets the best of me, shake it off and do my job.  I'm a, "go to work with a fever of 103 and a mask on my face to protect my patients" kind of person.  I rally and I get it done.  Always.  But I'm afraid I have finally met my match.  Double jaw surgery has beaten me,  and I'm finally saying, "I can't handle all of this".  I'm not trying to scare you all,  but take it from at two weeks post op is NOT A GOOD IDEA! 

I took off Friday, this is Saturday and  I'm taking off Monday to get a hold of my OS to see what they say about working.  I know I need more time and I'm going to have to take it, even though it almost guarantees I'll get fired.  I just don't know how much time, or what restrictions I could follow to make it easier on me. 

Some pics from tonight. Please forgive my shameful hair and not enough make up look. It was a very long day and I just felt obligated to post some recent pics.

Monday, April 9, 2012

Day 18- giggles and teardrops

Overall, I'd have to say today was CRAPTASTIC.  It was my first day back to work, which I was not ready for, but I had to go back.  Woke up at 630, took a pain pill, then went back to bed until 730, which was the plan.  Shower, dress, hair, makeup, and packing lunch all proved to be exhausting at 0730.  Got to work to find my boss was there (actually my boss's boss), so I had to put my game face on .  Talking had my face in knots by 0900.  At 1200 I slopped my soup into my sore mouth as gracefully as possible, then went for a walk with my boss.  That sounded like a great idea when he suggested it, but proved to be quite taxing from the cold-induced pain.  I don't know him well, we are both new.  But he seems like a genuinely nice guy and it was so nice to have a non-surgery related adult conversation.  I came back from our walk, tried to get back to work, then the pain hit me.  And then came the tears.  Luckily, nobody saw.  I quickly composed myself, took a Vicodin AND 3 Ibuprofen and got back to work.  The rest of the day was a cycle of laughing or smiling with/at someone and then immediately cringing in pain.  Wow does it hurt to laugh! 
When I got home I went straight for the cozy clothes and plopped my butt down on the couch.  I skipped dinner, no energy to even deal with it, took more pain meds, had a bowl of ice cream, now I'm off to bed. I'm pretty sure tomorrow will feel like groundhog day.  And I'm completely sure that I'm being a whiny asshole.  I'm okay with that.

This concludes tonight's self-pity party.  Tomorrow I will look for my dignity.

Saturday, April 7, 2012

Day 15- One wicked band

I've been in quite a bit of pain since my check up.  They pulled my cheek way out from my teeth and I think they tore some skin around my sutures.  My whole mouth is nothing but sutures and they hurt.  But the left side HURTS and is really swollen since Tuesday.  Also, this wretched band in my mouth is causing more pain than imaginable.  My joints hurt so badly since he put this on.  The only good news is, if I put my finger in my mouth and move my cheek out of the way then attempt to bite down, I see that things are squaring up quite nicely.  My lower jaw is much less "off to the left".

This one wicked little band has me back up to 3-4 Vicodin per day.  I hate taking pain pills!  I'm also getting really nervous about my appearance.  I thought the jowls from hell were mostly swelling.  Then I went on some other blogs to look at their 2 week pics.  I see no other jowls from hell.  Please tell me this is not my new face!

Aren't I just a ray of sunshine?! (insert sarcasm)

Wednesday, April 4, 2012

Day 12

On Day 12 (which was yesterday), Keir came to Mom's house at 9 am to help me pack up what Mom and I didn't gather up the night before.  I was having a lot pain that day.  I mean a lot.  I don't know why my joints hurt so badly, but I took a pain pill and composed myself rather quickly.  On the way home we stopped at Starbucks (oh sweet friend, how I've missed you!).

I went home and got dressed in real clothes!  It felt so good to be in jeans, especially because they were a bit looser than 2 weeks ago.  I've lost around 12 pounds, but I'm actually trying really hard not to loose too much.  Now, don't get me wrong, I know I can afford to loose A LOT of weight.  But I'm trying to stay healthy right now for better healing.  Bones won't heal quickly if my body is in starvation mode.  So, for now, I force myself to eat twice a day plus a protein shake every day for breakfast, even when I'm not hungry.  Now I focus on healing, later I'll focus on being thinner.

At my post-op appointment I had films taken and got to speak with Sam first.  Sam is the 6th year resident who assisted Dr. Ochs with my surgery.  He is great, always smiling and kind.  There is something sweet and reassuring about his face.  I can't explain it, but he really puts me at ease.  I hope he retains this quality throughout his career.  Dr. Ochs came in and said I looked great for day 12.  He said my swelling was less than expected for an adult (aka OLD) patient on day 12 and said he was happy with the way everything looked.  He was kind and patient and really took the time to talk with me about many different things.  I think these guys are wonderful and I'm happy I chose such a great team.

  My concerns:

1.  My bite is still off to the left.  It was not prior to surgery
                   ANSWER-  he carefully examined my jaw and movement in all directions.  Said I have
                                           a lot of swelling in the joint still.  Take 400 mg Ibuprofen 3 times daily until
                                           my next appointment to help with that.  He then put a band from my upper
                                           right first bicuspid to my lower right cuspid hooks.  He said sometimes the
                                           jaw needs a little guiding through the swelling and he was not concerned at
2.  I can't bite down because my left inner cheek is in the way. 
                  ANSWER-  I still have 50% swelling remaining.  I just have to be patient while that fades
                                         and try not to bite it too much.
3.  Did I actually have a bone graft?
                  ANSWER-   No bag bone or cadaver bone was used.  They were able to use a few slivers
                                        of my own jaw bones where needed.
4.  I have a sore throat and some swollen glands
                  ANSWER-  take some antibiotics just to be sure. gave me a script
5.  How much longer do I have to sleep sitting up?
                  ANSWER-  can sleep how ever I want now (yippeee!)
6.  How much longer am I on lifting restrictions?
                  ANSWER-  still take it easy for a while but I can lift my daughter (38 lbs) carefully if I
7. What should I do now for mouth care?
                  ANSWER-  continue salt water rinses 3-4 times per day (after meals).  brush twice daily
                                       after meals.  I can now use my water pic on lowest setting. (another yippee!)
8.  Should I keep using the nasal spray? 
                  ANSWER-  I can if I want, but I don't have to.  And I'm now allowed to blow my nose
                                       gently if I want.
9.  Can I return to work on the 5th?
                  ANSWER-  No, I need a few more days.  I may return on the 9th though. (insert
                                       waterworks, stress and anxiety)

So, all is going well, but I can't go back to work until the 9th.  This creates much drama for me and it's
possible I'll loose my job.  I'm trying to be positive and believe it will all work out.

Monday, April 2, 2012

Day 11

I'm excited for my first post-op check up tomorrow.  I wish it could have been seen sooner, but they made my 7-10 day checkup appointment for day 12, despite my disapproval.  I have a few questions, a couple concerns and I hope they give me the time to talk about it all. 

Today's culinary adventures included low sodium V8 and homemade lentil soup blended smooth with a dollop of flavored cream cheese.  Both were surprisingly delicious!

The Dr. Seuss factor is down today.  As cute as it is, I'll be glad when it's gone completely.

Day 10

I'm happy to report, that I feel well enough to be too active to post every day.  I'm very stoked about this.  I truly thought I would be dead in the bed for at least a week, dependent on others, pathetic and needy; this is what I was prepared for. 

Prepare for the worst and hope for the best. That's my second motto, right after "happiness is a choice".

That is IF I even made it home alive.  Yep, I said it...the thing no one ever wants to talk about.  But I was really afraid I might die.  It's a possibility with any surgery and I just had a bad feeling. gut was wrong (hooray for me) and I made it home.  Not only did I make it home, but I've been up and about, functional and active from the beginning.  If it weren't for the fact that I'm not allowed to bend over, I think I'd have been able to take care of all of my own needs easily from Day 3.  And if I would have got one of those handled grabby things to pick things up with,  I could have been completely independent I think, except for driving of course.  Anyone preparing for surgery, I'd put that on your list if money isn't tight.  That's the one and only thing I wish I had available that wasn't.  But,  I'm also painfully independent and it was/is awful for me to ask my Mom or whoever to pick up my snotty tissue that I dropped or sort my dirty laundry for me.  To others, maybe not such a big deal. 

So, Saturday was day 9 and we made homemade chili.  When I was looking for blended recipes I came across a site that said blended chili is a favorite among jaw surgery patients and it sounded good.  Mom and I made a ton of chili, went to the theater to see Hunger Games (which was slightly disappointing to me), then came home to have a scrumptious bowl of blended chili.  I can't even tell you how good it was, and that was the first time I felt full since surgery. 

Sunday was day 10.  I wanted to go for a walk, so Mom took me to Brady's Run Park and we walked 2 miles on the walking path.  I'm still taking it slow; It took us 45 min to walk 2 miles.  But I walked 2 miles on Day 10, I think that is fantastic.   We took a short drive to Nanna's house so I could help her with her cell phone plan then stopped at the store to pick up a few things.  We decided to run into Big Lots before Shop-n-Save to just browse around and I ended up buying almost everything I need for Mara's Easter Basket.  We were there for almost an hour, then picked up groceries and went home to pig out on chili.  It was good the second day too.  For lunch earlier, I steamed one part frozen spinach with one part frozen broccoli, drained, blended and melted in a bunch of Velveeta cheese (which I'm aware isn't really cheese, but it melts so smooth) in a bowl and it was super yummy.  Tasted kind of like a runny spinach souffle. 

So, on Day 10 I cooked lunch, walked 2 miles, sorted Nanna's cell phone problem, went shopping, bought Mara's Easter Basket stuff, picked up groceries and ate a big dinner.  I then plopped my butt down in a  chair and didn't get back up all night!   Sorry for the mundane play by play, but I want to give some hope to everyone preparing for jaw surgery...recovery may not be as bad as you think.  And remember, I had a 3 piece Le fort 1 (major upper jaw surgery) AND a BSSO (major lower jaw surgery) , I'm not a spry teenager(the older you are the slower you heal) ,and I have been fairly functional from the get go.  If I can do this, you can too!

Sorry for the homely pictures in my hoodie with bad hair, but I thought I should post some pics.  I noticed too, when my Mom takes my pictures and we are both standing,  you get a good view of the swelling in my jowls (blech)  because she is shorter than I am.  Oh well,  guess anyone under 5'10" sees me like this.