Day 53: Filling in the Blanks #1

Considering that things are starting to plateau now in my recovery, there are continually larger gaps between appointments and therefore between blog updates. Although, I know there is so much more to tell you all! This is why I have decide to start a slightly different sort of entry, not an update but a "fill in". These posts will be to inform you of rather important things that I somehow forgot to mention, so feel free to suggest any topic you're curious about! As the first fill in, this is about something so basic that I simply looked it over: what did they DO during my surgery?

As I've said before, I was initially scheduled for a double jaw surgery, but then was subjected to only single upper. How the surgeon and his team actually got to my jaw is through the gum line. They made incisions from virtually one side to the other, and then they proceeded to cut the bone. It's a little hard for a visual learner like myself to explain this next step, so I've included a diagram at the bottom for the other visual people out there (and just incase I don't describe it clearly). What the surgeons did after cutting the bone is move the jaw upward. After that, the lower jaw then sort of slid up in to place as well. To keep the upper jaw connected the surgical team used plates and screws to hold it all together cozily, like little metal blankets for bones. The hardware is titanium because it is a mental that isn't commonly allergenic, and all together I had three plates and 16 screws put in. Following that they took the steps to close my gum line by using stitches, then banded my mouth shut as seen in earlier posts. Tah dah! You now know the quick and easy version of what happens during upper jaw surgery (in my case).

If you're hungry for more information, there are actually videos of live operations on YouTube, just search 'orthognathic surgery' and there should be a fair amount of results. Keep in mind, these videos aren't for the squeamish. I've seen a few, and even though I like some slasher films, the surgeries are way too gruesome for my tastes. So, if you need a visual and want to skip the gore don't forget about the aforementioned diagram below the day 53 photo.

Day 43: She Speaks!

After six weeks of waiting patiently, and silently...I can speak! I am officially band-free from now onward and it feels so good. It was initially a  bit strange to experience having the bands off for extended periods of time, but I feel like that was just do to a familiarity that I developed for them over the past months.So far the only speech difficulties I am having are that my S's are slightly snaky, but it is improving daily. What was even more otherworldly than speaking these past few days was eating.

Eating what you might ask? Real food! Real, solid, chewable food. Keep in mind that the food I can now eat is still required by my surgeon to be soft. "As soft or softer than fish." as he says, which, really doesn't sound appetizing when put that way. However, even on a soft chew diet, chewing after over a month is more marvelous than you could possible imagine. It's comparable to that feeling children have when waking to the "perfect" present lying under a Christmas tree, or finding a large sum of money in the pocket of a jacket you haven't worn in a few months. My first meal, in fact, was tacos, soft shell of course.

Aside from eating and speaking, even more good news came today at my orthodontic appointment. Such great news that I believe it deserves a drum-roll (in a way)...

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My braces will come off in one to two months! I'm absolutely ecstatic. All that has to be fixed at the moment are minor details including small gaps that appeared in my upper teeth due to wearing the bands, and a slightly rotated lower incisor. Just from the time my wires were adjusted this morning until this evening I can see a significant reduction of the gaps that had formed, however; the rapid movement of my teeth resulted in my mouth hurting a bit. Although if a slightly annoying amount of pain means that I'll get my braces off this Fall, I can take it without a problem.

Unfortunately, Photobucket was down when I went to edit, so the fonts are rather lackluster.

Day 31: Freedom!... kind of...

For those of you that have been reading continuously, so probably 10 people, I apologize for the gap between this post and the last. However, due to the nature of my last appointment, I acquired a certain amount of freedom that I could just not pass up.

My last post-op appointment was just over a week ago and it was full of lovely surprises. To start it off, we checked out just how far I could open my mouth at that point in time. The goal was to get to 30mm by the six week mark, and guess what? I was already at 19mm and it was only three weeks in! This proved that I was progressing well, so I was able to get some other perks as well. The elastic bands that hold my teeth together were reduced to two instead of five, and I only have to wear said bands for 18-20 hours a day rather than 22. My progress also opened up a variety of new, mellow, activities. Golfing and kayaking, two things I love, are now within my reach and I cannot express just how fantastic it feels to get moving around more after three weeks of well...walking. My next activities mile mark will come around week ten, when I apparently can ride a waverunner again. That also happens to be when I will need my next post-op appointment.

It seems like that is a big jump, from a three week appointment to a ten week, but in reality there isn't much my surgeon can do until then because bone growth does not begin to register on all of their fancy machines until that time. So, he gave me a list of things to do and mile markers between now and then and said to just call if something is a little off.

•  Keep doing mouth stretches (open ten seconds, then close ten, repeat ten times) to get to 30mm by week six.

•  Stay on a no chew diet until week six, then on to soft chew (consistency of fish and softer)

• Meet up with my ortho for further treatment at week six. Until this point in time we have refrained from moving my teeth around and messing with wires and brackets so that my jaw could heal.

• -Bands are officially off at week six, that is, unless my orthodondist needs me to wear bands for repositioning.

As you can probably tell from this post's list, week six is the next interesting spot on my jaw surgery timeline, so posts will be weekly (if that) between now and then. Time is absolutely flying though, I cannot believe that it has already been a month since jaw surgery. Week six better come quickly as well though; this no chew diet deal is getting old and I really want a peanut butter and honey sandwich.

Also, settings that I was unaware of until now are officially changed and anyone is free to ask questions or comment regardless of whether or not they have a Google account.(:

Day 20: Tips and Tricks

Picture it, Bill Conti's "Gonna Fly Now" ( the Rocky theme) is blaring as I, ever so carefully as to not hurt my jaw, charge up a huge stairway. As I reach the tops of the steps I throw my fists in the air because... I made it to day twenty! Typing out the title of this post, I could hardly believe that day twenty had arrived. It seems like a huge number even though I still have a long way to go. However, in these first twenty days of recovery I have learned some things, and these tricks have helped a lot.

Sara's Tips and Tricks to Making Jaw Surgery Suck Less

Article I: Food Fixes:

The food struggle, it has been one of my major qualms with jaw surgery. It's not that you can't eat, you obviously have to for your jaw to repair itself, it's that your options are slim...or so I thought. Once I graduated to a no-chew diet, I was ecstatic. It really makes life much easier. Although, I didn't want to eat merely applesauce and yogurt. My stomach was set on more substantial food, so I bent the rules a little bit and found these more unconventional loopholes.

1. Cake - Cake is fantastic for a no chew diet because after a week of liquids, you will really want dessert. So mash up some cake with a fork and you instantly have a delicious, swallow-friendly, dessert. 

2. Angel Hair Pasta- You can't eat it in it's whole form, but if you cut it into very small bites (1cm or less) you can have virtually any pasta sauce you want from marinara to Kraft mac and cheese. 

3. Pie - Like cake, all you have to do is mash it up and you're set to go! Cream pie works the best, but fruit pies can be smashed as well.

4. Potatoes - Mashed potatoes are really versatile and easy to eat no-chew food. My favorite version is twice baked, yum!

5. Pork Ribs - I know what you're thinking, and no I didn't take too much medicine today. If you're a meat fan, shred up some ribs and add a little more sauce than you would regularly and you're set to go!

6. Chips - Once again, no I didn't overdo it on the meds. If you really want your favorite salty snack, you can crush any chip or cracker into a fine powder and then place it on your tongue. Also,this sounds silly, but sliced Cheetos melt in your mouth.

7. Chocolate - Chop a candy bar into tiny bits, add some peanut butter or caramel if you so choose, and then let it melt in your mouth. It's an easy way to cure a chocolate craving. 

Aside from these more unconventional options, you can always revert back to the blender to get some more healthy fruits and veggies or there are always the options of soups, applesauce, yogurt, baby food (there are some that aren't gross!), pudding, and basically anything else you can imagine. 

Article II: Calming the Cough:
My cough was due to congestion, but these tips may help with other coughs as well.

1. Cough Syrup - This is rather obvious, but when your bands are on it can be difficult to swallow thicker syrups, so water it down and put it in a shot glass.

2. Take a Shower - The steam is really helpful, and regardless if you've showered that day, standing there for 10 minutes can really help.

3.Humidifiers - My humidifier has saved my bum when it comes to sleeping. I leave it on all night and it's the only solution that keeps me from waking up coughing in the middle of the night. 

Please remember that I am not a doctor, and if you have a cough CALL YOUR DOCTOR for professional help first, I did. These are only tips, not a fool-proof cure all. 

Article III: Nasal Nuisances:

I left this tip for last because it honestly is a little gross. While recovering you aren't allowed to blow your nose because the pressure of blowing your nose can mess with the bone healing, and your sinuses have to heal as well. The prescribed decongestants don't always do the job. So, if you're all plugged up because of mucus, get a cotton swab and wet one end with a hydrogen peroxide/water mixture and gently swab out your nose without diving into your nasal cavity. Once again, not a doctor, talk to a professional first. 

That's it for my tips and tricks at the moment, new post-op appointment post this Thursday or Friday!

Day 15: Jumping for Joy!

As of yesterday I've officially passed the two week mark! And to mark this grand occasion I went to the orthodontists...woo... However, this actually turned out to be a great appointment and I am  set to get my braces off this Fall! I was so excited, after starting with orthodontics a decade ago (that makes me feel rather old), I am definitely ready to be finished.

Aside from that spectacular news, I feel mostly healed as well, even though this isn't the case. My bones still need to finish fusing, but the only "complications" I'm really having anymore are a little bit of residual swelling, postnasal drip, and exhaustion. The postnasal drip is the biggest downer. It is normal after upper jaw surgery to have the stated drip, but in my case I have been dealing with fits of severe coughing because the postnasal drip has aggravated my ever so asthmatic airways. It is slowly getting better though with loads of cough syrup, albuterol, and water, so I am hoping it will dissipate within the next few days.

So far, week three is shaping up to be much better than either week on or two. The best advice I can give to anyone else reading this to prepare for their own surgery is to sleep and stay busy when you aren't resting; it's vital to not dying of boredom. Keep your activities low key though and mind your doctors orders. Personally, I passed time with the magazines, word games, and movies that people kindly dropped off. Reading was generally out of the question though due to the swelling and coughing (I don't like being interrupted every half page). Oh, and I made myself a new hat...in summer...

Also, ask questions, make comments, or have dance parties in the comments boxes if you so choose, I will gladly reply(:

Day 13: Heavenly Potatoes, the Week One Catch Up

Due to the laziness I have acquired the past 18 years, and the desire I do not have to write an essay about "hell week", this shall be another one of my magical bullet posts. So, I hope this not only satisfies everyone's curiosities, but also makes room for more fun things you could be doing this summer. Here we go.

Day One: Hospital Holiday:
Pros:

• I get to sleep as much as I want.
• My bed is rather comfy.
• HOT BLANKETS(:
• Nurse Tina alerted people that I cannot talk! 
• Morphine button.

Cons:

• There is a gnarly tube up my nose to suck up fluids.
• Said tube is sucking up nearly 55cc's of blood and snot.
• When I press my call button to be disconnected from my IV and nose tube to pee, the nurses say "What do you need?" over intercom... I cannot talk. Oh the irony.
• I have to wear weird pulsating boots to keep my circulation going.

Day Two: Homeward Bound:

Pros:

• I get to go home!
• I can wear my own clothes again, no more bootylicious hospital gown.
• My IV/ snot tube/ boots are taken off.
• I got to take a shower.
• We missed most of the potholes on the way back.
• I got food! Kind of...

Cons:

• We had to sit in a car for two hours.
• I had to be awake so my head wouldn't hit the windshield.
• Still feeling pretty icky.
• I can't blow my nose, and there is quite a bit of snot.

Days Three- Five: Oh, the Humanity!

Pros:

• ....
• ......
• .........

Cons:

• You cannot blow your nose, which is way worse than it sounds.
• I had issues reaching even 1200 calories on a liquid diet.
• I threw up due to post nasal drip.
• Jaw spasms started.
• I was stuck sleeping upright in a chair.
• My swelling peaked, it was all the way to my eyes.
• Overall, I felt pretty cruddy.
• Had intestinal issues, couldn't use the bathroom.
• Most Ensure-type products are disgusting.
• Pain.

Days Six-Seven: Things are Looking Up:

Pros:

• I started to feel much better.
• My calorie intake was up.
• Down to oxycodone only in the mornings.
• On day seven I got to switch out my bands which entailed:
• Brushing my teeth.
• Eating a twice baked potato. (Heaven, difficult to eat, but heaven)
• Graduating to a no-chew diet instead of purely liquid.
• My energy is back up a bit.

Cons:

• Still feeling week sometimes.
• Sleeping is difficult, making my insomnia worsen.
• No-chew diets still aren't a party.
• Jaw spasms continue on.

Despite all of this, once the first week is over things get much easier. I even got to mash up cupcakes and eat them yesterday! The only thing that is really still bothering me is a cough that has come up due to that dreaded post-nasal drip. However, this is normal, it's just aggravated to due my asthma. Random fact: I can feel one of the screws in my face! It's really trippy.

New post Wednesday!

Day 10: Human Contact

I lied again, and I apologize. This is not the super massive post that I promised; however, that will come eventually. I was lucky enough to see some of my friends today and I just couldn't bear to leave mumbling inappropriate jokes and playing pool with them to blog. So, this is about solely the current week.

As you can probably tell from my billiards bonanza, I am feeling much better that I was when you all last heard from me on Day 1. I'm still not 100% myself, especially in my facial region, but my energy is back up. Earlier this week, Tuesday if you want to get technical, I had a visit with my surgeon for my one week update. All is going well and on track, the only thing I was chastised for a bit was my diet which I was slacking on. Although, I'm up in calories and protein intake now. The other major part of my appointment was quite a perk, I got my huge clunky bands off and they were demoted to much more manageable five elastics that I can take off for two hours a day. I also get to brush my teeth now instead of just rinse: it's heavenly. Seriously, never go a week without brushing if you don't desire to deal with scaggy breath and mouth goo. Not fun. Aside from that I'm finally off of my rather unpalatable antibiotic and down to oxycodone once in the morning for pain.

Jaw surgery has been a blessing in disguise. My bite is so much better and I'm healing much faster than I ever expected. I have a visit with my ortho on Wednesday, and I'm hoping he'll say I can get my braces off around September. Wishful thinking, yes, but it's worth a shot.

New post soon, I pinky swear!

Sorry I've been so lazy/tired about posting updates, however, all is well and a new super massive post will be ready by tomorrow. (:

Day 1: Homeward Bound

It was another bright and early morning, and I was greeted by my surgeon around 7:45. He was pleased to inform me that all appeared to be going well thus far on the road to recovery, so I got to come home today, woo! My pain has still been under control all day, with liquid oxycodone  rather than morphine though. Like all of my other liquid foods, the medication is also delivered though the same syringe shown in yesterday's Day 0: D-day post. However, I must say that I am rather tired today, so I'll just make you all a lovely pro's and con's of the day list rather than a true post.

Pro's

• There is no more annoying tube in my throat.
• I can already feel my tongue and various other regions of my face.
• My nose still isn't upturned, even with the swelling.
• I kept down all of my liquid diet.
• I came home.
• We managed to avoid 80% of the potholes on the drive back.
• No more annoying hospital gowns.
• I got to take a shower!

Con's

• It's pretty difficult to make a 1200 calorie quota on liquids alone.
• My nose gets a bit gunky at times, and I'm not allowed to sneeze.
• There is some green bruising on my face.
• My face is already pretty puffy, and swelling won't peak until about Friday.
• I have to still sleep sitting upright.
• My face is crazy round at the moment.
• I can't actually brush my teeth and have to use a rinse.

So as you can already see in the picture below, there is a significant aesthetic change in my face even with the swelling. My chin and overall face is not as long as it was pre-op, and my lips do touch, they were just at one of the more swollen stages during the day when this photograph.

In the "Up Close Bands" photo, I tried to make an attempt at showing you all how my mouth is banded shut, but it was a bit of a challenge to get my mouth far enough open for a good view. 

Day 0: D-Day

Today was operation day, and aside from my bite magically fixing itself without surgery, it could not have gone any better. As I had mentioned earlier my surgeon had thought that double jaw surgery was the only way to go, guess who was wrong? That's right! While in the operating room he found that only my maxilla (upper jaw) would have to be surgically altered. What he initially did was drill a small portion of my right lower jaw, but he then decided to work on the upper jaw. Due to my congenital deformity, there was apparently a large gap in my maxilla, and once he fixed that, my mandible(lower jaw) just sort of fell into place. The surgery, which was initially set to take 4 hours minimum, ended up only being 3 and a half and commenced at 11:30. Also, I didn't come out looking like Penelope!

 After leaving recovery and being moved to my hospital room, I wasn't even encountering much pain. They had it extremely well controlled and gave me a little button to push that could release a bit of morphine every 8 minutes if I needed it. The most annoying parts of my stay in the hospital were surprisingly the tube pumping my stomach, which irritated the back of my throat a bit making it hard to swallow anything from my syringe, and frequent potty breaks due to my saline drip. Although it wasn't the most pleasant or restful night I've ever been through, it was no where near as horrific as I had imagined it to be. I owe a lot of what made that night tolerable to my nurses, who were always willing to come and help me out, so huge thanks to Kim, Val, Tina and Sandy, as well as my parents who took shifts sleeping in my room overnight. My second doctor, Dr. Maxilla P. Bearstein, also helped out quite a bit. (Thanks mom)

Day -1: The Last Supper

Well, it's finally (almost) here. Tomorrow is my surgery date and I get to wake up bright and early to go get my jaw cracked, 5:30 to be exact. I won't go into the operating room until approximately 7:30, and the early arrival is to leave plenty of time to get the anesthesia and other prep work done. Luckily we are within walking distance of the hospital and I'll get a chance to move around a bit before lying down for what will seem like forever.

My surgeon was happy to report that my model surgery, which is done with the molds made from the impressions mentioned in "As long as I don't come out looking like Penelope..."  , went very well. He also realized through the model that double jaw surgery really is the only way to go for me to come out with the best results. Surgery is set to take about four hours and end around 12 o'clock, however, it could realistically take six hours. After that I will be in the hospital overnight, and possibly for a second day, depending on how well the operation goes. I realize that in earlier posts I said I would post daily after surgery, but I have no idea how I will feel tomorrow or the day after, so don't go crazy and get all up in my grill or assume that I died if I don't start blogging as soon as I'm out of the O.R. I promise I will catch all of you up once I am fit to type.

Aside from all of the official business of tomorrow morning, I'm set to go! Even though surgery is looming, I still don't feel all that worried and the biggest qualm I have at the moment is that I might wake up starving. I can't eat or drink anything after midnight, so I've been feasting for the past few days; I'm pretty sure I ate close to a whole cake over the weekend. Don't judge. As for my "last supper", I was in bacon cheeseburger heaven.

Hook, Line, and Sinker

   Only 8 days remain until mission double jaw surgery takes place and today's pre-surgical agenda included surgical hooks. What exactly are surgical hooks you might ask? They are small little antennae-like nubbins that are placed on the wire of my braces. The purpose of these otherworldly metal bits is to add places for the mouth binding rubber bands (or wire) to latch on to after surgery so that my jaws stay nice and closed. Surprisingly enough, the hooks aren't even that annoying, and I'm sure I'll be used to them within a few days.

   Now that you all can see my bite up close, I figure that it's time to explain just what is going on. No I'm not laughing, the picture above shows my mouth completely closed, and the reason for my teeth not touching in the front is my anterior open bite. My bite is caused by a congenital deformity of, well, basically my entire face, and the deformity results in the lovely 5mm gap we see above. The goal of surgery is to close my teeth, reduce the gumminess of my smile, and fix the cant of my jaw. And the goal of that goal is to make it easier for me to eat, talk, breath, etc. I don't know about you guys, but in my opinion those are some pretty important functions.


   Aside from all of the technical talk, I can't relay just how many times I've heard "are you excited?" this week and each time I have had the pleasure of replying "that's not exactly the right word." There is not a snowball's chance in hell that I am excited to partake in a 6 hour surgery, yet at the same time I'm not nervous either. It might just be that D-day is too far in the future for me to spend much time worrying; only time will tell. So the word I'll choose to describe how I'm feeling at the moment will be short and sweet: ready.

"As long as I don't come out looking like Penelope..."

Surgery is two weeks away, and today was my official pre-op appointment with the surgeon. The objective of  the day was pretty straight forward, take impressions, assessments, and measurements of my mouth and face so that I don't come out of the operating room looking like Frankenstein. It was pretty much an hour of standard things that have already happened during the good ol' orthodontic years. However, one thing was a little more pressing.

I was presented with the decision to choose (more like consent to) having double jaw surgery rather than having a procedure on only my lower jaw. For me, it wasn't a difficult choice. My surgeon made it perfectly clear that with double jaw surgery there is a longer healing time, a few more hours under the knife, and a higher risk. However, with DJS there is a greater chance that my bite will truly come to full closure, as well as a lower chance of the open bite recurring after the operation. Considering that the whole point of the surgery is to close my bite, I was fully prepared to roll with the punches, but my doctor had one reservation. By breaking my upper jaw, my nose may become slightly more upturned. What was my reply? "As long as I don't come out looking like Penelope, I really don't care."

Penelope, as played by Christina Ricci in the movie Penelope.

Peer pressure did me in...

It has taken a while, but I've finally caved to the peer pressure of creating a blog to document my jaw surgery journey. You could say that I'm a little late on the game when it comes to writing down the details of my orthodontia, however, I started off with ortho when I was 7, and I don't think anyone would be able to follow the mindless ramblings of a second grade me.

Formal introduction time! My name is Sara, I'm currently 17, and I'm t-minus two weeks and a day from jaw surgery to correct my open bite. People always seem to wonder just why I'm sacrificing the summer before my senior year to have my face professionally broken, and the answer is simple really. My open bite will supposedly get worse as I age and further impede upon my ability to eat. I like eating. I like eating a lot. There are other reasons of course,  but the gist of the situation is that it will have to be done sometime, and I'd much rather have it out of the way before college.

On this lovely face-smashing adventure I will be updating this blog periodically with all of the fun stuff that happens pre-op, and then daily post-op with, most likely embarrassing, photos of my puffy face. I've come across very few blogs for those of us with open bites, and I think it's time for a comprehensive one. So, here it goes! Welcome to the wondrous world that is Jaw Surgery Blog: Open Bite Edition.