9 months later..........

So.... Here is a look at my smile 9 months after surgery, braces off.
I am glad to be out of brace bondage finally!! I was so ready to get those things OFF! Although the upper retainer is cumbersome....
I have to wear the upper retainer for 6 months 24/7 except when I eat. I wasn't able to get one of the nice, clear plastic retainers that fits over the teeth like an in-visiline. It is one of the clunky, over the palate resin retainers that has a metal bar that goes across the teeth in front. I don't like it at all, so I begged my Ortho to let me wear one of the clear ones. He says after 3 weeks, I can come in and have one made, but I must wear the resin one as much as possible. Something about my "open" bite that makes the resin one much more effective. I also have a permanent bar type retainer across the back of my bottom teeth. It isn't too cumbersome. Easy to deal with.

My front tooth that had the discoloring after surgery has pretty much returned to an acceptable color.  Except when the brackets from the braces came off, the tooth is discolored underneath!! I can't believe it. After all these months of hard work trying heal well, I have a purple discoloration right in the middle of my big front tooth!! I am using lots of tooth whitening products in the hopes that it will fade, otherwise I may have to get a root canal and/or cap over it.

Overall, I am pleased with the outcome. I still have a tremendous amount of paresthesia (numbness) in my upper hard palate where the surgeon placed a bone graft. I am not sure whether or not any of the feeling will return. This may become my new "normal." My gums around my front 4 teeth are still numb. Underneath my upper lip where my nose connects to my face, where they lifted it for the Lefort osteotomy and the bone graft, is still quite tender and healing slowly.
I am thinking that at my age, healing is slower than it would be say for a 20 or 30 year old.

I have a lot of crepitus (grating sound or sensation produced by friction between bone and cartilage) in the left jaw joint...more than I had even before the surgery! This side of my jaw was manipulated much more than the right side. I still have a significant amount of pain in the left side jaw joint in addition to the grinding.

I often ask myself if I would have done this major surgery if I had an opportunity to rewind the months and the experience of the past year and I have to say..... I can't really answer that!
I am happy that I can now have nice straight teeth that can bite easily into a deli sandwich, but the journey hasn't been easy.

It's difficult to remember how things were before the double jaw surgery. I can say that I have about the same level of discomforts as I did before, they are just different. The discomforts are in different areas of my jaw and mouth.
So sometimes I feel that I just traded one discomfort for another. But my teeth are straight and my smile is nice.

So, there it is. A somewhat "end" to my jaw surgery journey.
I will post some other photos of the healing journey next time.

Some before and after photos

Before braces 2012

One year before surgery

Right before surgery 2015

15 days Post Op

10 days Post Op

Day 15 - First Ortho Appointment

 Two weeks, 1 day post op -  my first trip to see the orthodontist. Dr. H was happy to see me doing so well. The entire staff made me feel like a celebrity. Their encouragement and enthusiasm felt comforting at this juncture in my healing journey. He said my mouth looked great. Nice and clean. I have been doing my best to brush and rinse with the medicated mouthwash. I do have a "pink" front tooth. He sent a photo of it to Dr. B. Got an email from Dr. B and he says this happens, but it isn't seen very often. Happens when blood pressure forces blood into the area........ blah blah. Not sure all the specifics, but he says research shows that it will fade with time. I was glad to hear that.

My swelling has decreased the most on the right side. Left side still gives me muscle spasms by the end of the day. I had to ask Dr. B to prescribe me a muscle relaxer to help. He ordered me Soma, but after taking one and not even feeling any effects, I called my PCP and he prescribed me Flexeril. That seemed to do the trick.
The muscle spasms and sleeping are still my challenges. After talking and chewing all day, the left jaw muscle really aches. Sometimes it takes several hours of heat, ice, meds to finally get relief from the discomfort. It throbs all the way up into my ear like an ear ache.
My smile is still very tight. but each day gets better and better. I just have to keep reminding myself that this is not a "speedy" healing process. Slow and steady.  I saw a few friends the other day and they were perplexed that I still had numbness and aches in my face. Funny how people really don't comprehend just what a dramatic surgery this was. To expect healing from this surgery in two weeks is like expecting a broken leg to heal in two weeks. It just doesn't happen that way. The body has an amazing capacity to heal itself, but it definitely needs time and rest to do that.
I am still numb on my left cheek down to and across my chin. My chin feels like fire ants are stinging me. Or like Stinging Nettles.
Having to use wax to cover pokey areas of my surgical wire that is still in place. That's a good thing because it means I am getting feeling back inside of my mouth. Roof of mouth still numb as are upper gums.
 Fatigue is still greater than I would like, but I try not to fight it. After all, these chores and errands will all be waiting for me when I am better!
I have a 2 day training next week for my job, so I am hoping to rest and heal as much as possible before then.
Eating soft sandwiches with crusts cut off. Had pancake and scrambled eggs the other morning. I am not feeling deprived of food at all. I can eat a wide variety of foods, so that keeps me happy.
First Post op with DR. B in 2 weeks.

Day 13 - Valentine's Day

Day 13

Day 13

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Day 13

 Had another monumental step today. I drank my smoothie out of a regular cup!! I didn't even spill any. Now that I can drink regularly, I should be able to drink anything at all.
Soon I will have my first glass of wine!! Yay!

 I also ate a small bit of cinnamon roll. I had to chew very carefully and slowly, but man was it good!
I feel like the next few weeks will just be more of the same kinds of progress. Each day I will be able to feel more inside my mouth, the swelling will continue to go down, the foods I eat will progressively become more complex.

I have my first orthodontia appointment in 2 days. Not sure what that will entail. Below is a picture of the bite splint that I will wear for the next 8 weeks. I can take it out to eat, but I am to wear it most of the time. I goes up behind my upper front teeth over the graft area.


This is my dwelling place most of the time. In the corner of the bed you can see my newest rescue kitty, Annabelle. She has been resting on my bed the entire time I have been home. She only gets up every once in a while to do what all cats need to do. It's nice to know that I am not the only lazy one around here.  The weather has been nice and sunny so it's nice to get outside to catch some rays and some much needed Vit D.
Not really going out anywhere yet. Had an invite to a retirement party the other night, but I didn't go. I want to get as much rest as possible while I can. Besides, all that talking and smiling, I just know my jaw muscles would be killing me by the time I got home. My first outing will be to the orthodontist.

Days 10 - 11

The days chug on by. My day consists of  make smoothie, hot tub, shower, wash hair, take photo, cream of wheat, nap, lunch, putter around house for a bit, nap, smoothie, family time, dinner, and then a loooong night.  That is my greatest challenge right now. The nights. I am normally a belly sleeper, so having to sleep on my back in an upright position isn't very easy for me. I have to have several pillows, most importantly, the airline neck pillow. It seems difficult to keep my jaw closed with all of the swelling and what not. So the neck pillow helps to support my jaw without having to use the muscles as much. It seems to help.
BIG DEAL for me!! On day 7 I began to drink good out of a child's sippy cup!. This is so monumental for me because now I can put away the syringe!
By day 9, I am drinking out of a travel mug. The opening is a little bit bigger than the sippy cup which lets me slug down my smoothies without too much of a mess. I still have lots of numbness in my lips, mostly on the left side. I can feel the cold sensation of the smoothie enough to drink it this way.
My diet consists almost completely of instant potatoes and stuffing mix!! Every day. Sometimes 2 X a day! I baked some tofu with fake turkey gravy to go with it, but the tofu is a bugger to get out of my braces! Hubby blended up a Salmon burger with broccoli which was really tasty. I try to get enough protein as I know this is critical for the healing process. Eating spinach to help boost my iron and calcium.
I am brushing my teeth several times a day with regular toothpaste and a baby toothbrush. It is very soft and I go real slow. Then I rinse with the Chlorhexidine Dr. prescribed for me.

Day 10

Day 11

Bruising Day 11

Most days are slow and easy. I used my exercise bike 2 X this week. Mostly just because my legs were so jumpy in the evening. It seemed to help, but I couldn't go too long. Only went about 3 miles which takes about 10 minutes.
Other 4 grandkids came by today. They hadn't seen me yet. First they stared and then they went along like nothing was any different! I was so happy to see them.

On Day 10 hubby and I took the dogs out to the beach. He walked them and I sat in the sun near the jetty. It felt good to get out in the fresh air. I do get fatigued easily though. 

I have so much to be thankful for. Many of my family and friends have been praying for me during this journey and for that I am very grateful. Each day I am truly amazed at the healing power of the human body that God has created. A miracle for sure.

Days 5 to 7

Each day I feel a little bit better than the one before. Progress for healing will be slow and steady as this was a huge surgery.

Day 5

Day 6

Day 6

 Day 6  Cheesy smile!

Day 7

Day 7

Day 7

Day7

Day7

I can open my mouth enough to eat porridge textured foods or anything at all blended up into that texture. I am eating lots of calories every day. Still very tired so I rest a lot and try not to do too much. Some of the Grandkids came by today to watch a movie with Grammie on her bed. That was fun and all three of them were very, very good, being careful not to move around too much. After about an hour I was done. Mostly I was tired from talking and moving my mouth around. The muscles really ache when I smile or use them too much.
The nights are the hardest for me. There is nothing to distract me from the discomfort for all those long dark hours. The time seems to crawl by. I have to take a half dose of Oxy at night just to help me to relax.
I stopped using the ice pack and have switched to heat. Dr. told me at this point to use whatever I can get comfort with. The heated rice pack on my face felt soooooo wonderful! The only discomfort/pain that I have is on the left side of my jaw. This is the side the Dr. had to move forward the most. The jaw muscle just aches and aches by the end of the day. Almost like a muscle spasm. Some nights it's more difficult than others to find that sweet spot for relief.
The body aches that I feel from sitting and lying around can bring some discomfort also. I try to do some gentle stretching to work it out. I take a hot tub every day. That just keeps me warm!
I will continue with the Aleve every 12 hours. I can sure tell when it's time for my next dose even if I'm not watching the clock!
The numbness in my face really hasn't changed. Dr. said he wants me to eat soft foods and do lots of chewing, but I can't feel the food in my mouth, so I am going to wait a few more days. I tried Pasta on night 7, but it just felt too risky to try to chew and swallow when I couldn't feel when it was chewed enough.

I am excited that I see and feel little improvements every day. No matter how small a baby step it may feel, it is still a step going forward. I thank God that my healing has thus far been steady and progressive.

Days 4- The Journey Home

Will you look at that swelling!!!!  Moon face.
 These are taken right before we left the hotel to head to the airport. At this point, I had not had any substantial food since Sunday evening and this was Thursday morning. I needed calories if I were going to make it on this long journey home! Hubby went down to Starbucks and got me a Mango smoothie. YUM. Let me tell you, that was the most delicious smoothie I had ever tasted even though I had to drink the entire thing through a 10 ml syringe!!!
At this point, my face is so numb that I cannot use my lips at all, so I am unable to use a straw. I have some good purple bruising coming on as well.
We made it to the airport with plenty of time to depart since I wasn't moving all that fast. We had to drop off the rental car, walk to a bus, ride the bus to the terminal, then get our tickets. I was wiped out before we even got on the plane. I had my ice packs coddled against my swelling face as I patiently waited for my wheelchair to arrive. I had arranged for this ahead of time and I'm really glad I did. They wheeled me through security and on to my gate.

The plane ride itself wasn't too bad. My ears popped on the way up, but  not on the way down. THAT was painful, but endurable. I just put my ice packs on and my head down and rode it out.
Once on the ground in California, we had to drive 5 hours to get home. Again, we had to get our luggage, ride the shuttle bus to the long term parking, then drive the distance. I guess I just gave in to the fact that this is the way it is.  I knew that I was absolutely miserable the entire trip, though I also knew that we had to get home. These are the plans I made, so this is how it had to be done.

The car ride home was definitely the most miserable thing I have ever done in my life. I have had six babies, gone through Nursing school and yet I would've gladly done all of that again to not make that drive home! Well, maybe not all six births, maybe just one........... (and now that I truly think about it, nursing school was a nightmare I really don't want to relive!!)

I told my husband I felt like we were riding in a stage coach going full throttle down a bumpy road. We stopped every once in a while to refill the ice packs, but other than that, we just drove!
By the time I got home, my pain was the worst it had been since surgery, 10/10. I snuggled up in my bed and passed out!!
My sweet #6 child came in, held my hand and assured me that I would get through this and tomorrow I would be feeling better. He had a gift of comfort that way.
It was good to have all of it behind me now and everything ahead was the road to recovery.

Day 3

My memories of the days in the hotel room scroll through my brain like a late night movie. Much of the time it consisted of..."when do I get my next pain meds?"
My caring husband tenderly attended to all of my needs without any hesitation. When I was ready to eat some semi soft foods, he went out foraging for some instant cream of wheat. When I needed a decongestant, he scurried down to a local pharmacy to purchase some. He had to continually trudge up and down the stairs to fill the ice bucket with ice for my "jaw bra". I could not have done any of this with out his help and support. Thank you, Sweetie.

 These cute little flowers were in our room when we arrived. From my husband's co worker and his wife. My orthodontist had flowers sent also. I though that was extra special.

I had to use a syringe to get most of the sustenance I needed. This included meds, cream of wheat, smoothie, water. All of it had to be given through a small syringe. I wished I would've had a bigger one, but we did fine with the one we had. I was able to eat applesauce with a spoon. I had to crush pills and take them with the applesauce, YUCK. I never knew that Aleve and Sudafed did not come in liquid form.
 I slept in an upright sitting position with lots of pillows and an airline neck pillow for support. We brought along a boxful of post surgical supplies, such as drool cloths, Ocean saline nasal spray, a small portable Humidifier, a small blender, suction bulb and a bunch of other much needed items. So we just pressed on through until it was time to head home.

I look pretty miserable in these pics.
We stayed at the hotel for 2 days. Mostly I just laid there with ice on my face only getting up and down to use the bathroom facilities. I took a shower right away, being careful not to get my sutures wet.

I am going to my first post op appointment in these photos. We walked the 3 blocks to the Dr. office. I got a lot of weird looks from people on the street, but I didn't give it much thought.

Dr. says every thing looks great. During surgery, he had put in a bite splint to help support my new upper palate until it heals. He removed my bite splint and showed it to me. I had no idea it was even in there! It looks just like a retainer. I have to wear it for 10 weeks but I can take it out to eat.

I feel fortunate that I had such a wonderful surgical experience. I have read LOTS of other jaw surgery stories on the blogs and some of the things people have gone through have been pretty horrific. I had minimal bleeding, virtually no bloody noses, no problems with breathing or swallowing. When my surgeon asked me if I had encountered anything that I didn't feel prepared for I had to honestly say NO. I felt like everything went along just as he said it would. Truly, this surgeon is the most experienced physician that I have ever had. I would highly recommend him to anyone.

Day 2

 The video that I posted on yesterday's entry was actually taken on the second day. I am writing this blog days later, so don't think I am feeling so well that I am able to do all of this writing!!
Drooling like Tilly. She is my old black lab. Tilly is always willing to lay a wet slimy slobber on your pant leg or your lap if you're sitting down! (she seems to take such pleasure in it, I swear!)
The bandages that you see are the incisions on my outer jaw line that they use to place the  measuring rods. They had some self absorbing sutures and steri strips on them.












When it was time to leave the hospital, we made our way out to the rainy parking lot and headed back to the hotel for the remainder of our stay. We will hang out here at the Sorrento Inn until later in the week. The Inn is just 3 blocks from the Dr. office, so if we need him for anything we are very close.I have a post op appointment on Wednesday with the Dr.
We had a 20 min. drive, so I was pretty tired by the time we got back to the hotel. The staff at the hotel were so kind to me. I could just see the caring concern in each one of their eyes. They treated me with much comfort and gentility. Even if the Seahawks lost such an important game! Wasn't that just the worst ending EVER to a football game? It's all anyone talked about around here for days!

Surgery Day!

If you have a queasy stomach, you may not want to watch this. Not that it's gross, but someone suctions out my mouth about 5 secs into video. It just sounds kind of gross. At this point I felt fairly comfortable. Before surgery my biggest fear was having so much drainage and packing in my sinuses that I would not be able to breathe. I was pleased to find out that everything was just fine. I had blood drainng somewhat down my throat (at least it felt like it, who knows, with all the meds I had on board!) Me and morphine did not get along to well, so after a couple of tries ending in episodes of puking, we ended that relationship. Torodol and I did fine. I only had 4 doses during the 24 hours they had me in the short stay surgery unit. Took Zofran for the nausea, Oxycodone eilixir after I left the hospital.

 When I look back on these videos and photos, I am amazed at how cleaned up I am. I imagine there was a good deal of blood involved in this surgery, but the nurses had me extremely clean. Being an RN myself, I know good nursing when I see it. I had absolutely no signs of blood or anything, on  my gown, in my nose, though I did find a little in my hair, but way in the back!

My CNAs were fantastic. Ice around the clock, up and down for trips to the bathroom, my SCD's in place (AND turned on!), fresh water with syringe in it for drinking and another cupful for rinsing out my suction device that was pinned to my gown for my convenience. They really took good care of me. My husband was by my side the entire time. I felt a little bad for him having to sleep in that awful chair/cot thing, but he said it wasn't that bad. After all, hadn't he done this sort of thing with me 6 times already when I was having babies? True that. He's a good guy.

I had my mouth bound tightly together with elastic bands that the surgeon said he would remove when he comes in to check on  me. The video was taken after he removed the bands which allowed me to open my mouth like that. In the old days, when they moved the jaw forward they would use a bone graft taken from somewhere else on the body, usually the hip. This required them to wire the jaw shut until all of the bone fused together in a strong bond. Well, now they don''t use bone graft. They just use small surgical plates and screws to join the bone back together. This allows for the jaw to be used immediately and without fear of damage to the surgical site.
I began to use my white board to write a question for the Dr. and he told me to put it away and start to talk right away. Once the bands were off, he wanted me to eat some soft foods before I left the hospital to make sure that I could swallow properly.
Right out of the shoot, he wanted me to use my jaw and begin my healing journey. I liked that. I felt like I could be proactive and start exercising my new face into good working order.

I look just a little bit crazy here so I'm thinking it was the morphine. If anything negative I would say about the hospital stay, it would be that I wished I could've had something other than just Torodol. I know that I did get a few doses of Morphine, but I really could've used some OxyCodone or something while I was there. I had Oxy elixir waiting for me in the hotel room but that wasn't ordered by the dr. for me in the hospital, so they couldn't give me any. I went from 1 a.m. until about 9 a.m. without any pain meds. I also got a good IV push of Decadron (given VERY slowly diluted in 2 - 10 ml syringes of saline... Which still made me puke!)

Night before Surgery

When I went to Seattle for my pre op appointment in January, the CT machine, that the surgeon uses to determine how much and what kind of work he wants to do, was not working properly. I had only a couple of hours that day before my flight departed for home, so we had to come up with a plan to get the images he needed. The only alternative we had was to have me arrive the night before surgery to meet the Dr. at his office so he could get the image he needed. I thought, No big deal. We will still have plenty of time to go out to get one last delicious meal before it gets too late. Not actually how it all happened.

Now funny thing about all of this, my surgery was scheduled for the day after the Super Bowl. And the Seattle Seahawks were playing in said football game on that Sunday afternoon that we rolled into their lovely little city.
Well let me tell you, .EVERYBODY was watching the big game! The guys at the car rental agency, the concierge at the hotel, and of course the bar and lobby had the game on multiple TVs. Though it made for easy driving through town, most of the restaurants were jammed with fans watching their team. (We wound up eating our meal in the hotel bar/restaurant in order to avoid the huge crowds everywhere.)

Not sure whether the surgeon is a Seahawks fan or not, but all of this made it very inconvenient for the Dr. to meet me at a reasonable hour for to get the x ray. Apparently he did intend on watching the game, so we settled on a time of 8 p.m.

At one point while waiting outside of his office in the chilly night air, I wondered whether I could handle the anxiety of doing all of this when surgery is merely a few short hours away. I had a chill slither up my spine as I watched the hands on the clock swing past 8 o'clock and move towards the quarter past mark. What if he didn't show up? What if we are waiting in the wrong spot? I tortured myself with such silly fear.
Dr. showed up just a little late, but it was all good. His RN had to walk him through the process of taking an CT scan since he doesn't usually do them, but other than that, it was ok.
My last meal consisted of a Sorrento Inn hearty grass fed beef burger, fries and a cold IPA from Pike's Place Brewery. Yum.

 We took these in the surgeon's office while he was fiddling with his Xray machine

These are the last profile photos I have of my pre surgery face. In the morning it will be transformed into an image I have yet to see. I feel positive that I will be happy and fully satisfied with the results.
See you on the other side.

A few days before

Here are a few photos to show my facial structure before surgery.