Day 115: Day -6 II

In what is easily my worst titled surgery title yet, I bring you the latest update. As my last surgery-related blog post explained, I am going to be needing additional surgery to correct the inability to open my mouth. You can read up on that post to figure out exactly what’s wrong. There’s diagrams and everything (everything meaning the phrase “screwing the metaphorical pooch”). This surgery has been scheduled for 6 days from now.

Day -6 was also when I started really feeling the nerves about the major surgery back in December. So that makes this -6 II. If I have one more surgery, I’ll have to call it Surgery Day -6 III: SURGERY IN SPACE! Because that’s what happens with series when the third comes around.

I’m less worried about this one, as this is a procedure they can do in-house (I won’t have to go to a hospital) and the recovery should be somewhat easy (I may only need to be out a day or two). I imagine I’ll have to pull back on the ambition of my food choices (maybe not liquid diet, but probably not chicken alfredo for a bit). Don’t know how talking will be either.

The recovery is definitely fuzzy because, you’ll remember, the actual reason I’m having this surgery is because my symptom (inability to open mouth) is actually a anomaly of my recovery from the orthognathic surgery. My body, in essence, just does what it wants. So who knows what will happen with this one?

Anyway, I’m going to leave you with the term “kangaroo orgy” just so I can tag it and try to lure people with a very very peculiar fetish into extra clicks.

Day 104: The Future

Ninjatographer strikes again!
Ninjatographer strikes again!

I realized that if I were able to open my mouth fully, my recovery would have been basically as good as I could have possibly expected it to go. However, I can’t open my mouth as wide as I should. Tonight I was able to start with 15 tongue blades somewhat easily, but try as I might I couldn’t get a 16th in. This is still progress, as I started at 11, but still not anywhere near where I should be at this juncture.

What does this mean? Well, juncture means a point of time, especially one made critical or important by a concurrence of circumstances. Pedantic win!

I met with my surgeon last week and, while he’s pleased how my teeth are coming along, he is obviously disappointed with my jaw. He takes these things personally, especially because my slow recovery is NOT my fault, nor really is it his. It’s just how my particular body reacted to the procedure. He described what is happening as “uncommon”. Not unheard of, but probably only happened a few times in his 30 years. I’ll try to describe what he THINKS is going on.

In the space where the jaw meets the side of my face is a disk, very much like the disks in your back (see diagram 20358.3927729 1/2 below). When you open your jaw, two separate things happen. At first, the condyle rotates down until the mouth is about halfway open. Then, in order to open the mouth more, that condyle glides forward, pushing into the disk. It allows the mouth to open more.

For whatever reason, my condyle is rotating fine (about halfway open mouth) but it isn’t able to shift at all. He thinks there may be something blocking it (an enlarged disk or some gunk or something else – we wouldn’t really know without an MRI). He verified this by asking me to push my lower jaw forward. I can a little, but my entire jaw shifts to the right when I try it (because that side isn’t actually pushing forward and the left side is). Also, when I try to move my jaw from side to side, I can only move it to the left about 2mm (peanuts, essentially).

So what does this mean? Peanuts is possibly the most successful and famous cartoon of all time, penned by icon Charles Schulz. If only watching the daily failings of a clinically depressed child were funny…

Anyway, my trusty surgeon has basically suggested that I will have to go back under the knife again. Nothing as severe as the first time, thankfully, but surgery is surgery. The goal here would be to open up the joint. Then, with me being knocked out, my jaw would theoretically be at its most relaxed, he would try to physically manipulate my jaw to see if he can determine/get past whatever it is blocking its progress. From there, he’d clean it out if necessary, give it a steroid injection to hopefully calm whatever is screwing the metaphorical pooch, and then wake me up.

Recovery for this wouldn’t be great, but not liquid-diet only. I’d likely have to revert back to softer foods for a week or so, and I have no idea how talking would be. Probably just like after a root canal I’m guessing.

I’m disappointed by this. But as he pointed out, there’s not much sense to having the whole major procedure allowing me better air if it means sacrificing eating anything larger than, say, a hot dog. It’s totally emasculating eating a hamburger by cutting it into thin slices.

This could happen as early as a few weeks from now. Right now, they’re trying to get my insurance to cover it, but really, he said either way we’ll likely do it, even if it means waiving his costs. You can tell he’s retired; he isn’t about trying to squeeze extra money out of this, he’s trying to make sure his final patient is able to live a happy life. He really is a phenomenal surgeon and person.

PAIN: 0

INCONVENIENCE: 5

REGRET FACTOR: 3

Day 75: 12 Sticks

I met with my surgeon last week as a spur-of-the-moment visit when he heard that I was having trouble opening my mouth still. When I saw him, he asked me to open up and was immediately surprised by how little I’d come. Before my splint came out, I felt like my progress was coming along great. Now, I feel like it’s stopped altogether, and he couldn’t really argue with that. In fact, he almost took it personally. After all, this procedure, he said, was supposed to FIX my problems, not cause new ones.

The normal mouth should be able to open up about 24 tongue depressors wide. (Ashley’s, for comparison, could probably do about 28. With out help, with me just opening my jaws, I could do about 9 or 10. He started me off by jimmying in 11 between my teeth, which took some fancy finagling. I am supposed to breathe through the pain, and believe me, there is pain, or rather extreme discomfort. Then, for funsies, he jammed a 12th one between two of the other sticks. It didn’t go in all the way. So yeah, I’m less than half of a healthy mouth, and certainly below where I should be after 10 weeks. Let’s put it this way – the name tongue depressor is so very very apt.

He had a few suggestions as to how to proceed from here. It’s actually more of a three-pronged system.

  1. The tongue depressors. I think he called them tongue splints. Either way, word PART_1457839548114_20160312_192045can not describe how much I hate doing this. My job is to open my mouth as far as I can, sit with those tongue depressors in there for about 40-60 seconds, then try to put one more in. Every few days, I should be able to do a few more. Well let me tell you something, I’ve now been doing this 5 days, and I’m still at 11+1. Right before I wrote this, I managed to get a 13th in about halfway, but then it just stopped.

Because there’s a bigger problem: my gag reflex. Many things set this off, but opening my mouth wide is honestly one of them. So is having anything go near the roof of my mouth (further back than the teeth), so is having anything way in the back SIDES of my mouth (like when I get stuff jammed in there during dental appointments for x-rays), having stuff under my tongue. You name it, I gag. The problem with these sticks it that just having them in makes me gag. Then, as I try to add one more, the friction between the new stick and the old ones (as there really isn’t extra room – those suckers are wedged in there good) tends to push back one of the sticks to the back of my mouth. Gag city. I don’t know ways around this, so I just take them out, prevent vomit, then try again. It sucks.

2. I’m not sure how much the tongue depressors alone will work, but maybe they will. However, depending on progress, we may have to progress to cleaning out the joint (which he is pretty sure is locking up). He’ll clean it out surgically then give me a steroid injections right by my right ear (where it is hurting). That sounds like loads of fun.

3. If these fail, and possibly even if they work, we’re off to physical therapy. I wonder if it will be the same physical therapy I go to for my back? People in their fifties say getting old sucks – I’m a few years away from 40 and I agree whole-heartedly.

I’m supposed to try applying heat before (and after) the sticks, but I have either forgotten or not have the means to do it. I will try that tomorrow, hopefully alleviating some of the pain. I would guess that even in my heyday before surgery, I probably couldn’t open up 24 sticks wide (at least not without gagging), but it’s still disheartening to have these issues popping up when they really didn’t affect me beforehand.

On the bright side, eating hasn’t been as annoying, though I’m still really craving salad (WHY is lettuce either way too crisp or way too stringy?)

PAIN: 3

INCONVENIENCE: 4

REGRET FACTOR: 4

Day 70: A Pain in the Jaw

I like my fists like I like my martinis, shaken.
I like my fists like I like my martinis: shaken.

I remember reading a blog of someone who’d gone through orthognathic jaw surgery where he said that the recovery was much easier and much harder than he thought it’d be. Surprisingly, he said that the beginning part was easier than he though, partially because he had planned for it to be the single worst experience of his life. But at a certain point, he expected the recovery to continue at the same pace as it had in those initial weeks, and that’s where it was much harder.

That’s exactly where I stand right now. Up through the removal of the splint, I’d say my recovery was probably ahead of the curve in most ways. I talk with a more pronounced lisp now, which I can’t say I’m a fan of (especially with four years of pretty rigid voice training to constantly remind me that I’m lisping), but I’d say I was in a good place.

Then the recovery just sort of… stopped. I don’t think I can open my mouth any further than I could on day 42. I’m also experiencing more constant pain than I have through any point of the recovery so far. I haven’t been taking pain meds because it’s maybe only a pain of 2 or 3, but it’s constant (especially when eating, chewing, opening my mouth wide, or sleeping on my right side). It’s extremely frustrating.

My surgeon called over the weekend and I missed it as I was packing up the house, but I’ll call him later today to try to get in to see him (I wasn’t supposed to see him until around the four month mark). If not today it’ll have to be next week as I have a short business trip to take in the middle there.

Guess it’s time to load up on more soft pastas, and then have my face explode due to all the wheat.

Yeah, today’s a bitchy kind of day. It’s a Monday after all.

PAIN: 3

INCONVENIENCE: 4

REGRET FACTOR: 3

Day 34: Big Boy Pants

In recovery terms, I’ve passed infancy and have moved onto toddlerhood. No longer do I use the baby toothbrush; I’ve upgraded to a larger one (and I will occasionally use my electric one just for cleaning the underside of the splint). I have also long since stopped using syringes and even baby spoons; I can now fit a normal spoon or fork in my mouth.

In fact, I’m limited in what I can eat obviously by softness, but also by what can fit between my teeth. I am opening my mouth nominally more and more each day, but I still have trouble fitting anything fatter than scalloped potatoes in there. So my days of eating a lacrosse ball are still a ways away. ‘Cause it’s obviously a slippery slope from scalloped potatoes to lacrosse.

My weight seems to have stabilized at 169, a loss of about 12 pounds. I’m going to try to work out (whether it be going to a gym, yoga, or just stretching and hikes) with some regularity as my diet slowly migrates back to normal so that I don’t just put on the weight I had managed to starve off. With my back now bothering me once again (stupid doing stuff!) I have to try to pretend I’m not aging and I can still do all the things I could do when I was 20. I will probably not hit myself in the head with heavy objects though, just out of principle. I can’t imagine it did me any good.

I had my first wine since the surgery this weekend. It was pretty wonderful, and will continue to be wonderful for a while, as I don’t plan on drinking too much for the foreseeable future, so I’ll definitely have leftovers. Still no soda, and that’s something I hope to continue long after my recovery is but a distant memory.

Sleep has been fine. I’m still waking up fatigued, but that might have more to do with the fact that I still have some jaw pain when I wake up. That’s tiring. But I no longer have issues falling asleep.

Talking still generates so much saliva that it seems I have slurp-swallow every nine words. It’s incredibly sexy, trust me. It’s nice to know that, no matter what mutinies my glands are planning later in life, my salivary glands show no intention of abandoning ship. Rather, they come with reinforcements in times of trouble.

I spent almost an hour outside in the ~9″ of snow we got today with the boys and one of their cousins sledding. By the end of walking up a not big hill (I’d characterize it as more of a “small slope”), I was already breathing pretty heavy (not being able to open my mouth much). However, I remember a few weeks ago when I got that way by merely walking around the house. I think Thomas Jefferson put it best – I’ve come a long way, baby.

PAIN: 1

INCONVENIENCE: 3

REGRET FACTOR: 2

Day 24: Eat It

Coming back from yesterday’s tangent, we find ourselves back in my comfy chair, where I’ve spent less and less time in the past week. Despite being more or less “back to normal”, it’s still pretty draining working 8 hours, even if it’s just a less comfortable chair I sit in there. Concentration takes a whole lot of effort. I’m doing what I can.

I’m finding myself more and more willing to try swallowing larger bits of unmixed soup (or cherries in my yogurt) whole. I am not supposed to chew yet, and the splint makes mashing food against the roof of my mouth difficult, so I tend to just swallow things that get in my way. It’s made needing a perfect blend a non-requirement. But I will say this – I’m getting REAL tired of soup. I don’t have very many smoothies, but I feel if I did I’d simply be getting tired of smoothies quicker too. I’ll try being more adventurous tomorrow.

Which brings us to my new segment:

DOES IT BLEND?

Not to be confused with that series of videos where a blender manufacturer would stick random items (cell phones, small woodland creatures) into a blender to see if the machine could handle it. This is the informational segment where I tell you if it’s worth blending foods that clearly aren’t meant to be blended so you can eat them before your jaws are ready to chew. My first foray was lasagna, and that was a reserved success. I wouldn’t eat it every meal, but once it day it was certainly passable (with PLENTY of liquids to make it drinkable). 

Yesterday’s experiment was good ole-fashioned stuffing. It was made for us by one of Ash’s colleagues and Ash couldn’t have any because of the celery. So I got to try blending it. I mixed it on about a 1:1 ratio with chicken stock and blended it up, then heated it. The result was, at first, a rousing success. The flavor was just like Thanksgiving dinner if things got REALLY out of hand. However, by the second cup (I split my portions into two cups so I can heat it quicker), the texture started to become bothersome. Being a bread-based food, the drink version had the unique pleasure of being extremely dry. Not dry as in a good dry Beaujolais Nouveau (French for “you’ll have to Google how to spell this”). It literally felt like I was drinking a loaf of bread. The flavor was great; the texture? Not so much. I might need a “tackier” mixer like milk next time. 6/10.

I was recently asked if this recovery period will possibly influence my diet after I’m fully recovered. It was a good question. The only thing I can be sure of is – I may never have another soup again as long as I live.

PAIN: 1

INCONVENIENCE: 5

REGRET FACTOR: 1

Day 3: Progress and Regression

I have more than one of those shirts, but basically I'm still pretty gross
I have more than one of those shirts, but basically I’m still pretty gross

I imagine at this point that nearly everyone following my blog are my friends and relatives who are showing their support by doing so. But in the off chance there are people here who googled orthognathic surgery and were hoping for things to look forward to, let me bring up something I hadn’t read anywhere that’s now affected me twice: regression.

In the few first hours after coming out of surgery, I had (quite naturally) been able to mentally separate my nasal airway from my mouth airway. So when I had to cough, I could open up my throat and have the cough come only from my throat (if it comes from my nose, it could be a “mega sneeze” which would be bad on a number of levels). This, it turns out, was easy, because my nasal passages were pretty free. Once they started clogging up, around 24-30 hours in, I suddenly couldn’t tell my mouth to open. So when I had a cough, it would inevitably feel like a sneeze. I even wrote to Ash that I felt like I was “recovering wrong” because I could do this one thing so easily the day before.

Last night that happened again. By the 24 hour mark, I had figured out a specific way to slurp my food/water with nearly expert precision: hardly any drooling or leakage, right down the ole gizzard. Then all the sudden last night, I couldn’t. I would hit the same spot, and it would all sort of pool outside my splint (between my teeth and gums) instead of inside the teeth and down the throat. I thought it was the thicker stuff, but it was water too. We think the swelling (which hopefully has peaked?) was such that it changed where my pockets of air were. So drinking was a chore last night. I finally figured out a new place to put my syringe to get a straighter shot to my throat, so I think we’re okay there.

That being said, eating is even more my enemy than before. Ash has been pretty insistent that I eat today (I was way behind my water and my calorie intake yesterday) and I feel like I’ve spent all day eating. Looking at my cups, I’ve had almost a cup of water and almost a cup of soup (which has vitamins, prune juice, and other things I need it in). Still, all this eating and I’m probably still behind schedule? Incredibly frustrating.

The other scary moment. At 9:30, I asked if Ash needed to go to bed (I was playing Minecraft). She said yes, asked if I needed help, and fell asleep before I could answer. So I did the bedtime routine myself (including turning off the lights and xmas decorations). Now, pre-surgery, I’d sometimes have days where I played videogames (or something else similarly inactive), got up, did my basic bedtime routine, and by the time I went to bed, I was breathing pretty heavily. In those instances, I would take long deep breaths in through my mouth as opposed to my nose. Last night, it happened but I didn’t have that option. And despite having taken nose spray, I just couldn’t seem to get enough air. I started to panic, which of course raised my heart rate, making it harder for me to breathe.

Waking Ash wouldn’t have helped, there wasn’t much she would have been able to do at that point. So I just tried to take really long slow nose breaths until I calmed down enough for it to not be a problem. And it worked, eventually, but it was not a fun feeling.

Let’s talk about the good. One of my pre-surgery skills was sleeping, and it seems I’m a rock star in that department. I went to bed at almost ten and didn’t fall asleep for another hour or so (Ash woke up and gave me new ice for my jaw bra) but after that, not only did I fall asleep, I basically remained asleep until close to 8. I woke up maybe half a dozen times to readjust, reposition, take sips of water, but basically was out for a full night’s sleep. I’m not expecting that every night, but it’s nice to know it’s possible. And aside from my right shoulder hurting (it must be something with where I’m actually resting it in this chair when I sleep), no issues there.

My nose breathing is still labored, but I have only used my prescribed flonase the one required time, used saline spray a couple of times, and no afrin. I think my plan will be to use Afrin about 30 mins before I plan on going to bed, so it’s kicking in when I have to do my final standing up routine. That should help that panicky breathing.

We’re in good spirits. The boys stopped by for a couple of hours yesterday and will be staying here tonight. If I have another pretty good night, Ash will go out with the boys to spend time with them tomorrow and my awesome mother-in-law will stay with me to make sure I am doing okay (a plan we’ve yet to finalize – just in case Val reads this before we talk to her).

My lips are chapped and peeling, but that’s expected so nothing new there.

PAIN – 3

INCONVENIENCE – 7

REGRET FACTOR – 4

Day 2: It’s Good to be Home

20151230_131547

I met with my surgeon twice yesterday, and he seemed to be vacillating between having me stay in the hospital another day and having me go home. I was VERY ambulatory, had no vitals issues, was at 95% oxygen WITHOUT being hooked up to the machine, and could feel a surprising amount of my face. The only problem was breathing which, as you know, is a pretty good deal. He had only authorized me to take Flonase and Afrin one squirt every 12 hours.

I’m going to make a private admission here. I have TINY nasal passages. So tiny, in fact, that my anesthesiologist overestimated them and that caused issues that slowed the start of the surgery by 30-45 minutes. So when I’m just sick with a cold, I use Afrin like it’s chapstick in Reno. So I asked since that’s my only deal, and he was letting me now use Afrin and saline spray as needed, could I go home? He signed off.

No sooner was I packing up that my SECOND roommate game in. With his wife and ENORMOUS mutant poodle dog. Apparently, they still had to do Xrays on him or something like that. Also, the crazy lady down the hall had at this point been shrieking out for 30 minutes (which also hadn’t been happening when I requested to go home). Looks like my paranoia paid off.

I expected last night to be very rough. By midnight, I had maybe only slept for an hour and was fearing another night of insomnia. Fortunately I took my pain meds and those things are better than NyQuil. I managed to get a good 3 or 4 hours of sleep after that, and then woke up for a few hours, then napped for a few more hours. So yay!

  • Right now eating is worst part. It’s not “bad” per se, it’s just no longer fun. Putting everything into my body by slurping it through a syringe in the corner of my mouth is more like labor. Eating is a full-time job, and I doubt that I’ve even got 200 calories into me yet (it’s almost 1).
  • I’m very glad we bought this super cozy recliner. Even with that, I expected to have trouble because I’d kind of have to “make myself” fully recline, and I thought that would make me sore. So far, that’s not been an issue.
  • I’m glad we didn’t throw away those baby burp cloths. Comin’ in handy right about now.
  • I do have a fear about breathing. Afrin loses its potency and duration the more I use it. Theoretically, I’m not even at my peak day of swelling (that should be sometime in the next 24 hours). So I’m trying to be sparing with it, but before I go down to nap, it will be necessary.
  • I’m someone surprised by my tendency to want ice on my face and cold foods vs hot food/hot packs (especially with it being winter). I was actually hot a few times and the only time I was cold was after my shower last night.
  • Gonna try my first prune juice… ever. The sound of the drink alone always dissuaded me from trying it, but I gotta get my whole body working if you catch my drift.

 

It was a poop reference. Ash just made me an Ensure with 2 parts drink and 1 part prune juice, along with my Walgreens brand liquid vitamins in it. Surprisingly drinkable. Though the ensure does seem to foam up after blending.

  • This is the text-to-speech I have been using: http://www.naturalreaders.com/index.html. It helps to be able to type fast for this to be feasible, but I can basically have normal conversation now.
  • Ash says I’ve been exceptionally lucid. Not a compliment I have earned much in my life, especially by those who have read my writings.
  • Thank to everyone who has commented on my blogs, sent me texts, left me voicemails (remember those?), commented on Twitter and Facebook. It means a whole lot. Thank you to the mystery person who sent the soup/applesauce kit. I’m a little away from that, but you bet I’m diving in as soon as I can get a baby spoon in there.And Ash thanks everyone for not sending flowers, as she’s allergic to everything.
  • Also MAJOR thanks to Ash. She’s been a trooper, helping me without question, even when we both thought that it meant another sleepless night last night. Fortunately, we both got some Zs. Also thanks to Ash’s folks, who have had the boys since Sunday night and will have them at least one more night. Onward and upward.

PAIN – 3

INCONVENIENCE – 7 (clear nose), 10 (stuffy nose)

REGRET FACTOR – 5

Day -6: The Poop is Officially Getting Real

Two days ago, the prospect of my surgery was akin to that of a vacation that is very very far away; no need to worry about planning just yet, I’ve got all the time in the world.

Then yesterday happened.

It started with me pre-registering at the hospital, which included getting relieving confirmation of many of the facets of my surgery (that I will be staying in the hospital two days as originally told, that I will be knocked out for all of it, that it’s a six hour procedure). Those were good things. I also got my blood tested and just about everything came out in the middle. According to Ash, everything came out EXACTLY in the middle, which I find statistically improbably. I’m so average it doesn’t even seem possible!

Then we met with the surgeon, and that’s when things started to take shape. We spent about 90 minutes in his office learning, asking, listening, viewing, and so forth. One of the major things that’s changed in orthognathic surgery in the past few years is the use of computers to take the guesswork out of it. Years ago (not really all that many) it was mainly “look in the mouth, take Xrays, guess how far things needed to move.” Now, with my CT Scans and X-rays being processed by computers smarter than the average bear, he can know within a hundreth of a mm how far to move stuff. (He pointed out that the most the human eye can really work with is 1/2 mms, but it’s nice to know that science is far more exacting than human reflexes).

WHAT THE PROCEDURE WILL ACTUALLY ENTAIL

I’m going to show a few different pictures. I got more in my possession than I’m putting on my blog (including shots which show EXACTLY where the nerves are that he’s going to go out of his way NOT to sever), but I’m going to stick with just a few. Oh, and if the severing of a major nerve got you a little squeamish, I should point out that this is probably not a blog you want to read any further on, and I recommend you go back and look at this lovely Dirty Dozen list made by Jay and I.

Planning1

This is what my mug looks like currently. You’ll see that I still have an open bite, and you’ll also see (looking at either of the outside shots) that of all my teeth, really only my back ones touch. This is the major problem, and the thing I’m trying to get fixed. What you CAN’T see is my posterior airway. Most people’s posterior airways are 10-12mms. Mine is currently 4. So yeah, that’s apparently bad, as air is supposedly good for you. So more than my teeth not touching, being able to breathe is the real reason I’m doing this. Anyway, the braces have done wonders in getting my teeth to even look like this, but I’ve got a LONG way to go.

After sedating me, putting in a catheter (which freaks me out FAR more than the actual surgery), nose tubes, throat tubes, and just about everything else, they’re going to begin by working on the top jaw. What they’re going to do is… well, I’ll let the picture show you.

Planning2

They begin by a palette expansion. When you just listen to the term and don’t think about things, that sounds almost pleasant. Like, if I were an artist, I’d probably want a palette expansion because it would free up my creativity. Here, though, it means they take a chisel (yes, he used the word chisel) and basically fracture the top of my mouth into two separate parts. If I’m not mistaken, they end up putting some metal in there to hold it there. Also, while they’re separating it vertically, they’re also pulling it out a little (which seems odd as I have an overbite as it is). As you can see on the left, after they’ve expanded the palette, they put in this splint (off-white) that will ultimately be the indicator as to where the lower jaw is supposed to go to meet it (red). Dr. M explained that even after I’m done, not all of my teeth will touch, and that means I’ll have longer ortho still to go (he estimated 6-9 more months, but I’m still thinking a year).

Finally, after having done that, the real fun begins. I know what you’re thinking: “but isn’t getting your face smashed by a chisel the real fun part?” I know, you’re all jealous. Then they work on the lower jaw.

Planning3

See in the this picture the teal looking part, and how in the 2nd picture that part seemed to be fully connected to the chin part? Yeah, that doesn’t happen anymore. He will basically cleave the jaw in half width-wise, kinda like cutting apart one thick piece of bread into two. Then they move the chin part forward, and they will later attach it back to the jaw part with 3 screws (on each side). Here’s the really eye-opening part about this. He explained that the most you could/should ever move this jaw forward is 9mm. A typical procedure moves it anywhere from 5-6mm.

Do yourself a favor and get a ruler or something and look at how much 5-6mm is. When you’re talking about a face, it’s pretty significant.

Now here’s the kicker. He’s going to be moving mine forward 9mm. But that’s not all! With having moved the top forward a bit, they will have to rotate the jaw forward and upward to meet the angle of the top jaw. Between the sliding out and the rotation up, I will probably be moving my low jaw close to 12mm when all is said and done. That’s nothing to shake a stick at, because… WHY ARE YOU SHAKING STICKS AT MY MANGLED FACE?

As you can see by that final image, my teeth will more or less line up with each other, and I’ll eventually be able to chew food using all of my teeth, and not just my molars/wisdoms as I’ve done my whole life. (Note: I haven’t had wisdom teeth since February, and, come to think of it, I’m also missing some molars too). Next is a photo as to what my top will look like when I’m done. Note the large gaps that weren’t there before. I’m assuming those will be filled with highly-concentrated morphine, or so I’m hoping.

Top

WHAT TO EXPECT AFTERWARDS

Dr. M didn’t tell me a whole lot I didn’t already know, but that’s due mainly to me having researched this pretty extensively over the last 18 months. As I’ve linked here before, this handy timeline gives a pretty good idea of what a general person can expect from this procedure. I’m not going to expound too much on that. I’ll go over the specifics my surgeon’s told me about.

– I’ll be in the hospital for 2 days. This is good for a # of things. It will give Ash a chance to get my medicines, pick up last-minute stuff, and learn more while at the hospital in how to care for me. Also, as my throat/mouth/nose will all be filled with blood and other unpleasantries, they’ll have nice suction machines that will expel much of that without me having to worry about it. (I WILL have to worry about it when I get home, and from what I’ve read, it’s not happyfuntimes.)

– Any chance of nausea from the meds will almost certainly take place within the first day or so, so having people prepared to deal with that (and cut my bands if need be) is one less thing for me to stress out about.

– For the first week, the bands they have in place will be extremely rigid. I shouldn’t even TRY to talk/open my mouth. I’ve been teaching signs to the boys, I’ll have a whiteboard, and I also have the aforementioned Steven Hawking technology. But not only will I be on a syringe diet, I won’t be doing much of anything else for some time. This includes brushing my teeth. My first real brush won’t happen for a week. Just like I’m uncharacteristically hyperfocused on the catheter rather than the surgery, Ash is looking forward to my breath less than just about anything else (my one-day morning breath can be pretty killer).

– At one week, I get those bands off for a bit, get to open my mouth about 1 finger’s height, brush with a baby toothbrush, then get new bands on. The new bands will get replaced daily (during which time I can baby-toothbrush-brush and eat puree with a baby spoon), but the rest of the time it’s syringe and liquid diet. He wasn’t the first person to suggest that I’ll soon be asking Ashley to blend tons of atrocious sound drinks (lasagna puree? Yes please!)

– At six weeks or so, I’ll get the bands off, and from there the world of not only liquids begins! I also should get the splint out around then. Life in general will just be better. I’ll be able to talk more clearly (hopefully totally clearly), and I’ll be able to blow my nose by then. Before that, any blowing risks rupturing things in your sinus cavity, so yeah, there will be no blowing of the ole’ honker before then.

– Swelling starts around day three, lasts anywhere from 10 days to a month. Numbness will initially be basically everywhere below my eyes, and will slowly start to come back patchwork over the following months. Numbness can last anywhere from 3-9 months, but there’s a possibility parts of my face may stay numb forever. Ought to make shaving fun!

THE RISKS

Dr. M did much to ease our  minds with the consult. He assured me that, even though I’m his very last patient (he unofficially retired a couple of months ago, and just did his second-to-last patient yesterday), he’s not trying to beat out the clock. “I won’t be rushing off to make a tee-time. I don’t even like golf.” If he’s able to do the procedure in 5 hours, wonderful, but if it’s as long as he thinks (6 hrs) or even if he hits some complications tying and untying binding wires (7+ hours) he’s there for the long haul. Also, he is staying onboard with me specifically for all my follow-up appointments. He’s done this for 29 years, and the few people I have spoken to who had this same procedure, and with him as surgeon, had nothing but glowing things to say about him. That being said, something like this carries risks.

  • Death. Not because of this procedure itself, but because of the nature of surgery, basically. A non-factor.
  • Excessive bleeding. He was the surgeon who extracted my 8 teeth in Feb, and noticed nothing unusual then, but still, it’s something that could happen. You never really know how good a bleeder someone is until you’re in there, hackin’ away. Also of note, 3 weeks ago I was supposed to donate one unit of my own blood to myself to use in an emergency. This didn’t happen because I was ill (they wouldn’t have taken my blood even if I went in). He doesn’t imagine it will be a problem, and will go to a blood bank if he needs to. It’s at times like this that I really wish I knew which blood type I was.
  • Numbness as described above.
  • Incompleteness and relapse. No matter how perfect the surgery goes, it’s unlikely that I’ll have a 12mm windpipe after this. I may only go up to 6 or 7 (though hopefully higher). That’s not a fault, it’s just how people’s bodies differ with the procedure. Also, no matter how good he does, and no matter how good I am about maintenance going forward, it’s still likely I’ll relapse some. My teeth and jaws will want to naturally go back to the way things were for 37 years. If I take good care of everything, that should be at a minimum.
  • My facial structure will change, but probably not massively. I *could* opt for a chin implant if I really did want a chin. I was going to link a picture of me in profile, but I realized I never posted one on my blog b/c I dislike my profile so much. That being said, I’m not doing this for cosmetic reasons, so I’ll take whatever change I get and move on. I *may* end up bleaching my teeth when the braces come off. We’ll see. Okay fine, here’s my profile:
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    From January 2015

    And I’ll also post a picture of how my mouth looked right after the extractions (before the braces worked their magic)_1090206

  • As I’ve said a few times, I’ve packed on quite a few pounds this year (mostly bad weight, unfortunately) because I will have some weight loss. Dr. M pegged me at 10 pounds, but I’ve read anywhere from 10-50 pounds. The 50 was for a linebacker, but I’m anticipating being in the 20-25 pound range. I’ll also not have much energy until around week 4 (when I hope to be going back to work).

That’s enough for now. I’ll post more as it gets closer, and hope to blog every day, at least for the first few weeks.

p.s. Just felt a pretty significant earthquake while editing this. Apparently within the last 30 minutes we’ve had 4 hit, and this (what was the fifth) was the first one I’ve felt, and the most shaking I’ve ever felt. Probably over a 4.0.

The Final Day of Oral Freedom

Tomorrow I go to my orthodontist Dr. O to get my braces put on. I personally don’t care about aesthetics all that much (though when I look at the pictures taken in-office of my teeth from the underside, I find that this is not at all true), but I did opt to get the clear braces instead of the “normal” ones. First, they weren’t any different in price. Also, I want to make some of these transitions easier for my kids. They don’t like change all that much, and considering how much change I’ll be going through in the next year, if I can ease them into things, it’ll be better for everyone involved.

Braces aren’t a big deal – it seems like half the kids in the country have them when they’re growing up and they do just fine. However, in trying to actually make this entire process a truly healthy one for my face/teeth/jaw, I’m likely going to cut out soda. I was initially going to say for the entire duration, but I’m going to be realistic – especially since my boss was nice enough to buy me 2 large cases of Dew when I moved into my new office a couple of weeks ago. But the plan is to cut it out nonetheless because soda + braces = not a good combination down the line. I will also probably enjoy AT LEAST two pouches of microwaved popcorn tonight while I still don’t have to pick out the remnants later.

Truth be told, I’d been on the verge of cutting it soda (again) anyway. On the way home from my San Francisco trip with Landen, I bought a 1L bottle of Dew, and by the time I’d finished, my stomach was just miserable. I know, I know, moderation. But I used to have more than that every day with no ill effects. I guess a lifetime of not giving a crap about my insides has caught up to me. So the soda will be gone for at least a while – if all goes well through it will be through this summer.

Then we play the waiting game – see just when I’ll have to have my teeth removed to create more room for pulling/tugging, etc. There’ll be some flexibility with time, which is a good thing as I have a couple of MAJOR disc golf tournaments coming up (a 3-day A tier right in Tahoe at the end of June, and Worlds in August) and I’d rather not be dealing with extreme mouth pain during those events. As it is I’ll be dealing with the fact that I’ve become terribly out of shape.

I will take some “before” pictures of my mouth/face (in addition to the ones I’d already taken in Dr. O’s office) and probably post them. I am less sure about posting pictures of my recovery after surgery. a) they won’t be pretty and b) as was evidence by my ill-fated “DPOD” experiment, when I put a daily responsibility on myself, I fail, and that’s without coughing up blood every day. But three years from now, it’ll be nice to look at a before/after comparison.

So yeah, let’s roll. Feel free to comment along with these posts. When it comes to surgery time, I’ll appreciate the banter, even if it’s Aaron saying I have a dumb choice of something or other (pain meds?)

Today, I start a journey…

Today, I started a journey, and it all happened in an orthodontist’s office. Dr. O.

Of course, the journey started years and years and years and years ago, when I was thigh-high to an averaged-size adult. I had gone to another orthodontist, whose name is forever lost in time, and he gave me the prognosis as being an excellent tongue-thruster. I was advised I’d need to go to a “swallowing specialist” and then I would need braces. He also saw my twin brother. What happened next is still a matter of debate.

In my mother’s memory, I complained so much that they just got the necessary work done for Mitch – he had a more immediate orthodontic need. For my memory – and remember, this is the same memory that produced a very vivid impression of Mitch removing my stitches from an accident I had when I was 4 – my parents said they didn’t have the money for both of us to receive treatment and Mitch got it, again because of the immediacy factor. Anyhow, I never got any sort of treatment. That was when I was around 7.

Fast forward until a couple of years ago, when my dentist, Dr. B, suggested that I might want to see an orthodontist. He also was the first expert who uttered the term “surgery” to me. I’d heard from friends/family/others some rumblings that I might need it, but never had a person who actually knew much about teeth confirm it. He did. And he referred me to the aforementioned Dr. O, who took a whole bunch of photos, X-rays, and pink-goop-molds of my teeth. I’ve always known that my teeth were UGLY (as an acting major in college, I was told never to get them fixed as it gave me a great “character actor” look), but it never really bothered me looking from the front. But seeing huge pictures on a wall displaying my teeth in ghastly detail from the underside, the top-side, and wide open – my God I’ve seen assassinations that were less traumatizing. Before even getting all the results back, he pretty much assured me that surgery was in order and he referred me to an maxillofacial surgeon named Dr. M.

After more tests, pictures, Xrays, and discussion, Dr. M. confirmed that I’d need orthognathic surgery. I nodded since I’d heard that that’s where I was heading. Then he actually told me what that entailed.

And that’s when the shoe dropped. The thousand pound shoe. Onto my soul.

The process is awful and there is exactly no part of this I am looking forward to. The rough timeline of what to expect:

 

Today – final molds made of my teeth

Next Wed – braces go on. I’ll be one of those “cool” adults who rocks braces this late in life.

A few months from now – after my teeth have been pulled into better place with clear braces (I’m so going to rock white after Labor Day, bitches!), Dr. M. will do the first procedure, the “easy” one. He will remove eight (8!) of my teeth: the wisdoms and I believe the inner bicuspids. Then they will reattach the braces to do more pulling and getting stuff in line.

About a year from now – the surgery.

 

My work has come through BIG time and agreed to pay/reimburse me for all my regular expenses. We may have a bridge to cross if there are complications, but either way, I at least can have this procedure done without worry that it will cripple us financially.

Oh, I suppose I neglected to mention WHY I’m getting it done. Is it simply because I have horrible looking teeth? No, my vanity has taken plenty of other hits with my stomach issues and Middle Earth complexion. Dr. M. showed me some xrays of my jaw/neck/throat. The average width of the windpipe is (from memory) 12mm. Mine gap, because my jaws are essentially separating and are no longer parallel, has been constricted to about 5.5mm. That’s less than half. The result of which will utlimately be sleep apnea, eventually leading to needing oxygen at night. There are also problems that are only recently beginning such as pain while chewing very difficult things (such as nut-bars or tough steaks). I’ve long had clicking in my jaws too, which I can’t imagine to be “good”. These will all be fixed. Other secondary benefits will be aesthetics, improved smell, and maybe even less fatigue (even though I am not actually waking fully up, the doctor believes my body is waking up for short periods each night).

So where does that leave us? With a blog. Why am I blogging? I’m not the first person to have this surgery. Hell, I’m not the first to blog about this surgery.This guy already did, and he’s a veritable font of great information. I’m doing it for a few reasons. 1) To chronicle for myself what I’m going through. This will be, by far, the single biggest decision I’ve ever made about my health. This will also almost certainly be the most pain I’ve ever been in in my life (and remember, I saw the movie version of Mama Mia in the theaters). 2) For the first few weeks after surgery, I won’t have much else to do, so I figure blogging will be a healthy way to keep connected with the outside world. After all, there’s only so much GTA V I can play, right? Right? 3) I hope it will entertain. Even in the depths of self-pity, I hope to be able to make a few people smile.

The blogs won’t be too frequent at first, but I’ll try to keep it up. I’ve made a new category (“Surgery”) on the bottom-left of the blog, so you can click on that if you just want to filter out everything but tooth/jaw/face posts.

Come along for the ride and strap in. It’s gonna be something.