Thursday, November 30, 2006

Still Numb After All These Weeks

Its been just 5 weeks past my surgery and I'm still completely numb in my chin and bottom lip. I finally had the "hardware" removed from the bottom of my mouth, oh what a relief that was. Although my gums are pretty messed up. But seems like things are healing. I saw my orthodontist today to get the hooks removed and he put in new wires and is now starting to move some bottom teeth. I'm anxious to get the braces off and put all of this behind me.

I'm eating more, soft steamed vegies, really soft fish, mahtzo balls. But its not going so well with the chewing so I still tend to stick to really soft things or mushy soups. My teeth don't really know where to settle. Still holding steady at the 5 pound loss. Everthing I see on TV looks good, even the McRibs!

I am still using the torture device and am almost at the 4 point mark.

I still look like a chipmunk.

Monday, November 20, 2006

Out, Damn Appliance, Out!

I'm kind of at my wit's end with my appliance which is apparently wired onto my bottom of my mouth. It's really cutting into my gums. Called my surgeon and he said I can come in Monday to have it removed. Next Monday! I was hoping sooner but apparently my complaints of all the pain elicited no sympathy. I'm tired and hungry and I want it out, out, out. I don't even care that I can't eat a nice Thanksgiving dinner. I just want the pain to end. Oh, and feeling in my bottom lip and chin would be nice too!

Okay, I think that's the end of my tantrum!

Saturday, November 11, 2006

17 Days Post Surgery

I'm still completely numb in my lower lip and chin and also still swollen, a little more on the left than right. It feels really weird not being able to feel my lower lip when I drink--like its not there, kind of creepy. I'm not drinking as much because of it. When I eat, I have to wipe with each spoonful just to make sure I'm not dribling on myself.

I also still have mouth pain at various times in different locations. Sometimes I'll have a surge of pain in a certain part of my mouth like its coming back to life but it usually doesn't last long. And the one persistent feeling is the burning in my lower lip. With my lower jaw moved forward, the braces are rally cutting into my lower lip.

Yesterday my surgeon gave me device to exercise my jaw (the "torture device"). I have to insert the device, widen my mouth/jaw until it hurts, leave it there for a stretch and then relax. He wants me to do this 20 times about 12 times a day! Ouch, after doing it last night I had got a pretty bad headache and went to bed early. But I don't get to pass "go" until I get to a range of 40 mm and right now I'm barely at 10 mm.

Speaking of mm's, I learned yesterday that my advancement was a total of 11 mms; my jaw was moved forward 5 mms and my chin 6. My surgeon is very happy with my profile.

I went back to work mid-week which was two weeks from my surgery date. Interesting reactions from co-workers. Some really saw a difference. Some didn't. The hardest part about returning to work was talking. It really hurts with all the mouth pain, lip burning and rubber bands, to talk. And I do a fair amount of talking at work. My energy level is slowly getting better but still not really up to par. Because of the face swelling, I still have to wait a few more weeks to return to yoga. The only exercise I'm getting is walking a half hour in the mornings. And as of today, I have lost about 5 pounds since the surgery. (Jeff has lost 6!)

I had my third manual lymphatic draining (MLD) treatment yesterday. I highly recommend it. Its relaxing and seems to really be helping with the swelling. Last night I also got an amazing foot reflexology treatment. If you live in the Southern California area, I highly recommend my therapist, Cynthia Bartholmey (listed on Dr. Vodder's website). She definitely has the healing touch. She's located in the Beverly Hills/West Hollywood area, 323.240.9048.

Tuesday, November 07, 2006

The Gory Details

Wow, I can't believe two weeks have already passed since my surgery. They seem like lost weeks. My surgery for bilateral sagittal split ramus osteotomies with mandibular advancement and genioplasty was scheduled for 10/25/2006 at 8:30 am. We arrived at Santa Monica UCLA Hospital at 6:30 am. Everything went smoothly and I was in a hospital gown, cap and booties in no time. The blankets were warmed which had a calming effect. The nurses were really nice, the anesthesiologist looked like he just graduated from high school. My surgeon, Dr. K, showed up around 7:30 and so did my dentist who wanted to make sure that my bite was put in the right place. They wheeled me in sometime around 8:00 am or so. I had a conversation with the anethesiologist about using benzodiazepines because of my history with them but in the end, I opted for being calmed down. I don't remember much after they transferred me to the OR table.

My surgery lasted 4 and a half hours. I remember waking up and Dr. K telling me it was all over and I was doing fine. I was a bit woozy but otherwise felt fine, no pain, no weepiness. I came in and out of conciousness in the recovery room and remember thinking, thank god its over! When I first woke from the anesthesia I thought it was really funny and kind of odd that my legs were sort of buzzing and vibrating. It took me a while to realize that they had put some sort of leg-gloves on both my legs that were hooked up to a machine that massaged my legs to keep the blood flowing. Finally around 3:00 pm they wheeled me into a room. I remember being wheeled down the hallway and into an elevator and not caring too much if anyone saw me.

I remember waking up again and Jeff was sitting in a chair. I asked him how long he had been there and he said 5 minutes. My concept of time was warped. Other than my face feeling really big, espcially my lower lip, I don't remember feeling too bad. Until about 7:00 pm just as my surgeon came to see me. I was really thirsty and I had been chewing on ice chips and drinking small amounts of water. Then the nausea hit me and I started vomiting blood. Dr. K said that it was blood that I swallowed during he surgery. He said tried to suck it out but I became concious too soon after the procedure. So I threw up a couple of times and then I felt fine. I received wet oxygen and ice packs on for my cheeks and went back to sleep.

I did not use the pain pump, I didn't need it. Jeff left and I went in and out of sleep during the night. It certainly wasn't easy getting out of bed those first hours. Everytime I had to go to the bathroom, I had to ask for assistance. It was a production to take off the leg equipment and to unplug the IV. And I was completely mortified at how I looked. My face was swollen and my lower lip was huge. I couldn't imagine that I would ever look normal again. Thank goodness Jeff was there to assure me it would be okay. I could not have made it through this without him.

The next morning I turned on the TV. I was really tired since the aids woke me every half hour to take my vitals. The breaking story was the Esperanza fire. It was really terrible news and I watched it continue on throughout the day. Four firefighters (later 5) lost their lives.

During the day developed a fever. Nurse Barbara told me I had to sit up, take deep breaths and cough, that the fever was an indication of infection in my lungs. Another small complication was that my blood pressure, which is normally low, was really low. One aid was particularly concerned and he ended up raising my legs to improve my blood pressure. When Dr. K came to see me that day, he said I would be released the next day. Which meant a second night in the hospital.

That night my lower lip really started to burn. That was pretty much the only pain I had. What I really minded more was the numbness. And that I could barely brush my teeth as I had rubberbands on my eyeteeth. I had a big bandage across my face and so it was hard to wash my face as well. And one thing is for sure -- I really do not like being in a hospital. But the nurses assistants were the best! The food on the other hand was really pretty bad. It didn't dawn on me what my diet would be like until brakfast showed up. Clear broth and apple juice!

When I got home, Jeff started cooking up a storm of soups and I spent a lot of time on the sofa sleeping. By then my mouth started waking up and I started having a lot of pain. I didn't mind it because I knew it was an indication that I was beginning to heal. But I didn't expect to be so tired. Even today at Day 13 I am still feeling tired. Here's another picture of me during my recovery process.

Chef Jeff

Thought I would share the recipes for the blended soups Jeff has been making for me. My favorite is the cauliflower soup and I definitely recommend adding nutmeg.

Roasted Butternut Squash Soup

2 butternut squash
3-4 cloves of garlic, crushed or minced
Olive oil
Olive oil spray

Preheat oven to 425. Take 2 butternut squashes, cut off the two ends, and cut each in half lengthwise. Put on a baking sheet covered with foil. Spray with olive oil spray and sprinkle with a dash of salt and pepper. Roast in the oven for about 45 minutes. Remove and allow to cool until they’re cool enough to handle. Remove the peel from the cooked squash and put the squash meat aside.

Heat a large pot and then add a small amount of olive oil. Saute a few cloves of crushed garlic (3 or 4) a few minutes – making sure not to burn. Add the cooked squash – cut into chunks - and enough water to cover. Heat until the water comes to a slow boil and then simmer on low for about 15 minutes. Use an immersion blender or add the mixture in parts to a regular blender and blend until smooth. Add salt and ground nutmeg (preferably freshly ground) to taste.

Potato Leek Soup

2 large leeks
5-6 russet potatoes
Olive oil
Salt & Pepper

Prep the vegetables first and set aside in separate containers: Cut the base and the leafy green section off of the leeks, rinse, and make sure they’re very well dried. Cut lengthwise and then again to quarter each leek. Cut into small pieces about a quarter inch wide. Peel the potatoes and cube into approximately half inch cubes.

Heat a large pot and then add a small amount of olive oil. Add the leeks and sauté until soft being careful not to burn. Add the potatoes and immediately cover with water. Add some of the salt and pepper, though less than you think you need (it is easy to add more at the end but impossible to remove if you add too much early on). Bring to a slow boil and then reduce heat and simmer for about an hour until the potatoes are falling apart.

Use an immersion blender or add the mixture in parts to a regular blender and blend until smooth. Add salt and pepper to taste.

Optionally add a small amount of cream and blend in to make a richer soup.

Cauliflower Soup

1 small yellow or white onion
2 russet potatoes
2-3 large stalks celery
1 head cauliflower
2-3 cloves garlic, crushed or minced
Olive oil

Prep the vegetables first and set aside in separate containers: Dice the onion and celery and store together. Peel the potatoes and cube into approximately half inch cubes. Clean the cauliflower, remove all green stems and leaves, and break into roughly one inch pieces.

Heat a large pot and then add a small amount of olive oil. Add the onion and celery and sauté until soft and the onions are starting to get clear. Add the crushed garlic and sauté another couple of minutes, making sure not to burn anything. Add the cauliflower and potatoes and enough water to cover. Add some of the salt, though less than you think you need (it is easy to add more at the end but impossible to remove if you add too much early on). Bring to a slow boil and then reduce heat, simmering for about an hour or until both the potatoes and the cauliflower and almost falling apart.

Use an immersion blender or add the mixture in parts to a regular blender and blend until smooth. Add salt to taste.

Optionally, add some freshly ground nutmeg to taste.

Vegetable Soup

4 large carrots
4 large or 6-7 small yellow star squash
4 green zucchini squash
2-3 russet potatoes
3 large parsnips
1 medium onion
3-4 large stalks celery
4-5 cloves garlic, crushed or minced
¼ - ½ red bell pepper
Olive oil
Salt & Pepper

Prep the vegetables first and set aside in separate containers: dice the onion, celery, carrots, parsnips, potatoes (peeled), and red bell pepper. Trim the ends and peel the green squash. Cut lengthwise and then again into quarters then cut into ½” wide slices. Trim the ends from the yellow squash and cut into pieces about a half inch square.

Heat a large pot and then add a small amount of olive oil. Add the onion, celery, carrots, and red bell pepper and sauté until soft and the onion is starting to get clear. Add the crushed garlic and sauté another minute or two, making sure not to burn anything. Add the squash (both) and sauté another several minutes until the squash starts to warm up and get slightly soft on the outside. Stir often to allow even cooking. Add more olive oil if necessary.

Add the remaining vegetables and add enough water to cover. Add some of the salt and pepper, though less than you think you need (it is easy to add more at the end but impossible to remove if you add too much early on). Bring to a slow boil and then reduce heat. Simmer for roughly an hour until the potatoes are starting to fall apart and all the other vegetables are very soft and will almost fall apart with a fork.

Use an immersion blender or add the mixture in parts to a regular blender and blend until smooth. Add salt and pepper to taste.

Optionally, you may replace the squash with equivalents, including yellow baby squash, yellow crookneck squash, etc. You may also add other vegetables. For a slightly milder soup, you may leave out the red bell pepper or add more for a spicier soup.

Monday, November 06, 2006

Holloween -- Oh What A Face

So this is what I looked like on Holloween (Day 6). I didn't need a mask to scare anyone. Right around this time I was beginning to accept that it would take much longer to heal than I had expected (since I did no research beforehand). In particular, I realized that I could not wish away the burning feeling of my lower lip, that I would have to get used to it and that it could take weeks or months to go away. I hate the numbness in my chin!

My mouth started to wake up and everything hurt, my teeth, the insides of my cheeks which are pretty chewed up, and my gums where the appliance in my lower mouth is pushing against the gums and under my tongue. I had panick attacks several nights in a row, probably rebound effect from the benzodiazepines they gave me to calm me down before the surgery leaving my system. For the panic attacks I drank calm tea with raw organic honey, very calming. For pain I have been taking tylenol since the 1 darvocet I took made me feel sick. Even in the hospital after the surgery I opted not to use the pain pump as I am very sensitive to those types of medications.

Sunday, November 05, 2006

How I Got Here (or The Orthodontist Who Did This To Me)

(My fiancee Jeff and me x-mas 04.)

I was minding my own business a few years ago when my dentist told me that he would not be able to move forward on costmetic crowns on my top front teeth because I had an overbite and would need braces! At the age of 46 this came as a complete surprise to me. So off I went to see the orthodontist. This guy was just going to slap some braces on me even though my case was "difficult". He did not even have my x-rays on the day of the consult. So a friend sent me to her orthodontist, Dr. A (the man who "did this to me"), who spent quite some time measuring and then sent me off for more x-rays and pictures. Needless to say, I also found a new dentist.

I was stunned on the day I sat in Dr. A's office and he told me that I would need more than braces, that I would need orthognathic surgery, something I had never even heard of. I wanted to cry, I was really upset. But after it began to sink in and I began to look more closely at myself in the mirror, I could see what Dr. A saw -- that my chin was small and that my bite was off. Not by much but enough to have been the source of many of my dental problems over the years such as having lost many lower molars at an early age. But why had nobody ever told me!

I got my braces put on and then spent about a year trying to get my insurance company to approve the procedure. In the end, I was granted an exception and the surgery date was put on the calendar. Yikes! Now that I had fought so hard to have the surgery, I was petrified. Did I really want to go through with it? Well, my dentist told me that I really had no choice, that if I didn't want to lose more teeth and bone it was really my only option.

Now that the surgery is over, I have implants to look forward to. And that will require more surgery for bone grafts and then the implants!

Saturday, November 04, 2006

Thank You!

I would like to express my graditude to those who have shared your orthognathic experience. When I came home from the hospital 2 nights after my surgery (lower jaw advancement on 10/25/06), I was very thankful for the stories, blogs, pictures, etc. I found on this blog and other places. They helped take my mind off of my ordeal.

My surgeon told me my recovery would be 10 days and the only person who I spoke to regarding her experience before my surgery was a woman who went back to work after 6. She basically painted a rosy picture of the ordeal. While I appreciated that she put me at ease and I know she was well-intentioned, I was ill prepared for how awful I would feel and look. And how awful I would feel about the way I look. So when I found pictures of others and saw how swollen they were and how much better they looked only a few days later, I was greatly relieved!

The top picture is me 3 days after the surgery and this one is how I look today. I still have swelling on my chin and jaw; my chin is still completely numb and my lip feels like its on fire all the time. My fiancee has beent taking really good care of me, making sure I am eating and drinking enough so that I haven't even lost a pound although I am only eating soups and protein drinks. My surgeon says that I'm coming along quite nicely. Yesterday I had a manual lymphatic message (something I read somewhere as being recommended). I'm beginning to feel like a human being again.