picture progression: from braces to jaw surgery

I guess I should take a step back here and share some pictures of the journey my mouth has been on in the last year.

My dental fiasco didn’t start last October, actually. It started when I was 11 and I was told I needed braces. I got an expander (and then another) at 13 and braces on at 14. I got them off the summer before I turned 17, open bite and all. I made the terrible decision at 26 to stop wearing my retainers and see what happened and BAD THINGS HAPPENED. I jammed my top retainer back on, but it was never to fit very well again. The bottom was a lost cause. So that’s where these pictures are starting out, from day 1 of getting braces for the second time on October 21st, 2015, until right before the mandibular osteotomy/genioplasty in September of 2016.

Day 1, October 21st, 2015

These pictures are in time-order. I would take pictures every time I had an orthodontist appointment (every 4-12 weeks). In these four pictures I had bite turbos on my back molars in order to allow my cross bite to be corrected with elastics. This was not a good time for talking or eating.

Bite turbos out, yay! Things are coming together. These were my last four appointments before surgery, and with the Damon system of braces (which I have) your wires get thicker and thicker which each appointment, so my mouth was getting its shit together fast. During the time the last two pictures were taken was the first time I could touch my front top teeth to my front bottom teeth in 16 years. That really was a special moment and a huge relief.

My previous couple posts depict the uglier side of recovery, so here’s one taken on day 16 post-surgery to shine a little ray of hope into all this metal and misery. I can only mean mug right now and pretend like I’m trying to be sexy because of this goddamn occlusal splint, bane of my being, torturer of my soul. I get it taken out in two hours, giddy-up!

12

Green bruises and all.

12 days post-op

Have I mentioned how annoying this splint is? It’s like a retainer times 10 and makes it difficult to speak and eat. I negotiated with my surgeon when I last saw him on Monday to take my splint out a week and a half early, and he conceded, so that’s something to look forward to. I feel bad for anyone who has to have this thing in for the whole six weeks.

I thought I’d upload some pictures commemorating my first non-doctor’s appointment outing since surgery. I went out to a bar to play trivia with my boyfriend, and drove my car for the first time since surgery too. My mouth is open because because it’s still difficult and awkward-looking to close it fully because of the splint. Don’t be fooled by my mad makeup skillz–I still have green and purple bruises along the sides of my face and neck.

 

I stopped taking hydrocodone this week and my mind feels so much clearer. I have more intense jaw owies and twinges, but nothing so bad I wish I was back on narcotics. I’m still sleeping a lot, but have been trying to get out in the sun at least a little bit every day.

Tonight I was feeling really sick of cold protein shakes for dinner, so I bought some broccoli cheddar soup and orzo pasta. I combined them to make the soup a little bit more substantial, and have been swallowing the mixture whole, and it’s making my night. This is way better than when I tried to put macaroni and cheese in the blender (pretty gross, but I did it twice out of desperation). I have a feeling my surgeon’s going to find some icky pickles when he removes this splint next week.

Other than that, I’m still swollen, though a lot of that has dissipated. I’m still not chewing, though I have nightmares that I catch myself doing it on accident. The left side of my jaw and chin hurt a little where the screws are, and I’m also gaining feeling back faster on that side. My bottom lip down to where my neck starts (plus some cheek out to each side) is all still completely numb. I’m still scared to look at my stitches or explore too much in my mouth. I’m still sleeping with my  head elevated and putting hot compresses on my face to help get rid of the bruising. I still drool and have food on my face unbeknownst to me. It still kind of hurts to yawn or cough. But time is passing, and I feel so relieved to be through the worst of it.

9 days post-op, featuring The Bruise

I’d like to introduce my new friend, The Bruise. All the black and blue bruising I initially had in my face has now migrated down my neck, mainly on my left side. It’s turned into an enormous green bruise, not unlike what it might look like if someone tried to strangle me. My boyfriend and I feel aware of it going out in public, knowing it’s clearly visible and wondering if people suspect him, rather than the surgeon, of being the culpable party.

 

Left: The Bruise. The picture on the right was taken on day eight post-op. That’s my attempt at a close-lipped smile. I still have some work to do. But my swelling is going down.

There have been some surprising aspects of my recovery that I hadn’t expected. I have experienced close to no nausea, despite being prone to it in life in general. I think the Scop patch must be a miracle-worker. Either that or I’ve been taking aspirin under the guise of hydrocodone this whole time.

I’ve also been surprised by how much I can open my mouth. I could open it immediately after surgery because I wasn’t wired or rubberbanded shut, and the amount I can open it has been increasing as time passes. I don’t do any special jaw exercises or anything, but I can eat things (poorly) with a spoon now and easily drink out of a cup, so no more of that pathetic-looking syringe eating.

Another thing is how I can feel both aware and confused, lovely side effects of hydrocodone. I feel completely there mentally  when I’m watching Netflix, talking to my boyfriend, or texting someone, but I find myself forgetting a lot of things too. Did I tell him that or was it a dream? What am I looking for again? What was I excited to have for dinner? Why did I come back into the house? Have I listened to this part of the podcast already? It’s an early taste of senility.

Related to that, I haven’t read yet. Being an avid reader, I stockpiled books on my fireplace, ready to read for after surgery. But with my mind sort of fuzzy and lazy, I’ve preferred to watch Netflix or listen to podcasts or scary stories. I’ll probably start in on the books once I’m off narcotics.

There are a few other observations I’ve made that I don’t necessarily find surprising. I’m not surprised I tire easily trying to talk. This splint is really killing my vibe in that arena. I also keep biting my cheeks because they’re numb and swollen, so if I swipe my tongue between my molars there are raised teeth marks running along both cheeks like the joker, but inside my mouth rather than outside.

Something negative to pop up since I last wrote is that my pain level has slightly increased. I think it’s because my numb nerves are starting to heal, which is a good thing, but it’s leaving me with more feeling in the surgical sites. The left side has been especially achy, so I’ve been putting a warm compress on it, which only sort of helps.

Another negative is that my bowels are packed with poop that’s going nowhere fast. Side effect of narcotics, again. I went from never having taken a stool softener in my life to eating almost a whole bottle only to produce the most unsatisfying of rabbity turds. Sigh.

On a more serious note, my family and friends have been so caring and supportive during my recovery. I’ve received several care packages, cards, and texts wondering how I’m  doing. I’ve been particularly touched by how selfless my birthmom has been, volunteering to fly out here and help me during and after surgery, and how kind a couple of my coworkers have been, checking up on me, offering to bring me groceries, and suggesting movies to watch, though we’re not especially close. Having people I know simply remember I had surgery and acknowledge that I might be having a hard time goes a long way in keeping my spirits high while I bumble around my apartment alone.

I’ve gotten into the habit of sitting on my second-story porch at around 3am and watching documentaries. The other night I decided to do just that, but to pamper myself a little and use a Korean-style face mask with a cat on it that my boyfriend’s mom had given me. I ended up looking like leatherface.

0921160052

I laughed fucking hard for a sec, then put my icepacks on my face, tied onto my head using a canga (a Brazilian piece of cloth towel thing), Grey Gardens-style. While sitting out there, I thought about how terrified I would be to be walking down the sidewalk back from the club on a Friday night and look up to see THAT silently staring down at me.

 

 

jaw surgery–three days after

I’ve made it to the other side and it feels so good. So much time that used to be clogged with worry over this surgery has now been freed up in my  mind that I don’t even know what to do with the extra energy.

I’ve made little comments  in a journal along the way, hoping to be able to relay some helpful information to those who may be undergoing a similar procedure in the future and are also freaking out. Reading others’ blogs was my number one source of information and comfort in the time leading up to surgery, and no doubt they will continue to help and encourage me in the future.

Day 0 was full of new experiences, since I had never been in a hospital as a patient before (even though I work in one), let alone for surgery. I arrived at 5:30am for surgery at 7:30am. The nurses, anesthesiologist, and doctor were all so comforting and caring as I was being prepped for surgery . I was really grateful for that. I got some great hospital socks out of the ordeal, too.

I tried to keep my mind off of it as best I could; after waiting so long for this much-anticipated surgery, the few minutes before going in felt surreal. Apparently I was supposed to have been given Versed before entering the operating room, but someone messed up somewhere along the line and I was totally cognizant as I was flipped over onto the metal operating table. There were so many people in there, including my doctor with a suspicious-looking toolbox that probably contained horrible things like bone saws and scalpels. The room looked like a morgue, but by the time I was thinking that I was already waking up in recovery, with a tight, itchy layer of Coband wrapped around my head.

My time in the hospital was actually pretty good. I’m sure having a pain pump full of Dilaudid helped. My birthmom stayed with me through surgery and my boyfriend stopped by, and I was able to talk (mostly) intelligibly with both. I had very little pain in my face, but I was exhausted, and I still am. I was able to drink water, apple juice, Ensure, and some cream of wheat through a syringe, also a better experience than I was expecting. It’s slopping and cumbersome, but possible with a little bit of patience. I was numb inside and outside the lower half of my face. I didn’t throw up after surgery, and haven’t really felt nauseated either. The IV in my elbow and splint my surgeon put in my mouth  bothered me more than the surgical sites. Another thing that bothered me was that anytime I’d drink something or try to talk, my mouth bled. I went through a box and a half of Kleenex that day. My throat hurt from being intubated. I’d still say the first day my pain was around a 2.

Items that helped me out in the hospital:

facial wipes

iPod, headphones

phone

Arnica salve for stretched and cracked lips

free-standing mirror to allow the use of two hands while drinking out of syringe

glasses and glasses case

deodorant

face lotion

face mist (mine is bougie and scented, but it could just be a bottle that mists water–very refreshing when you’re feeling hospital icky)

 

I brought some other stuff, including a change of clothes and a notebook, but I didn’t end up using anything other than what I’ve listed.

Day 0

day-0

Come at me, boys.

 

The next day, day 1 after surgery, all of the anesthetic had worn off, so I could feel my tongue and the inside of my mouth again, which is great for eating, but not so great for pain level. My pain went up to a 4 and I had slight nausea. My swelling had increased dramatically.  I got to leave the hospital that day, and it felt so good to take a shower and move around my house unencumbered by an IV pole or pulse oximeter.

I was prescribed Ibuprofen and Hydrocodone for pain, Scop patches and Promethazine for nausea, and steroids and antibiotics for swelling and healing. I got behind on my meds yesterday after sleeping through the alarms I set to take them, and my pain level got to a 5-6. I got better about managing my meds after that, so it’s back down to 3-4. My lower face is mostly just incredibly uncomfortable. The skin on my cheeks and chin is swelled so much it’s shiny, and I have intense bruising around my mouth and on my neck, which is a lovely shade of purplish blue right now.

Day 3

Tomorrow is my first post-op appointment with my surgeon, which should just be a quick check-up. I’m dying to get this splint out, but won’t for another few weeks. It’s a food trap and makes it hard to talk. I think things will vastly improve after that. I can’t imagine going back to work with this thing in my mouth.

I’ve been sleeping a ton since getting home, and I keep dreaming I’m chewing food. Last time it was a hot dog fresh off the grill. The dreams stem not so much from food cravings as from the fear I’ll mess my new face up. I’m not wired or rubberbanded shut, which kind of freaks me out. At this point, I don’t like exploring with my tongue in my mouth very much. It’s like a Martian landscape that used to be Earth, and it will take some getting used to.

 

 

 

 

jaw surgery–before

In two days I will have a Mandibular Bilateral Sagittal Split Osteotomy and Genioplasty Advancement. In other words, jaw surgery. When I originally found out I would need this surgery three years ago, the orthodontist thought I would also have to have my top jaw surgically corrected and possibly segmented into three pieces to widen my bite. Thank God my orthodontist here is a miracle-worker and has resolved my open bite and cross bite without surgical intervention. So the problems I have left are my lower jaw and chin.

HOW: The surgeon will make two diagonal cuts through my jaw on both sides in order to pull it forward 12 millimeters and screw it in place. That may not sound like a lot, but it is when you’re dealing with facial proportions and jaw placement. Secondly, he’ll cut through the tip of my chin and move that forward too, screwing it in place to give my face better proportion after the movement of my lower jaw.

jaw

The places marked in red will be cut and moved.

WHY: I’ve addressed this in previous posts, but I’ve had a cross bite, open bite, and significant overbite since puberty (for about 17 years now). I had two expanders and braces as a high schooler, but none of my bite issues were corrected. At first, just the open bite bothered me, but I was pain-free. As time passed, I started having increased muscle tension and discomfort, especially on the left side of my jaw and down my neck. I also chew farther back on my teeth than I should, meaning my molars are wearing down faster than they should. My open bite and overbite also affect how I speak, giving me a little lisp and making me thrust my jaw forward to enunciate, which is exhausting, especially when I’m teaching linguistics, when accuracy and being able to talk at length is vital.

I’m adding some before pictures to show some of the issues I’ve mentioned and to be able to compare them to after (assuming I make it).

Left to right: the day I got braces for the second time, teeth 10 months later right before surgery, profile from both sides before surgery

Did I mention I’m extremely nervous? Current list of worries:

  1. Being aware but paralyzed during surgery
  2. Throwing up after just getting my jaw broken
  3. Getting a blood clot
  4. Having to wear a splint in my mouth when I go back to work and not being able to talk
  5. Not having my jaw rubberbanded or wired shut, so my freshly-detached jaw is just flying free
  6. Waking up with an incredibly swollen, different face than I went to sleep with
  7. Having to swallow medication immediately after surgery (not a pill swallower to begin with)
  8. falling into a deep depression
  9. crying immediately after surgery and having difficulty breathing

Obviously some of these fears are more justified than others, but in my anxiety-ridden mind, they’re all equally devastating prospects. I picked up a journal I’ve dubbed my jaw journal, and on the front it says “It’s Gonna Be Okay” with inspirational quotes sprinkled throughout the pages. I thought this would be a good, uplifting exercise, focusing on positivity, but I just don’t think I’m cut out for it. Most quotes have my cross-outs or scribbles on them, like “fuck optimists” or “bullshit,” then my own version of uplifting quotes written in place of the originals. For instance,”If we had no winter, the spring would not be so pleasant.” Seeing as I live in Phoenix, I obviously don’t agree with that pithy sentiment. I replaced it with, “It’s the same sort of cold comfort when we look up into a clear sky and see that we are mere specks in the enormous universe. Our actions here on earth contribute, no doubt, to the evolution of civilization, but in such a minor and minuscule way that there is freedom in knowing that what you do doesn’t really matter, can’t matter, in the scheme of things.” That’s from Enchanted Islands by Allison Amend, which you should read, by the way.

So I guess, in a way, my journal idea is working, just not the way this journal intended. I’ve been brainstorming ways to wrap my mind around this, deal with the fear and pain, and with not eating food for six weeks. I think good books, journaling, sunshine, and watching good shows will go a long way. Everyone says watching comedies improves your mood, but I’ve found that watching the most fucked-up things I can find (stories about kidnappings, murders, the deep web, torture, craniofacial surgery way more severe than mine, stalkers etc.) helps me put things in perspective and take my mind off my comparatively-petty problems. Whatever works, right?

So, with my fridge stocked with liquids and my credit card charged with any and all things from Target I thought might make this process more comfortable, away we go.