I Love Plates & Screws!!

Well due to the wonderful work of my OS I had my splint removed on Tuesday!! I really didn't think he was going to take it out this week, so I got a wonderful surprise. He said I was fitting into my new bite perfectly, so there was no need for the splint!! First thing once he removed it...I brushed my teeth. It was the most wonderful experience!! I won't even go into what the splint had stuck to it after two weeks. :)
I will still be in rubber bands for now..but only for 16 hours a day. So recovery for me at this point is much better. After my OS got the chance to look at everything, I finally got to take a look at my new bite. My right side(first set of photos) fits together perfectly! I about cried when I saw how wonderful my bite looked...I am actually on the road to having a normal smile! My left side has quite a bit more work that needs to be done. My OS and OD wanted there to be room for my upper molars to be able to come down. So the big black abyss in the back of my teeth(second group of photos) is there so the teeth have room to move down into. Apparently my "Old Bite" didn't allow those teeth to come down as far as what was needed. Obviously my open bite was closed. There is a small amount of space, again on the left side, but that tooth will come down also. So I am imagining once all this moving down business occurs...both sides will look equally as good! I can't wait for that day!! I still have some swelling in my face, so my profile pic is not quite what it will really look like. But I think it looks great.
I have to say I am extremely pleased with how everything looks at this point. I know that every bit of swelling and pain is worth a functional and beautiful smile.

Interesting Little Bit of Info

I went to see my OS yesterday, nothing exciting he thought everything looked great. Everyone in the office thinks I'm healing wonderfully! Apparently I am healing at a very fast rate....so I guess that is great news! I'm sure my age and good health has a lot to do with it.
Some other interesting stuff. I spoke to him about the numbness in my face...and thought I would share what I learned. The reason it takes so long to get feeling back in your face is this. When a nerve is severed, if not reattached immediately (within an hour or so) the nerve will die. At that point the nerve slowly dies off, imagine how roses slowly wither away. In about the third to fourth week, the stub were the nerve was severed begins to try to make signal to the old nerve. This is what causes the itchy pin and needles tingly sensation. The remaining nerves then acts like an octopus; it send signals to other nerves in the area, once a signal is made the nerve bud begins growing towards the nerve pathway. My OS explained it like this...The old nerves that died are like a hot dog. The inside dies away, but the outer bun stays in tact. The nerve then reaches through the path of the hot dog bun. The average growth of nerve is 1/2 mm a day. So depending were the nerve is cut...you can expect that there is about 25-50 mm of growth around the jaw that has to be regenerated before feeling comes back to the face. So for myself, I have a very long face...so I can assume based on this fact that including the 3-4 weeks it takes for the nerve to die, and the nerve regeneration to grow...I'm looking at a minimum of four months based on 50 mm of growth.
Another note on this subject. We have all mentioned that after surgery our faces don't register sensations quite the same way as before surgery. This is due to the way the nerve regrows. Sometimes as the nerve regenerates it isn't able to stay on the same path (inside of the hot dog bun), it will sometimes wrap around the bun or make various twists and turns. This changes the way the nerves sense various sensations on the skin. He gave me an interesting example of this. (try it...I think it is cool) The skin reacts differently to sensations. Such as if a mosquito bites you, you instinctively slap your skin. In most cases you miss completely unless the mosquito is within your eyesight. However, if a bee lands on your skin and begins walking along your body, you know exactly where it is. Thus you smack it, usually causing yourself to get stung. Easy way to try this out. Have someone use a toothpick to poke lightly on your neck ( have your eyes closed) your nerves will not create a sensation at that exact place...rather a general location. Then have someone lightly move the toothpick across the skin (without picking it up). Your nerves will sense this allowing you to feel the exact location. I know not everyone is numb in the face from surgery right now...but when you are this is very cool. I poke myself constantly to see if I am regaining feeling. (of course I'm not) I can never feel the pokes...however my OS in the office did the whole poking thing, which I didn't feel. BUT..when he lightly rubbed his finger across my chin (which is very numb) I was able to have slight feeling there. I thought it was very cool. He then went to explain that some patients after jaw surgery have problems with nerve reception confusing sensation. Some patients register that when something pokes them, it feels like wind across their face. Or vice-versa. This is due to the nerve regenerating irregularly; such as twists or growing "around the bun".
I find knowing why and how everything heals very interesting...and I know that everyone in our group feels the same. So I thought I would share that tid bit of info.

I also got the measurements for the movements made on my jaw.
Maxilla:
-2 1/2 mm forward
-back of maxilla up 2 mm, front up 1 mm ( this was done at slight
angle to close my open bite)
- 1/2 mm to the left
Mandible:
4-5 mm forward
1 mm over Left

Oh Happy Day Now!

Well life is going great for my recovery. I saw my OD today and he seemed ecstatic about my surgery!! That was great news. I got my appointment time a bit confused, so I ended up being an hour late. So...due to my discrepancy I get to keep the surgical hooks on another two weeks. :( I will survive I'm sure.
My swelling is going down considerably, however the numb feeling isn't going anywhere. So I still have that weird "my upper lip doesn't move when I talk" look.
My only complaint is sleep. I can't sleep for anything. I toss and turn all night. I am taking the meds my doc gave me for sleeping, but it doesn't help at all. I'm thinking b/c my activity level has decreased so much, that maybe I just don't require as much sleep?? But then again, my body has to be working overtime to try to get my mouth back in working order. Any advice on getting some shut-eye would be great!!
Well here are some photos to show my progress and healing. Now let's just hope for a little feeling to start coming back!

Post Op Day 8

Well it is a beautiful sunny Saturday in Florida! I just got back from dropping my Mommy at the airport, and decided I had to include a few funny pics from last night. For my Mom's last night I decided to order pizza from the greatest pizza joint around. Of course I knew I wouldn't really be able to enjoy it...but she definitely deserved a treat. Well to my surprise the Magic Bullet saved the day...I was actually able to enjoy pizza!!! It wasn't quite the same as sinking your teeth into it, but wonderful compared to bland soup!

So that made my evening to say the least!
I had a very hard time sleeping the last two nights. For some reason once I lie down I get a terrible pain in my upper left jaw joint (tmj area) I am still sleeping at an angle. But with this new pain I have found the only way I can eventually fall asleep is if I am completely up-right. My OS prescribed very low doses of Elavil for me, a anti-depressant, used to help relax my muscles and aide me to sleep. They haven't been helping at all. I take them, and am falling asleep on the couch, make my way to the bed...and surprise surprise I can't go to sleep for a hour. If anyone has any advice for that I would love it! I just can't get comfortable, and my TMJ joint area just throbs.
Other than that things are going 100% better!! I am only taking Motrin every four hours, just to help with swelling and inflammation. I am feeling almost back to normal. I still am on a full fluid diet, and have a bit of swelling. But the past two days have been a tremendous step forward! My lower face (from my eye lashes down) is still very numb. I am hoping I will begin having some sensation later in the week. I have an appointment w/ my OS and OD this week. I am hoping to have my surgical hooks removed. They just collect mush like no other. So it will be a bit of a relief to have a little less metal in my mouth. I still think the surgeon will keep the splint in for a week or two. But as long as I'm out of the terrible pain, I can bear the annoying POS. Well since I am feeling better I thought I would share one of my more humorous...yes "I am feeling better" photos. I will keep the photos and recovery success news coming!

Jaw Surgery Necessities

I know that there are a few fellow ortho folks that are out there that are getting ready to go threw this whole ordeal. I have though of some things that will make recovery more bearable. So here goes:

Food
Ice Cream
Yogurt
Soup (homemade chicken noodle is great)
fruit & veggies (or a pre-made fruit and vegetable replacement--GNC has a product called Maximum Greens Complete)
Ensure or similar product
Protein Supplements (used for making shakes)

Helpful Items
Bullet Blender- the blender can be ordered online, it is a super efficient blender that makes single servings. The blender comes with six separate cups so you can make several items at the same time. With this produce there is really no food you can't eat. I had pizza and enchiladas!
Syringe- works great for getting food in between the small opening in your teeth that you can manage the first week post-op. This is a HUGE HELP!
Catheter- My first three days I wasn't able to feed myself. My mom used a catheter to put in the back of my mouth so I could get food in my system. This works extremely well! ( a feeding tube will also work, this can be prescribed by a physician)
A Support System- It is very important to have people around you that care and love you. It is very discouraging to deal with the emotions of not being able to take care of yourself at first. With double jaw surgery you need to be prepared that you will not be self sufficient. I honestly should have a bib on when I eat. I am so numb that I am unable to detect the food that is running down my face and shirt.

Thanks to everyone that sent flowers, goodies, and warm wishes! This has been a real help when recovery gets me down. Hopefully I will be able to start posting daily w/ updates. I still have at least a week off of work...so I am hoping each day brings more recovery! Thanks again to everyone that has been cheering me on. It really helps a lot!

I Am Alive

Well after much debate I have come to the conclusion that I will survive this! I went in to this surgery w/ a very positive outlook, but mostly a nieve one. I knew it would be tough. But I really under estimated the pain and swelling. It is day seven post-op, and my first day off of narqotics. My swelling is getting better and better as I go, but it has been a lot of hard work for my Mother. I have ran the full gammet of pain killers...Loritab, Percocet, Vicadin, and on top of that I have used 9 injections of Dermerol to control the pain.
When I checked out of the hospital on Saturday...I knew that my worst day would be Saturday or Sunday. I surrvived both those days, due to my mother's expert care. But my Mom (she has been a RN for over 20 years) felt that considering the surgery my pain and swelling was not under control. I went to see my OS for an emergency appointment on Monday. I was doing okay at first, but about 5-10 minutes into seeing the doctor my pain become unbearable. Due to the significant swelling in my throat my OS put me in a jaw bra. That topped me off and sent me into a blunder of pain. I spent the next hour in the hospitals starring into space w/ tears running down my face. I was unable to walk, move, or even notice that everyone in the waiting area of the pharmacy was starring at me w/ sypmathy. Tuesday was quite a bit better, then Wednesday and Thursday I slowly began to draw back on my dosages of pain killers. Now I am only taking the motrin.
Yesturday I saw my OS for my first follow-up appoitnment. I begged him to take the splint out. He said it depended on how things look. He took one glance and said "nope, your keeping the splint in for another week to two weeks". And on top of that he put rubberbands on me. I thought I was going to die of pain when he placed the bands. But within an hour and a dose of vicadin it was tolerable. I am now much more comfortable w/ the bands. It feels much more stable having my mouth banded in place rather than just dangling.
Today is the first day that I really feel like I am begining to stabalize. So I guess the timing is good, b/c my Mom will be leaving tomorrow. For future jaw surgery paitents...I highly recommend having someone for the first full week there for 24/hr support. I would have ended up in the hospital again if I didn't have my Mom to help out.
Now for the exciting part....my expereince by photos!

Days 2-4

I am still very tired and in quite a bit of pain. My pain reached a plateau yesterday around 1 o'clock. I just so happened to be at an appointment w/ my OS b/c my Mother and I were concerned about my breathing. My swelling was enlarging around my neck making it difficult to breath. He ended up getting a wrap that would hold my jaw in place and help compress the swelling. I have to say it was one of the most excruciating things I have ever experienced. I ended up spending the rest of my time in a chair w/ tears rolling down my face.
Today has been much better pain wise. Today is the first day that I have gotten off Demerol shots in between Percocet and Loritab. So that is very comforting. I am hoping the hard part is over! For know I am just going to post pictures. Once I'm feeling better I will share more about my recovery.

Surgery Day

Surgery Day--Checking In


Bite--and chin angle before


Profile

Surgery day for me went fairly smooth. There was one patient before me, so I didn't have to wake up quite so early. Once I arrived they put me in my surgery gear, and started prepping. My biggest fear about surgery is always the I.V., Friday must have been my lucky day b/c they got it in on the first try. My official surgery time was from 1005 - 325. Once I woke up, I was send upstairs to my room farily quickly. Since I am allergic to morphine, I was started on a Demerol drip. I tried to use the pump as little as possible, thinking if I used it up it would all be gone. I found out two minutes prior to my IV being taken out that I could have had about 3 tubes of the stuff. Once I was able to wake up a bit more...I begged and pleaded to have my catheder taken out. Those things are really uncomfortable! Once that was removed, I had 4-6 hours to urinate....or it was back to the catheder for me. Thank God I was able to pee 15 minutes before I passed the deadline.
My over night stay was pretty uneventful. I threw up about four times...it was pure blood. Apparently a lot of blood hits the stomach during the procedure. Once I got that out of my system I was able to keep the pain under control.

While in the hospital I was on pain killers and a steroid to help with the swelling. Overall surgery day was fairly easy for me.