Entering the long awaited Recovery Stage 4! Through the hard part, I am now by and large recovered. It's hard to believe I've been back at work almost a month, on a liquid diet / soft food for 6 weeks, gone from in bed napping to short walks to tired after a normal day to having a bounce in my step again and energy to tackle whatever the day brings. As of today I am band free and easing into a normal diet.
Today's appointment with Dr Best was thoroughly enjoyable. He checked alignment and bite and agreed it looks great. The incisions have healed well also. I showed him my range of movement, slightly over two finger's width and rigid side to side / front to back. In his words, he worries about everything but my pain and motion will likely continue to improve. We discussed the right joint, which has been painful mornings and evenings. Both joints can be stiff, with sharp pain at various levels. He pulled up my xrays and noticed the bone cavity is slightly irregular, but nothing of concern. During the operation they took great care to adjust the joint exactly right before pinning the jaw in place. I have no pain in the break area, which would indicate cause for concern. The clicking they didn't have an explanation for, I'll wait that out and see.
Opening exercises will continue several times daily placing slight pressure on the molars to increase opening. Also a few lateral stretches, trying to relax. I've found that it's hard to fit in regular intervals during the day, mostly because I am occupied at work or with people. After a period of resting I regress to one finger's width opening, and only after stretches get back up to two. Longer stretches and light massaging of the joint help. At this stage in healing I can be a little more vigorous.
It's hard to feel the movement in some cases with my gums and chin still numb. As of yesterday my lower lip is starting to regain feeling, right on the inside edge. It feels very strange, partly because before it hit my upper teeth and now it contacts my upper lip. Amazing the changes! We spoke about movement and speech progress. Although it's hard for me right now, Dr Best didn't think I needed therapy just more practice and time. He sat with me for awhile, talking through my whole recovery process including diet, ups and downs and overall experience. It was encouraging to hear him praise my speedy recovery and he even requested my meal plan as a tool to share with other patients to improve recovery rates.
Most exciting part of the appointment - he showed me the cranial model developed from my CT Scans. Bone structure of my entire head in 3D, color modeled and capable of spinning to any angle. I could see all the bones and joints, the break, infill and pins. Quite fascinating! I wish I had snapped a photo.
When I left the bands were still out. I asked if that was okay and it was! I can leave them in during the day to provide an extra level of resistance when I talk or stretch to help the muscles recover, but the active stage is past. Unfortunately Dr Good will probably have me in more bands starting next week, so I will make sure to enjoy this week of an empty mouth. Continuing the food progression I can start chewing! Soft foods for short times to avoid straining or tiring the jaw. Pain is expected and should be managed, don't over do it. Lastly, exercise can resume! He said to start jogging on a treadmill to reduce impact, and to take it easy as aerobic exercise could cause throbbing due to increased blood flow. I am so excited to move again, it's been hard to go this long without a good workout.
This was the last in regular post surgery appointments! The remaining are spread out to 3, 6 and 12 months. I have a slight feeling of getting thrown out of the nest, but really I feel back to myself and have no reservations about continuing to progress without check ups. Next week I visit Dr Good to begin active braces, setting in motion the final phase of this ordeal. Within a few months my teeth will move into final position and not only will I have a clear braces free mouth, but the lasting change of a precision bite, white and even teeth, with vastly improved jaw alignment and facial appearance. Can't wait to get there.
Tuesday, August 2, 2016
Saturday, July 23, 2016
4 Week Post-Op
Another big milestone! Dr Bast had already outlined his plan for the appointment so I knew what to expect, which was fortunate because he wasn't there. Apparently double booked with a departmental funding presentation. His chief attending replaced him and it went well so I didn't mind. Big changes were:
Soft food diet! At last I am able to eat solid foods, just no chewing. The only limitation is my range of movement, I can still only open my mouth about a finger's width. This is enough to get in small foods like raspberries and a spoon or chopsticks. I celebrated with a poke bowl for lunch. Oh, so flavorful and yummy. I had a big energy boost that day and felt great.
Jaw Stretches! When the bands came out it felt strange to just be me and my jaw, unrestricted or supported. Opening was smooth and felt fine, just takes some getting used to. Dr walked me through a simple exercise to open and use slight pressure to stretch open further. 10 reps at 10 seconds each, every 2 hours. I, always overoptimistic, suggested increasing to a full four fingers by 6 weeks. He cautioned not to expect too much progress, that I might be back to normal range after 8 weeks.
Best part, he removed the sutures! Both sides had been loose from the start and at this point were getting stuck inside my mouth when I ate, caught when brushing and generally bothersome. It hurt a little and he said to expect a little bleeding when brushing and to continue salt water rinses. I can feel the incisions when I stretch my jaw open, otherwise it I don't notice.
We talked through healing status in more detail. At first a blood clot forms between the jaw segments, that is replaced gradually with scar tissue which is then flushed out or calcified. At the four week mark my jaw is relatively stable. I feel no pain and it doesn't seem to want to regress, the bands remain in place to make sure alignment is held. The joint and muscles are a different story. Gradual stretches, practice and time will continue to recover.
All but a small amount of swelling is gone now, down to scar tissue pockets along the break, and I continue to enjoy my new profile. Numbness hasn't changed in my lower lip and chin. I try to remind myself that people can't tell, but it feels strange talking and eating. I still have to be very careful for food & drink temperature, drips or biting my cheeks.
Speaking has gotten much easier being able to open my mouth a little. I have spent some time practicing in front of the mirror as there is much to re-learn. I expected it would simply happen and the improvement would be noticeable, but that hasn't been my experience. Whether from the muscle atrophy, numbness, bands, or new jaw position it is different and I can feel myself making weird faces or sounding slurred. Once again, I am finding it will take effort and patience to get the results. Slow down and focus on enunciating and using normal movement.
With the hardest part behind - more opening and more eating. Day by day.
Soft food diet! At last I am able to eat solid foods, just no chewing. The only limitation is my range of movement, I can still only open my mouth about a finger's width. This is enough to get in small foods like raspberries and a spoon or chopsticks. I celebrated with a poke bowl for lunch. Oh, so flavorful and yummy. I had a big energy boost that day and felt great.
Jaw Stretches! When the bands came out it felt strange to just be me and my jaw, unrestricted or supported. Opening was smooth and felt fine, just takes some getting used to. Dr walked me through a simple exercise to open and use slight pressure to stretch open further. 10 reps at 10 seconds each, every 2 hours. I, always overoptimistic, suggested increasing to a full four fingers by 6 weeks. He cautioned not to expect too much progress, that I might be back to normal range after 8 weeks.
Best part, he removed the sutures! Both sides had been loose from the start and at this point were getting stuck inside my mouth when I ate, caught when brushing and generally bothersome. It hurt a little and he said to expect a little bleeding when brushing and to continue salt water rinses. I can feel the incisions when I stretch my jaw open, otherwise it I don't notice.
We talked through healing status in more detail. At first a blood clot forms between the jaw segments, that is replaced gradually with scar tissue which is then flushed out or calcified. At the four week mark my jaw is relatively stable. I feel no pain and it doesn't seem to want to regress, the bands remain in place to make sure alignment is held. The joint and muscles are a different story. Gradual stretches, practice and time will continue to recover.
All but a small amount of swelling is gone now, down to scar tissue pockets along the break, and I continue to enjoy my new profile. Numbness hasn't changed in my lower lip and chin. I try to remind myself that people can't tell, but it feels strange talking and eating. I still have to be very careful for food & drink temperature, drips or biting my cheeks.
Speaking has gotten much easier being able to open my mouth a little. I have spent some time practicing in front of the mirror as there is much to re-learn. I expected it would simply happen and the improvement would be noticeable, but that hasn't been my experience. Whether from the muscle atrophy, numbness, bands, or new jaw position it is different and I can feel myself making weird faces or sounding slurred. Once again, I am finding it will take effort and patience to get the results. Slow down and focus on enunciating and using normal movement.
With the hardest part behind - more opening and more eating. Day by day.
Sunday, July 17, 2016
Liquid Diet Recipes
Beef Consomme
1/8 cup chopped onion
3 cups Bone broth
2 egg whites
3 stalks chopped celery
1/4 lb. Ground beef
Yield: (2) 8 oz. servings
Nutrition: 320 calories, 41g protein
Drizzle olive oil into a large saucepan and cook onions over low heat until transluscent and fragrant, 3-5 minutes. Add bone broth and bring to a boil. Meanwhile whisk egg whites in a medium bowl until foamy and add crushed eggshells. Whisk in celery, ground beef and add salt / pepper to taste. When broth reaches a boil carefully add beef mixture and bring back to boil, stirring as needed, 10-20 minutes. Reduce heat and simmer until impurities rise to the top and form a crust, 30 minutes. Carefully remove from heat and pour through a sieve or cheese cloth, letting all liquid drain through. Repeat until clear. Discard solids or retain for chili during Week 4.
Peach Smoothie
8 oz. Peach or Vanilla Greek Yogurt
1/2 Cup Almond Milk
1/2 Banana, sliced into rounds
1 Peach (canned or fresh)
2 tbsp Wheat Germ (optional)
Yield: (1) 8 oz. serving
Nutrition: 430 calories, 19g protein
Mix all ingredients in a blender. Start of puree and increase to liquify.
Add milk or water as needed for the desired consistency.
Acai Smoothie
8 oz. Acai Smoothie Mix (Sambazon)
1/2 cup Almond Milk
1/2 Banana, sliced into rounds
1/4 Cup Frozen berries (optional)
2 tbsp Almond Butter
1 scoop Spirulina powder
Yield: (1) 8 oz. serving
Nutrition: 400 calories, 10g protein
Mix all ingredients in a blender. Start on puree and gradually increase to liquify.
Add milk or apple juice as needed for the desired consistency.
Butternut Squash Soup
1/4 Cup diced onion (white or yellow)
1 Medium Butternut Squash (or 3 cups pre-cut cubes)
1 Apple (Granny Smith), chopped into 1/2" cubes
2 cups Bone Broth
Yield: (2) 8 oz. servings
Nutrition: 125 calories, 13g protein
Peal and cut squash into 1" cubes. Add olive oil to sauce pan on low heat, add onions, stir occasionally until translucent and fragrant, 3-5 minutes. Add squash and apple, season to taste (cloves, nutmeg, cinnamon, pepper). Cook an additional 3-5 minutes, stirring occasionally. Add bone broth to de-glaze and bring to a boil. Reduce heat and gently simmer 15-20 minutes.
Remove from heat, allow to cool slightly. Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency. Serve with a dollop of sour cream or yogurt and collagen powder.
Cauliflower Soup
1/2 head Cauliflower
1 cup Bone Broth
1 cups Vegetable Broth
1 cup Milk
1/2 Cup Grated Parmesan Cheese
Bring bone and vegetable broth to a boil, add cauliflower floretes and simmer gently for 15 minutes. Add milk and parmesan, season to taste (pepper, ground ginger, thyme, cumin) and simmer for another 3-5 minutes.
Remove from heat, allow to cool slightly. Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency.
Tofu Soup
1/8 cup chopped onions
6 Crimini or 4 Shitake Mushrooms, sliced
8 oz. Silken Tofu (1/2 package)
1 cup Coconut Milk
1 cup Soy Milk
1 1/2 tbsp. Green Curry Paste
Heat sesame oil in a medium saucepan, add onions and mushrooms, saute until slightly browned. Add milk and bring to a boil. Add tofu in 1/2" cubes, stir in curry paste, reduce heat and simmer for 5-10 minutes.
Remove from heat, allow to cool slightly. Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency.
Sweet Potato Soup
1/8 cup onion, chopped
2 tbsp. Ginger root, chopped
4 oz. Tomato Sauce
1 medium Sweet Potato, cut into 1/2" cubes
1 lemon grass stalk (optional)
2 Cups Bone Broth
1 Cup Coconut Milk
Heat oven to 400 degrees, lay sweet potato on foil lined pans, drizzle with olive oil. Roast for 20-30 minutes, until tender. Heat olive oil in a large saucepan over medium heat. Add onion and cook until translucent and fragrant, stirring occasionally, 3-5 minutes. Add ginger and cook another 1-2 minutes. Add tomato sauce and broth, bring to a boil. Add sweet potato, reduce heat and simmer until liquid has slightly reduced and vegetables are tender, around 10 minutes. Add coconut milk and cook an additional 5 minutes.
Remove from heat, allow to cool slightly. Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency.
Black Bean Soup
1/8 cup Onion, chopped
1 Red Pepper
1 cup Tomato, chopped (Tip: Use canned tomatoes. Skins will not liquify and are bothersome)
1 can Black Beans
1 cup Bone Broth
1 cup Plain Yogurt
1/2 Lime
Saute onions and pepper over medium heat in a large saucepan. Season to taste (cumin, oregano, black pepper) and cook until translucent, 3-5 minutes. Add tomato, beans and broth. Bring to a boil, reduce heat and simmer for 15 minutes.
Remove from heat, allow to cool slightly. Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency.
Mix in yogurt and lime juice before serving.
Corn and Red Pepper Soup
1/8 cup Onion
2 Celery stalks, chopped
1 medium Carrot, chopped
1 Red Pepper
2 cups Bone Broth
1 cup Coconut Milk
1 Yukon Gold Potato
2 Corn Cobs (Tip: Use Trader Joe's Corn Salsa for extra bite)
Heat olive oil over medium heat in a large saucepan, add onion and cook until translucent, 3-5 minutes. Meanwhile, cut corn off the cob and keep in a prep bowl. Add celery and carrot, season to taste (chilli powder, paprika, corriander, black pepper), cook an additional 2-3 minutes. Remove from heat and keep in a prep bowl. Add broth to pan and bring to a boil, add corn cobs and simmer for 5 minutes. Remove corn cobs. Add potato and simmer for 20 minutes, until tender. Meanwhile, scrape the corn cobs to remove the kernels and extra juice. Hold red pepper over burner on low heat to roast, when skin is blackened allow to cool, then peel and slice into small pieces. When potatoes are cooked - add celery / carrot mixture, corn, corn bits, red pepper and coconut milk, simmer an additional 5 minutes.
Remove from heat, allow to cool slightly. Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency.
Polenta
1 cup Polenta (dry, grit style)
1 cup Bone Broth
1 cup Water
1 cup Milk or Half and Half
1/4 cup Parmesan Cheese
Bring liquids to a boil, add polenta. Season to taste (thyme, black pepper). Simmer for 5 minutes, stirring occasionally. Remove from heat, stir in cheese.
Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency.
1/8 cup chopped onion
3 cups Bone broth
2 egg whites
3 stalks chopped celery
1/4 lb. Ground beef
Yield: (2) 8 oz. servings
Nutrition: 320 calories, 41g protein
Drizzle olive oil into a large saucepan and cook onions over low heat until transluscent and fragrant, 3-5 minutes. Add bone broth and bring to a boil. Meanwhile whisk egg whites in a medium bowl until foamy and add crushed eggshells. Whisk in celery, ground beef and add salt / pepper to taste. When broth reaches a boil carefully add beef mixture and bring back to boil, stirring as needed, 10-20 minutes. Reduce heat and simmer until impurities rise to the top and form a crust, 30 minutes. Carefully remove from heat and pour through a sieve or cheese cloth, letting all liquid drain through. Repeat until clear. Discard solids or retain for chili during Week 4.
Peach Smoothie
8 oz. Peach or Vanilla Greek Yogurt
1/2 Cup Almond Milk
1/2 Banana, sliced into rounds
1 Peach (canned or fresh)
2 tbsp Wheat Germ (optional)
Yield: (1) 8 oz. serving
Nutrition: 430 calories, 19g protein
Mix all ingredients in a blender. Start of puree and increase to liquify.
Add milk or water as needed for the desired consistency.
Acai Smoothie
8 oz. Acai Smoothie Mix (Sambazon)
1/2 cup Almond Milk
1/2 Banana, sliced into rounds
1/4 Cup Frozen berries (optional)
2 tbsp Almond Butter
1 scoop Spirulina powder
Yield: (1) 8 oz. serving
Nutrition: 400 calories, 10g protein
Mix all ingredients in a blender. Start on puree and gradually increase to liquify.
Add milk or apple juice as needed for the desired consistency.
Butternut Squash Soup
1/4 Cup diced onion (white or yellow)
1 Medium Butternut Squash (or 3 cups pre-cut cubes)
1 Apple (Granny Smith), chopped into 1/2" cubes
2 cups Bone Broth
Yield: (2) 8 oz. servings
Nutrition: 125 calories, 13g protein
Peal and cut squash into 1" cubes. Add olive oil to sauce pan on low heat, add onions, stir occasionally until translucent and fragrant, 3-5 minutes. Add squash and apple, season to taste (cloves, nutmeg, cinnamon, pepper). Cook an additional 3-5 minutes, stirring occasionally. Add bone broth to de-glaze and bring to a boil. Reduce heat and gently simmer 15-20 minutes.
Remove from heat, allow to cool slightly. Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency. Serve with a dollop of sour cream or yogurt and collagen powder.
Cauliflower Soup
1/2 head Cauliflower
1 cup Bone Broth
1 cups Vegetable Broth
1 cup Milk
1/2 Cup Grated Parmesan Cheese
Bring bone and vegetable broth to a boil, add cauliflower floretes and simmer gently for 15 minutes. Add milk and parmesan, season to taste (pepper, ground ginger, thyme, cumin) and simmer for another 3-5 minutes.
Remove from heat, allow to cool slightly. Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency.
Tofu Soup
1/8 cup chopped onions
6 Crimini or 4 Shitake Mushrooms, sliced
8 oz. Silken Tofu (1/2 package)
1 cup Coconut Milk
1 cup Soy Milk
1 1/2 tbsp. Green Curry Paste
Heat sesame oil in a medium saucepan, add onions and mushrooms, saute until slightly browned. Add milk and bring to a boil. Add tofu in 1/2" cubes, stir in curry paste, reduce heat and simmer for 5-10 minutes.
Remove from heat, allow to cool slightly. Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency.
Sweet Potato Soup
1/8 cup onion, chopped
2 tbsp. Ginger root, chopped
4 oz. Tomato Sauce
1 medium Sweet Potato, cut into 1/2" cubes
1 lemon grass stalk (optional)
2 Cups Bone Broth
1 Cup Coconut Milk
Heat oven to 400 degrees, lay sweet potato on foil lined pans, drizzle with olive oil. Roast for 20-30 minutes, until tender. Heat olive oil in a large saucepan over medium heat. Add onion and cook until translucent and fragrant, stirring occasionally, 3-5 minutes. Add ginger and cook another 1-2 minutes. Add tomato sauce and broth, bring to a boil. Add sweet potato, reduce heat and simmer until liquid has slightly reduced and vegetables are tender, around 10 minutes. Add coconut milk and cook an additional 5 minutes.
Remove from heat, allow to cool slightly. Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency.
Black Bean Soup
1/8 cup Onion, chopped
1 Red Pepper
1 cup Tomato, chopped (Tip: Use canned tomatoes. Skins will not liquify and are bothersome)
1 can Black Beans
1 cup Bone Broth
1 cup Plain Yogurt
1/2 Lime
Saute onions and pepper over medium heat in a large saucepan. Season to taste (cumin, oregano, black pepper) and cook until translucent, 3-5 minutes. Add tomato, beans and broth. Bring to a boil, reduce heat and simmer for 15 minutes.
Remove from heat, allow to cool slightly. Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency.
Mix in yogurt and lime juice before serving.
Corn and Red Pepper Soup
1/8 cup Onion
2 Celery stalks, chopped
1 medium Carrot, chopped
1 Red Pepper
2 cups Bone Broth
1 cup Coconut Milk
1 Yukon Gold Potato
2 Corn Cobs (Tip: Use Trader Joe's Corn Salsa for extra bite)
Heat olive oil over medium heat in a large saucepan, add onion and cook until translucent, 3-5 minutes. Meanwhile, cut corn off the cob and keep in a prep bowl. Add celery and carrot, season to taste (chilli powder, paprika, corriander, black pepper), cook an additional 2-3 minutes. Remove from heat and keep in a prep bowl. Add broth to pan and bring to a boil, add corn cobs and simmer for 5 minutes. Remove corn cobs. Add potato and simmer for 20 minutes, until tender. Meanwhile, scrape the corn cobs to remove the kernels and extra juice. Hold red pepper over burner on low heat to roast, when skin is blackened allow to cool, then peel and slice into small pieces. When potatoes are cooked - add celery / carrot mixture, corn, corn bits, red pepper and coconut milk, simmer an additional 5 minutes.
Remove from heat, allow to cool slightly. Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency.
Polenta
1 cup Polenta (dry, grit style)
1 cup Bone Broth
1 cup Water
1 cup Milk or Half and Half
1/4 cup Parmesan Cheese
Bring liquids to a boil, add polenta. Season to taste (thyme, black pepper). Simmer for 5 minutes, stirring occasionally. Remove from heat, stir in cheese.
Add in batches to blender (remember that heat combined with energy from the blades will cause the liquid to expand, use caution to not overfill). Start on puree and gradually increase to liquify. Add broth or water as needed for the desired consistency.
Thursday, July 14, 2016
Supplies
Essential Items:
Provided by your Surgeon:
- Aquaphor - Doctor recommended chapstick, better than Vaseline or other brands (Target)
- Quercetin Bromelain - Supplement proven to reduce swelling (Walgreens, Health Stores)
- Collagen Powder - Nature's best protein in tasteless, colorless, odorless form. Mixes well in water, juice or anything you are making and adds 40 calories / 9g protein. (Peaceful Planet)
- Juices, Milk - Liquids are heavy, purchase in advance to avoid difficult shopping trips. I went through (5) 32 oz. milks and who knows how many juices the first three weeks. One less thing to worry about when you're deep in recovery.
- Bone Broth - High protein, low sodium (reducing swelling). This is an excellent mixer for soups and easier than making your own broth. Stock up ahead of time, I went through (4) 32 oz. containers in the first three weeks.
- Child's Liquid Ibuprofen - For syringing / drinking. Take before all follow up appointments.
- Nasal Spray - recommend just in case. I had read horror stories about no being able to breathe until post-op and specifically asked my anesthesiologist to clean me out well. She did, and from the moment I woke up I could breathe way better than I ever could before.
- CVS Inter-dental Brushes - Mini flexible linear brushes to get in between wires and teeth or small places around brackets and bands. Great for quick touch ups on the go.
- Colgate Wisp Brushes - Small round brushes for when you can't open your mouth enough to get a tooth brush inside. Has a pick on the opposite end for dual purpose.
- Hot / Cold Packs with bands - I tried several versions and prefer the bead type as it held the temperature well and conforms well. Make sure the pack is large enough to fit your entire jaw from end to ear. Bands should wrap your head, holding in place comfortably as this is how you will spend your days: 48-72 hours with continuous ice followed by 24-48 hours with 20 min. heat several times a day. (CVS, Walgreens)
- Text to Speech App - No talking, but lots to communicate the first week. Much easier than writing on a whiteboard and you'll already have your phone at hand. Multiple countries have male or female voices, which can be fun to play with.
- Calorie Count App - Records stats for meals, activity, weight, etc. Most foods are already loaded in the searchable database or you can create your own manually or scan a bar code. Makes tracking much easier.
- Scale - Stable body weight is key, track it.
- Blender - Liquid setting handles most foods; I had a mishaps with wheat germ, raspberry seeds, blueberry and tomato skins (hold off until you can open your mouth a little).
- Hand Towels / Bib - Lots of dripping when eating the first few weeks.
- Pillows - Sleep on 2-3 to keep your head elevated and control swelling the first week.
- Books, magazines, movies and TV shows - lots of time to catch up on entertainment or light duty projects you're normally too busy to tackle.
- Before / After Photos - Consultation photos are fine for record, but you'll probably want your own. Smiling, not smiling. Front and sides. Snap away during recovery, it makes progress each day measurable. You'll be amazed in a few weeks looking back!
Provided by your Surgeon:
- Syringes - Take many. I used the 10ml size for everything the first 3 days, then gradually weened off to a cup for liquids, continuing only for medicine. I asked for several large ones just in case, never used them as the 10ml portion was enough at a time.
- Juice Cups - If you stay overnight grab a few on your way out.
- Dixie style Paper Cups - Nice for medicines and small servings of liquids the first few days. You'll go through a lot, disposables make it easy to cycle through.
- Ice Bags and Wrap - The hospital used the ones could work just as well as gel. I was more comfortable using regular hot / cold packs, could go either way.
- Meds - Goes without saying - you will fill many prescriptions the day after to tide through recovery as comfortably as possible.
Menus
Eating with your jaw banded shut is probably the most intimidating and arduous part of recovery. Instructions I received from the hospital nutritionist pretty much said eat lots of ice cream and have whatever everyone else is having, just throw it in the blender. I value my health enough to know that a sugary diet is not smart with or without surgery. Also although I have never been a picky eater I enjoy pairing foods based on texture and complimentary flavors, so blending standard meals is not appetizing at all.
The outline below covers my meal plan for the crucial first two weeks and extending as long as the liquid diet stage which varies from person to person. It is just a start that can be tailored to any preferences or daily urges, really there is endless variety for a delicious and nutritious diet even within the limitations. I still get cravings for favorites like pizza or BBQ, but having a several solid choices available and easily prepared or adapted allowed me to not dwell on that or feel stuck in a difficult or unsatisfying diet. Introducing a new food each day in the beginning gave me something to look forward to and created incentive for light activity preparing and the reward of enjoying the meals. More on that in my posts and recipes posted separately. Happy sipping!
Day 1 - 3: Clear Liquid Diet
(3) 8 oz. Cup Apple, White Grape or Pear juice
(4) 8 oz. Cup Water or Coconut Water (Include 1 scoop Collagen Powder)
(1) 8 oz. Beef consomme
Day 4 - Four Week Post-Op: Blended Diet
8-10am Breakfast:
(1) 8 oz. cups Fruit Juice (All kinds are okay now, consider Prune for added fiber)
(1) 16 oz. Odwalla Protein Shake (Chai, Vanilla Almond or Vanilla)
-OR starting Week 2-
(1) 8 oz. Cream of Wheat with 1 part milk / 1 part water
12-2pm Lunch:
(1) 12 oz. Smoothie
4pm Snack:
(1) 8 oz. Evolution Sweet Greens pressed juice
- OR-
(1) 2 tbsp. Hummus mixed with water
- OR -
(1) 3 oz. Plum Organic Mash Up (from Peet's Coffee; high sugar, good taste, easy on the go)
6-8pm Dinner:
(1) 8 oz. cup of Soup / Puree
(1) 8 oz. cup of Coconut water with Collagen Powder
10pm Snack:
(1) 8 oz. Hot Chocolate (Whole milk, Cocoa Powder and 2 tbsp. Almond Butter)
Week 4 - 6: Soft Foods
Breakfast:
Yogurt
Apple sauce
Chia Pudding
Scrambled Eggs
Hot cereal
Lunch:
Smoothies
Hummus
Avocado
Tuna Salad
Chicken Salad
Taco Salad
Dinner:
Flaky Fish
Chili
Desert:
Creme brulee
Pudding
Soft cookies
The outline below covers my meal plan for the crucial first two weeks and extending as long as the liquid diet stage which varies from person to person. It is just a start that can be tailored to any preferences or daily urges, really there is endless variety for a delicious and nutritious diet even within the limitations. I still get cravings for favorites like pizza or BBQ, but having a several solid choices available and easily prepared or adapted allowed me to not dwell on that or feel stuck in a difficult or unsatisfying diet. Introducing a new food each day in the beginning gave me something to look forward to and created incentive for light activity preparing and the reward of enjoying the meals. More on that in my posts and recipes posted separately. Happy sipping!
Day 1 - 3: Clear Liquid Diet
(3) 8 oz. Cup Apple, White Grape or Pear juice
(4) 8 oz. Cup Water or Coconut Water (Include 1 scoop Collagen Powder)
(1) 8 oz. Beef consomme
- Consider having ginger ale in case of nausea and Snapple teas for more variety.
- Apple juice tastes amazing at all times of day, especially first thing in the morning. It also mixes well in almost any smoothie. You'll want to get several large bottles to tide through recovery.
- I really craved something savory at dinner and found a robust beef consomme hit the spot. Avoid recipes with lemon or tomato as the acid will aggravate the incisions.
- Medications will fill most of your water intake, but monitor to make sure stay well hydrated. Mine consisted of 3x Ibuprofen (swelling) as long as needed (4 days), 3x Amoxicillin (antibacterial) for 10 days, dietary supplement 2x Quercetin Bromelain (swelling) starting two days prior and 1-2 weeks after, and 1-2x Collagen Powder (protein) throughout recovery.
- Hygiene routine includes salt water rinse 2-3x and brushing 1-2x daily. Use a soft pick to clean around the bands and splint.
- Eating a full "meal / meds" took me about an hour during this time and took a lot of concentration with all the swelling, tenderness and numbness. At first I used a 10ml syringe, by Day 3 I was drinking from a regular cup with lots of towels handy for drips.
- Goal is to stay fully hydrated and pack in as many calories / protein as possible.
- If this sounds like a lot - it is! Eating and sleeping will pretty much fill the day.
Day 4 - Four Week Post-Op: Blended Diet
8-10am Breakfast:
(1) 8 oz. cups Fruit Juice (All kinds are okay now, consider Prune for added fiber)
(1) 16 oz. Odwalla Protein Shake (Chai, Vanilla Almond or Vanilla)
-OR starting Week 2-
(1) 8 oz. Cream of Wheat with 1 part milk / 1 part water
12-2pm Lunch:
(1) 12 oz. Smoothie
4pm Snack:
(1) 8 oz. Evolution Sweet Greens pressed juice
- OR-
(1) 2 tbsp. Hummus mixed with water
- OR -
(1) 3 oz. Plum Organic Mash Up (from Peet's Coffee; high sugar, good taste, easy on the go)
6-8pm Dinner:
(1) 8 oz. cup of Soup / Puree
(1) 8 oz. cup of Coconut water with Collagen Powder
10pm Snack:
(1) 8 oz. Hot Chocolate (Whole milk, Cocoa Powder and 2 tbsp. Almond Butter)
- I felt best when eating / drinking every 2 hours, having juice or water in between larger meals.
- Find and meet your daily calorie target, can include breakdown of carbs, protein and calcium. Try to maintain a basic food pyramid for whole nutrition.
- Find and meet your daily protein target (Weight in lbs. x .45 = Protein grams)
Week 4 - 6: Soft Foods
Breakfast:
Yogurt
Apple sauce
Chia Pudding
Scrambled Eggs
Hot cereal
Lunch:
Smoothies
Hummus
Avocado
Tuna Salad
Chicken Salad
Taco Salad
Dinner:
Flaky Fish
Chili
Desert:
Creme brulee
Pudding
Soft cookies
- Continue to expand food options as jaw range increases. No heavy chewing, basically anything you can squish.
- Calorie targets will increase as activity increases.
3 Weeks
Midway through Recovery Stage 3! On Monday (Day 19) I had my first ortho post-op and it was exciting to see everyone with my new face! The appointment went quickly. Really it was all about the visual check to see that everything is in place, no wire change or adjustments. Dr Good is out on maternity leave so I was seen by a stand-in Doctor. Coincidentally he had double jaw surgery several years ago and the assistant is going in for lower jaw surgery in a few weeks! Nice to have that in common, there are so many more cases out there than I was aware of going into this.
The doctor looked over my jaw and teeth and concurred that alignment was good. He thinks the broken tooth will be okay in the end, but I am still skeptical. Will get records from the surgeon and review and wait until final cosmetic repairs to decide how to handle it. Best of all, he was able to cut the top surgical hooks off without removing my wire! Once again, my mouth feels incredibly open. At this point I can't remember what it's like to only have teeth without all the attachments.
Continuing the liquid diet, pretty routine at this point. I've graduated to morning Cream of Wheat and a cup of juice, with smoothies and protein shakes for lunch (portable and easy to drink from), juice snacks if needed for energy boost, and soups for dinner. Swelling persists on my jaw line, slightly hard to the touch. I had light pain on the right joint this morning from sleeping on my side. Pain in my left joint has stopped for the most part. Numbness on my chin remains unchanged, except that I can now feel sensation in the hollow below my lip, the one area that before was entirely numb. Lots of tingling in the evening. Trying not to sneeze or yawn as the stretching is a challenge.
Activity-wise I'm still keeping it light, although not too restricted from normal. Morning yoga (nothing too intense), work (talking and meetings take a lot of energy, both are getting easier by the day), walking around more, blending and activities around the house. Talking has gotten easier, but it still sounds a little garbled on certain sounds or if I get tired or talk too fast. Real food cravings start to set in when I get hungry.
One excitement was a hair cut, long over due I've been so preoccupied with surgery. For the first time I could see myself in a large mirror from other angles and for a long period of time. I remember in the past being uncomfortable looking at myself because my resting face was strange. The difference was subtle, but at the same time dramatic. I am so happy with the way it turned out, so much more relaxed and natural.
Overall I can still notice progress each day in my energy level, ease in eating and residual effects. The closer I get the more I look forward to exercising again, having full feeling in my face and finally the finished product.
The doctor looked over my jaw and teeth and concurred that alignment was good. He thinks the broken tooth will be okay in the end, but I am still skeptical. Will get records from the surgeon and review and wait until final cosmetic repairs to decide how to handle it. Best of all, he was able to cut the top surgical hooks off without removing my wire! Once again, my mouth feels incredibly open. At this point I can't remember what it's like to only have teeth without all the attachments.
Continuing the liquid diet, pretty routine at this point. I've graduated to morning Cream of Wheat and a cup of juice, with smoothies and protein shakes for lunch (portable and easy to drink from), juice snacks if needed for energy boost, and soups for dinner. Swelling persists on my jaw line, slightly hard to the touch. I had light pain on the right joint this morning from sleeping on my side. Pain in my left joint has stopped for the most part. Numbness on my chin remains unchanged, except that I can now feel sensation in the hollow below my lip, the one area that before was entirely numb. Lots of tingling in the evening. Trying not to sneeze or yawn as the stretching is a challenge.
Activity-wise I'm still keeping it light, although not too restricted from normal. Morning yoga (nothing too intense), work (talking and meetings take a lot of energy, both are getting easier by the day), walking around more, blending and activities around the house. Talking has gotten easier, but it still sounds a little garbled on certain sounds or if I get tired or talk too fast. Real food cravings start to set in when I get hungry.
One excitement was a hair cut, long over due I've been so preoccupied with surgery. For the first time I could see myself in a large mirror from other angles and for a long period of time. I remember in the past being uncomfortable looking at myself because my resting face was strange. The difference was subtle, but at the same time dramatic. I am so happy with the way it turned out, so much more relaxed and natural.
Overall I can still notice progress each day in my energy level, ease in eating and residual effects. The closer I get the more I look forward to exercising again, having full feeling in my face and finally the finished product.
Wednesday, July 6, 2016
2 Week Post-Op
Big milestone is here - can't believe it's been two weeks! Time moves forward steadily, ready or not.
Dr Best and his attending looked over the alignment and asked about numbness, pain and swelling. Nothing seemed out of the ordinary and they were impressed that I have gained half a pound. It was such a relief to have the bands clipped and removed. My jaw felt more natural this time around. I had taken Ibuprofen anticipating the change and movement and didn't notice any pain following the appointment. I took time to practice opening before brushing. Still couldn't open more than a finger's width, which meant I couldn't brush as normal. I had brought a tiny flexible pointer brush just in case and used that to go around the insides of the teeth scrape my tongue. A quick swish of alcohol free mouth wash and I felt sparkly clean!
From there we discussed continued recovery. The pain and fluttering I have been having in my left jaw joint is normal from the strain of the operation and will decrease over time. Numbness shouldn't get worse, since I have sensation and tingles occasionally likelihood is high it will recover in 3-6 months. Dr Best left me with only two bands, one on each side! Even better they stretch between molars, almost invisible except when I smile big. The bands stay in 24/7, he gave me extras to replace any that break. I can open my mouth slightly, but I wasn't expecting to stay mostly shut at this point. Most people talk about starting to open wider Weeks 2-4. I will start soft foods and opening at Week 4, beginning stretches toward full range of motion at Week 6.
Mentally I am preparing to return to work tomorrow. Getting back into my normal routine is exciting, but at the same time I am not entirely comfortable talking. Second, eating takes a lot of time and I need small meals throughout the day. Although I can open my mouth slightly to ease eating and speak more clearly it causes pain in my left jaw. To me it feels like the bone is tearing, which is probably not the case, but nonetheless unpleasant. Continue eating (drinking) well, gradually ramping up activity and immersing into real life with my new face!
Progress photos with a big smile, trying to look natural! I realized I never smiled with my teeth closed before, both because I my teeth always had space and because opening wider reduced the appearance of my overjet. Now for the first time my teeth nest and everything aligns neatly. Still looking for the swelling to go down on my jaw line, to the untrained eye nothing is off.
Dr Best and his attending looked over the alignment and asked about numbness, pain and swelling. Nothing seemed out of the ordinary and they were impressed that I have gained half a pound. It was such a relief to have the bands clipped and removed. My jaw felt more natural this time around. I had taken Ibuprofen anticipating the change and movement and didn't notice any pain following the appointment. I took time to practice opening before brushing. Still couldn't open more than a finger's width, which meant I couldn't brush as normal. I had brought a tiny flexible pointer brush just in case and used that to go around the insides of the teeth scrape my tongue. A quick swish of alcohol free mouth wash and I felt sparkly clean!
From there we discussed continued recovery. The pain and fluttering I have been having in my left jaw joint is normal from the strain of the operation and will decrease over time. Numbness shouldn't get worse, since I have sensation and tingles occasionally likelihood is high it will recover in 3-6 months. Dr Best left me with only two bands, one on each side! Even better they stretch between molars, almost invisible except when I smile big. The bands stay in 24/7, he gave me extras to replace any that break. I can open my mouth slightly, but I wasn't expecting to stay mostly shut at this point. Most people talk about starting to open wider Weeks 2-4. I will start soft foods and opening at Week 4, beginning stretches toward full range of motion at Week 6.
Mentally I am preparing to return to work tomorrow. Getting back into my normal routine is exciting, but at the same time I am not entirely comfortable talking. Second, eating takes a lot of time and I need small meals throughout the day. Although I can open my mouth slightly to ease eating and speak more clearly it causes pain in my left jaw. To me it feels like the bone is tearing, which is probably not the case, but nonetheless unpleasant. Continue eating (drinking) well, gradually ramping up activity and immersing into real life with my new face!
Progress photos with a big smile, trying to look natural! I realized I never smiled with my teeth closed before, both because I my teeth always had space and because opening wider reduced the appearance of my overjet. Now for the first time my teeth nest and everything aligns neatly. Still looking for the swelling to go down on my jaw line, to the untrained eye nothing is off.
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