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.
Saturday, July 2, 2016
Day 10
Swelling has dramatically reduced, first on the left side yesterday and on the right side today. I have defined cheek bones again! It's hard to tell from the pictures, but a significant amount of swelling remains. Puffiness around the mouth, cheeks and nose with hard pockets along the jaw. Bruising has all but disappeared. Had a few bouts with pain on my left side again. It tends to flare up at night, sometimes during the day. Nothing an Ibuprofen dose can't handle.
I was looking around a little closer since the swelling and discomfort are down I can see better. Major shock - my left canine is short! I hoped I was imagining it and pulled up photos from pre-surgery and it was exactly as I remembered. Before it was pointed, now it is blunt extending just below the bracket, shorter than the adjacent incisor. No sharp edges, it was smoothed off and at least looks normal. I will certainly address that with the surgeon as neither he or the residents made mention of it at any point. I won't know how bad it is until visiting with my orthodontist and seeing without all the bands, but to my eye it needs to be fixed. A cap was not in my treatment plan - very upsetting. Other than that, the teeth appear to line up right, within the range expected for final braces adjustments.
Continuing on the liquid diet, more protein shakes, smoothies and purees. While the routine has gotten pretty manageable I am looking forward to my next post-op appointment and recovery stage.
Thursday, June 30, 2016
One Week - First Post-Op
One Week Post-Op milestone! Feels like a split second and an eternity. I got a little emotional while sitting in the waiting room remembering my first visit just shy of a year ago and how stressful the last appointment was. All that in the past now, my newly minted jaw already a huge improvement from how it used to be and recovery on the downhill stretch.
While I was waiting for Dr Best the other surgeon passed by, saw me and stopped in. I was so excited and told (mumbled and texted) him all about my progress. He kept asking about and testing the numbness, but otherwise agreed that I was doing really well. Dr Best arrived and I gave him the rave reviews of his team and how smooth recovery had been as a result. He was eager to have a look at his work and before I knew it was clipping away the bands. I had four sets of triple bands on each side and three wires holding a splint (U-shaped plastic plate with impressions to hold the teeth in place after re-positioning the jaw, ie. "tooth cast") to the uppers. The splint was discarded forever and I was so glad to see it go.
With my jaw free he had me practice opening very slowly and carefully. Although I couldn't feel exactly what I was doing because of the numbness it seemed smooth and painless, just stiff. I was able to speak my first words in a week, that was startling and exciting. He left me with a resident to continue moving and (finally!) brush my teeth. Never thought my mouth would feel empty with only braces, but yeah... so easy without all the bands, wires and splint. I worked up to one finger's width opening, but not quite enough to get the tooth brush inside my mouth. A goal for next week. With that new bands were placed; this time doubles, three on each side. My instructions were to not lose weight and continue good hygiene.
Leaving the office I was in tremendous pain on the left side by my ear (at the jaw joint) and felt light headed. Occasionally at night or in the morning I get a tinge of pain, but nothing like this. As soon as I got home I took a dose of Ibuprofen and crashed, sleeping for five hours straight. It amazes me how so little activity can have such an extreme effect. By evening I felt better and started exploring the new set up. Without the splint I can feel the inside of my teeth, all neatly lined up with so much space compared to before. Most importantly, as expected it's a little easier to drink. With a few breaks to rinse, I was finally able to get the peach smoothie down. Now starting on more substantial soups, like lentil and polenta.
Before and after pics (sorry the close ups are a little scary).
While I was waiting for Dr Best the other surgeon passed by, saw me and stopped in. I was so excited and told (mumbled and texted) him all about my progress. He kept asking about and testing the numbness, but otherwise agreed that I was doing really well. Dr Best arrived and I gave him the rave reviews of his team and how smooth recovery had been as a result. He was eager to have a look at his work and before I knew it was clipping away the bands. I had four sets of triple bands on each side and three wires holding a splint (U-shaped plastic plate with impressions to hold the teeth in place after re-positioning the jaw, ie. "tooth cast") to the uppers. The splint was discarded forever and I was so glad to see it go.
With my jaw free he had me practice opening very slowly and carefully. Although I couldn't feel exactly what I was doing because of the numbness it seemed smooth and painless, just stiff. I was able to speak my first words in a week, that was startling and exciting. He left me with a resident to continue moving and (finally!) brush my teeth. Never thought my mouth would feel empty with only braces, but yeah... so easy without all the bands, wires and splint. I worked up to one finger's width opening, but not quite enough to get the tooth brush inside my mouth. A goal for next week. With that new bands were placed; this time doubles, three on each side. My instructions were to not lose weight and continue good hygiene.
Leaving the office I was in tremendous pain on the left side by my ear (at the jaw joint) and felt light headed. Occasionally at night or in the morning I get a tinge of pain, but nothing like this. As soon as I got home I took a dose of Ibuprofen and crashed, sleeping for five hours straight. It amazes me how so little activity can have such an extreme effect. By evening I felt better and started exploring the new set up. Without the splint I can feel the inside of my teeth, all neatly lined up with so much space compared to before. Most importantly, as expected it's a little easier to drink. With a few breaks to rinse, I was finally able to get the peach smoothie down. Now starting on more substantial soups, like lentil and polenta.
Before and after pics (sorry the close ups are a little scary).
 |
| Pre-appointment. Still swollen, bruised and puffy. |
 |
| Hooks, bands, wires and splint. One full mouth! |
 |
| Post-appt. Less puffy, getting closer to normal. |
 |
| Down to hooks and bands. |
Tuesday, June 28, 2016
Day 5 & 6
Day 5
For reasons entirely unrelated to surgery I slept horribly last night (loud neighbors). With only a few broken hours of actual sleep I was not happy in the morning and stayed low, drinking and taking the requisite meds. By afternoon I was ready to shower and get out for a bit and took a jaunt around the neighborhood. Being in public, albeit trying to avoid interaction, was incredibly refreshing. With that I felt up to more and spent the rest of the day cooking soups and blending smoothies, experimenting with recipes and foods. I will post more on that including meal plans and recipes separately. Today introduced acai smoothies, again a treat I have really been looking forward to.
Incremental changes are exciting to see each day. Today swelling continues to go down, however bruising is more noticeable. It's not a huge area, around and below my chin near the incisions. As the bruises heal the area grows and has turned bright yellow. Very strange looking. No change in numbness, I have resigned myself to that for awhile and will update when it progresses noticeably. I get lots of tingles after I lie down to sleep, a good sign that my body is working on it even if it's not visible yet. For the first time I can feel and see the end of my jaw bone and my cheek bones are starting to show better.
Even with daily changes and my extensive planning to get through recovery as quickly as possible, today was a reminder that no matter how well I am doing there is no fast track through recovery. I can do the right things and make it easier, but it has to run the full course which is a long road. Day by day - pay attention, adapt and wait it out.
Day 6
Today started off with my Mom departing. She came in the night before surgery and has been immensely helpful by my side through operation day and the challenges of the first days in recovery. Although I am set up and comfortable taking care of myself at this point, could not have managed the first few without her and the moral support has made the rest of it easier and more fun.
Swelling continues to drop. Still more swollen on the right side. Today I can almost see my profile and my cheeks and lip appear more natural. I'm hoping to look close to 100% for my one week post-op tomorrow, but even how it is today I think Dr Best will be pleased. Bruising has expanded more in the chin area, plus a slight shade on my throat where the tube was. A dab of tinted moisturizer covers it up for the most part.
Eating was a little traumatic today. One of the smoothies I had prepared yesterday included wheat bran for extra bulk. Unfortunately the flakes didn't liquefy in the blending process and it wouldn't go through the tiny space in my teeth where I am able to drink. I am hopeful after tomorrow's appointment I will be able to manage. In the meantime, an acai smoothie with added almond butter tasted amazing. I continue to drink every two hours, trying to keep well hydrated with small portions of substantial nutrients.
Activity is mostly back to normal, no naps or fatigue anymore. I attribute this to my surgical team for doing a good job setting up recovery so that I didn't have prolonged pain, medication, or complications. More or less since the afternoon of discharge my head has been clear. Now only continuing the week of antibiotics, which don't seem to have any side effects. At times I almost feel like nothing happened, but looking in the mirror is a reminder that how I think of myself, what I feel like and how I look are nothing alike. Plus, I don't actually know what my new face will look like.
For reasons entirely unrelated to surgery I slept horribly last night (loud neighbors). With only a few broken hours of actual sleep I was not happy in the morning and stayed low, drinking and taking the requisite meds. By afternoon I was ready to shower and get out for a bit and took a jaunt around the neighborhood. Being in public, albeit trying to avoid interaction, was incredibly refreshing. With that I felt up to more and spent the rest of the day cooking soups and blending smoothies, experimenting with recipes and foods. I will post more on that including meal plans and recipes separately. Today introduced acai smoothies, again a treat I have really been looking forward to.
Incremental changes are exciting to see each day. Today swelling continues to go down, however bruising is more noticeable. It's not a huge area, around and below my chin near the incisions. As the bruises heal the area grows and has turned bright yellow. Very strange looking. No change in numbness, I have resigned myself to that for awhile and will update when it progresses noticeably. I get lots of tingles after I lie down to sleep, a good sign that my body is working on it even if it's not visible yet. For the first time I can feel and see the end of my jaw bone and my cheek bones are starting to show better.
Even with daily changes and my extensive planning to get through recovery as quickly as possible, today was a reminder that no matter how well I am doing there is no fast track through recovery. I can do the right things and make it easier, but it has to run the full course which is a long road. Day by day - pay attention, adapt and wait it out.
Day 6
Today started off with my Mom departing. She came in the night before surgery and has been immensely helpful by my side through operation day and the challenges of the first days in recovery. Although I am set up and comfortable taking care of myself at this point, could not have managed the first few without her and the moral support has made the rest of it easier and more fun.
Swelling continues to drop. Still more swollen on the right side. Today I can almost see my profile and my cheeks and lip appear more natural. I'm hoping to look close to 100% for my one week post-op tomorrow, but even how it is today I think Dr Best will be pleased. Bruising has expanded more in the chin area, plus a slight shade on my throat where the tube was. A dab of tinted moisturizer covers it up for the most part.
Eating was a little traumatic today. One of the smoothies I had prepared yesterday included wheat bran for extra bulk. Unfortunately the flakes didn't liquefy in the blending process and it wouldn't go through the tiny space in my teeth where I am able to drink. I am hopeful after tomorrow's appointment I will be able to manage. In the meantime, an acai smoothie with added almond butter tasted amazing. I continue to drink every two hours, trying to keep well hydrated with small portions of substantial nutrients.
Activity is mostly back to normal, no naps or fatigue anymore. I attribute this to my surgical team for doing a good job setting up recovery so that I didn't have prolonged pain, medication, or complications. More or less since the afternoon of discharge my head has been clear. Now only continuing the week of antibiotics, which don't seem to have any side effects. At times I almost feel like nothing happened, but looking in the mirror is a reminder that how I think of myself, what I feel like and how I look are nothing alike. Plus, I don't actually know what my new face will look like.
Sunday, June 26, 2016
Day 3 & 4
Day 3
I woke up very tired and knew I needed some serious nutrition. I had planned to start the regular liquid diet on Day 4, but it needed to happen sooner. I went through my morning meds (ibuprofen for the swelling, amoxicillin for anti-bacterial, and qucertin supplement for anti-inflammatory) and had a juice, then had my first protein shake. Cannot describe how good it tasted! First to have normal food, second all the much needed nutrients. Then I showered for the first time since the hospital. It felt good to clean off all the surgical tape residue and the steam was great for my sinuses. After all that excitement I needed a nap.
The afternoon included a brief visit to my rooftop for some fresh air and a change of view, a nice diversion. More napping in the afternoon and more feeding. I made my first attempt at drinking from a cup, which was very challenging at first with a numb lower lip. I still keep towels under me to catch the occasional drip. After a few tries I got it down, much faster than syringing and moving my lips a little helps the healing process.
The swelling has started to go down, my right side is still very large. I have light bruising around my chin that is starting to change color. The numbness has gotten slightly better. My lower lip and chin area are still mostly numb except for slight sensation (can feel touch, but not a drip of liquid). I continue icing as much as possible using bands that wrap my head and jaw and light massaging to stimulate the nerves and increase circulation.
Still not even a hint of pain. I feel so lucky to not have had any of the nausea, congestion, bleeding or other effects any people talk about. I sleep propped up on a few pillows, which is a little uncomfortable since I am normally a side sleeper. Having had severe flue several times the past couple years I am used to that as well and know the difference it makes. Especially the first few days, any tilting of my head caused pressure increase. Very important to keep elevated.
Cleaning is essential, especially now that I have started more rich foods. I do a saline rinse a couple times a day and brush the outside teeth carefully, avoiding sutures. Although I can't open my mouth, my lips are still stretchy and the brush can go where it needs to. Aquaphor has been my best friend, regular application has helped my lips heal quickly from the operation.
Day 4
Stage Two of recovery, the worst is in behind! This morning I started with a protein shake and apple juice, which felt great. Today's snack menu introduced pressed juice and smoothies, both of which I have been looking forward to. Feeding sessions still take ages, small portions sip by sip. I continue to syringe my meds to get them toward the back of my mouth instead of coating all my teeth. My tongue is protesting the splint and feels sore around the front whether eating, swallowing or talking. More stretching to keep my mouth active. The numb area decreased again slightly, now covering about a finger's width inside my chin area. The swelling went down dramatically today. Encouraged, I stopped icing and taking ibuprofen. The bruising has turned yellow, a good sign it will be gone within a few days.
Second big step today - I showered and got presentable to go outside for a walk. Great to see life outside the apartment and move around more. I'm starting to feel like myself again, only mute and swollen.
I woke up very tired and knew I needed some serious nutrition. I had planned to start the regular liquid diet on Day 4, but it needed to happen sooner. I went through my morning meds (ibuprofen for the swelling, amoxicillin for anti-bacterial, and qucertin supplement for anti-inflammatory) and had a juice, then had my first protein shake. Cannot describe how good it tasted! First to have normal food, second all the much needed nutrients. Then I showered for the first time since the hospital. It felt good to clean off all the surgical tape residue and the steam was great for my sinuses. After all that excitement I needed a nap.
The afternoon included a brief visit to my rooftop for some fresh air and a change of view, a nice diversion. More napping in the afternoon and more feeding. I made my first attempt at drinking from a cup, which was very challenging at first with a numb lower lip. I still keep towels under me to catch the occasional drip. After a few tries I got it down, much faster than syringing and moving my lips a little helps the healing process.
The swelling has started to go down, my right side is still very large. I have light bruising around my chin that is starting to change color. The numbness has gotten slightly better. My lower lip and chin area are still mostly numb except for slight sensation (can feel touch, but not a drip of liquid). I continue icing as much as possible using bands that wrap my head and jaw and light massaging to stimulate the nerves and increase circulation.
Still not even a hint of pain. I feel so lucky to not have had any of the nausea, congestion, bleeding or other effects any people talk about. I sleep propped up on a few pillows, which is a little uncomfortable since I am normally a side sleeper. Having had severe flue several times the past couple years I am used to that as well and know the difference it makes. Especially the first few days, any tilting of my head caused pressure increase. Very important to keep elevated.
Cleaning is essential, especially now that I have started more rich foods. I do a saline rinse a couple times a day and brush the outside teeth carefully, avoiding sutures. Although I can't open my mouth, my lips are still stretchy and the brush can go where it needs to. Aquaphor has been my best friend, regular application has helped my lips heal quickly from the operation.
Day 4
Stage Two of recovery, the worst is in behind! This morning I started with a protein shake and apple juice, which felt great. Today's snack menu introduced pressed juice and smoothies, both of which I have been looking forward to. Feeding sessions still take ages, small portions sip by sip. I continue to syringe my meds to get them toward the back of my mouth instead of coating all my teeth. My tongue is protesting the splint and feels sore around the front whether eating, swallowing or talking. More stretching to keep my mouth active. The numb area decreased again slightly, now covering about a finger's width inside my chin area. The swelling went down dramatically today. Encouraged, I stopped icing and taking ibuprofen. The bruising has turned yellow, a good sign it will be gone within a few days.
Second big step today - I showered and got presentable to go outside for a walk. Great to see life outside the apartment and move around more. I'm starting to feel like myself again, only mute and swollen.
Friday, June 24, 2016
Surgery Day and Recovery Day 1 & 2
June 22, 2016
After thorough research I had compiled all the supplies needed and roughed out a menu plan for a 3 day clear liquid diet, 4 day - 2 week liquid diet, and progression to soft foods. All preparations were in place. My pre-op instructions cut off food, water and anything in the mouth from midnight. I ate a monstrous dinner that evening, then had a snack and ginger tea right before midnight, then settled in for a good night's sleep.
The next morning was go time! 10:30am we departed for the hospital where I checked in at 11:30. Shortly after I was taken up to the staging area and changed into a gown, then met with the anesthesia team. The lead was also named Allison and she was one week older than I am! She offered an anti-nausea patch and got me all preped. The surgical team trickled in and by 1:30 all were assembled except Dr. Best. A full hour passed and finally he showed up at 2:30 and I was wheeled away. Before we got in the elevator I was out and don't remember a thing until waking up in the recovery room. We stayed there for several hours, nurses cycled through, each being preped on my case and status. Eventually I was all alone in the back of the recovery wing while waiting for a bed upstairs. Around 11:30 a team came in for a CT scan, then back to sleep until vitals check. Around 1am I was taken up to the room. More ice, more IV fluids. I felt no pain or discomfort, no nausea, and no congestion in my nose that many people complain about. Allison took good car of me setting up an easy recovery. One of the surgical residents visited before he left for the night. All seemed to be going remarkably well. I was all smiles, so excited to have the giant hurdle complete.
Recovery Day 1 - June 23
I woke up at 6am to the whole crew paying a visit. It was good to see their familiar faces, but I was tired and didn't have much to say. They gave some medications and instructions to the nurse and cleared me for discharge after meeting with the nutritionist. That took all morning, although she was supposedly on the floor somewhere she never made an appearance, instead sending a trainee to give me a pamphlet describing a blended diet, protein intake and sample menus with recipes. The nurse came back with my prescriptions, took off my IVs, I changed and packed up, leaving the hospital around 2pm. A brief stop at Walgreens to fill prescriptions and finally we returned to my apartment. I took a brief nap, and started syringing drinks and medications. It takes about an hour to complete dosage of medication and juices. Lots of towels for dripping, and concentration to make it smooth. So far I have been using a 10ml syringe, inserting between my front bands and shooting to the side. Swelling increased through the day. I can run my hands around the jawline and have feeling everywhere, which is a good sign. Some numbness still that makes it hard to drink regularly from a cup. Regular icing and gentle massages see to be taking effect on the swelling.
Recovery Day 2 - June 24
Today I had more energy, started walking around a bit. I am trying to talk more and move my lips around, but my tongue hurts when it rubs on the splint. Other than that I still have no pain or discomfort. The swelling has started to go down on the left side, the right side and my lower lip are still very large. I started to feel small tingling sensations on my lip, like little champagne bubbles floating up on the sides or middle. No bruising, even around the area on my hands where the IV's were placed. I continue on the clear liquid diet until Day 4 where more dense beverages can be introduced. So far much easier than expected, aside from eating taking so long. A short nap mid morning and mid afternoon, settling in for the evening now. Waiting for my jawline to slim down so I can see my new profile.
After thorough research I had compiled all the supplies needed and roughed out a menu plan for a 3 day clear liquid diet, 4 day - 2 week liquid diet, and progression to soft foods. All preparations were in place. My pre-op instructions cut off food, water and anything in the mouth from midnight. I ate a monstrous dinner that evening, then had a snack and ginger tea right before midnight, then settled in for a good night's sleep.
The next morning was go time! 10:30am we departed for the hospital where I checked in at 11:30. Shortly after I was taken up to the staging area and changed into a gown, then met with the anesthesia team. The lead was also named Allison and she was one week older than I am! She offered an anti-nausea patch and got me all preped. The surgical team trickled in and by 1:30 all were assembled except Dr. Best. A full hour passed and finally he showed up at 2:30 and I was wheeled away. Before we got in the elevator I was out and don't remember a thing until waking up in the recovery room. We stayed there for several hours, nurses cycled through, each being preped on my case and status. Eventually I was all alone in the back of the recovery wing while waiting for a bed upstairs. Around 11:30 a team came in for a CT scan, then back to sleep until vitals check. Around 1am I was taken up to the room. More ice, more IV fluids. I felt no pain or discomfort, no nausea, and no congestion in my nose that many people complain about. Allison took good car of me setting up an easy recovery. One of the surgical residents visited before he left for the night. All seemed to be going remarkably well. I was all smiles, so excited to have the giant hurdle complete.
Recovery Day 1 - June 23
I woke up at 6am to the whole crew paying a visit. It was good to see their familiar faces, but I was tired and didn't have much to say. They gave some medications and instructions to the nurse and cleared me for discharge after meeting with the nutritionist. That took all morning, although she was supposedly on the floor somewhere she never made an appearance, instead sending a trainee to give me a pamphlet describing a blended diet, protein intake and sample menus with recipes. The nurse came back with my prescriptions, took off my IVs, I changed and packed up, leaving the hospital around 2pm. A brief stop at Walgreens to fill prescriptions and finally we returned to my apartment. I took a brief nap, and started syringing drinks and medications. It takes about an hour to complete dosage of medication and juices. Lots of towels for dripping, and concentration to make it smooth. So far I have been using a 10ml syringe, inserting between my front bands and shooting to the side. Swelling increased through the day. I can run my hands around the jawline and have feeling everywhere, which is a good sign. Some numbness still that makes it hard to drink regularly from a cup. Regular icing and gentle massages see to be taking effect on the swelling.
Recovery Day 2 - June 24
Today I had more energy, started walking around a bit. I am trying to talk more and move my lips around, but my tongue hurts when it rubs on the splint. Other than that I still have no pain or discomfort. The swelling has started to go down on the left side, the right side and my lower lip are still very large. I started to feel small tingling sensations on my lip, like little champagne bubbles floating up on the sides or middle. No bruising, even around the area on my hands where the IV's were placed. I continue on the clear liquid diet until Day 4 where more dense beverages can be introduced. So far much easier than expected, aside from eating taking so long. A short nap mid morning and mid afternoon, settling in for the evening now. Waiting for my jawline to slim down so I can see my new profile.
Tuesday, June 21, 2016
Pre-Surgery
At this stage I expected my surgeon to take the lead, informing me of process, guiding through and keeping open communication. That was not the case at all. Being a teaching hospital, UCSF operates much differently than private practice. Essentially lacking in business skills. The main phone system is a mess that leads to a dead end. The office manager doesn't pick up her phone or return calls. Trying to set this up and coordinate between a dentist, orthodontist and surgeon keeping in mind personal plans, travel arrangements, not to mention work projects was quite frustrating. Surgery is only every other week and regular appointments on the alternating week, a very narrow window of opportunity. Making matters worse, I was told the date wouldn't be confirmed until insurance approval went through, 6 weeks after my follow up consultation. Basically they wouldn't speak to me until I had the pre-op appointment. I did my best to schedule a tentative date while making it clear that I needed more than a week's advance notice on the operation and was not willing to let my treatment plan slip due to scheduling missteps. I had heard horror stories of treatments being delayed 3 months and having difficulty scheduling followup appointments and getting insurance approvals. After much persistence I finally found the right approach and began making headway with key contacts.
Follow Up Surgical Consultation - May 18, 2015
At this appointment I was seen in promptly at 9am and was out by 9:30am. Dr Best looked at my teeth and new molds taken by my orthodontist the week prior. He walked me through details of the the timeline and process and gave the okay. I followed up immediately to ensure the insurance submittal went through and scheduled my follow up dental cleaning and orthodontial pre-surgical appointment anticipating the surgery date. I don't know if it was my hounding or if I was overly worried about the process taking too long, but within two weeks it was signed off and the office contacted me to confirm. I am on the calendar for June 22nd, Week 38 of braces.
Pre-Surgery Appointment - June 15, 2015
One week in advance the surgical team meets to review and practice the operation. My final orthodontial appointment was the day before. All movement is paused until after, this was only to place the surgical hooks which will be used to stabilize my jaw while banded shut. All of my brackets have hooks built in already, the only additional hooks necessary are in between the incisors. They are big and catch on my lip, but at this point I don't really care as I will soon have bigger problems to deal with. Another twist - Dr Good is pregnant and will be on maternity leave in July and August. I am glad she has been able to see me through leading up to surgery. My follow up appointment and re-starting braces will be with a stand-in, which is a little disappointing. At least she will get to see better results in September. Hopefully by then I will be very close to braces off for the finished product.
Back to the surgical appointment, it took ages. 3 hours, most of which were sitting waiting for the staff to do something. All very stressful on the heels of navigating my two weeks off work, only to continue to have numerous post-op appointments before full recovery. Once again enforcing the fact that this is a huge time commitment and that some things can't be rushed. In the end I had a CT scan, current photos, current molds and and any last questions answered. Aside from the dysfunction of the office, Dr Best is capable and knows his trade. I have full confidence all will go well.
10 month progress photos, hooks and all, two days before surgery... can't believe it's here.
Follow Up Surgical Consultation - May 18, 2015
At this appointment I was seen in promptly at 9am and was out by 9:30am. Dr Best looked at my teeth and new molds taken by my orthodontist the week prior. He walked me through details of the the timeline and process and gave the okay. I followed up immediately to ensure the insurance submittal went through and scheduled my follow up dental cleaning and orthodontial pre-surgical appointment anticipating the surgery date. I don't know if it was my hounding or if I was overly worried about the process taking too long, but within two weeks it was signed off and the office contacted me to confirm. I am on the calendar for June 22nd, Week 38 of braces.
Pre-Surgery Appointment - June 15, 2015
One week in advance the surgical team meets to review and practice the operation. My final orthodontial appointment was the day before. All movement is paused until after, this was only to place the surgical hooks which will be used to stabilize my jaw while banded shut. All of my brackets have hooks built in already, the only additional hooks necessary are in between the incisors. They are big and catch on my lip, but at this point I don't really care as I will soon have bigger problems to deal with. Another twist - Dr Good is pregnant and will be on maternity leave in July and August. I am glad she has been able to see me through leading up to surgery. My follow up appointment and re-starting braces will be with a stand-in, which is a little disappointing. At least she will get to see better results in September. Hopefully by then I will be very close to braces off for the finished product.
Back to the surgical appointment, it took ages. 3 hours, most of which were sitting waiting for the staff to do something. All very stressful on the heels of navigating my two weeks off work, only to continue to have numerous post-op appointments before full recovery. Once again enforcing the fact that this is a huge time commitment and that some things can't be rushed. In the end I had a CT scan, current photos, current molds and and any last questions answered. Aside from the dysfunction of the office, Dr Best is capable and knows his trade. I have full confidence all will go well.
10 month progress photos, hooks and all, two days before surgery... can't believe it's here.
Saturday, June 18, 2016
Braces Progress
2 Months:
Eager for progress, trying to be patient while Dr Good works her magic. My second appointment inserted rubber spacers between the back molars, after two weeks the lower rear brackets were placed and I was fully braced. Then a longer wait til the next appointment. I asked to go to a heavier wire, to no avail. You can see in the close up the lower front teeth are so crowded the wire isn't even engaged on two of the brackets. My top incisor was angled in during pre-teen braces to compensate for the over-jut. That makes the wire look super crooked, due to the closeness a white rubber cushion was placed on the bracket below to keep it from hitting.
4 Months:
Getting in a groove, appointment were generally evenly spaced 5 weeks apart. I always asked for 4 to accelerate, to no avail. Worse still on a few occasions she did say 4 weeks, but the office would be closed or no times were available and it would end up 5 weeks after all. Sometimes visible progress was made by the time I got home from the appointment! My top teeth had started straightening out, evening of the wire. The biggest challenge was the lower incisors. To address the crowding Dr Good added coils, one on either side of my center lower tooth. They were very painful and in contrast to the ceramic brackets very metallic and obvious. I had to use wax constantly to reduce sores. It didn't stick well to the coils, complicated cleaning and adding further bulk to my mouth. Knowing that my over-jut correction involved undoing some of the work from my pre-teen braces I was prepared for my bite to get worse leading up to surgery. I was not prepared for the horror the coils created. Since the flanking two teeth were unattached, they got pretty crazy while the coil did its job pushing the outside teeth away. By cruel twist of fate this occurred over the holiday season with parties, family gatherings and a prominent project opening with most of my network and VIPs. Sigh... there is definitely a personal growth aspect to having braces. Starting out highly self conscious, going through braces and very messed up teeth has built significant self acceptance and thickened my skin to the extent that not much about my appearance and others opinion about it could throw me now. Appearance can help, but is secondary in any interaction. That is a valuable lesson to internalize.
6 Months:
Miracle occurred and the coil was removed! The adjacent teeth moved quickly back into place and in the following appointment clicked into the wire. To further adjust alignment Dr Good added a power chain, which I feared was yet another coil fiasco. Instead it was more or less a rubber band chain that hooked around each bracket. Since it was white it actually made the brackets less visible and it was comfortable, so I was happy. For my upper teeth the treatment plan includes veneers to increase the size of my "peg laterals", so we are creating space on either side. That involved more coils, only this time she used a smaller size that was hardly noticeable visually or on my lips (not shown in the pics below). The third photo shows my true jaw alignment with tongue crowded behind the teeth.
8 Months:
This is when I started to get anxious since my treatment plan indicated surgery 8-10 months in and I hadn't even had a followup appointment. It was stressful to juggle work and attempt to minimize impact without having any idea how schedule would work out. Dr Good finally gave me the go ahead at my 27 week appointment and I immediately called to set up my surgical appointment. Finally it is happening! Meanwhile, minor adjustments top and bottom continued. I was up to the heavy gauge surgical wires, which meant any misalignment was painful. Both the lower front teeth and back molars took a lot of pushing and prodding before clicking in. The assistant tried to warn me and be gentle, but I still whimpered as my tooth felt like it was being pulled out at one point. That was the most painful appointment (nothing a few Advil and a good night's sleep couldn't fix), but I knew it meant final adjustments were in progress. I noticed that my upper midline has shifted slightly off, that will be corrected after surgery. I also want to bring the uppers in as they are still slanting out slightly. You can see the lower power chain in the second photo. In the last photo I set my jaw forward, anticipating what it will be like. Teeth are getting very close to final alignment!
Eager for progress, trying to be patient while Dr Good works her magic. My second appointment inserted rubber spacers between the back molars, after two weeks the lower rear brackets were placed and I was fully braced. Then a longer wait til the next appointment. I asked to go to a heavier wire, to no avail. You can see in the close up the lower front teeth are so crowded the wire isn't even engaged on two of the brackets. My top incisor was angled in during pre-teen braces to compensate for the over-jut. That makes the wire look super crooked, due to the closeness a white rubber cushion was placed on the bracket below to keep it from hitting.
4 Months:
Getting in a groove, appointment were generally evenly spaced 5 weeks apart. I always asked for 4 to accelerate, to no avail. Worse still on a few occasions she did say 4 weeks, but the office would be closed or no times were available and it would end up 5 weeks after all. Sometimes visible progress was made by the time I got home from the appointment! My top teeth had started straightening out, evening of the wire. The biggest challenge was the lower incisors. To address the crowding Dr Good added coils, one on either side of my center lower tooth. They were very painful and in contrast to the ceramic brackets very metallic and obvious. I had to use wax constantly to reduce sores. It didn't stick well to the coils, complicated cleaning and adding further bulk to my mouth. Knowing that my over-jut correction involved undoing some of the work from my pre-teen braces I was prepared for my bite to get worse leading up to surgery. I was not prepared for the horror the coils created. Since the flanking two teeth were unattached, they got pretty crazy while the coil did its job pushing the outside teeth away. By cruel twist of fate this occurred over the holiday season with parties, family gatherings and a prominent project opening with most of my network and VIPs. Sigh... there is definitely a personal growth aspect to having braces. Starting out highly self conscious, going through braces and very messed up teeth has built significant self acceptance and thickened my skin to the extent that not much about my appearance and others opinion about it could throw me now. Appearance can help, but is secondary in any interaction. That is a valuable lesson to internalize.
6 Months:
Miracle occurred and the coil was removed! The adjacent teeth moved quickly back into place and in the following appointment clicked into the wire. To further adjust alignment Dr Good added a power chain, which I feared was yet another coil fiasco. Instead it was more or less a rubber band chain that hooked around each bracket. Since it was white it actually made the brackets less visible and it was comfortable, so I was happy. For my upper teeth the treatment plan includes veneers to increase the size of my "peg laterals", so we are creating space on either side. That involved more coils, only this time she used a smaller size that was hardly noticeable visually or on my lips (not shown in the pics below). The third photo shows my true jaw alignment with tongue crowded behind the teeth.
8 Months:
This is when I started to get anxious since my treatment plan indicated surgery 8-10 months in and I hadn't even had a followup appointment. It was stressful to juggle work and attempt to minimize impact without having any idea how schedule would work out. Dr Good finally gave me the go ahead at my 27 week appointment and I immediately called to set up my surgical appointment. Finally it is happening! Meanwhile, minor adjustments top and bottom continued. I was up to the heavy gauge surgical wires, which meant any misalignment was painful. Both the lower front teeth and back molars took a lot of pushing and prodding before clicking in. The assistant tried to warn me and be gentle, but I still whimpered as my tooth felt like it was being pulled out at one point. That was the most painful appointment (nothing a few Advil and a good night's sleep couldn't fix), but I knew it meant final adjustments were in progress. I noticed that my upper midline has shifted slightly off, that will be corrected after surgery. I also want to bring the uppers in as they are still slanting out slightly. You can see the lower power chain in the second photo. In the last photo I set my jaw forward, anticipating what it will be like. Teeth are getting very close to final alignment!
Friday, June 17, 2016
Braces On
Sept 25, 2015. My calendar calls it skull day. Days leading up to the appointment were spent indulging in all forms of crunchy, crispy, thick, chewy foods. Morsels of steak and caramels, savoring every bite. I had scheduled the appointment for end of day Friday, allowing myself the weekend to adjust physically and mentally before returning to work.
At the appointment I was very nervous. One by one the brackets were placed, upper wire inserted, then lower wire. Before I knew it my mouth was full! It felt weird to run my tongue around the edges, and my lips plumed (Dr Good called it "braces botox", hehe). I took Advil the first day as the pain hit before I even walked out the door. The dull throbbing through my entire head continued through mid afternoon the next day, then life resumed.
I had expected my tongue to swell and be painful as it was for the first two weeks during pre-teen braces, but instead felt nothing. I continued eating yogurt for breakfast, soups for lunch, and soup or very soft, smooth food for dinner. I was both encouraged and frustrated by the lack of pain, thinking that the treatment wasn't aggressive enough. My teeth are used to moving since being in braces and a lifetime of retainers so I hoped it would go faster than expected. After talking with Dr Good the following week I came to accept that no amount of badgering would increase her sense of urgency, that treatment would run its course.
I had expected my tongue to swell and be painful as it was for the first two weeks during pre-teen braces, but instead felt nothing. I continued eating yogurt for breakfast, soups for lunch, and soup or very soft, smooth food for dinner. I was both encouraged and frustrated by the lack of pain, thinking that the treatment wasn't aggressive enough. My teeth are used to moving since being in braces and a lifetime of retainers so I hoped it would go faster than expected. After talking with Dr Good the following week I came to accept that no amount of badgering would increase her sense of urgency, that treatment would run its course.
Looking back here are the thoughts that went through my head and what I've actually experienced.
Fear: What will my coworkers think? My clients? My dates? My friends?
Reality: I put in perspective how I would think of someone else. I would see it as an effort toward lifetime self improvement and would respect it. The first smile and conversation were tenuous, it took a few weeks for me to get used to it. I quickly learned it was a barometer for trustworthiness. If someone judged me they were not a positive part of my life anyway and their opinion mattered little. Conversely, whenever I see someone else with braces we smile and bond. It's not as rare as I thought, as with many things once you're looking you see them everywhere. I've heard many stories and even talked to people going through some pretty extensive jaw surgery plans. By the second month braces weren't even on my mind, I was able to go through life as usual and it was only when someone else noticed that I did.
Fear: Will they hurt?
Reality: Having had braces before and having a high threshold for pain I experienced almost no discomfort. My cheeks and lips get torn up from either being hooked or going between the wires. Dental wax is an easy fix, I always ask for a couple packs at my appointments since I go through a lot of it. Routine is to cap the last two brackets, top and bottom on both sides, since those have large metal hooks. Also the lower front four teeth, since my jaw position causes extra rubbing. Aside from that, I was sore overnight after the first four appointment. An Advil took care of it just fine. Occasionally a tooth will get sensitive, but that's the same with or without braces.
Fear: Will I have difficulty eating?
Reality: For the first few weeks my diet consisted of yogurt and soup. Since I have lots of problems eating I realized that most of the foods I like are soft foods, so it really didn't change much in terms of my meals. The one thing I miss is biting into a good hamburger. I probably could do it at home, it would just be pretty messy. The other difficult part is dark beverages. I love coffee, red wine, tea, tomato sauce, anything dark. At first I cut everything. Then I convinced myself I could have a few sips and slosh vigorously. Then it was small cups with sloshing afterward... Then almost a normal daily cup of joe. I had planned to do whitening after and I hope that I won't end up with spotted teeth!
Fear: Will I be able to keep my teeth clean?
Reality: Brushing is a necessity after every meal. I don't snack a lot, so I generally don't need to more than that. Most foods are easy to work around, but salads tend to be more time consuming. Lots of brushing, rinsing, more brushing and rinsing. For a few weeks it was hard to tell what belonged and what didn't, by now I can pretty much sense when I have more work to do. I have had a few laughs, thinking I was all done only to smile and have a giant piece of lettuce draped across my front brackets. Rinse, swish, brush, swish again and a close visual check are my routine. I am also totally comfortable brushing in public as having bad teeth I am used to brushing after lunch at work or wherever I happen to need to. For the night time routine - flossing is a pain! The first few weeks I meticulously flossed going through the wires every night. Since that process took half an hour, I soon stopped and found short cuts. It is entirely possible to floss the insides of the teeth normally. My dentist gave me a kit that had a metal rod with a pointy rubber tip that I can use to run around the gum line and go in between the teeth from the outside. Much easier than flossing and it works just as well on the front teeth. The back morals are tough no matter what. I also using prescription strength fluoride weekly. I have noticed some staining on my teeth, particularly in between the brackets and above where it's harder to brush. I intend to whiten after it's all done and am counting on those stains being light enough that I won't end up with spotted teeth.
Fear: Will it be worth it?
Reality: So far the pain / reward ratio is positive! It hasn't been nearly as bad as I had thought. Initially the 22 month estimate was overwhelming. To be halfway through now it seems like no time at all. Seeing incremental progress has been encouraging as each step gets closer to the end goal and my dream of the perfect smile! If it means enough to you that you are considering it, by all means go for it.
And with that, a few pics from Braces On Day...
And with that, a few pics from Braces On Day...
Saturday, June 11, 2016
Consultation Appointments
Step 1 - Dental Appointment; March 18, 2015
Dr Azad is extremely talented and has made the annual visits enjoyable by offering state of the art technologies, personable customer service and an office that feels more like a boutique hotel than a medical office. Best part is the yellow chairs and the view... but I digress. As we discussed the alignment issues I was keenly aware of, my confidence in her abilities and promise of the smile of my dreams made the journey seem inevitable.
Step 2 - Orthodontist Consult; May 28, 2015
Dr Azad referred me to Dr Good (impossible not to trust!). During the hour long consultation she took photos, measurements and walked me through her recommendations. I had braces as a child, and sort of knew that the current state wasn't entirely the result of not wearing my retainers regularly. I have a habit of shifting my jaw forward to ease lip teeth indentations / discomfort on my lower lip and speculate congested sinuses are related to a crowded tongue. Mentioning these and other issues I suggested that my jaw may also need adjustment. Sure enough, she indicated that Invisalign was not an option due to the severity of my case, predictable but nonetheless a huge disappointment. The treatment plan was 8-10 months of braces, jaw surgery, followed by 8-12 months of braces. She showed me an animated video of the process. Although entirely new and foreign to me, she has completed many similar cases with excellent results. Without hesitation I agreed to have molds made that day in preparation for the surgeon consultation.
Step 3 - Surgeon Consult; July 15, 2015
Dr Good referred me to Dr Bast (soon dubbed Dr Best). This is where I began to get frustrated as the first available appointment was almost two months out. I can take ages to make a decision, but once I do I proceed without delay and get extremely impatient. The appointment included more photos, measurements, and study of my facial features and molds. I was not impressed with the office as it is a teaching hospital and felt aged. During my hour long wait to see the surgeon interns kept stepping into the room, even during my consultation. I was already self conscious about my deformity and nervous about the prospect of a major surgery and the gawkers weren't helping. The surgeon gave me all the disclaimers - major surgery, 3-6 week recovery, potential for permanent numbness. I left feeling bewildered, but having begun could see the end goal.
Step 4 - Second Opinion, August 11, 2015
I consulted a second orthodontist who provided the same recommendations. She offered Invisalign and Propel, a technology to accelerate braces, and showed me an elaborate portfolio of dozens of cases, some identical to mine. I got very excited seeing the after photos and new it was for me. The alternate treatments seemed risky, perhaps leaning to what I wanted to hear versus best methods. Since I had a head start with the Good Team, I opted to go for it and scheduled the dreaded braces on appointment.
Before...
Dr Azad is extremely talented and has made the annual visits enjoyable by offering state of the art technologies, personable customer service and an office that feels more like a boutique hotel than a medical office. Best part is the yellow chairs and the view... but I digress. As we discussed the alignment issues I was keenly aware of, my confidence in her abilities and promise of the smile of my dreams made the journey seem inevitable.
Step 2 - Orthodontist Consult; May 28, 2015
Dr Azad referred me to Dr Good (impossible not to trust!). During the hour long consultation she took photos, measurements and walked me through her recommendations. I had braces as a child, and sort of knew that the current state wasn't entirely the result of not wearing my retainers regularly. I have a habit of shifting my jaw forward to ease lip teeth indentations / discomfort on my lower lip and speculate congested sinuses are related to a crowded tongue. Mentioning these and other issues I suggested that my jaw may also need adjustment. Sure enough, she indicated that Invisalign was not an option due to the severity of my case, predictable but nonetheless a huge disappointment. The treatment plan was 8-10 months of braces, jaw surgery, followed by 8-12 months of braces. She showed me an animated video of the process. Although entirely new and foreign to me, she has completed many similar cases with excellent results. Without hesitation I agreed to have molds made that day in preparation for the surgeon consultation.
Step 3 - Surgeon Consult; July 15, 2015
Dr Good referred me to Dr Bast (soon dubbed Dr Best). This is where I began to get frustrated as the first available appointment was almost two months out. I can take ages to make a decision, but once I do I proceed without delay and get extremely impatient. The appointment included more photos, measurements, and study of my facial features and molds. I was not impressed with the office as it is a teaching hospital and felt aged. During my hour long wait to see the surgeon interns kept stepping into the room, even during my consultation. I was already self conscious about my deformity and nervous about the prospect of a major surgery and the gawkers weren't helping. The surgeon gave me all the disclaimers - major surgery, 3-6 week recovery, potential for permanent numbness. I left feeling bewildered, but having begun could see the end goal.
Step 4 - Second Opinion, August 11, 2015
I consulted a second orthodontist who provided the same recommendations. She offered Invisalign and Propel, a technology to accelerate braces, and showed me an elaborate portfolio of dozens of cases, some identical to mine. I got very excited seeing the after photos and new it was for me. The alternate treatments seemed risky, perhaps leaning to what I wanted to hear versus best methods. Since I had a head start with the Good Team, I opted to go for it and scheduled the dreaded braces on appointment.
Before...
Thursday, June 9, 2016
Intro
Around one year ago I visited my dentist to discuss alignment of my teeth. I had a severe overbite and that caused difficulty eating and speaking, gum recession from bite alignment, teeth marks and sores on my lips, and general self consciousness about my appearance and facial function from the strain of closing my mouth. Growing up it was a part of my life and although I knew it wasn't perfect I didn't have the means or vision to look into a solution until then. At 32 years old it was a major life decision to get braces. With lower jaw surgery as part of the treatment plan the commitment became even more significant and would not be easy. The thought of dealing with my teeth in their current state forever became unbearable once I could see the potential improvement and freedom. I knew I had to make the leap.
In two weeks I will undergo orthognathic surgery to correct alignment of my lower jaw (5mm Class II Malocclusion). It is terrifying and elating all at once. Between now and then I will post to chronicle the background from braces to pre-op, then continue in real time through the recovery and the end result. My hope is that others going through similar situations will be encouraged and informed in their paths to a smile for a lifetime!
~Cheers
In two weeks I will undergo orthognathic surgery to correct alignment of my lower jaw (5mm Class II Malocclusion). It is terrifying and elating all at once. Between now and then I will post to chronicle the background from braces to pre-op, then continue in real time through the recovery and the end result. My hope is that others going through similar situations will be encouraged and informed in their paths to a smile for a lifetime!
~Cheers
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