Post-Surgery FUN!!!

[WhiteLurcher]

Hey phil sorry to hear about your bite shifting!

I guess you have just joined the post-surgery limbo club. I thought all those months waiting to hear if you were ready for surgery yet was bad enough, now I find I'm practically counting the days 'til my next ortho and surgeons appointments! Just hoping there'll be some improvement and desperately wanting to know what they'll do next!
It does nothing for your confidence when your surgeon kinda looks at you and scratches his head a bit of reassurance that they know what to do would be nice!

I guess we'll just have to wait and see!
Here's to you gaining more ROM so you can at least eat more!

[phil]

I'm TWO today! Well, two weeks post-surgery, that is! And, I am officially allowed to soft chew. For breakfast, I had two eggs, scrambled with yogurt and parmesan, and later on in the morning, I ate some fudge brownie crumbs. All from a regular size spoon, no less!

I also can brush my teeth with the baby tooth brush quite well now.

And, here are some pics to help celebrate the occasion.

[Brandyleigh35]

Hey Phil,
Wow, I'm always so amazed at how differently doctors do this surgery. I can't believe you can do soft chew at only 2 weeks post op. I was allowed liquids and fork smash only, and the doctor emphasized "ABSOLUTELY NO CHEWING, ZERO, ZIP, ZILCH, FOR 6 WEEKS" so while I could have fork smash it had to be swallowed whole. I just got the go ahead last week to start soft chew only for another 6 weeks, and even now I'm super paranoid about it, and my bite feels just about perfectly, spot on. I think if I was having issues with my bite shifting I would be totally freaked out about chewing. I remember reading somewhere that at day 10 is when your jaw bones are actually the most fragile.....you're barely even past that! YIKES!

[phil]

Brandy,

It's true, these surgeons are all different for sure. For instance, with my LeFort I, my surgeon used to large L-shaped plates, instead of several of the smaller ones I've seen with lots of other people's x-rays. Why, I don't know. The way he put me back together for the BSSO is pretty much what everyone else has gotten that I've seen. He said that of the two, the LeFort I is definitely less stable until the bone heals.

I actually haven't chewed anything today. The eggs, of course, require no chewing, and for lunch, I blended my lentils with rice, and then ate it with a spoon. This afternoon, I let tiny bites of a fudge brownie melt on my tongue, and chased them with water for fear that I might choke! It's so strange, now that I haven't used my mouth to eat for two weeks, and everything's in a new place, I'm not even sure how to do it!

I suppose it's a good thing that I'm much more cautious than my surgeon. I did try singing a little bit on Sunday. It was ok, not quite me, since I couldn't open my mouth very wide! I am happy, though that once again I managed to make it through surgery with no damage to my vocal cords whatsoever. I actually ended up having the same anesthesiologist and nurse anesthetist that I had for my SARPE last July!

Onward and upward!

[Brandyleigh35]

Meryten, wow! seems like chewing might be a bit different with just the lower jaw done. Perhaps like Phil said it is the upper jaw that is more unstable until healed. Still I think I would've been too freaked out to begin chewing that soon after surgery. Clearly things went ok for you though so it just goes to prove that there really isn't one right way to approach things.

Hey Phil,
Yeah I know what you mean about the whole chewing thing. Its like learning to chew all over again isn't it? I mean my teeth are pretty lined up now, but I have never really had teeth that met properly so things just feel very weird! I chew with reservation as I'm not sure I'm in the correct spot. Plus I still have some tongue numbness which makes it harder to maneuver stuff around.

I can tell you that I can swallow just about anything whole now! Not that that is necessarily a good thing, but I can do it! I'm actually having to force myself to chew these days. I have become so accustomed to just swallowing things with very minimal chewing that I find myself just doing it by habit now, and since the chewing, and biting down feels so weird I just find myself avoiding it. My range of motion is improving well though. I can now open my mouth to 32mm. Not sure how wide I could open it before surgery but I can pretty much yawn without too much discomfort now so that is a plus.

Soon you will be brushing with a big boy toothbrush and using regular utensils. That is pretty lucky that you got the same assistants as you had for your SARPE. I too was thrilled just to have survived the surgery no less for wear. It honestly wasn't near as bad as I thought it would be, and things just continue to improve after two weeks, so you have truly made it through the worst I would say.

Did your doctor say anything about sneezing or blowing your nose? I'm almost 7 weeks post op. At my one month appt my doctor told me to only sneeze through my mouth, and to continue with not blowing my nose at all. I just wonder how long until I can do that again.

Brandy

[phil]

Meryaten,

Thank you for adding your perspective on post surgical eating!

Brandy,

My surgeon is a man of few words. Every bit of information I've gotten has been the result of my many questions--it's a good thing I ask a LOT! So, he said nothing about blowing my nose. I've just used my common sense. Try to stifle sneezes if I can, and if I can't, open my mouth and let the chips fall where they may. My sinuses are doing really well, so I think I'm well out of the danger zone. I know you've had issues with this, so you might want to be more cautious. What's been far scarier is dealing with coughing while banded. I have such a fear of choking or not being able to clear my throat properly. When I get a tickle, it really makes me panic sometimes. Like all other things, though, I've learned to adapt, and cough with my mouth closed. As far as blowing, I haven't. But, I haven't really needed to.

A side note on my nose/sinuses. Since the surgery, I'm breathing better than I ever have in my whole life! It really is wonderful. I'm thinking that it is because of the 5mm maxillary advancement. So, I'm keeping my fingers crossed, with hope in my heart, that this is a permanent result!

[Brandyleigh35]

Hey Phil,
Part of that great breathing is due to the fact that your sinuses are not functioning properly yet. My doctor said that I should not blow my nose at all because what it does is force air under your skin in the sinus area. He said it will not hurt anything as eventually the air will be absorbed but that it is better, when you already have swelling going on in that area to not do it, as it can slow down healing. He said my sinuses are not going to be back on track for a couple of months and that if I needed to sneeze to open my mouth and sneeze through my mouth, and when I went back last time he also said to me (when I complained about sinus pressure) "Are you blowing your nose?" I said "NO, I've been using q-tips to keep it clean. He did tell me that I can sniff in as much as I want, just not to blow it.

I too had the great, clear sinuses for about 4 full weeks. In the last two weeks I've noticed my breathing is not quite as clear and things seem to be getting back to normal in the mucus production dept (if you know what I mean). I can still breathe really well just not as clear a those first few weeks. I'm glad my doctor is not a man of few words. He explains everything and is very personable, great bedside manner!

Brandy

[phil]

Hello, all!

My update today (day 16):

Swelling is still pretty much the same--only noticeable if you knew me prior to surgery. I have a lovely greenish-yellow patch of bruising on my chest. My right side is slightly more swollen than my left, which makes perfect sense to me because I had more pain in that side post-op.

I am eating blended food from a teaspoon quite well. This development this week makes me very happy! As has been from the beginning, my Kitchenaid immersion blender gets a workout every day. Although my surgeon said that I could eat a "soft chew" diet starting this past Tuesday, I don't quite know how to chew yet, and I think I'll wait until my next appointment (a week from next Monday) before I try.

My bite continues to shift forward and slightly to the right, particularly when I am stressed, or the muscles have been used very much. My guess is it's just the muscles trying to return to their previous position. It always seems to go back eventually, and usually when I wake up in the morning, all is well. Who knows where it will eventually decide to go? I'm continuing to use moist heat as often as I can. I'm not sure whether or not it's helping, but I feel somewhat better when I use it.

I am still able to open to about 15 mm, which is fine with me. I mean, how wide do I really need to open my mouth at this stage anyway?!? I imagine when I get looser elastics, my ROM will improve a bit. Right now they are pretty much restricting how far I can go.

I am beginning to get feeling back in my lower lip and chin, and the process is quite uncomfortable. It's difficult to describe the sensation. I guess it's achey, throbby, with interspersed sharp pains. Yep, that pretty much sums it up. Oh, yeah. How could I forget? PRICKLY and ITCHY! I am back to taking pain meds at night so that I can sleep. This is undoubtedly the greatest source of stress for me right now.

The upside of getting feeling back on my lower lip is that now I am successful at drinking out of things besides a straw. I can drink out of a cup if I'm looking in the mirror, and tonight (right now, actually), I am drinking a beer out of a bottle. Hooray for me! As Bobby McFerrin said, "the simple pleasures are the best." Of course, when I take the swallow of beer, the cold drives my lower teeth and chin absolutely wacko! Ah, the price we must pay.

That's all for now. Feel free to compare notes with me. Onward and upward!

[phil]

Hello, all!

Here is my news for day 17: BIG BOY TOOTHBRUSH TODAY!!!

You all know that my bite has been shifting a bit forward post-op, and here is an interesting article that I found online. Of course, as a scientific statement, I suppose it's pretty weak--a sample of 44 patients is pitifully small in my opinion. Still, it gives one cause to wonder.

Has anyone else who's had BSSO and/or combined surgery (LeFort I as well) experienced what this study talks about, the temporary shift forward for six months post op? Let me know.

http://ejo.oxfordjournals.org/cgi/conte ... act/14/1/3

It's an interesting statement, anyway.

[Beth85]

Hi Phil,

Firstly I want to say well done for getting through the surgery. And the change is fantastic! The pictures you posted of your progress have been a great help.

I'm having upper and lower jaw surgery for a class III underbite, similar to you i think?

I was told I had a 12mm discrepancy? Is that the right term??
And that they will move my top jaw forward 6.5mm, the lower back 5mm.

The question i wanted to ask was how long were you in theatre for do you know? I understand it's different for everyone but i'd like to have a rough idea.

Also i'm a complete wimp when it comes to pain & again i know it's different for everyone, but did you find it particularly painful or mainly uncomfortable?

Sorry for all the questions, you have had the surgery closest to what i'll be having, so I thought you may be able to help.


Thanks,

Beth.

[phil]

Beth,

Welcome!

Your case sounds similar to mine. The only difference is that it would seem that you have more of a maxillary deficiency than me, and perhaps are not quite as prognathic. My maxillary advancement was 5mm, and my mandibular setback was 7mm. The surgery should be similar. I was in surgery (or in "theatre," as you say across the pond) for 3.5 hours. The surgeon said it should take about two hours per arch, and I guess he didn't have any complications!

I will tell you that the first thing I told them when I woke up was "pain." In the hospital, they gave me morphine through my IV, so I'm sure I was comfortable. By the second day, I was asking the nurse if I could have something not quite as strong as the morphine, so for me, pain wasn't too bad. I've had some ups and downs with it since I came home, but nothing that can't be managed. Your surgeon will probably prescribe something for you before you go to hospital. That way you can have it all ready when you get home. Long story short--the pain is very manageable, just be sure to stay ahead of it with your meds!

Also, you should know that this surgery makes BIG changes to the structure of your face. So, if things are wacky with your bite post-op for a while, it's perfectly normal. The muscles are first of all, recovering from being stretched beyond belief in surgery, and secondly, getting used to the new position of the bite, so it makes perfect sense that they might rebel a bit! I wish I had been alerted about this before surgery, so that my mind would have been more at ease now. I've had problems with my mandible wanting to shift back forward, and rotate back to the right (they also corrected a 3mm assymetry in my chin by rotating my mandible further back to the left). It makes sense, but my surgeon did not really thoroughly explain to me how I might have problems with this. I am so glad I have the opportunity to alert other people of this possibility!

I have to say that the first week was rough, but I would do it all over again, even if I knew what I was about to face. The change in my bite is remarkable! I know that once my treatment is completed, life will be much better for me.

Good luck with everything, and keep us posted.

[Beth85]

Thanks Phil, you've been extremely helpful! It's so nice to have so many people giving advice through experiences of their own, i can't tell you how much it helps.

I'm glad you mentioned that things may try and "shift" back to their previous position. Cos if that happened & i wasn't aware of it, i may have panicked ha ha

I am concerned about the pain, i won't lie but i'm sure the docs will have things covered.

And i'm nervous about the way i'll look once all the swelling has gone down so i'm trying to prepare myself mentally also.

But having said all that i have around 5/6 months, or maybe more, til surgery anyway. (Had wisdoms removed 22 june so 6 months for the bone to heal.)

Thanks again for replying, good luck with the rest of your recovery.

Take care

Beth.

[phil]

I MADE IT TO DAY 20!!!

Welcome to my bumpy ride. Last night, the "muscle wars" threw my bite out of whack beyond belief. This morning, after a night of pain relief with the heavy-duty drugs, I woke up to a completely relaxed and normal bite. Amazing.

Currently, I am suffering the after-effects of those nasty drugs. I'm ready to pour the rest of it down the sink.

Here are some pics from this morning, though, before I was feeling so lousy!





Onward and upward!

[dubnobass]

I had my pre-surgery workup today and asked my orthodontist about potential problems with muscles spasms (I was thinking of your posts on this subject when I asked).

He said that he hasn't seen it all that often, but on rare occasions of complete spasm where it pulls the jaw completely out of alignment, they combat it with extremely heavy duty elastics until it settles down. Have they tried this with you, Phil?

[MGood]

Phil,

The pics look amazing!

I was wondering, if you could walk me through posting a pic from Imageshack. I uploaded 2 yesterday, then I clicked on post to a blog, it asked me for our URL. After the http:// I typed www.archwired.com and it kept telling me it was unable to post to my site. Any suggestions on what I am doing wrong?
Thanks for any info. and take care.

Michelle