Smiling Bella featured on Willow's Web Astrology

My friend Willow, an astrologer, has used my post-jaw surgery recovery as an example of "Saturn in Virgo" behaviour in the May issue of her monthly Astro Perspective. She says:

Saturn has been going retrograde for the past three months or so, allowing us to come to terms with a lot of issues related to health, diet, personal habits and trimming the fat in all areas of life/self - whatever we need to deal with before moving forward in life. Saturn has forced us to take responsibility for being our best selves and for making the adjustments and refinements we know we need to make in order for our lives (and ourselves) to function long-term in a sustainable, healthy way....

Virgo relates to service, self-mastery and holistic health, so we’re being challenged to make the changes we know we need to make in the pursuit of holistic health - body, mind, emotions, spirit....

I've noticed people doing a lot of home renovation projects lately (definite Virgo territory - related to improving what already exists) and dealing with long-standing health issues.

A textbook Saturn in Virgo experience is the one my journalism school friend, Bella, is going through (major jaw surgery). Check her story out at: http://www.smilingbella.com/. Bella’s taking responsibility for having a pain-free life - doing what she needs to do and dealing with (relatively) short-term pain for long-term gain. Virgo is co-ruled by Chiron (healing) and Mercury (communication), so jaw surgery affecting her speech and the healing process afterward are very much Saturn in Virgo territory.

It was helpful to see my situation through her lens and to be reminded that all of the discomfort and difficulty I've been facing lately is necessary for me to have a better quality of life in the long run.

If you're interested in astrology, I'd highly recommend Willow's sites. I am always amazed at how her insights speak directly to my life (even when I'm not mentioned.)

Good news, finally!

I went to see my surgeon this weekend. Since I got my jaw unwired, I see him every six weeks to make sure my jaw is healing on schedule. This was my second six-week follow-up and I have to admit I wasn't looking forward to it because of my last experience.

At my unwiring appointment, he fastened four elastics - two on each side of my mouth - connecting my upper and lower teeth and told me to wear them at all times. These were to train my jaw to open symmetrically. They were placed at an angle to keep my lower jaw in its new position and to ensure it didn't start regressing back to where it was before the surgery. At night, I had to wear a single elastic connecting my front upper and lower teeth.

The problem was that my teeth move easily and quickly. So, instead of keeping my teeth in their current position, the elastics started pulling them forward. Over the course of the six weeks from my unwiring to my next appointment, my teeth shifted into an underbite position, with the lower teeth on the outside of the upper.

My lower jaw was slightly further out than it should be.
But I'm still totally cute.

As you can imagine, when I went to my surgeon with an underbite two months after my surgery, he was not pleased with the results. I had expected that he would just reverse the elastics until my teeth went back to where they were supposed to be.

But that's not all he did. Oh no.

In addition to changing the elastics, he took his thumbs and pushed my lower teeth until they sat behind my upper teeth.

Let me repeat that: He pushed my teeth into place with his thumbs.

I'll wait while you imagine that and twitch, because I'm still twitching thinking back on it.

After four days of migraines, my teeth were back to where they belonged. And six weeks later, it was time to make the two-hour drive to see the surgeon again.

In addition to having waking nightmares about his thumbs coming after me, I was a bit stressed about being able to open my mouth wide enough. When I got unwired, my surgeon told me I had to work up to opening my mouth 30 mm before I could go back to my orthodontist and continue with braces adjustments.

The last appointment, I only made it to 25 mm, and in the six weeks since then, I had been struggling to stretch it farther than that, and not making much progress. Fortunately, about a week before the appointment, my jaw finally started to give.

I took my jaw stretching device on the road and used it in the car on the way to the appointment. And, miraculously, when I saw my surgeon, not only did he not come after me with his powerful thumbs, but he also announced that I had made it to 32 mm.

32 mm!! Wooo hoooo!!!! No more surgical hooks on these teeth, and one step closer to debracing!!

Finally, some good news.

In-valid

I'm struggling. Struggling to be well. Struggling to maintain a positive attitude. Struggling against the perceptions of others. Just struggling.

It's funny. You prepare and you do your research and you're ready for the worst when going in for major surgery. But that's the easy part. What they don't tell you is what happens afterward.

When you get your face cracked open, you expect that there will be massive swelling, nasty bruises and grotesque stitches. You mentally prepare yourself for that, and when it happens, it's not quite as bad as you thought it would be. You figure that once your jaw gets unwired and the physical signs of the procedure are gone, you're home free.

If you want the truth, I would gladly go back to having my jaw wired shut right now. Because the moment the wires came off was when things started getting difficult.

I expected it would be tough to eat for awhile, but not for as long as it has been. I still can't eat anything chewy or hard (raisins or fresh vegetables, for instance), because I literally can't chew it. And it's been more than two and a half months since the surgery now.

I expected that my mouth would have a limited opening for awhile, but I didn't expect that getting my range of motion back would be such a painful, slow struggle.

I expected that I would have some pain and that I might be tired, but I didn't expect that every physical action would be so exhausting.

Anesthetic stays in your body for up to a year after surgery. It slows you down, you forget things, you lose your train of thought, you stumble into doorways, and you get tired easily. When you go off prescription painkillers, you can plunge into depression because of the withdrawal. And after major surgery, your immune system is compromised, you're more susceptible to viruses and they hit you a lot harder than they did before.

You go to the mirror and see someone staring back at you who looks fantastic and you can't figure out why she just can't get it together already. The surgery is over. The time off work is over. Why is it getting harder instead of easier? What is wrong with me?

One day, I posted this status on Facebook: "Bella looks absolutely fabulous but feels utterly miserable." It's rare that I have a status that is less than racy or bizarre, so a friend of mine who had major brain surgery a few years ago responded with concern. I wrote him back:

It's the post-surgery stuff. Everyone is so supportive when you're just out of surgery and you look like hell. Flowers, cards, understanding, etc. But once you look okay, they forget that you've been through this major procedure and treat you like you're back to normal. But you're not.

I'm finding right now to be one of the most difficult times because I look great - you'd never know I had surgery. However, I'm so tired and everything is an effort. I misplace things, use the wrong words, forget what I'm doing, etc. Stupid anesthetic brain. Anyway, it's tough.

How long was it for you until you felt fully functional after surgery?

His response was right on the mark:

How long? In my case, I'm still waiting....The way I thought about what you're describing was to re-pronounce the word 'invalid' - i.e. as 'valid' with a prefix, meaning 'not a valid person.' I suspect that like mine, your inner person is seeking validation for the experience and the way it's making her feel. How to find validation? I dunno. Is it frivolous to suggest dark eye shadow UNDER the eyes, a sallow make-up foundation, and a carefully understated limp?

It felt good to talk to someone who knows what this is like. These days, I just feel frustrated. Frustrated that I can't do everything that I could do before. Frustrated that anything that contributes to my stress levels becomes unmanageable quickly. Frustrated that just when I think I'm doing okay, something as simple as chanting in a mellow yoga class re-injures my jaw and leaves me with crippling migraines for four days straight.

Frustrated that the people around me respond, if at all, with patronization or their own frustration at my lack of ability to be my usual high-functioning, overachieving, reliable self.

Frustrated, alienated, alone. Depressed. In-valid.

My secret weapon

A few weeks ago, I wrote about going to acupuncture to try to get the feeling back in my chin, post-surgery. At that point, I estimated that I had 98 per cent of the feeling back in my chin and lower lip after a few acupuncture treatments.

Well, let's just say that I spoke too soon. Shortly after I wrote that entry, I came down with the nastiest flu ever. It hit everyone I know pretty hard, but I seemed to get it much worse. I'm guessing it's because my immune system has been compromised by the surgery and the healing process. I was away from work for two weeks straight and was unable to get out of bed for the first week because my whole body hurt.

I'm not sure if it was all the coughing, my inability to keep down nutritious food, or the fact that my body was fighting off a virus instead of focusing on healing, but the feeling in my chin regressed back to about 80-85 per cent during that time.

It was upsetting and frustrating and scary. Did this mean that the nerve damage was permanent? It was one more thing to worry about that I really didn't need to add to the mix.

I went back to acupuncture and that helped a bit. Getting the coughing under control with a bronchial inhaler (I ended up with bronchial spasms after I got over the flu. Fun with a broken jaw, let me tell you) helped a great deal with the tension in my jaw, too.

But the one thing that made a really big difference was totally unexpected.

I am a big sucker for the clearance section at my favourite Canadian drug store, Shoppers Drug Mart. One day, not too long after my surgery, I found an amazing sale on the Neutrogena Microdermabrasion System. I had always been curious about it, so I thought it was a fair indulgence after having my face cracked open and all.

I had chipmunk cheeks and huge yellow bruises,
so anything to help me feel better was quite justifiable,
in my humble opinion.

I started using it on a regular basis while I was at home recovering from the surgery. It is a hand-held vibrating sponge that you use to spread gritty cream around your face. You concentrate on each area of your face a maximum of one to two minutes. Each time I used it, I thought I noticed more feeling in my chin. I wasn't sure if it was just getting better on its own or if the vibrating and stimulation was doing something to help restore the feeling. All I knew is that it was getting better.

Anyway, after my numbness returned, I started using the microdermabrasion more often and I noticed the difference right away. I have no idea if there is any medical evidence for this, as I have been unable to find any online, but I all I can say is, "Hooray for facials!"

Now, if only I could convince my insurance company that going for facials is an essential part of my jaw surgery recovery, I would be a happy gal indeed.

Surgery support link action

For those who have stumbled across this blog looking for more information about jaw surgery, I have a number of links posted in my sidebar that I'd like to draw your attention to.

When I was faced with making the decision to have this surgery, I was terrified and didn't know where to turn to answer the multitude of questions whirring through my head.

Then, I came across a blog by someone who had the surgery who took the time to write about it and post pictures. She also linked to the Yahoo orthognathic surgery support group, which was a wealth of information with helpful people who had been through it themselves and were willing to answer questions and share their experiences.

Because of the answers I found through these links, I was able to make an informed and confident decision to have the surgery. I went into it with my eyes open and I knew exactly what to expect. I credit my positive experience with the fact that I did my research and I was prepared.

That's why I started this blog - to help other people find the information they need to make the right decision for them. Being told you need surgery is a scary, scary thing and research is the key that changes that fear into power.

If you look at my sidebar, you'll see a heading called Online Support Group Links. These are message boards where people can ask questions and talk about their experiences.

Below those, I have two groupings of blogs listed. The first is Pre-Surgery Blogs: people who are preparing for the surgery. The second is Post-Surgery Blogs: those on the other side of the surgery and are either still in recovery or have completed the process entirely. Your surgeon or orthodontist is a great source of information, but there are certain things that you'll learn from people who have been through it that you won't learn anywhere else.

Beneath the blog links are some information links as well as links to homeopathic remedies, recipes and products that I found useful when recovering from surgery.

I would like to link to many jaw surgery blogs as I can so that there is a wide variety of experiences represented here. If you have a blog about your surgery, whether you are still waiting for it to happen or you're well beyond the bone saw, please email me or leave a link to your blog in my comments so I can add it to my list.

I hope you are able to find the information you're looking for. Good luck!

Animated illustrations of jaw surgery

I was searching for diagrams illustrating the surgery I underwent and I came across this really cool page from the Mayo Clinic that has animated illustrations of each of the surgeries.

Check it out.

Tools of the trade

Tomorrow marks the two-month anniversary of my jaw surgery. It's hard to believe that eight weeks has passed since my super high-five happy times, but here we are.

The bruising is gone, the swelling is gone, those awful wires binding my jaw together are gone, and people tell me that I look like a million bucks. And yet, my recovery is not over. Not in the least. There's the small matter of being able to open my mouth and chew things. Yeah, that little detail.

After I got my jaw unwired, I could only open my mouth a few millimetres. My surgeon gave me some exercises to do to help get my opening back. After one month, I was only able to open my mouth 15 millimetres.

In case you're wondering how much that is, here's a ruler. Put some household objects up to it and imagine only being able to open your mouth that wide.

15 mm = One thumb's width.
The diameter of a small coin.
Less than one Scrabble tile.
And keep in mind, it's 15 mm, teeth to teeth.

Do you know what you can eat when you can only open your mouth 15 mm? Not a whole lot. Unless you chop it up into eensie teensie little pieces.

The situation of sharing the same food as my friend's baby was getting kind of old. I had to get on top of that sucker. So, I ran to my physiotherapist, stat.

She stretched my jaw, moved it around, massaged it, and then handed me this:

I wondered if perhaps she was giving me some tools
so I could break into the pharmacy late at night
and swipe some of the good drugs
so I would no longer care that I couldn't really eat.

Alas, this was not the case.
I was supposed to use this device to stretch my mouth open.
That piece on the end goes into your mouth,
and then you use the grip to crank it open.

Seriously??
Look, I don't like you, and you don't like me,
but we're in this together, so we better make the best of it, alright?

At first, I couldn't even get my mouth around the thing.
But after a few stretches, I was ready.
I wasn't able to crank it open for quite some time,
but after a few weeks of baby steps...

Crank, crank, crank, crank, crank.
That's five, in case you were counting.
25 millimetres.

25 mm=two finger widths
The spine of a substantial self-help book
The width of a fork.

And might I mention,
it feels as comfortable as it looks.

The thing is, 25 mm is not enough. My surgeon won't let me go back to my orthodontist for braces adjustments until I reach 30 mm. And I am not considered fully recovered from this surgery until I have a "functional opening", which is around 40 mm. The physiotherapy torture device has 10 clicks on it. I have only been able to reach 5-6 clicks at this point.

This is what the torture device looks like when open 10 clicks.

More than a little daunting.

Infuriating, really.

But mostly depressing.

But I'll keep at it. I'm a trooper that way. A pathetic trooper who can't open her mouth wide enough to eat an ice cream cone, but a trooper nonetheless.

More before and after photos

My surgeon's office just sent me the pictures they took of me one week before the surgery.

And now I know what I would look like in mug shots.
I mean, do they try to make the "before" pictures look bad?

Here are some shots that have been taken in the last few weeks:

A silly shot taken on Day 45,
on the way to sushi, which guess what?
You don't have to chew.

A profile shot taken at the sushi restaurant.

You can really see the difference in my chin/profile in this shot.
I used to avoid profile shots like the plague.
Now, I loves them, I do.

If you compare this smiley shot to the smiley "before" picture,
you'll see that my smile is no longer lopsided.
Hooray!

A serious shot to show my lovely new chin...
and the new hairdo to go with.

Poke me, baby

One of the things that stressed me the most about having jaw surgery was the possibility that there would be nerve damage, leaving my chin and lower lip numb for a year or perhaps forever. My orthodontist told me the likelihood of permanent nerve damage increases with your age. As a 32-year-old undergoing the surgery, I had a 32% chance of permanent numbness.

This prospect was thoroughly unacceptable and made me determined to be in the 68% of people who regain full feeling in their lips and chin.

So, I did what I've done with pretty much everything surrounding this surgery: obsessive-compulsive research, or OCR for short. I found a number of homeopathic and natural remedies to help reduce inflammation and nerve pain, and I investigated acupuncture to help rejuvenate nerves.

I also stalked jaw surgery survivors. A friend had the surgery in her 40s and ended up with permanent nerve damage in her chin. When she finally discovered acupuncture, which helped her get some of the feeling back, the practitioner told her that he could have helped her get all of it back...if she had only come to him one month after the surgery, instead of one year later.

Some sharp needles in my face vs. not being to fully appreciate future make-out sessions = easy decision. I made the appointment for two weeks after the surgery. Stat.

You talkin' to me?
Can you tell I took this shot myself?

I had gone for acupuncture before, with mixed results. One practitioner took on so many patients that she made her storage closet into a treatment room. You'd be lying on the table, immobile (because needles were piercing various body parts, and moving would shoot pain up your limbs), and someone would walk in, reach up to pull something off the shelf above your head, and leave. And then someone else would do the same a few minutes later. She was also so busy that she'd even forget needles in you. I stopped going to her after discovering a large needle in my ankle and having to pull it out myself.

The other practitioner I saw could barely speak English. She had such a heavy Chinese accent that the majority of conversations with her involved the phrases, "What?" "Excuse me?" and "I'm sorry, I don't understand," as well as a fair bit of gesticulating. I don't know about you, but when someone is coming at you with a handful of sharp needles, it kind of helps to know what they're saying.

Regarding the acupuncture itself, both of the practitioners I saw were great at it and their treatments helped me feel a lot better. But when you've got a broken jaw, you just want to go to someone you're comfortable with. Fortunately, my new naturopath also practices acupuncture. I was relieved to discover this, as I really liked her, even though her elimination diet had nearly pushed me over the edge the last time I saw her.

A great up-the-nose shot. But you can see all the homeopathic and natural remedies in the background.
Plus, I have a cute nose, right?

I usually find acupuncture really relaxing. I go into a meditative state, and sometimes, I feel like I am levitating out of my body. Not this time, though, because my naturopath and I were goofing around with my camera, trying to get a shot that showed the needles in my face. The facial acupuncture needles are even thinner than the regular kind, so it was really hard to get them to show up in pictures.

Finally, we got a good one!

When she took the needles out from behind my ears, it was the strangest sensation - it felt like they were still there. I rubbed my skin, concerned that this was acupuncture déjà vu all over again, when she said, "Does it feel like they're still there? That means the chi is working."

I didn't know what that meant. But all I knew was that two weeks after my surgery, I had about 75% of the feeling back in my chin and lower lip. In the days following the acupuncture treatment, my feeling came back rapidly. By the one month post-surgery mark, I had 95% of it back, and today, I would say that I'm at about 98%.

Am I going back to get more needles stuck into me? H-E-Double-Hockey-Sticks, yeah!

21st century wireless gal

Now where was I? Ah, yes, I left off at the part of the story where my jaw was wired shut. That kinda sucked, didn't it? Don't worry, sweet Internets. The wired Bella only lasted two weeks. I'm one of the lucky ones - some jaw surgery patients are wired for six weeks. I can't even imagine.

When I left the hospital, the nurse gave me wire cutters and told me I had to carry them with me AT ALL TIMES. Sorry for the use of the capital letters there, but they were very serious about this point. I even had to sign a document promising that I would carry them AT ALL TIMES.

I knew they weren't to be used if you were throwing up. (Apparently, you're supposed to use your fingers to open up your lips, bend over, and let the vomit run out from between your teeth. Mmmmmm. Fun.) I assumed their only use would be if your airway were obstructed or you weren't breathing and someone needed to perform CPR.

Bella: So, how do you use these?
Nurse: I don't know.
Bella: I should know how to use them if I have to carry them at all times, don't you think?
Nurse: I'll ask and find out.

I think I was the first person to ask this question. That's kind of disturbing, when you think about it. How many jaw surgery patients are carrying these things around with no real idea of what to do with them?

Nurse: You just give them to the paramedics if something happens to you.
Bella: Uh...okay.
Nurse: We've never known of anyone who's actually had to use them before.
Bella: But what if I need to?
Nurse: Just get in there and start cutting everything.
Bella: Alrighty then.

The infamous wire cutters that no one uses.

As you can imagine, I was not going to miss carrying those things around in my purse. Their very existence reminded me that I was in a precarious position, choking wise. Something I'd rather not think about when my jaw's wired shut for two weeks.

Other things I was not going to miss: crazy concoctions made in the blender that, more often than not, turned out to be very unappealing; talking through clenched teeth; and finessing one of my pills, which couldn't be crushed up, through the tiny space behind my back teeth so I could swallow it.

But then, the magical day came. The day I got with the 21st century and went wireless (thanks for that turn of phrase, DK.)

The boyfriend had gone to plug the meter just before I got called into the office, so I held the camera up as the surgeon cut the wires and took all these pictures myself. My surgeon asked, "You can take those all by yourself?" My response: "Trust me, when you're as narcissistic as I am, you become very good at taking pictures of yourself!"

The first cut is the sweetest.

Get that finger in there. Good times.

He also had to cut the rubber bands that were over the wires.
Those snapped back something fierce.

At least he knows what to do with the wire cutters.

Can you tell I'm having fun here?

It was a very involved process and went on for awhile.

Also, it kinda hurt.

Except delete the word "kinda."

Freeeeeeeedoooooooommmmmmmmm!!!!

It was a very weird feeling to have those wires off for the first time. It was actually uncomfortable. My jaw was sore and I could barely open my mouth. If you look at my mouth in the above picture, that was literally as far as I could open it after being unwired. It felt really unstable. At that moment, I would have been quite happy had he said he was putting the wires back on.

But then, he gave me a toothbrush and some paste and told me to brush.

And the heavens opened and there was much rejoicing. Because let me tell you - not being able to brush the backs of your teeth for two weeks straight = downright disgusting. My tongue had been brushing up against a layer of fuzz for a week at least, so brushing was a higher priority than being able to eat.

My teeth just after unwiring and before brushing.
Pretty gross, hey?

I brushed for about 20 minutes to get all the stains off. At first, I couldn't even fit the toothbrush into my mouth to get at the backs of the teeth. But I was determined to get that gunk off, so I held my jaw and pressed the bristles against my lower teeth until some of them went on the other side. It was the best feeling in the word. I was so relieved once I was done.

It was then that I realized - I can talk! (So, I babbled the surgeon's head off.) And then it dawned on me - hey, I can eat! (So, I stopped talking and got the hell out of the office so we could go for lunch.)

Now we know Bella's hierarchy of needs: Brushing, Talking, Eating.

The boyfriend and I grabbed a friend of mine who lives in The Big City and went to my favourite Mexican restaurant to eat My First Meal As Someone Who Can Open Her Mouth. I was still not allowed to chew anything, so I had to get something soft and mushy. I ordered the mexi dip, which is refried beans, fresh salsa and cheese baked in a tortilla shell. And I ate that mo-fo with a spoon and a side of guacamole and sour cream.

And it was sublime.