Sunday, March 30, 2008

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!

Monday, March 24, 2008

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."


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.

Thursday, March 13, 2008

X marks the jaw

I'm still working on all of my post-jaw surgery entries, but I thought meanwhile, you'd be interested to see the inside of my face once again. Because who doesn't want to see that?

So, here are some after and before X-rays for your viewing pleasure.

The first one is the after-surgery X-ray.

You can't see a huge difference in the bite from pre- to post-surgery in this shot, but you will notice the surgical hooks between each of my braces in the post-surgery shot as well as the three screws the surgeon put in either side of my jaw.

It's still hard for me to believe that I have screws in my face.

I'm permanently screwed.


Moving on...

Post-surgery is up first, again. You can see the screws in my jaw in this shot as well. You'll also notice that my teeth fit together better than before, and if you look very closely from one to the other, there has been a slight shift in my chin.

My profile is a bit stronger and my chin is a bit further out.

It's subtle. The surgeon only moved my lower jaw forward 4 mm, but every day as the swelling goes down, I notice more changes. It's kind of neat, really. How often can you see your face transform before your very eyes?

Friday, March 7, 2008

Homeopathic healing

A lot of people have expressed amazement on how quickly my bruising and swelling went away. While I maintain that a positive attitude does make a difference when you're healing from major surgery, I certainly don't credit alone with my progress.

Before my surgery, I went to see my naturopathic doctor and she prescribed a number of homeopathic remedies and supplements.

Homeopathic remedies operate on the principle that like cures like. So, if something in great amounts causes a headache, then the theory is that a very, very, very small amount of the same thing will cure a headache. Homeopathic remedies dilute those substances to microscopic levels and then use them to treat that ailment.

There is a constant debate going on as to whether or not it really works. In my experience, it has. But everyone is different. The way I see it is there's no harm in trying. If it works, it works. If not, the remedies are relatively inexpensive (I paid $7 per vial, Canadian Dollars, for mine), so you're really not losing anything.

My arsenal of non-drug remedies.

This is what my naturopath recommended for me (please consult your doctor/surgeon/homeopathic practitioner before taking any supplements):

  1. Arnica Montana, 200K pellets. One or two pellets at a time, taken away from food, as often as needed to reduce bruising and swelling.
  2. Hypericum Perforatum, 200K pellets. One or two pellets at a time, taken away from food, as often as needed to reduce nerve pain.
  3. Calendula, 200K pellets. One or two pellets at a time, taken away from food, as often as needed to heal wounds post-surgery.
  4. Thiosinaminum, 6CH pellets. One or two pellets at a time, taken away from food, as often as needed to break down scar tissue.
  5. Wobenzym N., enteric coated tablets. One tablet three times a day, taken away from food, to break down inflammation. (Note: Wobenzym contains Bromelain, a digestive enzyme made out of pineapple. I know of a lot of jaw surgery patients who just take Bromelain, which would have the same sort of result if you're unable to find Wobenzym.)
  6. Traumeel, oral drops. This is a complex homeopathic with a variety of compounds in it. Five drops, three times daily, taken away from food, to reduce swelling, bruising and inflammation.
  7. Vitamin B12. She didn't give me an amount on this, but said that it helped encourage nerve regrowth and reduce nerve pain. I found these great dissolving Vitamin B12 strips that I could put in my cheek while my jaw was wired shut and they would dissolve. Awesome!
  8. Mediclear, protein and vitamin powder. One scoop in rice milk in the morning with breakfast. Provides protein essential for healing and liver support post-anesthesia.

If I had to do it again, there were some changes I would have made.

Firstly, I would have found as many of the homeopathic remedies in tinctures/oral drops to make them easier to take when I was wired shut. I used a method for taking the pellets called "pulsing" where you put a very tiny amount of water in a glass and dissolve the pellets in it before swallowing. It worked fine, but the usual method is to dissolve the pellets under your tongue. Drops would have been much more convenient.

Secondly, I would have started taking the Arnica and the Traumeel several days before surgery. You get a much better result that way. I took the Arnica just one day before, and I didn't start on the Traumeel until three weeks after the surgery. It turned out well for me, but it would have been even better to start earlier.

Otherwise, it's been going very well. I wasn't able to take the Wobenzym while I was wired shut, but I am taking it now. While I was wired, I focused more on taking the Arnica and Calendula as much as possible. Now that the swelling is mostly gone, I'm concentrating more on the Hypericum and the Thiosinaminum as well as making sure I'm taking my Mediclear every day. I added the Traumeel because I noticed there was just a tiny bit of swelling left that wasn't going down as much as I would have liked and I figured it would help.

The really nice thing about homeopathic medicine is that it is so diluted that it's impossible to take too much of it and it is not going to interact with any drugs, or so I'm told. It's kind of idiot-proof, which serves me quite well.

Monday, March 3, 2008

Through the wire

Kanye West recorded the song "Through the Wire" with his jaw wired shut. Good for him. As for me, I was just happy to get some tidbits of food through that wire. Rapping was the last thing on my mind.

I know I'm Little Bella Sunshine about my jaw surgery and all, but I won't lie: eating with your jaw wired shut sucks. And I use that term figuratively, not literally, because you're so swollen you can't even suck anything through a straw.

When I was in the hospital, I ate with the aid of this little prop:

Surprisingly, this device was not used to impregnate anyone.
Even though the antibiotics had rendered my birth control pills impotent.

That syringe was my lifeline. I would suck the liquid/mush through the tube, and then squirt it into the side of my mouth. In the hospital, they fed me things like meal replacement drinks, juice, pudding, cream of wheat, soup, etc. And then I had friends like Laura, who smuggled in Booster Juice, and Karen, who brought a delightful iced chai latte. Those drinks were absolute heaven and helped me make it through until I could go home and eat what I wanted.

The drive home from The Big City took more than two hours. Because a liquid diet doesn't stay with you long, I was absolutely ravenous by the time we pulled up to my place. I dreaded having to make some food. I was tired and achy and hungry and I just wanted something easy.

Then, I opened my screen door, and nestled inside was a Booster Juice with a nice little card from my friend The Bee. It was as though the heavens opened up and a choir of angels was singing just for me. That woman is getting the best birthday present from me this year, that's for sure.

Unfortunately, after that point, eating got a lot more challenging.

I began with the best of intentions: my freezer full of organic, vegan soups. I thought these would be what I'd be eating the entire time my jaw was wired shut, but it didn't work that way at all. I tried to eat them through my Zip-n-Squeeze bags, but the soups were too thick. I thinned them down with more broth, but they still got stuck in my wires. I realized that I would have to strain them to be able to eat them, but just thinking about straining all of that great fibre out of the soups seemed...wrong. I just couldn't bring myself to do it; it stressed me out. So, I shelved the soups until my jaw was unwired and I could appreciate them in all their glory.

My next attempt at "healthy food" was also a dismal failure. At the hospital, the dietitian had said something about blending oatmeal. She said to put it in the blender before mixing the water in, but I can't seem to follow instructions for some reason. Instead, I made the oatmeal and then put it through the blender with some milk and brown sugar and plopped it into a Zip-n-Squeeze bag. Bad idea. The blended oatmeal concoction turned into a gluey mess that barely squeezed through the tube. And it was much less appetizing than it sounds, trust me.

At this point, I turned to foods I knew I could get through the wires: Boost (with extra protein), yoghurt, pudding, hot chocolate, chai lattes, applesauce, juice, and commercial soups without chunks, like cream of tomato and cream of mushroom (put through the blender, of course), all supplemented with skim milk powder for extra protein.

Anytime I would deviate from the above list, my wires would get clogged with food and I'd be in the bathroom with my new boyfriend, Larry the WaterPik (I had moved far beyond George by this point.) I don't know how I could have done it without him.

Even with the "easy to eat foods", it took me about half-an-hour to eat anything. A cup of pudding. 30 minutes. A bowl of soup. 30 minutes. And in that time, about half of the food would end up on me. My lower lip and chin were numb from the surgery, so I wasn't able to feel where the spoon was going, or that there was food all over my face. The boyfriend got no end of amusement from this. Two-year-olds eat with far more panache than I did. In two weeks, I did more laundry than I had in the past three months.

Less than a week after the surgery, the boyfriend and I went to one of those sub sandwich places that also serves soup. I ordered the broccoli cheese soup. It seemed that it would work and I was looking forward to eating out like a normal person again.

The soup was quite chunky, so I picked out the bigger pieces with a fork and tried to eat around the rest of the vegetable pieces, slurping the creamy part off a spoon with my upper lip. After awhile, my wires got clogged (as usual) and I had to go to the restroom to brush some of it out.

When I came back, I decided to lift the bowl up closer to my mouth. Instead of lifting it straight up, I spilled it all the way down the front of my sweater. Fortunately, I jumped a bit, so it didn't end up in my lap, but rather all over the booth I was sitting in. Always a class act, that Bella. I was so frustrated, I almost burst into tears.

This was not going well at all. In my first week wired shut, I lost five pounds. Not that I'm complaining about that, but I knew that I needed to get my protein and calories in for my body to heal.

One day, I lost it and scooped peanut butter out of the jar and rubbed it against my wires, trying to suck it through my teeth. It kinda worked. But not really.

Another day, I melted down a chocolate bar and slurped it from a spoon.

I finally got so frustrated about getting food in me that I went to the grocery store and bought:

  • Whole milk
  • Cheese cake mix
  • Chocolate whipped cream

The second week, I don't think I lost any weight at all. Particularly once I rediscovered root beer floats made with Häagen-Dazs ice cream. Mmmmmm.

I think my naturopath had a mild aneurysm when I told her what I'd been eating for those weird wired weeks.

Ah, well. I survived, didn't I?

Sunday, March 2, 2008

Confessions of a morphine junkie

Perhaps Nancy Reagan was right. If someone offers you drugs, "Just say 'no', then go and tell someone you trust."

Of course, this is not what I did. I said, "Bring it on!" and became a morphine junkie within mere hours.

When I woke up from my jaw surgery, I was hooked up to an IV, attached to which were lines for fluids, antibiotics and morphine. The nurse soon told me that I was the one who would get to control the morphine flow. There was a little button that I could press anytime I felt too much pain, and that would release morphine into my veins.

Well, now, this was going to be fun. I quickly fell in love with my morphine dispenser. I named him George, cuddled him and considered leaving my boyfriend for him.

Oh, George. We were meant to be together.
Let us never part.

Anytime there was even a smidgeon of pain, I pressed George's button religiously. Hey, he was there, right? And who wants to feel pain, anyway? Plus, it felt goooooooood.

But, as with anything gooooooooood, there were some downsides to my relationship with George.

Take, for instance, one of the big things that we take for granted: going to the bathroom.

The first time I had to pee after my surgery, I went into the bathroom and sat there for a really long time, trying to pee. I knew I had to go, but it wouldn't come out. I ended up having to push it out in spurts for about 40 minutes until I was done. (Too much information, I know.)

When I saw the nurse next, I told her about the peeing drama and said, "That was really creepy. What the heck was up with that?"

She explained that it was one of the side-effects of the morphine - inability to control the bladder sphincter. Nice. But that wasn't enough to make me give up my love affair with George, that's for sure. So it would take me a bit longer to pee. So what?

But it got more interesting. One night, I felt like I was peeing, though I was pretty sure I wasn't. So, I dragged myself out of bed and went to the bathroom, sitting there for another 40 minutes until I was done, then went back to bed and passed out.

The next day, I went to the bathroom for another 30 minutes (I was getting a bit better at it by this time) and looked down at the floor. There was what looked like dried pee on the floor in front of the toilet. I stared at it and tried to figure out how it had gotten there and who it could possibly belong to. I had visions of some creepy old man breaking into my private room with the express purpose of peeing on my bathroom floor.

When I got out of the bathroom, I saw one of the nurses take the disposable pad off my bed and say discreetly, "I'll just change this for you."

Hmmm. Okay. Well, that's nice of her, I guess. I went back to bed. Later, I noticed a few nurses get a bucket and discreetly mop up the bathroom floor. "There's some pee on the floor," one whispered. They discreetly looked at me and then looked away.

Why are they looking at me? I thought. It's not like it's my pee or anything. Why should I be embarrassed?

I was still working on my creepy old man theory. But I couldn't figure out how the old man had managed to pee on the pad I was lying on without me waking up to see him. I guess it was my pee after all. Unless....maybe it was aliens!!

Probably not. But it's a theory I was willing to investigate further.

A day later, the nurses told me they had to start taking me off the morphine.

"But I need him!" I exclaimed.

They explained that I had to go home soon, and I couldn't take George with me, so I had to learn to manage the pain without him.

Nooooo. Please don't take George away! We love each other!

As you can see, I was very upset about this new development. I alternated between trying to cut back and pushing George's button for "old time's sake."

However, as I cut back, I began to realize how much of a junkie I'd become. Sure, I liked George and all, but I didn't need him, like I had previously thought. Also, the less I relied on George, the easier it was to pee, and that was no small mercy, because my stomach muscles were killing me from all that effort. (Another thing about George that I realized later on: when you're on morphine, you no longer poo. It took me five days before I could go again. Now that's creepy.)

Clearly, this was a co-dependent relationship and I needed to get out. I asked the nurse to remove the IV.

"Are you sure?" she asked. "If I take it out, you can't have any more morphine."

"Yes, I'm sure. George and I are through."

It was nice while it lasted, George, but eventually, we all have to return to the real world.


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