6 week update, plus some advice for anybody considering jaw surgery.

I can’t believe it’s been six weeks since my surgery! I’ve been meaning to write more often on here, but I guess life has just gotten a lot busier.

My recovery is going really well. I’m now taking out my splint 5 times a day for 30 minutes, which is infinitely better than the previous fifteen. When I had fifteen minutes out, I had to basically chug whatever I was drinking, brush my teeth, do my exercises, and then get right back into my splint. Now I have more time to enjoy my food, and I can be more productive with my time. I can drink a smoothie, take a shower, brush my teeth, do my exercises, and then get back in my splint.

The left side of my face has regained all feeling besides right along the incision. The right side of my face still has a little bit of numbness in the cheek and along the incision, but it’s much better than it was a few weeks ago. My eyebrows are almost back to normal!! I can actually raise my right eyebrow almost as much as my left, which is a huge improvement.

Look! I can look surprised now!

The ten mm is really easy for me to open now, and I’m not sure when they will increase the amount, but I’m happy that everything is functioning properly. I have an appointment next week, so I’ll have more info about my recovery plans for the rest of the summer.

I’ve been working out 6 days a week to stay strong (but lightly, nothing too strenuous – walking, stationary bike, stairs, lunges), and that in combination with how I’m eating is doing wonders for my health in general. I have more energy, I’m getting more sleep, my skin has totally cleared up, and I just feel better.

I’ve been thinking a lot lately about what I wish I had known before I had surgery. These aren’t major things that would change whether I had the surgery or not, just small tips that nobody really talks about. I’ve decided to put together a masterlist of things that somebody going through TMJ issues thinking about having surgery should know.

THINGS I WISH I HAD KNOWN/GENERAL ADVICE FOR JAW SURGERY

• Okay, I’m going to start with the obvious. I already knew this, but I wasn’t quite aware of exactly how important having a good blender is. If you have this surgery, you will be eating 4-5 meals a day that don’t involve chewing for at least six weeks. I use my Vitamix at least 5 times a day, and it’s totally saved me. This thing blends up everything you can think of, so you don’t have to worry about accidentally getting a chunk of frozen fruit in a smoothie.
• MAKE SURE YOU HAVE GOOD SOURCES OF PROTEIN. I cannot stress this enough. Your body will now be functioning on liquid, which means that things are going to go through your system faster. You will be hungrier than you probably have ever been on a consistent basis, and having lots of blendable protein is the best way to combat the hunger. I get my protein through soymilk, tofu, nuts, beans, peanut butter, plain greek yogurt (there’s so much more protein in greek yogurt than regular yogurt), Boost, and my favorite protein powder – Vega One chocolate.
• Vega One deserves it’s own bullet point because it’s so good. I made the mistake of buying Raw Meal protein powder without doing any research on good protein powders. I’m vegetarian and lactose intolerant, so I was looking for vegan protein powder with lots of protein and not too much sugar. Raw Meal has a ton of good nutrients, but it tastes AWFUL. It’s grainy and chalky no matter what you put it with, and we wasted close to $40 on this stuff that nobody in my family wants to touch. I went online and did some research about different vegan protein powders, and I found a ton of good reviews for Vega One. It has 15 g protein per scoop, 50% of your daily vitamins and mineral, 3 servings of greens, probiotics, the antioxidant equivalent of 2.7 cups of blueberries, 6g of fiber, and 1.5g omega-3s. Basically it’s chock full of nutritional value, full of super foods like chia seeds, hemp seeds, and acai berries, has only 2g of sugar, and tastes pretty darn good. I drink the chocolate flavor, and I combine it with unsweetened soymilk and fruit. I really like it with frozen strawberries, but it’s also delicious with blueberries and almonds.
• Spoons are not helpful. You may think, hey I’ll be able to use spoons when I can unhinge my mouth! False. Big spoons are horrible when you can only open your mouth 10 mm, and even teaspoons are hard to fit when you have your food on them. Forks are much more useful for things like tofu salad (like egg salad, but better), and I normally just drink soup out of a mug. To try and explain how utterly useless spoons are to me, here is a cat gif of what I look like when I try to use spoons:
  

  Click to see it in action =)

• Get ready for a different kind of soreness in your jaw. I was used to the pain from it being dislocated, but the pain from surgery is totally different. It’s more stabbing than the aching I constantly had, and heating pads are great for helping with pain. If I’m particularly sore I will do 5 mins heat, 5 mins ice, 5 mins of heat. It helps so much.
• Work out before you have surgery. You’re going to get weaker just by the lack of activity you’re going to be up to in the first few weeks, and you want to be strong and healthy. I wish I had done more, but I’m trying to make up for it now by sticking to a regular workout schedule.
• Drink lots of water. You may think that you won’t get dehydrated since you’re on a liquid/smooth foods diet, but that’s totally false. I wasn’t drinking enough water for a couple of weeks, and I was getting headaches. Not fun. Drink lots of water in between your mealtimes. I keep a water bottle with me throughout the day.
• Always have your supplies to unhinge when you go out. You never know when you might be out for longer than you think and suddenly need food fast, and if you don’t have any tools to take your bands off and your therabite, it’s just not a good situation. I purposely went out to buy a larger purse so I can carry everything with me wherever I go.
• Chapstick. Get lots of chapstick. Your mouth is going to be more open than it naturally is because the splint is in there, which results in your lips either having to be slightly open or pursed.
• This is one of the biggest things about jaw surgery that I didn’t really expect – YOUR WHOLE LIFE IS GOING TO REVOLVE AROUND YOUR JAW NOW. I knew I would be thinking about it initially, but I didn’t realize how much it really consumes your life. Everything you do is going to be related to your jaw. You’re going to be on a strict schedule of eating and taking out your splint, and it’s going to interfere with your normal habits. I can’t go out to hang out with friends or to the movies without planning when I’m going to eat and what I’m going to eat. I’m thinking about my jaw when I’m at the gym, making sure I’m not clenching it at all. I’m thinking about it when I’m reading, on the computer, with friends, trying to go to sleep, etc.
• I cannot imagine trying to go through this recovery process while in school or having a job, so if you’re a student and you can have it during the summer, do it. You’re going to need time to rest and adjust to your new schedule and habits, and having the added stress of classes and working is not something you need.

I hope this list helps anybody thinking about surgery! As always if you have any questions or comments, please leave them in the comments section, and I’ll get back to you as soon as possible. I’m going to try to post more (at least once a week) now that I’ve gotten into a rhythm of my own recovery. Thanks for reading!

Michelle

Three week recovery update! (plus some awesome recipes)

That’s right. It’s been three weeks since I had surgery!! I can’t believe how far I’ve come in these three weeks, and I can’t wait to see what’s in store for the rest of the coming months.

Last Thursday I went back to see my surgeon to have another post-op check-up. He really liked how things were progressing, and increased my Therabite exercises to 10 mm. My incision sites are all healing very nicely, and he said that they should be barely noticeable in about six months.

I’ve been slowly regaining feeling in my face, although I still have some numbness in my cheeks by my mouth and close to the incisions. The left side of my face had less numbness to begin with, and the nerves attached to my eyebrows seemed to have little to no damage, so that side still has more feeling. My right eyebrow is still not completely functioning, but in a couple of months it should be fine. The good thing about regaining feeling is that it means I’m healing. The bad thing is that I can feel more pain. I’m not in crazy amounts of pain, but on the left side of my face I’ve been having twinges along the incision sites as the numbness continues to disappear. Luckily I can just take some Tylenol and it gets rid of most of it.

I’m still not allowed to lift anything over ten lbs, which makes grocery shopping (and going to the library…) a bit of a hassle. I can walk as much as I want to and do a stationary bike inside, but I have to avoid anything that jostles my body too much, causes muscle strain in the face, or could potentially have me falling (thus why I can’t bike outside). I also have to sleep sitting up to prevent any additional swelling and pain, which has wreaked some havoc on my sleeping, but I’m slowly getting used to sleeping in a position that I would normally read or use my laptop in.

I think that the biggest change that I’ve had to make because of surgery besides my diet is how I interact with people in public. I’m getting better at talking while being banded up, but it’s still not always the easiest thing for others to understand. I’ve been doing as many self-checkouts as I can, and for those that I can’t I tend to just smile and nod. Last week I went to Barnes and Noble to buy the new Sarah Dessen book, and I couldn’t find it anywhere, so I had to go to the dreaded customer service desk. Luckily, I had put a pad of post-its and a pen in my purse the day before, so I wrote down my question, and that I had just had jaw surgery and couldn’t talk very well, and she just smiled and took me to where they were. I’ve gotten a few weird looks from baristas at coffee shops when I hand them a post-it with my coffee order on it, but honestly I would much rather have a couple of months of weird looks than have to deal with the pain that I was in for so many years before surgery.

After three weeks of being on a liquid diet, I’ve learned how to not get exceedingly bored of my food because of this one thing – soup! Don’t get me wrong – smoothies are delicious. But sometimes you just want a nice hot meal that isn’t sweet. The great thing about soup is that there are so many different kinds. There are tons of different flavors and vegetables that you can use to make different kinds, and they blend really well (even the chunky ones). Also, making soup actually involves some cooking, which I really enjoy, whereas smoothies you just throw everything in a blender. I’ve made some of my own stock, which I used very quickly, so I’ll be making more this week. I’ve decided to post some recipes of my favorites, which are somewhat modified versions of a few different recipes I’ve found online.

Carrot Ginger Soup (inspired by the Carrot Ginger Tofu soup from Healthy Blender Recipes) – this soup is delicious, and vegan! It’s pretty easy to make, and purees really well. I’ve made this a couple of times, and the first time I had some already cooked carrots, but the second time I chopped the carrots with the onions and garlic and cooked them all together. I prefer the first way, but the second works just as well. You need:

• 2 1/2 cups of FINELY chopped carrots (I had baby carrots on hand, so I just used those)
• 1 medium onion, chopped (or half of a large one)
• 4 – 5 cloves of garlic
• olive oil to sautee the onions and garlic (and carrots if you don’t precook them)
• 1/2 tsp salt
• 1-2 tbsp fresh ginger
• 2 cups of vegetable broth

1. In a large saucepan, heat a small amount of olive oil (1-2 tbsp, although I never measure…) and put your onions, carrots and chopped or minced garlic in and saute until onion is clear. You can also add some stock into the mixture if you wish.
2. Put the mixture into a blender (oh how I love my Vitamix) along with the broth, ginger, and salt. Blend until smooth.
3. Put the mixture back into the saucepan, and heat until simmering. Serve immediately.

Roasted Asparagus Soup – This is also a vegan soup, and absolutely delicious! This recipe is a slightly modified version of this one http://blog.fatfreevegan.com/2010/05/roasted-asparagus-soup.html I only had about 1 lb of asparagus that I got at the farmer’s market that day, so I augmented it with a few handfuls of spinach. I also had roasted cashews, not raw, so I used those instead (the cashews are the key to making the soup nice and creamy). Here’s my modified ingredients list with her instructions:

• 1 lb of asparagus with ends trimmed
• a few handfuls of spinach
• olive oil
• 1/2 onion, sliced
• 2 cloves of garlic, peeled
• 2 cups vegetable broth
• 3 tbsp roasted unsalted cashews
• 1/8 tsp white pepper

Instructions

1. Preheat oven to 450F. Place the asparagus spears on a baking sheet lined with a silicone liner or parchment paper. Roast for 10 minutes. Turn asparagus and sprinkle the onion and garlic over it. Roast for about 10 more minutes, until asparagus is very tender. If anything looks like it’s browning too much, take it out. (Important Note: These directions are for thicker asparagus. Thin asparagus may take much less time so start with 6 minutes, turn and add onions and garlic, and check again in 5.)
2. While the asparagus is roasting, blend 1/2 cup of the broth with the cashews and pepper until smooth. Leave it in the blender.
3. (this one is from me because you have to cook the spinach) take the spinach and a little bit of olive oil and cook in saucepan until wilted.
4. When the asparagus is done, select several of the best-looking spears, remove the tops, and set aside to use as garnish. Cut the remaining asparagus into pieces and put it and the onion and garlic into the blender, along with the remaining broth (AND THE SPINACH!). Cover the blender and blend on high until perfectly smooth.
5. If you’re using a Vita-Mix, you can blend it on high for a few more minutes until piping hot (remove the center cup and cover with a kitchen towel to allow steam to escape). Otherwise, pour the soup into a saucepan and heat until hot, stirring frequently. Add salt, if needed, to taste.

This soup is SO good. I will definitely be going to the farmer’s market again this Saturday to get more asparagus. My parents loved it as well, and it turned out really pretty and green. Here are a couple of pictures:

After roasting the vegetables.

I couldn’t have the extra spears of asparagus in mine, but my parents definitely enjoyed them!

Picture Time!

I am officially a proud owner of a brand new Vitamix blender!!! Again, this is all thanks to my Nana’s generosity.  We tried it out this morning with my normal breakfast smoothie, which is normally kind of frothy and thick. With just a small amount of blending in the Vitamix, it completely liquefied it. I can’t wait to make some green smoothies with kale and spinach in this…

Vitamix all taken apart and drying!

Look at all of those greens!!

Taking my splint out and putting it back in is slowly getting easier. I’ve learned that it’s much easier to use two of the plastic hooks than one, that no matter how many times you snap your mouth, it will always hurt, and that I will probably never put the bands on the  same way twice, which is okay.

These make putting on the rubber bands so much easier.

I have to keep everything together, otherwise I would go crazy.

I mentioned in my previous post that I have to exercise my jaw using a device called a Therabite. I figured it would make more sense if I showed it, instead of tried to explain how it works.

The Therabite in all its glory.

The basic principal is that you set it to a certain mm opening, and you put it in your mouth, press down the top, and it opens your jaw. I have to do 30 pumps every time I take out my splint.

In the closed position

Opening 7 mm

My jaw has a very small opening right now, but it will increase over time. Hopefully by the end of my recovery I’ll be at 35+ mm!

How far my jaw opens right now

Happy to be spending time out of rubber bands =)

The first time that my splint was out, I was shocked to find that my bite has completely changed. The splint has made my molars no longer touch in the back, so when I close my mouth without it, only my front teeth touch each other. The braces will eventually be used to fix this, but for now I have big gaps in the back of my mouth.

As always, feel free to ask any questions! I’m going to go experiment with my new blender now =)

Michelle

No more stitches, how a liquid diet works, getting snapped by rubber bands, and the dangers of feeling almost back to normal.

In case you couldn’t tell by the title, I have a ton of stuff to write about, and instead of separating this into four separate posts (I’m a lazy creature sometimes) I decided to make one GIANT MASTERPOST.

Okay. Here we go…

PART ONE: NO MORE STITCHES!! 

Today I went up to Naperville, IL to have my first post-op check-up. Planning the whole trip was an endeavor in itself, because we had to prepare to have enough food (aka smoothies) with us to last awhile, but more on that later.

At the appointment, we met with one of my surgeon’s associates who also helped with the surgery. He took out the stitches on both sides of my jaw, and checked my stomach incision, which has dissolvable stitches. Everything looked good. The incisions on my face are still tender, and I don’t have full feeling everywhere, but that will take some time.  He then proceeded to take off all of the rubber bands and unhinge my jaw from the splint for the first time since surgery. The sensation was so weird and different that I actually got lightheaded, which he said is pretty normal. I was able to brush my teeth for the first time since surgery too!! With everything wired shut, you can brush the outsides, but nothing else, which doesn’t get everything as clean as I like.

After he unhinged it, he showed me how to use this device called a Therabite that I will be using to help improve my jaw opening over the next nine months. I currently am using it to open to 7 mm, which is very small, but the more I use it, the wider I should be able to open. After he showed me the Therabite he showed me how to put my mouth back in the splint with the rubber bands, which is a pretty complicated process…but more on that later.

PART TWO: HOW A LIQUID DIET WORKS

One of the after effects of jaw surgery is having to maintain a liquid diet. I love smoothies, so I thought that it wouldn’t be too bad. But when you’re lactose intolerant and need to get ALL of your nutrients through liquids that you can syringe into your mouth, it can be kind of hard. At first, I wasn’t very hungry, so having soy milk, vegetable broth, and juice throughout the day wasn’t that bad. But my body started craving more protein, and was burning through everything very quickly, leaving me pretty weak and tired when I wasn’t drinking things. After some digging, my dad found some Ensure-like chocolate liquid, except it was lactose free, unlike Ensure. It’s called Boost, and it has 14g of protein per bottle, which is a lot better than a serving of soymilk or almond milk. Through some trial and error (we made some pretty gross things), we managed to find some good tasting combinations!

My favorite one had

• Chocolate Boost
• peanut butter
• a whole banana
• apple juice (apple juice is really, really useful for blending things without adding any distinct taste to what you’re blending)
• and sometimes if I was feeling a need for more protein/vitamins we would put in Hemp Protein Powder.

We also discovered that lentil soup blends up pretty well, especially if you add some vegetable stock. Green smoothies are awesome, and full of good nutrients. We made one, but with the current blender we have (I’m getting a Vitamix, thanks to my amazing Nana, which is one of the best blenders out there. I am SO EXCITED!) the kale ended up being a little too chunky and not blended enough with the mango, banana, and orange juice to go through a syringe well. Luckily I can actually drink things out of cups now when I unhinge my jaw, so no more trying to syringe whole meals into my mouth!

PART THREE: GETTING SNAPPED BY RUBBER BANDS

So back in part one, I talked about having to take out the splint 5 times a day for fifteen minutes each day. The amount of minutes will increase every few weeks, so at the end of three months then they start focusing on the amount of time that it’s in, not the amount of time that it’s out. Every time that I take the splint out and put it back in, I have to rubber band my mouth up really well.

When they first rubber banded it, they used a TON of rubber bands, and I’m using more like 10, and stretching them across lots of teeth to keep my mouth in place.

After surgery – this picture doesn’t even begin to show how many rubber bands are in my mouth

My first attempt at banding shut. I just kind of put them on and moved them around symmetrically until I could no longer move my jaw around.

The worst thing about putting them on and taking them off is that they snap you everywhere. Your gums, your lips, the inside of your cheek, your teeth, etc. Everything  gets snapped. It also takes a really long time to do this right now. I felt completely in over my head when I was doing it. It would be like somebody who just learned how to play bassoon picking up Tchaikovsky 4 excerpts and saying, “Hey I’m going to play this!!”  Hopefully, within the next week it’ll get a lot easier and much faster.

PART FOUR: THE DANGERS OF FEELING ALMOST BACK TO NORMAL

It’s been about 10 days since my surgery, and I’m feeling great! I’m back to walking like normal, driving, not taking pain medication, and having a general ease of life that was not there at first. I’m very happy about this, but I also have to be pretty wary of not mindlessly doing things. For instance, the other day I bent down to pick something up, forgetting that when I bend my head over, I get really dizzy. It was a rude awakening for me. I realized that even though I feel back to normal besides my jaw, I’m not. I have to pay attention to everything that I’m doing with my body – eating, talking, walking, lifting things, sleeping, coughing, sneezing (I haven’t had to cross that bridge yet. I’m trying to avoid the whole sneezing while wired shut thing…), you get my drift. Basically, I can’t just let myself do things that I used to be able to do on autopilot, and I’m happy that I realized that now.

 

Like I said before, I’m really happy with how far I’ve come in just ten days. I’m trying to take this one day at a time, and hopefully I’ll have more good news to post in a few days! As always, please feel free to leave any questions or comments.

Michelle

Surgery Update #1

I can’t believe that tomorrow will be a week since I had the surgery. I’ve been recuperating and only really functioning for the past few days, which is why I haven’t been posting.

Before I talk about the surgery itself, I would just like to say that I’m feeling much, much better than I was initially after the procedure. It’s amazing what a week can do.

I went up to the Chicago area with my parents last Monday, May 20th, the night before my surgery. I had a 7:30 AM surgery scheduled on May 21st, which meant I needed to be at the hospital at 6 AM (as someone who hates mornings, I was rather unhappy about this). I wasn’t allowed to eat anything past midnight, as per the usual protocol when put under with general anesthetic.

My mom and I the morning of surgery

That morning we arrived at Loyola Hospital and checked in. They took us to the pre-op area, where I had to change into the oh so fashionable dressing gown, slipper socks, and compression sock things that went around my calves to help prevent blood clots during surgery. I was nervous, but it was manageable until they brought the IV in. I have had IVs twice in my life before – when I got out my wisdom teeth, and when I had cortisone shots in my jaw. Both were in the crook of my arm, therefore I was (wrongly) assuming it would be the same for this. I very quickly found out that it would be in my hand, not my arm, and that though I have a very good vein in my arm, I cannot say the same for my hand. The first time they stuck me I immediately burst into tears (I REALLY hate needles) and I started uncontrollably shaking, so the nurse decided she would let the doctor do it as to not stress me out so much.

Once I managed to calm down more they managed to stick me, and started to wheel me out to the operating room. Meanwhile, the drugs started kicking in and I felt quite wonderful. I remember getting to the operating room, thinking it was a lot brighter than what they show on TV, them asking me to move onto the operating table which was kind of difficult in my basically drunken stupor, and then the oxygen mask coming on.

So what did they actually do to my jaw? For the last few years my jaw has been getting progressively worse. It started with clicking and popping it out of place while eating and talking, which was pretty painful. After awhile the left side of my cartilage completely dislocated, preventing my jaw from opening a normal amount. The right side of my cartilage was dislocated some of the time, so they decided to operate on both sides. The could do this one of two ways – either they make an incision right along the ear, salvage the cartilage, and pin it in place, or if the cartilage is too damaged to do this they remove it entirely and take fat from another part of your body (the abdomen, usually) and put it in instead of cartilage. They don’t know which one they will do until they actually get inside the joint. In my case, my cartilage was way too damaged to save. It didn’t have holes in it, but it was stretched so much on the left side that it was really difficult to even take out, let alone try and use it again. I have incisions on both sides, and one very low on my stomach from the fat grafts.

Back to that day… When I woke up, I was quite confused and kept on slipping in and out of consciousness. There was a woman who kept reminding me that I was out of surgery, and everything went well. After awhile I realized that I had something wrapped completely around the front half of my head, covering my ears, and that’s why everything was muffled. They wheeled me to the room where I would be staying that night and the next day. I was either sleeping or very groggy for awhile.

Right after surgery

At this point, they wanted to start trying to have me take pain meds orally. I was “wired” shut with elastic bands (and still am) and a splint in between my teeth, so the only way for me to take anything was by syringe. Trying to drink from a syringe for the first time was…interesting. It felt really odd, and the taste of the medicine was completely awful.

Due to a combination of the anesthesia and the lack of anything in my stomach, I ended up throwing up all of the medicine so they had to give me some through the IV. Throughout the rest of the day  I learned that everything (and I mean EVERYTHING) was going to be a lot harder for me to do. The first time I tried to get up I couldn’t lift my body I was so weak, and got nauseous and threw up. I had to have multiple people help me walk the very small amount from my bed to the bathroom, and changing positions took lots of time. Anything I had to communicate I had to write down on a white board because I couldn’t talk. The nurses and my parents were incredibly patient and wonderful caretakers, helping me every step of the way. The first day/night was pretty rough, but I started being able to drink things like vegetable stock and soymilk (the hospital was very accommodating to my vegetarian and lactose-free diet) and I eventually started keeping down the pain medicine, so they were able to discharge me the next day in the evening. On the second day, I got a surprise – they have therapy dogs come into the hospital on Wednesdays! So I got to meet and pet two very cute dogs =)

look at that face

This one was so excited, he tried to jump on my bed!

We stayed another night up in the Chicago area, then came home on Friday. The swelling peaked that day, and it was pretty hard to fit the syringes in my mouth to get nutrients, but it eventually worked out. Each day, I get stronger and more myself. I haven’t had to take nearly as much pain medication as I was, and my appetite is slowly coming back. I remember the first time I sat up by myself and I was just like YES! GO ME!, and every small victory since then of walking around, getting up and down the stairs, etc. has been the same way.

I will be going to the doctor on Thursday to get my stitches removed along my jawline, and hopefully I will then start my regimen of unhinging the elastics for 15 minutes a day, five times a day. I’m very encouraged by my progress so far, and I cannot wait to see how far I’ll be by the end of the summer.

Stay tuned for more updates on surgery and food (what I would do right now to be able to bite into a delicious veggie sandwich from Jimmy John’s is pretty ridiculous), and please feel free to ask me any questions!

Michelle