Reality check

I have been feeling cruddy this past while, exhausted and weak, generally run down. When I start to feel sick, my jaw pain tends to act up as well. I didn't really pay much attention to it in the past, but thinking back on it, this has been happening for the past few years.

I feel tired and run down, my jaw tenses up, I get a debilitating headache and can't go to work and do my job. More unpaid sick leave for Bella. Hooray.

Today, I got high on codeine to take the edge off the jaw migraines triggered by the overall cruddiness, spent the day in bed and went to see my physiotherapist late afternoon for my weekly appointment.

She asked how I was doing, so I told her, mentioning that I felt like some allergies were being aggravated or that I was coming down with a cold and that my jaw acted up whenever I felt this way.

She told me that when an area of your body is in pain for a long period of time and the condition becomes chronic, as my jaw likely has, the area grows extra nerve endings and becomes sensitive to histamines. So, if you do have allergies or are coming down with a cold, the pain in that area will flare up.

The news hit me kind of hard. I realized that I have been in pain for the past three years, and, as a result, this is something that I will probably have to deal with for the rest of my life, surgery or not.

In the spring when the snow melts and the mold underneath the banks starts swirling around, during cold and flu season, on windy days...I'm going to feel sucky. My jaw is going to act up. I am going to get horrible headaches, and I probably won't be able to go to work.

While I don't regret the surgery, and I believe that it has improved my quality of life (chewing, talking and singing) and saved my jaw from more damage in the future, the damage was already done before I went under the bone saw. And I'm going to have to live with that. And figure out how to deal with it.

Anyone have any thoughts on how to handle this situation going forward? (That don't involve allergy drugs, because those aggravate other health conditions I have.)

Ask Bella: Always wear protection

Q: I broke my jaw in three places by falling and landing jaw first on a concrete step. I had surgery immediately after the accident, which resulted in two titanium rods being inserted either side of my chin. I also broke some of my teeth in the fall. I had my mouth wired during the surgery and shut with elastics. I went to see my specialist and he removed the elastics after only 12 days. I still, however, have all the wires in for another four weeks.

The main problem is that my bite is miles from being where it should be. At the moment, only my teeth at the back touch. I am hoping that the jaw will loosen over the next few weeks and may improve my bite, however I'm not very optimistic that it will improve very much.

Would you have any advice here? It looks like I will need the help of a dentist/orthodontist to sort me out!

A: I cringed when I read your story - that must have been so painful.

I'm no expert, but I'm guessing you'll need some orthodontic help to get your bite in order. I was wired with wires and elastics over top for two weeks as well. My surgeon told me that the elastics were there to help level the bite while the jaw was healing, so there would be less work for my orthodontist to do.

Your elastics were likely there to do the same, so if your teeth aren't touching at the front, that means more would need to be done. I hope that everything works out for you.

A friend of mine was telling me about a guy he knew who fell off his bike and broke his jaw. After everything I've been through with my surgery, I'm considering getting one of those full-face bike helmets (here's an example of what they look like: http://www.mec.ca/Products/product_detail.jsp?PRODUCT%3C%3Eprd_id=845524442621427&FOLDER%3C%3Efolder_id=2534374302693161&bmUID=1215389828047) so that if I fall, my jaw, as well as my brain will be protected. Hey, a gal can never be too careful.

Good luck with everything - I hope the rest of your recovery is a smooth one.

*To ask Bella a question about her jaw surgery, email her at smilingbella at gmail dot com or leave a comment on this post. Go ahead: ask away!!

Brace-free and fabulous

I promised brace-free pictures, and I like to keep my promises, so here you go:

I am now officially at six months post-surgery, though I had my braces taken off at the five month mark (a record for my orthodontist, who says he's never had a surgical patient's braces taken off that quickly.)

I still have to have some dental work done, though. There are large spaces between some of my top teeth, common after this kind of surgery, that I have to get filled in by my dentist next month.

So, we're getting there. By the end of this year, I figure everything - jaw opening, chin numbness, tooth spaces - will be taken care of, and I can finally move past this phase of my life.

High...um...I mean "hi"

The last time I went to see The Jaw Master Grand Pouba of Physiotherapy with Thumbs of Steel, he put me through so much pain that I was gasping for air, crying, and doing Lamaze breathing to get through the appointment.

I wanted to hate him and swear I would never go back, but the dude's effective - he got my mouth opening from 30 mm to 36 mm in one session.

So, I just swore. A lot.

It takes months to get in with him, which gave me time to psych myself up for round number two. I decided that there was no way I was going into my next session sober. I was going to get very, very high on painkillers first. Fortunately, it doesn't take much to impair my brain function, which made me wonder a bit about the stability of my brain function, a thought that quickly disappeared with two T3s (codeine) taken in the waiting room before my appointment.

By the time they called me in, I was flying. An intern was the first one to see me.

Intern: The Jaw Master Grand Pouba of Physiotherapy with Thumbs of Steel is running a bit late, so I'm here to get you started. How are you doing today?
Bella: I'm doing GREAT!!
Intern: You certainly are chipper today.
Bella: I'm high. He's mean, so I had to get high so I wouldn't have to breathe like I'm giving birth, not that I know what it's like to give birth or anything, but yeah.
Intern: Uh...okay.
Bella: He makes me cry when he uses his Thumbs of Steel.
Intern: I have heard that before, actually. Though I don't know anyone else who had to get high before they saw him.
Bella: I'm special.
Intern: Yes, I can see that.
Bella: Codeine is goooooood.

By the time The Jaw Master Grand Pouba of Physiotherapy with Thumbs of Steel came in, I was even more far gone.

Bella: German orthodontic fetishists like me, you know.
Jaw Master Grand Pouba of Physiotherapy with Thumbs of Steel: [puts Thumbs of Steel in Bella's mouth and pries her jaw open]
Bella: You're mean. Codeine sucks!!
Jaw Master Grant Pouba of Physiotherapy with Thumbs of Steel: [cranks Bella's mouth even farther] Feel that? That's the end of your range of motion. Your mouth won't ever open farther than this because this is how far the bones will let me go. Let's just hold it here for a bit and measure it so we can see where we're at.
Bella: Aaaaaaaaaaaaaaaaaaaghhhhhhhhhhhhhhhh!

Then I said a bunch of other weird incoherent stuff I don't really remember and accused him of various human rights abuses. All I know is that they were pretty amused by my altered state.

However, in the end, I discovered that the end of my range of motion is about 47 mm, and in our session, he was able to get me from 42 mm to 44 mm, so I'm pretty much there. By the end of the year, my jaw physiotherapy torture sessions will be a distant, painful memory.

The next time I see him is in December. Hmmm...I'm pretty sure I have some liquid hydromorphone left over from my surgery...

Ask Bella: Nausea and eating post-surgery

Q: I just had upper and lower jaw surgery and some genioplasty. I'm so relieved I found your website. It has truly been helpful in answering some of my questions and it's good to know that there is someone else out there that has had the same problems as me. I do have a question for you though. What was the easiest way for you to eat anything the first couple days? It's frustrating. Also, did you have nausea and, if so, what helped?

A: I didn't have nausea right after the surgery, but I did purchase some children's liquid Gravol just in case. It came in handy a bit later on when some of the drugs made me a little nauseated. I just took some by syringe and it also helped me sleep, which was really handy, too.

The easiest way to eat anything the first few days was by syringe/tube. In the hospital, I got quite good at loading the syringe up with liquid food and shooting it into the side of my mouth. If you're eating soups or other things like that, make sure you strain it or it will get stuck in your wires. I had problems with that but for some reason stubbornly refused to strain my soups, even though that would have solved everything. I blame the drugs.

After a few days, I graduated to the Zip 'n' Squeeze bags, which made eating go a bit faster because you can fit more in the bags than you can in a syringe.

It is so frustrating to eat, because it takes so long - I feel you there. Try to cram as many calories into your food as possible. Use whole milk with extra skim milk powder in it, put whipped cream in your hot chocolate, that kind of thing, so that whatever you manage to get past your wires packs a good punch.

Best of luck to you. I know exactly how you feel. Just hang in there and keep telling yourself, "This will all be over soon."

*To ask Bella a question about her jaw surgery, email her at smilingbella at gmail dot com or leave a comment on this post. Go ahead: ask away!!

Bad vibrations

I'm a big fan of live music and shows, when I'm feeling well enough to go, that is. Since my surgery, I've only had the chance to go to two performances (a burlesque show and an outdoor folk festival), and I'm beginning to see a pattern emerge that concerns me a little. It's only a hypothesis at this point, but I'm curious to know if anyone else has had a similar experience.

When I go to live shows, I carry a pair of ear plugs in my purse. That way, if the sound system is too loud, I can take the edge off instead of getting a nasty headache from the noise. (You know you're getting old when...)

Anyway, I had my earplugs at the ready but was surprised when it wasn't the noise that bothered me this time; it was the bass.

I was enjoying myself at first, but as each of the shows went on, it felt as though the vibrations of the heavy bass guitar were reverberating through the speakers and straight into my jaw. They then travelled up the sides of my face, causing me to get a splitting headache and leave early.

My hypothesis is that the heavy bass is vibrating the screws left in my jaw from the jaw surgery, which irritates the healing bone and gives me a headache. The area where the screws are located seems to be the focus of the initial discomfort, before it spreads into a full-blown headache.

Has anyone else experienced this? I wonder if it goes away once the bone is totally healed, or if this is what I can expect anytime I go to a show for the rest of my life?

I really hope not. Because earplugs are a simple solution to loud music that hurts your ears. But what's the solution to music that vibrates your jaw screws?

Three weeks ago, something cool happened

It's hard to believe that it's been three weeks already and I haven't written about this. But that was part of the plan. Not to write about it. To have something that was just mine, that wasn't a status update on Facebook, that wasn't Twittered, that wasn't mentioned on one of my blogs. Something special. Something that could actually be a surprise.

And man, was it a hard secret to keep. I have a big mouth, and this is something that has to do with my mouth, so it was even more difficult to shut up about, so to speak.

Three weeks ago today, I went to see my orthodontist for a ten-minute check-up. He just wanted to see how my teeth were progressing so we could talk about the potential of getting my braces off in the next month or so.

He looked at my teeth and said, "They're perfect. Take them off!"

I looked at him, puzzled. "So, I should make an appointment to get the braces taken off, then?"

He said, "No. Take them off now."

"You mean, right now?" I asked, incredulously.

"Yes."

"But I don't even have my camera with me!" I cried.

I am such a blogger, jeez.

Next thing you know, they're coming at me with pliers and a drill. Two hours later, I was brace-free and grinning ear to ear. I'm sure the grinning had nothing to do with all the painkillers I downed before I'd let them come at me with the pliers and drill.

So, what was the first thing I did with my new metalless mouth? Well, I didn't eat corn on the cob, like I had originally planned, because the lady with the pliers told me that I should wait for my teeth to settle into the bone more - she was worried that eating anything too hard would pull them out of alignment. I couldn't argue with her on that one, because once you've gone through everything that I have, you don't want to take any chances.

I don't remember what I ate, but I do know how awesome it was to brush my teeth for the first time without all that metal in my mouth. It was so...easy. Brushing your teeth is awesome! The brush feels so good against your teeth and gums. I don't know why we don't do it all the time, like for fun:

Imaginary friend in alternate universe where teeth brushing is uber cool: Hey Bella, what do you want to do this weekend? Live music, hanging at the pub, going to a movie?
Bella: Why don't we all get together and brush our teeth?
Imaginary friend: Why didn't I think of that? That's the Best Idea Ever!
Bella: And get this, after we brush, we are totally going to floss!
Imaginary friend: Hooray!!

And flossing! Oh, my, flossing! Why did I ever not floss before? It's practically effortless. Just glide that string between my nicely spaced teeth and I'm done in a few seconds. People who have never had braces don't understand how awesome flossing is. Once you have to maneuver around wires and brackets for a few years, you want to do it all the time when it's easy again.

After all the gratuitous oral hygiene, I did something that I've wanted to do for the past year and a half. I told my boyfriend that I had something important to show him and that he had to come over right away.

Once he walked in the door, I kissed him.

You see, the entire time we've been together, I've had braces, so I didn't know what it was like to kiss him without them. A year and a half is a long time to wait for that kind of thing.

And I must say it was worth the wait. The boyfriend is a very good kisser, even better when he doesn't have to worry about my wires digging into my lips.

As for my other friends, I didn't post my news online because I wanted to show them myself. I thought they would just notice right away, but none of them did. I had to resort to staring at them and grinning like a maniac until their fight or flight instinct kicked their brains into high gear and they exclaimed, "Oh, you got your braces off!"

Yes, yes I did. Thanks for noticing.

Ask Bella: Nerve damage and chin numbness

Q: It's such a scary thing to anticipate putting oneself through such a major procedure, and I must say I also find the prospect of permanent nerve damage terrifying. Thanks for sharing your experiences with acupuncture, as that gives me some hope that things can be done afterwards to help! I just wanted to ask: Are you still having improvements in recovering sensation in your lower face?

A: With the chin/lip numbness, I notice an improvement every single day. It's amazing, really. After the surgery, I noticed the numbness starting to go away alongside the swelling. At the two week post-op point, I would say I had about 85% of my feeling back. The return of feeling each day was very noticeable at that point.

Now that I'm at about 99% of feeling back, the return is more subtle. Instead of getting back 5% a day, it's .05% a day (or some other microscopic amount. I'm into words, not numbers, so please excuse my lack of accurate mathematical estimates.) But I notice it everyday, particularly after acupuncture or one of those home microdermabrasion facials. What a great excuse for a facial!! Anyway, I'm fully confident that I'll have total feeling back by the end of this year at the latest. I'll keep everyone posted on my blog, but I know it will happen.

*To ask Bella a question about her jaw surgery, email her at smilingbella at gmail dot com or leave a comment on this post. Go ahead: ask away!!