Ask Bella: Talking after unwiring

Q: I just had jaw surgery 3 1/2 weeks ago and I'm going to get the wires out next week. I'm pretty concerned with my speech 'cause I'm still in school and I have to practice on my public speaking skills. I know you can't exactly talk perfectly right away or open your mouth but I want to know how long did it take you to start talking normal and be able to open your mouth?

A: I didn't find that the surgery affected my speech at all. Once I was unwired, I could only open my mouth a little bit, but it was enough to speak clearly - more clearly than I could with my jaw wired shut, that's for sure!

I could open my mouth wide enough to get a small toothbrush as well as a spoon in there right away, so that's what really mattered to me. Food and clean teeth! More information on how long it took me to get my mouth opening back to normal can be found on my blog under the category "range of motion."

However, I will mention my jaw was only advanced 4 mm. I have heard of some people who had major advancements (more than 7 mm) and found it affected their speech enough that they had to go to speech therapy. So, it depends on how much of an advancement you got (I'm assuming you had the same lower jaw surgery I did.)

In any event, you will be fine. It might be great right away or it might take a little work, but you'll know for sure in a few days, right?

Best wishes, and please let me know how it goes.


*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!!

Zip-N-Squeeze debacle

Just wanted to warn all the jaw surgery buddies who are having surgery over the next few months that something seems to be up with Zip-N-Squeeze.

According to Carrie at The Winnipeg Teeth/Lower Jaw Surgery Transformation, the company has been accepting orders online but hasn't been sending them out, leaving a lot of people scrambling to try and get their money back from PayPal. I checked Dinner Through a Straw, the site I ordered my Zip-N-Squeeze bags from, and it states that all of the Zip-N-Squeeze products are "temporarily out of stock."

So, anyone wanting this product is out of luck for now. It will be interesting to know if this is truly a temporary situation, or if the company is done like the pureed dinner we wish we could put in their bags.

If anyone hears updates, drop me a line.

Ask Bella: Fuzzy teeth

Q: I have having trouble with oral health. Did your mouth feel nasty after your surgery??? My tongue is white and I am trying to drink water but my mouth feels gross. I had surgery on my top jaw and a huge metal splint put in my mouth that has to stay there for six weeks until the next surgery. I try to brush my teeth (the bottom anyway) but things still are not great. Is this to be expected? I want to know if its normal or if I am doing something wrong.

A: Oh, how I remember the grossness of my mouth post-surgery, and I was only wired shut for two weeks. The first week was alright, but by the second week, I could definitely feel a fuzz growing on the back of my lower teeth. When I got the wires off, my teeth were brown. It was absolutely disgusting.

Gee, thanks for taking me back to those oh-so-happy times :)

I actually think that was the worst part of the surgery for me. Not being able to get the crud off my teeth with all that metal in my mouth, so I do feel for you. The only advice I can give you is to keep doing what you're doing (brushing the bottom teeth), and also get a Water Pik to try and get some jet action around that splint (being careful to aim it away from any stitches, etc.) and do lots of mouth rinses with salt water and/or alcohol-free mouthwash.

And then accept the fact that probably no matter what you do, your mouth will be gross and fuzzy for a few weeks, because that's the way it goes. (I did all of these things and still had fuzzy, brown teeth after two weeks, but you gotta at least try, right?)

Once you're done doing what you gotta do, take some time to fantasize about the moment when you get to brush away all that fuzzy sludge with a toothbrush until you wear its bristles down to nubs.

Aaaaaahhhh. Better than porn.

(I bet it's even better than German orthodontic fetish porn. Just guessing.)

Seriously, good luck. This sucks, but it will all be worthwhile once it's all over.


*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!!

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!!

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!!

The soup recipe to end all soup recipes

My friend Krista sent me this very versatile soup recipe just before my jaw surgery. If you're creative, you can use it for just about any flavour combination you can think of. Let me know how your experiments go, and I'll post any recipe ideas that result!

Cream of anything soup

Onion, diced
Potato, peeled, diced
2 cups of any vegetable
Vegetable or chicken stock
Spices and/or fresh herbs
Cream, if desired

Saute an onion. Add potato, vegetables and spices. Cover with broth/stock. Simmer until all veggies are soft.

Puree. Top with cream and fresh herbs, if desired.


Note: If you're making the soup with sweet potato or similar starchy veggie, you won't need the extra potato for creaminess. And if you want high-fat cream of anything, skip the potato and just use cream.

And of course, if you're trying to up your protein content post-surgery, you'll want to put extra skim milk powder or other high-protein additions into the final product.

Enjoy!

Ask Bella: Drooliscious

Q: When your jaw was wired shut, did you drool constantly, or is it just me? I feel like a rabid dog. It's not cute.

A: It seems so long ago that I had my jaw wired shut, but from what I remember, I didn't drool all the time - just when I was eating, which was decidedly not cute. (Though my boyfriend found it endlessly amusing when I would smear chocolate pudding all over my face without knowing it, because my chin and lower lip were numb.)

I have a feeling that I didn't drool much because I was able to get my swelling down quickly, and swelling would interfere with being able to close your mouth and keep the lovely liquids where they belong. Or maybe some people have more drool than others? I dunno.

Hang in there! One day, the wires will be gone and the drooling will be all but a distant memory. That, or all the drooling will dehydrate you to the point that your mouth will be no longer able to produce saliva; either way, it's gotta end sometime, right?

In any event, I bet you're still pretty darn cute, Chinderella.

*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!!

Ask Bella: The basics

Q: What exactly was done in the surgical procedure? Was it upper or lower jaw? What was done?

A: My lower jaw was advanced 4 mm. I was in braces for two years and then had the surgery on Feb. 12. It was a bilateral sagittal split osteotomy (BSSO) where they bisect the bone, slide it forward on itself and then secure it with three screws on each side. The screws stay in my jaw forever and don't dissolve. I have my X-Rays posted on the site, before and after, as well as an animation of what the surgery involved and actual pictures of someone getting the jaw surgery (very gory, just so you know.)

Q: How far along in recovery would you say you felt "normal" again (little to no swelling or bruising, easier to eat/drink/talk, etc.)?

A: I did a lot of research about homeopathic and natural remedies before the surgery and I feel like those really helped me get the swelling and bruising down fast. My swelling and bruising was pretty much gone after two weeks. If you can get the swelling down quickly post-surgery, it's easier to talk and be understood as well as eat when your jaw is wired shut.

After I had my jaw unwired, I was unable to chew anything - just eat mushy foods, as my muscles were quite weak. At about the six week mark, I was eating most things without problem, though at the 4 month mark, there are still things I can't eat, like fresh veggies and other hard, chewy foods. My surgeon says it will be six months post-surgery before I can eat everything.

*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!!

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.

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?

A week in pictures

The first week, post-surgery, in oh-so-flattering full-colour.

This picture was taken right after the surgery.

A friend of mine commented, "You look so tired in this picture."

I responded, "I wasn't tired. I was stoned."

And the swelling begins.

I loved those ice packs like my own mother.

Determined to keep a positive attitude.
After all the high-fiving, I switched to a thumbs up.

The swelling gets worse, but surprisingly, I'm not dead.

The swelling peaked on Day 3.
This was my last full day in the hospital.

Finally at home.

Can you tell I was not a fan of Day 4?

And now, we have the oh-so-alluring yellow/green bruises.

On Day 6, the bruising was worse.
The liquid diet started to get to me.
I contemplated hunting down Mrs. Vickie and holding her ransom for a handful of her salt and vinegar delicacies.

The swelling's almost gone after a week. Yay!

A lovely shot of the stitches they put in my cheeks

(that's where they put the screws in.)

A close-up of my sexy bruises.

My wired and elasticized jaw.
A friend told me this wasn't what she expected.
"It looks like pimped out braces," she said.
Oh yeah. Rappers got nothin' on me.

My left hand bruising, where the intern screwed up my IV line.

I got the external cheek stitches taken out on Day 8.
I felt much less freakish afterward.

Look ma! No stitches!
It was insane how quickly these cuts healed.
By Day 13, you could barely tell I had ever had stitches there.