Jaw surgery articles

I haven't been writing here as much lately, as I don't have any real updates for you, but I have been doing some writing about jaw surgery over at Braces Info. It's kind of like my Ask Bella feature here at Smiling Bella, but to a wider audience.

I thought you might be interested in some of the topics I'm covering. Here's what I have been working on so far:

• Smiling Bella jaw surgery case study: This is my jaw surgery story from start to finish, all in one post.
  
  
• What is orthognathic surgery?
  
  
• What are the risks of jaw surgery?
  
  
• How long is the recovery after corrective jaw surgery?
  
  
• How long does swelling from jaw surgery last?
  
  
• How long after corrective jaw surgery can you start talking?
  
  
• Does jaw surgery change the shape of your face?
  
  
• Can you have a tongue piercing while getting jaw surgery?
  

I'll post more links to my articles when they're available.

Happy Second Jawiversary!

Friday was my two-year jawiversary (jaw surgery anniversary date) and today, Valentine's Day, marks two years since I came home from surgery with my jaw wired shut. It's hard to believe, because it feels so long ago, like it never actually happened.

A few weeks ago, I was absentmindedly running my fingers lightly across my chin when I realized that it felt...normal. There was no difference in sensation from the skin on either side of my chin to that on my chin itself. Which means the nerves damaged by the surgery have completely regenerated!

The majority of the sensation returned in the months after the surgery, but there was just a slight difference of sensation that very slowly improved over the past two years, and now it's totally healed. Hooray!

I'm thrilled with the results of the surgery. My smile is straight, my teeth fit together, I can chew like a real person, I don't have TMJ problems anymore, and I have a fabulous chin and profile.

I have no regrets about the surgery; although the recovery was really difficult, it was worth it in the end. Life is good.

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: Sleeping after jaw surgery

Q: I have a question for you that I don't recall any mention of in your blog - How exactly did you manage to sleep through the first few weeks of recovery? I'm reading a lot of comments from people about the necessity of sleeping in an almost upright position. I've been on the hunt for some kind of reclining chair, but I would hate to buy something I'll never use again. What did you do to manage? Any suggestions/tips?

A: Thanks for the question! You're right - I don't think I've talked about that at all on this blog.

In the hospital, they'll have the upper part of your bed elevated. At home, you can do the same thing by putting a stack of pillows behind your head/shoulders. No need for a special chair at all, or to sleep in an upright position - just propped up. I think some people get carried away with getting all kinds of accessories for this surgery!

I bought a pillow with arms on it, which is sometimes called a "Bed Rest Pillow." It works really well at keeping your upper body elevated without being completely upright. It looks like this:

Image via www.smarter.com

It was inexpensive - something like $30 - and should be available in department stores. It makes more sense than buying a special chair for just a few weeks. Plus, I'd rather sleep in my own bed than in a chair, wouldn't you?

I slept propped up for a month or so after surgery. I found that I got used to it, and that after I started sleeping without the bed rest pillow, it was strange to get used to the "normal" way again.

Good luck and sweet dreams!

*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: Numbness and nerve damage

Q: During my meeting with the surgeon last week, he warned me about the small possibility of damaging the nerves. I kind of knew the risks that exist with these types of surgeries, but as I sat there listening to him, I really had this overwhelming fear that I will lose feeling on some parts of my face. So then I started really to research more about it. Given that, I wanted to ask you the following questions:

1. Did you have huge concerns over nerve damage?
   
   A: I was concerned, but I did a lot of research, read people's stories on the Internet and talked to people who had the procedure done. I also looked into alternative health practices that would help with nerve repair, such as acupuncture, supplements, and homeopathic remedies. You can see my list of homeopathic/supplements that I took before and after surgery here. Also, all my posts that deal specifically with numbness can be found here.
   
   
   
2. What did your surgeon tell you about the risks involved and how likely it is that something will go "wrong"?
   
   A: My surgeon told me that there was a risk for permanent numbness in the chin/lower lip and that risk went up with age. So, at 32 years old, I had a 32 per cent chance of having permanent numbness. However, this guy had been doing this surgery for longer than I have been alive, so I had faith in his abilities to minimize damage and risk.
   
   
   
3. Did you hesitate about going through the surgery? If so, why did you decide to go ahead?
   
   A: No hesitation. Once I did all my research and felt comfortable with the surgery, I moved forward and never looked back. I did this surgery because I was having a lot of TMJ pain as a result of my overbite and knew that it would get worse if I didn't do something.
   
   
   
4. Do you regret having gone through the surgery because of nerve issues?
   
   A: No regrets. And no major nerve problems because of the surgery.
   
   
   
5. Has all the feeling gone back to your chin/jaw/lip areas?
   
   A: A year after surgery, I have almost full feeling in my lower lip and chin. It is more than 99 per cent there and improves everyday. I don't notice it unless I touch the area very, very lightly. If I use a regular touch, it feels like the rest of my face, and I can't tell the difference. The majority of the feeling in my chin/lip came back very quickly (within a month of surgery) and then slowed down, but improved on an ongoing basis. I have faith I'll have full feeling return, but even if I don't, I can live with the way it is - it's not weird at all.
   
   
   
6. Would you have done something differently?
   
   A: I would have taken iron supplements post-surgery. It was the only thing I didn't think about doing and I became anemic as a result. Of course, this isn't the case for everyone, but it was for me. I also would not have let my orthodontist take off my braces when he did - it was too soon and gaps opened up between my teeth and I had to have the braces put back on a few months later. Otherwise, no "what ifs". I was very prepared.
   
   
   
7. Knowing what you know now, will you do the surgery all over again?
   
   A: Absolutely. No regrets. I'm happy with the results, and I am looking forward to a pain-free life with a winning smile.

Of course, this is my situation and experience and everyone is different.

Thanks for your questions, and good luck!

*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!!

Free at last...kinda

I went to The Big City to see my surgeon for my one-year post-surgery appointment the other week and he said that my bite looks great and I don't have to go back to him anymore!

Yay!!

The only reason I would have to go see him is if the screws in my jaw get infected and have to be taken out, which he says is quite rare.

Double yay!!

Another exciting development is that when I go see my orthodontist today, I will not have to pull out my credit card to make my monthly payment. Because, last month, I made the FINAL one. After three years of monthly payments, I am done, baby!!

Triple yay!!

I did a little dance around the reception desk with my credit card, singing, "This is my final payment, this is my final payment" while the ladies laughed at me. My orthodontist didn't seem phased at all. Maybe he sees this a lot?

The only area where I am not free is in the upper braces department. But hey, after all I've been through, what's a bit longer?

Happy Jawiversary

February 12 marked my 12 month jawiversary, one full year after my face was sawed open and screwed and wired together. Wow. It's hard to believe. It feels both like forever ago and like it was just yesterday.

Things have finally started settling down for me. I still have the braces on my top teeth (put back on in October after three months of being off) and the gaps are closing nicely.

A month or two ago, I started developing some problems with my right joint - crackling and clicking and pain upon opening and chewing. Fortunately, a physiotherapy session helped resolve that. I am confident that once the braces are off again, the joint will settle into place, because I don't recall having problems with that joint when the braces were off last time.

My opening is at about 44 mm and my jaw swings slightly to the right when I open to my full range of motion. Again, some physiotherapy exercises are helping to correct that, and also build some more strength in the jaw. Though I am told that it will take months of these exercises before I will be opening straight. It's a marathon for this kind of thing, not a sprint.

I have my one-year checkup with my surgeon next week, so we'll see what he thinks. I have a feeling he'll be happy with how things are going. One thing I noticed over the past few weeks is that there's a spot on the left side of my jaw that's a bit tender. It seems like the location of where the screws are, so I'll have to ask him about that.

There is still a slight, slight amount of numbness in my chin. I only notice it when I run my finger very lightly across it. When I touch my face normally, it feels fine. I notice minute improvements still, so I know it continues to get better, even though it's at a slower pace than at the very beginning. I am hoping that full feeling will return eventually, though I can live with the amount that I have now without any discomfort, so I'm not too worried about it.

As for the depression I have been dealing with since after my surgery, it seems to be lifting with the proper drugs and treatment. I've had to accept that this will likely be a life-long struggle for me, as it runs in my family, but I am sure that I can fight it and come out on top.

I always come out on top.

I thought you might like to see some pictures of what I look like now:

Medical claims

So, last year was quite the year for medical expenses for me. Fortunately, I do live in Canada, where my surgery and hospital stay were completely covered by our health care system.

But that doesn't mean that there weren't major costs associated with this surgery for me. The surgical splint was $500 and wasn't covered under any of my benefit plans. Also, I had my surgery in another city, which meant lots of travelling back and forth to see my surgeon. And then there was a lengthy recovery, which included extra insurance, medications, physiotherapy, massage therapy (including lymph drainage massage), acupuncture, naturopathy, homeopathy, orthodontics and dentistry.

I avoided totalling it all up until now. And the damage: more than $4,700.

Wow. That's a lot. And the above is just the amount my benefits didn't cover. If it were the full amount, it would be another few thousand for sure (not to mention the shortfall in my gross pay because of all the work I missed due to related illnesses over the past year.)

Then again, being able to chew like a normal person and replace frequent migraines with a winning smile?

Priceless.

And hey, at least I get a good tax return this year.

Ask Bella: Bite post-surgery

Q: Hi Bella. I'm having the exact same surgery in a month or so and your blog has helped me so much to prepare myself. Thank you so much for sharing your procedure! I've got a couple of questions (if you don't mind answering).

Immediately after surgery, do you have a normal bite? - Do your back molars touch?

My orthodontist will have me slide my lower jaw forward to give me (and him) an idea on how it will look after the surgery. When doing this, of course there is a strain and it's not comfortable. After surgery (and healing), does the moving of the jaw forward feel normal and comfortable/relaxed? - Does it feel like you're jutting your jaw forward all the time?

A: I do believe I had a normal bite after surgery. I was wired shut for two weeks, but from what I can remember, my molars did touch at the back.

As for your other question, it sounds like your orthodontist was trying to give you an idea of the aesthetics of your face post-surgery - the changes to your chin/jaw line and what you look like. That uncomfortable strain you were feeling isn't reflective of what it's going to feel like post-surgery because that's not what's going to be happening to your jaw.

You jutting your jaw forward pre-surgery means moving the lower jaw forward in its joint, which is not what the surgery does. The surgery cuts into the bones on the sides of the jaw and lengthens them, making your jaw bone longer. This way, your joint stays put and you're able to use your jaw the way "normal" people do - without jutting it forward to be able to have that function and aesthetic.

Does that make sense?

After the surgery, your joint and muscles will have to make some accommodations to get used to your new jaw length/position, but it won't be the same feeling as jutting it forward. I don't know how much advancement you're having (mine was 4 mm) but I imagine there is more of a difference in feeling with larger advancements because your muscles have to stretch/change their orientation to connect with a longer jaw. Also, don't forget that you will also have some numbness in your chin, which will affect your feeling of what's "normal."

Good luck!


*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: Update on "Changes in appearance"

There was a strong response from my blog readers on this Ask Bella post a few months ago, so I'm sure you'll be happy to hear this update:

Kerry Rose has left a new comment on your post "Ask Bella: Changes in appearance":

I just wanted to email an update about this particular post. I am the gal that sent in the question in the first place. Its now 12-14-08 which means I am almost 3 months post-op.

I have adjusted to my altered appearance and my initial terrified reaction at my transformation.

In fact, my post-surgery experience unfolded in ways I never expected.

After I sent this message, I started to experience great amounts of pain as a result of muscle spasms. For about a week, I couldn't sleep because the muscle spasms would wake me up every few minutes. Using a combo of prescribed sleeping pills and the pain medications, I was able to overcome it.

Then about 6-weeks post-op, I experienced an unanticipated break-up with a person with whom I had been dating for 5 1/2 years.

Ironically, I have met a lot of fellow ortho patients whose surgeries were the catalyst for numerous major changes in their life (including break-ups like mine).

I can honestly say that I am better than great!

I still think that my doctor should have been more clear about the physical transformation I would go through. I would even suggest that going to a therapist that deals with body issues (specifically one that relates to people undergoing surgeries) should be done ahead of surgery.

Thanks for all of the comments. It turned out to be so important for me to express what I was going through - especially because I had become somewhat of a prisoner of my home and my body. I needed reaffirmation that there was some action I could take to change my situation.

10 months post-surgery

It's 10 months since my jaw surgery. WTF?

In good news, The Jaw Master Grand Pouba of Physiotherapy with Thumbs of Steel has signed off on me, meaning that I don't have to go every week to get my jaw stretched anymore. My range of motion is somewhere between 42-46 mm now (depending on the day), which is well within normal range. Though he did mention that he expected that I would be a "long-term intermittent" patient of theirs.

I'm okay with the intermittentness, seeing that each appointment costs me $42 and doing that weekly for almost a year (on top of my many other appointments) has gotten pretty expensive.

Right now, my regular physiotherapist has me coming for TMJ classes, where I learn stretches for my jaw that I can do without her. She wants me to do them everyday for a period of time, with our sessions to evaluate whether I'm doing them correctly. Then, the responsibility will fall on my shoulders and I will only go to physio when the pain/tension gets really bad, due to stress, etc.

My braces are still on (having been taken off for three months and then put back on because my upper teeth relapsed), which causes some tenderness. Since they've been back on, I've noticed that my joint has been kind of crunchy and poppy when I open my mouth really wide. I hope that the joint is just settling and adapting to the new position of my teeth and that this isn't going to become a long-term problem.

In not-so-good news, I've been continuing to have problems with fatigue and depression. I haven't felt physically well since my surgery. I've tried to be upbeat and proactive about everything, but the stress of the long recovery and anemia seems to have taken its toll on my body and mental health.

It took a long time for my doctor and me to figure out that this is a depression, because there were so many other things going on with my body, and because the symptoms I was experiencing were very physical - headaches, aches and pains, fatigue, exhaustion, etc. I also have a family history of this kind of thing, so it's not too surprising that this is my body's reaction to something as intense as major jaw surgery.

So, I'm off work for awhile to rest and get this fatigue/depression taken care of. I'm optimistic that in the next few months, I'll get back to my old fabulous self, with a winning smile that I can't help but show off.

Ask Bella: Changes in appearance

Q: I had upper and lower jaw surgery (turbinates removal & genioplasty as well) about 2 1/2 weeks ago. Like most people, I did this surgery for purposes of function and not appearance. I loved my appearance - I loved how dainty I thought I looked.

While I don't think my reaction a week post-op is much indication of how I will feel forever...after most of the swelling had gone down and I could tell what I would look like, I was devastated. I didn't recognize myself. I had this dysmorphic type of reaction to the results of my surgery and I couldn't stop staring at what I saw as the destruction of my appearance. Even 2 1/2 weeks out, the steroids have worn off, I'm not on meds, I'm getting normal sleep, I'm not in much pain at all....yet my reaction to the alteration of my appearance still stays.

Have you received emails from other people that have had this reaction? Do you know how they overcame it?

A: I'm so sorry you're going through such a hard time. Your email made me want to reach out and hug you.

My surgery wasn't nearly as extensive as yours, so I can't speak to the dysmorphic reaction to your reflection from personal experience; however, I have read on message boards about other people who have had similar reactions to yours.

And, really, who can blame you? We all identify with our outer appearance - you've lived within this skull and skin your entire life and then one day, suddenly, you look in the mirror and don't recognize the person staring back at you? That is a huge shock to the senses, psyche, and identity. How are you supposed to just accept that you look completely different in just 2 1/2 weeks?

Let yourself mourn your old appearance. It's okay to feel sad because you have lost something that was a big part of who you are. But at the same time, try to find things that you like about your new appearance. Take a good look. Check out your profile. (I know I always hated mine because my weak chin made my nose look bigger. Now, it's more in proportion, which I like a lot.) Make a list of what you like and focus on that as much as you can. Because the reality is that this is what you look like now, so you need to find ways to look at yourself in the mirror and like what you see, after the surgery.

I think time will help, focusing on the positive will help, and then if you still feel that things aren't where you would like them to be, talking to a therapist would be the next step.

When I'm frustrated and upset about the fact that I still don't feel like myself these days (I'm struggling with a lot of fatigue, even after my post-surgery anemia has gotten better), my boyfriend always says to me, "You're pretty hard on yourself, you know." It makes me realize that I do put a lot of pressure on myself to be perfect, to be healthy, to be this super achiever and that sometimes, I just need to be good to myself and say, "It's okay if it's not happening as fast as I want. I'll get there" and just give myself a break for once.

Two and a half weeks is not that long. Even if everything seems to be going swimmingly, you've had major, major surgery where they took a bone saw to your face and rearranged your bones. That affects your body and your mind and your spirit in a big way. So, don't pressure yourself to be totally healed and accepting of everything just yet.

Just be good to yourself. I hope everything goes well for you.

*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: Healing time

Q: I'm 20 years old, work and go to school full-time, and I'm having my upper jaw advanced, lower jaw set back, and maxi expansion. my case is pretty bad, to the point where my insurance is covering 100%! I will be ready to get my jaw surgery in April. My ortho's assistant told me that from what she's observed with other patients, I could do the surgery over Easter break (one week) and be back at school after that. I nodded politely, but in my head I was thinking, "Uh, no." From all the research I've done it seems like you need at least a few weeks. I was thinking about taking online courses next semester so I could get the surgery in April and not have to spend the summer healing. From your experience, how long would you say I should expect to be out of school/work?

A: When your ortho assistant told you that you'd be back at school in a week, did you happen to notice a crack pipe nearby? Or perhaps some telltale trail marks on her arms and a glazed look in her eyes? Because she had to have been on something to say that.

Seriously. That is nuts.

I only had my lower jaw done and I was off work for a month, and I wish I would have taken six weeks off. My surgeon had told me that I would be fine to go back to work after two weeks, but he might have been smoking the same thing that your ortho's assistant was, because there was no way I would have been able to go back in that time frame.

It wasn't so much the pain from the surgery, but the exhaustion of my body trying to heal and also not being able to get enough calories in that did it for me. Granted, I am 12 years older than you, so you could heal faster and have more energy, but for the first month after surgery, I had to take a two to three-hour nap after I did just about anything. Even something simple like tossing a load of laundry in the washer knocked me out for a few hours afterward. Ditto for when I had to put stuff in the dryer.

Because my surgeon had told me that two weeks off would be enough, I only asked for a month off work, and felt that I was being indulgent taking that. In reality, I needed more time to rest and going back to work that soon probably set my healing back awhile.

I think it's a great idea to take some online courses and then you can take things at your own pace and not worry about rushing yourself to get back to school/work before you're ready. Just listen to your body and do what's right for you.

Best of luck to you!

*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!!

Before, during and after pictures

I finally got my "after" pictures taken at my last surgeon visit, so if you would so kindly ignore the bags under my eyes, here you go! (The order goes: before braces, before surgery (with braces), and after surgery and braces removal.) Enjoy!

And here are my teeth, pre-braces, pre-surgery and post-braces and surgery:

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!!

Ask Bella: Post-surgical depression

Q: I discovered you blog via a google search of "orthognathic surgery recovery depression." My son had surgical advancement of both lower and upper jaws on June 6. My question is regarding depression. He does not want to see any of his friends, which I am attributing to mild post surgical depression. He said it's because they make him smile and laugh which still hurts. Do you think I should insist that he he allow his friends to visit? How important were/are visits from friends during your recovery time?

A: I can really relate to what your son is going through. And it sounds like his surgery was far more extensive than mine, so his recovery will likely be more difficult.

Depression post-surgery is quite common, from what I've read, and what I've experienced first-hand. During the surgery, they pump you full of steroids to keep the swelling down. The steroids stay in your system for a week and during that time, you're feeling pretty good. Then, after a week, you go into steroid withdrawal and crash into depression.

It was very severe for me and I was absolutely miserable. Fortunately, it passed quite quickly - three or four days at the bottom and then things got better, particularly after I talked online with other people who had had the surgery and been through the same kind of thing. (I also went through a bout of depression at the three-month mark, which you can read about here.)

I can also relate to his problem of being in pain after having fun. I have had jaw problems for a number of years and have often felt torn between doing what's going to be healthy for me psychologically (i.e. going out and having fun with friends) or what was best for my jaw. Because going out, having fun, and laughing and smiling with my friends meant that I would have migraines for four days afterward and pretty much not be able to do anything. So, was it worth it? Or to what extent could I do it? Could I try not to have too much fun?

I wouldn't push him too hard, but I might suggest limited activities, such as going out for ice cream for just 1/2 an hour, or going to a movie so there wouldn't be too much talking/laughing but he'd still be out and around other people, which is important. Maybe his friends could bring over some DVDs or video games?

I think it's important not to isolate yourself when you're recovering, but at the same time, I get where he's coming from. I found that for a month after my surgery, I was very exhausted and had to have a two-hour nap after I did just about anything, even laundry. So, don't push him too hard, but make sure he doesn't totally cut himself off from the rest of the world while he's still listening to his body's need for rest.

Best of luck to you both!

*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: Advice

Q: I'm 15 and my lower jaw stopped growing in the first grade. I live in a small community and go to a small high school. Everyone except my best friends make fun of me and this has been going on for such a long time...fifth grade. I'm a sophomore now. I don't get my surgery until next summer. Will they have to remove my wisdom teeth before that? And do you have any advice you could give me? Most of the time, I dread everyday at school.

A: My heart just goes out to you. This sounds like such a horrible situation. I mean, elementary and high school are hard enough to get through without major jaw problems and people teasing you about it.

I'm glad you have best friends who are good to you, and at least you have a problem that is fixable, you know? Think about all of those people who get teased for things that they could never change, even if they wanted to.

One year seems like a lifetime right now, but in one year, no one is going to be able to tease you about your jaw or teeth again. If your problem is that noticeable right now, imagine what a dramatic difference the surgery is going to make! You are going to look fantastic. I bet people who've known you for years won't even recognize you! It's really exciting, when you think about it.

Try to concentrate on the end results. Make a calendar counting down the days/weeks/months until your surgery. You probably don't have a date yet, but estimate one and outline it in glitter and bright colours. When people tease you, just say to yourself, "Wow, they're pretty stupid to be teasing me about something so superficial. Just xxx more days and this will all be over."

Of course, if they're really nasty people, they'll find other things to tease you about that have nothing to do with your jaw. But some people are just jerks that way. They're probably insecure about the way they look and tease other people to distract everyone from their own flaws. Losers.

It's great that you're getting the surgery done while you're young, by the way. The younger you get it done, the quicker you heal and the less chance there is to be complications with nerve damage and that sort of thing. As much as it sucks, you're really fortunate to be doing this now, and not having to live for another 17 years (like me) with a short jaw and the pain it brings, physically and psychologically.

So, hooray for you!

And yes, from everything I've read about the surgery, you do have to have your wisdom teeth removed first. Fortunately, I had mine out when I was in my late teens, so I didn't have to worry about that before my jaw surgery.

Just one tip for you: If you can, go to an oral surgeon to have your wisdom teeth out and get them to give you the good drugs (IV drugs). I know some people who just went to a dentist to have them out and were quite traumatized. Besides, any excuse is a good excuse for the good drugs, in my books.

Best of luck to you, and please let me know how you are doing as things progress!

*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: 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 real basics

Cecilieaux asks: Okay, what I have never understood is...why? (Or maybe I missed it.)


A: You missed it only if you've read all my archives, because I've been dealing with jaw problems for more than two years now. So you don't have to go digging for it, here's the story of why I subjected my face to the bone saw.

I had an overbite, which isn't a big deal for most people, but in a few, it can cause jaw joint problems. I was fine the majority of my life, until I started doing a lot of stage work, singing, acting and using my jaw a lot more than I was used to. Then, I developed crippling migraines and jaw pain while I was a poppy/jitterbug/citizen of the Emerald City in an extended run of the Wizard of Oz musical. Because of the overbite, I was thrusting my lower jaw forward in order to sing and enunciate properly, and that was putting strain on my jaw joint.

I saw an orthodontist, jaw physiotherapist, and orthognathic surgeon and all suggested that this surgery could help my TMJ problems get better. Of course, it wasn't guaranteed, but the stats I was told were that 70 per cent of people get better, 20 per cent stay the same, and 10 per cent get worse.

Singing is such a huge part of my life and my expression of who I am that I couldn't imagine not being able to do it because I was in too much pain. The TMJ pain was also interfering with my social life - I found myself not spending as much time with my friends because I had too much fun. After a night out of talking, laughing and smiling, I had migraines that kept me at home and alone for four days straight.

I had a strong feeling that for me, the surgery would work. I'm still recovering and haven't tried going back to the stage yet, so we'll see what happens in the next few months.