Monday, December 22, 2008

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.

Thursday, December 11, 2008

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.

Wednesday, November 5, 2008

And the heavens opened and there was much rejoicing

Yesterday, I went on an epic quest in search of the elusive orthodontic wax.

I was positive that I had seen it on a particular shelf in a drug store the last time I was there. I went to a different location of the same chain, only to find they didn't carry it.

I then drove all the way across town to the original location where I'd seen the wax, expecting that it would be exactly where it was just a few days ago, but it wasn't there, either.

I begged the store clerks to help me find it, but they confirmed the fact that it wasn't there. I soon realized that I was so desperate for the stuff that I had actually been hallucinating it was at the store. They don't carry it, and hadn't carried it for years. It was all just a beautiful, beautiful dream created by my wax-deprived mind.

It's kind of sad, really.

I was almost in tears when I realized that you can't really buy this stuff in stores, at least not in my city. Also, my orthodontist doesn't have an office in town - he just comes in on weekends every few weeks, so it's not as though I could get some from him.

And then one of the clerks suggested I go to the dentist's office in the mall to see if they had any.

Good idea! I ran there and begged the clerk at the desk for some, conveniently not mentioning that I was not at all a patient at that office.

She wasn't sure if they had any, but after much searching in a back room, she came out with a plastic baggie with about a lifetime supply of the stuff. I almost kissed her, I was so relieved.

And then I mushed a whole bunch of that stuff into my wires and cried tears of joy.

Sigh.

Life is good.

Tuesday, November 4, 2008

Damn you, Four Months Ago Bella!

One of my new brackets is rubbing against the inside of my upper lip, creating a very raw bump that catches on the metal every time I talk, smile, eat and...do just about everything.

Last night, I tore apart my purse, bathroom, bedroom searching for that little magical box of orthodontic wax. The fact that I couldn't find it anywhere drove me absolutely nuts, because I'm the Queen of knowing exactly where all of my stuff is at any given time. It's my thing.

As I obsessed over where it could possibly be, I suddenly got a very distinct image in my mind of me tossing the box in the garbage four months ago and saying smugly to myself, "Hah! I'm never going to need that again!"

Right now, I would be quite happy to smack Four Months Ago Bella across her braceless face.

(In case you were wondering: Yup, braces + raw lip = cranky Bella.)

Monday, October 27, 2008

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!!

Friday, October 24, 2008

Choo chooo

It's true: the train tracks, they are back on.

As my orthodontist was placing them back on, he commented, "I don't even remember the last time I've had to re-place brackets because I needed to fix something."

So, I've gone from the patient who had her braces off after surgery in record time, to the only one in recent memory who has had hers put back on.

Oh, how the mighty have fallen.

Wednesday, October 22, 2008

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!!

Friday, October 17, 2008

An apple a day

Even though I have had my braces off since early July, it took me until this week to eat an apple without cutting it into sections first.

I think I avoided it for so long because I had a hard time believing my jaw would be strong enough to eat a whole apple out of my hand instead of sliced up on a plate.

When I finally got around to it, it was as though I had forgotten how to eat an apple. I bit in with my top teeth and tried to pull of a chunk with them, as I used to do with my overbite. It wasn't working. And then I discovered that I had to move my lower lip out of the way and my lower teeth could actually dig into the skin, too.

Then, the coolest thing happened - I got a full bite out of the juicy flesh! And it was awesome!

I have been gorging myself on sweet organic apples ever since, and every bite fills me with a sense of marvel.

It took me this long to figure it out...and guess what?

My upper braces are going back on tomorrow.

Saturday, October 11, 2008

8 months post-surgery

It's hard to believe eight months has gone by since my surgery. It feels like forever, making me wonder if it ever happened in the first place. But I need only look in the mirror to see my new chin and smile to remind myself that yes, it really did happen.

In good news, I went to my physiotherapist yesterday and we got up to 45 mm for the first time! I'm almost at the end of my range of motion, so that's incredibly exciting. I still have some work to do, though, because my muscle memory is interfering with my mouth opening properly.

When I open my mouth wide, my jaw swings to the right, because the muscles are remembering the way my jaw was positioned for 32 years (it was a bit asymmetric before). So, I have to start doing exercises using my hands to guide my jaw into the proper position while opening my mouth.

I've also noticed the muscle thing when I smile. My smile is still somewhat crooked because my muscles have been compensating for the asymmetric jaw. I have to start taking time each day to practice smiling in the mirror so my muscles can relearn what to do.

I have to spend hours in front of a mirror smiling at myself? How tragic.

In other good news, I have full feeling in my chin now - no more numbness! If I pay super close attention and use a very light touch across my chin and lower lip, I can tell that the feeling isn't 100% back yet, but it's barely noticeable (we're talking 99.999876%). There are still improvements every day and I am positive that I will get to 100% in the next few months.

In the not-so-good news department, I am one week away from getting my top braces back on to close a couple of gaps that opened up at the back.

Until then, I will be eating popcorn, corn on the cob, apples, and other crunchy "forbidden" foods to my heart's content!

Chow down!

Saturday, October 4, 2008

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!!

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