I'm Back {Month Two}

For the first time in YEARS, I feel like ME again! I didn't even realize how different I had become, until I started feeling so much better. Pain really takes the life out of you. Now, I wake up in the morning ready for the day. I don't feel groggy and grumpy. I'm not tired all of the time, and I don't feel anxious anymore. I am back to my old HAPPY-GO-LUCKY self. I feel like a huge pressure has been lifted off of me. This has been the Greatest Gift of All.

PROGRESS
Pain- My overall pain has been a Level 1. For the most part, I only have quick, sharp pains (Levels 5), when I am doing my Therabite and Jiggle exercises. This is also when I hear the cracking or cellophane noises in my ears. I am still on the number three hole on my Therabite. Once, while I was talking with my splint out, my left joint popped and hurt pretty badly. However, when these things happen, the pain comes and goes quickly.

...

Stamina- I do have to be honest, after a few hours of hanging out with friends, and trying very hard to speak clearly enough to be understood, I get exhausted and feel some pain. I try not to overdo it, because speaking and smiling a lot, with my splint banded in place, makes my masseter muscles fatigued and very sore (Level 4-5). But, resting and applying the heating pad always help. No discomfort is constant, and I am still headache free!

...

Stomach Incision- The incision has healed very well. I continue to put Mederma on it, and massage the scar tissue daily. It has flattened out a lot, and the hard tissue underneath the skin is now only about one inch in height by three inches long. I still haven't been able to wear a pair of jeans or regular pants, but I am making progress, as I am now able to lie flat on my stomach. But, to be totally honest with you, I'm loving the comfort of the Legging Lifestyle ;).

...

Ears- As for inner ear pain, I've had very little. Like the other pains I have, it is always fleeting and usually only happens when I am speaking with my splint out. I can now place the sides of my head on a pillow. I always sleep on my back, to keep the pressure off of my ears/jaw, however, if I'm on the sofa, it is not painful for me to lean my head on a pillow. The top parts of my ears are still sensitive to the touch, and they do hurt if they get cold. I also have to be careful when I'm blow drying my hair, but my ears are healing very well. Physically, no one can even believe I've had surgery, and my sideburns are growing out. 

TIP- Bundle up! I am lucky that this has been one of warmest winters on record, as the cold really makes my ears, facial muscles, and joints get sensitive. When you're out in cold weather, try not to linger too long, and be sure to wear a scarf, hat/ear band, and gloves. These items will make a big difference in how you feel. I suggest fleece for items touching your ears, because it is softer, stretchier, washable, and doesn't itch. Make sure your ear/head items are not too tight. You don't want to defeat the purpose. And by the way, there is no need to look frumpy when you bundle. Mix things up with your Scarf Style...

TIP- Once you've gotten cold, it's important to apply Moist Heat! Using my heating pad helps to relieve my facial pain. Taking hot baths also helps. Due to my lack of good circulation, my hands and feet are always cold (even in the summer). Dr. Piper explained that the blood flow and circulation in the hands and head/jaw joints are related. Thus, it is important for me to always wear gloves (even inside when needed), and stay as warm as possible.

Monday, Feb. 13th 

Dr. Piper Phone Appointment

The morning of the appointment, I faxed in my Progress Report. During our call, Dr. Piper asked how everything was going, if I was still fitting into my splint properly, if I was clenching, and about my pain levels. I let him know that I was doing very well. My splint still fits the same as it did when I was in St. Pete, I have not felt that I have been clenching at all, and, for the most part, I only have fleeting pain in my joint and facial muscles when I am talking or doing my Therabite and Jiggle exercises.

Next, he asked if I had any questions or concerns. I did. I asked him when I would be able to start running again. Dr. Piper gave me the go ahead to start back up. WooHoo! 

My only concern was that several weeks ago, I began having severe sensitivity to cold on one of my top teeth, which never bothered me before. Dr. Piper said that sometimes the bands can torque the tooth, exposing the root. He suggested that I move the band off of that tooth, and place it in a different location, until he could check on it at my 3 month appointment. This has helped a lot.

TIPS- Other things that help with my tooth sensitivity are to use a Prescription Sensitivity Toothpaste, called NeutraMaxx, which I obtained from my local dentist, to always use WARM WATER in my Waterpik and when brushing, and to use a straw when drinking cold liquids.

Thursday, Feb. 16th
45 Minute Breaks
Having a 45 minute break means for the first time since my surgery, I was able to eat outside of my home. The extended time allowed me to meet a friend at TCBY, and get home in just enough time to clean and band back up. This was a huge day, because...

It's also really relaxing to take a shower without the splint, so I don't have to worry about drowning ;). Overall, longer breaks give me so much more FREEDOM and a renewed sense of NORMALCY, which makes an enormous difference.

Friday, Feb. 17th

I'm a RUNNER again!

I've been walking a lot, but have not run since the night before my surgery, so I didn't really know what to expect. I decided to try it with Scout for the first time. I much prefer being outside in the fresh air, hearing the birds, and tackling the hills, to running at the gym. So, I bundled up and took off. 

Much to my surprise, I made it one mile before the cold air (making my nose run), and the Hoover Dam in my mouth, made it impossible to get enough air! I know it's not far, and I physically felt like I could have kept going, but the breathing was a challenge the entire time. My inability to breathe easily will be my biggest obstacle as I run. I also have to really focus on not pushing myself too hard, so I don't clench, and/or make my stomach incision hurt. 

I'm sure the people who passed me were wondering why I sounded like I had a serious case of emphysema, and looked like a puffer fish, but it felt so good to be out. No matter how ridiculous I sounded and appeared, I'm going to keep up the running (with Scout of course, and luckily she doesn't mind the noise).

Feeling Unattractive

 

Once I started to finally feel better, I began to look at myself and feel ugly. I wouldn't consider myself a vain person, but I had to go through a little period of grieving, as I came to terms with my mumbled speech, the splint, and braces (which I never even had as a teenager). Everyone was excessively telling me how great I looked, and I was thinking, oh sure, I'm a regular beauty queen. 

The hardest part for me was the loss of feeling like I could smile freely. Out of all of my friends, I'd never been known for my eyes, hair, or perfect figure. I'm the friend with the big, happy smile. My SMILE has always been MY THING.

Don't get me wrong, I didn't feel badly about myself on the inside, or have low self esteem, I just felt sorry for myself the first few times I noticed people were staring at me, or when that horrified look crossed a store employee's face, as she tried to talk to me, and I just pointed to the splint. 

But then I thought, Christine, GET OVER YOURSELF. You aren't the type of girl who sits at home having a pity party. You are intelligent, kind, and have a loving husband, family, and friends who couldn't care less about what you look like. After about a day, I got my confidence and mojo back. I just had to come to terms with it on my own, and remind myself, that TRUE BEAUTY is something that only comes from the INSIDE.

The most therapeutic thing, for me, has been the ability to laugh at myself and joke about my "Darth Vader" mouth. Laughter truly is the best medicine. And trust me, although you'll think they do at first, nobody really cares anyway! 

P.S.- Be prepared for the thousands of comments you'll get from others wishing they could have their mouths wired shut to lose weight, or that their spouse would love it if they couldn't speak, etc. People aren't trying to be insensitive. They probably just feel really terrible for you, and don't know what else to say, as they're staring at an apparatus they've never before encountered. Ha, I tell myself, just smile and nod, Christine, smile and nod ;).

Home at Last {Weeks 2-4}

DAY 11- Saturday, Jan. 14th

Home Sweet Home- My first weekend at home was fantastic. For the first time, I actually felt like watching movies, checking my email, and reading. I relaxed, exercised, went to church, and spent the next few days reorganizing my life. I also felt with-it enough to take over managing all of my medications and logs. This was a big step. My mom stayed with me for a few days, and before she departed, she helped me with the laundry and made double batches of lots of healthy, delicious food for us, much of which I had enough extra to freeze for later, when I didn't feel like cooking. Nutrition is a key factor in healing, so it is really important to have energy rich foods readily available to puree and eat.

WORK- I am blessed with a wonderful job that allows me to work from home (Thanks, I.O. METRO), so I didn't have to rush back to work in an office with others on Monday. I have spoken with a lot of people who have struggled immensely with going back to work right after returning home from surgery (because of the splint schedule and speaking). You are technically physically able, and cleared to do so, but talking while wearing the splint is a real challenge, and often leads to increased pain. I too, felt little bump-ups in pain when I was struggling to speak through the splint (and actually be understood). I had to make a conscious effort to monitor myself. This week I found a happy medium between exercising my muscles by speaking, and not straining them by using my newly invented "sign language" and magnadoodle board.

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 My Daily Plan for Healing at Home

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Scout was always ready for a walk, and generally, she just made me feel happy and better. I mean really, who wouldn't fall in love with her sweet face? 
Plus, medical research studies show that PETS HELP YOU HEAL.

MY WEEKLY ROUTINE

• Walking 2 to 4 miles (at least 5 days a week)
• Daily Physical Therapy Exercises for my Neck, Shoulders + Upper Back
• Following the 5x/day Splint + Medication Schedule
• No-Chew Diet- Eating Healthy Whole Foods made at Home 
• Drinking lots of Water
• Private Stott Pilates Lessons
• Applying the Facial Heating Pad 
• Using my Brookstone i-need Neck and Shoulder Pro Massager
• Focusing on my Neck Posture while Working on the Computer
• Outings (going to movies, museums, running errands, etc.)
• Monitoring my Interaction with Others (so not to strain myself)
• Using a Humidifier at Night

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PAIN- WEEK 2: Several days after I got home, the constant ear pressure and frequent pains stopped, and I just began getting quick sharp pains occasionally. The only areas that still really hurt were the upper inner parts of my ears (photo above), the sides of my head (photo below) and stomach incision, which was still sensitive. I was sleeping much better and only woke up a couple of times in the night, or very early in the morning, from discomfort. A few times I felt as though I had been clenching, but never had any muscle spasms. I began only taking Tylenol, as needed, for pain. I also stopped taking my daily hour naps, because I was less tired, and wanted to get the best possible sleep at night.

I improved my smile to where you barely notice the braces/splint (well, if you're half blind and you just look quickly). Still, it's a huge progression from my photos right after surgery.

My stomach was healing up very well, too. On Week 3, I started rubbing Mederma Scar Gel on it four times a day. However, there was still a puckered up area of scar tissue that I was trying to get to flatten by massaging it daily.

DAY 15- Wednesday, Jan. 18th

Moved up to #3 on the Therabite

My muscles had to stretch farther than ever before, so there was some discomfort as I did my exercises. Using the heating pad afterward really helped.

DAY 16- Thursday, Jan. 19th

Phone Appointment with the Piper Clinic

The morning of the consult I faxed in my Progress Note. Since everything was going well, they just gave me some directions for my 30 minute breaks and medication changes. I asked a couple of questions and after that, the quick call ended.

TIP- When you have your first consult, you're going to have to do it on one of your 15 minute breaks. Make a protein shake/smoothie you can be drinking during the call, rather than trying to eat.

DAY 21- Tuesday, Jan. 24th

Started Weekly Private Pilates Lessons

STOTT PILATES® incorporates modern exercise principles, and applies proven and accepted practices in biomechanics, rehabilitation and athletic performance enhancement. After realizing the benefits of the concepts of the original Pilates method, and in collaboration with a team of physical therapists/physiotherapists, sports medicine and exercise professionals, the Merrithews dissected and re-connected this unique form of exercise into a comprehensive, systematic, contemporary approach to the original teachings.

STOTT PILATES exercises are designed to restore the natural curves of the spine and rebalance the muscles around the joints. This involves placing more emphasis on pelvic and scapular stabilization, and integration of all the parts of the body into one. As well, preparatory exercises and modifications allow the technique to be appropriate for many different body types and abilities, making it applicable to sport-specific training and everyday life.

FIVE BASIC BIOMECHANICAL PRINCIPLES
1.  Breathing
2.  Pelvic placement
3.  Rib cage placement
4.  Scapular movement
5.  Head & cervical spine placement

I could not ask for a better Pilates Instructor. Joetta has been such an amazing help, and has really worked with all of my limitations. I can already feel myself getting stronger!

DAY 22- Wednesday, Jan. 25th

Discontinued Relafen + 2 Front Elastics

Being able to remove two more frontal bands, also enabled a little more wiggle room in my splint, which took a day or two to get used to. Here is my newest smile with less bands...

DAY 23- Thursday, Jan. 26th

Break Times 5 times per day for 30 min.

Thirty minute breaks make all the difference in the world! If you get everything ready beforehand, as you would for the 15 min. breaks, you'll have time to make a phone call, visit with friends, or have coffee or dessert. The added time allowed me to enjoy my first cup of coffee since before surgery. Sometimes it is the little things in life that make you the happiest.

FYI- I only choose to drink clear liquids when I'm wearing my splint, so it doesn't get discolored. I really don't want it to be brown, since it is hanging around for 9 months.

PAIN- WEEK 3: Due to the combination of getting off the Relafen, 30 minute splint breaks, and increased talking, I felt a little bump-up in pain and a general tightness/achiness in the Masseter muscle in my face. Occasionally, I still got sharp ear pains, which only lasted a second, when doing my Therabite or jiggle exercises, and when hiccuping, sneezing, talking, blowing my nose, or accidentally biting my tongue, etc.

I also began to hear crackling cellophane-sounding noises in my ears when doing the jiggles, which Lisa previously told me was normal and to be expected. I had a couple of headaches (the normal people kind, not migraines), which were easily cured with Tylenol. I did not notice myself clenching when waking in the mornings, and I began sleeping through the night without waking up. Overall, my pain level was always under a Level 3. The muscle pain went away as my body got used to my new schedule.

... doing well and feeling more like myself!

4 WEEKS POST OP- Wednesday, Feb. 1st

Focusing on my Posture

I was really feeling great with regard to my jaw, ear, and facial pain levels (usually a Level 1). I had not  gotten any more headaches, and I religiously continued my daily routine (as outlined above). However, as I worked more on my computer, I began to feel that old muscular tightness and strain in my shoulders returning. I knew I had to get it under control before it started moving up my neck and getting really bad again. 

Thus, I began focusing even more intently on my posture and doing research to truly understand why poor posture was such a stress on the whole body. 

Good Posture

Once upon a time I had good posture. But, as my TMJ Disorder and chronic pain took their toll, without me even realizing it, my good posture slowly slipped away. Thus, I have to make a constant effort to think about, and correct, the way I am sitting, walking, and standing to ensure the best recovery possible.

15 Minute Breaks

Fifteen minutes is not a lot of time to perform your Therabite + jiggle exercises, clean your splint, eat, take your medications, use the Waterpik + brush your teeth, and get the splint back in place and all banded up. You must be diligent and organized to do it five times a day within the time limit.

TIPS- Successful Splint Changes in 15 Min.

1. MEDICATION: As soon as you wake up in the morning get all of your medicines separated out, into five individual containers, for the day.

It is helpful to keep a list of what medicines you take during each splint break. This way you won't forget anything, take too many pills, or get confused.

2. SUPPLIES: Keep your hygiene and splint supplies on an organized tray in your bathroom. Have everything ready to use in a hurry. I even count out my rubber-bands beforehand, so that I can quickly get them back in. Once you've done it enough, you can band back up in about one minute.

I use three toothbrushes-- the baby toothbrush for brushing my teeth, the second for brushing my splint once I have soaked it in Efferdent (during the first morning break), and the third for brushing my splint with toothpaste (at each break), and ACT Fluoride Rinse (after the evening soak). Make sure to have hand towels and Kleenex readily available. That Waterpik loves to splatter everywhere.

3. FOOD: Prepare your meal, puree it, and have it heated and ready to eat before you take out your splint. Your spoon/straw, napkin, drink, and meds should all be set out. Be careful when you're popping in big pills, you don't want to accidentally bite down on one when you're swallowing.

4. TASKS: As soon as you unband and remove your splint, start your timer, brush your splint and then soak it if it is the first or last break of the day. Next, do your Therabite and Jiggle Exercises before eating. This way, you will be sure to get them in, and you won't hurt yourself rushing in the last seconds.

I quickly open and close the Therabite, so not to strain my muscles.

I slide side-to-side, on the tongue depressor, for my Jiggle Exercises.

5. LOG: You're not going to remember what time you complete each splint break. Since they have to be at least two hours apart, keep an ongoing log of the times you finish up.

The 15 minute breaks only last for the first 2 1/2 weeks, and then you get more time. But no matter what, STAY ORGANIZED, because...

Post-Op Appts. {Days 6-9}

DAY 6- Monday, Jan. 9th
9:00 AM: Physical Therapy
Today they gave me a handout of exercises to do on my own, a resistance band, and small roll pillow to support my neck. After PT I went straight to see Dr. Piper.

10:15 AM: Piper Clinic
HOORAY, I got to take my splint out for the first time since surgery and remove a couple of the frontal bands forever! From here on out, I was able to remove the splint for 15 minutes, five times a day. Dr. Piper said everything looked great. It was amazing to see how much my bite was corrected with this surgery. My teeth almost fit together like a normal person's, and Dr. Piper said that the orthodontic braces that I'll wear after 9 months in surgical braces should work pretty quickly.

Lisa taught me how to properly use the Therabite, by doing 30 up-and-down pumps, and advancing to the next hole only when it becomes easy to get the bar all of the way down on the current hole.
FYI-There are five holes in the Therabite which are set to progressively increase difficulty as one moves up in number. You don't have to get to the last hole, #5, until 3 months post-op.


Next, I learned how to properly do the Jiggle Exercises, by quickly moving my jaw side-to-side for 5 seconds, 5 times. I would do both every time I took out my splint. She also gave me a bag with tons of extra rubber-bands and supplies for the months to come.

TIP- Be sure to keep your breathing hole open and clean by shooting the waterpik through it.

My ears and drain holes were continuing to heal well, but as could be expected, were still very sore.

My temples and the sides of my head were still numb and sensitive to any touch.

FYI- When you start the splint breaks and exercising your jaw, it is totally normal to have bump-ups in pain and swelling. And at every appointment, they'll ask...

MY PAIN

My pain levels this week were always slight to mild (1-4), as I was taking all medications religiously at the prescribed times. Dr. Piper said, "It is much easier to keep up with pain, than to play catch up with pain." I kept this in mind, and by following his detailed instructions, never had any severe pain. However, I did have some continued lightheadedness from the medications, facial achiness, and was generally tired.

I was really pleasantly surprised that it was not more painful. Besides the soreness and sensitivity on the incision sites and on the sides of my head, the main discomfort I had was in my ears. For the first week, I felt a constant pressure and random sharp shooting pains in my inner ears. However, the shooting pains would only last for a few seconds and then were gone. I would also get an occasional stabbing pain in my jaw muscles. The ear and muscular pains were never constant and usually only happened while I was taking out my splint, doing my exercises, sneezing, or yawning. I had zero neck pain or headaches, which was such a relief!

TIP- Wear leggings, yoga or work-out pants, because it does hurt if your pants are rubbing against the stomach incision or the sensitive skin around it.

Considering the pain I was in before surgery, for me, this new healing pain was very manageable.

MY DIET

On a positive note, I said SEE YOU LATER to my liquid diet, ground up medications, and syringe feedings! And HELLO, to my No-Chew diet. On the No-Chew diet you can eat anything as long as the food is altered to a pureed consistency. (I really was excited about it, there was probably just food in my braces in the pic below.)

My first real meal was Panera Macaroni + Cheese (pureed in the Magic Bullet with extra milk to thin it). Then it was time to band back up, use my heating pad, and take a nap.

During our long late afternoon to early evening walk we saw a pod of Dolphins looking for food right along the bay wall. They were only a few feet away, and it was as if they were giving us a show to lift my spirits, by swimming back and forth and popping out of the water right in front of us. Then, I remembered that in many cultures, the Dolphin is a symbol of protection, and is said to bring good luck. I like that belief, and although I don't really believe in luck, they made my heart very happy.

They were iPhone camera shy, but you get the idea.

DAY 7- Tuesday, Jan. 10th

7:40 AM: Piper Clinic

Dr. Piper and Lisa were very proud of my healing progress and continuous low pain levels. Dr. Piper said if I kept doing so well, I would be able to go home a day early. I wanted to do a happy dance.

9:30 AM: Physical Therapy

After Physical Therapy, I spent the rest of the morning focused on my 15 min. splint breaks, eating, using my heating pad and resting. Then we walked from the Vinoy to The Pier and back, which was two miles in the heat. After this, I took a much needed one hour nap. In the evening, we took a stroll around the resort and then downtown to get some frozen yogurt. Although I felt puny, it was a good day.

DAY 8- Wednesday, Jan. 11th

9:00 AM: Piper Clinic
I was feeling really good, and because I was doing so great, my stomach Suture Removal was moved up from Thursday to Wednesday.

Since it was still healing, after she removed the stitches, Lisa placed steri-strips over the incision site. She instructed me to leave these strips on for three days, and brushed on an orangish-brown glue to keep them in place. I also had to wait another 24 hours before I could take a bath. After the strips came off, I began massaging the area daily to try and help flatten the scar tissue.

TIP- Shop at The Fresh Market. After my appointment we went to The Fresh Market on 4th Street, where I was able to get Greek yogurt, fruit and small individual containers of prepared foods. I kept them in my hotel fridge, and ground them in my Magic Bullet at each meal time. Some of my favorites were chicken salad, pesto pasta salad, egg salad, Thai honey chicken, dill cucumber tomato salad, quiche, and sun-dried tomato + mozzarella pasta. Smoothies, protein shakes, oatmeal, and soups are great, but it feels really good to eat flavorful foods (even if they are pureed).

Later, as I was going for another walk in Vinoy Park, and being passed by runners, I was thinking...

Below you can see the most bruising that I had the entire time. There was redish bruising behind my ears.

And there was yellowish bruising on the sides of my face, where the skin had been pulled back. All in all, I thought it was totally amazing that there weren't more signs of a major five hour surgery.

3:15 PM: Physical Therapy

Once PT was finished, we were off to see the amazing + eccentric art work of Salvador Dali.

The inside view from The Dali Museum. The architecture is breathtaking.

After the museum it was back to the hotel for some rest, another walk, splint changes, eating, heating pad time, and packing to go home!


TIP- Be careful when you're packing. After being somewhere for over two weeks, you'll have a ton of stuff to get together. I over did it a bit, by getting up and down too much. This made me lightheaded and dizzy. Don't try to do it all yourself, even if, like me, you're anal and like things packed a certain way. Get your family to help you, because they'll be happy to do it.


DAY 9- Thursday, Jan. 12th

9:00 AM: Piper Clinic
Finally, after my final appointment and checkup, I was officially discharged a day early. This was a wonderful day, because since I was feeling less pain and more independence and strength, I was really ready to get home.

11:00 AM: Goodbye, St. Pete! We're out of here.

We decided to drive to St. Pete, rather than fly, because I did not want to risk getting motion sick during the flight, with my mouth banded closed, and because I didn't want the pressure to hurt my ears. Driving was also good for me, because I was able to bring everything I needed and I had my own car while I was there. Dr. Piper just told me to make sure to get out and walk around along the way, watch my neck posture, and to prop my feet up in the car. I used the neck roll from the Physical Therapist, which really helped. The only added discomfort I felt was in my stomach incisions, probably from sitting for so long. It helped me to lie back some of the time, and to wear yoga pants which I could fold down. Here's a funny picture of me getting in my one hour nap...

The only bad thing about us driving (besides 20 hours in the car and one flat tire), was that it was difficult to do my splint breaks. It really sickened me to even think about changing my bands and doing my exercises in a public restroom. Thus, after one quick, tearful experience, I managed to do my exercises, eat, brush my teeth and band back up in the car while riding. I made the most out of our hotel stop and got several breaks in there, as well. You just do what you have to do to get home.