Day 10-15: Photos of Weeks 1 & 2

Hello! Recovery is getting a lot easier now! Zero pain, some discomfort… but mostly I am just waiting for my swelling to go down and my bones to heal so I can finally chew (and get this damn splint out of my mouth).

Aches

The muscle situated near my left temple aches quite frequently now. Very annoying. Feels like someone is pounding on the side of my head with a sledgehammer. My surgeon said it is because my muscles are trying to move in the old way but my elastic bands are resisting this movement. She also mentioned that it is nothing to worry about but it is such a PAIN IN THE ASS.

Swelling & Bruising

I am still puffy around my cheeks and upper lip. Especially the latter, because that is the area where they slit me open. But the swelling has gone down to the point where a stranger would just think I have a chubby face. Discolouration of my neck and chin is mostly gone! Yay!

2nd Post-Op Appointment

On Day 14, I went to meet my surgeon for the second appointment after surgery. She removed the stitches from the surgical sites, which was uncomfortable and stung quite a bit (quite a bit of blood in my mouth after that). I was really dreading it because I thought it would hurt a lot but it wasn’t that bad I guess, and I feel a lot less stiff now that the stitches have been removed.

My surgeon reduced the number of elastic bands from two on each side to one on each side, and also taught me how to change them. I’m advised to change the bands every other day and to brush the insides of my teeth. With the elastic bands on I can open one finger width. I haven’t replaced the bands yet so I have yet to measure how much I can open my mouth without bands.

Next appointment will be exactly a month after surgery AND I WILL BE REMOVING MY SPLINT!!!!

MUGSHOTS

I AM BARING MY SWOLLEN FACE FOR THE INTERNET. These are portraits taken almost everyday in the first 2 weeks. I’ll add Day 1 when I get it from my mother’s phone. Unfortunately, I forgot to take a picture on one of the days so… opps.

Before

Before

Day 2

Day 2

Photo on 2014-01-12 at 14.14

Day 3

Photo on 2014-01-13 at 18.23

Day 4

Photo on 2014-01-14 at 11.53

Day 5

Photo on 2014-01-15 at 15.51 #3

Day 6

Photo on 2014-01-16 at 19.04

Day 7

Photo on 2014-01-17 at 20.48

Day 8

Photo on 2014-01-18 at 18.06 #2

Day 9

Photo on 2014-01-19 at 18.34 #7

Day 10

pufferfish

Day 11

Photo on 2014-01-21 at 16.48

Day 12

Photo on 2014-01-22 at 21.45 #5

Day 13 – Hairbun = Replacement for Hair Curler

Photo on 2014-01-23 at 19.10 #3

Day 14

Photo on 2014-01-25 at 00.45 #2

Day 15

Collage

I don’t think the pictures accurately show how chubby I really am in real life. There is more volume around my cheeks and upper lip in reality. In a 3/4 profile shot, my swollen cheeks have overtaken my cheekbones as the most prominent facial outline.

Overall

I am getting my energy back, and am less frequently plagued with less negative thoughts now. Finished all my medication, and I have no need for extra painkillers. I can open my mouth wider, which increases my food options. Not a fan of the texture of blended food, so I have been opting for very small pieces of normal food that I swallow without chewing. I also tried blending fried chicken as I said I would and the texture is disgusting so… don’t do it. The hardest part is definitely over and all that’s left is waiting for my bones to heal and swelling to go down.

Was this surgery worth it? Too early to say, really. My two main reasons for going through with this surgery are to improve my chewing and pronunciation. The splint is still in my mouth so I can’t pronounce properly, and I haven’t tried chewing either. Also, I am not completely satisfied with my appearance right now because I really don’t like the whole ‘chubby cheeks’ business going on with my face. I LOVE my side profile though. But this is not my final face so there’s little I can conclude about appearance at this point.

I’ll answer this question again in the near future, when I am able to judge how much my pronunciation and chewing have improved due to an aligned bite. As of fifteen days post-op, I am not regretting the surgery, and I am optimistic about things. For now, it’s a good position to be in!

Day 9: Insatiable Itches

I am happy to report that I did not wake up in excruciating pain. My soreness was gone when I woke up in the morning! However, as I write this, I have become sore from the day’s activity – which makes me think that maybe soreness is just inevitable.

Swelling is going down, finally. Still a lot of it left but I can finally see a bit of progress!

Something new: I am starting to get itching sensations on my face, around/on my nose. Except unlike a mosquito bite, the itching does not go away no matter how much I scratch the area! It’s almost like the itching is beneath the surface of the skin. Not sure if this means that the nerves are healing in that area? I think my nerves were slightly strained in that area. I don’t have completely numbness there; I can feel it when I touch that area with my fingers, but it feels almost as if it is not my own skin that I am touching, if that makes sense.

I don’t have much of an issue with anything else, I think… but I really miss being able to sing in the shower.

Day 8: Face Ache

…I overdid it today.

Before surgery I said I would never let this happen to me and I would lead a sloth’s life. But I’m only 8 days in and I already tired myself out. My facial muscles are sooooo sore. I was taking too much advantage of the little bit of freedom that I had gained after a few elastic bands were removed in my previous surgeon’s appointment: I talked a lot, ate blended food (which involves opening and closing my mouth rather than just letting the food go through the natural gaps between my teeth), and smiled one smile too many (yes it is possible to smile too much).

Gosh I am so sore. I hope I don’t wake up in pain tomorrow.

A little aside: I just found out today that it doesn’t actually take more muscles to smile than to frown. The opposite, actually! Of course I am going to be doing neither for the rest of today, I’ll just remain expressionless. I moved too many facial muscles already. 

Days 3-7: Still a Chipmunk

Firstly, I apologise for the lack of updates, but I thought it’d be easier if I broke down the post into issues instead of days so you can see a progression over the first week.

Nasal Congestion

I thought I wouldn’t have much of a problem with this since my nose didn’t bleed post-surgery, but it was really quite difficult to breathe on Day 3 & 4 for some reason. The Breathe Right Strips and Q-tips were utterly indispensable. I would not have been able to have a good night’s sleep without them, but even then they really didn’t help much when the problem peaked. Sometimes I was really close to panicking because I wheezed so loudly and my nose felt like it was slowly but surely clogging up, but then I remembered that I can still breathe through my mouth, even when it’s wired shut! Of course it’s a bit uncomfortable, but that dispelled much of the worry of like… dying of suffocation or something. Hot showers were also very useful, but my humidifier stopped helping much after a while.

By the 5th day, my nose cleared up considerably and now (the 7th day), breathing is pretty much normal.

Sleeping

I have no problems at all sleeping – I’m able to sleep throughout the entire night, and I usually have a 1.5 hour nap in the middle of the day after lunch because I get so tired. It’s important to remember that your body is still recovering from a very major surgery, so rest is still very much needed and you shouldn’t exert yourself too much! Having said that…

Walking Around/Going Out

Don’t keep yourself cooped up at home all day long, if you can manage it! I’ve been going out for short walks to the nearby malls. The doctors said that walking will help with the swelling, and I find that I can muster the energy and strength, although I often need to pause for soup or drinks (because liquid diet = CONSTANT HUNGER PANGS). I definitely recommend taking walks during recovery, even when you are all puffed up, because it just helps in keeping you optimistic just a little (especially if you are the sort who doesn’t like to stay indoors for long periods of time)

Swelling

My swelling is really really really really really really really bad. IDK why it hasn’t really gone down at all in days 3-6. I don’t know if it’s something to do with my blood clotting thingy, because the surgeon mentioned that it does affect swelling? I dunno. All I know is that I used to have a really slim face that tapered to my chin, but now it’s like… oblong. There’s definitely a lot of swelling that hasn’t gone down. It’s rather frustrating because I’ve been reading blogs and most people don’t seem to face much swelling/their swelling goes down really fast, but I still can’t envision what my face will look like after all the swelling goes down.

Trying to be optimistic on this point, but my mind has been riddled with worries to be quite honest. I know I am still swollen but I don’t know how much of the extra volume on my face is because of swelling. I’m actually sort of scared my face will be stuck like this, and I’ll be a chubby chipmunk. I’m trying to remind myself that it’s only been a week, and my swelling will slowly go down. I’ve found that not facing a mirror 24/7 kind of helps keep me sane. My laptop is usually placed right next to the mirror so for the first few days home I couldn’t help but obsess about how SLOW swelling is going down, but now I have forced myself to move my laptop so I am facing away from the mirror. At this point, however, I definitely don’t feel up to meeting with friends while there is still this much swelling on my face.

Eating

I am still eating mostly liquids, even though on Day 6 my surgeon removed some of the elastic bands. I still can’t really open my mouth much though, because the existing elastic bands are still really tight. Haven’t really tried blended food, actually, and I’m a bit apprehensive because I have no way of brushing the insides of my teeth. I haven’t had much of a problem with the liquid diet, except yesterday I watched my family have dinner and I REALLY WANTED SOME FRIED CHICKEN. I can’t imagine having to wait 5 more weeks before I can finally have some fried chicken. One day I’ll be desperate enough to try and blend it, and I’ll tell you how blended fried chicken tastes like. I’m guessing that the taste will be satisfying enough to make up for the disgusting texture.

On a side note, I recommend Soup Master 老火汤 to the Singaporeans!!!! They have a few branches around the island and their soups are pretty ok. Most of all you get to refill the soup for free. 🙂 You won’t be able to eat the meat and all, so I recommend you share it with someone because you are only going to drink the soup (which have I mentioned is refillable???)

Talking

I am able to talk (sort of… or at least be vaguely understood) now that a few elastic bands have been removed. Enough to not be dependent on a whiteboard any longer! However some words still come out sounding like utter gibberish so I often have to repeat. It’s also weird having to learn how to ‘re-pronounce’ words, especially because I am still more or less banded shut. Since I had an underbite previously, I pronounced many sounds differently than what would be the ‘normal’ way. For instance, sibilants were difficult since your teeth NEED to meet to create the ‘ssss’ sound. Now I am sort of able to produce that sound, though it still feels unnatural. Baby steps, I guess!

Bruising

My neck and face are so yellow right now I am positively a Simpson. It has been like this since Day 3/4, and it’d only gotten worse! Doesn’t really bother me, since I know for sure that this is going away, but I thought I’d just let you know that this may and probably will happen to you post-op!

Comfort

A little note on the emotional and psychological aspect of recovery: you neeeeeeeeed to make sure that you have things during the recovery period that will make you a little happier and let you take your mind off the fact that you are a swollen mess of a person! Be it food, friends, or any form of entertainment. For me so far, my comfort objects are fruit juice and Sherlock (BBC). I had also prepared a few books, but frequent hunger pangs make it a less than ideal period for reading… So yes, a word of advice – prepare some comfort items!

Overall

The first week – hell week – is finally over and I am so glad that it hasn’t been as bad as I thought. Currently I am quite comfortable and my recovery appears to be on track except for swelling (where I appear to be lagging very very very very very far behind – SUCKS!). No pain since the first night and morning after surgery. Trying to be optimistic and soldier on! And of course, patience is important (and unfortunately lacking in me, oh well).

Day 2 – Oil, Drugs & Prophetic Warnings

Since I’ve started posting about my recovery I noticed that my blog’s hits have shot up. So hello to you new readers, and welcome to my self-documented journey of voluntary dental purgatory. 🙂

Now before I begin this post, let me just warn you that the disgusting/gross factor of its content will be stratospheric. This will read like an issue of ‘Horrible Science’, except it’s 100% horrible and 0% science. I’ll say it again in case you skimmed through that:

WARNING: DISGUSTING POST.
The things in this post may make you go ‘ewwww’.

Ok now that that’s out of the way:

My surgeon swung by in the morning of Day 2 and told me that I could check out of the hospital by late morning. I was elated! By this time I couldn’t wait to head home and have a nice shower. My hair was greasy, and my face was slicked with enough oil to fry a batch of bacon. OK that was disgusting – I’m sorry. But truthfully, the surgery made the oil glands on my face, especially those in the T-zone, work on overdrive. I became addicted to this after I got home:

It didn't control the oil as promised, but it did provide immediate relief.

It didn’t control the oil as promised, but it did provide immediate relief!

Medicine & Supplies

I left the hospital at around noon, with these:

  1. 14 tablets of antibiotic [Co-Amoxiclav 625mg] – One table twice daily for 7 days
  2. 3 tablets of painkillers [Arcoxia 120mg] – One tablet daily for 3 days
  3. 40 tablets of panadol – Two tablets twice daily in case of pain or fever symptoms
  4. 1 bottle of iliadin nasal decongestant – Maximum three drops daily for up to 7 days
  5. A couple of syringes of various sizes
  6. 2 bottles of Orasol disinfectant mouthwash – 15ml twice daily
  7. Paraffin lip mosturiser

Because I can’t separate my teeth at all, I have to crush the medicine into powder and dissolve them in water. They taste so gross. On my doctor’s advice, I tried adding honey. Didn’t make it much better. In fact, it made the medicine taste really weird, so now I just suck it up and finish the disgusting mixture.

I don’t take panadol or use the nasal decongestant regularly – only when needed. So far the pain has been very manageable so I haven’t had to take the panadol at all except once. Also, I found out that I can actually drink straight out of a cup, because I can feel still feel my lips!!! So I don’t use the syringes for anything except taking the disgusting medication mixture, only because I want to be super sure that I don’t spill/drool.

Nasal Congestion

Apart from swelling, nasal congestion is one of the primary issues I have to deal with at home. My nose didn’t even bleed, so I guess I don’t have the problem as severely as most people, but it still gets really hard to breathe sometimes!!! I woke myself up in the middle of the night once because I was wheezing so hard.

The nasal decongestant is supposed to help, but I try not to use it unless I am very desperate. I don’t want to risk  the side-effects of overuse. As the manual said, ‘muscle atrophy’ may occur. What affects me more, however, is the advice my pharmacist left me with:

“Don’t use it past the seventh day. I tried it once. On the eighth day you will regret it.”

I don’t know about you, but her words were ambigious and ominious enough to scare me away from relying on the prescribed decongestant for clearing my nose. Instead, my nose-clearing routine mainly relies on other steps:

  1. Breathe Right Nasal Strips [INDISPENSABLE!!!!!!!!]: I sleep with the nasal strips on, and they help tremendously. In fact, I managed to sleep a full 10 hours on the night of Day 2 because of this thing! On the night of Day 3 I tried to do without it, but I woke up in the middle of the night feeling like I couldn’t really breathe. I placed one on my nose and I managed to sleep uninterrupted for a good eight hour.
  2. Humidifier: I read somewhere that it helps, and my sister owns one, so I just use it. I am not sure how it is supposed to work, but it does somewhat provide relief when I let the mist blow up my nose. I found that steam from a mug of hot water works just as well, if not better.
  3. Cotton buds/Q-tips: I’m about to be really gross now so pardon me: when my nose gets really really stuffy, I have to resort to ‘fishing’ out dried-up crusted material with a cotton bud. It is super gross, but helps a lot with clearing your nose. Of course you have to be really careful during the process, so as to not dislodge a blood clot or something…

Phlegm

Unfortunately, phlegm is another major issue. It’s really bothersome: the phlegm gets stuck in my throat but I can’t really spit it out because my teeth are banded shut. The best I could do was swish around some water in my mouth and let the water+phlegm slowly ooze out from the gaps between my teeth. I know, I know, gross!!! But another necessary detail that a potential jaw surgery victim should be warned about.

Weight Loss

Because I am really really really really puny petite, weight loss was a major concern for me. I was originally 43kg (94lbs) so I couldn’t afford to lose any weight. Hence I was pretty apprehensive when I stepped on the weighing scale at home… Imagine my surprise when this flashed back at me:

42.9kg

Yes, I lost almost no weight from 1 day of virtually no food and another day of very little liquids. Weird!!!

Day 1 – The Peak of Just About Everything (Pain, Discomfort, Swelling, with a Dose of Self-Deprecation …)

Day 1 was an emotional roller coaster!

The morning was agonising. I was sent to the dental clinic in the hospital to have my mouth and nose cleaned by one of the doctors from my surgical team. My head felt really, really heavy, so I had to be wheeled down since I was in no clear state to be walking around. It felt like someone had attached iron weights to my temples; they were throbbing like crazy and I was just in sheer discomfort. On top of that, the pain was unbearable. After the doctor was done cleaning everything, I was tearing like a baby! Soooo embarrassing, but I felt so helpless at the same time so I didn’t spare my dignity any thought. I think everyone who saw me being wheeled back to the high dependency ward was probably wondering what the hell this girl with the big swollen face was put through. Haha at least nobody will be able to recognise me after this swelling goes down…

My doctor decided to give me stronger painkillers, which were injected instead of ingested. I puked (pretty badly) but the pain and discomfort subsided almost instantly. I was really quite comfortable after that. Fortunately, I didn’t actually face any problems breathing during the first few days, because my nose didn’t bleed at all so it didn’t get congested. They moved me back to the normal ward for one more night after removing all my IV drips and the urine catheter. The feeling of the catheter being removed is something I do not want to relive again. It wasn’t very painful, just very… weird and intrusive. Very intrusive.

In the normal ward, I applied cold packs every now and then, and I’m pretty sure my swelling peaked that night. My face didn’t really have a shape. It was just this… amorphous blob of… swollen-ness. Ok I don’t make much sense but basically I looked a lot like this:

Image

I just wasn’t as cute and much oilier.

I’ll post pictures when I’m past the one week mark. Firstly because most of the pictures aren’t taken on my phone and I’m a bit lazy to go ask for them, but mostly because I AM SO DISGUSTINGLY SWOLLEN so you have to give me a bit of time for my sanity to be regained.

I slept in 3 hour intervals the whole night. It really wasn’t that bad. I took the time to drink milo and reapply ice packs. The nurses were sooooo nice, they weren’t bothered at all by my constant bell-pressing and whiteboard-writing (because my teeth are banded shut so I cannot talk AT ALL. Frustrating.) I cannot stress how important a supportive and kind nursing team was to the whole experience! You should do everything in your ability to endear yourself to the nurses! In hindsight it would have been a good idea to bring some chocolates and maybe a ‘thank you’ card for the nursing team. I’ll definitely give them something when I go back to the hospital for my return check-up, though I have a feeling they won’t recognise me at all in a week or two…

Day 0 – Surgery

As I had a blood clotting problem detected earlier in the week, I was administered a bag of cold plasma and transemicacid before the procedure via IV to help me with bleeding issues. I was wheeled in to the waiting room of the operation theatre at around 9.30AM, where I waited for a pretty long time before my surgery started. I think it started at 12PM and I was wheeled out at around 7PM.

I thought that they were going to do the typical ‘put me to sleep’ procedure where they made me count backwards, but instead they put me on 100% oxygen and injected the anesthesia through my arm. I remember hyperventilating for a bit because I thought I couldn’t breathe (stupid, I know) but then before I knew it I was out like a light.

When I woke up in the recovery room I was in quite a considerable amount of pain, and was surprised that I did not face complete numbness anywhere on my face. After giving me some painkillers they wheeled me out of the operating place where my family was waiting for me outside. My brother snapped a few unglamorous pictures which I will post up soon when I get my hands on them.

I spent the night in the high dependency ward. It was terrible though. I was nauseous and puked a few times because my empty stomach couldn’t take the medicine. One thing I would suggest is being completely calm when puking. It’s easy to panic because your teeth are wired shut. But the gross stuff can easily ooze out of the gaps between your teeth and it helps A LOT if you keep calm.

For the whole night I could hardly sleep because my face was in so much pain, and at one point in I actually started tearing up a lot. At its worst I would put the pain at around 9/10. I honestly wasn’t expecting to feel much pain, since I thought I would come out of the operation completely numb. I guess it’s one or the other and I happened to land the option that induced intense short-term suffering.

I was trying to stave off negative thoughts the whole night. It was very difficult, being in so much pain at all, but I kept reminding myself why I decided to have this surgery and that in a few weeks I would (hopefully) find it was all worth it in the end. Thank goodness the nurses were pretty sympathetic and nice, otherwise the night would probably be more terrible.

T-1 Day – Packing List

Hi guys! I’m posting this from the hospital.

I can’t believe it is actually happening, after two weeks of running around from doctor to doctor because of an undetected blood clotting issue. Thank goodness it was not too serious and I can actually go ahead with the surgery, except now I have a haematology team as well!

Here’s what I brought to the hospital, based on very useful lists done by other bloggers.

  1. Toiletries, including baby toothbrush and normal toothbrush (for tonight)
  2. Entertainment: Macbook, iPad mini and my iPod. My mum will bring the first two home because the hospital advised me not to leave any valuables here overnight. I’ll probably have an early night because otherwise I’d be bored to death. There’s a small TV here though, but I wanted to watch Sherlock on my Mac. 😦
  3. Snacks in case I get hungry before I have to fast at 12midnight (very likely)
  4. Neck support pillow
  5. Thermal water face spray
  6. Cold packs (two so I can alternate)
  7. Cotton buds/Q-tips
  8. Wet napkins and a tissue box
  9. Stuff for communication: whiteboard, a paper printed with questions and statements
  10. Clothes and towels (though I shouldn’t have because the hospital gave me a set
  11. Mum will buy a portable standing mirror for me

A while ago, a medical student came in to ask me what I am doing here (everyone else is probably above 60 here). I had to explain the surgery and my underbite to her. It was pretty amusing. After that, the anaesthetist and my surgeon’s team came in to check up on me and ask if I had any questions. Here are their answers to a few questions that I asked:

Q: What is the possibility of anesthesia awareness occurring?
A: (From anaesthetist) Very little chance. We will take necessary precautions to ensure that you are in deep sleep, including monitoring brain waves.

Q: I brought ice packs. Will they help?
A: (From anaesthetist) We will be injecting steroids to help with the swelling. If steroids don’t work, then the ice probably won’t either.
(From surgeon) It will probably help, and you should use them since you have already brought them.

Q: I’m worried about nasal congestion after surgery due to swelling and nosebleeds. I brought a nasal strip to open up the air passages. Will they help?
A: (From anesthetist) Probably not by a significant amount. We will however insert a breathing tube and oxygen mask if you face problems breathing.

I am not sure if the haematology team will swing by later, or if they will just do their examination tomorrow. My surgery is scheduled to start at around 10AM. I’m not really scared or anxious now… maybe I will be tomorrow. Now it just feels kind of surreal because all those months of waiting are finally over.

I have been bracing myself for the worst recovery possible because I’ve always been one to plan like a pessimist. It’s important to have realistic expectations of recovery, I think. The first few days will probably be filled with regret and questions along the lines of “why-did-I-put-myself-through-this-torture-and-agony???”. But I need to keep reminding myself that the pay-off will come eventually. I find that it’s much easier to be optimistic when you expect the worst and end up having things a little better than what you expected. So I am trying to tone down my excitement and keep my expectations reasonable.

On an unrelated note, I have a friend who went through the same procedure about two weeks ago. She faced zero numbness on the outside. She could completely feel her face, including her lips!!!! How amazing is that?! Her recovery has been so quick, she can already eat rice now!

Speaking of rice, I’m starving. I hope the hospital serves dinner soon. In the meantime, I’m going to watch some Sherlock before my entertainment devices are taken away later.

I probably won’t feel well enough to blog for a while (plus I won’t have access to a laptop and blogging on the phone is troublesome) so I created a twitter account for me to fire quick tweets on my phone. I don’t have any tweets now, but it’s @kimsjawsurgery

See you on the flip side!