The musings of a final year medical student

Sunday, 9 August 2015

Jaw surgery recovery: days 6 to 9

Hey all,

So far the changes are amazing and I see improvement everyday.

Above: me 1 week prior to surgery 

On Friday I saw my orthodontist who removed the plastic wafer and attached looser elastics. The appointment was a bit painful because for some reason opening my mouth that wide started to make the left side of my jaws really ache and throb; the same side that has greater swelling and was throbbing considerably in my initial recovery. I am seeing my surgeon on Monday so I shall ask him more about this then. However, I have been told that it’s normal to have one side of the jaw to hurt more, sometimes one side is harder to manipulate during surgery.

One thing that is frustrating about recovery is some days I will wake up with loads of energy and quickly just after small activities like a short walk or hospital visit that energy is totally zapped. I am trying to resist napping during the daytime to establish a good routine, but sometimes I have to give in. Even seeing people for less than hour the talking can make me feel exhausted. I’m not good at sitting around doing nothing and I normally drive everywhere. I haven’t started driving because I don’t think it’s safe to drive when I’m tired and I can imagine driving will be able to zap energy from me in the same way that walking and talking does.

I keep getting these EXTREMELY IRRITATING itches on my face that I can’t actually itch because the sensation hasn’t fully returned to my face. Honestly, they are the bane of my life. You just have to distract yourself with something else, but they are sooooooo anooooyyyyyinggg.

I have nearly ran out of Fortisip shakes which is good in a way because it encourages me to eat ‘real food’. I am definitely eating more proper food than the shakes now, especially because the looser elastics allow me to eat thicker liquids. I now have my soups and smoothies a lot thicker and they are more filling. Everyone has their fave foods during recovery; for me I am loving those iced coffees you can get for around £1 at the supermarket, Innocent smoothies and my own homemade smoothies to get my fruit.  My absolute favourite thing is to make a smoothie that includes whole milk, one banana and custard. It is absolutely gorgeous. My mum also makes a lovely spicy curried parsnip soup and a starchy leek and potato soup that is very filling. Beware though, I made the mistake of having Heinz tomato soup and now have some lovely orange-stained elastics. Great. I have been using the Nutri Bullet and I HIGHLY recommend it! It can get through anything, so easy to use and clean. Of course, if you already have a hand blender or similar then a Nutri Bullet is not an essential, but it has really helped me to be independent and make food for myself really easily. It’s important to note I am very uncomfortable with very hot liquids and I am having all the soups around body temperature. I can drink everything from cups now but still use syringes for liquid pain relief because it’s just easier. I still don’t have any appetite so I don’t mind the liquid diet because I’m not craving real food yet.  

Above: the liquid diet

I sporadically still use ice packs on my face because I can get a bit hot. You definitely need to get some small icepacks for recovery once you have been discharged from hospital as they help so much with the swelling. Frozen peas would probably do at a pinch but really ice packs wrapped in a thin muslin cloth or flannel work wonders.

At times I have been irritated that my family members haven’t appreciated how serious my operation is and have tried to rush my recovery. On Friday my dad offered me bread with my soup with complete sincerity, and he’s a doctor! I had to remind him that the fact my mouth barely opens a centimetre rules out practically everything. It’s good to get out of the house and go on walks which I do most days, but sometimes I just feel like I have no energy and I have to really dig my heels in and stress to them how shattered I am. I don’t know if the lack of energy is primarily due to the general anaesthetic or the lack of calories, or maybe they both have equal contribution to the fatigue.

I am trying to be more like myself and make sure I get dressed and do my makeup and hair each morning so that I feel more like myself. Some days this feels so hard. It is really strange to dip my face in the shower water and not be able to feel the water hitting my cheeks, or when I dot foundation onto my face and I can’t actually feel the foundation brush buffing in the liquid. I am getting a lot of tingling, particularly on the right side of my face, but it hasn’t completely come back. My upper lip feels very stiff and immobile, which is odd when you can see I have complete control of my bottom lip.

I am really happy with the results of this operation. As I have mentioned previously, my nose is smaller which is a nice coincidence of the surgery, and now that the swelling has gone down considerably I can actually see my new jaw properly and it looks amazing. I feel extremely empowered and I feel very strongly that this is the ‘real me’ in a weird way. Even with the elastics in my mouth and the swelling, I feel more confident and very content. The orthodontist thinks I am recovering at a normal rate that he would expect, so I hope I can give hope to others that recovery really isn’t that bad. Yes, it isn’t exactly fun, but once you get through the first 3 horrible days, life becomes fun again. It is so exciting to see how the face changes each day; you start to feel normal again and can start doing things for yourself. Yes, the elastics are on for at least a month and therefore a good month of liquids only, but it isn’t as bad as it’s cracked up to be. Once you are through those first 3 testing days, you will feel euphoric and extremely positive.

In terms of pain relief, I am nearly off it! I take maybe one or two ibuprofen a day, partly because it helps to reduce inflammation, and sometimes paracetamol if I get a bad headache. This is so much different to a week ago, when I had a pretty hefty prescription of codeine. I used to be taking some sort of pain relief every 3-4 hours, alternating between codeine, ibuprofen and paracetamol. Therefore  you really need to keep a pain relief diary at the start so that you don’t take too much and you keep them spaced out so that you have a certain amount of pain relief left over that you can take if suddenly the pain comes back.

As I reflect on this surgery, it truly is amazing. It isn’t for everyone – you need to think long and hard and assess if the surgery will make a notable change to your day-to-day life. I am so thrilled that I can keep my mouth closed comfortably without pain; this is the first time I’ve been able to do that since I was a child. I am excited to see how normal eating will be as this was quite difficult when I had my overbite.

If your jaw deformity is affecting you on a daily basis psychologically or physically in one or several ways, I think that would suggest you would benefit from jaw surgery. If your overbite/underbite/open bite/cross bite does not affect your daily routines and you are content with your jaw, and there is no medical knowledge that suggests you will develop any complications later in life if you DON’T have it, then I wouldn’t suggest it. I used to be irritated with friends who would often exclaim, “But I can’t see anything wrong with your jaw?!” An overbite can be very subtle and sometimes you only see things if you’re looking for them. I didn’t have a clue that my jaws were ‘weird’ until my orthodontist told me at 15, and then I realised it was the reason behind the daily discomfort I was putting up with. For others, a jaw deformity can have a severe effect on mental health and some people have suffered relentless bullying for it; I am so lucky to say I am not one of them.

I cannot stress how horrible those first 3 days were, physically and emotionally. Because of that, I wouldn’t want anyone to rush into the surgery. It honestly is life changing, but I wouldn’t want anyone to go through this process unless they really deemed it necessary because it’s hardcore. Some people may smirk at that and think it isn’t that bad, but honestly I really don’t think I could go through it a second time.  Pain may be temporary, but the brief time I was in hospital I did not enjoy one bit. Truly, having this operation is my proudest achievement because it tested me so much, and only now do I appreciate how major an operation it is. I remember crying my eyes out in my hospital bed as I was throwing up blood, saying to my mum, “Why have I done this to myself?” My orthodontist constantly describes me as being a car crash survivor, and that I’ve been hit in the face by a bus. That may sound terribly morbid, but that’s the gravity of the operation.

Above: bruising from the needles

Above: day 6

Above: day 7 

Above: day 8

Above: day 9 
Above: the new elastics allow much more movement. Please excuse my very dry skin and lips!


1 comment

  1. It is amazing how the human body is geared to always healing itself. All the time! Those progress pictures show an amazing difference each and every day. The human body never ceases to fascinate me with it's amazing abilities. Glad to know you're happy with the results!

    Cynthia Bowers @ Bay Area TMJ & Sleep Center


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