Day 8

     Got my elastics off today! Well....not completely. The tight ones that were holding my bite shut are off now. My orthodontist gave me some new ones that are looser and allow me to still open my mouth a bit; kind of like your standard elastics for braces. Being able to open my mouth a bit, I now can take another step with eating. Today I had some Beefaroni and Kraft Dinner. I had to blend both a bit with the blender. Not pureed by any means; just substituting for the ability to chew. All I had to do was use a spoon to get it past my teeth and then just swallow it whole. Boy was it good! I have now started doing very light brushing of my front teeth that I can reach. My lips are still particularly swollen and chapped  and it hurts to try and move them to get to my back teeth.  Another good thing is that I'm not constantly drooling and having to constantly walk around with a paper towel. I only drooled like 3 times today! My weight has also gone up a few pounds to 122! Recovery is going to be all downhill from here!

Days 5-7

   Things are looking up! I turned a corner on day 5. I have been sleeping better these nights, only getting up a couple times for a stretch. My swelling has been going down gradually and I have dramatically been eating better. In particular today (Day 7) I have had 1300 calories today of liquids. I've started to make milkshakes and eat soups. Ensure (a store-bought drink) is the best form of calories I have right now; 400 calories in one small bottle. On Day 6, yellow bruising appeared on the front of my neck and bottom of my lower jaw. This is normal and is the end of the bruising stage. I have even stopped taking my pain killers because I really don't have any pain, just discomfort from swelling. Although I still have to take my antibiotics 4 times a day to prevent infection. My surgeon says infection is a serious problem but he only sees 1 or 2 a year. Remember that I had said he does 6-7 surgeries a week! So less than 1% chance.
     Days have been much easier now. Although I am still looking forward to getting healthier, I'm not just praying for the next day to come anymore. I am currently enjoying the Prison Break series on netflix and very addicted to it, as I am already through Season 1 as of day 7 (started on day 5). The lowest number I've seen on the scale so far is 118lbs, yikes!
    Great news! I'm going to the orthodontist tomorrow to have my elastics taken off so that I can finally talk again. This will be a huge step for me and I'm looking forward to it!

                                                                 At the eating station

                                                                    Where I sit all day

                                        Side view - see some yellow bruising on my neck

                                                                            Day 7

Here is just a really funny picture of me. My mom and I found out that I look hilarious when I am laughing because I am so numb and swollen. We always burst out laughing when we see this picture now:

                                                                           Selfie

May 24th & 25th - Days 3 &4

      These were the worst days for me. They say your swelling will peek 48-72 hours after surgery. This made my throat even more tight, making it nearly impossible to get any food in you. I felt as if someone was strangling me when ever I went to swallow any liquids. I basically starved for 2 straight days; wake up and go to bed hungry. My parents were worried and kept urging me to eat something. I was quite grouchy during this time.
      In other news, on day 4 I took off that compression bandage on my chin. This made it only slightly easier to eat. Still not really in any pain, just a lot of discomfort as I was craving food. I was so hungry that I was even jealous of the food my cats were eating. Throughout my early days of recovery I was using a notepad to communicate with my parents. Looking back, here are some of the things that I wrote down during this awful couple of days:

      "Just keeping up with medicine drains me of energy to eat food"

      "Makes me wish I didn't have surgery"

      "I keep getting the urge to yawn and I'm fighting it"

      "Eating is like torture"

       "Throat area so stiff"

 
    Having to fight back yawns was (and still is) horrible. When I feel one coming on I'll start grunting and clenching my fists to fight it off. It's safe to say that these were the worst two days of my life. By the end of these two days I only weighed 123lbs.

                                              Looking very exhausted and hungry on day 3

                                                   day 3  - compression bandage = day 4

                                                                    Taking my meds

May 23rd - Day 2

      After spending that long night in the hospital, I was up pretty early at around 6-7am. I relaxed a bit and watched the hockey highlights from the last night. At 8am Dr.Tocchio came to see how I was doing and answered any questions that I had before I left. We hit the road at 10am for a long car trip home. I remember walking out of the hospital to the car; everyone was staring at me as if I was in a horrible accident.
       The car ride was comfortable enough; I had lots of pillows to rest my head. I didn't really feel much different than yesterday in terms of symptoms. I discovered today that I really liked flat ginger ale from the syringe instead of apple juice. Towards the end of the day, I could feel twitching on my face. This is normal as it is just a sign of nerves regenerating. For that reason I really like when this happens.

                                                                      Ready to go home

                                                                 Back in my own bed :)

May 22nd - Surgery Day (Day 1)

Alrighty, here is my experience on the day of my surgery:

         I woke up at 5:30am, completely ready for this surgery to happen. I had to be at the hospital for 6:15am to check in. When I arrived I had to go through a few customs (like at the airport) such as signing some forms, taking pre-surgery medication, and getting all dressed up for surgery. At 7:20am-ish I left my parents and was brought closer to where I would be getting surgery. I sat on a bed for about 15 minutes while members of the surgical team came back and forth to talk to me and give me some instruction. I then followed a doctor and walked myself into the surgery room and laid down on the surgical table. As I laid there, I talked a bit with the surgery team as they were putting needles into me to get me all drugged up. Here's a picture of me before I left my parents for surgery wearing this nice gown they gave me:

        I had heard a few stories as to what it’s like being put to sleep before surgery, but I didn’t have quite the same experience! I heard it was easy and that everything would go smoothly as the doctors tell you to count down from 10. I was told that I would not reach 7 as I would already be asleep. This is how my experience went: One doctor told me that he was going to proceed and inject the anesthetic into me and I would fall asleep shortly. So I laid there with a grin on my face because I was thrilled to be having the whole "being put to sleep" experience for the first time. I could feel right when he started putting the anesthetic into me because I felt this viscous, chemical substance being pumped into my veins and spreading up my arm and to the rest of my body. It was extremely unpleasant! I felt like I was dying; like my body was shutting down. I was panicking on the inside because I was starting to find it very difficult to keep breathing. However, this only lasted for about 5-7 seconds. I felt like I woke up instantly and was in the recovery room at 11:00am.  

        Perhaps the most awful hour of my life was from 11am-12 noon after I woke up from surgery. I was incredibly loopy and nauseated as I threw up all the blood that went down into my stomach during surgery. I threw up in a container and filled it up to the 250ml mark by the end of that hour. This period of time was very blurry for me as I could not keep my eyes open for most of it. 

          I remember seeing my parents for the first time around 1:30pm once I had been moved up to my overnight private room. Word of advice: It is worth the extra $50 to get a private room instead of a semi-private or non-private room because of how bad you will feel. I was very drowsy and remember my aunt coming in to see me at one point but I just have blurred memories of her being there. For the rest of that day I stayed in my hospital room with my parents to keep me company; though I kept drifting off. I would say that around 6-7pm I stopped dozing off and was fairly alert. Here are some pictures from this time:

                                           Me when I was very sleepy from 1-6pm

                                                 This is me quite alert that night

         In these pictures I've got a two-part contraption going on here: I have an icepack wrapped around my head, along with a humidifier that is keeping me from getting too congested (blue tube, very helpful!!!)

  Without my headgear the swelling shows a bit more, especially on the right side of my face

         I felt very swollen, but this is nothing compared to patients that had longer jaw surgeries. Remember, the longer you're in surgery the more swollen you will be. I was only in for 1 hour. The nurse helping me out, who has seen many other jaw surgery patients, said she thought that I looked fantastic! I still felt quite awful though.

     My pain level, at the time I was vomiting a lot, was a 3-4/10 but after that I was never higher than a 2. I would say discomfort is a better word for what I was feeling. My whole face below my eyes was numb (especially my nose and upper lip). Before exiting surgery the surgeon wired my teeth shut using strong elastics so I cannot move my jaws at all. This is me trying to get a bit of calories in me using a syringe:

     Due to the swelling in my lower face, it was very hard to swallow any liquids. I was taking some medications through the syringe as well. This would lead to the hardest part of my recovery: getting food into me. My calorie total for day 1 was probably 30 calories. I only had a small amount of apple juice, water, and my medications. Throughout this first day, I had a continuous nose bleed that would drip every 20 minutes or so.  

     Aside from me, there were two other lucky guys (around my age), both getting double jaw surgery on the same day. Those poor guys spent the night on their own while my mom stayed with me; my dad went back to the hotel to get a good sleep for the ride home the next day. 

      That night was a long one because I had slept so much that day that I was wide awake when night came. Every couple hours I would stretch my legs/back and go for a walk around the hospital floor with my mom. My back was terribly sore from laying down inclined on the bed all day.

                               This me out for a walk around the hospital. Peace!

I weighed myself after a whole day of no food and was 132lbs, which is very light, but my beanpole frame was only 130-135lbs going into surgery. It is a good idea to try and gain weight before surgery but if you don't it's not too detrimental as far as I know.  

Anyway, this was my first day so I'll continue with some posts about the days to follow!

Hey there! Sorry about taking so long to write back about my recovery. It has been a rough start but I am now feeling much more energized and ready to type up a storm today. I'll start by making some posts about each day in chronological order:

May 21st - 12 hours until my surgery

           Just a quick update here before surgery tomorrow. I made the trip to Toronto on Tuesday (May 20) and had my pre-op consultation with the surgeon at 3pm. It was very similar to the first time that I met with him a year ago, although he took X-rays, impressions and went into a bit more detail about the surgery. He was great at explaining the whole procedure and made me feel better about what is ahead. His name is Dr.Tocchio and he has been doing maxillofacial surgery for over 30 years. To get an appreciation for how experienced he is at this just multiply the 6-7 surgeries that he does a week over a span of 30 years. This guy is the best around at what he does. I was assured again that my surgery is very easy for him to do as it only involves my upper jaw. Doing work on the lower jaw is much more complicated because of all the nerves and vasculature. He actually said that I shouldn't have much pain for this reason.
       Today I went to North York hospital to get more info about my stay there as well as filling out some paper work regarding my medical history. They said that these appointments would take 2-4 hours but I was out in 30-45 minutes.
       Aside from all of this I've been doing some shopping with my parents and eating dinner at two of my favourite places to eat; The Mongolian Grill and Memories of Japan. I ate dinner an hour ago and that will be the last solid food I will be eating for some time now. I am very much looking forward to tomorrow!

Thought I'd share some tips/tricks that I've come across and use to help relieve day-to-day jaw pain:

1) Pineapple contains a fiber called bromelain and it is a natural anti-inflammatory. I eat a slice or two of canned pineapple every morning to ease my jaw. It is surprisingly effective!

2) Oil Pulling - look it up. You swish some kind of oil (coconut, sesame seed, etc) in your mouth every morning for 15-20 min to see anti-inflammatory effects on your jaw.

3) Stretch your neck muscles, this helps relieve stress on your jaws

4) Watch this lady's video on youtube for some quick and easy pressure points that will help your jaw! (https://www.youtube.com/watch?v=VTKqvaY84G4)

5) Some fish oil pills in the morning help relieve symptoms, OMEGA 3 is an anti-inflammatory.

6) Keep hydrated with water to keep your joints nice and loose.

 Hope this helps!

May 2nd, 2014 - 20 Days until my surgery (First Post)

         Hi guys, welcome to my blog. I will be tracking my progress throughout my procedure that is scheduled for May 22, 2014 (3 weeks from now). Leading up to this point I have found it very helpful to read through all the different jaw surgery blogs that are available on the internet. It really put me at ease to learn a bit about the process so that I wasn't completely blindfolded going into my own surgery. I just want to pay it forward and share my experience with anyone out there that may require jaw surgery in the future. I have read many of the other blogs and taken notes on them, so I hope to share all of the best tips for a great recovery.

Background information:

     My name is Shane and I am 20 years old. Ever since I was very young my dentist told me that I seemed to grind or clench my teeth a lot during the night; he could tell by the wear and tear on my teeth. By the time I reached 10 years old I started complaining to mom that my jaws were a little bit sore when I ate. Of course, this just started out as very, very mild symptoms. These symptoms progressively got a little bit worse as each year passed, but they were only related to eating.
     In my grade 9 year, out of the blue, I started to have arthritic symptoms in both of my hands. All of the joints in my hand (but not the wrist) would ache with every movement. It bothered me a lot at the time in my gym class. It didn't seem to really affect my performance in most sports but it made it quite uncomfortable. I loved sports and wasn't going to let that stop me! My mom brought me in for blood work that revealed I had a slightly high R factor. This marker can indicate if a patient has rheumatoid arthritis. My level of R factor was just a little bit above the threshold that would indicate an arthritic patient. To get through the year I was taking ibuprofen for the pain. Before I knew it, all those hand symptoms were gone by the summer and I still to this day have never experienced anything like that again. For all I know, this could be unrelated to what is happening with my jaw. Whenever I go and see doctors about my jaw I always mention this incase there is some relationship.
      Back to the jaw. As I said above, my jaw symptoms have pretty much slowly, but steadily worsened with each year. I got braces at the end of grade 9 and they were taken off at the end of grade 11. The reason for them was just that I had both of my top eye teeth pulled down to the level of the rest of my teeth along with some minor straightening. Here are some pictures of me below on the day that I got my braces off:

Here is a nice little momento of my time at my orthodontist's office. It was supposed to be a farewell gift, but I ended up having to come back a couple of years later.

                             
                           

                                                 My bite has not looked this good since.

                                                                 

          My regression into the symptoms/problems that I have today can be tracked by looking at my lower jaw year-by-year. What has gone wrong is that due to my constant grinding/clenching of my teeth during the night growing up, the articular cartilage that cushions the head of my mandible (lower jaw) into my skull has worn away; leaving me with bone on bone contact. Basically, the head of my lower jaw is eroding away. Due to this, my jaw began receding as a function of time.
       

       Based on pictures of my past, I've estimated that my lower jaw structure started to change at some point in grade 11.

         As I said, I have read MANY of the jaw surgery blogs out there on google and it seems that most people are having TMJ (temporomandibular joint) problems because of either an over or under development of their mandible. My case is a bit different as I have a deterioration problem as opposed to a growth problem; though the end result is still an under-developed mandible. Below is a younger picture of me just to show that there were never any visual signs of jaw problems as I was growing up, until-mid high school:

                                                                around 13 years old

         After getting my braces off, my symptoms were still worsening and my jaw was getting shorter and shorter in length. What also started to happen was that I was losing occlusion of my teeth (my teeth of each jaw were not coming together properly, which you will see later in pictures of me today). Because the mandible is an L shaped bone, if deterioration happens at the head, the jaw is going to want to recede back into the socket where the head sits. The result is that as the jaw recedes, it will also rotate the jaw downward so that the front teeth come apart and the back teeth are closer together. This altered position of my jaw causes a lot of tension to be put on the chewing muscles, especially my masseter muscle; trying to massage it is like playing the harp but with enormous strings (knots). I am also known for being THE SLOWEST eater on the planet. Back in grade 11 or so my brother timed me while I ate a 6 inch sub(way) for 18 minutes!

            Ok, so this pretty much brings me to today. Below are all of the main symptoms that I currently have with my jaw today:

-tender/sore jaw muscles
-limitted jaw opening
-jaw fatigue/discomfort all the time
-jaw pain when eating
-less ability to talk
-tight neck muscles
-difficulty swallowing (only within last year)
-clicking or popping jaw joints (only within last year)

        Only a couple of these symptoms came on within the last year. Two other noticeable symptoms that are often mentioned by people are headaches and locked jaws. For whatever reason, I thankfully have not experienced these.

Here are some pictures of me today:

                                                                                                               

Above here are my side profiles at 17 and 20 years old. As you can see, my lower jaw has receded more within these 3 years indicating that there has been more degeneration of my lower jaw.

This is just a picture showing a small patch of white hair that has been growing behind my left ear for the past year and a half. It is a bit more prominent when my hair is longer (I just got it cut) but for the most part it doesn't bother me. This is known as Poliosis and can be a sign of an autoimmune disease (arthritis for me). I've seen other people with this too, but it is usually just a birthmark.

Here I just took this picture to show how my teeth are coming apart at the front. As my jaw recedes, my teeth move farther apart. This is me biting down, so only my molars are touching when I do this. People that have this problem know that it is very difficult to eat thin foods that you can't grab onto with you front teeth; you've got to get it back to your molars to chew. It is also hard to finish your "s" sounds with this gap in your teeth.

        In the summer of 2013 I finally was referred to Dr. Tocchio; an Oral and Maxillofacial Surgeon in the Toronto area. He met with me and said that he has seen many cases like mine before and that he could fix me. Before I met him, I read a lot of great things about him from both the internet as well as my dentist and orthodontist. He is said to be "the best" in his field. My procedure was booked on June 2013 for May 2014. I am in post secondary school and will have a whole 4 months to recover before the beginning of a new school year. It was at this time that I was officially diagnosed with having degenerative joint disease (a form of arthritis).

The Procedure:

          There are a total of 3 procedures being done on me. The first is shown below and it's goal is to align my jaws so that my teeth will come together properly:

https://www.youtube.com/watch?v=LiUMaokTidw 

This entails them cutting off my maxilla (upper jaw bone), changing the angle on it, and then holding it in place to heal with screws. This will bring my teeth together for a proper bite. I haven't been told this by any professional, but a Leforte Osteotomy is the name for this procedure that I've found online.

         I got braces put back on (for the second time) last summer right after my consultation with the surgeon. They wanted to align some teeth a bit so that when they changed the angle here my teeth should fit together perfectly. This will reduce the stress on my jaw and hopefully relieve a lot of my symptoms.

         Secondly, they are going to do what is called a genioplasty. This is where they will move a small piece of my lower jaw forward to help my appearance and make it look as if I never lost any bone mass.
                                          https://www.youtube.com/watch?v=d_ExY370wbA

        The final procedure is totally unrelated to my jaw problems, but I'm actually having all 4 of my wisdom teeth taken out at the same time.
     
I was told that the procedure would only take 1 hour. Believe it or not, it turns out that what I'm having done is an easier procedure to do. I've read blogs about people with cross-bites and other horrible things that need 3-5 hours of surgery and their mouth wired shut for 6 weeks. I will not have my mouth wired shut at all.

What I know about recovering after surgery:

         My surgery is on a Thursday, so on Tuesday I will make the trip to Toronto to have an appointment with the surgeon to get a bit more information about how everything will work. On Wednesday I will have x-rays taken. I need to be at the hospital for 6:30am to have my surgery at around 9-10am on Thursday. I will stay the day and night there and then if everything is going well I'll leave to go home the next day. I will be on a liquid diet for the first 2 weeks, soft foods for the 3rd week and then after 4 weeks I should be able to eat anything that is not extremely hard. Nutrition is CRITICAL for recovering from surgery. The better you feed yourself, the more quickly you will recover.


        Swelling: The longer that your surgery takes the more that you're going to swell. Mine is only 1 hour so I won't be awfully swollen. I've seen some people that had surgery for 3 hours and their head was the size of a melon. However, most of your swelling will go away within the first 7-10 days and it won't be noticeable at all really after 2-3 weeks.

        Pain: I have heard that when you wake up after surgery you may be a bit nauseated but you are too swollen and numb to feel a whole lot of pain. It is during days 3-5 where you are in the most pain as you start getting sensation back on your face. People have said on blogs that the pain is no more than a 4/10 during this time if you are not taking any medication. Overall, people say that after day 10 they start feeling much better and it is much easier to get through it.

        Sensation/Numbness: You will be very numb when you wake up. It really depends case to case how quickly sensation will return. During surgery, the surgeon tries to preserve nerves but small ones have to be cut to do the surgery regardless. Nerve fibres have the ability to regenerate, so if they are cut they may take some time to do so. The rule of thumb seems to be after 1 year, the amount of sensation that you have is the amount that you'll have for the rest of your life. Generally people will get all (or almost all) of their sensations back. There are some cases where a small portion of their bottom lip (for example) will never feel again. It seems horrible, but people say that they get used to it and it doesn't bother them at all.

       That is about it for my first post, that took me a really long time to write up. I will probably be posting again a few days before my surgery or if I forgot something important that I want to share. If anyone has any comments or questions I would be more than happy to answer any questions. Also, if someone who knows better than me catches something that I was not correct about let me know! Bye :)