Monday, April 2, 2012

Returning to "Normal" After Jaw Surgery

     An odd way to start the week, but I have been thinking about this recently and felt it was worth writing on. Tomorrow (Tuesday) marks 16 weeks since I had jaw surgery. On December 13th, 2011 I underwent a 3-piece Le Fort I procedure and genioplasty to adjust and correct and open-bite. Prior to surgery I received orthodontics treatment for 14 months to prepare my "bite" for surgery, essentially making the open-bite worse. I am still wearing braces, but I am almost finished with that treatment as my orthodontist closes any remaining gaps and ensures my teeth become rigid, for lack of a better term, in their new positions.

Obsessing Over Jaw Surgery and Recovery
    We all do it. It's scary. It's important. We're afraid of the worst possible scenarios... prior to surgery and often during recovery, many patients obsess over what's going on with their bodies (or mouths, to be more precise) and they Google, Google, GOOGLE!. I did too. But when I realized most blogs out there are not really helpful, I put more effort into scientific and scholarly research, nutrition, anatomy and physiology, patient psychology, and related research... all of which is being compiled into a major resource website for jaw surgery patients which I've dubbed The Jaw Recovery Playbook.
    During recovery, it's tough. It's really difficult to ignore what's going on, especially when you can't eat properly and you feel limited at every turn. By "properly" I, of course, mean that you can't just pick up a cup, fork or spoon. Most patients are relegated to syringes for at least a couple of weeks. I used syringes for weeks 1-6 but after the major elastics were removed and I could open my teeth a bit I started using a mix of syringes and disposable cake decorating bags which allowed me to have a bit more freedom with food choices.

    Even after my bite splint came out in week 6 I found I just couldn't move past the whole surgery and recovery process. I was still "obsessing" a bit. I made a list of my remaining questions and my surgeon was kind enough to give me a special "bonus" appointment. He answered ALL of my questions and he really took a lot of time to make sure that I felt comfortable and satisfied with my treatment experience. Things like that mean a lot to me...

    After that appointment, I felt excellent. I wasn't obsessing over it anymore because I had the answers I wanted/needed. I didn't have to "wonder" because I "knew"...

Anemia - The Guest That Wouldn't Leave
    The anemia I've been dealing with is related to the blood lost during my surgery. The symptoms were not noticeable at first. During the first 4 weeks or so after surgery, I might feel a little winded or dizzy but I thought that was from having the bite splint in and breathing through my nose most of the time, or from the change in diet. I'd sit down and relax and feel okay.

     In week 5 I attempted 3 workouts. Well, I planned to do 3 but only completed 2. They were only 35 minutes long and they were non-cardio, weight-training workouts. I used light weights, nothing over 12 lbs. Yet, I seriously thought I might die! Okay, maybe not "die" but I felt like I would pass out if I didn't stop after every exercise. Red flags went up because I knew I wasn't in such poor shape to suffer so much from an easy workout, but I ignored the red flags. In week 6 I saw another doctor for my regular exam and she ran bloodwork which showed the anemia.

    When the symptoms didn't improve after a month on iron supplements I went back and was told that it takes 100 to 120 days to replenish the lost hemoglobin. I didn't know that haha...

   Now, at 16 weeks, I am feeling significantly better. Not winded with minimal exertion anymore. A little dizzy still, on occasion, but not like it was. I feel comfortable saying the anemia is likely not a problem right now but I will continue taking the iron supplements because I have a feeling my labwork has always shown lower (though "normal") hemoglobin levels and this might be necessary... for a while at least.

But When Do I Get Back to Normal After Jaw Surgery?
     This depends on the individual, of course. For me, at 16 weeks (4 months) I'm still not 100%. A couple of other things (health-related) have occurred during this time which has sort of slowed my return to normal. When I went back the second time for the anemia my doctor and I discussed my acid-reflux (GERD) which I'd been taking a PPI (proton pump inhibitor) for since 2006 -- over 6 years! They're not meant to be taken that long, but I was told that I would need it for life (?)

    As it turns out, in 80-90% of people diagnosed with acid-reflux, usually before they're in their 30s, the underlying cause isn't actually GERD but an infection with a particularly stubborn bacteria known as Helicobacter Pylori, or H. Pylori for short. My doctor ran two tests for this. There are three types of diagnostic tests they can run, but he ran two blood tests on me; (1) for acute infection and (2) an IgG serum test. The acute test came back negative, but the next day he called me saying the IgG test was positive. After 10 days on 2 types of antibiotics (it's stubborn haha) I should be "cured"... I'll continue my Nexium for 2 weeks then start to wean off it.
   The other thing is an ovarian cyst. Most women get ovarian cysts that come and go, without ever noticing them. This one was apparently noticeable (BIG) and I've been told "no running, no jumping, no twisting" until it's gone, to hopefully prevent it from twisting around the ovary causing what I imagine will be excruciating pain. That sucks though! I mean, I can deal with it.... but I was hoping to start working out again. It's been 4 months :-(  When I can't workout it affects my sleep, my appetite, my overall energy levels....

    So I'm not back to "normal" yet... and it seems I won't be for at least a few more months. So what do I do in the meantime?

Tai Cheng: Tai Chi - Beachbody Style!
    I was hoping to start working out again this week or next but with that cyst and the stipulations placed on me by my doctor, it wasn't going to happen. I saw that Beachbody released the new 90-day Tai Cheng program. When I was younger I did Tai Chi, among other forms of martial arts, and I LOVED it! I looked at the program details... I'm a Health & Fitness Coach with Beachbody so I have access to a lot of material on the different products, and I get a 25% discount :-)

    I made the decision to order it. It's pricey, even with my discount, because I bought the deluxe package, but it's worth it to me. To have SOMETHING I can do in the meantime... a structured program that I'll enjoy... yeah, it was worth it. I should get it this week.

     It's a 90-day program, as I mentioned, complete with all the extra stuff you would need for the workouts like the foam rollers (the deluxe package comes with two styles of foam roller), resistance bands (if you use them), the complete workout program schedule, over 30 different workouts, a complete eating guide to help maximize the program, and there's also a bonus disc for improving posture, flexibility and joints called Body Alignment.

Lastly... Adjusting to Your New Face After Jaw Surgery
     I forgot that I wanted to talk about this too. At 16 weeks I am STILL adjusting to the subtle changes in my face from Jaw Surgery. These subtle changes are barely noticeable to people who either don't know me well or who rarely see me, but to my family, close friends, husband... and especially to myself.... these changes are pretty obvious.

     It's important to remember that there's a difference between ADJUSTING and unhappiness. I'm not unhappy with my face or profile, I am simply still adjusting to it.

    That being said... I took this picture today...
    To reduce distortion I set the camera timer instead of holding it and I tried to get a natural picture instead of one where I was deliberately posing for a picture. When I see this... I'm fairly comfortable with what I see. I think that I will notice the changes less and less over time, but at 16 weeks I am probably about 65 to 70% comfortable with the way my face looks... in the sense that, when I pass a mirror, wash my face or apply makeup I'm not looking at or touching my face and thinking it looks or feels weird. Progress.... I suppose.

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