Tuesday, August 27, 2013

Day 27: One Month Check-up

Today's pic:


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Today was my one month (or 4-week) check-up.  Dr. Turvey said my incisions look great and he doesn't see any issues.  I was hoping to get my splint out today, but no cigar.  I admit that I was being a bit too eager.  I am having it taken out at my next appointment which is scheduled for two weeks from today - Tuesday, September 10th.  At that time, he will release me back to my orthodontist.  Once the splint is taken out I should be able to start chewing soft foods.  I think I am going to start with a big plate of pasta!
 
I took a list of questions with me to the appointment.  See below (with answers).
 
1)  When can I stop sleeping on my back in an elevated position?
A:  I no longer have to sleep on just my back, but I do have to continue sleeping in an elevated position.
 
2)  When can I stop wearing SPF 45?
A:  I need to continue to wear the SPF 45 for now.
 
3)  How long do I need to continue to take the iron supplements?
A:  I no longer need to take the iron supplements.
 
4)  When can I blow my nose?
A:  I can start blowing my nose.
 
5)  When can I start to jog?  When can I resume my normal exercise routine (i.e. sports, vigorous gym classes, etc.)?
A:  I can start jogging in 2 more weeks.  More strenuous activities will have to wait.
 
6)  When massaging my cheeks and around my incisions, how often per day should I massage and what kind of pressure?
A:  I should massage 3 to 4 times per day.  I should start with a warm damp rag wrapped around my head/face to loosen the muscles and scar tissue, then massage and do face exercises.  The massage pressure should be comfortable but firm.  I can take ibuprofen if this leads to pain and soreness.
 
7)  The joint where the condyle was removed aches occasionally, is this ok?  I have tried to work on stretching my mouth opening but the joint is sore and I feel I am not getting anywhere.
A:  The pain is normal.  This is my physical therapy, so I have to do it or I won't get the results that I want.  Same as the answer above, I should start with a warm damp rag wrapped around my head/face to loosen the muscles and scar tissue, then massage and do face exercises.  I can take ibuprofen if this leads to pain and soreness.
 
8)  Now that the swelling has drastically decreased, I have noticed that my chin is off-center.  Is this going to be the final result or do you still expect it to be centered once fully recovered?  If the off-center chin is final, what can we do about it?
A:  Dr. Turvey acknowledged that that my chin does look off-center; however, he doesn't think this is anything to worry about at this time.  He said that it will take 9 months for my face to mature and settle into it's final place.  At that point we can talk about the chin again.
 
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Last puzzle, I promise!
 

 

Monday, August 26, 2013

Day 25: On My Own

Today's pic:


I took my daily walk at the zoo today.

You are never too old to ride a rhino!

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I left my Dad's house on Friday and moved back to my apartment.  I've been fending for myself the last two days.  It hasn't been that bad, since I watched both my parents make many smoothies over the last 3.5 weeks.  (Shout out to my parents for taking such great care of me!!!)

My first smoothie all by myself (it's a pb&j):

I've been getting out a lot lately without any troubles.  I went to a Mudcats baseball game Saturday evening and walked around the zoo today (Sunday).  Pain and discomfort have been minimal.

Fireworks after the baseball game:

Gorgeous day for the zoo:


This past Wednesday was my first day back at work.  However, I am only working 6-hour days for the first 1.5 weeks (starting from this past Wednesday through this coming Friday).  I space the 6 hours out with 2 one-hour breaks, so that I can build my stamina.  The first day back went well; however, it was exhausting and I had to take two naps throughout the day.  Thursday and Friday were a bit easier and only required one nap.  Tomorrow (Monday) begins my first full week back at work.  Hopefully, I will be even stronger this week!

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3-D puzzle! WHAT?!?






Monday, August 19, 2013

Day 19: Bringing the Sunshine In

Today's pic:


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Good news!  I official do not have nose bleeds anymore!

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I go back to work on Wednesday of this week (August 21st).  That will make 3 weeks that I was off of work recovering from my surgery.  Recovery is not over with yet though.  It could take up to 6 months or a year for the rest of my swelling to go away, for my feeling and movement to return, and for my face to settle into it's final position.

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I have about a 3/8 inch mouth opening.  I need to work on increasing this.  My right jaw joint feels fine, like it could easily open more; however, my left jaw joint, where the condyle was removed, feels stiff and sore.


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Numbness update!

The areas of numbness have decreased in most areas except for the chin.  I find it odd but the left half of my upper lip is not numb anymore while the rest still is.  I've found that the right side of my face seems to lag behind the left side of my face, not just in numbness but in movement as well.


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Since I couldn't go out in the bright sunshine this past weekend (I have to keep my incisions out of the sun), I decided to bring the brightness inside to me! :)


(Nails with Alli)


(Toes with Mom)

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Of the baby items that my mom bought for me, I really only used the sippy cups.  We tried to use the food grinder but it seemed to be of poor quality, so didn't work too well.  However, with a good quality one, a food grinder would make a nice transition when moving away from mushy puréed food.  I was able to use regular spoons, so mom will be returning all the ones that I did not use.


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I found this gem last night on the internet...


Decided to give it a try for lunch today...


Delicious!!!

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And blueberry pancakes for breakfast this past weekend:


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Friday, August 16, 2013

Day 16: Progress Update

Today's pic:


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Profile pictures are looking pretty good!  No more bruising and the swelling has drastically decreased.  Still a little bit to go though.



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Incisions are healing up nicely!

Notice how clean my hair is looking now! The greasy ointment may have won the earlier battles, but I won this war.


The jaw bone/neck incision is starting to get so itchy!


The ear incision has given me the least amount of trouble.  Probably because it is still numb while the other two were never numb.  And check out the hair that is growing back where it was shaved for surgery.  I have a feeling I will have a sweet sideburn in a few weeks.


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Today is my last day on prescription pain meds.  It will be over the counter drugs from here on out as needed.  The only med that I will still be taking on a regular basis is the iron.

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I am soooo over mushy puréed food.  I have officially moved on to 'real' food that has been chopped very small.  Today for dinner I had chicken, cauliflower with cheese sauce, and cous cous.  So much more satisfying!


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I think I am also ready to give up the princess sippy cup and move on to big girl cups!


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I already figured out the riddle, but I won't ruin it for everyone else!



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Now this is just evil.  Thanks, Carillon!


This was about all the patience I had for today.

Wednesday, August 14, 2013

Day 14: Two Weeks Down

Today's pic:


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Today marks 2 weeks since surgery!!!

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I had an emergency appointment at UNC on Monday.  I cracked my splint over the weekend during my sleep (I think I was dreaming of eating bread and crackers) and the oral & maxillofacial resident on-call told me to come in at 9am Monday morning.  Dr. Turvey checked my splint and since the crack didn't go all the way through the splint, he said I didn't need to have it replaced.  He also gave me a full check-up and then told me that I could push back my appointment for next Tuesday by a week.   My next appointment is now scheduled for August 27th.

Dr. Turvey also told me to start massaging the area around my incisions and my cheeks to soften the scar tissue in these areas.  I am a little uneasy with touching the area around my incisions because they are still tender (plus it just weirds me out).  But I gotta do what I gotta do!

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On Monday, I also moved over to my Dad's house where I will be staying for another 1.5 weeks.  Meet Carillon & John:


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Meds Update:
I have finished all my meds except for the ibuprofen and iron supplements.  No more hydrocodon for me!  Let's hope the pain is managed with just the ibuprofen now.

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The punch lines from Day 11, plus a new joke!





Tuesday, August 13, 2013

Day 12: A Caregiver's Perspective

Today's guest blogger:


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ALERT!  Guest Blogger!   (Consider yourself warned as this is my first blog entry ever.)

8/12/13

Let me introduce myself... My name is Karen Biegler and I'm Jenny's mother.  Jenny asked me to write a few words about my experience since I've been with her 24 hours a day for the last 12 days.

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The Hospital Stay (Wednesday, July 31st through Thursday, August 1st):  

The day of surgery was extremely stressful.  Surgery was scheduled for 5 hours.  At the four hour mark the surgeon sent a message from the OR that it would take a couple more hours.  The surgery was 7 1/2 hours when it was all over.  Jenny didn't want to wake up in Recovery.  They would not administer pain meds until she was fully awake, otherwise they risked shallow breathing per the nurse.  They called me back to Recovery thinking my voice would help bring her around.  It was gut wrenching.  She wouldn't open her eyes but tears were leaking out the side.  Eventually, she would respond with her fingers.  I would ask "can you hear me? move your pointer finger if you can hear me."   "with 10 being the worst pain you've ever had, show me with your fingers how bad your pain is now."   She got to her room about 9:30 Wednesday evening.  She was in the Neurosciences Hospital on the 6th floor with the epileptic and dementia patients.  The nurses were good at administering her meds but they didn't seem comfortable with a surgery patient.  There was a lot of blood pooled in her sinuses and when she moved the blood would pour out of her nose.  Blood was also coming out of her left ear.  At 11:00pm a resident arrived and he got the nurse and aid to change Jenny's gown.  He cleaned up the blood on her face, neck, ears, etc.  He showed me how to clean her jaw bra (I didn't make that name up). It's like an ace bandage that goes under the jaw and up over her head.  You can see the jaw bra in several of her pictures.   I'm not sure what it's made of but the blood came out of the jaw bra with ease.  He did a neuro and physical exam.  She was still groggy but she knew what day it was and where she was and her eyes followed his finger right and left and up and down.   Jenny was in a semi-private room.  Her roommate had been in the hospital since June.  At 4:00am the roommate kicked the IV out of her foot (her hand and arm veins could no longer be used for an IV) and drama ensued.  All this woke Jenny and she asked for her phone and started texting.  I took this as a good sign.  The resident returned at 5:30am and repeated the neuro and physical exam.  At 7:00am the surgical team came by.  At 8:00am Jenny was transported through the bowels of the hospital to the Dental School in the building next door.  They did her 'after' x-rays and she was seen by a different resident.  She had to remove the rubber bands from her braces, brush her teeth and put the rubber bands back on.  While brushing her teeth she became light headed and had to finish sitting in the wheel chair.  She was exhausted when she got back to her hospital bed and slept for 4 hours.  When she woke she was much better than she had been that morning.  She had to do four things to be discharged:  eat, drink, pee, and walk.  About 5:00pm we walked several times around the 6th floor.  About 6:00pm Dr. Turvey, surgeon, came by and it was decided she could be discharged.  At 7:00pm the remainder of the surgical team came by.  The discharge orders didn't come through until 9:00pm.  They wheeled her out of UNC Hospitals at 9:30pm with 5 Rx's.  The first 24 hour pharmacy was only able to fill 4 of the Rx's.  The second 24 hour pharmacy told me the manufacturer was having problems supplying the last Rx.  A call was made to the oral & maxillofacial resident on-call and he changed the Rx.  We got home at 11:30pm.  She took her meds at midnight and off to bed.  

Just a couple more notes about the hospital stay.  For lunch and dinner on Thursday I had to call a phone number and place an order for her food.  In the room was a 10-12 page menu from which to pick from.  When you call they ask the patient's name and room number.  They guarantee they will deliver the food to your room within an hour.  She was on a soft food diet and wasn't allowed to pick from the menu.   But I could.  I just had to give them my debit card number and they would deliver to the room whatever I picked from the menu.  And the prices were very reasonable.  The food was good.  The other thing I want to comment on is the technology in the patient room.  The nurse would walk into the room with Jenny's meds in her hand.  She had a wand for scanning in her other hand.  She would scan her badge, then she would scan a box on the wall that gave her the room number and which bed in the room, then she would scan the medicine bottle and then she would scan Jenny's arm band.   Then she would check the monitor that was in the room and when she was satisfied with everything on the screen she would dispense the medicine.  Now if only they could figure out how to fix those @!#% IV poles that kept going off all night long up and down the hall.  

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Once home she fell into a routine that included a lot of sleeping.  I was responsible for making sure she was awake to eat and take her meds at the appointed times.  She has three external incisions.  One in her hair where they harvested the bone.  One by her left ear.  And the last one is on the right side about an inch below the jaw bone.  After eating, taking her meds  and brushing her teeth it was my job to clean the incisions with a hydrogen peroxide and water mixture.  Then I applied the antibiotic ointment.  I would help her put on her jaw bra.  The bra helped to hold her face which was swelling bigger every day in the beginning and felt very heavy.  

She was able to shower after her one week post surgery appointment.  Then we started working to get all the ointment out of her hair.  Thankfully, she had gotten a hair cut a few days before surgery and had cut about half her hair off.  First I rubbed in a lot of shampoo.  It didn't do a very good job of removing the ointment.  Jenny came up with the idea of using Dawn dish washing soap.  So the next day I rubbed stands of her hair with a lot of Dawn.  It helped, but didn't get it all out.  If you look closely today you can still see a bit of ointment. 

Today she's not sleeping as much but she tires easily.  This morning we went to UNC for an appointment and when we got home she ate, took her meds and went to bed.   

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Hydration is a constant concern.  When her rubber bands are on a straw is about the only thing that can get between her teeth.  But she is not supposed to suck a straw.  I bought two sippy cups.  They are the kind that if knocked over they don't leak.  Each cup has two holes:  one that the child sucks and the other allows air to enter the cup.  I cut out the thin silicon that covers the first hole and inserted a 2 inch straw which fits snugly in the hole.  Jenny places the straw between her teeth, tips the cup up and water pours into her mouth.  You can see one of the sippy cups in the picture of her by the car ready to go to her doctor's appointment.

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Jenny and I went out last week for pedicures.  The saloon that we went to has an IPad at each chair.  So we played Solitaire while the chair massaged our backs and our feet were pampered.   

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Four times a day, every six hours, she takes prescription medicines.  A couple of the Rx's cause an upset stomach if not taken with food.  Nausea is a particular concern for jaw surgery patients as the rubber bands would make it very difficult to throw up if necessary.  To ensure that her medicines do not cause nausea she eats four times a day, just prior to taking her medicines.  She is not allowed to chew, therefore everything must be 'chewed' for her.  Prior to her surgery I invested in a VitaMix.




For the past 10 days this machine has easily ground through everything I've put in it.  Cooked or raw.  Hot or frozen.  On several occasions Jenny has had visitors when it was time to eat and the VitaMix easily made 3 or 4 smoothies at one time.  I had no trouble making a batch of gazpacho in the 64 oz. container.  I know this is sounding like a VitaMix commercial.  Given everything else we have to do or keep up with, I'm just thankful that blending Jenny's food isn't a frustration, rather it is sort of fun.


The first week her jaw would feel heavy and tired after just a few minutes of eating.  She had to force herself to eat.   With each day her jaw is a little stronger.  Even now, she rarely finishes all the food I blend for her.  Her doctor is watching her weight closely.  She was weighed this morning and she lost 3 pounds in the last 6 days.  That's on top of the weight she lost the first six days after surgery.   I work to make all her food nutrient dense and calorie dense.  I add almond milk instead of water/ice to smoothies to give the smoothie some additional vitamins and minerals.   Oatmeal is a great base on which to build.  One day I added peanut butter and bananas to her oatmeal.  The next day I added coconut, walnuts and chocolate to her oatmeal.


In prior posts Jenny has shared pictures of some of her meals.  She's had a lot of variety in her diet.  For at least two meals a day she eats what everyone else in the household is eating.   She's never been a picky eater which has made meal planning pretty simple.  And while we didn't try blending pizza, we did satisfy that craving by blending Baked Ziti (made with sweet Italian sausage instead of ground beef).



http://allrecipes.com/Recipe/Baked-Ziti-I


The first meal of the day, 6:00 am, is a smoothie or oatmeal or yogurt.  And the last meal of the day, midnight, is always a smoothie.  Last night we tried a new smoothie recipe.  It was a bit different than any of the other's we've tried.  Jenny's older brother, Jarrod, was here to try this one with us.  All agreed that this one is a keeper.  But it will never replace the cherry/chocolate or the blueberry cheesecake as favorites.



If you have never tried ginger before, cut the amount of ginger in half.  If you love ginger, add the entire tablespoon.  From Pinterest.

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I am very thankful for Jenny's surgeons.  I'm also very thankful the day of surgery is behind us.  The next several months are dedicated to recovery and after that this will become a distant memory.  



Sunday, August 11, 2013

Day 11: Face Exercises

Today's pic:


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Below are a few pics of my face exercises.

Pucker:

Open wide:

Big smile:

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Dark chocolate caramel creme donut!



Yuuuummm!

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Erin came by with some more puzzles!! 



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My manager, Joe, and his wife came by yesterday with a get well gift from my team at work.  :)