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It's been a while since I've posted about my recovery. Not a whole lot has changed in the last 2 months however I do have exciting news - I have a date for when my braces will be removed!

First the boring stuff. My bite has been coming along quite nicely the last 2 months. My front teeth line up perfectly now. The elastics that didn't seem like they were doing their job actually did something useful and I also had a couple of small gaps in my lower front teeth which have been closed off now. The last thing remaining is to make my upper and lower molars touch. The trusty elastics are in place so we'll just have to watch and wait.

Knowing all of that, my orthodontist felt comfortable in giving me a de-bracing date. And the much anticipated day is... November 26th!!! I think I'll book a hygiene appointment a few days after that so I'll have a shiny new smile to sport before Christmas rolls around. Christmas will be a little brighter this year!

Upcoming milestones:
Oct 17 - Visit orthodontist
Nov 26 - Braces come off

I really shouldn't be posting right now since I'm going to miss my tee-time but I feel inspired!

I think I'm at 8.5 weeks post-op now, can't remember - it's such a great feeling to lose track of how long ago my surgery was! A lot has happened since my last post.

Firstly my splint came out. That was an interesting saga. I walked into the surgeon's office glad as could be. I walk over to the receptionist and she tells me I need to sign papers for my surgery today.

I say: "Oh no no, you've made a mistake, I already had my surgery. I'm just getting my splint taken out today."

And she responds with: "Yes, but it's a surgical procedure."

I nearly crapped my pants! I would prefer to keep the splint in than going through surgery again. She tells me I'm going to get local anesthesia and will have to sit in the recovery room and all kinds of things I didn't want to hear! Once I got called in, the nurses started taking my blood pressure and started prepping me for what looked like a surgery. And then Dr. Freidman walks in and says, "What's all this? We don't need anesthesia. I'll just take the splint out without it. He won't feel any pain." What a relief! In retrospect, I think it's just a nasty prank they like to pull off with their post-ops.

So the splint got removed. It reeked like an ogre. All kinds of food had crusted on the back of my upper teeth and it took 3 consecutive brushings to feel semi-normal again. My speech came back pretty quickly - about 30 mins to get used to talking and finally people can understand me again!


What else has happened recently? Dr. Freidman also cleared me to start resuming my regular diet but at 2 months post-op I'm not all the way back yet. My jaw isn't strong enough to take on the hardest of hard foods but I'm gradually getting there. It didn't turn out to be a big-bang now-you-can-eat deal so I didn't really get a chance to go for a celebratory post-op meal. I've had pizza 3 times since then though.

Other than that, I visited my orthodontist. The million dollar question I had for him was when I'll get my braces taken out and the million dollar answer I got was disappointing - "hopefully at the end of the year." He also slapped on elastics and wants me to wear them 24 hours a day so that was a colossal disappointment too. They don't seem to help either. My bite isn't any better than it was 1.5 weeks ago. We'll see what my surgeon has to say when I visit him next week.

Upcoming milestones:
Jul 25 - Visit surgeon
Aug 13 - Visit orthodontist
Dec 2007 - Braces come off (hopefully...)

I'm only 2 days away from getting my splint taken out. Only 2 days away from freedom! Well, mostly... I'm still not allowed to resume my regular diet until another week but my jaw is feeling strong enough to already handle it - I'm going to be a good boy and wait it out though.

I've been getting a little more adventurous with my eating habits recently. Biting more and more meat everyday (although nothing more than ground meat and chicken still) and I also had a veggie burger at our company picnic on Wednesday.

I still can't decide what I'm going to have first when I can finally resume regular eating. I'm thinking something unhealthy that tastes really good.

• Perhaps KFC fried chicken?
• Pizza? (which I've been craving ever since the Thursday lunch meeting at work - thanks Matt!)
• Or the peanut pasta and fried ice-cream at Thaifoon?

Not sure yet...

Upcoming milestones:
7 weeks post-op - splint comes off!!!
8 weeks post-op - resume regular diet
4 months post-op - braces come off (hopefully...)

I had another visit to my surgeon this past week. He noticed my bite was a little off - my left molars don't touch perfectly so he asked me to start using "poster elastics" on my left side. "Oh no, I've been posterized!" He said it was no big concern so I'll leave it to the experts to fix up.

In other news, I'm starting to get feeling back in my upper gums ever so slowly. The inside of my upper teeth also need a good scrub - just 1.5 weeks away until the splint comes off! I can't believe I'm saying this but I'm looking forward to flossing.

Upcoming milestones:
6 weeks post-op - one week until the splint comes off
7 weeks post-op - splint comes off!!!
8 weeks post-op - resume regular diet
4 months post-op - braces come off (hopefully...)

I hit the 4 week mark on June 19th. It meant I was allowed to soft chew! That felt like being a kid in a candy store.

Here's a list of things I've been chewing the last few days:

• lightly toasted bread
  
• fried rice (with ground pork)
• pasta
• fish and chips
• muffins
• timbits
• chunky soup (with chicken chunks)
  
• channa masala

I'm quite the happy camper these days...

Upcoming milestones:
5 weeks post-op - visit surgeon
6 weeks post-op - one week until the splint comes off
7 weeks post-op - splint comes off!!!
8 weeks post-op - resume regular diet
4 months post-op - braces come off (hopefully...)

I had my visit with my surgeon Jun 12 and I finally got to see what he did with my jaw. The procedure is called a "Lefort I Multi-Piece Osteotomy". The Lefort I can be 1-piece, 2-piece or 3-piece. I believe I got the 2-piece since they had to expand my upper jaw. In layman's terms:

2-Piece Lefort I Osteotomy:

• makes an incision under the upper lip
• fractures the upper jaw
• completely separates the upper jaw
• removes a wedge of bone
• splits the jaw down the middle
• re-positions the jaw
• re-attaches the upper jaw with titanium screws and plates
• sutures the incision

• Step by step photos displaying incisions, blood and bones:
• Lefort I (WARNING: Not for the faint of heart)

Diagrams showing the 1-piece Lefort I:



Diagrams showing the 2-piece Lefort I:



Diagrams showing the difference between a Lefort I, Lefort II and Lefort III:



Upcoming milestones:
4 weeks post-op - start soft chewing
5 weeks post-op - visit surgeon
6 weeks post-op - one week until the splint comes off
7 weeks post-op - splint comes off!!!
8 weeks post-op - resume regular diet
4 months post-op - braces come off (hopefully...)

I'm way behind on blogging about my recovery from surgery. When I hit the 2 week mark (Jun 5th), I was plenty excited. I was back to work, my elastics were going to come off, I was going to start up on mashed foods and my splint was due out in just 2 more weeks!

And then I had my visit with my surgeon and orthodontist.

The Bite: My surgeon thought my bite on my jaw was lining up very well. No concerns. He put one of the x-rays up but I couldn't see the screws on it. I asked him to explain the exact procedure I went through but he didn't have the time for that either. He promised he would show me on the models next time around.

The Elastics: I thought finally, the elastics come off and he disappointed me, well, only partially. He said I had to continue wearing the elastics at night but I could take them off during the day. I can live with that.

The Splint: Here's the one I was most anxious to hear about. "When does the dreaded splint come off?" He thoroughly disappointed me on this one. "5 more weeks", he said. I have my appointment on July 10th. Hmmff...

The Bone Graft: I asked him about the stitch in my lower cheek and I was right. He took a bone graft from there. I guess that solves that mystery. He used it to fill in bone when he separated my upper jaw.

Nose Blowing: Leading up to the 2 week milestone, I was starting to look forward to blowing my nose. It was really starting to feel grungy and yet again, I was disappointed. He said, it was best if I waited another week. I guess there was something to look forward to at the 3 week milestone now.

Cleanliness: Both my orthodontist and my surgeon thought I was doing an excellent job keeping my teeth clean. Hooray! I'm not so concerned about cavities and gum disease now.

Braces: I had to ask my orthodontist when he thought the braces will come off. He said he couldn't really comment until the splint came out but he has to leave them in for at least 4 months to support my upper jaw while it completely heals. There could be some tweaking he has to do which may push it past 4 months but I won't know more until July 10th.

Upcoming milestones:
3 weeks post-op - visit surgeon, start blowing my nose
4 weeks post-op - start soft chewing
5 weeks post-op - visit surgeon
6 weeks post-op - one week until the splint comes off
7 weeks post-op - splint comes off!!!
8 weeks post-op - resume regular diet
4 months post-op - braces come off (hopefully...)

Wow, what a great day. So, I went back to work today and almost everyone commented about my changed face. Mostly positive comments too! I had to stumble and mumble through a couple of conversations but eventually got the message across. I think all the extra talking and smiling did me really good. My mouth feels relaxed and I can move my lips around a lot more freely. Dare I say it, but I'm kind of getting used to the splint too.

I also broke an elastic yawning today. I had a spare elastic so I replaced it but I visit my surgeon tomorrow to get them taken off anyway. I probably could have just removed the other one but it's only one more day so I might as well go the distance. Mashed foods here I come!

I woke up this morning with a terrible tummy ache. I knew I couldn't afford to throw up with my jaws bound together with elastics. Yuck, what a mess that would make! Fortunately I didn't have to but I did spent the better part of the morning writhing around in pain. It took 2 large gulps of Pepto-Bismol to finally clear up the ache.

The rest of the day wasn't terribly exciting. I spent a good portion of the day playing this addictive game - Shuffle.

I also geared up for my first day back at work. It feels like I'm going camping with the all foods, meds and other gear I'm taking with me. I guess it's better to be safe than sorry. I'm somewhat anxious about returning. I wonder how my co-workers will react with my inability to speak! Ok, it's not that bad. I've got the same feeling you get before a big speech or presentation - anxious until it begins.

Finally I got a good night's sleep! I slept like a baby last night. I must have finally tired myself out. It feels good to be refreshed and recharged.

I've been looking through my pictures and I'm not noticing much of a difference over the last couple of days. I guess the rest of the swelling will gradually go away. I did notice my droopy right eyelid though!

I developed it about a year ago. I was taking a nap in the sunlight and my left eye was cuddled on the pillow while my right eye was exposed to the sun. Anyway, I woke up with a puffy right eye - it looked like I'd just come out of a 12 round fight. Ever since then my right eye lid has always drooped a little. I expected it to recover over time but it sure looks like it hasn't. In any case, I looked up some exercises to strengthen up the muscles on the right side of my face. Here they are:

You need to be patient, and work the muscles gently. The idea is not only to regain motion, but for the motion to be balanced with the good side. Don't force things to the point that the two sides pull against each other. If you see a motion pulling other muscles that shouldn't be moving, back off a little, and freeze it at that point, and relax the muscles that shouldn't be moving. Keep your eyes on those eager-beaver muscles in the cheek area as you work your eye or mouth. And check the muscle that runs down your neck to make sure it doesn't "pop out". Keep the muscle movements appropriately isolated. Use a mirror - the feeling of motion you get while exercising can be very deceptive, so this is important. The mirror will also help you avoid letting the good side overcompensate by moving in an exaggerated way.

Remember not to push it - better to hold a position at the point it can go without inappropriate muscles jumping in to help than to try too hard to do things your face isn't ready for. Movements will elongate with time.

Exercise in short sessions, but repeat the routine 2-3 times a day, more if you can. Quantity is not as important as quality, so don't do your exercises when you're tired.

1. Sniffle. Wrinkle nose. Flare nostrils.
2. Curl upper lip up and raise and protrude upper lip.
3. Compress lips together. Pucker lips & attempt to whistle.
4. Smile without showing teeth; then smile showing teeth.
5. Try moving your lips into a small smile slowly. Then gently pucker slowly using equal strength from both sides.
6. Draw angle of mouth upward so as to deepen furrow from side of nose to side of mouth.
7. Harden (wrinkle) the chin; "stick out" the chin (like a boxer).
8. Using your index finger and thumb pull the corners of your lips in toward the center. Slowly and smoothly push out and up into a smile. Continue the movement up to the cheekbone. Use a firm pressure.
9. Placing 4 fingertips on the eyebrow rub using a firm stroke up to the hairline. Return downward to the eyebrow. Do the same type of massage in a circular motion on your cheeks and chin, and outward to your ear.
10. Try to close the eye slowly and gently, without letting your mouth pull up or your eyebrow move downward.
11. Raise eyebrows and hold for 10 -15 seconds (watch out for synkinesis - hold the brow at a point before the corner of your mouth starts to move or your cheek tries to help). Wrinkle forehead.
12. Frown and draw eyebrows downward.
13. Gently wink with one eye and then the other to the best of your ability. Don't push it.
14. Open eyes widely, but without involving your eyebrow. Stop if you see any inappropriate muscle actions.
    

And here's a set of exercises specifically for droopy eyelids:

1. Gently tone the muscles of the eyes by pressing two fingers on each side of your head, at the temples, while opening and closing your eyes rapidly. Repeat 5 times.
2. Sit upright with your eyes closed and relaxed. While keeping your eyes closed the whole time, first look down and then look up as far as possible. Repeat the facial exercise 10 times.
3. Sit upright with your eyes closed and relaxed. Keep your eyes closed while lifting your eyebrows and stretching your eyelids down as far as possible. Keep in this position for 5 counts, relax and repeat 5 times.
4. Sit upright with your eyes relaxed and open. Lift your eyebrows while closing your top eyelids until about halfway closed, then open your eyelid wide open until the white of your eye shows over your iris.
5. Sit upright looking straight ahead with your eyes open. Look up then down, while keeping your head still. Repeat 10 times. Then look left and right - repeat 10 times.

Oh, I just made a discovery! I was brushing my teeth after dinner and there was something bothering me on the left side of my bottom teeth. I thought I had some leftover food stuck there so I slithered my finger in to get it out and BAM... I just felt a stitch! A stitch on my lower jaw? How could this be?

I think my surgeon slit open a spot under my left gum to get a bone graft! That would also explain why that area was swollen when I came out of surgery. In any case, my poking opened up the wound a little and a gush of blood came out. I'll have to ask my surgeon on Tuesday about that since he never mentioned it.

And I almost forgot to mention, the oat is gone! I don't know if it got unwedged or if it dissolved away from my saliva but it's not longer there. Alas, it feels much better not having a wedged oat in my mouth.

Today's been a really good day for me. My second day of working from home and I didn't get tired at all. My energy level is starting to feel almost as good as normal now.

I'm still having sleep issues though. I didn't get to sleep until a little past 2:00 AM last night. Not sure what's keeping me awake but perhaps I'm not tiring myself enough through the day. I didn't nap today so we'll see how I sleep tonight.

The other thing I noticed while in bed last night was my tongue is starting to get scaly. I think it's because of the plastic splint which is starting to feel waxy now. Can't wait to get my elastics off so I can give my tongue a good scrub.

I tried taking a peek at my stitches this morning but couldn't get a glimpse. I also had some bleeding in my mouth today. It was from the inside of my lower left cheek so either I cut myself on my braces or I have a bit of an infection due to inferior brushing capabilities. The tightness around my upper lip and nose seems to have reduced so maybe I lost a stitch this morning. Finally!

I'm making more and more discoveries of people in the Ortho-blogosphere. Check this out - Brandy had her surgery just 2 days after mine. It's kind of comforting to know that I'm not the only one going through this massive inconvenience.

I woke up at 9:15 AM and worked from home all day today - the full 9-5 PM! It felt good to get back some normalcy in my life. I had to lie down a couple of times during the day, once at about 12 PM and then again at 5 PM.

My sinuses were going crazy today. My nose kept dripping of the mucousy-blood mixture. I thought the blood was supposed to stop by Day 10 but today's been the worst day for it. My stitches haven't dissolved either which has me a little concerned too. My upper lip and the right side of my nose kind of stings. Perhaps its a combination of the numbness almost being gone and my wounds healing.

I discovered Rebecca's blog today. I can't believe there's an entire Ortho-blogosphere out there! I wish I knew about it before going into surgery. It sure would have made my life a little easier. For example, there's a more intelligent way then watering down all my meals - the syringe! Not sure how it works but I'm only a handful of days away from getting my elastics taken off now so I'll just man it out.

From reading Rebecca's blog tomorrow might be even worse for pain - "Your jaw is weakest on Day 10". We'll see how it goes...

I got caught up on all my email from work today so I'm hoping I'll be able to put in a full day of work tomorrow - working from home of course.

I still haven't managed to resolve my wedged oat problem. It's really jammed in there and it's super-annoying. I think I'm going to have to live with it.

In other news, for the last 2 days I've been battling a downpour of mucousy-blood mixture from my nose. Alright, it's not quite a downpour but it does make going outside a little bit of an inconvenience. I'm constantly concerned about the state of my nose. Thankfully, I almost have all the feeling on my face back so at least I know when something is starting to dribble down. It's supposed to clear up by day 10 so I'm definitely looking forward to that.

And finally, I'm finding yawning really difficult. Well, it's obviously difficult because my jaws are bound together by elastics but it really hurts to yawn. I couldn't find any mention of how to handle yawning in the booklet my surgeon gave me so hopefully it's not bad for me.

I'm at the one week stage. Yeah me! I think I've been doing quite well. The swelling has reduced, I don't have a lot of numbness and my head isn't as woozy anymore. I don't think I have the strength to get through a day of work though but my eating habits have been quite alright.

I have 5 meals a day and some of the meals I've had over the last few days include:

• oatmeal
• tomato soup
• cream of mushroom soup
• pea soup
• mashed potatoes
• spinach curry
• channa masala
• malai kofta
  
• baked beans
• mushy fish
• banana shake
• strawberry shake
• Chocolate Boost

I did have a bit of an eating catastrophe today. My Dad was on an important phone call so I didn't want to fire up the blender and decided to have un-blended oatmeal for breakfast. The eating was fine but I managed to get an oat wedged between my splint and the roof of my mouth. It's been stuck there all day and there's no way for me to get the thing out. It kind of concerns me because it may stay there for 4 more weeks! Hopefully I won't develop any disease or cavities due to 4 weeks of wedged oats.

I woke up this morning with a purpose. I want to start working from home later this week since doing nothing at home is just killing me. I'm also targeting next Monday or even as early as Friday this week to be back at the office. I need to work on improving my speech though.

I've come to the realization that others can't understand me when I use words with the letter 's' in them. I just can't pronounce the 's' properly' with the splint in my mouth. So I'm replacing my 's' with a 'sh' and having more success (or rather shuccshesh). I like to think I sound like Sean Connery now. If it's good enough for James Bond, it's good enough for me!

I also ventured outdoors for the first time today. Took a walk in the courtyard behind my apartment building. Weather was really nice and 15-20 minutes of walking tired me out. Hopefully the extra activity will help me get some better sleep tonight.

Yet another night of bad sleep. It felt like I hadn't slept when I woke up this morning. I kept waking up every hour through the night and I must have had the lightest sleep known to man!

After having a couple of miserable days and more bad sleep, today turned out a lot better. I got out of the apartment for the first time in days. Ok, it was only down the hall to the laundry room but it was still something. And I shaved for the first time. Shaving felt kind of weird with the numbness and all but at least I don't look like a complete hobo now.

I was all excited for dinner today since I was going to have mushy fish but it didn't really taste that good. I think the texture turned me off a little. Oh yeah, and I've been meaning to mention my love for fruit shakes for the last 2 days but I keep forgetting. Banana is my favourite and Strawberry a close second. I can't wait for the summer to really kick in - a cool Coffee shake with Pralines & Cream ice-cream will be pure bliss!

Another night of poor sleep. This time, I got really uncomfortable with my sleeping arrangement. I have a soft pillow chair with 2 pillows on it but I had to fluff and switch the pillows around multiple times through the night.

The day turned out even more miserable than yesterday. I had oatmeal and orange juice for breakfast. Watched another episode of Hereos while icing down my jaws and by the time the episode ended I was hyperventilating. My head feels even woozier than yesterday. Initially I thought the anesthesia hadn't completely worn off but now I'm thinking it's the meds.

I'm starting to get really concerned about this splint and my ability to talk. It's going to be 4-5 weeks until they take it off and it's really hampering my ability to speak. I'm not sure how I'll be able to get back to my regular schedule when I get to work. I usually spend anywhere from 2-4 hours on conference calls so I may be as good as useless.

On a positive note, I'm kind of surprised with how much feeling I have on my face. My left cheek almost has all it's feeling back and my upper lip and right cheek aren't completely numb either. When I had my wisdom teeth taken out, I had absolutely no feeling on parts of my face for 2 months. At this rate, I may have all my feeling back by the end of the first week.

I didn't sleep very well at all overnight. The only quality sleep I got was between the hours of 7 AM and 11 AM. I didn't feel terribly uncomfortable so I'm not sure why I couldn't get into a deeper slumber.

Had a pretty miserable day today. I had blended oatmeal for breakfast, took a nap and woke up feeling a little woozy in the head. There isn't a whole lot I can do. Don't really feel like reading and definitely don't have enough energy to be up and about. Fortunately I have about 4 episodes of Hereos, 3 episodes of Desperate Housewives and 2 episodes of Grey's Anatomy PVRed.

Watched a couple of episodes of Heroes which took my mind off things but I got pretty depressed after that. I can't talk very much because of the stupid plastic splint so I just sit there with a grumpy look on my face. Even trying to smile hurts!

Lunch consisted of cream of mushroom soup, had a Chocolate Boost at tea time and mashed potatoes watered down with tomato soup for dinner.

My nose is all crusted up since I no longer have the benefit of the oxygen mask under my chin to moisturize my nasal passage. Q-tips and the Otrivin nasal spray help but it's still feels pretty gunky up there.

I guess the one positive is I did finally bathe today. I wasn't sure if I should be going under the shower so I sat in the bath tub with my rubber ducky.

I slept alright overnight. Woke up a few times as they had to check my vitals every couple of hours and I had to constantly empty my bladder being hooked up to the IV. Perhaps it was all a dream, but there was this really cute nurse that walked in midway through the night. I remember thinking, if only I didn't look like a blowfish... I guess my inability to talk didn't help either!

I wasn't feeling very much pain. I had told my surgeon the day before that I was a 2/10 on the pain scale so they didn't give me any morphine overnight. Visiting hours didn't start until 2:00 PM so there wasn't very much I could do. They gave me some kind of milky breakfast gruel and orange juice in the morning. I had the orange juice and a little bit of the breakfast gruel, but didn't feel like having much more. I wasn't nauseated which was a good sign and my nasal passage was pretty clear, albeit somewhat crusty.

They let me get up and take a walk in the hallway dragging my IV around. It felt good to be up and walking. Slept a little more, had tomato soup for lunch. Dad came by a little after 2:00 PM. Talked to him for a bit but I think he was mainly just nodding and pretending he understood what I was saying. For some reason, I've been salivating like crazy. It must be due to the plastic splint they put in my mouth. In any case, the combination of not brushing, breakfast gruel, tomato soup and lots of saliva did not make for a good aftertaste!!

My surgeon came by at around 4:00 PM and asked the nurses how I was doing. They said I had been a model patient. He took a quick look at my pumpkin sized face and said I could go home. My surgeon thought I hadn't swollen up a lot but the right side of my face seemed huge to me and for some reason the left side of my lower jaw was swollen too even though he didn't do any work there.

Anyway, it was good to be home. I had pea soup for dinner, watched a little TV and it was lights out for me.