Friday, October 12, 2012

8 Day 49. 3D Video fly-through of my skull, Post-Surgery X-Rays

My X-rays have finally been processed and emailed to me C-Dental X -Ray. I now have 30 titanium screws and 6 titanium plates in my face holding my jaw bones together as they heal.

Here's the over-all panorama.


You can tell where the bones were cut, and that the left mandible was truncated while the right mandible was extended.


My jaw joints also now fit much more squarely into the sockets as shown in the image above. My upper jaws were also advanced forward by 3mm. While the right still appears to be a little off, I believe that is within the margin of error of this type of surgery. I will need to confirm this in the next few weeks to make sure I do not need another fix, which is a rare occurrence but sometimes necessary.

I did notice recently that when I open and close my jaws, the right jaw joint tends to "pop" out a little further than the left; by this I mean i can actually feel with my fingers the joint protruding outwards when I open and close my jaws. I do not know if this and the observation I made in the previous paragraph has any correlation. Either way, the joint is much more comfortable than it used to be.

Included with the X-rays is this really cool 3D video fly through of my skull. It's a good perspective of all the procedures that were performed on me.


Tuesday, October 9, 2012

5 Day 46. Post Surgery Orthodontics Begins!

I was ousted from my mayorship at my orthodontist's office on Foursquare, but I'm in the running again.

This is the face of a proper mayor:



Due to the stiffness of cheeks and my inability to open my jaw more than 2 fingers width apart, Dr. Ashouri decided to just put bands on the sides of my teeth. They serve the same purpose as the bands previously from my surgeon, though in a different configuration; they help hold my jaws over to the left counter-acting the muscles on the right and their tendency to pull the jaw into its former position (see My Reasons for a better idea of what I mean).

The bands on my left are to be worn permanently until instructed otherwise, and only removed when eating and brushing. The bands on the right are to be worn only during bedtime. They look a little something like this:


My next appointment with the orthodontist is in 5 weeks. I do hope by then I will be able to open my jaws wide enough for her to really get to work.

Monday, October 8, 2012

0 Day 45. Tackling Noodles. And Ice cream. But mostly noodles.

Day 45 Post double jaw (orthognathic) surgery


Lunchtime at work, I decided to go get some Pad Thai from Amarin Thai Cuisine in Downtown Mountain View with my buddy Frank.It sounds easy. Noodles; they're soft and easily chewable. But in this case, it is less about the chewing, and more about lip movement.

Specifically, that moment when you fork noodles or spaghetti into your mouth, and you have some extra dangling from your mouth. For the average, fully abled Joe and Jane, he and she would just use their tongue/lips to kind of reel that extra length in. For the disadvantaged double jaw surgery patient suffering from a severe case of stiff and numb lips and cheeks, this is NOT so easy. I can't even feel if I have noodles clamped into between my lips. Yes I have partial feeling, but the sensitivity isn't' high enough to detect neither noodles nor ice cream and chocolate syrup dripping down, apparently.

I highly suggest having your napkins placed bib style. You'll look like a dork, but an intelligent dork, who will not be embarassed later by walking around with a grease stained shirt. If you're friends are as good as my buddy Frank, they won't even notice that napkin bib is out of character. This may or may not be a good thing.

Day 45 post double jaw (orthognathic) surgery eating noodles

Work after lunch was kind of an unfocused mess; PDFs tend to lose their charm after about 5 hours. Emails after 3. But seriously, if you do not have Camera Awesome on your smart phone, you really should download it.






Sunday, October 7, 2012

3 Day 42. 6 Week Checkup. I CAN EAT AGAIN!! Chewing 101.

This entry is definitely a bit late, but I have been busy.

Busy EATING. At restaurants, At San Francisco Fleet week. At America's cup in San Francisco. At Downtown San Francisco. With many many others. Seriously, 1 million visitors in the city this weekend. Giants game, 49ers, 8 stages of Hardly Strictly Bluegrass festival, Castro street fair, Italian parade?, Uniqlo grand opening, etc etc... jealous you don't live here yet?

My 6 week checkup marked the end of my liquid diet. After my surgeon inspected my mouth for 30 seconds ,  our conversation went a little something like this:

Dr. H: "You can start eating. Start out soft, but as long as it doesn't hurt when you try to chew, you are good".
Me: "Does that mean I can eat steak?"
Dr. H: "Well, the soft part of the steak. You need to build up your jaw strength first. After a week, go all out."

I know that his contradicts my recovery forecast in the past, where I stated I will be upgraded to a blended/soft food diet, before moving on to everything else. My best guess is that since I was on a full liquid diet for 6 weeks (instead of 4, followed by blended), my jaw bones have fused sufficiently without interference for me to tackle tougher foods more quickly. This is only my best guess; I do not question my surgeon's wisdom.

However, definitely no hard foods yet. Apples, almonds, pecans, crunchy stuff, I'll be missing you a little longer.

Right after that appointment, I went out to get my first meal with my friend Dylan. Enchiladas -- can't get softer than that, and can't get much more filling than that. (Dish: Enchiladas al sol (con pork) at Palo Alto Sol restaurant).


The photo above shows me happily taking my first bite of solid food in 6 weeks. This joy was actually rather short lived when I realized that I could not chew. After being on a liquid diet for 6 weeks, chewing is no longer a natural task. I had consciously think about the up-down motions, roll the tongue, push the food to the sides, etc, etc. Chewing now will also take effort -- keep in mind the jaws muscles are very weak. Even then, as I chewed, food fell out of my mouth because of my awkward tongue movements and inability to retain food. Partial numbness on the inside of the mouth did not help and soon I had food chunks caught in my braces between my cheeks and gums.

Also, I can open my mouth a little under 2 fingers width apart at this point. I naturally overestimate how wide my mouth is open. When scooping food into my mouth, I would constantly hit my lower lip and chin instead, only to have the food fall right back onto the plate.

While this was all rather hilarious for Dylan, it was extremely frustrating to me. I was essentially a toddler re-learning how to eat.

After this meal, I went to the office and grabbed the softest food I could find: Madeleine's Vanilla cakes. I think even a baby with gums only could eat this. However, I bit my cheeks 5 times eating this pathetic little snack. While not entirely visible, my inner cheeks are still "puffed" from scar tissue (not to be confused with swelling).


The one thing I may actually miss about my liquid diet is..... Ensure nutrition shakes. I have developed a fondness for them, and by fondness I mean cravings.

 In the past 42 days, I have consumed 151 bottles of Ensure shakes. I saved every single one of these bottles too.

While I attempted to build a pyramid out of these, the tapered tops and round-edged caps made stacking a little difficult, so I decided to just build a wide double-decker structure. It's still successful in conveying the sheer amount of Ensure I've had.


In all honesty, I might start stocking up on these as a pantry essential.



Tuesday, October 2, 2012

4 Day 39. First haircut after 7 weeks, rescheduled "solid food" appointment

I FINALLY got around to this pressing task. My hairstylist was most certainly surprised to see me walk into the salon. It was good seeing her again! Especially since my head was starting to feel really heavy from all the hair. Goodbye Justin Bieber... mop head... bowl-cut hair!


I realized today that my next appointment with my surgeon, (A.K.A the appointment where I get official approval to start eating soft foods, running, etc), was scheduled at the 6 week 3 day mark instead of 6 weeks.  There is absolutely NO way in hell I am waiting 3 extra unnecessary days to start eating solid food. I have rescheduled it for this Friday, and I am very much looking forward to practicing chewing on pasta and scrambled eggs this weekend. And if I am lucky enough to improve quickly, potstickers! (and other ground meat products)


Monday, October 1, 2012

1 Day 38. Out of my elaborate prison! Feeling in the right chin!

Went into the office for the first day in 5 weeks today. Since I'm still not allowed to do any strenuous exercising, which unfortunately includes bicycling on the hills of San Francisco, I had to walk to the train station today. It takes about 3 times as long, but on the bright side, this is now my exercise instead of treadmill walking.

Being with the hustle and bustle of all the other professionals in the morning had never felt so great. I probably walked across Union Square grinning like an idiot -- a grin I couldn't feel, but it was most likely there.

On a side note, in the past 5 weeks, the CalTrain schedule changed on me. My usual morning bullet train left 3 minutes early, and stopped at stops that it usually passes. In a moment's panic I was worried it would not actually stop at my stop. But, it turns out Downtown Mountain View is still a stop for ALL bullet trains. I'd like to thank Google, Apple, Firefox, Meebo, Loopt, etc tech Headquarters for making this one of the most critical stops on the route.

And here's me hard at work, looking serious, with my still puffy looking chin.The day I get my jaw/chin definition back will be a happy day.


The intern wasn't in today, which actually did make the day rather dull. On the bright side, I was able to semi-close my office door and turn up some music so it kind of felt like home. Yes, I have my own office unless we hire an intern to help out. It's really quite a great setup. But it currently looks more like a boy's (say, Justin Bieber's) room with my mess, and my dismantled mountain bike in the corner. This is taken with the new panorama feature on iOS6. Pretty neat!


I miss google maps though.

Feeling, though faint, is returning to my right chin! My concerns of permanent absolute numbness on this side is hopefully over. Looking forward to having it recover a lot more. 

Thank you apartment for being such a great recovery prison for me the past 5 weeks. I love my apartment, but am definitely glad to have the freedom to leave it more frequently now.




Thursday, September 27, 2012

7 Day 34. Dark discolorations on Back Molars, and Justin Bieber Hair

I was able to open my jaws wide enough today to brush my back molars with my kid's toothbrush normally. In other words, from the top, instead of at an angle from the side.

As I was enjoying this new-found ability, I noticed something peculiar. The entire top of my back  molars was covered in dark stains. I immediately panicked thinking that during my 2 weeks or so of limited teeth brushing, the entire top of my of my back molars were in decay.

Suddenly, my new-found ability to open my jaws wider was used in an expression of horror

 
Note the improvement in jaw opening
I immediately emailed my surgeon about this.

One thing to note is that for my first 2 weeks, I was using a prescription strength Chorhexidine Gluconate Oral Rinse, that warns of increased tartar build up and teeth discolorations. While I was aware of this,I assumed that discoloration meant some minor yellowing here and there, and not the propagation of a dark, almost black layer over the entire top of my molars.

Well, turns out that this propagation is normal, which is unattractively fortunate.

Unfortunately, what this also means is that I will have to get the discoloration buffered away by a general dentist, which means sitting through a session of having a rotary grinder passing over my teeth, listening to that high pitched buzz vibrating through my skull.....

My sister commented on my entry from Day 31 that I now have Justin  Bieber hair. My stud of a buddy Brian Baumgartner claims I've been afflicted with Bieber Pyrexia.What do you think?


The similarities are uncanny. I desperately need that haircut.
 

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