The Cheeseburger Experiment

Some of you may remember my comment a while back to Erin about putting a cheeseburger in a blender. As I learned, she's vegetarian and therefore I had to step up to the challenge. Well after some clinical studies and numerous pie charts we've received the data back from the labs and I think I'm ready to publish.

Going into this thing I speculated that keeping the quintessential burger meal in tact would be the best plan. Burger, fries, and a shake. Have any of you dipped your fries in a chocolate shake? It's not half bad. We did it all the time at Wendy's growing up. Anyway, here are the ingredients before:

...aaaaaand here's the after:

...it was pretty awful. Maybe a beef broth instead of the shake? I wasn't sure. After some contemplation I noticed the cheddar soup my mom had bought earlier. Hm. Intriguing. So a couple days later after the shock of the initial attempt had passed I gave it another go.

This is a Jack-in-the-Box Ultimate Cheeseburger (no lettuce or tomato which helped I think) with a small order of onion rings in a bowl of Vons Cheddar Ale Signature Soup.

It came out the consistency of a stout oatmeal and while the flavor was exactly wht one would expect when chomping into such a greasy-cheesy-melty-mound-of-heaven, it wasn't exactly the same without the actual chomping. Until then, I'll be enjoying my Cream of Burger Soup.

Heal 4 Real

Just wanted to mention that the day before the soft-food extravaganza of mashed potatoes (sweet and regular), stuffing, green bean casserole, and super chopped turkey I finished my expansion regiment. I'm all done at 19 turns total (none were done during surgery) and totally jazzed about letting the bones heal up nice and properlike. The sooner they get going the sooner I can dive into the foods I really love. The Chainsaw said I wouldn't be able to eat until after the new year but with Christmas dinner on its way I know I'm going to be pushing my luck.

Check, Check, Double-Check

Last time I saw The Chainsaw he said he wanted to see me before Dr.Styrt did to check on my expanding progress.

So I slipped in for a early appointment with him this morning to give him a gander at my ever-increasing ghetto-fabulousness. He basically said I've healed really well and that I was ready to be passed on to Dr.Styrt's care until the next surgery. I'll see Dr.Tawfilis again in 6 weeks to make sure everything is healed for real (no foolsies) after the expansion is done. I asked when I could start lifting again and he said I could go easy now but any over exertion will lead to broken blood vessels, soreness, and re-swelling. So I'll go easy until the new year I think. It'll be nice to ease back into it anyway.

And off I whisked (can one whisk or does one have to BE whisked?) off to see Dr.Styrt. And this, I think, is a great indicator of how well I know my body and it's healing capabilities. I lie down in the chair and he takes a peak inside.
Checks my file.
Looks again, and says, "So did you have the surgery on the 3rd?"
("No I always look like a field goal post.) "Yup, I did," I said.

"Wow. You healed really quickly."

Bam. No sweat. I thought that was cool.

So we're on for a date after the new year to get bonded and wired. The best part is I'll get brackets on my lower 6 & 7's instead of bands so I won't need spacers. Pow. AND, I only have to click my way to 19 instead of 24. How ya like me now?

Halfway House

This is a 12-turn gap. I'm trying to have fun with it.

On a serious note though, I can't help but think that only the right side of my jaw is moving over and not the left side. I'm sure it can all be fixed when the expanding is done but it's weird to notice.

6 Turns

I've gotten used to cranking the expander at this point. Yes, I do it myself. And I really enjoy trying to feel the difference in the gap right after I've done one. Amazing technology.

And finally, I got the surgery pictures up. Enjoy.

Back to Work

I've been hopping in to clear out my email and check on things since Sunday but today was the first day there were actually other people around. It's nice to be missed even though nothing super important was going on.

Click!

How fun. I saw Dr.Tawfilis this morning for my first post-op visit and he showed me how to start opening this thing up. Not that complicated, just a mild formality really. He clicked me twice and honestly I couldn't feel a thing. I was expecting a lot more pressure with each turn but it just wasn't there. I can, however, see daylight through my front teeth. How cool! Progress! It's happening! I can't stop jumping around! The Chainsaw wanted me to do 2 turns in the morning and 2 at night. But Dr.Styrt said 1 in the morning and 1 at night. I feel like I could do 4 a day without a problem but we're gonna go with Dr.Styrt on this one because its the more conservative route I suppose. I dunno. I asked about the gummy movement and if my maxilla would get sucked back up as it heals and he said yes. It's just swollen and not scarified yet but that'll change during the "consolidation period," or the six weeks after expansion.

I'm so happy I've finally gotten to this point, where things are happening. In theater, sometimes you have days where you can work hard for 10 or 12 or 16 hours and at the end of the day the theater looks the same as at the beginning of the day. Other days you can have half a crew working only 8 hours and it feels like a different world when you lock up. We like those days.

Well I Can't Figure It Out

Ok SARPE survivors this one's specifically for you. I've been working out that fleshy mouth meat and getting used to the movement. When I first started checking things out after the hospital it looked like my front teeth were WAY more prominent than before. I thought this might've been because my upper lip was pretty swollen in an upward position and maybe they were just being "revealed" more than normal. But after careful observation I've noticed my maxilla is actually hanging lower than it used to and when I bite down (or would it be biting up?) I can press my upper teeth up a good 3-4mm. I understand that it has to flap around in order to allow for lateral movement once expansion starts, but once that's done how does the maxilla heal back up where it should be? Does the scar tissue just tighten up and pull everything back into place? Does bone fill in where it hangs and will I need to live with it until it can be reassessed for the next surgery?

I go in bright and early Monday morning to start clicking but am getting this kiddish impatience about the whole thing. Don't make me do the pouty lips. I'll do it. I have no shame.

Wisdom Teeth vs. Jaw Surgery

All this comparison talk of having surgery and your wisdom teeth pulled has prompted me to post my views on the subject. For the most part, I do think people are just trying to empathize by relaying their extraction experiences when talk of surgery comes up. I've seen enough sour faces and cringes of terror (even before the graphic descriptions) to know that most people don't envy the surgery patient. And I think it would take a truly insensitive person to actually believe that their outpatient procedure could trump an osteotomy. So when your sister-in-law or buddy at the office tries to make you tense up with their little story, just try to be polite, they obviously don't know any better. I will offer my opinion of each side having just done both.

Wisdom Teeth-
-point of information, all four of mine were erupted. I'm sure they would not have come in as smooth as they did had I not had a set of premolars removed in middle school. I will say that I'm pretty sure the swelling would have been 10 times worse if they were impacted.
-pain, during the first day or so the pain from the extractions was more noticeable than from the osteotomy. After the 5th or 6th day when I was completely off the pain meds they again became the more annoying of the two pains. It's sharper and more localized for obvious reasons.
-bleeding, when blood spills out of your mouth while you're rinsing it's hard to say exactly where it's coming from. But I'm fairly confident that there was very minimal bleeding after I left the hospital 27 hours later.

Two-piece Leforte I-
-what makes this surgery above and beyond an extraction is how it effects everything around you for a much longer period of time. Putting the gory details aside let's look at the two side by side. Longer operating time, more blood loss, liquid/soft food diet for about 5 times longer, pain meds prescribed are much more serious (morphine for crying out loud! They give that stuff to dying soldiers)
-from a lifestyle point of view, if I wanted to go lift weights or play hockey after an extraction I could do it that day. Might sting no doubt, but it'd be possible. After surgery? My maxilla is being held in place by the meat in my mouth. That's all. When I bite together I can feel my upper arch moving closer to my brain. Walking is now considered a jarring activity. Let's just say that that sort of instability changes the way you do simple things like sit in a chair, turn your head, and swallow your juice.
-pain, during the first couple days it felt like a burning sensation at the line where the cuts were made below my nose. But worse than that, when re-learning to swallow the maxilla does a whole lot of clanking around. And feeling it clank together up there was enough to stop everything around me. These last couple days have gotten better with that scar tissue starting to grow in there. The stitches are tight and dry up there and smiling is still very painful.
-bleeding, the bleeding thats going on seems to be leftovers from the procedure. A couple times a day I'll lean forward in just the right way and my nose will start dripping blood. Not a nosebleed, just leftovers that've pooled up in the nasal cavity. Gunks of blood have become slowly coughed up from the throat and the nasal area and I'm sure this is ok because it feels so relieving when I get a good piece.

With this in mind, I'd like to say that having your wisdom teeth is like hitting your thumb with a hammer. But jaw surgery is more like being splattered across the sidewalk by a bus.

Clean Yourself Up

Day#5 and there's not a whole lot to talk about. It seems like the most difficult part of this game is keeping the roof of my mouth clean and dry. I spent the better part of the morning cleaning out gobs and gobs of gunk from up there. It has also been an ongoing front to dissolve the clotted blood holding my upper lip to my front teeth. I've certainly gotten my hunger back. The first couple days out I could only put down a few ounces of anything at a time but this morning I made myself a nice big old pineapple and vanilla shake and downed the whole thing. And yes, I did make it myself. Hooray for being proactive about your recovery schedule. Then I took a nice bath (which is waaay more relaxing than a shower, which is all I have at my place) and made another shake for lunch, this time cookies 'n' cream. The sad news of the day is that virtually all of the weight I had put on is now departed from my body. 198lbs was the closest I could get to my goal and I weighed 195 the morning of the surgery. Now, a scant 180 I feel like a waif. I'm hoping that I can get back to a 3-shake-a-day regiment to stop any more loss, but once I get eating again I'm hoping to put some of it back on.

Swallowing is still a little disturbing at times but not as bad as it was. I'm carrying around a towel for saliva so I don't have to swallow for swallowing's sake. Still lots of pressure in the sinuses and the very few times I've tried to utter a word it sounds (as it should) very, very congested. I'm not taking any more Vicodin during the day but they do help me get to sleep. So the pain isn't too bad.

Oh, I am taking daily pictures but won't be able to post them until next week.

Land of the Living

Day #4 and mom wouldn't let me stay in bed anymore. Tough love in my family.

The surgery went well. Dr.Tawfilis said everything went as planned, wisdom teeth caused no issues. We showed up at 5:30am to check in and you'd think I was the only person having surgery that day. There wasn't a long wait from getting into my gown till I was in the room. I met my anaesthesiologist just prior, Dr.Cochran I think. I asked him where he went to med school. University of Michigan, he said. Some of the best hockey in the world there so I'm at ease ;) It didn't take but a minute after actually getting into the operating room that Dr.Cochran told me he was going to give me some stuff to sleep and that I should just relax. After the night I had before believe me I was ready to relax and go to sleep. No counting. Just relaxing and I was probably out in a second or two. When I woke up I was able to recall exactly what was going on, knew that I'd have gauze in my mouth etc. The wisdom teeth were the most painful part right off the bat. I got nauseated twice and it felt like a precursor to passing out but the nurse was able to give me something that calmed me down immediately. I think I remember her using the word "Dulotid," mmmm. Then they wheeled me to my room and got me hooked up on Torridol. I had the option of that or Morphine. I gave the Morphine a chance once and absolutely did not like it. They only gave me 1mg instead of the max 4mg but it was enough to make my breathing race so much that I couldn't sleep. So no more morphine for me. Later that night they started trying to get me to take in some liquids which was a challenge. Without rigid fixation you really can feel the maxilla shifting around when you swallow. It's disturbing. Sleeping through the night was hard because the pain came back. This time it was like my nasal area was on fire. The next morning I got up to use the bathroom and watched some football until The Chainsaw came to check up on and possibly discharge me. I felt ok and he said I looked good so I was free to go.

First, We Show Up

...Then we see what happens. At 7:30am PST start counting backwards from 10...

9...

8...

...

Bring it!

I Have a Pahwette Exthpander

Having conversations with people has become like a staring contest. I endure the hilarity of it as long as I can before telling them I have an appliance in my mouth. I can only imagine what's going on in their heads when I'm speaking. Not that I'm self conscious about it, I'm really not. They could think I'm drunk for all I care. I started chatting up the Artistic Director of the theatre today at lunch (who has no idea I'm having surgery or any of this done) and it really was sort of a joke's-on-him feeling I got.




Here's a picture of the device. For the rest of the world, see that slot just left of the two dots? That slot is where you put in the key which is basically a small wire comparable to a paper clip. By rotating that wire towards the back of the mouth (as indicated by the arrow) it spins a screw which pushes the two sides apart. Each "turn" of the key is actually about a quarter turn of the screw. At the prescribed 24 turns for my treatment and the desired 6mm expansion I figure it's a 1tpm screw (1 thread per millimeter. 24 "turns" times one quarter turn per "turn" divided by 6mm = 1 thread per millimeter)...I'm a mechanical person, this is what I think about :)




I'm gonna go shopping for recovery stuff tonight and then play hockey one last time before the thurjeree.