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Jaw Surgery at 39: The First 5 Days

Last Saturday I had corrective bite surgery on my lower jaw to fix an underbite issue. This was planned over the last year or so, as part of a longer full braces treatment.

I thought I’d document my experience as I know it can be quite a scary thing with many unknowns, especially for older folk who have spent more time on this earth being “conditioned” in their ways.

As teenagers, we generally go with the flow, what our parents say goes.

But as we get older we become responsible for our own decisions, our fears grow stronger with time and re-enforcement and it can become harder to take on such challenges.

So when I first took on my braces journey just over a year ago, and surgery was brought up, I kind of agreed to it. I thought if you’re going to do something you may as well do it properly.

But given the actual date was never specified, it just kind of sat in the back of my mind as something that would happen but I didn’t need to actively think or worry about when.

That was until around 3-4 months ago when my orthodontist said: “Okay, it’s time to go ahead and book your surgery for around 12 weeks time”. It became a bit more real then but I still didn’t actively worry about it.

As time went on though, and the date grew closer, I found myself worrying a little more. Doing the bad thing researching what it would be like (note; if you’re reading this you probably are too, we can’t help it, but it’s highly recommended you don’t).

I watched a few videos and read a few blogs and it didn’t seem too bad until I read on Friday – the day before surgery which had extensive timelines… that created a bit more worry and the typical anxiety set in.

The next morning we headed off to the hospital early though, and I had successfully put the worry behind me. I remembered all my meditation and anxiety tools and how it would just be an experience to float through as Dr. Claire Weekes would say.

Under past medical conditions, I was pretty much a big no to everything, rather healthy except anxiety so I don’t know if this made the nurses try to calm me down with distractions, but it really wasn’t needed anyway as I was completely calm just going with the flow happy laying on the table about to enter the surgery room and prepare for what was about to happen.

I had complete confidence in the medical team, my surgeon and the hospital, as you should when entering such an endeavour voluntarily so it was really no big deal to have the attitude of “I’m just here for the ride”.

Being no stranger to surgery I know how it goes now. They say we are going to put a needle in your arm, let you know you’re about to be sedated and before you know it you wake up in recovery seeming like no time at all has passed. Even with sleeping you generally sense time has passed, but I always feel with surgery it’s like closing your eyes then opening them a second later with everything done.

So that is how it went, waking up in the ICU. I now knew the actual hard part would begin now with a night in the ICU and then a night in the ward.

Obviously, it’s pretty difficult to speak with your mouth banded shut but I was able to murmur most communication just fine, and answer the frequent “You okay, need anything?” questions with a simple thumbs up.

Pain relief was in the form of common paracetamol (Panadol), and a button on the wrist delivering Fentanyl on hand. Two gel ice packs were tied around my head in a cloth sleeve to help with numbness and reduce swelling.

I spent most of the first 24 hours just “relaxing” – honestly, everything is numb and apart from a weird pressure type feeling, it really isn’t that bad at all. Meditation and just focusing on the breath and acting as an “observer” to the going on’s around me in ICU was a breeze, quite entertaining in fact.

Once moving to a private room in the ward it felt pretty much the same. The pain was still absent for the most part. During the first 36 hours or so I believe 3-4 was the highest pain scale I gave. The second night, however, the pain did start to get a little worst.

Nothing extreme just an aching type pain. Medication generally handled it without a problem and the ice packs were single-handedly the best prescription.

On the Monday morning I was discharged to go home with a prescription of liquid vitaminized food for the next two weeks.

What form this takes is left entirely up to you, however, I look for high protein, non-chunky soup (you can blend any to make sure its non-chunky, anyway), total meal replacement powder with high protein, and frozen fruit and veggie smoothie mixes.

I generally aim to ensure every meal has lots of protein and vitamins, and drink V8 fruit and vegetable juice during the day to keep hydrated.

I’m not really a fan of juices, sodas or other calorie beverages, however I know during the next month keeping caloric intake up will be a chore so I have no problem drinking 1-2L a day for the extra calories.

The surgeon told me I would lose around 5KG (11 LBS) on average, as it stands I have lost approximately 1 KG (2.2 LBS) in 5 days, likely mostly from the first day in ICU where I didn’t eat anything at all.

How is the Pain?

Probably everyones biggest concern is the pain factor.  It really isn’t as bad as you imagine, and it’s actually easiest right after surgery.

After day two to three the pain does increase but it still isn’t overly bad.  More of a constant ache.  It does get a little tiring not being able to open and stretch your mouth however you do get used to it quite quickly.

I like to think of the whole experience as more of an inconvenience, however, an inconvenience that will pass soon enough.  Every day will get better and after the first week, it will be so much better.

I would rate most pain during the day as around 2-3, sometimes spiking to a 4-5, however, ice and pain medication easily reduces it.

Pain at night is often at it’s highest, reaching around a 6 however again ice and pain medication brings it back down.

Expect to wake up a few times a night, for me, it’s generally around 1 am and 4 am and each time I just grab some fresh ice and take a tablet if needed.

Swelling peaked at around day 3 and bruising peaked at around day 5.  Keep in mind although the bruising looks quite horrific it is purely visual and doesn’t feel as bad as it looks.

Tips for After Jaw Surgery

Having read some material before-hand, I did learn some tips and supplies to gather, and I have since learned some of my own too.  Here’s a collection of the tips I find most useful.

Ice Packs

Gel Ice packs have been an absolute must, even after leaving the hospital.  I took the sleeve I was using there home and grabbed some from the pharmacy.

Aim to purchase 4 packs if you can so you can use 2 while 2 are in the freezer getting cold again.  Unfortunately, my pharmacy only had 3 in stock so I bought all of them.

I will use these sometimes during the day, however, they are invaluable at night when pain seems to be at its highest (probably from laying down?)

Panadol (Paracetamol)

I try to get by on the minimum amount of pain medication and only use the codeine-based prescription medication during the bad night-time pain when sleeping.

I try to go as long as possible during the day without any medication too, so the liver gets a well-deserved break and as time goes by this isn’t too difficult at all.

Quite often I find myself simply taking a panadol for a headache rather than any jaw pain being unmanageable.

Greek Yoghurt, Other Blends etc Squeezies

Greek yoghurt is available in baby-food type squeeze sachets and it’s very high in protein.  These are great to keep in the fridge (20-30 at a time) so any time you’re hungry just grab one and squeeze it down.

They make a pleasant change from all the smoothie-protein shakes too.  I also have other forms of baby-food style sachets such as oats/fruit/flax superfood blends to alternate with.

1 Litre (32 oz) Condiments/Sauce Bottle

I saw this tip in a video review so grabbed one and I’m glad I did.  It may appear weird drinking juice from a large sauce bottle, however, it’s very easy to squirt straight into your mouth without causing any pain to the sensitive stitching areas in the gums.

Fibre Supplement

I’m adding this one after the original post, with good reason.  With your new, restricted diet fibre intake will likely be reduced, especially if you are no longer able to eat whole fruit and vegetables.

And as I’m now learning, it would probably be wise to incorporate this into your daily routine immediately when getting home from the hospital as a preventative method rather than an after-fact.

Something like Metamucil or another supplement which generally contain 3-4 grams of fibre should be sufficient to add to each meal – after all, we are supposed to intake much more over the day (around 30 grams per day).

As surgery stops the bowels, it can be rough getting them going again.  Add to this the opoid based pain medication you’re likely on is also known to increase constipation, it can create quite a bit of discomfort.

Basically after jaw surgery, you have all the things promoting constipation working against you, so you need to even the odds as such.

Get Moving

While it may seem like laying on the couch for 7 days is the best thing to do, I find some movement and getting some sunshine in short amounts to be very beneficial, not only for the body but also the mind.

I definitely don’t feel up to my usual 4.5 KM (3 miles) walks yet, however a walk around the block slowly working up to 2 KM has been okay so far with just a slight “spaced out” feeling as to be expected from a steady dose of drugs going through the body.

Conclusion

That wraps it up for the first 5 days or so.  I have already had a follow up with the surgeon yesterday who is very pleased and said it went great and everything looks great and will see me again next week where I should start looking more like an unbeaten human being too.

For the next post in the series, check out my followup post two weeks after jaw surgery.