RustBlog

D+42 - Six Weeks and Tired

2011-05-17T02:27:05Z

For certain personal reasons I decided I wanted to see how 'eating' went so tonight I got a 12" meatball sub from Subway. This was a test to see how I could act 'in public', in a small way.

Eating it was, to put it mildly, an unpleasant trial.   Tasty, but tiring and hellishly messy.    The fact I can't open my jaw wide enough to place my forefinger and index finger between them edgewise, combined with lack of sensitivity in my lips, meant I ended up with marinara sauce all over my face, and food smooshed all over.

I so want to be normal, and every time I fail at this sort of thing, I get to realize more and more that normal is a mirage that as I think I am reaching it, disappears only to pop up again in the distance.

I'm lucky I'm not the type to get depressed, because this is depressing me.   Six freaking weeks, and I can barely drink in public without spilling some from my insensate lips.   Eating in public is basically impossible - even if I get food I can chew, bits fall off as I try to push it into my mouth.

So much for my normal.   I quit. I give up on normal for now, it'll be another six weeks or more.

The stitches in my lips are freezing my face - I can't move some muscles at all, smiles are a dead rictus as my upper lip is immobile...

At least the pain seems to be fading - I haven't had to pop a Demerol in days, and I'm dialling back the Aleve now to try to spare my liver.

D+39 The Art of Pain Medication

2011-05-13T13:43:40Z

So I'm back on the Toradol/Ketorolac for swelling. Which is fine, except it lasts 4 hours. So when you take youe last dose at 11pm or so, it's worn off by 3 am, and you wake up when your face startes to tingle.

Also, it does't really work alone - it isn't a very good analgesic, so you need to take either a narcotic (Demerol) or an actual analgesic (Tylenol - APAP [acetaminophen]) with it.   The Tylenol I have are also 4 hour duration.

Problem is I want to sleep 8 hours.

So what I did last night was time my pills so that when it was time to go to bed, I was to take an NSAID, so I took Aleve, which lasts 8-10 hours (naproxen).   Worked.   I still woke up early, but it was only because my APAP had worn off (you can tell from how the face feels if it's the NSAID or the APAP.)

It seems they make an extended-release Tylenol.   So tonight it looks like I'll be okay, assuming they sell it in Canada....

Daytime - Toradol + APAP
Night - Naproxen + APAP

I'll ask the Doc if this is okay too, but it seems reasonable.

As of right now, the only part of my face that feels odd is upper lip (vermillion), lower lip (vermillion) and front of chin. Most of the discomfort is my chin where they did the genioplasty.   Go figure.

What they did to my upper jaw, maybe

2011-05-12T14:19:15Z

Web page talking about how they do upper jaw stuff. Asked Dr. T. if this was a fair description.

http://tinyurl.com/3z4youm

Makes me woozy reading it.

D+35 - Five, five, five, five let's sing a song of five...

2011-05-09T04:20:11Z

Five weeks to the day from surgery. Some ups and downs, including my sudden bout of swelling this past week which led to pain and using up some of my dwindling stocks of assorted narcotics. Kinda threw me for a loop, I hadn't had any real backwards steps for some time and when you do run into something like 'swelling could be an infection in your sinuses' you overreact.

Trying to get my life back on track... to gettting back on track to normal. Last week was basically a wash, I think. But the swelling's down again and I didn't need any surgery to fix an infected maxillary sinus, or huge amounts of antibiotics. But it could have been and that's depressing.

Edit: yay 3 am and wide awake after 2h sleep :P

A Swell Thing

2011-05-06T03:11:51Z

So last evening someone mentioned they thought my face was somewhat swollen, so today, I tried icepacks and stuff during the day to keep it down, on top of the Aleve.

Around 2pm I called Tocchio's office and mentioned I had swelling - he is OoO so they called the other surgeon who worked on my operation (Dr. Tim Sands) and his office was 'GET IN HERE NOW'.

So I drove up to Woodbridge, to 4600 Highway 7 West, and the office of Dr. Sands.   We chat a while, and he thinks it's not what they feared, possible (Streptococcus) infection.

Seems when they cut my maxilla off, it cuts through the sinus cavities - and when they reattach, the sinus is not intact after, maybe full of blood, etc.   Eventually this heals - but in the mean time, blowing your nose (even gently as I do sometimes to clear a runny nose now) can trap air inside the sinus and this can cause swelling.   Ugh.

Also found out they somehow detatch and reattach the muscles when they move the jaws - so this is why I have limited motion of my jaw, most of the muscles are still conked out - they also did that to my nose muscles!   So this is why my nose is basically immobile - I can't even flare my nostrils.

On the good side the swelling's also maybe an indication the nerves are waking up and the increase in sensitivity and discomfort can result in swelling, and I do note some feeling is slooooowly creeping back into my face, even my upper lip.

Bad news: some of the internal stitches will take 2 months or even LONGER to dissolve - the stitches under my nose are some sort of super-duper 6 month dissolving stitch (he mentioned the trade name but I missed it, sounded like Mucilex or something oddly wrong).

Oh, and he confirmed the high tech mechanism they used to remove 2/3 of my lower turbinates was a pair of scissors. Just snipped 'em off, bone and mucosa all, and let them bleed :P    Eesh.

I didn't know this but cartilage doesn't need blood supply. Makes sense I guess. It's why they leave the septum alone. They did trim the base of the vomeral bone (the one what divides yer nasal cavity into left and right) but left the mucosa intact.

The most amusing thing was he mentioned at this stage about 80% of people who have this surgery don't think it was worth it. I actually completed the sentence for him as '... don't think it was worth it.'   I knew instinctively what the statistic was about.   His point was 'wait to six months'.   Well it's Day 31, not Day 180, today, is the problem.

Sigh.

D+31 - Sleepless, not in Seattle

2011-05-05T11:44:49Z

Hurray, we're into week 5.    Sleeping flat, whole 9 yards.   No more regular pain pills, just Aleve.

Why, for the last 3 nights then, have I been unable to sleep?   I just lie there with my eyes closed almost all night.

Yesterday and today, also, facial swelling is back.

This. Sucks.     I'm guessing it's from sleeping on my side, pillow pressure on face = swelling?    I'm going to use an ice pack this morning.

Work's picked up 110% as well - three new deal pursuits and I've had to talk a fair bit on the phone.   Probably also not helping.

I'm thinking I'll try napping sitting in the Zero-G chair today and use an icepack to kill some swelling.   Can one get immune to Aleve??? I doubt it.

Annoying.

Vote splitting = Con majority

2011-05-03T03:37:56Z

I'm at a loss to know what else could have been done, apart from the Liberal Party and NDP entering an electoral pact on a set of seats, but vote splitting in the GTA region gave the CPC enough seats they got to 168 (as of now, projected).

Well, it's as bad as I feared. Elections always go worse than I expect and this one was no exception. The Leader gets his majority, and I get a tax cut I didn't want.

I'd try to be happy for Layton as Opposition Leader but it isn't in me tonight. I even liked Duceppe as a guy but he's out with the rest of the BQ.

D+28 Elections and Depression

2011-05-02T17:09:54Z

Four weeks today since surgery and also federal election day here in Canuckistan.

I feel okay physically, but lately mentally the realization of the long-term nature of recovery has been getting to me. A number of things have brought it home forcefully that the rapid improvements I've felt since April 4th are tapering off rapidly. I still can't feel or move most of my upper lip, which makes smiling, drinking, eating, kissing, whatever, more awkward. Chin's still numb, I can feel the knots of scar tissue like little clumps of density inside my cheeks.

Taking this much Aleve can't be good for my liver - so I need to taper it off.

I want to get back to normal, and I've been kidding myself that it's a matter of days; it's not. I've been pushing my recovery, like deluding myself I could make the Rush concert, or start doing work a week and a half after surgery, or dialling down the narcotics early. Each time my body proved it knew more about me than I did.

So it's time to face the fact it could be weeks before I get more sensation back - I ate some fruit salad last night, at least I was able to bite through fruit, and even carefully chew peaches and pears (pears are REALLY dense, ow).

So it's a step, but not where I want to be. And it's depressing me some.

D+27 - Sinus ow

2011-05-01T16:04:19Z

Woke up this morning with clogged sinuses - had to take off my elastics to mouth breathe better - lay down all morning hoping they'd drain or something, no luck. Took another pseudoephedrine just now - my nose feels dry inside but something's not working. Took

Image via Wikipedia

TWO demerol and I still feel headache, and now I'm faintly stoned.
This sucks. I have things to do today, dammit.

Edit: ended up idiotically sleeping all afternoon when I doped myself up and then ended up taking a 15m nap that lasted about 5 hours. Well there went the entire day.

D+25 - OTC Meds time

2011-04-29T21:04:20Z

Basically the last few days I've been on Aleve, rarely popping a Demerol. The Aleve lasts 9+ hours when you take it. So this morning, I woke and really felt no pain, so I skipped the Aleve - by about 3pm I could feel some swelling though, so I took some.

Today's no-flash shot - oh yeah, I got a haircut.

:

Ladies, the Chin is In.

D+23 - Aleve-iating my discomfort

2011-04-28T03:47:32Z

So week 3 @ Tocchio and all seems well - my facial swelling seems to be decreasing, and the nerves in my lips and cheeks are asleep but giving hints they may be waking up. This week he only gave me Demerol for pain, which was nice, in a way.   I have a few percs left but they probably won't be needed. He suggested Aleve (naproxen) for an OTC NSAID anti-inflammatory to work on pain and swelling left over.

So I've been talking a lot more this week. Yesterday a LOT more, and I'm not sure if the exercise is helping, or hurting. My upper lip feels like it grew from swelling while I was talking on the phone. I don't like the feeling at all, but it may just be waking up. So today was talk almost nothing day.

The Aleve seems ok - it's 225mg a tablet, and supposed to be 1 tablet every 12h - the pharmacist said the former dose was 500mg so if one tablet wasn't working, to take two. I suggested this was off-label or something... but he was right, I went home and took one Aleve and the lip was still on fire - a second put it to sleep.   The Aleve doesn't REALLY last 12h it's more like 8 or 9.   But the extended half-life of the naproxen makes it GREAT as I can take them at 11pm or midnight and be pain free until 7 or 8 am the next morning. Which means I can sleep though the night.   Huge win.

As to sleeping, yesterday I was sore sitting in my lawn-chair napping so I threw caution to the winds and lay on the couch.   With no pain. I was hopeful, but I've been there before, so later that night I decided to test it again, and slept on the couch. Still no pain, so I spent the night on the couch. Slept okay.   So tonight, it's sleeping in my bed, with normal pillows and sheets and no sitting up and oh, God I hope this works.   I'm craving normal life. I want my face to work and I'll take the minor pain and the mumbling if I can see some progress - the incremental improvements are smaller and smaller so they give me less of a lift over time.

Everyone says I look great but it's the inside that rules how I feel and it's still sore - I'm glad to feel like I can skip the narcotics and prescription drugs, but I want my nerves to work again.

Oh well, time to take my 2 Aleve and lie down and hope to sleep. Going to a movie tomorrow so we can see what we can see...

D+17 shots

2011-04-21T21:29:10Z

So last few days it's still been 'trying to sleep' - sitting all day makes yer ass sore and then sleeping sitting upright is sore too - the Zero-Gee reclining lawn chair has helped a lot actually.

5pm April 21st shots:

Profile:

Had a bit of a problem - took a percodan at noon and at 1pm I started to barf, and kept being sick for six hours. That took the steam out of my sails, but good. No idea why, I've had percodans since then to no ill effect. Just bad luck I guess.

D+15 - Second Followup Checkup

2011-04-19T19:37:58Z

Went for my 2nd followup at Dr. Tocchio's today. He said I'm doing great, and trimmed some of the stitch knots in my mouth that were protruding a lot.   We had a discussion of my status, my healing, etc, and if I was managing to eat better.   I told him I got the Slap Chop (as seen on TV) and he laughed.

New pain meds:   since the NSAID (ketorolac) would eventually kill me if I keep taking it, and the codeine in the Tylenol-3s I had to complement them seems to affect me less and less each week, I have new white pain pills.

Demerol and Percocets.

Took a demerol around noon, and it wasn't really getting all the pain. So at 2 I took a percocet and at 2:30 it kicked in and for the last hour I have been in no pain to mention and also, I am fucking stoned.

First time in 2 weeks, no pain bothering me at all. Oh yeah.   Funny thing is I mentioned percocets to Dr. T, and he added them to my prescription when I mentioned I liked them from the time I had them for my wisdom teeth removal.

Ok, I'm gonna go lie down 15m while this buzz lasts. :D

Day+14 - Pain's back

2011-04-18T14:06:04Z

So yesterday I spent almost the entire day only on the NSAID and pseudoephedrine.   I didn't take a Tylenol-3 all day, until the evening to damp down some leftover pain.

I couldn't sleep at all after 2 am.   This morning around 7 am it got so bad I got up and took both painkillers and a PE tablet, and lay there for over an hour waiting for the pain to go away. It didn't.

I'm sitting here now and I'm staring at the clock for the 90m before I can take another Tylenol-3 and the it's 3 hours for a ketorolac NSAID pill.    I'm debating taking some of the few mL of liquid codeine I have left over.

I guess this is my nerves waking up? Or something?   Ow. :(

D+13 Update

2011-04-17T14:13:12Z

Sleeping marginally better - tried sleeping upright in a chair last night at first, then moved to bed around 4 am, and at the end of the night actually managed flat on back with head up on pillow for a bit without much discomfort. Really that will be huge when I can lie flat on my back, I'll be able to sleep properly a whole night.

Swelling seems to be mostly gone externally. I can still feel the foci over my upper canines where most of the incisions were made and I guess most of the damage done. Nose still clogs a lot but I've stopped waking up with dried blood flowing out of my nostrils. :) Still feel like my left nostril is kinked inside or something and pinched so that it has much less room inside for air versus my right. In the photo that's reversed - I think you can see my nose is not symmetric now though. That's expected since they moved my jaw forward and, I think, sideways some.

Obligatory bathroom shot, Day+13

And the profile: