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“Are You Sarah Connor?”

They say you can only judge a person’s character from the inside. And judging from these x-rays, I’m an unstoppable automated titanium-reinforced killing machine from the future (with a heart of gold).

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Week 3: Start Your Grinnin’ !

With three weeks of recovery behind me and a return to work coming in 7 short days, I’ve been on a tear to get my life back to normal as soon as possible. And this week there have been plenty of ways to spend my new found equilibrium.

Say Cheese: First, an awards ceremony at my kids’ school. Since I’m rarely available for these types of events, it was really a treat to be there! But I noticed during all the picture-taking (both kids won academic awards), my wife would tell me “smile more” when I thought I was already smiling! Turns out, the combination of numbness, hardware, and residual swelling makes my smiles seem a little less than completely sincere.

Going Camping: Next opportunity to spend some energy is camping with my son’s Cub Scout Pack in the forests near Pacific Palisades. The fresh air, tall pines and abundant sunshine really helped me forget that I couldn’t eat all that great camping food. Oh well….

Photos: I realize that I haven’t posted any reference pictures of my face in a while. I’ll blame the dizziness, the busyness, and the fact that the daily differences between these photos has diminished to imperceptible levels. So going forward, I’ll update the Mug Shots every week, rather than every day, at least until it makes sense to go monthly. That said, here’s my 3-week photos:

   

You may notice that my cheeks are starting to “hollow out”, and the swelling in my upper lip has begun to go down from previous post-surgery photos. My doctor has commented that my face looks longer since the surgery. Perhaps that has to do with a combination of the weight loss and the reduced amount of skin hanging from my neck. So far, I’m feeling good about the changes in appearance.

Pain: This week I’ve gone from a 24-hour Tylenol regimen, to an “as-needed” regimen. In fact, the last couple of days have been free from pain, and I haven’t taken any Tylenol. So, the end of the post-surgical pain management era is nigh.

Weird Sensations: I’ve had a few, mainly in my upper gums, roof of mouth, and numb areas of my face. I take this as a good sign that the nerves are regenerating, as all of these areas are numb to some extent. At this point, I don’t get very many of these sensations (maybe 1-2 week), but they are making their debut this week, and worth mentioning. The strangest thing is that I’m feeling an itch on the outside of my right nostril, but when I scratch it I’m reminded that it’s numb and impervious to scratching. This must be what Hell is like.

Energy: As I mentioned, I feel as if my energy is in the “normal range”. If I had to quantify, I’d say I’m 95% back in terms of energy.

Weight: Since losing over 12 pounds on week 1, I’ve ping-ponged between a 10-12 pound loss, which I’ve maintained through week 3. Not as much as I had hoped, but a welcome bonus to this whole process.

Mouth Stuff: I’ve spit out several stitches this week, and having checked this morning in the mirror, I can tell you that most of my sutures are gone and my wounds are healed. I think I counter 3-4 remaining sutures all together. I expect those to be gone soon. As I mentioned above, moving my lips around (i.e. smiling, talking, yawning, etc.) seem like very foreign movements. But as I exercise my muscles and jaws, all will seem more flexible soon enough, and I’ll lose the trout-pout permanently.

Food: I’m getting into a routine on the “no chew” diet. Lots of mashed potatoes, yogurt, chunky soup, Manwich sauce with finely ground hamburger, smoothies (vitamins, fish oil, calcium supplements, strawberries, and Sambazon juice), some whole wheat bread with no crust (for much-needed fiber), and bananas. One night during camping, the cooks prepared 20 punds of tri-tip steak on the grill. I couldn’t resist, so I threw a few pieces in my blender (yes, I brought it with me) and successfully ground it into yummy, swallow-worthy bits. Necessity is the mother of invention.

Next Wednesday is my 4-week follow-up. I’ll update then.

Checkup #2 – The Surgeons Are Happy!

Today was the second post-surgical follow-up appointment with Dr. Kupferman and Dr. Relle. They were both amazed when they entered the room and saw my face – they couldn’t believe it had only been two weeks since surgery, and my swelling is almost completely gone!

Dr. Kupferman checked my bite and decided that, given my demonstrated ability to heal quickly, decided to allow me to go rubber band-free during the day, and just use one rubber band in the front while sleeping. This is huge for me, because it greatly reduces the amount of time I’m spending doing oral hygiene, and allows me to talk much more clearly.

Diagnosing the Dizziness: Dr. Relle had a theory as to why I’ve been experiencing acute dizziness since last week. He suggested in an earlier email that I might have something called “Benign Paroxysmal Positional Vertigo” (BPPV).

The idea here is that small particles of calcium carbonate, which grow like stalactites in the inner-ear, break off during the rigors of surgery and float into the inner-ear canals where the sense of balance is derived. These little particles cause the dizziness when I move my head in certain ways. This apparently happened in my right ear during surgery, and began manifesting itself when I attempted to start sleeping flat (rather than elevated).

Dr. Relle performed a simple test (called the Dix-Hallpike Test), which basically has me sitting up and turning my head 45 degrees to one side, then the doctor quickly guiding me into a laying down position. While there, he watches me for specific pattern of involuntary eye movements (called nystagmus) one gets when vertigo happens. I didn’t demonstrate nystagmus when my head was turned toward the left, but when he repeated the Dix-Hallpike test with my head turned toward the right, I got dizzy a few seconds later and my eyes did the nystagmus dance!

Fortunately, there’s a very quick and easy treatment for BPPV: It’s a sequence of head/body movements called the “Epley Maneuver” which, when performed correctly, can coax the particles out of the inner-ear canals and back where they came from (to be reabsorbed into the body). Dr. Relle advised me to go home and look it up on YouTube and perform it. I did this, and the dizziness was instantly gone! Amazing! It’s possible it can recur if the particles find their way back into the vestibular canals before they are reabsorbed. If that happens, I can just perform the maneuver again. Eventually, the symptoms won’t return.

So, now my dizzy spells are gone, and my energy is returning. With that big setback behind me, I’m looking forward to continuing my quest for “normal”…

Week 2: Just Like Week 1, But Easier…

Week 2 is behind me, and it has been easier than week 1. Pain, swelling, energy, are all much improved. But, now I’m struggling with sleep and dizziness issues. Here’s the rundown on status:

Sleep: Slept upright last night, but experienced no insomnia and slept through the night. Incidentally, this was the first night without the Vicodin, just regular Tylenol.

Bruising: Bruising is almost completely gone. Just a small patch of discoloration about an inch below my collar bone at this point. I expect it will be gone by the end the week.

Swelling: Swelling of my face has diminished greatly this past week. I’ve noticed my cheekbones are starting to show, as well as the hollows of my cheeks. I can feel “lumps” of swelling around each of the cut sites on my jaw, and my upper-lip is still swollen, but my face is certainly starting to emerge (photos soon). To quantify, I’d say the swelling is 85% gone.

Pain: I’m officially off prescription drugs and managing pain with over-the-counter drugs! Pain today was very controllable, and wound up taking Tylenol “as needed” rather than once every 6 hours. Wound up with only one dose in the morning, and one before bed. Spent most of the day at 2-3 on the pain scale, and went to bed (with a fresh dose of Tylenol) at a 4. Liking how manageable the pain is getting..

Dizziness: Received a reply from Dr. Relle regarding the dizziness – he said it sounded like “Benign Positional Vertigo” and can easily be tested and treated. What I don’t know is if the treatment is curative or not. My appointment with Dr. Kupferman & Dr. Relle is Tuesday. Hopefully this can be easily (and permanently) resolved.

Energy: I feel like my energy would be a lot higher if it weren’t’ for the dizziness, which makes me want to sit and/or sleep most of the day. If I had to guess, I’d say without the dizziness, I’d be at about 80% of normal energy.

Weight: I’ve been creeping up the last couple of days, but was down today. Currently hovering between an 10-12lb loss. At this point, I usually have a smoothie for breakfast, snack on liquids through the day, and have some sort of mushy option for lunch & dinner. This regiment keeps the number of oral hygiene rituals down to a minimum.

Food: To improve upon the “Blended Chipotle” experience, I made some instant mashed potatoes today, and made them very runny on purpose. The their was that with a mush “binder”, I should be able to blend any food I wish and mix it with the mashed potatoes for a tasty meal. Tried it with the italian sausage/sweet potato/spinach hash (one of my favorite dishes) and voila! I was easily able to gobble down a blended bowl full. At this point, I can eat anything I want, as long as it can blend (which doesn’t discount too many items).

Day 13: Dealing With The Dizzy

Last night I hit the sack a little earlier to try and reverse an entire day beset by dizzy spells. I also reverted back to sleeping in a sitting-up position, to see if that would have any impact. Unfortunately, sleep didn’t come until around 3am. I did, however, manage to sleep until noon, and so I did wind up with a full night’s sleep in terms of hours.

Ran through the morning routine and tested the dizziness. Looking up & looking down are reliably causing the vertigo, which now lasts for 10-20 seconds per episode. No nassea, just 4G turns. Emailed Dr. Relle (on-call this weekend for Dr. Kupferman) about the dizzy spells. Hopefully this is a normal side effect of the surgery and will resolve itself.

Spent most of the day doing low-key stuff and trying to keep my head from moving too far up or down. I was able to manage the dizzy spells this way. Kept my jaw unbounded the entire afternoon so I could exercise the jaw more. Perhaps jaw movement would help reduce any swelling near my inner ear which could be causing the vertigo. Did lots of water, and rested.

Late in the day a great friend from New York arrived. He’s staying with us a few days while he looks for an apartment in L.A. We stayed up way too late talking, which got my morale up and my jaw sore. Felt great to get the bands on and get to bed.

Day 12: Oh, the Spinning…

Last night in my zeal for getting back to normal, I decided to try sleeping in my own bed. Until now, I’ve been bunking in the guest room to spare my wife the various head-clearing rituals that are necessary just after this surgery. I thought it would also be a good time to try and attempt sleeping horizontally again. So, around 11:30 pm, I settled in for a nice, peaceful night’s sleep.

Which finally came at about 5am. Dang!

I awoke around 8am, feeling about as crappy as you might expect after 3 hours of sleep. But, I decided not to let a minor setback like losing a good night’s sleep deter me for the day, so I resolved to get out of my bed and into my routine as quickly as possible.  Off fly the covers, my feet hit the floor, and get three steps toward the bathroom when…

Bang! My eyes roll up into my head and the room is spinning wildly out of control. Thankfully I was able to grab the edge of the bed while it was flying past and managed to break my fall. The spinning lasted for about 20-30 seconds at high velocity before it wound down and disappeared as suddenly as it came.

So, ok. I’m dizzy. Did I just get up too fast? What the heck just happened? I slowly attempted to get up again, taking care to hang on. No problem.  Slowly got through the bathroom routine. No problem. Drank some water – no problem. Bent down to throw on a pair of shorts – Bang! On the floor again, spinning wildly. At this point, I thought the lack of sleep and perhaps dehydration had gotten the best of me. I aborted the “soldier on” strategy and crawled back into bed to attempt to get more sleep. Which I did for another 4 hours or so.

Woke up later feeling better and slowly got dressed, taking care not to bend over or move too suddenly. Made it downstairs and got some food. Told Kristi about the episode. Did some quick stand up/sit down tests on the couch. All ok. Decided to run some errands, so I drove into town to buy some batteries for our cordless phones – no problems driving. Went over to Guitar Center to grab a capo and a couple of short cables. While there, I was staring up at a sweet ‘72 Telecaster Custom hanging from the top row and had another dizzy episode, confirming the theory that these spells are triggered by head position. Drove home without incident, and pretty much rested downstairs for the rest of the day. Resolved to drink a lot of water, ice up my jaw (to reduce any swelling which might be impacting my inner ear),  and get to bed early…

Hello setback. I should have known you’d be visiting soon…

Day 11: Losing My Prescription

Last night was my final time sleeping in the guest room. Slept through the night and woke up fairly refreshed, so I’ve decided to sleep in my own bedroom tonight.

The big milestone for today is to get myself off Vicodin, at least during the daylight hours. Switched to regular Tylenol (1000 mg) every 6 hours during the day, and a dose of the Vicodin at night before bed. If it turns out I can manage the pain well enough with the Tylenol for a couple of days, I’ll drop the Vicodin altogether.

I spent the day very low key, just in anticipation of more pain. Watched a few episodes of “Up All Night”, as I am preparing to write a spec script for that show for my portfolio. Did some blog updates, and practiced guitar.

Although lazy, it was a good day from a pain management perspective. Pain never got beyond a 3, until it was time for bed. Took Vicodin anyway, to ensure I get a good night’s sleep. I’ll be off the narcotic train soon enough.