Survived the Holidays, and that One Big Detail (12.31.15)

Today is four weeks and one day since my surgery, and I can safely say we survived the holidays thanks in large part to Amy's planning that reduced the amount of activity in any given day by spreading it out.  In the end, we didn't get to do everything we wanted to do, but given how a shower wiped me out for several hours just the day before it all began, we were able to do a lot more than we had planned.  I was also very good at effectively timing my exercises and 30-minute talking windows to get the most out of them.

We returned to Santa Barbara three days ago and saw Dr. Gunson for the four-week post op appointment two days ago. Things are continuing to go well.  I told them how I'm beginning to feel my upper jaw more and that, starting a few days ago, I could tell it would collapse or expand slightly depending on what I was doing (e.g., swallowing).  I simply could not feel this before due to nerve damage, and I now understand why Dr. Gunson does not allow me to drink through straws, blow my nose, or talk much during the day.  Kim, one of Dr. Gunson's staff, reassured me that this is normal and that the most trouble they have in this area (e.g., for relapse) is with patients that smash food against the top of their mouth when eating (another reason for a pure blended diet). Kim also said that the fact I can begin to feel all these things is a very good sign and that these feelings will only get stronger with time.  

It's amazing how much food is shown on TV and how big a part of our lives food is.  Of course this makes sense... but it's taken for granted until it's no longer available.  Although I blended anything and everything I wanted during the holidays, it also surprised me how difficult it was to watch a simple plate of bread/rolls pass by and not be able to grab one and take a bite.  Kim said the desire to eat real food will only get stronger too.  

During the appointment, Dr. Gunson made some more adjustments to my cheeks and now, two days later, I'm swollen again.  Same thing happened last week, and it's nothing like what happened after surgery, but it is still uncomfortable.  I also came down with a minor bug (sneezing, runny nose, hurts to swallow) which isn't helping, but benadryl helps a lot.  

One other piece of good news: every time we see Dr. Gunson, he often wonders aloud if he should change my dental wire in my upper jaw.  I thought making the change was a sign of progress and the lack of the making a change was a sign of non-progress, but he clarified two days ago that the less he has to do, the better it means for my recovery.  

About a week ago, I started feeling (fairly frequently) itches in my chin, but I can't scratch them because my chin is still completely numb!  My lower front hook has also become more painful when I put the elastics back in.  Additionally, I can also feel how tight the medium-strength elastics really are.  Kim says all of these issues are good signs for nerve recovery and that they are all likely to get stronger as I recover further.  The lesson?  If you have major jaw surgery and are lucky, your nerves will recovery quickly... and then you'll feel all the pain (and other not-so-fun things) that you haven't been feeling before they started recovering.  Yay for recovery?

To try and bring back a small sense of normalcy to life, last night I washed all the dishes from two meals (lunch, dinner prep, dinner post-consumption) on my own for the first time in a month.  By the end, I was completely done with activity.  Today, I took a shower, went for a 0.75-mile, slow walk around the neighborhood, and wrote this blog post.  It's been a very big day and now I'm tired and have a headache.  I had some other, small things I wanted to get done today (like finally put away the small number of clothes that I haven't yet put away from our holiday trip) and I'm not sure if they are going to get done.  It always surprises me how I can sit around and do nothing and feel like I can get up and do a lot of things, but that when I do get up, I can't actually do very much at all.  

Now, about that little-big detail not previously mentioned:

During the surgery, one of my nerves in my lower left jaw was severed.  Out of respect to me and my privacy, Amy didn't want to post this little-big detail on her own - she wanted me to do it, if I chose to do so.  Going into surgery, I knew this was a risk, but I also expected this to be a relatively low risk because my nerves in my lower jaw are lower than most people's nerves (which is good for this type of surgery).  

The night of the surgery, Amy and my mother said that everything went well and that the part that was expected to be the most difficult - trying to find solid bone - actually turned out extremely well.  This was a huge relief.  The next morning, when Dr. Gunson came by to check on me, he told me everything that happened during surgery as it happened.  I was surprised and terrified when he told me that my nerve had been severed.  Immediately my mind was flooded with thoughts of "Oh my God, what have I done?" "What does this mean for long-term recovery?" "Did Amy and my mother know about this?" and "Why is this a surprise? Oh, right - because so far everyone has told me that everything went well!"  

Fortunately, Dr. Gunson has an amazing presence and leads by example.  He waited, calmly, as I processed what he had just said.  Noticing that he wasn't freaking out helped calm me tremendously. Once I was ready to hear more, he explained all this means, in the worst-case scenario, is that I would not have sensation in a very small portion of the left side of my chin, but I would still be able to control my muscles (so not quite like a stroke victim).  Hearing this, too, was a huge relief. Going into surgery, I knew this kind of outcome was a possibility and I had already accepted that it might be a price that I may have to pay for a lifetime of being able to sleep, and it is a trade-off I chose to make (and still would if I could do it over again).  

Dr. Gunson went on to explain that he investigated what happened. Based on what he saw (the nerve was not severed near one of his cuts), it wasn't his cutting that severed directly by his actions but rather indirectly.  Namely, he cut and fractured the left side of my lower jaw first and the nerve was fine, and it was severed when he fractured the right side of my jaw.  Dr. Gunson then said that severing a nerve in this way (i.e., when fracturing the opposite side of the jaw) has only happened twice before in his entire 15-year career.  That's not really a consolation, but it does reinforce my belief that I am "special" in some really unfortunate ways.  (In a future post, I can comment on how incredibly unique my whole facial structure is - one out of several million at a maximum.  If only I could be this "lucky" in Vegas or the lottery!)

Finally, Dr. Gunson also explained that he did everything he could to give my nerve the best chance for a full recovery.  Namely, he pulled the nerve across the 17 mm gap he created during the surgery and cleaned up the nerve canal. Unfortunately, he wasn't able to connect the two ends or tie them together as it would have required pulling on and further damaging the nerve elsewhere. A good family friend of ours has told me that she's had two of her nerves severed during previous surgeries (not jaw surgery, though) and in both instances they eventually came back to 100% (though it did take a very long time).  While that is comforting, there is a difference between simply severing a nerve and creating a gap between the two nerve ends.  

Dr. Gunson said that, in these instances, only one in five of his patients have recovered to 100% of normal sensation.  While this is not the reassurance I wanted, and I do not yet have any sensation in that portion of my chin, the other sensation/recovery that I have had to date is pretty far ahead of average and a good sign for recovery overall, so I'm trying to stay hopeful.  I'd really like to have enough sensation to at least know if I have food on my face in that spot, but at this point, only time will tell.  Wish me luck!

Happy New Years (almost!)

Those of us on the west coast will be celebrating the new year in just over nine hours, though I'm not sure I'll be joining. I'm not going to push it, and for most of my recovery, I've felt tired by 9pm and very achy and extremely ready for bed by 10pm if I'm not in bed by that time.  Then again, it's also generally taken me two+ hours to get to sleep, so perhaps I'll go to bed at ten tonight and then ring a bell (since I can't cheer) for a few seconds at midnight just before I nod off to sleep.  

I hope this year is a good year for all!  Happy New Year!

The Ebb and Flow of Recovery: An Update from Chris! (12.23.15)

Hello world!  It’s good to be “back,” although I think I’m exaggerating a bit in that statement; as I learned in the last few days, they’re right when they say “setbacks happen” and now I have a much better understanding of what that means.  I also have new insights into why so many people say that this surgery is the hardest thing they’ve ever done.  I had thought (hoped, really) that by now I’d already come to understand all the ways this statement could be true, but apparently I was fooling myself.  I’ll be glad when I don’t have to learn any new “’lessons’ on this topic.

Today is Wednesday, December 23, 2015. It’s currently 7:20pm.  At this time three weeks ago, I had been in the recovery room for two hours.  I am currently sitting behind Amy as she drives us (and our dog) to my mother’s home in southwest Los Angeles County, about two hours away with current traffic.  This may be a long post, since I’m still not allowed to talk much with my elastics on and I really don’t want to fall asleep and screw up my circadian clock. More on that later. 

Before I say anything more, I must give a huge THANK YOU to everyone who has sent their best wishes and to all of our friends and family that have directly lent their support – Eric and Bill, who made the recliner disappear in a snap and were gone before I could even finish my morning round of meds to get outside and thank them; Mary and Jim who came up and, like Mary Poppins, had so many projects (that neither Amy nor I were physically capable of doing in our current conditions) completed in a snap; my mother, who has devoted over two full weeks to my care and left her life at home on hold despite everything going on during the holiday season and made this surgery possible; my brother, who made sure our mother’s house was not destroyed in her absence by her circus of animals; and most of all, my wife Amy, who has proven she has the patience of a saint and has shown me a level of love that is rivaled only by God him- (or her-) self.  Despite being 33 weeks pregnant (as of today), she has continued to be my rock, can understand me and get (or provide through her support) me what I need when I can’t even say it out loud.  She has been there, day and night, through everything.  No words can express my love and gratitude for Amy and what she has given to me, not just in the past three weeks but also in the past several months leading up to the surgery, with my schedule filled with long days at work, one doctor’s visit after another, obligations as a volunteer member of the Board of Directors of the Desert Tortoise Council, among other things.  I have to stop this line of thought now, as the love and gratitude I feel is overwhelming.

I knew Amy was writing a blog to keep everyone updated, and I finally had the energy to read through it today.  I think you’d agree with me that she’s done a marvelous job!  In this post, I’m going to jump between different subjects to provide my perspective and fill in some gaps (and there’s a big one that I’ll share in a future post that Amy chose to leave out so that I could address it – I’m not exactly sure why, but I’m not going to second-guess her decisions like a Monday Morning Quarterback while I was largely out of it for three weeks!).


Update on the Past Few Days.  As you can see from Amy’s recent posts, I had been doing pretty well.  While I initially ditched the recliner around the week 2 point, I went back to it after just five nights.  I found it was just too tempting to sleep on my side (which I’ve been doing exclusively for the past four years) when sleeping in a normal bed, and I find I still can’t sleep flat on my back (it’s not doctor’s orders, I just can’t). I hope this odd phenomenon will change soon.  More on that later, in a future post.  For now, I’ll just share that it turns out the recliner was the best option for me and I actually (generally) sleep a lot better while in it, though it still took me about 1.5-2 hours to fall asleep each night.  I’m not sure what I’ll be sleeping on during our holiday vacation (but most likely it will be a bed) – wish me luck that it goes well!

So, I was doing a lot better up until about ~40 hours ago, when I should have fallen asleep after lying in the recliner for two hours.  I’m not sure what exactly was going on, but I was at least “80% wide awake” until about 4AM.  Maybe my brain was wired from trying to deal with insurance issues earlier that day (more on insurance in a future post).  Maybe it was wired because I took 1.5 teaspoons of tramadol just before going to bed.  I thought Tramadol was supposed to make me sleepy, but I hadn’t taken more than a teaspoon per day (and that during the middle of the day) for the past several days.  Maybe I was just not comfortable because my jaw had been broken in six places less than three weeks earlier and I had a bad night.

Around 4, I finally fell asleep, but only very lightly.  At 4:45, our dog woke me up.  He had been in a 90-minute repeating cycle all night long.  He’d sleep peacefully for about 15-20 minutes (25 if I was lucky), after which his breathing would get heavier and heavier.  Over the course of the next 45 minutes, he would make all the apnea-like sounds (e.g.., heavily strained breathing, snorting, not breathing for a few seconds…) that I would make if I tried sleeping on my back before the surgery.  For those of you that don’t know us, neither our dog nor I am overweight – our apnea is due entirely to other reasons.  After those 45 minutes, our dog would then spend 20-30 licking himself. In a very quiet room, when you happen to be super-sensitive to noise (at that moment, I’m not normally so), it’s torture.  I got up at least four times to get him to stop whatever he was doing.  I don’t think I got more than 15-20 minutes of very light sleep at a time between 5am and 8am.  I then got about 40 minutes of decent sleep before I had to get up to get to an acupuncture appointment at 9:30am.  So I figure I got about 2-3 hours of light sleep that night.

To my surprise, I actually felt pretty good during most of the following day.  During the appointment with Dr. Gunson, at one point, he asked me to stand up at my own speed, after I was ready and was not feeling dizzy.  I hadn’t had that sensation for so long that I frankly thought it was odd and chalked it up to either him being over-cautious (which he naturally is, which is another reason why we like him so much) or that this is just his standard protocol regardless of who the patient is and how he or she is doing.

During the appointment, Dr. Gunson also measured my ability to open my mouth at about 20 mm – the same as the first reading I had approximately two weeks earlier, and this time I’d had the benefit of being able to do a week of exercises.  While I’d like to see more progress, I recognize Dr. Gunson put me in some very, very tight elastics for the 24 hours following that first measurement.  At first they didn’t bother me much – my teeth just stayed very, very shut.  After a few hours, however, I began to feel all the muscles in my face tighten up, and by the time he took them off the next day, my ability to open my mouth was drastically reduced.  He let me stretch for about half an hour, during which time Amy said it looked like I got it back to about the same 20mm opening as the day before, but no official measurement was taken and I remained skeptical.  I also then spent another week with the elastics in (thankfully not as tight) before I was allowed to do the exercises.  My point is, elastics protect the bite and prevent relapse (i.e., bones moving to where they shouldn’t be) but cause a secondary evil (tightening of the muscles).  Also, while they are kind about it, neither Dr. Gunson nor his staff have much sympathy for my perceived lack of progress since most patients at this time only have a 7-10 mm opening.  Also, progress is just going to be very slow.  If I’m lucky (and work very hard, which frankly is very difficult to do, both physically and mentally), I can increase the opening by a paltry one to two millimeters per week.

Dr. Gunson also adjusted the cheek augmentation during the appointment. He confirmed that I hadn’t done anything to flatten or modify them in any way (always a concern of mine since I have to sleep with my head somewhat to the side, and I often wake up with at least a portion of my cheek resting softly on part of a very soft pillow).  His office staff person let us know that this can cause more swelling in the following 1-2 days.  More on this below.
After the appointment, we returned home and I expected to fall asleep from exhaustion, but I didn’t. At best I was a bit groggy, but I was definitely ready for bed by 9 and we had the lights out at 9:45.  I fell asleep within 15-20 minutes (hooray!) and generally slept deeply.  At one point in the middle of the night, I woke up drenched from a night sweat.  Those happen to me occasionally, but usually only at the end of a flu or cold and I know, after that time, I’ll feel a lot better.  I have no explanation for this night sweat (nothing about the temperature or the blankets, etc. had changed, and I hadn’t felt sick).  Not only that, but I was also extremely groggy and didn’t feel much better.  After waiting 15-20 minutes hoping I could just ignore it and fall back asleep, I realized I wouldn’t be able to do that. I didn’t have the energy to get up and change, so I just took off my bathrobe (which I’ve frequently slept in as I often get up at least once or twice a night and I don’t want to get cold when I do so – any feelings of cold, hungry, or tired are multiplied by 10 when recovering from this surgery). Fortunately that was enough to let me get back to sleep.

Except for that one episode, to my surprise, I slept soundly until 5:45am.  At that time I woke up feeling fairly well, I just had a craving for something warm to drink.  By 6am, it was still very dark and I didn’t want to wake Amy, but the need to drink something warm became too strong to try and ignore further. So up I went, and from our kitchen window, I could see the faintest hints of dawn.  I was only somewhat tired but otherwise felt good, and I began getting a hint of what it would be like to get 8 nearly solid hours of sleep from 10pm to 6am and how amazing that must feel.  Knowing I needed more sleep given what happened the previous night (and I’m still recovering!) I went back to bed.

Around 9:30, I woke up very, very groggy but I couldn’t get back to sleep – apparently I was finally done.  By 9:45-10, I joined Amy in the living room.  I drank my breakfast and took off my elastics to do my exercises.  By 10:30, I had been unable to shake the feeling of being cold despite turning up the heat several times and crawling under blankets, so I took a shower.  (Backstory: Dr. Gunson’s office staff cleared me to take a shower about one week earlier, which is so much better than a bath because I would always get cold during the bath no matter what I did.  Dr. Gunson’s standard paperwork advises taking only short, warm [but not hot] showers for a long time after the surgery, once you are cleared to take a shower.)  Since nobody had recently mentioned the “don’t take long, hot showers” thing in a while, I thought I could disregard this advice, and I could not have been more wrong.  I stood in the shower for 5-10 minutes just enjoying the feeling of warmth all around me.  I then started actually getting myself clean, but by the time I’d finished just washing my hair (doesn’t take long), I began getting dizzy.  I immediately started making the water cooler, but apparently not fast enough.  Within another minute, I had no choice but to sit down (Dr. Gunson’s office is very clear – if you’re dizzy, you MUST sit down!).  With the (cooler) water hitting my back, I sat on the tub floor for several minutes, light-headed, trying to catch my breath.  After I thought it might be safe to stand, I stood up, only to immediately become dizzy again and go back to sitting.  I must have waited another 5-10 minutes before I was actually strong enough to stand up slowly. I decided my shower was done even though it wasn’t complete and began to dry off. By the time I was dry, my breathing was under control and I felt better but I was cold, again.  So I decided to get back into the shower, at a mildly warm temperature, and finish getting clean as quickly as I could.  Within a few minutes I was drying off again, but utterly exhausted.  I moved to our bed and called Amy to ask for her help getting my clothes so I could get dressed before I got cold.  She did so with such amazing love, patience and support, and I was so tired, that it overwhelmed me.  (I’ve also learned in the last few days that the combination of anesthesia and major surgery can change one’s personality and can make people far more emotional – more on that in another post).

After getting dressed, I laid in bed for a long time trying to regain my strength.  The timer to tell me to brush my teeth and put my elastics back on went off while I was still in the shower, but I couldn’t get up for a very long time without getting dizzy.

While waiting to regain my strength, Amy’s family (two sisters, their husbands, their two newborn babies, and Amy’s parents who recently became grandparents with the birth of these two girls) got together and Face-Timed us to include us.  I was very happy to see everyone, but the thought that we’re not there enjoying this very special time with them now solely because I had this surgery crossed my mind and was very hard to take.  Seeing them all together, seeing the joy in the baby’s face whenever anyone said just about anything to her, seeing my other niece as a newborn, and wanting to be there and be a part of it was so overwhelming at times that I had to signal off-camera to Amy to take me out of their view so that I didn’t cause a scene, and at one point I had to ask Amy to leave the room entirely before I broke down completely. 

By the way, exercises and facial movement have been a lot harder today.  I can’t visually pinpoint the swelling caused by Dr. Gunson adjusting the cheek augmentation yesterday, but I can definitely feel its effects.  I have more pain and a whole lot more general discomfort in my mouth and the bottom half of my face.  Throughout this process, I’ve gained a much deeper appreciation for the problems that swelling can cause.  I’m used to ankles and wrists swelling after some kind of injury, and I’m used the pain that the injury can cause, but that would go away relatively quickly after immobilizing it.  Unfortunately, it’s just not possible to immobilize the muscles in your face, especially when you have to do exercises three times a day.  And this kind of swelling is like nothing I’ve felt before – it actually causes pain, and facial swelling can be extremely uncomfortable.  I cannot find words to describe this phenomenon appropriately.


In conclusion, I learned today what they mean by “setbacks happen” (and it’s pretty literal – you go back to how you were before, not being able to care for yourself) and one more aspect of what people mean when they say “this is the hardest thing I’ve ever done.”  (I’ll discuss other aspects, and why some of them were a surprise to me, in a future post).  If I could do it again, I wouldn’t have a choice – I had to have this surgery done when we did.  But that doesn’t make losing out on this very special time with my family any easier.


FYI, in future posts, I’d like to provide a synopsis of my perspective of my recovery timeline (with photos) as well as a discussion of surprises (both pleasant and otherwise) and other observations I’ve made. While we’ll continue to post updates on my progress, the focus of these particular future posts will be to provide one more perspective of how recovery can go after undergoing such a major surgery so that anyone else thinking about having the surgery done that stumbles on this blog may benefit.  I know how much my family and I benefited from other people’s blogs before the surgery (and still do).


We just arrived a little after 9pm at my mother’s home.  Time for this long post to end and for Christmas to really begin!

What Tastes Good Blended (12.21.15)

Just thought I'd check in and give a quick update.  Chris continues to do well.  His exercises get easier the more that he practices them.  The morning session is always the hardest (because it's the been the longest since he's done the exercises and his muscles get tight), but it gets easier as the day progresses.  We had some friends in town visiting yesterday and he was up for about 5 hours of socializing - yay!  He was able to do two exercise sessions during that time, so he was able to talk freely for 30 minutes each time, which was great practice.  We were all laughing and sharing, but poor Chris - it's hard for him to smile and laugh and sometimes it's too much.  A highlight was when he got out my laptop and tried to get Microsoft Word to narrate his text (ala Stephen Hawking).  He could get the narrator to voice basically everything except for his text - it was awesome.  We would hear the laptop say "question mark" and then "period" but none of the text before it.  Silly technology!

Chris continues to experiment with different food choices.  I know he is hungry because he's always commenting on the food he sees during commercials.  He also weighed himself for the first time since surgery and he lost about 15 pounds.  Here is a summary of the food he's tried to blend so far:

• Tom ka coconut soup - he's had this a few times - a definite winner!
• Pad thai with chicken - he finished it, so I think it was pretty good.
• Slice of spinach and cheese pizza - he said it basically tasted like milk-flavored pizza.  It was just OK.
• Chocolate chip cookie and milk - he really wanted a cookie!  He looked at his glass after the cookie was blended and told me, "this isn't a cookie" :(  I still think he enjoyed it though.
• Potstickers - I'm not a fan, blended or not, but Chris seemed to like it.
• Veggie chili - He made a big pot of veggie chili in our crock pot and ate it for a few nights in a row.  He seemed to like it and all the spices.
• Potato soup - He liked it (this is a recipe we have even had before his jaw surgery) but had to water it down because it was too viscous.

We are going to try some ground beef and veggies in the crock pot today - we'll see how it turns out!

Day 15 (12.17.15)

I can't believe that it's been over two weeks since Chris's surgery.  We spent years waiting for it to happen that it still feels surreal that the surgery chapter has opened and closed.  We are fully into the routine of recovery mode now.  Chris had another appointment yesterday to take an x-ray at the doctor's office.  It was a quick appointment and we will review the results next Tuesday when we go in for his weekly check up.

Chris has spent a lot of time going to doctor's appointments since his surgery that today feels like a nice break because he has no appointments scheduled.  His day consists of doing exercises three times a day (he also gets to practice talking and brushing his teeth - woo!), continuing pain meds as needed (though he has needed them significantly less this week), drinking blended food until he is content, watching TV shows, taking naps as needed (the exercises make him really tired because they're hard work!), and researching new fun foods to eat.  He also has to deal with short-term disability paperwork (bah - no fun!) and insurance (also no fun) - a never-ending battle.

He's no longer sleeping in a recliner but rather in a bed lying all the way down.  I think he prefers this because being propped up at an angle caused him to feel pressure and pain on his upper jaw.  He would relax his lower jaw and then the elastics would pull down on his upper jaw and it would be hard to get comfortable and sleep through the pain.  I know he wishes he could also sleep on his side but that won't be an option until many more weeks have passed and his bone grafts and cheek augmentation have healed.

We're beginning to look forward to the holidays!  We're optimistic that Chris will be up for a trip to LA/Orange County for Christmas.  We are going to play everything by ear and just take it day by day, but things look promising.  The keys for successful travel will be to make sure that we bring our fancy blender (!!) and don't let him overdo it.  We will probably only have short outings to visit family and friends and we'll also limit the number of outings per day so that he doesn't get over tired.  Naps will be his best friend. :)  I'm looking forward to enjoying a long holiday weekend and then coming back to Santa Barbara for the new year.

BLENDED FOOD DAY! (12.15.15)

Well, he made it!  Today is the big day when he can officially drink blended food.  He's already requested pad thai in the blender, so that's what we're going to try.  Will it taste good?  Who knows!? But he's excited. :)

We had another productive visit at the Dr.'s office today.  He got to take his elastics off and practice three exercises.  He will be doing these exercises three times a day for 15 minutes each time.  He has to practice opening and closing his mouth, moving his jaw side to side (Kim said that this is the last motion to be relearned), and pushing his lower jaw forward.  The hope is that each week he will see an increase in motion of 1 to 2 mm, so the progress will be slow.  I think the exercises are painful and really hard work, so I'm hoping that this gets easier the more he practices.

He also got to brush his teeth today!  He said that this was a bit painful but that ultimately it felt really good when it was all done.  I can only imagine after not being able to brush his teeth for 2 weeks what it must have felt like today.  He also learned how to take his elastics on and off, which will be necessary for his exercises each day.  He's also allowed to talk for communication purposes only; he's still not allowed to carry on a long conversation so they want him to be conservative with his talking.

The good news is that everything looks good with his left joint; it seems to have settled down and in the right place.  Dr. G. said it's too early to know for sure how his bite is because he's still too swollen.  He will start doing more detailed evaluations in the next week or two.  Chris also has a lot of numbness in his mouth so anything that Chris is feeling is likely not representative of reality because of the patchiness of sensations he's feeling.

All in all, a good day!

It Gets Better Each Day (12.12.15)

I'm writing from the waiting room at the acupuncture office.  Chris felt a lot of relief after Thursday's appointment, so we signed up for another treatment.  He uses acupuncture needles and traditional Chinese medicine, such as glass bottles that stick on his skin through heat/cold suction and draw blood into his back to aid healing.  He looked like a cheetah after his last appointment with all his spots, but it did loosen his muscles and make him more comfortable, so at least he's a happy cheetah. :)

Yesterday was a great day!  It was the first day that Chris didn't need a nap.  We cooked some bone broth in our crock pot using raw bones from Whole Foods.  I think he enjoyed it, and know that it is very healthy and will provide a lot of essential nutrients for recovery.  We enjoyed some TV shows (my parents beat us again in Jeopardy!) and the weird windy/rainy weather in Santa Barbara.

My parents were very helpful and put together a bookcase for the nursery and our stroller/car seat.  It's exciting to see everything come together.  I played Dad in chess and was so close to beating him, but alas he was victorious.  It was a close game!  They headed out last night to return home, so Chris and I are enjoying a quiet weekend at home.  I definitely couldn't have taken care of everything last weekend by myself because Chris needed so much support, so it's been nice to get to the point where Chris can do a lot of things for himself and become more independent.  Just another sign that progress is being made and that we're one step closer in his recovery journey.

It Takes A Village (12.10.15)

Today I am grateful for all the support we have received from family and friends during Chris's jaw surgery recovery, especially since I am 31 weeks pregnant and limited in what I can do.  Sarah, Chris's mom, has been very helpful with taking care of Chris, running errands, walking our dog, scooping out the kitty litter (being pregnant, I'm not allowed to do this), cleaning/doing laundry, and enjoying conversations and company.

Today, we had the task of putting the electric recliner that Chris is no longer using to sleep back in Sarah's van.  We all looked at each other and thought, "how are we going to do this?".  Thankfully our friends Bill and Eric were kind enough to come over this morning and help us load it into the van.  They took the time out of their day to make our lives so much easier, and we are very grateful for that.

My parents drove up and arrived around 2:30 today.  This allowed Sarah to drive back home and check in on things and get a little break (but she'll be back!).  They ran grocery errands, picked up dinner, helped me take the trash/recycling out, filled up Oliver's dog food container with a new 40 lb. bag, and kept Chris and me company (and totally creamed us in Jeopardy!).  Plus, they played "fake fetch" with Oliver, which is when two people stand on either sides of the house with a tennis ball in their hands.  You don't throw the ball, but pretend to do so, and our super-intelligent dog (ha!) runs back and forth, thinking that the ball has been thrown.  He loves it so much and gets to burn up some energy (plus, it's a lot faster than waiting for him to drop the ball each time you throw it).  Too much fun.

Chris's progress continues each day.  He had another doctor's appointment and then had an appointment with an acupuncturist, per the jaw surgeon's staff recommendation.  It provided a lot of relief to his neck and upper back which have been in crisis mode ever since the 8.5 hour surgery and trying to protect his new jaw.  Chris was awake for most of the day, with only a short nap this afternoon.   He had some potato soup, chicken broth, milk, and lots of fluids today.  We got some raw beef bone so we hope to make our own beef broth tomorrow as a special treat.

We're looking forward to Tuesday - he'll be able to drink a blended food diet, brush his teeth, and perform exercises each day to loosen his muscles without the elastics on.  Until then, we'll maintain the status quo.

Good Day (12.9.15)

I think we have officially hit the turning point in Chris's recovery.  He stayed awake for most of the day, watching TV shows, taking a bath, going to his doctor's appointment, and drinking lots of fluids.  He had us laughing at the doctor's office when he was allowed to have his bands off for 20 minutes or so by trying to sing "Mares eat oats".  We've learned that, when he can talk, he should focus on speaking slowly and clearly, over-enunciating each syllable.  This will help retrain his muscles to speak correctly.  They also measured his ability to open his mouth and he is at 20 mm.  The average for 7 days post-surgery is 7 mm, so he is doing ridiculously well.

For now, they asked that Chris not talk as his left joint is a bit swollen and not exactly in the correct place.  The doctor put tight elastics on his jaw, which could become loose if he talks.  The hope is that the tight elastics will help with the joint healing.

He's feeling more muscle spasms in his face as his muscles begin to come back to life.  Not fun, but a good sign of healing.  He's walking more on his own and was even able to walk up to the doctor's office without a wheel chair today.

All in all, a good day!  

Ups and Downs (12.8.15)

Today started off with some challenges but ended on a really good note.  There are lots of ups and downs through this process; I never know exactly what to expect.  Chris was clearly in pain and uncomfortable this morning, even though his swelling has started to subside, saying that he was dizzy whenever he moved and just wanted to sleep because that's when he felt the best.  We encouraged him to get his pain medicine and antibiotic down, as well as some fluids (he's still drinking a lot!), and then let him sleep.  He didn't feel up to a bath and wanted to save his energy for his afternoon doctor's appointment.  He slept most of the morning and early afternoon until I woke him up around 2:30 for his 3:30 appointment.

We get relief and good news every time we visit the surgeon and his staff.  They did some more cleaning in Chris's mouth/nose and answered our questions.  They're always full of ideas for increasing Chris's comfort and happiness, which we really appreciate.  Dr. Gunson let Chris open his mouth for the first time since surgery when he removed the elastics off his teeth.  They wanted Chris to practice opening and shutting his mouth so that he could relieve tension in his facial muscles.  He also took the opportunity to down some hot (well, more like warm) chocolate without any elastics because he was hungry.  We learned that increasing his movement will help relieve his headaches and also his dizziness (though that may be related to lack of calories too).  We walked away with our homework assignment and had new things to try at home.

We gave him new allergy medicine that might help to relieve his nasal congestion.  I heated up a warmer with rice in it in the microwave and put it on his shoulders and gave him a massage.  He was in heaven!  We had him move his head more and do some stretches.  For dinner, he requested strained tom ka soup from one of our favorite thai restaurants and he said that it actually did a good job of filling him up.  With a full tummy and less tense shoulders/neck, his spirit shone through again.  He watched a TV show with us this evening and watched me open various packages we had received from friends.  It was a very positive evening!

We'll see what tomorrow brings... another doctor's appointment, hopefully less swelling, and more progress.

Much Better Day (12.7.15)

Thank you all for your support and prayers.  Today was a much better day than yesterday, and I truly believe we can feel your positive thoughts giving us energy to get through.

I had a restless night, getting up with Chris at 1:30 and 5:30 and getting patchy sleep in between.  I was really starting to worry about him after yesterday's scary episode.  We are still balancing his comfort with liquids, medicine, and heartburn.  Thankfully we were able to go to the surgeon's office today.  It was very positive and reassuring to hear that all of Chris's symptoms are normal, expected, and right on track.  They said he is at the top of Mount Everest, shouldn't get discouraged, and know that he is about to feel a lot better soon.  Dr. Gunson had to use bone morphogenic protein (BMP) during the surgery to accelerate bone healing in his upper jaw because it was so thin.  However, one of the side effects is that it enhances the swelling.  They have seen patients who haven't been able to open their eyes because the swelling was so big.  They said Chris may not want to hear it or believe it, but they have seen other patients with even worse swelling, so in some ways, we're lucky.

They were able to suction out his mouth and nose (gross, right?) but it greatly helped him be able to breathe again.  They approved him taking his prescription heartburn medicine, which should help his tummy be happy again.  He also can drink animal milk, which will be a pleasant change compared to all the sugary drinks that he has been drinking (and they have been causing heartburn).  When we got him home, you could see the change on his face.  He was much more relaxed and he even wrote down that he felt much better.

Chris is resting now.  We're hopeful that he'll start to gain his energy back after the sleep, ease of breathing, and more liquids/sustenance.  We go back to the doctor's office for another check-up tomorrow.

Hard, Hard Day (12.6.15)

Today has been by far the hardest day for Chris (and us).  His swelling increased quite a bit this morning, to the point where even the skin under his eyes is swollen.  The pressure is so intense that his ears are hurting.  His nasal congestion also blocked his ability to breathe through his nose so he had no choice but to breathe through his mouth.  I came home from church around 11:30 and he was having an anxiety attack because he literally couldn't breathe.  His heart was racing, his body was somewhat shaking, and he was very, very upset.  We were debating whether to take him to the ER because it was so bad.  We reached out to his doctor/nurse for advice on what to do and there was a time where each minute felt like an eternity as we tried to figure out what to do.  His lips are so swollen that it made breathing through his mouth very difficult, if not impossible.  Eventually we were able to cut a syringe in half so that we could put it through his swollen lips and he could breathe, as if through a snorkel.  That was a game changer.  He also was prescribed some anti-anxiety medicine because anxiety constricts the throat and makes breathing even harder.  It has helped Chris relax and get through today.  I am so relieved that it's the end of the day and we got through it.  Chris is currently in the recliner with his eyes closed, successfully breathing.  To say he's comfortable is inaccurate, but he's coping.  This is progress from earlier today.

We're nervous about what tomorrow has in store (please oh please don't let the swelling increase any more).  I knew to anticipate up-and-downs, so I have to remind myself that this is temporary and that even though today was really rough, it will get better.

One Day at a Time (12.5.15)

Chris continues to hang in there through the worst of the recovery.  We were told in advance that the first seven days are the hardest and it is somewhat similar to getting knocked out by a really bad flu.  It's hard to see Chris uncomfortable and in pain, but he's such a trooper and he's getting through it.  His spirit shines through in moments when he makes a point that he wants to pet the dog (which Oliver LOVES) or sit outdoors for a moment to enjoy some fresh air.  He's also made a few jokes here and there, which keeps us all smiling.

The swelling continues to build each day.  Chris wrote down that it feels like his lips are going to burst.  Unfortunately there isn't much we can do for the swelling and it's just par for the course.  It is anticipated that his swelling will peak and then will start to go down.  We are all looking forward to seeing some improvement, hopefully starting on Tuesday or Wednesday.  Until then, we have to have patience.

He continues to nap and rest as much as possible when he's not taking medicine or drinking fluids.  He's averaging over 100 ounces a day; I'm so proud - this should hopefully help rid his body of the strong medicines from the hospital and help with healing. 

Chris mentioned he had some heartburn this morning so we gave him some alkalizing phresh greens powder (which he used before surgery) to settle his stomach.  We also found the liquid arnica that we had ordered on amazon (which they surprisingly packaged in the same box as the large humidifer box, so I didn't see it originally - oops!) and gave him some drops.  Liquid arnica is a natural supplement that helps with swelling, so we thought it wouldn't hurt to give it a try (we ran it by the doctor first).  Fingers crossed that he gets even the slightest bit of relief.

I continue to read him the emails and messages from families and friends.  We all really appreciate it.

He's Home! (12.4.15)

Less than 24 hours after the completion of his 8.5 hour surgery, Chris is home.  I think we all felt a sigh of relief when we were able to get him comfortable and relaxed at home yesterday afternoon (he got home around 3 PM).  Sarah and I have become organized drill sergeants trying to make sure that he completes all that he needs to get done.  Here are some examples of what he has to do:

• Pain medicine every 4 hours.  This is a top priority because we want to keep his pain under control and not let it get past the uncomfortable threshold.  This meant waking up at 2:30 and 6:30 in the morning to stay on schedule.
• Drinking at least 3 quarts (96 oz.) of liquid a day.  The nurse recommended sipping all day but Chris is a rock star and has been able to drink 8-10 ounces in one go without complaint.  I was concerned about his ability to swallow, but this is not an issue!
• Antibiotic, 3 times per day.
• Congestion relief: this includes an Afrin nasal spray, sudafed up to every 6 hours (as needed), using a suction bulb (good practice for our baby!), children's liquid benadryl at night, vick's vapor rub, and saline nasal sprays at least three times a day.  He had more congestion last night but the Afrin spray really helped him.
• 10 deep breaths each hour to prevent pneumonia.
• Walking (very short walks around the house) multiple times a day.
• Continuing to use blistex on his lips and ointments on his brow stitch and nose.

It's challenging to balance all of this, while separating medications by one hour to prevent upset stomach and finding time for him to sleep, but we're getting through it.

Chris is currently sleeping and I think much happier after taking a bath.  We finally got him out of his hospital clothes and into something clean and comfy.  There was a sweet moment after his bath when Chris mentioned that he wanted our dog, Oliver, to say hi.  Oliver walked right up to him (Chris was sitting on the couch), and leaned his head against Chris's legs so that Chris could pet him.  He was very gentle and sweet with him - I think Oliver knows Chris isn't feeling well and Oliver wanted to comfort him.

Chris has mentioned that he feels more facial pressure as a result of the swelling, but this is to be expected.  It looks fairly similar to yesterday, but it's only day 2.  Fingers crossed that the swelling isn't too bad come Sunday and Monday.

He's allowed to sleep as much as he wants until Saturday afternoon, as that's when they want him to try to stay awake more during the day.  The last thing they want him to do as a sleep apnea patient is wake up with insomnia at night so it's important to teach your body to sleep at night and stay awake during the day.  Last night he was interested in watching TV (though he had to multitask with everything going on so I don't think he saw very much), so we can try more of that.

First Night Done (12.3.15)

We survived the first night!  Overall, things still continue to go really well.  Sarah (Chris's mom) and I got to visit with him last night around 8:45 PM.  He took a little longer than 3 hours in recovery and we were anxious to see him because they initially told us he would be in his room at 7:30.  It was a long night!  He is swollen (totally expected) but definitely coherent and looking good.  He has a strong jaw line!! The surgeon requested that he talk only when absolutely necessary, so he's been writing down notes on a pad of paper to communicate.  His drug-affected notes are difficult to decipher and we had to ask him to rewrite multiple words.  We were laughing that we will keep the paper and one day look back at it with him and see if he can figure out what he was trying to say.

We all have learned so much in the process.  He learned how to use the suction device to remove any mucous/blood that comes up after surgery.  We watched him learn how to do salt rinses, which also helps with cleaning everything out.  We have to coat his lips with blistex and cover his brow stitch wound with vasoline or neosporin and the wound on his nose (where the breathing tube was rubbing for 8.5 hours!) with an ointment - we can't let these areas dry or it may scar.  He is relearning to swallow and it was great to see his eyes after his first sip of gingerale - his mouth and throat are dry and I'm sure it felt very soothing to have cold gingerale - he was very happy.

I left the hospital around 10:45 last night.  The staff was great and called a security guard to walk me to my car.  I got home safely, spent a little time unwinding with the pets, and got about 5-6 hours of patchy sleep.  Sarah stayed over night with Chris and said she was able to get some sleep and woke up a few times when they came to check in on him.  She had peace of mind being able to see him and make sure that he wasn't leaning his head too far to one side, which could compromise the jaw or cheek augmentation.

I got back to the hospital around 6:30 this morning.  Dr. Gunson came in shortly thereafter and was able to tell Chris what happened during his surgery and answer all his questions.  I am sure he had places to be and things to do, but it really feels like he gives you 100% of his attention and he's in no rush when he comes to visit.  We are so grateful that we found Dr. Gunson and that he was Chris's surgeon.  Chris heard some cracking sounds in his jaw this morning, for example, that he thought was a problem.  Right away Dr. Gunson assured us that some air got into his face during surgery and hearing those sounds are completely normal and expected.

Dr. Gunson removed the pressure bandage around his face and we all kept talking about how his swelling isn't that terrible.  Yes, it's there, and yes it will get worse (peaking sometime around day 4-6) but all things considered, he looks great.  He also has minimal blood issues.  Many patients need a patch taped under their nose to catch blood, but Chris said that his airway is actually not congested and fairly clear.  Dr. Gunson was really happy with this result and I'm sure Chris is much more comfortable being able to breathe.  Dr. Gunson thought that if he hasn't had blood in his nose by now, that it won't happen.  He also thinks his congestion may be less than average, but we should continue with decongestant medicine pro-actively.

I am back at work but will keep tabs with Sarah on his progress today.  They want him to get up and walk and transition him from his morphine medicine in his IV to liquid medicine.  It looks like he will go home this afternoon if everything continues to go as planned.  He still has many more milestones to go, but we are all so relieved that the surgery is done and we're just going to take it one day at a time.

Surgery Day (12.2.15)

Today is the big day!  After a night of restless sleep, we all got up around 6 AM and headed to the hospital by 7 AM.  We checked in and, after a short wait, headed back to pre-op.  We met with the nurse, Dr. Funk (anesthesiologist), and Dr. Gunson.  Chris has a great team of people working on him today, and for that we are very thankful.  Dr. Funk began his IV, which apparently was less painful than a blood draw Chris had in his hand when he donated peripheral blood stem cells.  They dressed him in compression stockings to reduce the chance of blood clots - he was very stylish!  :)  They recorded his blood pressure and oxygen level (he was very proud that he was at 100%) and gave him some anti-nausea medicine.  Then around 8:30 AM they wheeled him back to the operating room.

Dr. Gunson expects the surgery to take 6-7 hours, so for now we wait.  We're sending lots of prayers and positive thoughts his way and to his surgical team and hoping for the best possible outcome!

The Big Day is TOMORROW (12.1.15)

Chris is scheduled to have jaw surgery tomorrow.  I cannot believe it's happening so soon.  We have been on a journey for years to resolve his obstructive sleep apnea.  At first, he tried various oral appliances and then a CPAP machine with every face mask imaginable.  He originally contemplated jaw surgery at UCLA, but I was optimistic that we wouldn't have to go the surgery route.  Then he went to Stanford for a sleep study and ultimately decided that jaw surgery would be the best solution and even scheduled jaw surgery there for December 26, 2014.  After that surgery got delayed due to reasons out of our control, we re-evaluated what would be best and ultimately decided to choose Dr. Gunson in Santa Barbara to be his surgeon.  Dr. Gunson had specific orthodontic requests, which Chris began in April and took 7 months to (mostly) accomplish - some adjustments will also be performed after his surgery.

Yesterday we met with Dr. Gunson and Kimberly to go over his post-operative care and the plan for the surgery.  We got a list of items to pick up, as well as his prescriptions.  The office staff was incredibly kind and they spent a lot of time with us going over every detail.  There was some good news (i.e., Chris's nerves are out of the way and *hopefully* will not be affected by the surgery) and bad news (i.e., Chris's upper jaw bone is extremely thin, which may make screwing in plates nearly impossible and require a super-long plate that gets attached near the bridge of his nose or connecting bone only by wire if the screws do not work).  As a result, Chris may be told to not talk for two weeks after the surgery so that the bones can heal safely and without any stress or movement.  Eep!  I'm already anxious for this to be over and it hasn't really begun yet.

We had his pre-op appointment at Goleta Valley Cottage Hospital this morning.  It's a beautiful new hospital that opened two months ago.  I'm fortunate that I work very close to the hospital so I will be able to walk over and check on Chris tomorrow after surgery.  It was nice to meet some staff and get a tour of the facility.  I truly feel like Chris will be in the best hands possible tomorrow.  He also had his pre-surgery physical, which I heard went well.  We are getting lots of last minute things done today, like picking up post-surgery supplies, getting his prescriptions, ordering things online, and trying to relax (mm, that might be difficult!).  I do have to take time to take a step back and appreciate the fact that we are able to have this surgery in our backyard and that Chris can recover at home.

I hope to use this blog to inform family and friends on the progress that Chris is making after surgery.  I'll be in touch!