How I Prepared for TJR

As soon as I got the call from my OMS in August saying the FDA chose me for titanium implants, I began to prepare. 

For whatever reason, I am terrible at math yet excellent with money.  I began looking at my insurance to figure out deductibles and max out of pocket.  In fact, I called the insurance company several times to make sure I understood everything. 

As soon as I was sure of the cost, I began putting money aside from each paycheck.  If that meant not going out one weekend, I didn’t go out.  I knew I needed to create a financial plan.

Because I am in a single income household and have no children, I recognized I needed to be smart when it came to my bills.  Many people told me that recovery would take between three months and a year.  With this in mind, I made a list of my monthly bills and guestimated how much I would spend in three months.  Then I created a budget, and began paying off three months of each bill.  This includes house and car payments.  Trust me, all this budgeting is not easy, but for me it was necessary.  If you have a family, this could be challenging. 

As a teacher, I am fortunate to have vacations throughout the year.  When my implants where made and the office knew the date of arrival, they told me when they scheduled the procedures.  I didn’t have a choice in the date; however, it was close to the end of the school year, which would give me plenty of time to heal.

Here is how else I prepared for the surgery:

*I created freezer smoothie packs for after surgery (only to find that I don’t like sweets any more and never drank them-lol)

*I bought soft foods

*dry shampoo (I never used it)

*baby spoon (I never used it)

*button up shirts

*a small dry erase board

*a baby toothbrush (I never used it)

*I also have a cat, so I bought a 3-month supply of wet food, litter, dry food, and his arthritis medicine. (I also paid for a pet sitter to come and spend time with him the week I had surgery and administer his daily arthritis meds)

*I bought a 3-month supply of household items (toilette paper, deodorant, papertowls, etc).
*I paid for Netflix (what a lifesaver)

Creating and sticking to a budget can be arduous, but it was necessary for me to feel secure after the surgery. 

One-Month Post Op

It feels like just yesterday I was fretting over the surgery and its implications on my life.  Was this the correct decision or not?  I just didn’t know.

That anxiety subsided as soon as I awoke from surgery.  It was done.  Now I must heal.

All of the cards and gifts are a constant reminder that I will get through this :)

In the month since the TJR, there are minimal changes to my face.

My face is still frozen except for a slight grin.  I sometimes show teeth when I smile naturally, but if I attempt to smile on purpose, well, it looks like a snarl.  On the positive side, people pay good money to have a forehead such as mine.  It looks as though I spent quite a bit on Botox, so I can’t complain about that!  

My right eye still doesn’t close the same as the left.  It does close, just not as tight and bothers me when I am trying to focus. Driving at night or in the rain is a challenge.  I’m sure it looks a bit goofy, but I don’t care.  I still go about my normal day-to-day routine. 

I'm practicing my smile with the rescue dogs:

 I do still have some numbness on my cheeks.  At times I get random pains on different parts of my face as nerves are regenerating. 

In addition, my chin looks better because my teeth are aligned.

At the moment, my pain level is wonderful.  I haven’t taken a pain pill in three weeks and I have not taken Excedrin.  I've noticed that the weather causes headaches.

I do have random aches and pains on occasion.  When I am out with friends or family, I tend to get achy.  I also have first bite syndrome when I drink/eat something either cold or hot.  It’s annoying, but not the end of the world.

I go to physical therapy once a week.  The physical therapist is trained in jaw issues.  He spends quite a bit of time with his hands in my mouth.  I’m not sure what he’s doing, but it excruciatingly painful.  If it gets to be too much, I’m supposed to raise my hand.  I don’t.  I want to heal as quickly as possible.

This week I could open to a 30 on my own.  When I left, I opened to a 36! 

I have to do my main PT exercises 4X a day and my other PT exercises 7X a day.  It’s a lot, but my goal is to open to a 33 on my own by next week.

He is pleased with my opening and says that I am progressing faster than most people who had my surgery.  He is not as happy with my face, so I need to continue to work on that. I am still on a soft/mushy food diet.

At this point in the healing process, I do not regret my decision.  I recognize that I have a long road ahead of me, but am optimistic of the future.

TJR-Expectation vs Reality

Keeping in mind that my perception of this experience is my reality, I recognize that everyone’s experience differs.  Moreover, the only complication in my face was my actual jaw joints, which is not the case for everyone.  I also acknowledge that I have an exceptionally high tolerance for pain.  With this being said, here is a list of what I expected versus my reality.

I expected to be in a medically induced coma from Monday-Wednesday. (I know many people want to know why, but I honestly can't remember. I was in shock when they told me.)	Luckily, this was not the case.  The surgeons decided to wake me up after each procedure.
I expected to wear the metal guides (arch bars) and be rubber banded shut for 6 weeks.	The surgeon was so happy with my bite, he took them off after the surgery (I was still under anesthesia).
While in the hospital, I expected the pain to be managed quite effectively.	Because the nurses had so many patients, this was not the case.  Thankfully I had my parents their to advocate on my behalf.  I also requested a pain pump that I used the day after the surgery, so I could be in charge of medication.  I had it for less than 24 hours.
I expected to lose between 10-25 pounds.	I lost 12 pounds while I was in the hospital.  The first day or so I was on liquids, and then I was switched to soft diet.  I kept getting meals that included sandwiches and big food that I couldn’t eat.  Once home, I started eating again and gained the weight back.
I expected to be on liquids for a long time.	In fact, I pre-made smoothie packets.  I was  on liquids for less than 48 hours.
I expected the surgery to last between 8-10 hours.	The actual TJR took 12 hours.  My surgeon stated that it was more complicated than he thought it would be.  (I didn't ask why he considered it more complicated because I didn't care.  It was over with and I was happy)
I thought I would need a baby spoon to eat.	Within 24 hours of having the surgery, I was able to pry my mouth open enough to fit a regular spoon or fork. It hurt, but it was good practice.
I thought I wouldn’t be able to brush my teeth for a while and when I did, I would need a baby toothbrush.	Three days after surgery, I walked to the sink in my room and found the regular sized toothbrush the hospital gave to me and brushed my teeth.  I couldn’t reach my back teeth. I used my electric toothbrush when I went home. I started flossing 2 weeks post op.
I expected to have problems urinating after surgery because of the catheter.	This did happen, but lasted for a very frustrating 24 hours.  If you are a woman, you can use a cup of water to pour on yourself to get things flowing. (they put the catheter in after you are asleep, so you will not remember it at all)
I expected to combat chapped lips with lip balm.	While I used my chapstick often, there was no avoiding chapped lips.  They were chapped for about six days.
I expected to talk and use my dry erase board to communicate.	Thank goodness I had the dry erase board, because I had no voice at times.  My voice came back full within four days.  I couldn’t clear my throat, but at times I would cough and that would clear it.
I expected to be visibly swollen and bruised for a long time.	While my face is still swollen, it is much better.  My head was at its biggest 3 days post op, but got better every day after that.  I had no bruising on my face.  My neck had some bruises, but they cleared up within five days.
I expected to stay at the hospital for 5 days after surgery.	I went home three days after surgery.  In fact, I was so excited to be discharged that I walked from my room across the hospital (outside and all) to get to my post surgery appointment.  It is quite a distance, especially when you don’t feel well. Areal view of the hospital
I knew that temporary muscular paralysis was a possibility.	My face was completely frozen.  I had no facial expressions at all.  My right eye was not closing properly. My face doesn't move-I am attempting to raise my eyebrows in this pic lol
I expected to have my stitches in for two weeks.	They were removed one week after surgery.  I had close to 80 stitches in total located on both sides of my face and neck.
I expected to only have to wear my bandages for one week.	I had to wear them for two weeks.
I expected to have to wear button up shirts or clothes that didn’t have to be pulled over my head.	This helpful advice I received from someone.
I expected to stay at my parent’s house for 3 weeks.	I stayed there for 7 days.  I went home after that.
I expected to be on painkillers for a while.	I went home on a Friday, Saturday I took four throughout the day/night, Sunday I took one at night, and then I stopped taking them.
I expected to be in bed because of unbearable pain for a long time.	While I needed to relax to help heal, I still was able to walk every day, go to the grocery store, etc.  I was not bed ridden at all.
I expected to not go back to work until next school year.  I was also concerned that I would have to give up my career.	I went back the 3rd week after surgery.
I expected some at home physical therapy.	I do PT exercises 5-7 times a day.  I also see a physical therapist once a week.  It’s a lot, but it’s important to do. (I was afraid going to a physical therapist would be excruciating painful and I would hurt all day afterwards.  It is painful, but I am fine when I leave.  Plus, it's been amazing in getting my jaw to open)
I expected to not want to leave the house because of pain and the way I look.	Once I got to my parents house, I went out every chance I got (CVS, walks, out to dinner). Once I got home, I started getting back to my normal life.  I didn’t even care if I had a huge head and was wearing bandages.
I expected my jaw to be sore.	It was, but so what my entire face.  My shoulders and neck also were extremely sore.  It was nothing unbearable.
I expected my teeth to be sore.	They were, but I was chewing pasta within a week.  Before that, I just cut food up and swallowed it hole.
I expected to have a lack of energy.	I did for a few days, but once I stopped the pain meds and started eating protein it wasn’t so bad.
I expected to not be able to exercise for a long time.	I started walking while in the hospital.  Two weeks after surgery I was cleared for light exercise.
I expected to not be able to wear glasses or sunglasses because of swelling and soreness.	While I didn’t wear them while in the hospital, approximately two weeks later I was wearing them.
I expected to drink a lot of smoothies.	I made about 30 smoothie packs, and drank one.
I expected my taste buds to remain the same.	I don’t like sweets anymore, which is also the reason I didn’t drink the smoothies.
I expected to have no side-to-side movement because of having bilateral implants.	I do have some side-to-side movement, but still am unsure of how good that range of motion will get.
I expected to have a lot of my hair shaved for the surgery.	While the doctor shaved some of my hair, no one but me would notice. It's growing back not, but you can see the small area that was shaved.
I expected to not be able to wear earbuds for a while.	Two weeks after surgery I started wearing them.  It was slightly uncomfortable, but nothing terrible.
I expected to use the Chlorhexidine Oral Rinse while I was in the hospital.	I did use this rinse, but not effectively.  I couldn’t swish the rinse from side-to-side.  That motion took several weeks to come back.  I had two refills on this prescription, so I am still using it.
I expected to swallow normally after surgery.	I have first bite syndrome, which is a sharp pain in the lower jaw whenever I eat or drink something hot or cold.  It's annoying but doesn't last the entire time I am eating.