Recovery Day 98 - 25th March 2013

Today is recovery day 98, my jaw is healing really well. Most of the swelling has gone down apart from a little bit on either cheek and the majority of my feeling has come back apart from the right hand side of my lower lip which is still completely numb. I get increased swelling if I've been particularly smiley or chatty. 

I am still having issues with my Trigeminal nerve and the Trigeminal neuralgia. I'm still getting awful pain / sensations whenever I move or touch my chin. This includes any movement whatsoever by talking, laughing, smiling, eating, drinking or brushing my teeth and I have constant pain in my teeth. 

I went back to the doctors on Thursday because this was the two weeks of taking the Gabapentin tablets and i'd had no improvement. The doctor said I was to up the dose and include a midday dose. This meant I was taking 1-1-2. She said if there was no improvement after 3 days to up the again to 2-1-2, then if no improvement after that that dose up the again adding 1 tablet each time until the tablets either work or I reach the top dose of 9 tablets a day. I really hope they work soon because I need some relief from these sensations and teeth pain soon. The pain is literally draining. 

I upped the tablets to the 2-1-2 dose yesterday and I was quite poorly. I had a headache and felt sick and dizzy. The doctor said this may happen when I'm upping the doses and said that I should avoid driving. Grrrrr I hate it when I cant drive, I tried a little test drive, driving 3 minutes up the road to my mums the other day and I really didn't feel right so I'm going to take the doctors advice. I felt so awful yesterday after upping the tablets, I spent the day in bed. The dogs and my husband were very supportive and also spent the day in bed. They claim they were looking after me but I think they were being lazy! 

In regards to eating I'm doing really well. I can eat things that are reasonably soft such as noodles, rice, pasta, vegetables. I can't eat anything that requires biting or chewing because that movement effects the Trigeminal neuralgia. It's not really my jaw that's effecting the eating at this stage it's the Trigeminal neuralgia. I went out for the first time on Friday for a friends birthday on Friday. It was nice to get dressed up even though applying make up is painful. But picking food in the restaurant was hard work. There were so many yummy things I wanted to eat and couldn't manage. It was a nice evening but I was swollen and sore on Saturday as a result of all the chatting, smiling and laughing. 

In regards to the Eustachian tube dysfunction, I'm still a bit deaf when I wake up and my cheeks often ache. I also get shooting pains, mainly in my right ear. I'm going for a CT scan on 31st March to have a look a what's going on with the tubes and sinuses. 

I literally can't wait for this Trigeminal neuralgia to go away, its really annoying and can get you right down in the dumps. If it wasn't for that I'm sure I'd  be feeling great, the lasting side effects of Eustachian tube dysfunction, limited swelling and numbness are liveable and in a way expected to still be flaring up at the this stage of the recovery every now and then. Fingers crossed over the next few weeks I'll find my dose of medication and the Trigeminal Neuralgia will be in hand. 

Enough is Enough - Day 80 & 81

So over the last few days the sensitivity in my chin has intensified, and any movement or stimulation has been reducing me to tears. I arranged to see my consultant Mr D yesterday to see if there is anything he could do about it and to see if he could check my puffy cheek.

Matt has always driven me to hospital appointments because I'm still struggling with my ears and balance but today nobody was around to drive me so I had to drive myself. I was anxious about it because its a 40 minute drive, but I made sure I left with plenty Of time, so I could take my time and wasn't rushing. The drive wasn't too bad but when I arrived at the hospital the parking was a nightmare as usual! 

I eventually got parked and made my way to the clinic. When I checked in at reception another patient in the waiting room said she recognised me from my blog and we had a little chat about our surgery and recovery. It's so good to chat with people who are going through similar things as you. Although every operation is different there are similarities in every case. It was nice having someone to chat to as there was a 30-40 minute delay to see Mr D. 

Eventually Mr D called me in, firstly we discussed my cheek. He poked around the area of the cheek plates and didn't think there was infection.

Then we moved onto the chin. He asked me to remove my brace elastics then started prodding around. First he touched my gums at the plate locations to see if there was any pain that could indicate infection. There was tenderness but no pain. The tenderness is likely to be scar tissue. Then Mr D moved to the right hand side of my mouth and he touched exactly where is giving me grief. I jumped out of my skin then burst into tears it felt so awful.

I think Mr D was horrified that I was crying, he was so reassuring and was trying to calm me down. He asked me some questions about what triggers the pain and my response was anything really, teeth brushing, talking, shouting, laughing, smiling, washing, moisturising, walking. Basically anything that involves my chin moving. Mr D injected some local anaesthetic into the inside of my mouth. The idea of this was if the pain disappeared when the anaesthetic worked he could diagnose and treat me. He sent me for an X-ray while the anaesthetic started to work. The X-ray was to check for signs of infection around the plates. 

As I was walking to X-ray the anaesthetic was working and the pain had gone, oh my god it felt amazing to be able to move my mouth without having intense horrible sensations whizzing around  the lower part of my face. I had my X-ray then headed back up to the clinic. Mr D checked the X-ray and there was no sign of any infection around the plates. He said there was a bit of arthritic shading at the jaw joints that he would expect and all in all the X-ray looked great. 

So as the pain had gone with the local anaesthetic Mr D is certain the I have Trigeminal neuralgia. 

(information for NHS choices website) 

Trigeminal neuralgia is sudden, severe facial nerve pain.

The main symptom of trigeminal neuralgia is a severe stabbing or piercing pain in your face that comes on suddenly.

The pain is almost always on one side of your face, although in rare cases it is on both sides. It can be in the lower jaw, upper jaw, cheek, and less often the eye and forehead.

The pain may last from a few seconds to two minutes each time and you may also feel:

tingling or numbness in your face before the pain develops

a slight ache or burning feeling during the attack

You may have spasms of pain regularly for days, weeks or months at a time. In severe cases, you may feel pain hundreds of times a day. Some people experience a constant dull ache in certain areas between episodes of pain. However, it is possible for pain to disappear completely and not reoccur for months or years.

Triggers of trigeminal neuralgia

Episodes of trigeminal neuralgia can be triggered by certain actions or movements, such as:

talking

smiling

chewing

brushing your teeth

a light touch

shaving

swallowing

a cool breeze

head movements

Living with trigeminal neuralgia can be difficult, and it can interfere with your quality of life. You may feel like avoiding activities such as washing, shaving or eating in order to avoid triggering pain.

Living with pain, especially if it affects your quality of life, can also lead to depression (feelings of extreme sadness or despair that last a long time).

Mr D prescribed with some Gabapentin tablets that are given to people with epilepsy and peripheral neuropathic pain which is long lasting pain caused by damaged to nerves. The tablets aren't painkillers, they desensitise the nerves that effectively lessens the pain. So I have to start taking one tablet a night for two days, then one tablet twice a day for two days, then one capsule of a morning and two of a night thereafter. They can cause drowsiness and dizziness and may make you giddy! So I'll have to assess driving after each increase of tablets.  

In regards to the Eustachian tube dysfunction effecting my ears, cheeks and nose Mr D has requested a CT scan to check my sinuses to see if they're blocked, so I'll be having that in the next few weeks. All in all, a very productive appointment. Mr D knows I'm not a baby and I'm normally in his words 'a tough cookie' so he knows things must be bad for me to be reduced to tears with the pain.

Mr D said that I was to take it easy in the afternoon as once the local anaesthetic wears off the pain might come back with a vengeance! So I drove home, had some lunch, took advantage of brushing my teeth virtually pain free then chilled out. Mr D was right, once the anaesthetic wore off it was back in its full glory! Totally depressing. 

At 11pm I went to bed, took my tablets and fell asleep nice and easy. I'm not sure if this was because I was so tired or if it was the tablets, but I was ready for a good nights sleep. 

So I woke up this morning nice and fresh, my chin, cheeks and ears are still the same but at least now we're working towards some relief now. That's reassuring in itself.

Update so far.... Day 77

I'm 11 weeks post op tomorrow and I feel as though I've hit a recovery brick wall, so I'm not going to bore you with the same old stuff day in day out. 

I've got Eustachian Tube Dysfunction effecting my ears, sinuses, cheeks and nose giving me deafness when I've been lay down for a period of time and pain in those areas. 

I also have issues with the nerves in my chin and gum giving me very unpleasant sensations when my chin is moved for example when I speak, laugh, smile, wash etc and teeth brushing is horrendous when contact is made with my right gum or when my chin moves with the vibrations of brushing.

In regards to swelling 70% has gone, it's mainly my cheeks at the moment that are puffy, especially my right one that has also gone hard due to infection. The swelling fluctuates depending on how much action I've had that day. 

The majority of my feeling has come back apart from my right lower lip, that is completely numb and my chin that only has about 30% feeling in it. 

From an orthodontics point of view, everything is great and I still have about four weeks of wearing tiny bands between the upper and lower teeth.

Thanks for reading and for your messages and comments, I'll post weekly unless anything of note happens

KjS-T x 

Recovery Day 75 - 2nd March 2013

Oh I had a lovely, deep sleep last night. I felt well rested this morning but still felt unwell. I think it must be this infection. My right cheek is still extra swollen and firm and I still have earache. My chin and gums are still very sensitive and this is to starting to make my life hell now. I'm struggling to talk, eat, drink , shout, laugh and smile with it and teeth brushing is horrendous. My ears were very deaf this morning too. After some pain killers and antibiotics I started to get ready for the day. I started with brushing my teeth, I just feel like I can't get my teeth clean these days. I brought expensive sensitive and repair toothpaste and mouthwash and still my teeth just don't feel clean. I usually use an electric toothbrush which, I had to stop using when this chin and gum nerve issue started and I had to revert back to using a child toothbrush. I thought I'd give the electric one a go this morning but as soon as it touched the right side of my mouth it triggered the gum and chin and the horrible shocks started and I had to stop... Grrrr

After my shower I went to mums, my Aunty and little cousin were there and mum did a little tea party for my little sister who is 21 tomorrow. It was nice to see all my family and my little cousin is mesmerised by me, my jaw, my operation and my brace. He loves my brace so much he's even been to the dental hospital with me to see how they change and adjust it. 

I spent the afternoon at mums catching up with my family and we went to cemetery to put some flowers on my nan and granddads grave. Matt came to mums at 6 pm and we got a curry for tea.  I was very tired come 9pm so we went home. I waited until 10pm and took some painkillers then went to sleep. Thankfully I fell asleep early, I woke up at about 3am and I couldn't hear a thing. My ears sounded like I had my fingers stuck In them. This is linked to the Eustachian Tube Dysfunction but in recent days the deafness has been more severe. It doesn't last long once I'm sat up but the fact it's there at all is annoying!   

Recovery Day 74 - 1st March 2013

Woke up at 08:27, I still felt 'unwell' as well as having the usual aches and pains and my cheek was still extra swollen and firm so at 08:29, I called the doctors. It doesn't open until 08:30, but if you get on the phone at 08:29 you won't have too much of a wait on the phone... The things we do to ensure a doctors appointment! I was 3rd in the queue to be answered, that's good, I've been 38th before now. I got an appointment with Dr N for 9:30 so I got up, and got washed and dressed. I've not been putting make up on as it hurts my chin but this morning I looked that rough, I had to put some on. I think it's the extra puffiness that's making me look so awful. 

We got to the surgery at 09:25 and didn't have much of a wait before Dr N called me in. I explained to her the pains in my ears and my swollen, firm cheek. She checked my temperature and looked in my ears. My temperature was normal but she described my right eardrum as 'opaque' she said she was concerned about the increased swelling and prescribed some amoxicillin. She said that the trapped mucus in the Eustachian tube may have become infected, and infected my sinuses. She also prescribed some codeine to try for the pain. 

After the doctors I had a routine dental appointment, they didn't do anything other than look in my mouth really, they didn't want to do anything too extreme so soon after surgery. He said my teeth are really clean considering and he doesn't want to see me for another 6 months. 

After the dentist we went home and I made Matt an omelette for his lunch, I made myself one but only ate half, I just didn't really feel hungry. When Matt went to work I had a sit down for half and hour and took some of my new antibiotics and painkillers. I then nipped to the village to run a few errands for dad. I was well wrapped up as it was a bit on the chilly side. When I got back to dad he advised me that he hadn't had any lunch. It was 3pm and if I hadn't of had lunch by then he'd have shouted at me! I nipped home and made him and his work mate a BLT. It smelt and looked amazing!! Shame all I could do was 'smell' 

When I got back home I sorted out my sisters birthday stuff out as its her 21st on Sunday and put some washing away, by that time I was tired and sore and I had a really bad headache and felt sick. I lay by the fire for an hour watching TV and playing on my iPad. I literally had no energy and felt very lethargic and nauseous and had no energy.  

I made my tea of chilli and rice and after it I felt a little bit better, well less sick at least. Matt came home at 8pm and we watched some TV. After taking my last antibiotic I went to bed and watched some more TV. I fell asleep just after midnight quite easily for the second night I a row. I just wish I felt fresh when I wake up instead of groggy.