It's been a long road to make it to the one year mark after major jaw surgery to treat sleep apnea, but I'm happy to report that I made it through the hardest part of this journey. This post will consolidate my experience of the healing process from months 6-12 post-operatively.
Let's start with the good stuff.
Most importantly, my sleep apnea is GONE! This was verified in a proper in-lab overnight sleep study with electrodes and wires hooked up all over me. My AHI (Apnea Hypopnea Index) came back at 1 which is pretty darn amazing. An AHI of 0-5 is considered little-to-no sleep apnea. My previous home test came back as 5 which was a huge improvement from over 50 before my surgery, but 1 is incredible and more than I could have hoped for.
Many of the previously numb areas in my lips, chin, and palate have regained feeling. Areas that still exhibit parasthesia are manageable at this point. Of course I would like for them to continue to improve and suspect that they will, but if for some reason they don't I would be okay with it. The palate has enough feeling to feel like a large palatal burn that occurred a few days ago. It's at that point where if it had actually been burned, it is no longer painful from the burn, but is also not healed enough to have normal sensation either. But at least I have enough sensation there to not have it feel completely foreign when I eat, and I also have improved taste as compared to 6 months ago.
My jaw pain from TMD is only an occasional minor issue now and typically only occurs if eating something hard or very chewy. But at least I can comfortably eat nuts now as long as I chew on my good side and don't eat very many at once.
On a negative note, I have had an increase in the amount of gum tissue recession over the past 6 months. I've also started to notice multiple abfraction lesions, which are notch-like areas in the exposed root surfaces of the receded sites. This was very unexpected, because as a practitioner, I usually note these in patients over a much longer time period, and usually associate it with night time clenching or grinding patterns called bruxism. It would not surprise me if I brux, but what does surprise me is the amount of breakdown in these root surfaces that I've seen over a period of months especially when I'm wearing Invisalign trays which I would expect to have a protective effect on the tooth surfaces since it would be the plastic-like material over the teeth that should absorb the forces being generated. I have yet to figure out how to handle this situation. Any other dentists out there reading this, let me know your thoughts.
My Invisalign use is expected to extend until summer 2019 which will be 1.5 years after the surgery and will be followed by additional gum grafts, teeth whitening, and maxillary anterior crowns and veneers to accommodate for small tooth size and much chipping of the incisal edges. My maxillary teeth have had to flare buccally (towards the lip) more than anticipated based on the final maxilla position from surgery. It's still to be determined if this issue will be able to be addressed through the shapes of the crowns or may need an extension of the orthodontic treatment.
As far as chewing goes, I still have difficulty with certain foods, especially things like steak or apples. The issue is that my teeth are very mobile when my Invisalign trays are not in place. And of course, I need to take the trays out in order to eat. I can get by if I cut these types of foods up into very small pieces but biting into an apple with my front teeth is out of the question.
A few other unfortunate issues are that I still have some disturbance in speech quality, as I still notice a bit of a lisp. Additionally, the screw on the upper left at the base of the orbit is annoying. I wouldn't consider it painful, but it has a constant sense of pressure and does exhibit discomfort with light pressure (so of course I constantly want to press on it). Also I've had frequent post-nasal drip and discolored drainage from that side frequently which does make me a bit wary of the situation.
Let's switch gears and talk about my biohacks. These are the things I've done in the past 6 months to try to manipulate my environment to positively affect my biology and healing.
First up, regular cold therapy. For me, this includes going into an outdoor pool 2-6 times per week in the winter in Oregon, so the pool ranges from 40-50 degrees. I stay in the cold anywhere from a few seconds to a few minutes. I've somehow convinced my young kids that this is fun, so they'll often voluntarily jump in there with me, and sometimes we only do a few seconds but alternate with the hot tub and end up going into the cold pool 10-20 times in just one session. This is a huge feat for me, as cold water has always been a major hurdle for me to overcome. I really have to psych myself up and usually go in slowly. But after a lot of practice, I can now make myself jump in up to my neck if going in straight from the hot tub and I don't have to sit there and over-analyze it for 10 minutes first. So it has gotten quite a bit easier, but I certainly can't say that it is effortless. I also make myself end on cold for 30 seconds to a minute at the end of my daily shower and say positive affirmations while doing box breathing during that time. Which brings me to another biohack: gratefulness. I've tried to incorporate this one with our whole family, as during dinner and/or bedtime my husband and I will ask the kids for the things they are grateful for. I also try to spend a few minutes in bed each morning and evening thinking about all of the things and people I'm grateful for. This makes for a lovely way to fall asleep as well as to start the day.
I've added a gentle daily detoxification support in the form of a zeolite solution called CytoDetox. I use this either right before bed or early morning on an empty stomach. It's simple to take and I feel that our bodies have such heavy toxic burdens in modern society that anything simple we can do to support the bodies' own detoxification pathways is a win.
Another thing I've added into the mix is, well, a mushroom mix. A variety of beneficial mushroom drink mixes to be more precise. The brand I've become quite familiar with is called Four Sigmatic, and although I've tried most of their products, the ones I use most are the mushroom coffees and the mushroom cacao. The coffee mixes give a nice energy boost without too much caffeine, and the cacao mix is perfect for having before bed to help relax and wind down.
Lastly, I've really put more of an emphasis on an increased focus on movement throughout my day. I started playing soccer weekly, which I honestly never though possible after having two major back surgeries in my mid-thirties. I've also been focusing on strength and flexibility, and noticing a difference in how my body handles daily stress and in how quickly it heals. I do my previously described physical therapy double chin exercises daily as well as simply looking as far back and up as I can to give my neck muscles a good stretch because so much of the post-surgical tension is under my chin.
Well that about sums up months 6-12 of this long journey. We spent my one year surgery anniversary in Disney World, so I'll end with a happy one-year-later pic: