Day 7: I think I Need a Wiring Diagram for my Face!

Left Jaw Pain: 1/10
Right Jaw Pain: 4/10
Hip Pain: 1/10
Inconvenience factor: 8/10

Oh yeah! One Asymmetrical face!!!

Glad I like jigsaw puzzles. 4 elastics if you can count them!

A few of you may have noticed how often I have mentioned (complain about) the right side of my face!

 It's so sore! It's too hot to touch! It's too painful to touch! I must have an ear infection! It really just aches ALOT all of the time! It feels like it is going to explode off the side of my head! Arrrgh! 

The picture above shows the extra swelling and the reduced movement due to numbness that are still evident one week after surgery.

Last night before bed I really was a bit concerned by the epic heat radiating out of my right cheek. A wet face cloth used to douse the flames was hot to touch after only a 5 second compression. Oh well. Down the pain killers and ask surgeon in the morning! 

I woke up about 4:30am absolutely soaked to the skin. Shirt and shorts drenched and hair feeling like I'd just hopped out of the shower. My first thought was that I had caught the dreaded sweating fever currently sweeping through 16th Century England and was about to die. Then I realised I was not actually in the The Tudors, not in England, not in 1528 and happily not dying of sweating fever. Phew!!! (Thanks for nothing Bruce)!!! A quick shower, fresh PJs and it was back to la la land. When I woke this morning though, I immediately notice a distinct difference in my face. The right side was actually bearable without my morning drug hit. It wasn't a nuclear reactor, no ear ache and I could even touch it a bit! Hooray! My epic temperature must have driven the heat and fever out!

So what is the deal with my blasted right cheek then? Today was my date with the Surgeon for the Post-Op Review and I was prepared to get technical to get to the bottom of it. I am no surgeon. I have doctored the images below so can't say if they actually correct anymore but after listening and looking at a model skull, I have my interpretation and will try and explain it to you is my truth. X-rays will be available next week! :)

What happened is called an unfavourable condyle split.

I did feel really bad for my surgeon. After splitting 550 jaws, 3 perfectly within my face already, the last, my right mandible is the very first one that has ever split unfavourably on him. I can't imagine what feeling that gave him in the pit of his stomach - poor man!

The Plan

The Condyle is the rounded bit of the long sticky uppy bone you can see on the jaw below.

The idea is to cut the jaw and then split it. See the picture. Cut the the bone up from the bottom arrow and then across the top of the jaw line and then apply pressure at the second arrow to create the neat bone split pictured. This then allows you to easily shorten the jawbone and screw the two pieces back together neatly and firmly. No mess, no fuss!

What I think happened in my face. 

The cuts were made as planned, but when pressure was applied to split the jaw bone open, it did an inverted split. So the outside piece, which in 'The Plan' stays attached to the condyle, actually came away from that whole bone section leaving the condyle still completely attached to the main jaw bone (with the teeth in it) and some other bit of jaw bone that was detached and pretty useless. Impossible to shorten the still intact jaw bone.

To salvage the situation:

Cut the condyle off of the jaw bone. Re-split the jaw bone so that you can shorten it as planned. Then try and plate, screw and pin it all back together. 

Given the circumstances, I think the surgeon has done an incredible job under what must have been some pretty intense pressure. No follow up surgery will be required to fix any of the right side of my face and my bite is lining up amazingly. 

The stitches were removed from my face, my mouth washed and I was 'spec'ed up with some coloured bands direct from Italy to manipulate and hold my jaw in the position it needs to adopt its new functional bite. The muscles and soft tissue need time to settle into their new spaces and strengthen, and the guiding of my teeth will speed this up. The most effective configuration is as mind-boggling as the picture suggests. It's feeling pretty restrictive at the moment and it adds a whole new level of tedium to eating time - removing, cleaning and refitting the elastics but if anything it's great encouragement to workout how to drink through a straw so I don't have to untie them! :) I am just a bit jaded by how many pink, and how few purple elastics there are in the bag!