Thursday, October 30, 2014

Day 14: My smoothies bring all the boys to the yard (diet after jaw surgery)

It's now been two weeks since my surgery, which also means it has been two weeks since I started a liquid only diet.  Aside from wanting to stuff my face with the biggest burger known to mankind, I'm getting quite used to my new diet and coming up with creative ideas for my meals.  Making your own smoothies and meals is so much better for you than drinking store bought protein drinks - because no matter how the packaging looks, those things are full of sugar and artificial ingredients.

So for today, I thought I'd share some of my favourite smoothie recipes.

First you will need:
  • A personal blender of some description.  But before you rush out to buy a nutri-bullet (seriously those ads are becoming annoying), please shop around.  Here in Australia they charge almost $300 for the nutri-bullet, which sells in the USA for less than $100.  Instead, I bought a Sunbeam personal blender for around $45 and it does exactly the same thing.  And no matter what those ads say - it's a bloody blender, not a 'nutrition extractor'.  That's like calling a treadmill a 'fat pulveriser'. 
  • Plenty of fruit and vegetables.  I suggest either buying the snap frozen kind or buying fresh and freezing them yourself.  It saves adding extra ice or water to your smoothies and of course makes them last a lot longer.
  • Supplements - I have whey protein isolate which is 100% milk protein with no added rubbish.  I also keep chia seeds for when whey protein powder will not suit.  Unless I am blending a meal that already has lots of protein, I always try to use one of these supplements.
  • Natural greek yoghurt - a great way to add a little more protein.  It tastes great too.
  • Creativity - you would not believe what can be blended.  Use your imagination.  

The basics

A smoothie requires not only ingredients to make it interesting, but some kind of liquid to help blend everything together and allow you to drink it.  A lot of recipes call for water or ice to do this and that's fine if you are wanting to keep the calories down, however as I am replacing all of my meals with liquid I use almond milk.  It's still very low in fat and sugars compared to regular milk and has a good amount of protein to keep me going.  In smoothies with a fruit juice base, I use my juicer where possible to make it fresh.

On to the recipes!

The below recipes are my favourites, but remember to experiment with whatever you like.  You can add almost anything into a smoothie.


Breakfast - Banana Berry Smoothie

This is my favourite morning smoothie and I drink this almost every day.  It's full of fibre, antioxidants and lots of nutrients - plus the added protein and oats ensure you get a quick energy kick as well as sustained energy release throughout the morning.  If you like caffeine and want an even bigger kick, use half almond milk and half strong coffee.  It's great!  Below is the recipe, however I've also created a YouTube video to show how I make this smoothie.  Click on the video link below.

1/2 banana
4-5 strawberries
A small handful of blueberries
1 cup of uncooked oats
2 heaped teaspoons peanut butter
1 scoop of protein powder
1 tablespoon greek yoghurt
Almond milk



Lunch - Mean Green Smoothie

Half an orange - seedless or seeds removed
A handful of kale or spinach (honestly, you cannot taste this in the smoothie - but it's great for you)
1/2 banana
A couple of leaves of fresh mint
2 teaspoons chia seeds
1 tablespoon greek yoghurt
Almond milk

If you like a little extra zest you can also add some kiwi fruit and/or pineapple.


Dinner - Blend a regular meal with a liquid base

I was very lucky when recovering from surgery to have a friend staying with me for the first two weeks.  While I was thinking within the constraints of fruit and vegetable smoothies, it was her idea to blend my usual meals into dinner drinks.  Some of my favourites so far are as follows:

  • Ravioli blended with tomato soup.
  • Spaghetti bolognese blended with tomato soup.
  • Pizza blended with tomato soup.
  • Thai Tom Yum soup blended - noodles, vegetables and all.
  • A chicken burger blended with chicken stock - that means the bun, the cheese and the veggies.
  • Chinese stir fried beef with mushrooms, blended with noodles and beef stock.
At first blending some of these meals seems like quite a gross idea, but they actually taste pretty amazing.  The nest thing is that while they are not solid food, they still satisfy the taste cravings associated with solid food.  Plus these can be made as thick as you like to help you feel fuller.

I hope you've enjoyed this post and that it helps with your meal planning.  Of course Google is a great resource for smoothie recipes as is YouTube.  Enjoy.


Tuesday, October 28, 2014

Days 11-12: Post surgery appointments and I'm feeling fantastic!

Over the last couple of days I have had follow up appointments with both my orthodontist and my maxillofacial surgeon to check on my progress.  My temporary live-in carer (aka Cindi, my amazing friend from California) is still in Australia so it was fun to be able to take her along to my appointments.  I really wanted her to meet the people who have been taking care of me.

First was my orthodontist appointment on the Monday morning.  I absolutely love visiting the office of my orthodontist because the team there are so warm and friendly.  They were all really excited to see me and commented on how good the results looked, which of course made me feel great.  The appointment was a fairly quick one and my elastic bands were changed to a different configuration.  Elastics are really important after jaw surgery as they guide/train your jaw to its new bite.

My beautiful new elastics!
The appointment with my surgeon the following day was a general check-up to see how I am healing and if I was having any discomfort or pain.  I can honestly say that I am feeling pretty wonderful - especially considering my surgery was less than two weeks ago.  Aside from the first few days which were very uncomfortable, I have had no pain or soreness, no major trouble talking, no trouble sleeping, no bleeding and no sickness or nausea.  Even my surgeon commented that I seem to be a couple of weeks ahead of where they would expect me to be.

I'm not writing this to gloat, but hopefully to give some hope to others going through (or about to go through) this process.  It's not all dribbling and pain and my surgeon puts my fast recovery down to my positive attitude.  I absolutely agree with this, because it is amazing what your body can do and how fast it can heal when you feel happy and positive.  I also put it down to having a fairly high pain threshold.

I took the opportunity to ask my surgeon again about what he did during surgery (the last time we discussed this I was in hospital in a drug fuelled state) and I have to say it is nothing short of amazing.  He explained that at my next appointment they would be taking an x-ray so I could see the results, but I already see the results every single day and here are the latest photos.


The most important question I wanted to ask my surgeon - when could I start brushing my teeth?  He said that I could have been doing that already (which I didn't realise) and gave me some tips on how to brush and where to be careful.  So the first thing I did on returning home was brush my teeth for at least ten minutes and I can tell you, it felt great!  Fresh breath ahoy!

Sunday, October 26, 2014

Days 8-10: Big journeys start with small steps

It has certainly been a busy weekend and I didn't do too bad at keeping up.  Cindi's niece (also from California) has been studying in Melbourne for the last few months and came to spend a weekend with us in Sydney.  It would have been a shame for them to not see each other,  so we agreed that I would join in for as much as I could and rest as much as needed.

I really got to test myself in terms of how much energy I had and just how much I could (and couldn't) do in three days.  We managed to power through the majority of the iconic sights of Sydney, but while we took the car to most places, it still caught up on me big time.  If I'm honest, I probably pushed myself a little too far.  The swelling on my face has been going down rapidly and I am speaking better than ever, but I need to remember that I am still recovering and only just over a week out of the operating theatre.  So my advice would be to listen to your body and take small steps.  And if you do go out for a full day make sure you take extra smoothies with you for in-between meal snacks.

I'm slowly seeing the changes to my jawline and loving my much shorter face and squarer jaw.  Because my upper jaw was taken upwards, it means that my mouth now naturally sits in the closed position.  Prior to surgery I had to consciously close my mouth.  And even then it looked odd.

Here are a couple of pictures (taken on day 9, 25th October) of my progress so far.

You can see that my jawline and chin have taken on a new shape

My side profile looks a lot more balanced than before my surgery - the overbite is gone!



Thursday, October 23, 2014

Day 7: When all else fails, take a nap

Napping is officially my new favourite pastime - in fact it's become a necessity.  While I'm eating (and by eating I mean drinking) lots each day and getting some exercise, I need to remember that my body is still healing and getting over surgery and that I shouldn't push myself.  Luckily for me, Cindi reminds me of the fact that I need to rest and she has also joined the napping club.

Today was no exception as my morning involved a lot more exercise that the previous few days.  We took a short drive to the local Medicare office to claim some of the money back on my surgical fees.  Medicare is the national health system in Australia which partly funds medical costs for all citizens (very different to Medicare in the U.S).  By the time we returned it was time for another early afternoon nap.  The evening was spent walking into Newtown (my local area) and even stopping for a quick beer at the local pub which I did not think I would be doing only seven days after surgery.

A friend popped over for dinner in the evening which consisted of take away food from the local Italian restaurant - and I even got my dinner from there as well.  You'd be surprised at what you can blend for dinner and it's been interesting testing out some new recipes, but more on that in a later post.

I'm now 3kg down in weight from the day I went for surgery, so that will be something to watch as the days go by.

Wednesday, October 22, 2014

Day 6: Pumpkin and spice and all things nice


I'm really happy to say that having major jaw surgery has not stopped me from being able to drink coffee, albeit through a straw.  And what a treat that my friend Cindi bought pumpkin spiced coffee with her all the way from California.  It's really become a lovely treat in the morning.

Today I ventured out for another walk (with my trusty minder in tow) for around 10 minutes and once again I was exhausted, but glad to be out and getting some sunshine and exercise.  My doctor had said that it will take some time for my energy to return and considering only six days had passed since my surgery I was not too worried.  Then we settled in for our afternoon/evening on the couch to watch movies.

No photo updates today but just thought I'd keep you up to date with my progress.

Tuesday, October 21, 2014

Day 5: It's all yellow

Today I've noticed a couple of things:

  • I'm becoming very bruised on my arms, neck and chest - a good sign that my body is healing.
  • My face is starting to tingle in different places and there is an itch I cannot scratch.
  • The shape of my face is changing each day and I wonder what the final result will be.
  • I absolutely need a shave although I'm also liking this rugged, manly look on me.

       

I'm getting quite used to this whole liquid diet and the weight is dropping off pretty quickly.  If there is one suggestion I can make to anyone about to go through this surgery, it is to bulk up beforehand.  I purposely put on 5kg (11 pounds), but I'm losing it pretty quickly and feel like I should be writing a Bridget Jones style diary: 



OK, maybe not.

Today I participated in a little outdoor exercise as I felt that the swelling had gone down enough to not make children scream.  And by a little bit of exercise I mean walking to the car and back.  This completely exhausted me.  Although Cindi and I are packing lots of nutrients into my smoothies we realised that I need more protein - cue an online order of 1kg of whey protein isolate.  We are by no means nutritionists - although Cindi does know a lot about health, but packing more protein and fibre into my liquid meals will ensure that I feel satisfied for longer while at the same time giving sustained energy release.  Compare that to sugars and carbohydrates that give a quick burst of energy that then decline rather rapidly.

Anyhow here is an updated photo of how I am looking so far.


Monday, October 20, 2014

Day 4: I wish they all could be California girls

Monday was very exciting as it was the day my amazing friend Cindi arrived from California.  Cindi has travelled all this way to take care of me for my first two weeks of recovery.  I said it before and I'll say it again - I'm lucky to have such amazing people in my life.  A friend of mine who stayed the previous night went to the airport to pick her up and in no time at all they had arrived back at my apartment.

Cindi and I have become a little spoilt recently with the frequency of seeing each other.  The last time was only four months ago in June when I surprised her at her home in California for her birthday.  And only six months before that I had spent Christmas and New Year at her home.  Regardless of only four months passing though, we drank coffee and talked for as long as we both could.  Cindi of course was quite tired (it's a long journey from her home in Napa to Sydney) so we both took long naps. 

In terms of my recovery - my sinuses are still very congested and I'm finding it a little difficult to breathe through my nose.  My face and neck are still swollen but I am in no pain.  I have no energy though so am trying to take my recovery as slowly as I can.

Sunday, October 19, 2014

Day 3: There's no place like home

Sunday - three days after surgery and I was ready to go home.  In fact not only was I ready to go home, but I just had to get out of that hospital.  The food was bland, the bed was uncomfortable and I was completely bored!  I must have seen the same daytime TV shows over and over again and while I had brought my laptop, I had left my hard drive at home with all of my movies.  On a positive note though, I can now tell you everything about personal blenders, carpet cleaners and frying pans made from stone.

Luckily for me, the checkout process is just as fast as the check-in.  The nurse came and removed the valve from my hand and I removed (rather painfully) all of the sticky pads from my chest.  I packed (how did I end up with so much stuff) and waited for some friends to come by and pick me up.  I had time for a couple of selfies before I was collecting my drugs and on my way home.


As you can see my face is still very swollen but I am starting to talk clearer as each day passes.  I still have a lot of numbness all over the lower part of my face and this is to be expected for a number of weeks.

Finally I was back in my own apartment and it felt good!  I made a smoothie before sleeping on and off for the remainder of the day.

Saturday, October 18, 2014

Day 2: Oh what a (terrible) night

So I wish I could say that my first night in the ward was uneventful but it was actually quite scary.

Throughout the first day after surgery I had been experiencing reflux - this had made my already swollen and sore throat worse and in turn limited how much I could comfortably breathe.  The weird thing was that I kept feeling as if there was a lump at the back of my mouth that I couldn't swallow.  As my nose and sinuses were also completely blocked, it didn't make a great combination.

Late at night as I was trying to drop off to sleep, I suddenly felt as if the swelling in my throat was too much and I couldn't breathe properly.  I started to work myself into a panic where my heart was racing and I was sweating profusely.  I pressed the call button for the nurse who took all of my stats, but by that point I think I had worked myself up too much.  A doctor also visited and listened to my breathing and assured me there were no obstructions, but again this did not help.  It didn't fill me with a huge amount of confidence that neither the doctor or nurse seemed to know the actual surgical procedures I had been through - they knew I had jaw surgery but did not know that included a septoplasty, which when you are complaining about breathing problems would be very important to know.  And while I don't want to speak badly of the hospital staff - I was in a panic and yet the while all this was going on I felt as if the nurse would disappear for 10-20 minutes at a time while I was feeling as if I would pass out.

Finally at 1am, I asked if they could call my surgeon as I felt I needed his advice.  Around ten minutes later the nurse returned after having spoken to my surgeon who said that this was a normal reaction and that I could use a nose spray to try and relieve the pressure in my sinuses.  After hearing the advice that came from my surgeon I relaxed as I feel very confident in his care.  I finally calmed down and dropped off to sleep a couple of hours later.

In the morning my surgeon came to visit and I of course apologised for having him be woken up - he didnt seem phased at all.  I told him about the lump I could feel at the back of my mouth and he said this was soft tissue that is left hanging because my upper jaw was moved back.  Apparently it will tighten over time.  Knowing what it was instantly made me feel better.  He said that I could leave the hospital that day if I wanted to as they generally want you to leave as soon as you can (less chance of infection at home), but if I felt like I needed to I could also stay another night.  I decided to stay another night as I didn't quite feel ready to go home.

After he left I had the compression bandages taken off my face which relieved a lot of the pressure.  It did give my face a lot more space to swell though and swell it did!

I am not an animal, I am a human being, I am a man!

My drips and lines were also disconnected just leaving a valve in my hand - this added a great level of freedom as it meant I no longer needed to wheel around a whole bunch of equipment.   During the day I had some more visitors and my friends Luke and Sheryn dropped off some lovely flowers and books.  My other friends also returned with balloons.  I'm lucky to have such great people around me.

More updates to come....

Friday, October 17, 2014

Day 1: Let me sleep!

I had slept on and off throughout the night in intensive care and by very early the next morning the place certainly was a hive of activity.  I always seemed to have someone poking or prodding me - either taking my blood pressure and other stats, putting antibiotics or fluids into one of the three lines in my arm or moving me around.  Of course they were only doing their job and making sure that I was well, but it was still really tiring!  To help ease the discomfort though I had my handy self-administered morphine, which I could press every 5 minutes giving me 1ml morphine each time.  Good times!

At some point early in the morning I was moved from my bed to a reclining chair before I was finally able to sleep for a while.

My surgeon came to see me mid-morning and told me that the operation was a great success and that they achieved all they wanted to.  If I remember correctly he said my upper jaw was moved both upwards and backwards 5mm in each direction, my lower jaw was extended forwards 11mm and my chin was repositioned outwards and downwards.  He also said that I had some bone loss in one area of my jaw and he used bovine bone which my body would accept and fuse with my own bone.  His parting words to the team were that they could remove both the gastric tube and the catheter.  While it was not a very pleasant experience having either of them removed, I'll spare you those gory details and just say that I was happy once it was over!

I think one of the most surprising things for me on this morning was that I could talk pretty well and had a good chat with surgeon, albeit with slurred speech and a lot of drooling.  Prior to my surgery I had read blogs where people couldn't speak for weeks, but here I am talking there very next day.  A big reason though will be that here in Australia, they generally do not wire your jaws shut and just use elastics to guide your bite.  While the elastics restrict movement to allow your jaw to heal, they do not completely stop movement.

After lunchtime I was transferred to a ward where I had a private room and I got to have my first liquid meal of fibre milk, clear consommé and water.  I also looked at myself properly in the mirror for the first time - it was not a pretty sight.  Everything was swollen and bruised - my face, cheeks, lips, neck and my arms where the lines were inserted.  On the inside everything was swollen too including my gums and throat - of course this is to be expected after major jaw surgery.

Sing to me, my angel of music!

I was feeling very weak so lots of rest and sleep were in order.  Having to wheel around a drip and grapple with five sets of lines each time I wanted to use the bathroom was tiring in itself.  Later on that afternoon Frankie came to see me in hospital followed by my friends Gerry, John, Jack and Daniel.  They brought me a lovely robe and lots of magazines to keep me occupied.  After another liquid meal I bedded down to try and sleep off the discomfort.

Thursday, October 16, 2014

D-Day: Jaw surgery time

I'm writing this post six days after my surgery but backdating it to October 16th (the day of surgery) to preserve the record.

I woke at 4am on the morning of my surgery feeling fairly calm as I had been all week, but unable to sleep any more.  As I showered and got ready to leave to leave though, the nerves really started to take hold.  The gravity of what I was about to go through came crashing down around me and the end of two years of treatment and planning was finally here.  All I wanted to do was have a cup of coffee but as I had been fasting since midnight all liquids were a no-no.  I got my things together for the quick 20 minute drive to the Prince of Wales Private Hospital and headed out into whole new day.

The good thing about having a 6am check in time was that it was quiet.  There was no traffic on the roads and the hospital itself didn't have hordes of people so actually felt quite serene.

I made my way up to surgery check-in where I filled out some forms, paid my insurance excess (of course!) and signed various waivers about surgery.  I then met my anaesthesiologist who re-iterated the information he gave me over the phone the previous week and generally just wanted to ensure I was feeling okay and had all of my questions answered.

Finally I met with a nurse to talk about my health and and was given some rather attractive compression socks and a gown to get changed into before I was asked to wait in the patients lounge.

What an attractive gown!

Nervous grin

From here everything moved pretty quick.  I was asked to leave the patient lounge after only a couple of minutes and climb up onto a trolley.  At this time I said goodbye to Frankie and was wheeled through to the operating theatre holding area.  I got to speak with my surgeon Dr. Tsakiris and with the team that would be looking after me during surgery.  My anaesthesiologist then popped in to give me some pre-surgery sedation drugs (felt like I'd had a few glasses of red wine) and advised there was a slight delay on the surgery as they were waiting for someone else to recover first.  Twenty minutes later I got more of the sedative and that's the last thing I remember until I woke up after surgery.  Even though I had apparently been conversing with the team right up until having the general anaesthetic - I have no memory of those moments.

Waking up after the surgery was not great, but not as bad as I thought it was going to be.  I had no nausea and as the drugs were still in my system I had no pain - but I did of course feel very uncomfortable.  I remember trying to talk to one of the nurses and wondering why I could not get any sounds out.  In the end I reverted to a pen and notepad to communicate.  Things were a little bit of a blur from here.  I'm sure I spoke with my anaesthesiologist as I seem to remember him saying 'you'll have an attractive smile in no time', but that easily could have been a dream.

After recovering from anaesthetic I was taken to intensive care and this was when I first felt the gastric tube that was inserted during surgery (and still there).  This was really thick and went up my nose and down the back of my throat all the way to my stomach.  I remember trying to swallow and feeling it there and I can honestly say it was one of the weirdest and most concerning things I have ever experienced.  I suddenly noticed all the lines and cables around my body when Frankie arrived to see me and I suddenly felt very emotional.  I kept asking myself 'why did I do this?' but the realistic part of me knew this was a natural reaction and it would be worth it in the end.

From here I slept on and off for until morning and lost all concept of time.

Tuesday, October 14, 2014

Various pre-op appointments - only days to go!

Over the last month I've had a number of appointments in preparation for my surgery which is now just a couple of days away - so here's a quick update.

On September 17th (one month prior to surgery) I had a pre-op appointment with my maxillofacial surgeon.  It was quite a lengthy appointment which I was glad of as it gave me a chance to ask lots of questions and generally be put at ease.  We discussed the surgical plan and what he hopes to achieve before he took some moulds/impressions (to make the surgical models and splints), 360 degree x-rays and plenty of photographs.  He also took various measurements of my jaw and profile and explained what I should expect during my stay in hospital - which will involve waking up from surgery with a gastric tube and (I'm cringing while writing this) a catheter.  Eek!

A couple of days later I had a telephone call from my anaesthesiologist who introduced himself and had a chat with me about how they would be taking care of me.  He again re-iterated that I will have a gastric tube and a catheter when I wake up from surgery.  The thought of a gastric tube didn't actually bother me until just now as I have realised what it actually is.  I thought it was a tube which goes down the throat to the stomach to deliver food.  Nope.  It is a tube which is inserted through the abdomen and into the stomach.  For some reason that bothers me a lot more than a tube down the throat.  Of course all I need to do to forget the gastric tube is think of the catheter.  Double eek!

Then on October 10th I had a pre-admission appointment at the Prince of Wales Private Hospital where they took my blood pressure, did an ECG, took some blood (in case I need a transfusion) and gave me information about the big day.  On October 16th I will be checking into the hospital at 6am and can expect my surgery to start around 8am.  As it is a 5-6 hour surgery, it will be the only one my surgeon performs that day.  Then after a night in intensive care, I will be transferred to a ward where I will most likely stay for 2-3 days.

Finally today I had a pre-op check with my orthodontist who also placed several surgical hooks into my mouth.  These are small metal hooks which are crimped around the wire of my braces.  They are used during surgery to help my surgeon move my jaw around once the bone has been cut.  In the photo below you can see one of them between my front teeth.



So that's it!  No more appointments now, just a count-down to the main event.  I must admit that I am feeling very excited, scared, positive and apprehensive all at the same time.  While I'm not too concerned about the surgery or the pain, I am nervous about the end result and hope that after all of this time and effort I will finally be happy with what I see in the mirror.

And on that very deep note I shall finish this post and will write another update soon.