Nearing the End of the Third Week With a Fractured Jaw

With roughly 75% of the range of motion returning and constant pain beginning to subside for several hours at a time I feel pretty good about not going to a hospital on this one.  Had there been a clear break in the bone I definitely would have gone to get whatever metal was needed implanted and get wired shut.  Sometimes it baffles me how interconnected the bodies musculoskeletal system is and I am constantly reminded of how layered its concert is.

I didn't realize how many different ways and how often I shift my jaw and slide my teeth against each other when I am processing information or thinking through conversation or using my eyes and ears to take information in.  Left, right, backwards, forwards, clenching some sections of teeth and relaxing others at the same time.  Everything from pulling on a door knob, to swinging a hammer, to stretching, sitting down, standing up, turning my head, opening a mailbox, to driving a stick shift is tied to the muscle groups around the neck and jaw.  Suddenly hundreds if not thousands of long memorized motions and activities that you could perform with blindfolded confidence are thrown into doubt.  "Is this going to hurt?"  "How will this affect the healing cracks?"  "Will this pull apart soft scar tissues not yet stabilized and calcified into bone?"  In the third week I am starting to regain some confidence.

For most of the first and second week the pain never felt less than a five or six on a 10 point scale throughout the day from waking to sleep.  Depression became a huge factor.  You are not sad because of what happened or how it happened.  You become depressed because you cannot laugh without shooting pain.  You become depressed because you cannot fall asleep because of sudden spikes of pain that cut through your over the counter pain killers like the barrel of a bat slamming into a light bulb tucked inside a pillow case.  You become depressed because the muscles of your tongue and throat put enough pressure on the angle of your jaw, right on the side of the cracks, to make your eyes tear up when you swallow what you can.  Everything you casually associated with happiness in sleep, smiling, laughter, rest, sustenance, is hot wired and reprogrammed to fear and ache and apprehension and anger and it weighs on you hour after hour after hour until depression becomes crushing.

In week three many self imposed restrictions are beginning to lift.  I can get through the day and night without a single pain pill.  The constant background ache has dropped to an occasionally noticeable two or three.  When I press on the impact site gently, the bone doesn't flex and make crunching sounds.  In the second week I successfully set the condyle back into its natural position.  I couldn't help crying for several minutes afterward.  It was important and necessary as my bite was out of alignment from front to back.  Once I did that the grinding noise right at the ramus's tip finally stopped and when I bandaged my mouth closed with a thick elastic wrap my teeth sat almost as evenly as they did before.  I think that dislocation is probably what saved the angle from snapping clean through.

I can almost yawn again.  I still have to brace my chin when I sneeze.  At the end of this third week I can chew very soft pasta and cheese and drink thick soup relatively pain free, but I am taking it extremely carefully to be absolutely certain I don't retard the healing process or get too enthusiastic about my food choices.  It felt so good to finally be able to scrub my beard again without fireballs of pain shooting through my face.  Nothing changes the complexion of the day like starting it off with a good deep beard scrubbing, good god I missed that.

All of my anger and hatred toward the people that did this to me is gone.  What really makes me happy is not caring what happens to them.  Being able to let their aggression go and not have a second thought about retaliation or feeling like I'm owed something or that I owe them something.  The transaction is over.  What matters is what you decide to do next for yourself.  What matters is that lying in bed your jaw doesn't sag and fall to one side like a screen door with one hinge.  What matters is that you survived and you can physically laugh again without fear of splitting bone apart from the spirited ways in which you normally like to jump on life's comedy.

I still cannot laugh too much or the pain piles up and grows to wince worthy proportions and twists my face sour.  I still can't make some facial expressions.  I still can't sustain hours of conversation, but then again I was never particularly great at making conversation as much as listening to it, but it is still something to get used to realizing that I can only say so many words before I have to rest and close my mouth tightly.  I still can't clench my teeth in consternation.  I can feel some lingering instability and pain in the healing dislocated joint when I run up or down stairs or shake or nod my head too vigorously.  Hopefully these things and instabilities will pass as week four progresses.

I know there is potential for some level of permanent pain in the joint since it was not reset by a professional and was not wired shut to ensure speedy and complete recovery of the fracture site.  There were evenings when I slept and would wake with a start in the second week so abrupt I could feel the joint strain and hear the angle click and flex.  There was a day when I woke to a spider landing on my cheek and a slapped at my face and new before the pain even registered that I screwed up big time in doing so and set myself back all of whatever healing occurred through that day.  Common sense tells me this too, as my back injury from two and a half years ago still bothers me from time to time and sends numb sensations down my right buttock and thigh if the barometric pressure is too far off from my body.

Some of the nerves likely died as well as there is noticeably diminished feeling along the left side of my jaw bone.  I expected as much.  I expected the worst, but progress has been good and some levity has returned to day to day life.  I am not out of the woods yet.  Two to three more weeks to go before I'll try to bite into a piece of meat that hasn't been blended to the consistency of mashed potatoes.  At least three more weeks before I try to bite into an apple.  I think I may attempt a sandwich next Saturday... a grilled cheese or peanut butter and jelly.  My tummy can't wait to have fun with food with my mouth.

The food has been spectacular.  At first, the only things I could eat were nutrient shakes and very thin liquids for the first two weeks.  Very finely blended and extremely water heavy meals put through the blender and then only a half cup or so every few hours because the pain was too intense to do much more than that.  Since then the horizons have begun to grow and meals become more intricate.  Right now it's an assortment of pastes and soups of varying composition, from fresh bell peppers ground into bacon pate with rice and spinach soups drizzled all around to sweet bean mashed potatoes with soft sharp chedder shredded over the top alongside peas carrot beef mash and oreos in a little cup on the side blended into a desert syrup.  Nothing makes lunch quite like peanut butter and jelly paste beside a cup of milk.  It has been a little bit of a challenge and through the first two weeks I lost 25 pounds, but as time is getting on, some of the weight has come back.

I still feel weak from not being able to work out or move much, but some strength has returned and will only increase as the healing progresses.  At the end of week 3, I feel alright about the future.  There's a decent chance I will be close to what I was before my jaw was fractured and dislocated.  I know I will never be the same, but I am alive and can continue and I am happy for that.  Happy with that.  It kind of mirrors my mental problems that I deal with and constantly manage without medicine.  I know I will never be better than I was, but I can try to make sure I don't completely unravel and if I can be close to as sound as I was the day before then I have done the best I can.




///Deptford Goth - "Objects Objects"  the bass filled silence between the searing walls of the chaotic