Thursday, October 28, 2010

Yawning, swimming, humming, yelling, whispering, spitting, brushing teeth, coughing, coughing up phlegm

How the hell do I do it now?

And what the hell is your uvula for?

Turns out that both of those curious questions from Minions can be answered in the same post. Anon asked the first question and Wayne the second. Let's take that second question first:

Basically, your uvula keeps liquids and solids from going into the back of your nasal cavity from the back of your throat. It doesn't keep things out of your trachea; that's a totally different job and one that's handled nicely by the epiglottis. Uvulas (uvulai? uvulae?) are also uvu-useful if you speak a language with a lot of crazy fricatives like Turkish or, well, I guess German uses the uvula a lot. The folks who speak languages like !Kung also use their uvulas/i/e to make what are called "uvulual consonants" or "that clicky noise". English speakers find it handy in pronounding "b" sounds, which can come out like "m" if you don't uvulate.

Uvulas, in short, are handy to have, but you can certainly do without one. You'll snort soup into your nose now and then, but you can get used to anything.

As for swimming, yawning, humming, yelling, whispering, spitting, brushing teeth, coughing, coughing up phlegm...I've tried most of those things (except swimming) with varying success.

Yelling I cannot do. Not because I'm missing the bits that would keep me from doing it, but because my throat is, as yet, too damned sore to be yelled out of. The rest of the things have either no changes (coughing, whispering, humming, spitting, coughing up phlegm) or very strange changes (yawning, because my jaw muscles are hugely sore, brushing teeth because well, I'll get to that in a second).

Let's start with the basics: swallowing liquid. It's tricky, but your body will adjust in about ten hours (if you practice a lot with tiny amounts of liquid) to swallowing in very careful, delineated stages. Since I don't have a flap to close off the back of my sinuses any longer, a swallow takes about 1/3 longer than it used to, and I can swallow about half as much at a time as I could before surgery.

Moving on to things you might want to be able to do, like coughing up crap from a lung, I was surprised: that and spitting did not change at all. I used suction for the first 24 hours to clear my secretions once I'd coughed 'em into my mouth, but that was because my tongue was so swollen I couldn't get it out of the way. Now, it's just like it was before.

Brushing teeth....that's the biggest change. That's the one thing I do every day, twice a day (and will be doing more often once I start radiation) that reminds me that there's actually something going on in there.

See, because I have no schnozz-closure flap, food and fluid can get up in my sinuses. And because I'm missing my right eustachian tube, all kinds of ick can get back in there, too. And there's this magnificent hole in my right upper jaw that used to hold a tooth, and some other, smaller holes I haven't quite figured out the purpose of. Oh, and the whole back of my throat is gone. So there's a lot of places for crap to hang out and ferment and get gross.

When the prosthodontist took out the first obdurator--the one that had been sewn in that I couldn't remove--I nearly passed out. It was easily in the top five of Gross Things I Have Seen, and certainly the grossest thing ever taken out of my body.

So. How do I brush my teeth, keeping in mind that I don't want to get toothpaste into my sinuses?

Step one: take out the oburator and scrub it with a soft toothbrush and toothpaste, then stick it into its cute little Obdurator Hut and cover it with tap water.

Step two: Mix up a pint of sinus rinse (buffered normal saline).

Step three: Brush teeth for two minutes using Sonicare toothbrush. Using plain toothbrush, scrape tongue from back-to-front energetically, then spit repeatedly. (Note that I cannot swish water around in my mouth; it'll come shooting out my nose and that HURTS when there's mint involved.)

Step four: Floss teeth, using the low-trauma method of flossing (morning and night only).

Step five: Brush teeth for two minutes using Sonicare toothbrush. (The oral surgeon recommends that I brush for a total of ten minutes a day in four to five sessions. This will help keep my gums and teeth healthy during radiation. I'm working up to that now.) Scrub tongue and spit.

Step six (where it gets gross): Working from back to front as best as I can, use the sinus rinse kit bottle to rinse out all the little crevices and healing bits at the back of what used to be a mouth. Use at least two pints of fluid for this, as the world's nastiest stuff tends to get loosened up by the first pint and flushed out by the second.

Step seven (as if step six weren't enough): Mix up two more pints of sinus rinse and use them to rinse my sinuses out. Some people apparently use a Water-Pik or other comparable instrument to do this, with home-made saline solution. I am not that butch.

Step eight--almost done! Rinse for thirty seconds with carefully-swished-around chlorhexidine 12% wash and spit. Try to ignore the taste.

Very niggly, very time-consuming, and not at all sexy. This is not the sort of routine you want to have to go through on a first date. Plus, it's decidedly strange to be rinsing out the inside of your own head as a part of your daily ablutions. It would be easier if I had a flip-top head.

Which reminds me: it's time to start the routine. And no, I am NOT providing pictures of this.


Crazed Nitwit said...

I'm so glad you're not butch enough to use a water pik up your nose........thank heavens you're human!!! You still make me laugh.

Pam said...

That is a very cool thing to know. Thanks.

Jenn said...

I just love the phrase "cute little Obdurator Hut". Does your obdurator need a knitted cozy for the hut as well? I'd gladly knit one!

id said...

Jo, Thank you! Sometimes--or maybe most of the time--us non-medical people have no idea what some of our parts actually do. Since I can't look in my throat when I swallow or swish or whatever, I had no idea that uvula thing was good for anything. I guess that goes with never having had an anatomy class.

Lynda Halliger-Otvos said...

Pulling for a solid recovery with no additional problems. Stay strong,

Anonymous said...

glad you are learning all the tricks!
It is amazing how quickly you have learned to swallow and eat without
too much grossness. It gets easier.
Please YAWN now - keep the jaw stretched out - very important during radiation as well. YAWN - big stretch! Good!


Celeste said...

Whoa, that's intense as oral hygiene goes. I had no idea.

I guess the only thing to do is soldier through, and be happy they are helping you prevent mouthly badness.

messymimi said...

Makes me feel like a wus because all I use is a neti pot twice a day.

Anonymous said...

Oh, my. Oh, My!! Did you say earlier that after a year parts of the soft palate can be rebuilt? The uvula too? How?!! Oh, my. It's overwhelming, but I'm so glad your sense of humor is intact. Carry on, Jo. Make It Work.


bdaiss said...

Oh holy buckets. I shall never again complain about spending a few minutes each day brushing/flossing.

And thanks...for making something that has to be so awful still seem so humorous.

Anonymous said...

Your attitude is amazing! I know you're probably just so glad to get rid of that bastard that so rudely interrupted your life, but the uvula-talk reminded me of the time my uvula must have been sleeping off a 40 oz and let a large chunk of Kraft Single American Cheese get itself up there - when the damn thing finally flew out my nose it was stunningly uncomfortable in ways unlike other discomforts I've felt in my life like lodging a 3 inch long splinter in my foot. I can imagine myself hurling jugs of saline with bullet force against the wall. I know you don't like the gushing compliments but Jo you are one hell of a 10/10 person. Elyse

Urbie said...

To a tuba player, the implications of all this are too awful to contemplate! :-D

Be well,


birdergirl said...

OMG, Jo! What a routine. I do not believe you will be able to fit any nursing work into your oral hygiene process. ((((hugs))))

Omaha1 said...

Good luck with that "ignoring the vileness of Chlorhexadine" thing. Thanks to poor dental hygiene earlier in my life I have to use it now to improve the health of my gums, although I am down to once every other day thanks to faithful flossing. It not only tastes horrible when you rinse but has the added "benefit" of removing the flavor from foods you eat later. Probably not helpful with that weight loss issue.

Anonymous said...

you are so awesome. thank you for living on the same planet as me.