Here is my panoramic x-ray, so you can see all of my hardware. You can also see the gaps in my bones from where my mandible was advanced.
Tuesday, December 9, 2008
Here is my panoramic x-ray, so you can see all of my hardware. You can also see the gaps in my bones from where my mandible was advanced.
Thursday, December 4, 2008
I forgot to mention yesterday on my post that when I run my fingers along my lower jaw line on both sides, I can feel the gaps from where they advanced my jaw! He took another x ray today after the plate removal and I am down to 7 plates now, 39 screws. The sutures should disolve much more quickly this time, within a week or so. I am hoping I will be feeling this well later when the IV sedation wears off ... so far a piece of cake!
Lately I have been getting a lot of food stuck in between my last two molars on my upper right side. The other day, I took a toothpick and usually the end would tightly wedge in between the two teeth. Well, I forgot about the coil that was creating a gap in between the two teeth, so the toothpick went right in and stabbed me. I put my tongue up there and a siqeable gap has opened up. So, that's good news. I have also been flossing for the last few weeks ... I can feel the floss in between my lower teeth, but I can't in between my upper teeth. If my teeth have even a tiny gap between them so the floss doesn't "click" between them, I keep putting pressure waiting to hear the click, and then realize that the floss is already on my gums. They don't bleed, though, I think because the surgery cut off the blood supply and all of those blood vessels have not reconnected and regenerated yet.
My lower incisors have dark stain marks on them from the Peridex. I am hoping things heal up quickly from my plate removal so I can go in and have a cleaning. Hopefully I won't have to keep taking it. That would be a great Christmas present, my pearly whites back!!
I'll post an update after tomorrow's procedure ...
Sunday, November 23, 2008
Saturday, November 22, 2008
I scheduled to have it removed on Thursday, December 4th. I was hoping to do it on a Friday so I had the weekend to recover, but that didn't work out so I took off on the 5th. If I don't have to take the heavy duty pain meds after (I will try to get away with just OTC if I can, but certainly will take the heavier ones if needed), I may try to go in to work the next day, we'll just play it by ear.
As far as the procedure goes, I will be sedated with a cocktail of Versed, Fentanyl, and a steroid to reduce the swelling. You are half awake, half asleep for the procedure, but 95% of people don't remember. Hopefully the fentanyl won't affect my vision again, I guess it is just temporary if it does, although I'm not sure if it was my anti-nausea patch or the fentanyl patch that blurred my vision so much after my bimax surgery . The procedure will last about 45 minutes. Pretty straight forward and MUCH less invasive than the last time.
Recovery wise, it shouldn't be too bad, I will just need to keep away from the stiches and incision site again. I am prepared for the lopsided swelling, but hope it doesn't linger too long so I am back to normal by Christmas and New Years. It should be pretty good after a week. It could limit my ROM some, we'll have to wait and see. I can get 1 finger in there now, vertically, all the way back to the back knuckle, so I still have a ways to go. I think I was able to get 3 fingers in before surgery.
I'll post if anything happens before my plate removal, but no appointments between now and then. I'll try to get some new pictures up before plate removal.
Saturday, November 15, 2008
I am almost at 10 weeks right now, and still have some residual swelling. On my right side along my jaw line, I can feel a lump there, I am not sure if it is just more swollen there than on the other side, or if it is scar tissue, but it definately feels different. It is also a little tender in that area when I touch it. Strange, since I would have expected that to happen more on the side where the plate is exposed.
Still no migraines ... I just can't tell you how happy I am about that. Over ten years of suffering from them ... I don't want to speak prematurely because who knows what could happen once I get my range of motion back, but if they are truley a part of my past I will be more grateful than you can ever imagine for having this surgery. I still get the occasional ear pains, but they usually go away and don't last too long.
I can't wait until I can stop using the Peridex. My teeth are now very dingy looking and I am looking forward to getting them cleaned, even if the hygienist can only get the outsides and can't get inside my mouth.
I don't think I mentioned this before, but my cheek is basically healing over my lower left bracket. It is almost completely covered now. My OS told me last week that the same thing happened to him. It is like that on the right side, too, but not nearly as bad as the left. Not too fun, unless you like chewing on your own cheek.
Well, that is about it for now, I will post more after my appointment Thursday.
Saturday, November 1, 2008
I have an appointment with my OS on Wednesday, I am hoping to get cleared for soft chew, so cross your fingers for me!!
Tuesday, October 21, 2008
I ventured to ask about the plate removal procedure, if/when it takes place around week 10. It will be an in office procedure, using IV sedation, and I'll be in and out within an hour or so. He'll precribe me some of the heavier artillary drugs if I have excessive pain, but hopefully I will be able to get by on OTC meds. If we do the procedure on a Friday, I should be back to work the following Monday. I will only have to go back on liquids for a day or 2, and it won't have to be clear liquids, as the plate removal procedure is much less invasive than my original surgery. So that was good news.
We talked about my range of motion ... he doesn't think I'll progress too much more as long as I am in the bands still 24/7 ... although he did say that I may get some more ROM when I move to soft chew and have my bands out for 1 to 1.5 hours each time I eat. He said that it can take up to a year to get my ROM back, his ROM is less than before he had his surgery and since it has been over a year now he doesn't think he will get it back to what it was pre-op.
He will be in Canada next week, so I will not see him, but he still wants me to meet with one of the other doctors just to check on the plate, but so far everything is still looking good.
Monday, October 20, 2008
O.K., back to my mouth. On the way out at airport security, they accepted my letter very easily from my OS regarding my liquid nutritional suppliments. I had a tight schedule when arriving to Paris, so I had carried all 18 nutritional suppliments (I hoped I would find other alternatives, but you never know so I was prepared), plus my liquid tylenol and my Peridex, in my carry-on with me without checking any luggage. I knew I would have more of an issue on the way home (they can be very strict in Paris!), so I only brought the liquid tylenol, Peridex, and one Ensure on the plain with me, and the rest I checked. They held me up for about 30 minutes, because they needed about 5 levels of approvals before they would let me through! Part of the problem was that they were looking specifically for the name of the products on the letter from my OS, and he of course was very general in stating nutritional supplements. Plus, I don't think the language barrier helped. But I made it through and am back now.
Today, I had my first appointment with my OD where we were going to start moving and changing things. I was scheduled for 1 hour, but it ended up lasting about 2 hours 45 minutes! Lots of new information though.
First, I asked if the fact that Dr. P could not get all of the movements necessary in surgery because of my tight tissue would alter my outcome. Dr. L doesn't think so, he said it should be no problem to get the expansion I need in the back orthodontically. I also asked about my overjet, as it seems larger to me than it should. Dr. L agreed and said that is why he suggested the band configuration I had when I first started changing my bands. We have some work to go, my lower teeth will pretty much stay where they are, but we can push my upper teeth back some, which will reduce my overjet.
They took out my wires today and repositioned most of my brackets on my upper teeth. For about 20 minutes, I had naked teeth! It gave me a preview of what I had to look forward to on de-banding date, and I can tell you, I liked what I saw ... and that is with still having a bit of work to go! On the lowers, they put my same Sure-Smile wire back in -- minus the surgical hooks (yeah!). As for my upper teeth, I believe I won't get the Sure-Smile wires back in anymore, and Dr. L will finish things off with traditional wires.
The techs had a really hard time with my upper wire. My ROM is still pretty limited, I can get my thumb in there and maybe a tiny bit more, so they had a hard time turning in the wire in the back on both sides. On my left side, they didn't turn it in because of my exposed plate, we didn't want to mess around too much there. So, she cut the wire short so it hopefully wouldn't bother me. On the right side, they put a coil/spring in between my last two molars to open up some space, because in several months (probably 3-4 months) I will get a TAD (temporary anchorage device) put back there, and we will pull my teeth back. So, she couldn't clip that wire too short because it needs some excess for when that space opens up, and since I am still pretty swollen in there the wire was really jabbing. When she tried to turn the wire in, the tool was too big and I couldn't open enough, so it would rub against my stiches and caused some bleeding. I told her I would deal with that pain at the moment because I would rather have that than 7 weeks of a poking wire. Finally, she got it, but I felt like I really stressed the techs out today because they didn't want to hurt me. It was uncomfortable, but I am just glad she was able to get the wire turned in.
So, on my right side I am 95% Class I (Yeah!) ... so just some tweeking to do there. On my left side, I am still Class II, but with the coil and the TAD we should be able to correct that. Overjet, Dr. L will push my upper teeth back to take care of that. My mid-line is still about 2 mm to the left, so we have that to correct that as well. I got a new elastic configuration today (no more box config on the front!). The elastics are much lighter, and I have just 2 bands. I will wear them 24/7, take them out to eat, and at night I have to double up on the elastics on my right side. I believe that will help work on the mid-line.
I think that covers most of my appointment ... at the end Dr. L told me he found out about my blog and has taken a look at it. I asked him if it was from the my Dentist's office (I had sent the gals a link to my blog to follow my progress), and he said no, that he found out from someone (I assume a colleague or professional acquaintance) in Texas. Apparantly, there are not a lot of Sure-Smile patients yet that have been through this surgery. So, between my reference to that in my blog, and my references to Dr. L and Dr. P, and the fact that I am in Green Bay ... they put it all together. So, Dr. L ... if your reading ... thanks to you and Dr. P for all of your hard work to give me a functional bite and beautiful smile!
In other news ... it looks like my plate continues to heal over, although it doesn't seem like anyone is optimistic that it will heal over completely. The good news is that there is no visible bone which means that the chance of infection is much less. I have an appointment with Dr. P (OS) tomorrow so I will update more on that if necessary.
Lastly, kind of a random thought ... but it has been so strange for me to see the way I open my mouth now. I felt in the past like my jaw opened like a hinge, whereas now, with the lower jaw rotation, the top opens paralell to the bottom ... like an eel. It is just so different as your perception of normal changes ... apparantly that is how most people open their mouth!
I know ... I need to post some new photos. I will have my husband take new ones of me in the next couple days. I feel pretty swollen now from this morning's appoinment ... but tomorrow should be better. Today is my last day of working from home ... I will go into the office daily from now on. It should be much better now that I have a much more manageable band configuration.
Thursday, October 16, 2008
Sorry for the negative post ... just haven't felt the greatest the past few days, but I think I mostly have the pain under control now. I am leaving for Paris this afternoon, so I was particularly worried about my ears because of the flights. There is nothing worse then having congestion or an ear infection and going up to 30,000 feet! It's the way down that's painful ... OUCH! Luckily, I haven't gotten congested, although the doctor I saw said this could be just the start. I hope not!
In better news, I got my toothbrush inside my mouth yesterday! I was so excited ... although just because it is in there doesn't mean you can brush like "normal". But, I got my tongue and the insides of my teeth the best I could. When I tried again last night, I couldn't repeat, but at least this means I've made a little progress on the ROM.
I will try to get up some new pictures when I get back from Paris, I feel like my swelling hasn't been going down much at all anymore. It is mostly concentrated above my upper lip, around my nose, and in my "jowls". I know ... I need to be patient. Patience, grasshoppa ... patience.
All right, I'll update more when I get back from my trip ... Au revoir mes amis!
Friday, October 10, 2008
Thursday, October 9, 2008
I didn't have the courage to ask him once I get the plate removed (not sure exactly when that will be yet) if I will have to go back on the clear liquid diet again for a week. Ugh ... I am torn now. The longer I wait to get the plate out, the longer I have to be on this blended diet because I have the open incision. But, the longer the plate stays in, the more time my bones have to fuse together and heal. Luckily, at least I can still feel somewhat satisfied on the blended diet. I was just hoping I would have a few more options when I go to Paris. Now it looks like it will be Ensure/Boost/Juice for most of the trip, unless I can find some good soups here and there. I guess I should be happy everything is looking healthy and infection free in my mouth given my open incision. And I am ... that is why I will take Dr. P's advise and stick with it. It is crazy looking at that plate in my mouth though ... you can see the screws.
My stitches are slowly starting to disolve, on the inside they "melt" into your tissue and on the outside they start to fray. Dr. P snipped a stitch for me today that was hanging down and wrapping around my braces.
A shout out to Holly who will be having her second surgery tomorrow. Good luck Holly ... I know you will do great!
Wednesday, October 8, 2008
The things that stand out to me are how my upper lip was lenghtened (it seems to come down further now), and the angle it sits at (it comes more straight across, versus how it sas very angled upwards before), which really does the trick in reducing my lip incompetence. And, of course, the stronger chin, which isn't nearly as strong as in the projections (they decided not to do the genio), but I do think I prefer the softer look.
Saturday, October 4, 2008
My mother-in-law leaves today to go back to Mexico, so as of tomorrow life as we know it will be back to normal. I really was blessed to have so much post-op help ... I am so greatful to my mother and mother-in-law as they both helped to make my recovery so much easier :)
Thursday, October 2, 2008
I saw Dr. P for my 3rd follow-up appointment since surgery. He said that the mid-lines look better than last week. He said instead of my maxilla moving, it may be that the swelling is creating an illusion. So, let's hope this is the case, and as the swelling goes down my midlines will be spot on! We'll see what Dr. L says on Monday.
In other news, he took a look at my plate, and said that it has opened up a bit since he last saw me. So that is bad news. It means it probably will not heal over on its own. So I will need to continue to do the Peridex treatment, he told me I could reduce it to only once a day, but I had to continue to reduce risk of infection. I asked him if he preferred me to do the rinse twice a day, and he said yes, but it will cause more discoloration to my teeth. I told him that if he wants me to do it twice a day, I will, because right now my primary concern is my health, and I can worry about the aesthetics of cleaning the dark film off my teeth later. He agreed, I am also to do 4-5 salt water rinses a day as well. Once I move to soft chew, which will be around the 6-8 week mark, we will give it a couple of weeks and decide at that time if I am ready to get the plate removed. He explained that in a human being, bones take about 56 weeks to heal. It would obviously be preferable to keep the plates in, but the risk is infection. So you need to weigh the better of two evils. At 8-10 weeks post-op, the bones are only semi healed, however I have 2 plates on each side of my jaw where the BSSO incisions are, and he will only remove one of the plates, the one that is exposed. So, I feel much better about this now. From all of the stories I have read, I wanted to keep those plates in as long as possible, to prevent relapse or non-union. But I feel a lot better if I reduce the risk of infection by removing the plate plus I keep one plate in. Many only have one plate on each side with the BSSO to begin with, so I am feeling pretty good about this. Obviously it would be nice to not have this complication, but when I decided to go though this process, I knew that I would have to do "whatever it takes" to get to the finish line and deal with whatever complications arise. Normally, he would clear his patients at this point to see them in 4 more weeks ... but given my exposed plate, I have to continue seeing him weekly (not that I mind).
I asked him what may have caused the exposed plate, he said it could have been a multitude of causes, but possibly, since when viewing my x-ray, the plates appear a bit higher on the left side than on the right, they could have been a bit to high (too close to the incisions).
I asked Dr. P about my sutures, he said that they are self-dissolving and should start to go away around the 5-8 week mark. The ones under my upper lip will take the longest. I am ready for them to go so I have the resemblance of a normal smile again!
I told him that I could open about as much as my pinky finger, and it felt like there was something stopping me in my left joint. He said that is normal, that it would take me months to get my ROM back, and the blockage that I feel could be from a variety of reasons such as swelling in that area or other factors.
he said my swelling has gone down nicely since my last appointment, particularly in my gums. He said the ones in the back are about a quarter of the size (swelling wise) of what they were last week. I have noticed that the swelling in there has gone down considerably as well. I wonder if the bromlain has had anything to do with that, or if that is just my body healing naturally.
He said my profile is coming in nicely, he is glad that he did not to the genioplasty because I will have a good profile without it. I concur, the projections were a little bit strong (masculine) looking, and I prefer the softer look, plus I believe it made my recovery much easier. Not to mention the finacial bennefit of not doing the genio.
He said I should see the swelling in my lower jaw to continue to come down, but the swelling behind my nose, under it, and along side it could take up to a year to diminish. I gues sthat is consistent with what I've read elsewhere ... and everyone heals a bit differently.
He asked me how I was feeling overall, and I told him that I prepared myself for the worst, and recovery has been "easier" than what I anticipated. The worst was the 2 full weeks of liquids no particulates. He empathised and talked a bit about his experience, how hard it was to choke sstuff down when nothing tastes good and you just loose your appetite.
I just can't say enough about my OS and OD. First, that they are in such close contact to ensure that I have an optimal result. And Dr. P takes the time to answer all my questions, calmly, and he's not put off by any question. He just has such a great bedside manner and explains everything in laymans terms so I am comfortable with it. I wonder if he was always that way, or if part of it is a result of him having undergone the surgery himself. Either way ... I feel pretty lucky to have such a competent team of medical professionals.
Lastly, my boss asked my yesterday if I would be able to go to Paris. Not for the food show that I was originally considering, but for a meeting which is taking place about the same time. I said I didn't think there was any reason I couldn't go, but I would get it cleared with my surgeon. The food show was completely out because how can I be on my feet for 5 days, 10 hours/day, talking with clients and potential clients all day long while still banded shut and on a blended diet. But, a 4 hour meeting seems perfectly acceptable, and my surgeon agreed. He just wants me to let him know before I go because he will put me on antibiotics, he doesn't want me to go to be in a foreign country and have an infection. I'll only be gone 2 or 3 days at the most, so I think I can survive on juice, Ensure, and Boost for that period of time.
Sorry for the long post ... I will update with more photos this weekend.
Sunday, September 28, 2008
Thursday, September 25, 2008
Then he saw the exposed plate. He said that wasn't exposed last week either! So, he has me doing Peridex twice a day now for the next couple weeks, apparantly it will help skin heal over the plate hopefully. I cringed when I heard him say Peridex because I know it stains the teeth, but he said only when used long term, so hopefully my teeth won't get too dingy from a couple of weeks of use.
He showed me how to change my bands, and tonight I changed them for the first time. I did it in about 15 minutes! I thought I would take much longer, but I have to say, the one on my lower left back molar is so hard bacause the hook is so close to the gum. Since I can't feel my gums, makes it a lot harder to try to hook the band on, and you don't know if you are beating your gums up. But, I did it, so I was happy. I also can brush my front upper and lower teeth, along with my upper molars. He won't let me brush my lower molars yet because of the sutures.
I am also cleared now for a blended diet and I can eat dairy now! So, after leaving my OS's office, I got a Vanilla shake from McDonald's and sucked it down. We stopped at the grocery store to get a few more things now that I am on blended, and I cooked up 3 strips of bacon and mixed them in the magic bullet with home-made black beans and beef broth. Wow, that was good, but it was so weird to eat something with particulates. Since I can't really open much, they didn't get into my mouth. Oh well ... the appetite is definately back and it was DELICIOUS!! I can't even describe how weird the eating process was, though. I envisioned moving to particulates much easier.
That's all I'll post for now. I should also mentioned that I lost all of the 8 lbs that I gained inicially and I am now down 9 lbs. from where I started. That seems more normal!
As of Tuesday morning, I was off all pain meds, including children's motring (ibuprophen). I took some tonight beacause my teeth are a bit tender from the new band configuration.
Monday, September 22, 2008
I saw Dr. L at the Oral Surgeon's office, and found out some new information that made me understand Dr. P's conservative approach to eating much better. When he started checking out my mouth, he said to me that I need to do a better job of brushing. My mom and I glared at him and we both blurted out that I had strict orders from Dr. P NOT to brush, that I wasn't to disturb my sutures in any way. He wasn't sure why Dr. P wouldn't let me brush yet, and started looking around my mouth, and said "ah ... I see now. It looks like you have an exposed plate". What??? I guess that kind of freaked me out. He said that happens occasionally, that the skin will not stretch completely over the plate. The skin very well may grow over it while it is healing, if not, I can have it removed down the road. He said there was one gentleman that had been one gentleman who recently came in that had an exposed plate for 2 years now, he was just getting sick of food getting stuck there so had it removed, but otherwise caused him no problem. I will definately be asking Dr. P about this at Thursday's appointment. But it explains why he doesn't want me to have anything with particulates. I also asked Dr. L about eating dairy ... he said the reason I shouldn't have dairy is because it leaves a thick film on the teeth, and since I am not allowed to clean them yet, not a good idea. So I am really crossing my fingers that on Thursday Dr. P gives me the ok to brush (I know I won't be able to brush my back teeth because of the exposed plate, but at least the front) and move on to a pureed diet.
In other news ... the last two nights I have woken up every hour to hour and a half, and have had a hard time getting back to sleep. I asked Dr. L about this today, and he said that this is common when you are coming off the pain meds as they can be a bit addictive, even though I didn't take them for that long. So, hopefully that will be short lived ... as it is quite annoying not getting a good night sleep.
I am going back to work tomorrow on a part-time basis, just for the week, and next week I will be back to full time, although I will be working from home. It will be good to get my mind back on work so I can start focussing on things other than my mouth again, hopefully it will make time start to go faster as I think I have been feeling the "blues" these last few days.
Sunday, September 21, 2008
I am starting to get some tingling in my left nostril and roof of my mouth as the feeling is begining to come back.
I occasionally get sharp pains in my ears. Tomorrow is my first appointment with my orthodontist. I am looking forward to Thursday's appointment with my OS because I am hoping to graduate to any blended food. I just don't have an appetite so it is hard to get things down, but I am trying to force myself so I atleast get some calories in.
Wednesday, September 17, 2008
And here are the photos from after the MLD/Reiki session:
I have been slowly trying to reduce the use of meds, right now I just have my pain patch and anti-nausea patch which will last until Friday, and I haven't taken my Oxycodone since 7 am yesterday morning. I have taken liquid ibuprophen twice when I start feeling a bit of pain. I am hoping once the pain patch is gone I can just be on the ibuprophen.