Tuesday, December 9, 2008

3 months post-op and exciting news!!

Recovery from the plate removal was much better than I expected. I had absolutely no swelling, and I didn't need to take any pain meds, not even OTC. By the next day, I was feeling absolutely normal.

Today I am 3 months post-op. I had an ortho appointment, which went very well. Dr. L looked at my bite, and could tell I have been very diligent about wearing my bands, because my bite is almost perfect! He said that we won't even need to put in the TADS anymore to pull my bite back! So we can close up the space that was just opened with the coil. He said that in the "old" days, when they used the splint, it could actually work against the orthodontics if the splint wasn't exactly in the right position, and the orthodontist is basically SOL. But now, without the splint, he can get started much earlier with elastics to move things into place before they set. I believe I read on Archwire that teeth are more mobile than usual in the couple of months post-surgery, due to the prostaglandins that are released around the damaged tissue. The OD can make the most of this by getting a lot of movement done in those few months. And it looks like that held true for me!

Given the good news on my progress, I finally had the courage to ask about a potential debanding date. The news that followed made my day, and was honestly much better than I ever had hoped. He said I could expect to get my braces off in 4 months, which would put me at April! I have been in braces for just over a year now, so I can handle another four months. I am so excited ... I really didn't expect to get them off so soon.
I now only need to wear my bands after dinner and at night, just to keep my bite wear it is. I got my power chain replaced on my upper teeth, and a new power chain on my lowers. The coil came out as we are going to close up that hole between my molers now that we don't need the TADS. I also asked about my airway, so Dr. L ordered a Lateral Ceph so we could compare. Below are the side-by-side images ... it is amazing how much my airway opened up!

In addition to the wider airway, there is a dramatic difference in the soft tissue around my chin in the above x-ray. When I got my plate removed last Thursday, I mentioned to Dr. P that I haven't had any migraines. He mentioned that coventional wisdom points to my now stable occlusion and less load on the joints, however he also has been reviewing some recent research on airway and I believe he said fibramyalgia. Basically, these studies show that there is a correlation between pain and small airway. When the airway is opened, the patient many times doesn't experience some of the pain they suffered from before. This could also be something that is helping to reduce my migraines, in addition to to my TMJ's being much more stable now. The piece I don't really understand is why I used to get migraines when I drank alcohol, and now it seems that alcohol does not trigger a migraine for me anymore. I was hoping for my migraines to be reduced with the surgery, but I honestly didn't think they'd be eliminated completely because I never thought it would prevent me from getting one when I drank. In the end, I guess I don't need to understand it, I am just elated that they have been almost non-existant! I just hope it stays that way!

Below are my 3 month before and after pictures. I am so happy I went through this. It has been worth it in every way and I am very pleased with the results thus far, on all accounts.

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.

I will post more pics of my teeth and bite later this week. My teeth were somewhat sore after my ortho appointment today, I don't know if it is because that space is already trying to close up, or because I was really aggressive with chewing today. I am hoping my ROM will start to increasing at a faster rate now that I am only in bands at night.

Thursday, December 4, 2008

Plate Removal Successful ...

I am back home, everything went very well, in fact I believe I was awake for most of the procedure and remember most of it, but felt nothing. I had to stop on the way home for my antibiotics, but at this point no pain and no swelling as far as I can tell. Hopefully it will stay that way! I have to be on the Peridex another 2 weeks which is when I will see him next, and hopefully after that I can schedule a cleaning!

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!

Plate Removal Tomorrow and Before and After Pics

I thought since I will be puffed up tomorrow on my left side from my plate removal procedure, I should put some before and after photos from the month before surgery to 12 weeks post-op. You can really see a difference in my nose. I think there is still some swelling in my nose because my nostrals are uneven, so it will be interesting to see how things settle out. You can also see a big difference in my lip incompetence, no more gummy smile, and a more defined profile.

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

Pics - 10.5 Weeks Post Op

It's hard to believe, over 10 weeks since surgery. Here are my pics from today ...

Saturday, November 22, 2008

Plate Removal Scheduled

I saw my OS on Thursday. He asked me how soft chew was going, I said good ... I can just about eat anything as long as it is small enough to get between my teeth. No pain what-so-ever. That's what we were waiting for to remove the plate. Everything appears to be solid, plus I will still have the other plate that will still be in the side they remove it from, so there shouldn't be any risk of relapse. He will also cut away some of the over growth from my cheek at the same time so i am not chewing on my cheek.

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

Soft Chew!!!

Sorry that I haven't posted and left you all hanging ... I am in Argentina right now and going to Brazil tomorrow ... so I haven't had much time to post. I did get the ok for soft chew on week 8 as I was hoping, and I have been really enjoying it! I was upgraded on my flight here, and they give you mixed nuts before your meal. I was shocked that I could actually eat the cashews! The biggest pain is getting them out of the braces. I actually think I can eat about anything right now if I have the patience to chew it. The most limiting factor for me is my range of motion, I can only open about a finger and a half, so it is not like I can just bite into things and start chomping. I also have to try to just chew on my right side so I don't get a ton of food stuck in the gap where my exposed plate is. I have my next appointment with my OS this Thursday, so I have a feeling we will be discussing at that time when we will take the plate out. At my last appoinment, my OS held my forhead firmly and torqued on my maxila and then on my mandible. No mobility what-so-ever, so it looks like thinks are pretty solid at this point. When I go through airports and crowded areas, though, I am still a little gun-shy, afraid that someone is going to elbow me in the jaw and knock something out of place.

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

8 weeks post-op ...

Well, I am just shy of 8 weeks post-op ... day 53 to be exact. And I am long over due for some photos, so finally I took some new ones today. I believe I have just a bit of residual swelling left, but pretty minimal by this point, mostly around my nose area.

I still get some shooting pains in my ear now and then, but it is manageable. What I am most pleased about is that I used to get migraines every time I would have a few cocktails, and the few times I have had drinks over the fast few weeks have not resulted in a mind boggling migraine. I haven't really had them period ... so I am hoping this lasts.

So ... here are the latest pics ... I am definately pleased with the results so far ... we have some work to do yet on my bite but actually having a side profile, plus (hopefully) reducing the migraines ... has made this whole process all worth while.

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

2 more weeks of liquid/blended diet ...

I had my weekly OS appointment today, and was "hoping" I would get cleared for soft chew ... but in the back of my mind I guess I had a gut feeling that wasn't going to happen. Dr. P took a look at my plate, and said indeed it seems to continue to be closing up, although he said again that it would take a small miracle to heal over completely. Since I am healing up so nicely ... my reward is ... 2 more weeks of liquids! He fears if I move to soft chew it could rub the incision and prevent further healing. Oh well ... I've gone 6 weeks, what's another 2? (that is my attempt to be positive :) ) . Everything else looked good, yesterday I got cleared from my OD to use my Sonicare and water pic, and I guess it showed because Dr. P commented that my hygiene looked very good.

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

6 weeks post-op

I am back from Paris, and I can say it went pretty well for my first trip since surgery. Although I was feeling like my energy levels were pretty good and mostly back to normal (if I even know what "normal" is now), I wasn't sure if the time change and change of pace was going to kick my butt. But, adjusted very well going over, as well as coming back. I even managed to squeeze in some sight seeing since I had Saturday free. Since I've already seen the main sights of Paris, and I was staying near Versailles, I went to the Palace of Versaille which I must say was amazing. I highly recommend it if anyone has the time to explore beyond the confines of Paris while in France. The city is also very quaint and unique.

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

A virus and a fever ...

The last couple of days have been a bit rough for me. On Sunday I started to feel achy all over, then came down with a sore throat on Sunday night. By the time Monday night came around, I had a fever of 102, so I called the on-call doctor and he had me start taking the antibiotics my surgeon had prescribed for Paris. The worst was the shooting pains that I started to get in my ear late Monday night … they continued and were much more than I have felt before, I would get sharp pains many times a minute, and also had some constant pain in there as well. I went to see my surgeon Tuesday, and the plate is looking good, he said it has healed over a bit since last time he saw me, although he does not think it will heal over completely. He said around week 10 we will make a decision if we should remove it (I am at 5 weeks right now). Then, I went to urgent care to see what was going on with my throat and ears. He looked in my ears, and said everything looked 100%, but often people come in complaining of ear problems when it is really their throat that is the problem. He looked at my throat and said he saw the irritation, but said that it looked viral, so it just has to run its course. If it is strep, however, the antibiotic I am taking works well on that too, so it will take care of it. So, I’ve been taking Tylenol to help with the ear pains, which has made it much better, although it seems like my worst time of day is 3-6 pm. For some reason, everything just culminates around that time and I feel like crap. It is so strange to me, that after all I’ve been through with breaking both jaws and being banded shut, that a sore throat and earache would be my worst pain of it all! Amazing, isn’t it?

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

Plates and Screws, insurance and bills ...

I tried to take a picture of my exposed plate and screws since Kam asked! It is really hard to get the right lighting inside the mouth and the camera to get the right focus for the pictures to turn out right, so I appologize that they are not the best, but you can at least get an idea. The plate is silver, and the screws are actually a gold/bronze color. Hopefully you can make sense of it ...

The bottom two pictures probably best show the gold screws, but the first pic turned out the clearest.
I forgot to post the other day about my insurance. I was reviewing my EOB's that starting coming in (not all have come in yet), and they were processing my surgery claims as out of network! Which meant that they were only covering 70%. I hadn't planned on this, and I had verified several times before hand that my surgeon was in network. So, I called, and the rep I talked to made several phone calls, and their internal information wasn't up-to-date, so he said that all claims would be re-adjusted to in-network coverage. "Good for you for following up on this and not just letting it go!" he said. Jeeeez ... we are talking about a lot of money to just let it go! He was a very nice and helpful guy, though. With all of the bills coming in, I just wanted to verify what applied to my out of pocket max and what I actually had to pay. We got it all sorted out, and he took the time to anser all my questions.
So, when in doubt, call! Make sure you understand your plan beforehand, and go over EVERYTHING with a fine tooth comb to make sure it was processed correctly. In this case, it saved me many THOUSANDS of dollars!

Thursday, October 9, 2008

Back to blending ...

I had my appointment today with Dr. P. He took a peek at my mouth, said everything looked good, the plate is still as visible as day but the tissue around it looks healthy and pink, no infection. I reminded him that I would be going to Paris in a week so he wrote me a prescription, and also for my joint medications which I will start taking again (the Feldene and Amitriptyline, not the doxycycline since it caused me so many problems). I mentioned to him that I had eaten a fried egg ... I didn't chew ... just slurped it into my mouth and he said no ... I have to stick to the liquid diet because if a piece of what I eat gets caught in the incision, it could cause infection :( So I had my few days of bliss ... but it looks like I have to go back to blending things again into minute particles.

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

4 weeks post op - ortho profile photo ... Before and After

I had an appointment with my ortho (Dr. L) on Monday, he just wanted to check out my midline and see how my bite was settling in. He said that he's not going to worry about the midline yet because there is still some swelling, things might look a bit different when the swelling goes down. The band configuration looked good, so no changes there. I thought I would post the before/after profile view to date since my ortho took a profile pic. The first picture is pre-braces, the second is a few weeks before surgery, and the third photo is just under 4 weeks post op:

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.

My next appointment will be October 20th, 6 weeks post-op, and it will be about an hour. It sounds like he will be repositioning some brackets, so we will be re-initiating the orhtodontics. Let's go!

In other news ... I have been "eating" soft foods such as fried eggs, pudding, applesauce, yogurt, today I even cooked up some whole-grain pasta mixed with gravy, but had to break it up with my fingers to get it down. I am not chewing so I don't think my surgeon should take issue with it, just anything I can get in my mouth and break up with my tongue on the roof of my mouth that has texture is very inviting to me right now! I know I am not supposed to move to soft chew until 6-8 weeks, but I don't really consider it chewing if I am just slurping it in and swallowing, without chewing, so I don't think I'm cheating :) I have an appointment with Dr. P tomorrow so we'll see what he says. Tonight I picked up some cottage cheese and pineapple tidbits, also some whole grain pancake mix, so I might try that tomorrow.

Saturday, October 4, 2008

3.5 weeks post-op ... Day 25

Just a quick post this time with today's pics ... my smile looks a little crooked in the photos today so I must have some uneven swelling ...

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

Day 23 post-op

Today I received a call from my OD's office, they said that Dr. P had spoken with Dr. L regarding my situation, and Dr. L (OD) wanted to schedule an appointment with me before Oct. 20th when I was scheduled to see him next. So I have an ortho appointment now on Monday.

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

Day 19 post-op

Wow ... what a weekend. On Friday, our house was like a revolving door. The cleaning people were here, and then the window washer came. The phone rang a couple times to ask for directions for a couple of deliveries??? I received a beautiful ficus tree from my godmother for my recovery, and some beautiful sunflowers from my boss and his wife. The morning was starting off to be a good one. Then, around noon, I was on working on my computer, and all of a sudden my mom showed up at my house with my best friend and her husband! They flew in from Denver ... apparantly they had been planning this with my husband for several months. It was a VERY nice surprise!!
Last night, we were out on the patio hanging out and chatting, and there were a few times I was just cracking up laughing. I had to hold my upper lip so I didn't smile too much as I was worried I'd pop a stitch. I ended up getting sharp pains in my ear, I think all of the tension in my jaw from laughing got to me. I swelled up considerably. Everything in moderation I guess.
I can only open my mouth up about one finger, I was able to get my vitamins and a bromelain pill in. When I open and do my jaw exercises, it feels almost like something is preventing the left joint from opening further, it's so wierd.
As for my bands, I spoke too soon after my last post. The second time I had to put my bands on, it was an absolute nightmare. I took about 30 minutes to get my lower left one in, and thought I would never get it. I was so swollen after that, it was ridiculous. The next couple times were a little better, but now I think I have the hang of it. Definately not fun at first.

Here are some pics from today, day 19. I can't believe it has almost been 3 weeks ...

Thursday, September 25, 2008

Day 16 post-op

Today I had my 2nd appointment with my OS, and lots happened today. First, when my OS was checking out my mouth, he said that my mid-line has shifted to the left on my upper jaw, and it was right where it should have been when he saw me last week. So, we are going to have to use rubber bands to get it back to where it should be. When I looked in the mirror, wow, it is way off ... I didn't measure but I would venture much more than before my surgery (I was 2 mm to the left) ... I think I am about 5 mm to the left right now. Yikes.

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

13 days post op ...

Last night, I coughed in the middle of the night and popped the band on my front teeth, so I called today and they had me come in, although I was going to see another doctor, not Dr. P. First I had my Ortho appointment. He checked everything out, and said things looked very good, although Dr. P had mentioned to him that he had a very hard time stretching my pallet (the tight skin issue). He said that I would be very happy with my progress by the 4 week mark, and that my profile was settling in very nicely. They took a few pictures (no lip retractors, but they had to stretch my mouth with the assistant's fingers so she could get pics of both side of my bite) and I was on my way.

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

Day 12 post-op

Sorry ... I've been a bit lax lately about posting. I have pics from most days but I will post just the ones from today. I am completely off all my meds now, except ibuprophen. My vision is slowly returning to normal, it is not perfect yet but gets better every hour. Here are today's pics:
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

Day 7 and 8 post-op

I had my first post-op appointment with my OS yesterday. Everything looked good, and I've graduated from clear liquids to any liquids without particulates. So basically, I can eat any liquids as long as I strain them first to make them particulate free. That at least gives me a little more variety for the next week. I can't clean my teeth yet, only with peroxide/water/mouthwash and saltwater rinses which I do all day long. No matter how much I rinse, it still gets yucky up there. I can't wait until I can use a toothbrush!

Today I went for another session of Manual Lymphatic Drainage today. Since I just did it last Friday, she mixed in some Reiki this time and I really think it made a difference. Below are pictures I took this morning before the MLD/Reiki:

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.
I still feel like I have a considerable amount of swelling but I am making progress every day. I started taking some supplements, today I mixed in some soy protein and I crushed up some bromelaine tablets to put in my juice. I also had bought some Coromega (fish oil gel) ... I mixed it with a little bit of 7-up and put it in the Magic Bullet ... it was so good! It tasted like a "Dreamcicle"! I highly recommend that for those of you who want to get some Omega 3 in your diet if you can only take in liquids (I don't think opening a fishoil capsule would taste very good!). Tomorrow I will try crushing my Usana vitamins and mix in some L-Glutamine.

Monday, September 15, 2008

Day 6 post-op

This morning I though my swelling had gone up since yesterday, but I think it is definately much better this afternoon. The thing that is causing me the most discomfort for me at this time is the congestion. My mom called Dr. P this morning because she had a few questions for him, and he suggested that I take Dimetapp instead of Sudafed, he though I might have had a bit of an alergic reaction to the Sudafed. In any case, he wants me to come in tomorrow vs. the Thursday appointment we had scheduled. Even though I have most of my feeling, I can really feel the tingles today, my lips feel a bit raw, and I seem to be more sensitive to cold than I was before. I wouldn't same I am in pain, it is just different, a wierd sensation.

As of this morning, I was back to the weight I originally was when I went in for surgery. So since last Tuesday, I gained 8 lbs and lost it. I definately expelled more liquids today than I took in, so I am thinking tomorrow morning I'll show some weight loss on the scale. I still feel very bloted though.

I have to really take it easy on talking, I think I've pushed myself to hard and now I am really stiff, so I "sound" much worse than I did before, but that is just because I am congested now and my lips have become more stiff when talking.

I have been pleasantly surprised that I don't feel like I am starving yet. I have been surviving on water, chicken and beef broth, vitamin water, sprite and apple juice, but I have been making sure to get lots of those down, so I haven't felt too hungry. I can be drinking all day, though, and still don't think I come close to 1000 calories. I wonder if he'll give me the ok tomorrow to go on the blended diet, or if I have to stay on the clear liquids another week.

My mom and I went for a walk this afternoon, and when we got home the owner of the Rottweiler was at my house. She appologized profusely and said they decided to put the dog down. It made me feel a lot better that they had remorse for the situation, because I didn't feel that way on Friday. I am also glad it won't have the opportunity to hurt anyone in our neighborhood. It has to be quarantined for 10 days (in a kennel), and then it will be put down. So now I can take a normal route on my walks vs. cutting through other people's lawns. Everyone in our neighborhood is breathing a sigh of relief right now.

So, here are the pics from day 6. The bruising on my face is almost gone, most of what I have now is on my neck and chest.