Monday, October 22, 2012

10 Months and Counting

Before my surgery I read every jaw surgery blog I could find, especially those of folks with open bites like mine. They were incredibly helpful to help me prepare for my surgery and get an idea of what I might look like in the end. Those blogs inspired me to start this blog to help future jaw surgery patients and also keep my family and friends informed. I swore to myself I wouldn't become one of "those bloggers" who just dropped off the face of the earth one day and stopped posting, and, well, I became one of "those bloggers". I'm so sorry about that! I'm back now to fill you in on what's been happening since my last update.

I had a 2nd opinion with another surgeon at the 4.5 month mark (my 2nd choice surgeon, someone I felt very comfortable with and whose opinion I trusted). He did a very thorough exam and said that my surgical results were excellent and within the normal range for being 4.5 months after surgery. He said the mobility I experienced at that point was due to the short roots on my upper teeth and should go away when my braces come off. It was such a relief to know I won't need another surgery!

I developed a problem with my right maxillary sinus at the 8 month mark that I'm sure is a side effect of the surgery. One day I was fine, and the next day I couldn't breathe out of my right nostril. Just like that. Thankfully it's not infected but it is very inflammed and will not drain. My surgeon said he could enlarge the sinus opening when he does the implant procedure, but since that is a long way off (after my braces come off), I started taking a nasal steroid spray which has helped immensely.

Although I'm at the 10 month mark, my bite is still off and changes after each adjustment. My front teeth are banging together again and they are all mobile. Some of the teeth in my mouth don't touch at all. I really thought I would be closer to the finish line by now and at this rate it will probably be another year (my guesstimate given how my treatment has been handled so far). We'll see.

I will post new pictures soon - as soon as I can sweet-talk my husband into taking them :-)

Monday, March 19, 2012

11.5 Weeks: Orthodontic Torture Devices, Chewing, and More!

I had appointments with my orthodontist and surgeon today. Lucky me.

There has been no change in the mobility in my front segment and my orthodontist is still concerned. He spent a good 5 minutes studying my teeth as I opened and closed, looking at how much the segment moved, which teeth hit and in what order, and then put some new bends in the wire. The newly bended wire will move my top front teeth up and my bottom front teeth down so they stop banging into each other. He also put me into class III elastics to pull my upper jaw forward and my lower jaw back and offset some of the movements happening on the top (orthodontics is one big game of push and pull). The elastics gave me an instant headache, but they did pull my lower jaw back far enough that my teeth aren't clashing anymore. Small miracle - I'll take it!

My surgeon still maintains that the amount of movement in my front segment is normal. He also thinks that the amount of movement is less this time than the last time (it isn't - but there was no point in arguing). He said that my upper and lower teeth mesh together well with good overlap (this is true - when they're not banging into each other) and it will all work out. I wish I was as certain, and I'm sure my poor husband wishes this, too. He will get the moral support medal of honor when this whole ordeal is over. On a positive note, my surgeon gave me the OK to chew very soft things like pancakes and eggs. I'm so excited about this!!!!

I'm seeing another surgeon for a second opinion next month. I really hope surgeon #2 can confirm that everything is normal so I can stop worrying, although part of me feels like the appointment will be a waste of time. When I made the appointment, the only thing they wanted to know was who did my original surgery. That is irrelevant and they were not happy that I wouldn't tell. I feel like it violates my surgeon's confidentiality if I tell, just like it would violate my confidentiality if they told my surgeon I saw them for a 2nd opinion. Geez.

My next appointments are in a month and I hope to have better news by then. Fingers crossed!

Friday, March 2, 2012

Day 65: Can 2 out of 3 Dental Professionals Be Wrong?

I sure hope so. 

In my last entry I noted that my upper front teeth were mobile when they took the splint out. Turns out it isn't just my teeth, it's the entire segment (from canine to canine) that's mobile. I was elastic-ed shut for the past 3 weeks in the hopes that it would firm up, but nothing has changed. 

My dentist and orthodontist are both concerned about it - apparently it is not normal to have your jaw still moving around 9 weeks post-surgery. However, my surgeon says it's completely normal and my dentist and orthodontist don't know what they're talking about. He told me to wait another 3 or 4 months and it should firm up by then. If it doesn't, I will need another surgery. And just for fun, I'm not allowed to chew until it firms up. That will make 5-6 months of not chewing, and potentially 9 months if another surgery is required. I left his office and cried. I made the best of the past 2 months of recovery and not chewing, but I am beyond irritated at the prospect of another 3-7 months of not being able to eat properly. I really, really, really don't want to go through this surgery again, but if I do have to, I'd rather get it over with sooner than later. 

Readers, have you or anyone you know had an upper jaw segment that is still mobile 9 weeks after surgery? Is this really normal? In addition to my dentist and orthodontist believing it is not normal, everything I can find online says it is not normal, so I'm working on finding another surgeon who will give me an honest 2nd opinion. I'm not sure I will be able to find one, professionals in my town are a close knit group, and they don't like to comment on another's work (even when you don't disclose your current provider's name, which I wouldn't do). I want to believe my surgeon, I really do.........I think he is amazingly talented and dedicated to his patients.but I don't want to let another 4 months go by only to find out that something should have been done right now. 

Friday, February 10, 2012

Day 43 / Out Damn Splint!

Yesterday was a joyous occasion - my splint came out! It took about 3 minutes for my surgeon to snip all the wires and remove that little plastic speech disturber from my mouth, then another minute to remove the last few stitches that hadn't fallen out yet (so much for dissolvable stitches). I was so excited to finally see my teeth and bite. It felt very strange to feel my front teeth touching each other - they have never, ever touched before.

Say cheese!

Pre-surgery pic for comparison

My upper front teeth are a bit mobile (which is very disconcerting) and my far back teeth on both sides don't quite touch (they're close, but no cigar), so I'm elastic-ed shut for at least the next 3 weeks to correct these issues. They're uncomfortable but at least I can take the elastics out to eat. Active orthodontics will start in 3 weeks when my teeth have settled down. Yesterday I just had new wires put in and my orthodontist and his staff took a look at my teeth (this was my first appointment after surgery). They were almost as excited as me to see how the surgery turned out. They also got a good laugh at my request to brush and floss after the old wires were removed - this is an unusual request in an office that sees mostly kids.

On the jaw surgery recovery front, feeling in my upper teeth started coming back this week. My surgeon said it's unusual to get feeling back so soon and that I must be a fast healer. Yay me! The only problem with the feeling coming back so soon is that it has somehow caused me to start clenching and grinding my teeth at night. This isn't something you want to do when your upper jaw is healing, but unfortunately there is nothing that can be done to stop it. To add insult to potential injury, when my lower jaw gets tired of clenching, it opens up wide despite the elastics holding my mouth shut. Grr. Needless to say, I haven't slept much this week. I know it's all temporary so I'm trying to ride it out without too much complaint. 

I'm halfway to being allowed to chew again, although I have to admit that the last 6 weeks haven't been bad at all. It's amazing how many things you can eat without chewing - pretty much everything except crispy/crunchy things. I don't feel deprived at all. The biggest issue (and this is probably a benefit) is that because I need a knife and fork to eat anything, eating on the run is out. I never realized just how much I ate in my car now that I can't do it. 

Thursday, January 26, 2012

Day 29

Just saw my surgeon for my 4 week checkup and everything looks good. My range of motion is now 40 mm and he said that's right on track and maybe a little better than most (he was probably just being nice, but I'll take it!). I'm finally allowed to blow my nose (gently) and drink through a straw. I tried drinking through a straw on the way home and it was.....awkward. My upper lip doesn't move enough yet to get around the straw when it's between my teeth, so I have to either suck liquid onto my front teeth (gross) or put the straw in through the corner of my mouth (weird). Guess I have  bit more healing to do before drinking through a straw is do-able.

The BEST news, however, is that he made an appointment to remove my splint in 2 weeks. Yippee! I still hear some clicking in my upper right jaw, much less than before but it's still clicking. I was worried that this might impact the splint removal date, but my surgeon said it's normal and nothing to worry about. Whew! After the splint is removed I will go straight from his office to my orthodontist to have a new continuous wire made for my upper teeth.

I asked about using muscle relaxers for my jaw tension and headaches, and he suggested taking Aleve every 12 hours instead. Grr.I'll try it but I must confess that I don't think it will work. Ibuprofen is my holy grail for pain relief and it wouldn't even put a small dent in my headaches. My other concern is that NSAIDS slow down bone healing. My surgeon isn't concerned about this but I am - I've come this far and don't want to do anything that will slow down the healing process. I need to balance my paranoia with the ability to function without holding a heating pad to my head, too...

Wednesday, January 25, 2012

Day 28 - 4 Weeks Down!

My surgery was 4 weeks ago today. I can't believe that much time has passed! Here are some pics to commemorate the occasion:

Swelling continues to come and go, no change on that front. My upper lip and cheeks are still a little puffy, but I doubt anyone but my husband and I would notice on a low swelling day. Wait, I spoke too soon. I just took some profile shots and my upper lip is noticeably puffy.

4 weeks post-surgery

On the numbness front: my face continues to thaw out from left to right and from the outside in. It's very strange - I can feel a light touch brushing against my skin more than I can feel pressure. Inside my mouth is another story - my upper right gums are starting to regain feeling (I would have expected the left side to regain feeling first, since the left side of my face is regaining feeling faster). My entire palate is starting to regain feeling pretty evenly. I can tell when my face is swelling up without looking in the mirror because it feels very stiff when I try to talk (I say "try" because the more swollen my face gets, the more difficult it is for me to speak coherently. It's almost as if my tongue is moving a mile a minute like it always does but my lips and face just can't keep up. You don't realize how many muscles you use when talking until they are numb and don't work properly. :-)

My headaches continue but not as severe as they were to start. I always feel better after an acupuncture appointment and wish I could spend an entire day there as a human pincushion, listening to zen spa music, napping, and willing my body to heal itself faster. Unfortunately, these pesky things called work and money will not allow it.

Speaking of work, I went back last week at the 19 day mark. I thought I would be up for full days by then but my body thought otherwise. I ended up working 6 hours per day which allowed me some extra time to nap and nurse my headache. This week is going better already, so YAY!

My surgeon said that he usually takes the splint out at the 6 week mark unless the orthodontist needs it to stay in place longer. That's just 2 weeks away! The splint really hasn't bothered me so if it stays in longer it's no big deal except that I want to see my teeth and bite without all that plastic in the way. I see my orthodontist for the first time next week. At some point he will need to make a continuous wire for my upper teeth, but I'm not sure he will be able to do with the splint and all the extra wiring holding it in place. We'll see.

For anyone wondering why I sound like I have a mouth full of marbles, here's your answer in the shape of my splint:

Friday, January 13, 2012

Day 16

I saw my surgeon yesterday and everything looks good. He clipped some stitches on the inside of my upper lip and HOLY HELL it HURT! Dr. G was surprised that I have that much feeling already and I was surprised to be in so much pain that I was in tears.

My range of motion is 37mm which is a bit of a bummer to me - I've been working really hard to increase this since my visit a week ago and only increased it by 3 mm. Guess that explains why the headaches haven't gone away yet. The acupuncture has helped a lot and they're not as severe as they were, but they are still hanging around. They seem to get worse the more talking I do, which might be a problem next week when I go back to work. I have a few more acupuncture appointments scheduled and will continue to stretch my lower jaw muscles - determination and diligence has to count for something, right?

My eating options have greatly improved now that I can eat soft things. I'm not allowed to chew, but it's amazing how many things can be smashed up with a fork and swallowed without chewing. Pasta, chili, burritos, eggplant parmesan, pancakes, eggs, french toast, PB&J sandwiches, Chinese food, Thai food..............even rare steak. Really! Hubby took me out last weekend and I shared his rare ribeye and I thought I had died and gone to heaven. It was that good. Add in some soup, a baked potato, a sweet potato and some bread and butter, and I didn't miss out on anything. I am really looking forward to the day that I can chew again, but until then, I'm good. I was really worried about my eating options during recovery and am happy to cross that worry off my list.

Swelling continues to come and go, mostly at random. I started taking a homeopathic remedy to help my bones to heal faster (Symphytum officinal) and within 30 minutes of taking it, my face swells up. I take this as a sign that it's working, since some inflammation is needed during the healing process. I will be really happy when the bones on the right side of my upper jaw stop clicking. Even though my surgeon says it's normal, it freaks me out.

As my face thaws out, I can show a lot more expression. I can almost smile normally now. When I get past the scary metal and plastic, I can't believe how much wider my smile is now.

The left side of my face seems to move normally but the right side is lagging a little because it's still numb. I can laugh without pain most of the time, which is a welcome relief.

Just for fun, check it out - my top teeth overlap my bottom teeth! The plastic you see covering my top teeth is the splint that I will wear for another month or so - it's acting as a cast to hold the segments of my upper jaw in place until the bone heals.