Saturday, December 31, 2011

Day 3

I slept great again last night. I still can't believe how good I feel compared to what I was expecting.

My surgeon called me this morning to see if I needed my nose cleaned out again. It's Saturday. His office is closed. How awesome is it that he called to check on me on a Saturday and offered to come in just for me? I am so lucky to have the world's best surgeon. :-) Thankfully I do not need my nose cleaned today - it's still dripping but it's not clogging up. Yay for me!

My swelling is a little worse today. My husband's interesting comparison is that the shape of my face went from somewhat light-bulb like to moon-like. I just remembered that he made me laugh last night - really laugh - and it HURT! My face just doesn't want to stretch into a full smile or anything remotely close. I've had good spirits and have been cracking jokes left and right, but it was nice to have a real laugh work its way into my soul. Thanks for that, baby doll!

The back part of my palate is swollen and mostly numb and it feels like I need to constantly swallow. Every time I swallow the bones in the right side of my upper jaw make little clicking sounds. It's very disconcerting. Per my surgeon this is normal and will stop in a couple of weeks as the bones begin to fuse.

I ate gooooooooooood today. Aside from the act of chewing, I don't feel like I am missing out on anything yet. For lunch I had chicken tikka masala pureed with naan and chicken broth and it was delicious. I had a mini-meltdown just before I ate, though. The 2 syringes the hospital gave me were sticking and no amount of coaxing, oiling, cold water/hot water would get them to work. So, I went to the nearest Walgreens figuring they would have more syringes. No luck, Walgreens doesn't stock them and suggested a medical supply company (which was closed at the time). I resigned myself to eating with a spoon and dealing with the dirty splint but an empty condiment bottle turned up and worked out perfectly. I bought the bottle a month before surgery on the recommendation of another jaw surgery blogger. How it ended up on my kitchen counter in exactly the right place at the right time to short circuit my meltdown and allow me to eat, I will never know....but I am grateful.

Tonight we stopped by to visit our dear friends who are more family than friends, the B family. It was so good to see everyone and I can't wait until the next time when I have a bit more energy. Thanks for the well wishes and love, guys!

On the way home we stopped to get some new juice/smoothie fixins for me and chicken wings for my husband. He was so sweet and ordered a few extra so I could lick the sauce off of them. I had no intention of doing this (what kind of weirdo licks the sauce off a chicken wing????) but they smelled so good and I became that weirdo. They tasted just as good as they smelled. Then I drank my smoothie and took one last lick of the chicken wing for dessert. I suspect much more weirdness as my 3 months of no-chewing goes on.....

After dinner I did something really exciting (for someone who has been unable to properly brush their teeth for several days, anyway). I was able to open my mouth wide enough to properly clean almost all of my top teeth and floss some of my bottom teeth. This was done with the help of my husband holding a hand mirror and flashlight - it was too difficult to see anything and maneuver around by myself in such a tiny, swollen space. The entire operation took close to an hour and utilized 3 different tooth brushes, a proxabrush, a tongue scraper, a strand of superfloss, an oral syringe, a tiny oral mirror, a hand held mirror, a flashlight, a reading lamp, some toothpaste, chlorhexidine mouthwash, several very creative curse words, and a very patient husband.

Speaking of my husband....I would like to publicly thank him for all of his support. He's taken such good care of me while I recover, he knows exactly what to say/not say and when, he's my biggest cheerleader and I couldn't do this without him. ILY baby! Thanks!

I have finally added some pictures - see the link on the right nav bar for Before & After Photos, or click here:

Day 2 - Dec 30th

I slept well last night but woke up very congested. I broke down and went back to my surgeon's office to have my nose cleaned out. That made me feel sooooo much better! My nose is still dripping blood tinged discharge (an improvement from pure blood) and I asked my surgeon about it. He said it's normal and a good sign that healing is under way. It will keep dripping for a few more days. He thinks my swelling peaked today and should start to improve tomorrow. I sure hope so. Although my swelling isn't nearly as bad as some others have had, it's still uncomfortable. I feel like I'm wearing a heavy, tight mask over the middle part of my face. It's starting to loosen up - yesterday I couldn't move the right side of my upper lip and today I can. More and more feeling is coming back and things are tingling. It doesn't hurt, it just feels weird. It looks weird, too, because I haven't regained full use of my face and lips.

On the way home from the surgeon's office my husband and I picked up cheeseburgers and shakes for lunch. I tried to eat my cheeseburger chopped up in tiny pieces but kept choking on them, plus the instinct to chew was too strong (and I'm not supposed to chew for 12 weeks), so I tossed my cheeseburger into the blender with some beef broth instead. It looked gross but tasted delicious and I was in heaven for a little while. :-) The milkshake was good, too. I'm not able to use a straw yet so I ate both through a syringe. It sounds like a pain but it's easier and less messy than drinking out of a cup. That is, unless your syringe gets stuck, which mine did later in the day. It had a blowout and I had a small temper tantrum while cleaning up the mess. Stupid syringe!

My BFF came over this afternoon and it was so nice to just hang out. Except for the part where I fell asleep (SORRY!). Thankfully she did most of the talking because I'm unintelligible a good portion of the time. Today I seemed to have more trouble talking than the previous 2 days, mostly because my mouth is full of thick drool. It resists all efforts to spit it out or rinse it out, so the only thing I've been able to do is soak it up with a paper towel. Thank goodness we bought an industrial sized package of paper towels a few weeks ago. I think I will go through them all if this drool and nose dripping keeps up.

My energy level comes and goes. I seem to bounce between feeling really, really good and energetic and so tired that I must take a short nap.

I also had a headache for the better part of the day. Tylenol and cold packs helped a lot.

Thursday, December 29, 2011

Day 1

I woke up this morning feeling like a million bucks. I slept for 6 hours last night, could breathe through my nose, the anesthesia finally wore off, and I didn't need any pain killers. I feel incredibly blessed and am so glad my recovery hasn't been as bad as I was expecting. Yet. :-)

I had a follow up appointment at my surgeon's office  this morning to take x-rays and clean out my nose. The x-rays looked amazing - my anatomy looks normal now, thanks to my surgeon's amazing handiwork and the help of some titanium plates and screws. Although I could breathe through my nose, it was still oozing and dripping blood and was filling up. It was uncomfortable and a little painful to get it cleaned out but I felt better afterward. My surgeon offered to clean my nose any time I like, and I might go in tomorrow as well. I also learned today that instead of a 3 piece LeFort, they did a 4 piece due to the amount of expansion that was needed .Here's a breakdown:

Upper molars were impacted 5 mm and expanded 2 mm
Premolars were impacted 5 mm and expanded 5 mm
Anterior segment (canine to canine) was brought forward 1mm and down 2 mm

I can't wait to see what it will all look and feel like when I'm fully healed.

My surgeon cleared me to take my elastic bands out to eat and brush my teeth. Yippee! When I take them out, my jaw naturally closes into the proper place in the splint, so I hope I can stop wearing them sooner than later

My swelling continues to increase despite ice, steroids, arnica pellets and cream, bromelain and quercetin. The swelling isn't as bad as I was expecting so that's good. Really, nothing has been as bad as I thought it would be.

My nose and mouth are still oozing blood. My surgeon assured me this is normal and will go away in a few days.

After lunch my husband and I picked up some Pho soup for lunch. I threw my portion in the blender: broth, noodles, cilantro and basil, and boy was it delicious. I'm so glad I won't have to live on Ensure and fruit juice for 3 monhts!

Feeling is already coming back in my face and lips. I'm surprised and not sure if I should be happy about this or not. On the one hand, I'm healing quickly and that's good. On the other hand, numbness for another month or 2 might be nice to mask any pain.

I will post before and after pics as soon as I get around to scanning them in and uploading them.

Day of Surgery

I'm happy to say that I had surgery at 11:30am yesterday and feel well enough to recap. :-) Here's how it all went down:

We arrived at the hospital at 9:40 (10 minutes late due to a car snafu - I left my headlights on the night before and my battery died - DOH!). Realized on the way to the hospital that I forgot my phone. Can you say nervous??? Not scared, just nervous and excited.

The hospital was expecting us at 9am - I'm not sure why since the paperwork they gave us said to arrive at 9:30 - and we got dressed down by the nursing team lead for being late. I was able to channel some of my nervous excitement into annoyance and indignation at the lecture, so thanks nursing team lead for taking my mind off things! Thanks also for passing us off to a nicer, more friendly member of your team!

Things progressed pretty quickly once our nurse came in. He checked us in, reviewed the risks, ordered 2 different anti-nausea meds, got the IV started, etc.

Anesthesiology came in to review my history and my biggest concern was post-op nausea and vomiting (which I have done after EVERY other surgical procedure in my life). I really didn't want to be puking with a mouth full of open incisions. They decided to do complete IV anesthesia and gave me a bunch of anti-nausea meds in addition to that, and it WORKED! I didn't get sick. Not even one bit of nausea. So for anyone out there who barfs after surgery, ask for total IV anesthesia. I'm getting ahead of myself here, so back to chronological order.

After meeting with our nurse and anesthesia, my surgeon and his assistant came in to review the plan one last time, answer any outstanding questions we had, etc. Once that was done I said goodbye to my husband and gave him a good, long kiss (sorry to anyone who was in the room at the time - I'm not normally a PDA kind of person, but I knew it would be awhile before I could kiss him again).

Then they wheeled me into the operating room, had me scoot onto the surgical table, and I remembered looking around the room at all the people buzzing around (there had to be 6 or 8 people in there), the huge lights, etc. The surgical table was actually comfortable which surprised me. My surgeon took a picture of me right before they put me under.

Next thing I remember was waking up in the post-anesthesia unit, very sleepy, but asking for my husband. I must have asked for him 10 times and probably annoyed everyone until they took me into recovery where I could see him.

We stayed in recovery for about 2.5 hours. The nurse came in to give me a steroid shot which took down my facial swelling immediately. Hubby took a picture of my new bite and I started to cry with joy when I saw my upper teeth overlap my lower teeth - it looked just like the models we saw at the surgeon's office. What a feeling! I also noticed that I had a ton of room for my tongue despite the splint due to all the expansion (2 mm at the back and 5 mm in the premolar area). I could also breathe through my nose which was an incredible feeling and a big surprise. Most other upper jaw patients I've read about are not able to breathe through their noses for a week or more. I drank some water through a syringe and peed and they released me to go home at 6pm. The nurses who took care of me in recovery were very nice.

Got home at 6:30 pm and took a nap for a few hours, then took some pain meds and started eating. I was pleasantly surprised to discover that I could open my mouth wide enough to get the tip of the syringe in, so anything that could go through the syringe was fair game. So I ate some soup. And yogurt. And juice. A smoothie. Water. I think I will be the only person on this planet who has jaw surgery and doesn't lose any weight. Figures.

After my eating frenzy I slept some more thanks to my friend hydrocodone. I didn't have much pain, just a bit of discomfort, but I didn't wait to see if it would turn into pain. Much better to stay ahead of pain than to chase it. I also iced my face constantly all day and night after surgery to help with any pain and to keep swelling at bay.

My husband has been a tremendous help and is taking such good care of me. :-)

Friday, December 23, 2011

Last Pre-Surgical Items Complete.....Let the Countdown Begin!

Yesterday I had surgical hooks put on my teeth. They are little wire hooks attached to my 2 top central incisors and my 2 bottom central incisors that will be used to band my mouth shut during recovery. I LOVE the ortho assistant who put them on - she put these wire hooks in instead of the kind that crimp onto the wire because they can be bent out of the way when they aren't needed and are easier to adjust to. It took her a lot longer to get them in than the crimpable hooks and I really appreciate the effort. Picture to follow soon.....

Today I had my pre-surgical bloodwork drawn at the hospital where my surgery will be done. This completes my pre-surgical workup and all that's left to do is wait.....and EAT. I want - make that have a compulsive need - to get my fill of all the things I'll miss while I'm on a liquid and mush diet.

Tuesday, December 20, 2011

Christmas Came Early!

Today I saw my dentist and his very talented hygienist to get my teeth cleaned one last time before surgery. My teeth are now sparkling clean and feel like a million bucks! I'm seriously worried about not being able to keep my teeth clean while I'm recovering from surgery so at least I'll be starting with a clean slate. :-)

The best part of the day BY FAR was meeting with my amazing surgeon to review the final molds from my "mock surgery." During the mock surgery, my surgeon cut up the molds the way he will cut my jaw during the real surgery, then he put them back together to make sure everything fits. All I can say is WOW! Everything fits perfectly and I'm in a state of disbelief that in just 8 days, my real teeth will also fit perfectly. It's one thing to know in your head that eventually your teeth will fit together into a perfect bite, but it's another thing entirely to see it right there in front of you. Not only did we get to see my new bite, but we got to play with the molds. Open, close, open, close, compare old bad bite to new perfect bite. Open and close some more. My husband was just as giddy as I was to see the molds and we were like 2 kids on Christmas morning. Here's a video of my surgical models:

To help you understand why I am so freaking excited about my new bite, take a look at this picture of how my teeth currently come together (note: I am biting down with my back teeth):

We also got to see an example of the splint I will need to wear for 6+ weeks, and it wasn't as bad as I thought it would be. It will still suck, but it's not as large as I was expecting. My teeth will actually be touching and the splint is just there to stabilize my upper jaw during the healing, and also to remind my lower jaw where it is supposed to bite. Since they are moving my upper jaw to a new position surgically, my lower jaw will have to close a little more than it currently does to meet the new upper jaw position. Lower jaws apparently have "muscle memory" and will keep trying to go to their old position unless they are reminded where they should be with a splint and elastics.

Monday, December 19, 2011

Surgical Plan

Last week I had an appointment with my surgeon for final molds and records. Measurements were taken, molds were taken, risks were discussed, money changed turning back now!

The surgeon will cut up the molds and do a mock surgery to ensure that what he wants to accomplish can be done. Tomorrow I will meet with the surgeon to see the final mock-up and ask any last minute questions. I can't wait to see the molds- I've been wondering how everything will line up but I just can't quite imagine it. Unless anything changes during the mock surgery, here's the plan:

My upper jaw will be split into 3 pieces
Piece 1: My 6 front teeth, from canine to canine
Piece 2: My left rear teeth 
Piece 3: My right rear teeth

Surgery will take about 2 hours. All cuts are done from inside the mouth so there will be no visible scars. Titanium plates will be used to hold the segments of my upper jaw in place. Bone chips and PRP (Platelet Rich Plasma) will be packed into any gaps to help the bone regenerate with a minimum of swelling.

After surgery I'll be watched in recovery until I can drink water, walk and pee. As soon as I can do all 3 they will release me to go home, probably around  2 or 3 in the afternoon. It blows me away that they can do something so invasive and send you home the same day. I'm not complaining, because I hate hospitals and would fight to leave if they wanted me to stay.

I will have a plastic splint wired to my upper teeth and elastics/rubber bands holding my jaws shut in their correct position. The splint will stay in for 6-8 weeks which will make eating and talking difficult. It's a necessary evil, the equivalent of a cast on a broken bone. The pieces need to be held in exactly the right position until they heal.

I will be on a liquid and fork-smash diet for 12 weeks. No chewing is allowed for at least 12 weeks. I love to eat and think the chewing restriction will be the hardest part of the whole ordeal. I'm mentally prepared for temporary pain and swelling from the surgery, but I am not at all prepared for modifying my diet for 3+ months. I know I'll be able to find plenty of tasty things to eat - almost anything can be chopped into small pieces and/or thrown in a blender. I just think I'll get bored real fast with having to chop everything up or puree it. We'll see.

Frequently Asked Questions

Your teeth looked fine before. Why are you doing this?
  • My teeth and jaws were not healthy - they did not fit together properly and they were failing one by one because of my bad bite. If I did nothing I would lose all of my upper molars within 5 years and not be able to replace them.

This surgery seems so drastic. Isn't there something less invasive that can be done?
  • I researched this extensively with multiple orthodontists and could not find any alternatives that would work for my case. Believe me, I looked. There are a lot of risks associated with the surgery and I wouldn't go through with it if I had any other options.

Why didn't you get clear braces instead of metal braces?
  • Ceramic braces are more difficult to remove. They can damage the enamel on your teeth during the removal process. I've had enough things go wrong with my teeth that I decided not to risk damaged enamel in the name of vanity.
Will you get your braces off before surgery?
  • Unfortunately not. The braces are needed to do some fine-tuning of my teeth after the surgery.
  • My braces will come off between 6 months to a year after surgery. The way things are going, it will probably be closer to a year.

    Friday, December 16, 2011


    When I was a kid and my permanent teeth started coming in, they were a mess - crooked and crowded with upper canines that came in above my other teeth (they looked like fangs). I wore braces for 3 years (complete with 2 different types of headgear and elastics) and was rewarded with beautiful, straight teeth....and an anterior open bite (my front teeth don't meet) caused by misaligned jaws. The braces could fix the teeth but not the bite/jaws. At the end of my teenage treatment, my orthodontist recommended jaw surgery to fix my bite/jaws, but at the time, surgery seemed like a very drastic thing to do to make what seemed like a cosmetic change. My parents and I declined. I wore removable retainers for a year and a half and then stopped wearing them (standard advice at the time)It wasn’t long before my teeth started shifting, and my bite opened up a bit more, but nothing looked so far out of whack that I was concerned. 

    Fast forward 10 years....I went to a new dentist, and the first thing he recommends is jaw surgery to correct the open bite. He said that my molars were being subjected to abnormal forces and they might eventually start to fail. I was not interested in surgery. I was scared to death, thought it was cosmetic, and even if I wanted it, it wasn’t covered under my health insurance and I couldn’t afford it. "Might" eventually fail wasn't a good enough reason for me.

    Fast forward 10 more years... As predicted, my molars began to fail one by one.Several upper molars/pre-molars needed repeated root canals, apicoectomies, and 2 eventually needed to be extracted because the roots were cracked. After the first extraction, I wanted to place an implant but again was told that I should pursue the surgery route, get my jaw fixed, and then place an implant. If I didn't fix the jaws, the implants would more than likely fail - they are less able to withstand abnormal forces than real teeth. I waffled around for 2 years until I lost my 2nd molar, and it became suddenly clear that if I didn't take action, I would lose all of my teeth.

    My only real option at this point was to bite the bullet and get the surgery done. I’m too young to lose my teeth (mid-30’s), and I’m already embarrassed about missing 2 teeth, so I began consulting dentists, orthodontists and surgeons to get my team in place and get this show on the road. 

    One of the unfortunate things that goes along with jaw surgery (as if that wasn't unpleasant enough) is braces. Train tracks. Metal mouth.  The teeth in each jaw have to be in perfect position before the surgery so that both jaws fit together perfectly after the surgery. My teeth had been shifting out of their formerly perfect condition for 25 years, so braces were required. 

    My orthodontist noticed some gum recession on my lower incisors that could compromise my treatment, so I had gum/gingival grafing done on those teeth to build up and stabilize my gums before the braces were installed. They took tissue from my palate and stuffed it under my existing gum tissue, which sounds worse than it was.

    Here's a picture of my teeth on day 1 of getting braces on. Note: I'm biting down with my back teeth:


    Hello family, friends, and fellow jaw surgery bloggers!

    On December 28th I will be having orthognathic / upper jaw surgery. This is something I've been told I needed since I was 13 years old, but I only accepted the necessity 2 years ago.

    A lot of people don't understand why I need to have this surgery, so I thought I'd start this blog to explain what's being done and why. I have also read many, many blogs of other jaw surgery patients that have helped me tremendously, so I'd like to pay their generosity with information forward (I'm sure there is a much better way to say what I'm trying to say, but I can't think of it at the moment, sorry!) and help the next batch of jaw surgery patients through their experience.