Four Months Post-Op

Well I know that most people out here in Adult Ortho world think I have forgotten about you... I definitely haven't. I am separating from the military and just arrived back home to move in with my folks about two weeks ago. I have been w/out personnel Internet access since the end of March, and of course the day after I arrive home where I do have Internet access, my digital camera breaks on me. Luckily, I have already met with my new OD in Oklahoma and they took new pics which they were kind enough to email me. So my long awaited results are finally here!! I have made tremendous progress and could not be happier with my bite! I am actually getting to the point where my teeth look as good as BrandyLeigh's!
The new OD is awesome and he has moved a lot around. I went in today and they took off all my brackets around my molars (to include the nasty ones that my RPE was attached to) And they did some bonding on my left lateral that is part of a bridge. Once I get my camera back I can take pics of that...my teeth look dramatically different already. I have to say it has been awhile since an adjustment made me sore; but today is definitely one of those adjustments. But well worth the pain! I hope the pics end up being big enough to see the detail/improvements. But my camera is being shipped back to me today...so hopefully more pics will be forthcoming.

Wow...Way To Long

I am extremely sorry that I have not posted an update in the past like month!! I am taking the hardest college course yet, and am in the process of separating from the military. So I really have been busy. I had my surgical hooks removed yesterday...and am absolutely ecstatic about it. However, they decided to put in wires that aren't connected all the way around..which really means they poke and really hurt!! I will try my best to get some new pics up this week. I have to say my teeth look better than I ever could have imagined! If you ever have or are in the process of having this procedure...DO IT! It is amazing what these docs are able to do. Like I mentioned...photos are to come. Thanks for being patient with me during the past month.

I Love Plates & Screws!!

Well due to the wonderful work of my OS I had my splint removed on Tuesday!! I really didn't think he was going to take it out this week, so I got a wonderful surprise. He said I was fitting into my new bite perfectly, so there was no need for the splint!! First thing once he removed it...I brushed my teeth. It was the most wonderful experience!! I won't even go into what the splint had stuck to it after two weeks. :)
I will still be in rubber bands for now..but only for 16 hours a day. So recovery for me at this point is much better. After my OS got the chance to look at everything, I finally got to take a look at my new bite. My right side(first set of photos) fits together perfectly! I about cried when I saw how wonderful my bite looked...I am actually on the road to having a normal smile! My left side has quite a bit more work that needs to be done. My OS and OD wanted there to be room for my upper molars to be able to come down. So the big black abyss in the back of my teeth(second group of photos) is there so the teeth have room to move down into. Apparently my "Old Bite" didn't allow those teeth to come down as far as what was needed. Obviously my open bite was closed. There is a small amount of space, again on the left side, but that tooth will come down also. So I am imagining once all this moving down business occurs...both sides will look equally as good! I can't wait for that day!! I still have some swelling in my face, so my profile pic is not quite what it will really look like. But I think it looks great.
I have to say I am extremely pleased with how everything looks at this point. I know that every bit of swelling and pain is worth a functional and beautiful smile.

Interesting Little Bit of Info

I went to see my OS yesterday, nothing exciting he thought everything looked great. Everyone in the office thinks I'm healing wonderfully! Apparently I am healing at a very fast rate....so I guess that is great news! I'm sure my age and good health has a lot to do with it.
Some other interesting stuff. I spoke to him about the numbness in my face...and thought I would share what I learned. The reason it takes so long to get feeling back in your face is this. When a nerve is severed, if not reattached immediately (within an hour or so) the nerve will die. At that point the nerve slowly dies off, imagine how roses slowly wither away. In about the third to fourth week, the stub were the nerve was severed begins to try to make signal to the old nerve. This is what causes the itchy pin and needles tingly sensation. The remaining nerves then acts like an octopus; it send signals to other nerves in the area, once a signal is made the nerve bud begins growing towards the nerve pathway. My OS explained it like this...The old nerves that died are like a hot dog. The inside dies away, but the outer bun stays in tact. The nerve then reaches through the path of the hot dog bun. The average growth of nerve is 1/2 mm a day. So depending were the nerve is cut...you can expect that there is about 25-50 mm of growth around the jaw that has to be regenerated before feeling comes back to the face. So for myself, I have a very long face...so I can assume based on this fact that including the 3-4 weeks it takes for the nerve to die, and the nerve regeneration to grow...I'm looking at a minimum of four months based on 50 mm of growth.
Another note on this subject. We have all mentioned that after surgery our faces don't register sensations quite the same way as before surgery. This is due to the way the nerve regrows. Sometimes as the nerve regenerates it isn't able to stay on the same path (inside of the hot dog bun), it will sometimes wrap around the bun or make various twists and turns. This changes the way the nerves sense various sensations on the skin. He gave me an interesting example of this. (try it...I think it is cool) The skin reacts differently to sensations. Such as if a mosquito bites you, you instinctively slap your skin. In most cases you miss completely unless the mosquito is within your eyesight. However, if a bee lands on your skin and begins walking along your body, you know exactly where it is. Thus you smack it, usually causing yourself to get stung. Easy way to try this out. Have someone use a toothpick to poke lightly on your neck ( have your eyes closed) your nerves will not create a sensation at that exact place...rather a general location. Then have someone lightly move the toothpick across the skin (without picking it up). Your nerves will sense this allowing you to feel the exact location. I know not everyone is numb in the face from surgery right now...but when you are this is very cool. I poke myself constantly to see if I am regaining feeling. (of course I'm not) I can never feel the pokes...however my OS in the office did the whole poking thing, which I didn't feel. BUT..when he lightly rubbed his finger across my chin (which is very numb) I was able to have slight feeling there. I thought it was very cool. He then went to explain that some patients after jaw surgery have problems with nerve reception confusing sensation. Some patients register that when something pokes them, it feels like wind across their face. Or vice-versa. This is due to the nerve regenerating irregularly; such as twists or growing "around the bun".
I find knowing why and how everything heals very interesting...and I know that everyone in our group feels the same. So I thought I would share that tid bit of info.

I also got the measurements for the movements made on my jaw.
Maxilla:
-2 1/2 mm forward
-back of maxilla up 2 mm, front up 1 mm ( this was done at slight
angle to close my open bite)
- 1/2 mm to the left
Mandible:
4-5 mm forward
1 mm over Left

Oh Happy Day Now!

Well life is going great for my recovery. I saw my OD today and he seemed ecstatic about my surgery!! That was great news. I got my appointment time a bit confused, so I ended up being an hour late. So...due to my discrepancy I get to keep the surgical hooks on another two weeks. :( I will survive I'm sure.
My swelling is going down considerably, however the numb feeling isn't going anywhere. So I still have that weird "my upper lip doesn't move when I talk" look.
My only complaint is sleep. I can't sleep for anything. I toss and turn all night. I am taking the meds my doc gave me for sleeping, but it doesn't help at all. I'm thinking b/c my activity level has decreased so much, that maybe I just don't require as much sleep?? But then again, my body has to be working overtime to try to get my mouth back in working order. Any advice on getting some shut-eye would be great!!
Well here are some photos to show my progress and healing. Now let's just hope for a little feeling to start coming back!

Post Op Day 8

Well it is a beautiful sunny Saturday in Florida! I just got back from dropping my Mommy at the airport, and decided I had to include a few funny pics from last night. For my Mom's last night I decided to order pizza from the greatest pizza joint around. Of course I knew I wouldn't really be able to enjoy it...but she definitely deserved a treat. Well to my surprise the Magic Bullet saved the day...I was actually able to enjoy pizza!!! It wasn't quite the same as sinking your teeth into it, but wonderful compared to bland soup!

So that made my evening to say the least!
I had a very hard time sleeping the last two nights. For some reason once I lie down I get a terrible pain in my upper left jaw joint (tmj area) I am still sleeping at an angle. But with this new pain I have found the only way I can eventually fall asleep is if I am completely up-right. My OS prescribed very low doses of Elavil for me, a anti-depressant, used to help relax my muscles and aide me to sleep. They haven't been helping at all. I take them, and am falling asleep on the couch, make my way to the bed...and surprise surprise I can't go to sleep for a hour. If anyone has any advice for that I would love it! I just can't get comfortable, and my TMJ joint area just throbs.
Other than that things are going 100% better!! I am only taking Motrin every four hours, just to help with swelling and inflammation. I am feeling almost back to normal. I still am on a full fluid diet, and have a bit of swelling. But the past two days have been a tremendous step forward! My lower face (from my eye lashes down) is still very numb. I am hoping I will begin having some sensation later in the week. I have an appointment w/ my OS and OD this week. I am hoping to have my surgical hooks removed. They just collect mush like no other. So it will be a bit of a relief to have a little less metal in my mouth. I still think the surgeon will keep the splint in for a week or two. But as long as I'm out of the terrible pain, I can bear the annoying POS. Well since I am feeling better I thought I would share one of my more humorous...yes "I am feeling better" photos. I will keep the photos and recovery success news coming!

Jaw Surgery Necessities

I know that there are a few fellow ortho folks that are out there that are getting ready to go threw this whole ordeal. I have though of some things that will make recovery more bearable. So here goes:

Food
Ice Cream
Yogurt
Soup (homemade chicken noodle is great)
fruit & veggies (or a pre-made fruit and vegetable replacement--GNC has a product called Maximum Greens Complete)
Ensure or similar product
Protein Supplements (used for making shakes)

Helpful Items
Bullet Blender- the blender can be ordered online, it is a super efficient blender that makes single servings. The blender comes with six separate cups so you can make several items at the same time. With this produce there is really no food you can't eat. I had pizza and enchiladas!
Syringe- works great for getting food in between the small opening in your teeth that you can manage the first week post-op. This is a HUGE HELP!
Catheter- My first three days I wasn't able to feed myself. My mom used a catheter to put in the back of my mouth so I could get food in my system. This works extremely well! ( a feeding tube will also work, this can be prescribed by a physician)
A Support System- It is very important to have people around you that care and love you. It is very discouraging to deal with the emotions of not being able to take care of yourself at first. With double jaw surgery you need to be prepared that you will not be self sufficient. I honestly should have a bib on when I eat. I am so numb that I am unable to detect the food that is running down my face and shirt.

Thanks to everyone that sent flowers, goodies, and warm wishes! This has been a real help when recovery gets me down. Hopefully I will be able to start posting daily w/ updates. I still have at least a week off of work...so I am hoping each day brings more recovery! Thanks again to everyone that has been cheering me on. It really helps a lot!

I Am Alive

Well after much debate I have come to the conclusion that I will survive this! I went in to this surgery w/ a very positive outlook, but mostly a nieve one. I knew it would be tough. But I really under estimated the pain and swelling. It is day seven post-op, and my first day off of narqotics. My swelling is getting better and better as I go, but it has been a lot of hard work for my Mother. I have ran the full gammet of pain killers...Loritab, Percocet, Vicadin, and on top of that I have used 9 injections of Dermerol to control the pain.
When I checked out of the hospital on Saturday...I knew that my worst day would be Saturday or Sunday. I surrvived both those days, due to my mother's expert care. But my Mom (she has been a RN for over 20 years) felt that considering the surgery my pain and swelling was not under control. I went to see my OS for an emergency appointment on Monday. I was doing okay at first, but about 5-10 minutes into seeing the doctor my pain become unbearable. Due to the significant swelling in my throat my OS put me in a jaw bra. That topped me off and sent me into a blunder of pain. I spent the next hour in the hospitals starring into space w/ tears running down my face. I was unable to walk, move, or even notice that everyone in the waiting area of the pharmacy was starring at me w/ sypmathy. Tuesday was quite a bit better, then Wednesday and Thursday I slowly began to draw back on my dosages of pain killers. Now I am only taking the motrin.
Yesturday I saw my OS for my first follow-up appoitnment. I begged him to take the splint out. He said it depended on how things look. He took one glance and said "nope, your keeping the splint in for another week to two weeks". And on top of that he put rubberbands on me. I thought I was going to die of pain when he placed the bands. But within an hour and a dose of vicadin it was tolerable. I am now much more comfortable w/ the bands. It feels much more stable having my mouth banded in place rather than just dangling.
Today is the first day that I really feel like I am begining to stabalize. So I guess the timing is good, b/c my Mom will be leaving tomorrow. For future jaw surgery paitents...I highly recommend having someone for the first full week there for 24/hr support. I would have ended up in the hospital again if I didn't have my Mom to help out.
Now for the exciting part....my expereince by photos!

Days 2-4

I am still very tired and in quite a bit of pain. My pain reached a plateau yesterday around 1 o'clock. I just so happened to be at an appointment w/ my OS b/c my Mother and I were concerned about my breathing. My swelling was enlarging around my neck making it difficult to breath. He ended up getting a wrap that would hold my jaw in place and help compress the swelling. I have to say it was one of the most excruciating things I have ever experienced. I ended up spending the rest of my time in a chair w/ tears rolling down my face.
Today has been much better pain wise. Today is the first day that I have gotten off Demerol shots in between Percocet and Loritab. So that is very comforting. I am hoping the hard part is over! For know I am just going to post pictures. Once I'm feeling better I will share more about my recovery.

Surgery Day

Surgery Day--Checking In


Bite--and chin angle before


Profile

Surgery day for me went fairly smooth. There was one patient before me, so I didn't have to wake up quite so early. Once I arrived they put me in my surgery gear, and started prepping. My biggest fear about surgery is always the I.V., Friday must have been my lucky day b/c they got it in on the first try. My official surgery time was from 1005 - 325. Once I woke up, I was send upstairs to my room farily quickly. Since I am allergic to morphine, I was started on a Demerol drip. I tried to use the pump as little as possible, thinking if I used it up it would all be gone. I found out two minutes prior to my IV being taken out that I could have had about 3 tubes of the stuff. Once I was able to wake up a bit more...I begged and pleaded to have my catheder taken out. Those things are really uncomfortable! Once that was removed, I had 4-6 hours to urinate....or it was back to the catheder for me. Thank God I was able to pee 15 minutes before I passed the deadline.
My over night stay was pretty uneventful. I threw up about four times...it was pure blood. Apparently a lot of blood hits the stomach during the procedure. Once I got that out of my system I was able to keep the pain under control.

While in the hospital I was on pain killers and a steroid to help with the swelling. Overall surgery day was fairly easy for me.

~*~*9 Feb 2007~*~*

Well my surgery date has been set. I will be going in on 9 Feb for a Lefort I and BSSO. I spoke w/ my OS last week and he disagreed with my OD thinking that I needed more expansion. So I will be going through what my OS originally told me I would possibly need. It has been a lot of back and forth on whether I will need the second surgery, but my OD finally felt that there wasn't much more he could do w/out some surgical adjustments. I am pretty excited at this point. I am hoping that w/ the second surgery I may be out of braces by next fall. But I guess only time will tell.

On Monday I went in for an adjustment...and for the first time I decided to go w/ colored ligs. My boss probably won't be too thrilled, but I just got bored w/ gray. So I will be in purple for the time being!! I go back in about two weeks for my surgical hooks, so I guess I can always go back to boring then. I'm not really nervous about surgical hooks b/c I've seen what they look like...not to bad.

Well here are some pics from after my adjustment. I don't know if the wire "stepping" is noticeable in the pic; but my OD did some bending to the wire. Apparently it allows him to do some fine tuning. I thought it was cool. I just like the sound of them being to the point where they even use the word fine tuning. :)



After talking w/ my OS I have some what of an idea of what movements he his trying to achieve. He is going to bring my mandible forward about 3-4 mm to get rid of my over-jet. He will then do some left-right adjustments. My midline is quite noticably...well not in line. So between the upper and lower adjustments from side to side hopefully we will get it pretty close. The Lefort I is going to bring the front of my maxilla down, while on the other hand he will take the entire maxilla and bring it up about 1 mm. So the entire thing will be moved upward, but the front will have a slight forward tilt. This will hopefully close my open bite and help my lower portion of my face look more proportional. I believe the wording was creating the "text book" face.

So I have one month to prepare myself. I'm actually pretty excited; as much as surgery isn't fun...I do enjoy the 3-4 weeks off from work. :) Well I will post more pics as I see changes. I will definetely post pics of the surgical hooks.

Surgery Two

Well I went to the OD this week and the doc wanted to put me in elastics. So that was really exciting. Then he decided to go ahead and take some molds and x-rays to check on my progress. I got a phone call on Thurday and he thinks that I am ready for a second surgery. Apparently I didn't get enough expansion between my canines and I-teeth. And I also need to have a upper jaw adjustment. He said I needed a two piece jaw...something or another. I'm not really sure what the entails. I'm assuming it will be like a Lefort I. I have an appointment w/ my OS on 4 Jan, so I will find out exactly what I'm looking at having done.

The pics I am posting are before/after shots between this week and in March. I also have some new pics from being in elastics for a week; it's amazing how much my bite has changed already.


Before Early This Week Now


Before Day Expander Came Out Now

Before & After

My day has finally arrived. I am a SARPE survivor!! I had my appliance removed last week and have been enjoying life feeling more normal again. Above are my before and after pics so far. The before pics are from two days prior to getting braces, and the second photos are from today. As I'm sure that everyone can see my smile has changed drastically already! I am so excited to see what future progress lies ahead.

The actual removal of the RPE was more painful than I expected. When they removed the bands that connected the RPE in my mouth it was uncomfortable to say the least. The bond didn't quite want to break. Then the scrapping of the old cement was really uncomfortable. But I toughed it out, and am doing much better. I had to go in today b/c another one of my bands came loose. But that was a blessing b/c I was having a lot of pain with my back molars rubbing on the remnants of the RPE.

Well I will keep more pictures coming. I don't know how long it will be until they put me in power chains again. But I'm really ready to get all the spaces closed up in the front.

I hope everyone is doing well in adult braces fun, and have a wonderful holiday season.

One More Thing

I realized after looking at Graham's page that I haven't posted a pic of my arch in a while...so thanks to Mr. Graham one more pic!! :)

Countdown to RPE Removal

I had the greatest news today. Due to a work conflict I had to re-schedule my appointments for my RPE removal...luck for me they are doing it a week earlier! So my new date to take the RPE out is 2 November!! I can't wait I will be RPE free in two weeks. This is the day I have been waiting for since the end of May. So to say the least I am super excited.

Besides the removal of my RPE my gap has been closing slowly, but definetely making progress. Everyone is starting to really notice that the gap is almost closed. So I am finally starting to feel more human again. I have been invited to a Halloween Party, so I am contemplating dressing up as a school girl..a nerdy one with glasses and braces. :)

Well here is a pic I took this evening. As everyone can tell my gap is really making a lot of progress! But please feel free to keep encouraging those little guys.

The Countdown is On

Well I have exactly 30 days before I go see the doc for spacers. Then seven days later I will be RPE free. That is all I can really think about with my braces right now. I hate the RPE and can not wait to be able to talk to people w/out always being asked to repeat myself. Not to mention I will finally be able to enjoy a glass of wine again. I have three Pinot Noirs waiting for me that I have refused to open b/c I know the appliance will ruin the flavor. Besides the RPE the space is slowly closing I think. I expect that it will probably stay about the size it is now until I go see the OD again. I am hoping he will do powerchains all around. But I guess we'll see. Well here are the updated pics. I can't wait to have pics that look more like Brandy's. I pray that my teeth will be as quickly moving!


Wednesday Sunday

Powerchain Time

Well it has been a while since I have posted. There are several reasons for that. First, my teeth didn't seem to be moving worth a darn (well at least the gap wasn't closing) and two, I am in school right now meaning I have no time to spend doing anything enjoyable. So I am taking the time today to update my Ortho friends and family with fun progress pics!! I had an ortho appointment on Thursday. I had nothing but wonderful news and prospects of progress. First off I had my power chain placed on my incisors. Finally some "closure" with that relationship. ( I know I'm hilarious) It was a little painful, my two incisors are very sensitive to pressure. The rest of the appointment went pretty smoothly. Then one of my OD told me that she wanted to see me in about a month to place spacers. I was like ugh...why? Then she said I would need to come back a week later to have my RPE REMOVED and bands placed on my back molars!!! So the date is set...November 7th I will be RPE free. Which just happens to be the day before I graduate from the College of the Air Force! So November will be a great month!

Immediately after leaving the office I could tell I would be limited on my eating for at least a day or two. But the pain wasn't near what I was expecting. Within about two hours the space in my front teeth was definitely beginning to close. I also noticed a space to the outer side of my incisors forming. The next morning the space was about 1/2 of what it was on Thursday..but I do have some pretty obvious spaces between my central and lateral incisors. Two steps forward...one step back. But as long as I'm moving I'm pretty happy.
And since I am having movement again I am going to definitely take lots of pics, and update at least weekly. :) So without further anticipation here are the pics!!

I Think We Have a Winner!

Attention all "we have movement", again I say " we have movement!" My teeth are far from perfect and still so far from coming together...but were there is a will there is a way. And I do think that these two incisors have decided that they do have will. Ok...a little overly dramatic. But I have refused to take a pic until today. I have been too disappointed with the lack of movement. But I must say..the gap is truly closing. My OS assured me that it would be closed if not all the way very close by the end of the month. I will have powerchains placed on the 21st, my OS informed me it will be like closing a door. A bit frightful I have to admit, but anything is better than this gap. I'm so ready to be able to move on with my progress. Which I know means closing the gap.

It seems crazy to think that I am nearly seven weeks post-op. I am able to do so much more now. My eating is getting better and better, however with a big gap in the front everything must be cut. Although my incisors never formed to make a bite before...it is still quite difficult to begin to eat with such a space. My teeth are feeling much stronger, but very weak in between the gap. Not like my teeth are still loose, but more so that they don't have the strength of the other to truly try to hold on to anything. But I can only hope that in the next month that will all change.

And with the closing of the gap, and the recovery from my surgery I can look forward to having this RPE taken out. I have wanted braces for about two years now, and I could have never imgained that the whole process would change my lifestyle so much. I have lost nearly twenty pounds, mostly due to the RPE, and am frightful of getting it out sometimes. Today for breakfast I ate about a 1/6 of a 1/2 gallon of ice-cream. It is wild I used to never be able to eat like that w/out gaining weight. I am finishing off about 1/2 gallon of icecream a week. I know this will all catch up to me. I am thinking once the appliance comes out and I am able to eat Cheez-Its again I will gain more weight back. I used to be a health freak. I worked out on average 6 days a week, and had a very healthy diet. Now, I have lost so much weight I have to slow down the work outs and try to eat more calories. I am beginning to wonder if I will ever be able to go back to all the excersice and healthy eating. I guess time will only tell. :)

I have the next two days off from work and school, so I am trying to figure what to do with myself. As I type I am thinking of either doing a work out video...or better laying out in the back yard with a book. Maybe I have time for both. I would love to go out to the beach with some friends, but again with the gap and RPE it is a bit difficult. But about a month or two I will be done with the whole mess. Thank God for that!

Well I am off to the back yard to do some tanning! Hopefully then I will make it to the work out tape! So hopefully next week I can take some pics with a really small gap! Good luck to all in RPE land.