I created a new template for the blog and lost my links to my videos of the first surgeries.
The below link has video taken by my surgeon in 2005 of the SARPE expansion.
Keep in mind this is graphic video of actual surgery, for those that are interested.
Surgery Videos
Saturday, March 02, 2013
Back Under The Knife
It has been six years since I have posted to My Elective Torture. I am sad to say that I am back to the world of Orthognathic surgery. I recently have noticed changes in my bite and my physical appearance. In my complete nativity I assumed that I needed to replace my retainer.
A visit to Dr. Steffen in Edmond OK began with the initial opinion that a retainer would not correct the shift in my bite, I would likely need braces again (for the third time). I questioned if the condition would be such that braces would correct, and in time would still shift back to a less than functional bite. We did a full work up to include X-Ray, molds, and photos.
Dr. Steffen called me back to his office for a 5 pm appointment, this should have been alarming to me, but I thought they were being considerate of the two hour drive required to get to the city. Dr. Steffen informed me that my bite had shifted due to a condition called condylar resorption. the bone that connects within the TMJ joint was missing on one side and my entire face was shifting due to the bone moving upward toward the joint. He referred me to Dr. Larry Wolford in Dallas, he warned he was expensive, but the best.
I have had my consult with Dr. Wolford, and I have very mixed emotions on the cost of the procedure. If you Google this man, one of the first hits you will find is that he lives in one of the top 50 most expensive homes in Dallas...this is telling of the lucrative business the man has built. I understand being the best at what you do, but don't understand creating a practice that refuses to be in-network with any insurance companies. But I digress on this topic.
Dr. Wolford has recommended a total joint replacement for both sides, utilizing the TMJ Concepts custom prosthesis. Literature on the prosthesis can be found on PubMed, which includes Dr. Wolford as a participating member of the study. I have to admit I wonder if he has participated in the development and/or manufacturing of the prosthesis considering his status as the industry expert for this specific surgery.
The treatment plan is to address the complete dissolved condyle on the left, and the right side has significant arthritis and the disc is not positioned well. This is another major jaw surgery, and my third in the past 10 years.
This all brings me back to the blog, and back to the online support groups. This go round I am substantially busier as a Mom and in my career. I am also substantially more critical of the surgeons and treatment plan.
To those that are new to my blog, I hope my previous surgeries and experiences help you through your current situation and to those that are on the same path I look forward to sharing our experiences.
A visit to Dr. Steffen in Edmond OK began with the initial opinion that a retainer would not correct the shift in my bite, I would likely need braces again (for the third time). I questioned if the condition would be such that braces would correct, and in time would still shift back to a less than functional bite. We did a full work up to include X-Ray, molds, and photos.
Dr. Steffen called me back to his office for a 5 pm appointment, this should have been alarming to me, but I thought they were being considerate of the two hour drive required to get to the city. Dr. Steffen informed me that my bite had shifted due to a condition called condylar resorption. the bone that connects within the TMJ joint was missing on one side and my entire face was shifting due to the bone moving upward toward the joint. He referred me to Dr. Larry Wolford in Dallas, he warned he was expensive, but the best.
I have had my consult with Dr. Wolford, and I have very mixed emotions on the cost of the procedure. If you Google this man, one of the first hits you will find is that he lives in one of the top 50 most expensive homes in Dallas...this is telling of the lucrative business the man has built. I understand being the best at what you do, but don't understand creating a practice that refuses to be in-network with any insurance companies. But I digress on this topic.
Dr. Wolford has recommended a total joint replacement for both sides, utilizing the TMJ Concepts custom prosthesis. Literature on the prosthesis can be found on PubMed, which includes Dr. Wolford as a participating member of the study. I have to admit I wonder if he has participated in the development and/or manufacturing of the prosthesis considering his status as the industry expert for this specific surgery.
The treatment plan is to address the complete dissolved condyle on the left, and the right side has significant arthritis and the disc is not positioned well. This is another major jaw surgery, and my third in the past 10 years.
This all brings me back to the blog, and back to the online support groups. This go round I am substantially busier as a Mom and in my career. I am also substantially more critical of the surgeons and treatment plan.
To those that are new to my blog, I hope my previous surgeries and experiences help you through your current situation and to those that are on the same path I look forward to sharing our experiences.
Thursday, October 11, 2007
Saturday, September 29, 2007
Coming Off in Countdown 4 Days!!
Well it has been a LONG time since I have updated. And please do forgive me... life has been super busy. Since my last post I have went on vacation to Florida, then Colorado (where I got engaged) then three days later found out my future husband got orders to Japan. So from that point I planned a wedding in about three days. So I am now officially a military wife! So hopefully everyone will forgive me!
Anyhow about the teeth. I am getting my braces off on Wednesday. I am so extremely excited! I am now about seven months post-op, and have been in braces for a year and four months. Due to my departure to Japan with my husband my orthodontist and I have had to really push up the visits. I have been going in about once every two weeks for the past two months. But my OD says I'm only coming out of braces about a month earlier than I would have. So I think that isn't overdoing at all.
A little update on my surgery recovery. I still have not completely gotten all my feeling back in my lower jaw. I have had full sensation in my upper since about a month post-op. Not so fortunate in the chin and lower lip area. I have regained feeling to about the corners of my lower lip, but it is slowly regaining sensation. Some days are better than others; strangely it seems after I get done with a strenuous workout that my feeling is somewhat more numb in my lower lips.
The one area where I am experiencing major problems is in my TMJ joint on the left side. In this same location immediately after surgery I had extreme pain, that never was eased by any amount of pain killers. This is a problem that not many people experienced with this surgery. I know a lot of individuals started their ortho journey in order to help with TMJ, it appears b/c of my journey this will be the new problem. I am still unable to open my jaw fully w/out pain. It feels as if I have a rubber band around that joint not allowing me to open my jaw. It is extremely painful sometimes, and I always have limited motion in the area. I have spoken with my doctor about this, He said more than likely when my surgeon adjusted my jaw he did not ensure that the disc that lies in the joint socket was in place. And of course if this is the problem it is only fixable by means of a third jaw surgery.
He did inform me that by wearing a splint at night I may be able to reduce the tension and pain.
And finally... with the end of my braces journey comes the dental work that must be completed. As you will soon see from my pictures, I have a large gap between my two front laterals. I will be getting a veneer placed on my peg tooth. My left second lateral does not exist. I currently have a bridge there that has been cut during my braces to allow movement. Due to time constraints I will have bonding done to cosmetically correct the tooth. And during the next year I will be having a implant placed. This will mean I will have a third surgery, but I'm sure an implant is nothing compared to jaw surgery. :)
That is the bulk of my progress. I will add photos to a second post to show some of my progress over the past few months!
A little update on my surgery recovery. I still have not completely gotten all my feeling back in my lower jaw. I have had full sensation in my upper since about a month post-op. Not so fortunate in the chin and lower lip area. I have regained feeling to about the corners of my lower lip, but it is slowly regaining sensation. Some days are better than others; strangely it seems after I get done with a strenuous workout that my feeling is somewhat more numb in my lower lips.
The one area where I am experiencing major problems is in my TMJ joint on the left side. In this same location immediately after surgery I had extreme pain, that never was eased by any amount of pain killers. This is a problem that not many people experienced with this surgery. I know a lot of individuals started their ortho journey in order to help with TMJ, it appears b/c of my journey this will be the new problem. I am still unable to open my jaw fully w/out pain. It feels as if I have a rubber band around that joint not allowing me to open my jaw. It is extremely painful sometimes, and I always have limited motion in the area. I have spoken with my doctor about this, He said more than likely when my surgeon adjusted my jaw he did not ensure that the disc that lies in the joint socket was in place. And of course if this is the problem it is only fixable by means of a third jaw surgery.
He did inform me that by wearing a splint at night I may be able to reduce the tension and pain.
And finally... with the end of my braces journey comes the dental work that must be completed. As you will soon see from my pictures, I have a large gap between my two front laterals. I will be getting a veneer placed on my peg tooth. My left second lateral does not exist. I currently have a bridge there that has been cut during my braces to allow movement. Due to time constraints I will have bonding done to cosmetically correct the tooth. And during the next year I will be having a implant placed. This will mean I will have a third surgery, but I'm sure an implant is nothing compared to jaw surgery. :)
That is the bulk of my progress. I will add photos to a second post to show some of my progress over the past few months!
Tuesday, May 08, 2007
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.
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.
Tuesday, March 27, 2007
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.
Wednesday, February 28, 2007
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.
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.
Thursday, February 22, 2007
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
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
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