My Orthognathic Adventure

Yet Another Prep Appointment

2010-03-17T07:56:00.000-07:00

Some advice for anyone undergoing a total reconstruction -- make sure at the outset that you and your posthedontist are on the exact same page. I mean, get into the details. Find out what types of crowns your prosthodontist will use and be clear about what color you want. This may require some strategic planning of using whitening agents. This will save you time and headaches in the long run.

Yesterday I spent another 3 hours at Dr. S's office doing to prep work for the porcelin crowns. This actually required more drilling! Let's just say I'm glad to have that behind me. I'm ready for these crowns to be done!

Four months later ...

2010-02-27T09:09:00.000-08:00

Well its been four months since the process of finalizing my front crowns began and they still aren't in. Had a slight detour--in November I had to have an emergency root canal and apparently the endodontist went to far up into the root causing inflammation. So 10 days ago I had surgery on the gum above the root canal to fix that. And still no crowns.

I'm not to happy at the moment with my prosthedontist. It seems to me this is taking all too long!

Apt was total disaster!

2009-12-27T11:13:00.001-08:00

I think my prosthodontist is losing his patience with me. Because he told me several times on my visit on Tuesday that I had to be patient. Once when I asked to rinse and I forgot the other time. Anyway, my apt was at 2:00 pm and I didn't leave until 4:15 pm. When I left I looked like a wreck, like I had cried my eyes out which I did. Good thing my next stop was yoga. Which I barely made on time. Yoga was the best thing for me although with all that novocaine I did not have good muscle energy.

Anyway, this particular apt was for fitting my final crowns. Mind you I've been in my provisional bridge (which spans 9 front teeth) for well over 8 months. Well, I don't know what the problem stemmed from (since I'd been in twice to have molds etc. made for these crowns) but they were awful. Horrid! Too big, sticking out forward like buck teeth and just generally ugly and unflattering. And they did not fit my gums well. Dr. S actually didn't hand me to mirror to look and I think he would have preferred for me not to see. But his sweet assistant Jenny gave me the mirror when I asked.

After I saw them and because of how impatient Dr. S was with me, the tears just started streaming from my eyes. I couldn't stop and I just got more and more upset. Finally Dr. S came back in and it took him a while to realize I was crying. My nose became stuffed up and I couldn't breath. So he put me on oxygen. After a while the oxygen calmed me down and we finished the appointment. Dr. S spoke softly to me and explained that he didn't like the way these crowns looked and he was sending them back to the lab. At least we were on the same page on this. But will I ever get the crowns I like? It doesn't seem so at this point. :-(

Wow, has it really been 3 years?!

2009-12-13T20:07:00.000-08:00

So I have not logged on in a while and I just realized that October marked my 3 year anniversary since my BSSO. Hard to fathom that three years have passed since I sat here in the very same spot with a swollen face looking like a Macy's parade blimp.

I'm about to get the final crowns on my top 9 teeth and I'm a little apprehensive. Will I love the way they look? Gosh, I really hope so after spending all of this time and money. I will post pictures as soon as they are on.

Aug 2009 Update

2009-08-18T12:10:00.000-07:00

So progress is slow but there are a few new developments. I had my 4 month check up on the last two upper implants and Dr. K said everything looks good. That means in two months, I can get the crowns on those implants plus the crowns on the other teeth that have been prepared for the crowns. I still have the molars on either side that will have to wait until next year.

Also, I had minor gum rebalancing surgery on one of my two front teeth to even out the gums. On side was lower than the other. The surgery went well and the gum in that area has healed nicely.

That's it for now.

Last 2 implants are in!

2009-04-10T21:27:00.001-07:00

So a lot has happened in the last month. I had my upper implant preparation "procedure" on March 10. Dr. Shlosberg removed both bridges on either side where the implants were to go and made one bridge consisting of 9 teeth all the way across (from tooth #4 to tooth #12). The procedure lasted about 4 hours during which I was under twighlight anesthesia. The temporary bridge looked quite comical, like rabit teeth.

On Tuesday March 25 I was fitted with a provisional bridge that would be removed during the implant surgery. The teeth look amazing for a provisional bridge and I was quite happy. I however need a gum rebalancing to make it look more natural.

I had the actual implant surgery this past Wednesday, April 8. That surgery lasted only 2 hours, again with twighlight anesthesia. Dr. Kaufman is an amazing surgeon and I had no pain and hardly any swelling. Unfortunately I am once again on a soft-chew and no hot food diet.

So now I lay low for the next 4-6 months while the implants fuse with my bone. By the end of 2009 I should have my permanent crowns! In the meantime, I go back next Wednesday for a post op check up.

Part 3

2009-03-09T11:56:00.000-07:00

So tomorrow I go in for preparation for my two upper implants, one on each side. This will entail sitting in the dentist's chair for about 4 hours. My dentist suggested -- and I agreed -- to have an anesthesiologist to make it easier. He will be taking off the two bridges where the teeth are missing and also begin the prep for the crowns on all of my front teeth. Quite extensive. I'm not sure how it will all look. I will have a temporary bridge across about 11 teeth. Yikes!

All's Well That Ends Well

2008-12-05T15:14:00.000-08:00

So the meeting with Dr. Shlosberg actually went really well. It turns out that I didn't fully understand the treatment plan or the sequencing. So Dr. S and I sat down and he explained it to me and so I now have a better understanding that I really don't know anything about prosthodontics or the sequencing of such. Dr. Shlosberg was more than happy to accommodate my financial situation and he is now working on a new plan to split my treatment up into four years, instead of 3 as originally planned.

Tis the Season!

2008-12-04T07:35:00.000-08:00

So I've stirred things up a bit. Its been percolating in my mind that I might have to revise my $80,000 treatment plan a bit. 2009 is year 2 for a total cost of $40,000+. This encompasses all of my upper teeth including "cosmetic" crowns for my front teeth. Cosmetic but also necessary as they all have fillings and/or are bonded. Anyway, Dr. Shlosberg did come up with a really creative plan. The problem is I don't want to go into debt and its unlikely that I could get a good equity loan at this point. So I decided to continue with the plan except that I would have the cosmetic crowns on my 6 front teeth done in year 4, after all of the other work is done. I have a meeting with Dr. S this morning, so we shall see how he responds.

In the meantime I saw Dr. Kaufman yesterday and he agrees with me. So I will have two upper implants and then 8 crowns on the upper back teeth to fix the drooping of those upper teeth. Then in year 3 (2010), the lower provisional crowns will be replaced to meet the upper teeth.

I'm sad that I have to wait to have the perfect smile that was the catalyst for all of this to begin with, but financially this makes sense.

Next stop -- root canal. Ick!

Two Years Later

2008-10-25T07:44:00.000-07:00

Its hard to believe that it was two years ago that I was being rolled into the OR at Santa Monica UCLA for my BSSO. I was SO nervous! I remember when it was all over and I woke up in the recovery room (with my legs buzzing) thinking that hey, this isn't so bad at all. And it really wasn't. The hardest part was looking in the mirror and seeing a Macy's parade balloon face. The days after the surgery were also a bit rough. I was tired, in pain, and hungry. Finding blogs from fellow orthognathic patients is what got me through those first hours and days. . . .

So here I am two years later. My bottom lip and chin are still pretty numb but even now I continue to get more sensation back. And I have five dental implants in my lower jaw! I never thought I could go through all this. Its so awesome!

Crowns are on!

2008-08-14T16:13:00.000-07:00

So I sat in Dr. Sholosberg's (my prosthedontist) chair for almost 3 hours yesterday morning. I was not a happy camper. For one thing, my gums are hyper-sensitive even just to brush. And there was a lot of pressing going on. So Dr. Shlosberg gave me novocain on both sides but it hardly worked. All it really did was make me anxious. Dr. Shlosberg did offer me a valium so I ended up telling him (an abbreviated version) of my benzo story. So no valium for me.

After fitting the crowns into place and then taking them off again, Dr. S put some sort of strings around the abutments to expose the abutments more (I'm assuming that since he placed them on five weeks ago, the gums may have closed around them. The strings really bured.

The crowns looked really beautiful but he had to really drill them down since my top teeth have come down so far. (That will be fixed when we do the upper next year). Two on one side, three on the other. And they are linked together. With spaces for me to clean between. So I was pretty upset that they didn't look quite the same after he had to whittle them down to fit my bite. That's what took the longest. He kept placing them on, asking me to bite down on the blue paper stuff, and then taking them off and adjusting. My gums really hurt and my bottom lip started to burn. I felt completely beat up by the time we were done.

I do have to say Dr. Shlosberg did a fabulous job. My bite is perfect. Its so strange having teeth back there and being able to really chew, after 32 years. Now I realize how inefficient the partial really was. I can't even imagine what its like have full dentures. Learning to chew is a challenge. I keep biting on my tongue on the left side.

I'm so glad I went ahead with the implants!!

I'm Getting My Implant Crowns Tomorrow!!!!

2008-08-12T15:17:00.000-07:00

Pearls Before Swine

2008-07-13T22:12:00.000-07:00

Abutments, healing caps, and more feeling is coming back

2008-07-08T13:54:00.000-07:00

So I had another visit with my prosthodontist today -- actually two visits in one. He unscrewed and took off the healing caps and put the abutments on so that he could take the impressions for the crowns. It was not the most fun visit but I survived. Even though I'm still numb on my gums on the bottom, I'm also supersensitive, so when he started pushing the impression caps onto the abutments, it hurt like heck, in a prickly painful way. I was glad when that part was over. My bottom lip, which is still numb, was tingling like crazy.

Rather than take the abutments off and rescrew on the healing caps, he left them on. Better chance for accuracy, I think is how he explained it. Also, it would eliminate and in-between-visit before getting the actual crowns on. So he put (snapped on) white plastic healing caps on top of the abutments. Three of them came off when I ate my lunch. So much for snapping! Three weeks of this . . . I guess its back to soft chew.

Oh, and I've noticed lately that I am getting slightly more feeling back on the lower chin and lip.

Implant Update: Good News and Bad!

2008-05-30T21:33:00.000-07:00

So I saw my surgeon yesterday. Of course I was a little anxious. This was the appointment where I would have an xray of my implants to find how my implants were doing. And the good news is yes, Dr. Kaufman was happy how the implants looked and in a few more weeks I can get the abutments and crowns put on. Yeah!! I'm so excited. But he also saw a shadow under a tooth on the bottom where I have a crown and told me I would need a root canal. Ugh!

Look Ma -- No Overbite!

2008-04-03T16:55:00.000-07:00

Apparently what I need is a Booby-Lifty!

2008-03-22T12:27:00.000-07:00

Did I mention that I will be 50 this year? Next month actually. So one of my old friends who moved away years ago was in town visiting. We decided to get together with another old friend at Gladstones last night. And they actually remembered my birthday was coming up so we ended up celebrating (a bit early) and we had a really really lovely dinner with a cake and everything. And they gave me a hand-made card that had a poem which I thought I would share:

Happy Birthday Poem for Mary Ann
Even though you're almost fifty
We still think you're really nifty
and even though our card is thrifty
It's filled with love and better than a gifty!
Anyway, we couldn't think of what to get
other than a booby-lifty!

Isn't that sweat! And I'm having cake for breakfast! And its not even my birthday yet.

I feel liberated!

2008-02-08T07:23:00.000-08:00

I didn't realize how liberating it would be to get rid of my partial. For example, after my jaw advancement I couldn't wear it for six months and I felt completely insecure without it. But hated it at the same time. My dentists over the years have all told me I should have implants and I just couldn't see myself going through the whole process. But now I'm so glad I'm doing it.

What's also interesting is when I tell other people about my implants, all of the sudden I'm findout out how many people have missing teeth. They are wearing bridges or dentures or just walking around with missing teeth. It certainly isn't something I ever wanted to reveal.

I am really excited that I won't ever have to wear a partial again!

Life (With Implants) So Far

2008-02-02T07:20:00.000-08:00

So I feel like a jaw surgery veteran. I made it through the first week post surgery. The nerve repositioning was a bit more extreme than I thought it would be as my surgeon had to drill into the bone to move it over. There are some similarties to how I felt/feel between the two surgeries (not much pain except the mouth-waking-up pain; tingling, itching; numbness of the bottom gums, lip, chin) but there are also major differences. I was able to go back to work after 5 days and felt fine. I'm able to eat pretty well and probably won't lose much weight. The swelling and bruising are almost completely gone. Also, I realize now how much feeling I actually had now that its gone again.

I saw Dr. Kaufman yesterday and he was surprised at how little swelling I had left. He said everything looked good although my gums are still swollen and are growing over the caps on the implants on the left side (where I have 3) so he may have to cut the gum back. He gave me a really soft toothbrush to start brushing over the gums where the implants are. Next week the stitches come out.

As always I had a great visit with Dr. Kaufman. He had been to Tibet over the holidays and had interesting stories. He said there is very little of Tibel left as the Chinese are doing everything to destroy it and to anihilate the Tibetens who he said are really amazing people.

Day 4 Post #2 Surgery

2008-01-29T08:37:00.000-08:00

I wanted to thank everyone for their comments and encouragement. Sometimes I question my sanity for going through all this at my age (I'll be 50 in April!). Not just for tearing up my gums for example, but for spending all this money. So its really nice to get your support.

As for the swelling, its already come way down. I still feel wiped out and beat up after the long surgery and my stomach is not too happy with the antibiotic and the anti-inflammatory (which I had to stop). Luckily I've had very little pain. Like with the jaw advancement & genio, my mouth is starting to wake up with twinges and zaps. Its interesting how numb I am again which does give me some indication of the feeling I had regained. My nerve is still intact and I am still hopeful of eventually getting all of my feeling back.

Implants are in! And the Macy's Balloon Face is Back!

2008-01-26T07:17:00.000-08:00

So my surgery for 5 lower dental implants, nerve repositioning and a tooth extraction took about 5 hours which is longer than my BSSO took! The surgery was performed in the my surgeon's office and everyone was really great. I wasn't nearly as nervous. But I was surprised how awful I felt when I woke. I felt over-anesthetisized, my heart was beating too fast, I felt like I couldn't breath. Fortunately that didn't last too long and then Jeff was there to pick me up.

When I woke up this morning (after not much of a good night's sleep), I was really surprised to look in the mirror and see that I was about as swollen as I was a year ago. Hah, an old familiar face! And back on the old familiar soft chew diet. At least I don't have to contend with braces and rubberbands.

I have a surgery date!

2008-01-04T21:48:00.000-08:00

January 25. 5 lower dental implants plus a wisdom tooth extraction. Yikes!

What a Difference A Year Makes!

2007-12-15T09:59:00.000-08:00

So these are last year's and this year's holiday party picture -- last year (on the bottom) I couldn't really eat anything or even really smile. I was still swollen and there's a big difference in vitality between the two pictures, don't you think? The lovely lady with me in both pictures is my co-worker Delores.

Cost of Implant Surgery, Implants, Cosmetic Crowns -- Reality Sets In Day after Thanksgiving

2007-11-23T10:33:00.001-08:00

Felix post bladder surgery

So on Tuesday I had my consultation with my prosthodontist where we sat down to go over my entire treatment plan. The good news is that he came up with a creative plan that covers three years and he took into account that the first year, 2008, I would also be paying for the implant surgery. And Dr. Shlosberg did exactly what I asked him to and what my last dentist was not able to do, he itemized each expense so I know exactly what its going to cost. Of course, when I saw the total amount, I about fell off the dentist's chair!! I paid the deposit for the first portion which entails the surgery stint (so that Dr. Kaufman knows where to plant the implants), the abutments and 5 provisional implant crowns on the bottom (it will actually be 6 as he thinks I need to have my last wisdom tooth on the bottom pulled), and a night guard.

When I got home, in the mail was my surgery bill for the implant surgery from Dr. Kaufman. Dr. Kaufman is giving me a hefty courtesy discount as a returning patient, but it's still more than the BSSO was. The surgery will include nerve repositioning so that the implants will not actually go through the nerve since my nerve is very close to the top of the bone. We had talked about taking bone from my hip to add bone but that would mean taking it from my hip . . . and I really don't want to have to walk around with a cane!

That all happened Tuesday. On Wednesday we went shopping for Thanksgiving and then had a great Thanksgiving dinner yesterday. I did not even think about the whole thing -- you know, how you talk to yourself and worry and fret. I didn't do any of that.

So this morning (in a food hang-over stupor) I sat down with all the numbers to make a plan. The plain includes using money I have in my savings, putting $10,000 for each the next 3 years into my flex spending account, my dental benefit which is $1,500 a year (that's $4,500 over 3 years so not too bad) and for the remainder taking out an equity loan to be paid off over 5 years. Also, I will have to pay off my one credit card balance and not use the credit card for the next three years. Whew, I think I will be able to swing this so I won't have to worry or talk to myself about it.

Suddenly, the $3,000 we spent for Felix' bladder surgery last week seems like small potatoes.

The implant surgery will be in January. Even though its going to cost an arm and 2 legs, I'm really confident in both my surgeon and the prosthodontist and am happy about getting this all done. Hopefully nothing will go wrong!

Total cost for implants: Too Much Money! Value of new smile: Priceless!

"Bloggers Like Me"

2007-11-16T15:34:00.000-08:00

There are so many orthognathic bloggers -- its quite exciting. And they are quite clever -- I borrowed my title from someone who listed their links "Bloggers Like Me."

I keep adding them to my links and then I find more. Its an epidemic! I'm going to try to add them all which could take days and days . . .

Coming home after having your jaw sawed in half and looking like a Macy's balloon is quite the emotional experience, I know. So its quite uplifting to see so many bloggers who are going through this and who can offer support to the one's to follow.

Scan Results--Implants are a Go

2007-11-01T06:34:00.000-07:00

The other day when I mentioned to some of my co-workers that I was seeing my surgeon for an implant consultation, I got some funny looks. I guess you have to say "dental implants." Anyway, so I saw my surgeon and after a long chat, we decided that we would go ahead with the lower implants. I can either have the implants without a bone graft from my hip by moving my nerve during the surgery (risky of course) or I can have the bone graft to build up my bone so that he won't have to go through the nerve. My nerve is very close to the surface of the bone.

My surgeon was actually pleased when I told him that I was getting some feeling back in my lower chin area. He didn't really expect it. So he is going to be talking to my new dentist and my orthodontist and in the next few weeks I will get a plan (and of course find out the expense) for how we are going to proceed.

I think its going to be 5 implants on the bottom and 2 on the top, but I will know more in a few weeks.

Yeah, no more partial. I'm so excited!!!!

One Year Later--Looking Back

2007-10-28T18:36:00.000-07:00

It was a year ago on October 25 that I arrived at UCLA/Santa Monica Hospital and voluntary got onto an operating bed. I remember being quite nervous and afterwards feeling really silly about it. Clearly there was nothing to be nervous about, it was a piece of cake. Part of me thought if I weren't nervous, then something might happen, so better to be nervous.

Looking back now a year later, it all passed too quickly. I feel nostalgic about the days and weeks after the surgery. They were actually really great. Except for the first few days after I came home from the hosptial. I wasn't prepared emotionally for how I would look, like a total freak! Appropriately it was Halloween.

But that soon passed and I basked in the care I received from Jeff. He went shopping and brought home all kinds of soy shakes and made fresh soups everyday. He pretty much indulged my every whim. I remember being pretty hungry for a week or two but I was soon eating mashed potatoes with gravey which went a long way towards making me feel like I was actually eating something.

Finding blogs by other people who had or were having this surgery was a life saver during those first weeks. I spent hours reading other people's blogs and it helped me to feel normal and to know what to expect. I really appreciated that people took the time to write about their experiences as I had no idea what this surgery would entail until after I had it.

There were a lot of ups and downs, like having a splint wired onto the bottom of my mouth. And the hardest part to deal with was and still is the numbness in my bottom lip and chin. I learned to drink with my tongue under the cup or glass. I'm so used to it now, I hardly notice. But it still would be nice to get the feeling back . . .

My orthognathic surgery really was an adventure. And now I am finally moving on to dental implants. I have my consult on Monday.

Still Numb After All These (11) Months

2007-09-19T21:29:00.000-07:00

So I'm just coming up on 11 months post surgery and (except for the numbness on my bottom lip and chin) life is pretty much back to normal. Next month I get my scan to find out whether I'm a candidate for implants. I have the feeling that the answer will most likely be not. My new dentist, a prosthodontics, thinks that the bone and tissue loss is to severe. So, we'll see. In the meantime, I have my new partial and even though it doesnt fit that well (which is why I switched dentists), I am chewing quite well these days -- so well in fact that I have gained back 10 pounds.

Nine Months Later!

2007-07-21T09:03:00.000-07:00

So its been nine months since my orthognathic adventure began. Things are pretty much back to normal, including eating (especially since the braces came off and I got my new partial). I do have little chipmunk-like pockets in my cheeks where the scars are on each side. Food likes to gather there, even though its not winter! Also, I'm not crazy about the retainer that is glued onto the front of my bottom teeth. Its a strip that is the color of teeth but tends to get discolored from food I eat, such as blueberries or things of that nature. But overall I have good mobility of my mouth (I can now open my mouth to about 53 mms.) and the weight is slowly creeping back up. I'm trying to maintain my weight at 110-115. Oh and in this picture you can see where on the left side I have a fat bottom lip -- that was where I was biting myself (see previous post).

So I'm now waiting to start the implant procedure which will be in about 3 more months (October). Its all kind of up in the air until I get the results from the scan I will have to have to see whether I can have implants, etc.

In the meantime, I'm still numb on the surface of my bottom lip and chin although I am getting more and more feeling back in my bottom gums and I also have feelings underneath my chin and bottom lip, just not on the surface. I still get a lot of different sensations like itching that I can' scratch, hot and cold feelings on my bottom lip, etc. So that's about it!

%$$^$^^$%){OUI#@%)_&

2007-06-19T11:24:00.001-07:00

For some reason, I keep biting my bottom lip on the left side. I have been walking around with a fat lip. The inside of my lip in not numb so I actually feel it!!!!!

Thirty-Three Weeks Post Op

2007-06-12T15:22:00.000-07:00

Too much carrot/beat juice do you think?

I'm beginning to get a tiny bit more feeling back in my chin and on my bottom lip. Just a wisper.

Also, I'm gaining my weight back. I was down to 105, now I'm back up to just over 110.

The "Plum Pit" Is Back

2007-05-27T12:30:00.000-07:00

At 7 months post surgery, my biggest health issue at the moment is the return of the "wicked lump" sensation in my throat. Along with this feeling of something being stuck in my throat, I feel crappy, under the weather. In Chinese medicine its called "plum pit" syndrome. Here's an interesting blurb in an article I read:

Plum pit qi refers to an abnormal sensation of something in the back of the throat which can not be swallowed down nor spit up. In modern Chinese medicine, this definition is supplemented by the comment that, upon examination, there are no pathological changes observable in the throat. In Western medicine, this condition is referred to as neurotic esophageal stenosis and globus hystericus.Within contemporary Chinese medicine, this condition is now associated with psychiatry. It frequently occurs in those with depression and/or anxiety disorders.

We are driving to Vegas tomorrow to spend a couple of days with my parents. And other than the typical work issues (dealing with petty rivalry and antagonism of co-workers), I have a very happy, satisfying life. So if I'm depressed as the article suggests, then the cause is completely unknown to me. Well, I'm depressed right now because I couldn't go to yoga today and because I feel like crap right when we are going on a short trip.

From a Western medical point of view, globus hystericus is caused by acid reflux. So why do I have acid reflux? I don't know anyone with a better diet! I don't drink coffee nor alcohol. I don't eat junk food. Recently I went through a two week course of the "triple threat" treatment for h-pylori (which I have had for years): Cirpo, Protonix, Pepto-bismol. About a week or so after getting off of that crap is when this came back. Those stomach acid suppressors seem to do more bad than good.

2007-05-08T22:34:00.001-07:00

Is it just me? I noticed since I first learned about orthognathic surgery that I look at people differently. Today I was watching a taped Opera show with Tommy Hilfiger as a guest. And the whole time I was looking at his mouth. I would guess that he had an overbite and his orthodontist just slapped braces on him much like my first orthodontist had proposed. Dr. Aronowitz pointed out to me that if I just had my overbite fixed without advancing the lower jaw, aside from all of the other problems, my top lip would just hang over my teeth and I wouldn't like how it looked. And that's exactly how Tommy looks -- his top lip just kind of collapses over his top teeth (which are beautiful by the way). Of course, I'm probably completely wrong, Tommy probably never wore braces.

And I do this a lot, notice people's bite, their jaw, their lips, etc. Its funny HOW MANY PEOPLE actually have a misaligned jaw. Mostly I notice people with overbites and a receding chin. I guess I kind of wonder if they can go through life with an overbite, why couldn't I? Why did I go and have this surgery. Ha, its six months too late for that kind of introspection. But actually, I'm glad I had the surgery. Even with the numb chin.

Dr. Aronowitz & Staff

2007-04-27T13:39:00.000-07:00

So getting the braces off was not that much fun for me! (I'm sure not for Harry or Lashon either -- I'm no prize patient -- they are really patient!)

I had a band on one of my top molars and I thought that the whole tooth was going to come off. The brackets came off fairly easy. To get the glue off, Dr. A used a drill and I had to hold my breath each time he started it. It took about 45 minutes to get everything off and for a good polish (Dr. A did a really nice polish). My teeth and gums are very senstive, particularly on the bottom.

Then I got a permanent retainer glued onto my bottom teeth -- a wire in the back, a bonding thread on the front. This keep my bottom teeth stable while my bones settle down. There is a raging debate about whether I will get implants on the bottom. Well, not really raging. It will depend on whether I get my feeling back. My dentist thinks I will; my surgeon doesn't and he wants to go right ahead and put the implants in which would most likely severe the nerve.

I picked out a removal retainer for the top which I pick up next week. I went with a very exciting color -- clear.

Total time spent at the orthodontist was 2 hours 38 minutes with one minute to spare on the parking meter. I didn't go back to work. Instead, I decided to stop off for a chocolate muffin! Time in bottom baces: 23 months; time in top braces -- about 9 months.

I just realized that I am six months and 2 days post surgery.

Look Ma, No Braces!

2007-04-26T17:22:00.000-07:00

Thursday, Not Monday

2007-04-21T15:28:00.000-07:00

Slight delay in the "de-bracing." I called my dentist to tell him the braces are coming off on Monday and he said that he needed them to be on for my appointment on Tuesday when he is going to add some bonding to the lower teeth to build them up. Apparently they have become grinded (grounded?) down over the years because of my overbite. So instead of getting the braces off on Monday, it will be Thursday afternoon. Dr. Dybnis made it sound like the de-bracing would cause some pain and/or discomfort. Mmmm, haven't heard that from anyone. Guess I'll have to wait and see.

In the meantime, here is an updated photo taken at Spagos. Right before the batteries went dead. My bottom lip and chin are still completely numb on top. My lip has been burning a lot and it feels like something is pressing across it making it kind of pushed in against my teeth. Dr. Dybnis told me that he has no patients who have a numb lip or chin in their 60s so he thinks that everyone gets their feeling back eventually. Gee, that's comforting!

Lunch at Spago's

2007-04-21T00:19:00.000-07:00

So David, my office administrator, took a few of us out to lunch at Spago's in Beverly Hills the other day (for my birthday actually). There was not a whole lot on the menu that I could eat. I had some dish that turned out to be raviolis (not that it said the word ravioli anywhere) and of course as always, I was the last one eating. But it was awfully good! No star sightings. And I'm glad I wasn't the one paying the bill (I felt slightly guilty about inviting so many co-workers to go with!). My camera batteries died about a minute after we got to the restaurant so I didn't really get any good pictures. I was glad I could find this one on line.

Untitled

2007-04-17T12:15:00.000-07:00

The braces are coming off on Monday! Yeah!

The bad news is that it will be at least six months before my dentist can proceed with the next phase of my dental work, which will include implants and crowns, because the bones need a chance to heal from the effects of the braces. Darn!

Oh well.

Whose Blog is it anyway!

2007-04-05T17:30:00.000-07:00

Since there really isn't much going with the orthognathic blogfolks, I've been trolling civilian blogs. Wow, there's a whole virtual bloglife-culture out there!

And so many blog tools. Here's an interesting blog tool link I found, oh, and here's another.

I don't know, this could cause me to loose hours and perhaps even days of my life . . .

Where Have You Gone, Mrs. Shanton?

2007-04-02T18:07:00.000-07:00

Brandy found this on Kelsie's blog.

So Many Blogs, So Little Time

2007-03-31T23:06:00.000-07:00

So before I had my jaw surgery I had never read a blog. I mean, with almost 7 billion people on the planet, who's (whose??) blog would I pick? Right? When I came home from the hospital from my surgery and I looked and felt like a freak, I started looking for information about the surgery to see what I was in for. (Yes, I know, most people do that before the surgery. But I did not want to have anything freak me out and have me cancel the surgery, so I did not look.)

The first pictures I found were Dovie's and that gave me a lot of reassurance. She was about my age when she had her BSSO and her result looked great. Plus she had pictures of her swelling and bruising and that was exactly how I looked. So I felt hopeful.

Then I found Mrs. Shanton's Wacky Teef. She didn't have any gory pictures but she had lots of links and that's where I found Kelsie. Kelsie had just had her surgery about five weeks before me and she was still all nice and swollen so it was helpful to see what she was going through.

From there, the whole Blog experience exploded. Every person who had a blog had more links. I mean, you could spend all day just finding people who have started a blog relating to their orthodontic and/or orthognathic experience.

So today I spent some time updating my links to include all of the ones I have been reading at all their various stages. (Hopefully I didn't miss anyone.)

We are an interesting bunch. Several Canadians. There's Brandy in Alaska who is the most supportive and is having her surgery in May. Poor Graham doesn't have a date yet. And then there's Bill, the marine, who has to have his surgery again! And Kelsie just got her braces off; so did Beneath The Stars (what IS her name!?). Steph's blog is the funniest but we haven't gotten any updates for a while. Rebecca looks really great. Cary is healing quickly. And Kristen's blog is my favorate, she's so interesting! And people are so clever with their blog titles.

Oh and I added a link to a blog unrelated to orthognathic surgery -- Petite Anglaise. Petite is a 33 British (ex-pat?) woman who lives in Paris with her daughter Tadpole (the ex's name is Frog -- isn't that clever?) and her blog has made big news since she got fired because of it. I've always wanted to move back to Germany or Europe and write entertaining and witty stories about my life. Sigh!

Harry Makes My Day!

2007-03-29T17:30:00.000-07:00

So I had my orthodontic appointment today and Harry -- my orthodontist -- told me that with my dentist's approval, my braces can come off next month! Yeah, so I'm just following right behind Kelsie. She had her braces off at six months post surgery and (hopefully) I will too!

I still had a little gap so I got one power chain. Other than that it was a pretty uneventful visit. I got to floss and brush while the wires were off so that was fun.

I'm still having sensations on my lip and chin but so far nothing else is happening ie no more feeling has returned. I am however getting more feeling in my lower teeth. Today, for example, I felt it when the ortho assistant, Marcy, took the ties off my bottom teeth. And in fact, my bottom teeth in general feel pretty normal. And I do have more feeling and sensitivity in my lower gums but still not 100%.

Its just all so interesting. And thanks to all for your comments and support. Its just so much easier going through all this with other orthognathic "blogfolks."

I'm Itching and I Can't Skratch

2007-03-20T16:10:00.000-07:00

Talk about frustrating. I wish for just one good scratch, right on my chin! Ugghh!!!

I've been having a lot of sensation in my bottom lip (mostly burning but also some pain and some pulling feelings and it feels frozen and indeed looks frozen). And I've been having a lot of itching, burning, tingling, and warm sensations on my chin. Almost like I can feel something on it but when I touch my chin or lip, nothing. Like its not there.

I still have to feel whatever I'm eating or drinking with my bottom lip. And I still catch myself drooling. Mostly when I'm home alone as if I'm out I always have a napkin in my hand to wipe! And it still takes me a long time to eat. Today we had an office lunch at a Chinese Restaurant to celebrate a birthday. Everyone got up to leave and my plate was still full of food!

So anyway, that's what life is like at almost 5 months post surgery.

Ouch!

2007-03-08T10:08:00.000-08:00

So I had my weekly acupuncture appointment this morning. Ping, my acupuncturist (doctor of chinese medicine really) usually puts in 5 needles, two on each side of my chin on the jaw and then one right smack in the middle of my chin. And its always so wierd because I can hear it go in and there is a sensation of it going in, but without any pain at all. (Don't believe anyone when they tell you that the needles don't hurt-there is usually a small sting and sometimes not so small depending on where it is inserted. On the feet, right between the toes for example, its a rather large ouch.)

Anyway! This time, when she put the needle in the chin, I actually could feel a small sting deep in the chin. It was quite exciting. I now have hope that I will actually get my feeling back. Yeah! Well, I guess I'll have to wait and see. But still, I'm excited!

The Nerve! (The inferior alveolar nerve that is.)

2007-03-01T10:40:00.000-08:00

More info on nerve regeneration, this comes from ThunderDent at Igobraces:

On average, nerve tissue in the maxilla regrows at an average rate of 1 mm per day. With the bloos supply in the maxilla, everything grows back (mostly) and you get feeling back to your teeth, etc.With the mandibular surgery, if you sever the Inferior Avelor Nerve (IAN) then it is gone for good. In which case you'd loose sensation to your chin, lower lip, teeth and mucosa on the Buccal (outside toward your cheek) of the side that is damaged. You'd still have your tongue side mucosa, and your tongue (unless the Lingual nerve is severed). People that suffer from severe Trigeminal Neuralgia often get the IAN cut on purpose so the pain will stop.

Here is a link to an interesting article about nerve damage and BSSO surgery: http://herkules.oulu.fi/isbn9514267508/html/x440.html. I'm not sure what to make of all this and whether I would have gone through with the surgery had I known that I would have permanent numbness. As it is, I have a lot of burning, tingling and itching and I'm still hopeful that I will get the feeling back completely, but with everything I have read, and based on the comments my own surgeon made to me, its quite possible I will have to live with this.

Hot Dog Anyone?

2007-02-24T21:27:00.000-08:00

I don't know if its all the excitement of watching Meredith come back to life on Grey's Anatonomy on Thursday night, or if I have phantom sympathy pains for my fellow bloggers who have recently undergone their orthgnathic surgery, but I've had a lot of sensations (pain, tingling, itching--how I long for just one good scratch! ) on my lower lip and chin in just these past days. And then I read Jennicole's post about nerve regeneration and I realized that at 4 months post surgery, my nerves may be at the point where they are trying to reconnect. How exciting is the possibility of that!
Here is Jennicole's post, which I thought most interesting:
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 yself, 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.

Now don't you just want a hot dog!!!

Proud Mary Keeps on Burning

2007-02-22T13:44:00.000-08:00

Sunday will be my 4 month anniversary since my surgery. I am still numb on my bottom lip and chin. For the past couple of days I have had more burning on my lip and more itching. I hope that's good! I also continue to have a strange feeling across my lip, like someting is pressing against it, restraining it, even though I can move it. Its hard to explain. Sometimes I have a really strong ticking sensation on my chin that I can't scratch. I had a lot of that right after the surgery and then it kind of subsided. My acupuncturist thinks there's a good chance I'll get my feeling back but I have to admit, I'm a tad discouraged. I wanted my feeling back since day 1!

And I'm eating quite normally even though I still have an issue with the mobility of food in my mouth. Seems I just can't chew as big as a mouthful as I'm used to. But I'm eating quite normally, almost everything. My scale says I still weight the same, 105, but my yoga pants say 125. I'm sure its just a matter of time before the weight comes back on. Its interesting how it took its time coming off.

I'm getting more comments from people who see me about how I look, how different I look, positive comments. Its kind of nice. Now I'm looking forward to getting my braces off and getting the rest of my dental work finished. Seems like it will be forever!

Nostalgia--a bittersweet longing for things, persons, or situations of the past.

2007-02-16T19:06:00.000-08:00

It's kind of wierd that with several bloggers just having gone through their surgery, I am experiencing this nostalgia for those first days post surgery. I know realistically I would never want to go through it again, but there were so many new and interesting experiences. Like going to Starbucks for a soy green tea latte (which I was seriously craving) and being completely embarrassed about my monsterous look and inability to speak clearly. And for the first week after the surgery, I seriously regretted doing it and I questioned my motivation and sanity. I rembember having a conversation with a girlfriend who had had a breast augmentation and she told me she felt the same way. But there was also something very special about those days, getting flowers, having Jeff cook yummy soups and being very supportive. And being off from work for two stress-free weeks and just enjoying, as much as I could, napping, watching TV (Oprah) and reading. I guess what I did enjoy was indulging myself, my emotional self, and being okay with it.

But then again, after looking at this photo of about Day 3, which I just came across, I think my nostalgia has now worn off. :-)

So here's my new chin

2007-02-11T16:18:00.000-08:00

That's quite a chin, don't you think?

And here's a "before" picture which kind of shows a side view of my chin.

And here's an updated frontal view, 15.5 weeks post surgery.

Fifteen Weeks Post Surgery

2007-02-09T13:31:00.000-08:00

So I saw my surgeon, Dr. Kaufman, yesterday, for my 15 week post checkup. My orthognathic adventure is pretty much over and everything turned out well, all 3 of my doctors (orthodontist, dentist and surgeon) are all thrilled with the result. Now we are moving forward with implants, starting with the three on top. And then finally, the cosmetic crowns. I can't wait until I won't be embarrased about my teeth.

I have decided to have Dr. Kaufman also do my implants and we had a long talk about it yesterday. He told me that there is a good chance that the numbness on the bottom will be permanent due to my age. I wasn't so happy about that. But, if the feeling does not return, this means that he will be able to do bottom implants without bone grafts. So it won't be all bad if I stay numb.

However, if the feeling comes back, he said there is a good chance he may not even be able to do the implants on the bottom, even with bone grafts, because of my small face structure and the nerve is too high. He would not be able to put the implants in far enough without damaging the nerve. Interesting. So, we'll see.

So now its just a matter of waiting for the braces to come off so that I can proceed with the implants on top. Probably about three months.

I really like my surgeon. He spent a lot of time with me yesterday. And he told me all about his adventures in India. Sounded a little hairy!

Good habits are easy to break!

2007-02-08T07:09:00.000-08:00

Its funny how bad habits are hard to break. Like it took me years to wean myself off of coffee. But a good habit, like getting up to walk every morning, is out the window in no time flat. I got sick about a week and a half ago with a really bad cold. Of course I haven't been to yoga or walking in the morning. And finally I'm starting to get better. And this morning it didn't even occur to me to get dressed and go on my walk. Instead I have now gotten used to sleeping in! So its going to be like ripping a bandage off -- having to make myself get up and put on my sweat pants. And the funny thing is I love to walk. I have been in this routine for years. Oh well. Just a thought I had this morning.

My "Benzo" Story

2007-02-04T09:17:00.000-08:00

Anti-anxiety medications known as tranquilizers such as valium, zanax, ativan, etc. are drugs commonly referred to as benzodiazepines. Those of us familiar with these medications call them "benzos". I thought it might be worthwhile to post my benzo story here for others who are considering taking them to decrease their surgery anxiety. My advice unequivocally is -- DON'T!!!

I started taking valium in my early 20's which were prescribed to me by a military doctor for pain. I didn't think twice about it. Not too long after I started taking valium, I started having strange health problems. I never equated the two and when my perspcription ran out, I stopped taking them. Until about a year or two later when I was getting a divorce and I found another doctor who perscribed them. That's also about the time my panic attacks began. Again, I did not equate one with the other. What I didn't know was that benzos cause rebound anxiety and panic attacks, especially the ones with the longer half life. I then took valium and other benzos over the next 20 years mostly on an as-needed basis for panic attacks, sometimes as little as .5 mgs per month. Throughout these years, I continued to suffer from strange symptoms for which I went from doctor to doctor with no diagnosis.

Then in my early 40's I got really sick. One of my doctors told me I had "anxiety neurosis" and prescribed 1 mg of ativan on a daily basis. For a while the ativan did help alleviate my symptoms. What I didn't know was that I had developed tolerance withdrawal even though I was not taking the valium on a regular basis because of its long half life. That's why the ativan helped. But then I continued to get worse, having trouble even walking. I went to many specialists who diagnosed me with among other things, MS, myesthenia gravis, lupus, toxo plasmois, and finally, chronic fatigue. It got to the point where I really didn't think I could go on. All of the doctors knew my benzo history but not one of them thought to consider that they were making me ill. Such a small pill has such a tremendous effect on the nervous system.

Finally, it was my accupuncturist who suggested that I slowly taper off the ativan. And when I did, that's when it hit me like a DUH! that it was the benzos that had been making me ill all those years. By then, a lot of nerve damage had been done. But fortunately I was one of the lucky ones who was able to taper off and actually recover my health and my life. Unlike most drugs, benzos are not something that you can just detox off. Benzos alter the landscape of the brain, its ability to naturally calm itslef down. You have to taper very very slowly and even then its barely tolerable. It took a good 2 years before I started feeling somewhat normal again and even today, almost 6 years later, I still have chronic muscle fatigue and other benzo damage issues. For about a month after my surgery, the panic attacks and aggitation came back most likely due to the benzo they gave me right before they put me under.

So anyone who may be considering tranquilizers to deal with anxiety, I recommend that go to "benzo.org.uk" (click on My "Benzo" Story title for link.)

Three Month Update

2007-02-02T22:16:00.000-08:00

Actually, not that much has changed. I'm still numb in my bottom lip and chin but more feeling is coming back into the peripheral areas. I actually have more pain on the inside of my lip and some sensation on my gums when I brush my teeth. I saw my orthodontist on Thursday and I am done with my rubber bands. I should be getting my braces off soon, within the next month or two, after some final tweeking, so that's good news.

I saw my dentist a few weeks ago and he is happy with my new bite and we talked about proceeding with a cat scan and implants as soon as the braces come off.

I'm still holding steading at 105 pounds for a total weight loss of 15 pounds. Two weeks ago Jeff got chicken pox (I know !!??) and just as he was beginning to feel better, I came down with the worst cold I have ever had, so I haven't been eating that much. I have been holding off buying new pants (inspite of people telling me I am "getting too skinny" coz my pants are bagging) because I am sure that the pounds will creep back on sooner than later.

I was looking at my profile the other day and it seems that my chin is now a little more pronounced than I realized. Mmmmmmm. Maybe its just me . . .

So that's about it, no big changes or anything. I see Dr. Kaufman next week so we'll see what he has to say.

All choked up--GERD & Globus Hystericus

2007-01-14T10:59:00.000-08:00

Felix aka Fat Boy
So about a month before my surgery, I had a bad GERD episode, what is commonly referred to as globus hystericus (my accupuncturist said in Chinese medicine they call it plum pitt syndrome). Anyway, it feels like there is a lump in my throat or food stuck in my throat, or like someone is choking me like when my cat felix sits on my throat. It makes me tired and cranky. It was of course understandable that the anxiety of the upcoming surgery was the cause of my episode. But now, 12 weeks post surgery, the big bad lump is back. I suppose I got too lax about what I was eating. I had some friend fish last weekend when we drove up to Oxnard to visit some friends. Fish and chips just sounded good, although I had the mashed potatoes. And I also ate a burger and fries (not on the same day). And on New Year's day I had French toast at Kate Mantalini's. I guess that's what I get for getting a little excited about being able to eat more foods. So its back to mashed potatoes and bananas which seems to help with the GERD. Ughhhh!!! So frustrating.

Before & After

2007-01-01T08:58:00.000-08:00

Here are before and after photos. Its kind of interesting looking at pre-surgery photos with an eye towards how I look different now. I don't think we ever like to see photos of ourselves and I can't really say that I feel any different about it now. But I definitely see a difference.

I also got these below before photos, which include my 5 mm overbite, and a diagram of my before measurements, from my orthodontist on my visit today. It turns out the gaps on either side of my front teeth were caused by my new bite. So he put some ties on the teeth to get rid of the spaces. I have to admit, I don't know much orthodontic jargon.

Another before & after set:

PS--A lot of people ask me about the grey streaks in my hair -- they are natural since I don't color my hair.

Nine & A Half Weeks

2006-12-30T17:35:00.000-08:00

Christmas Day marked two months since my surgery. Other than some remaining swelling (more on the left than right side) and the numbness in my chin and bottom lip, I am pretty much back to normal. I am eating somewhat regular foods like cut up chicken and turkey along with soft foods. I still have some mobility problems with eating, I don't really have good control over what's in my mouth. So it takes me quite a bit longer to finish a meal. I'm really self-consious eating in public. And I actually kind of miss my soup diet so I am still having Jeff make them for me.

I'm getting used to the numbness to the point where I don't notice it that much anymore (except when I'm eating). I still have strange sensations and I'm hoping this means nerve regneration. To me my chin kind of feels frozen and I feel like I look funny when I talk.

Another complication is that my partial that I had for some bottom missing molars no longer fits so I don't have enough bottom molars to really chew. I can't have a new partial made until I am done with the orthodontics.

I am anxious see my orthodontist on Tuesday. Its been just a little over a month since my last visit and I am having some strange teeth movement. My two front teeth seem to be moving closer together causing gaps on either side. I imagine my orthodontist has some good plan in mind but it is just a little unnerving. What I am really looking forward to is getting the braces off. I only have some minor tweeking of teeth so hopefully they will be off in 3-4 months. After that I will have a CT scan to see about bone grafts and implants.

PS--I have regained some feeling in the inside of my bottom lip when I bite on it, on both sides. So that is encouraging!

Six Week Update

2006-12-07T17:06:00.000-08:00

I am still numb on my chin and bottom lip!
I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!I am still numb on my chin and bottom lip!

Life After Bilateral Sagittal Split Ramus Osteotomies with Mandibular Advancement and Genioplasty

2006-12-02T12:12:00.000-08:00

Going back to yoga the first time after my surgery was probably one of the hardest things I've ever done. I have been doing yoga regularly for almost 2 years so its not that I'm not used to it. After my first class (about 3.5 weeks post surgery) I was shaky and weak. My surgeon told me I could go back to yoga but to take it easy with the down facing poses. Surprisingly I really felt almost no pressure on my face. What was missing was energy, stamina, endurance. I did notice that after the yoga my bottom lip was tingling and burning quite a bit but that hasn't happened again more than otherwise. I did my 7th class last night and its slowly getting easier. So I'm pretty happy about being back at yoga.

I have noticed an increase in aggitation and irritation since the surgery. It actually comes and goes. I'm particularly impatient when I am stuck in traffic (yeah, I live in LA but I hardly ever have to drive far), or when I can't find a parking space, or when I have to wait in a long line at Starbucks for my green tea soy latte. My aggitation and impatience seems to be heightened, out of proportion. I suspect that it may have to do with the benzodiazepines they gave me with the anesthesia. I have a history with tranquilizers -- I used to take them on a regular basis for panic attacks until I developed paradoxical effects. Apparently benzos wear out the nerves that help you stay calm, or something like that. One thing is for sure, I have a heightened sensitivity to everything!

I saw my periodontist today for my first teeth cleaning after the surgery. I really needed it. He said my gums look surprisingly good for all they've been through. My gums and teeth are definitely more sensitive!

My insurance company came through and paid my claims so that's a releif. Even though it was pre-approved, I was still nervous that they maybe wouldn't pay for the genio or that I would have to fight to get the claims paid in a reasonable time frame. So that's one thing I don't have to worry about.

Of course what I do worry about is the numbness in my bottom lip and chin. There is that small chance that its permanent. I hope not but the fear is there in my mind. It feels so wierd to not know where my mouth is. And I am getting used to my new chin, to there being more of it, even though its really slight.

So I guess that life (almost) 6 weeks after Bilateral Sagittal Split Ramus Osteotomies with Mandibular Advancement and Genioplasty is getting back to "normal," whatever that might be.

Still Numb After All These Weeks

2006-11-30T22:10:00.000-08:00

Its been just 5 weeks past my surgery and I'm still completely numb in my chin and bottom lip. I finally had the "hardware" removed from the bottom of my mouth, oh what a relief that was. Although my gums are pretty messed up. But seems like things are healing. I saw my orthodontist today to get the hooks removed and he put in new wires and is now starting to move some bottom teeth. I'm anxious to get the braces off and put all of this behind me.

I'm eating more, soft steamed vegies, really soft fish, mahtzo balls. But its not going so well with the chewing so I still tend to stick to really soft things or mushy soups. My teeth don't really know where to settle. Still holding steady at the 5 pound loss. Everthing I see on TV looks good, even the McRibs!

I am still using the torture device and am almost at the 4 point mark.

I still look like a chipmunk.

Out, Damn Appliance, Out!

2006-11-20T12:55:00.000-08:00

I'm kind of at my wit's end with my appliance which is apparently wired onto my bottom of my mouth. It's really cutting into my gums. Called my surgeon and he said I can come in Monday to have it removed. Next Monday! I was hoping sooner but apparently my complaints of all the pain elicited no sympathy. I'm tired and hungry and I want it out, out, out. I don't even care that I can't eat a nice Thanksgiving dinner. I just want the pain to end. Oh, and feeling in my bottom lip and chin would be nice too!

Okay, I think that's the end of my tantrum!

17 Days Post Surgery

2006-11-11T06:48:00.000-08:00

I'm still completely numb in my lower lip and chin and also still swollen, a little more on the left than right. It feels really weird not being able to feel my lower lip when I drink--like its not there, kind of creepy. I'm not drinking as much because of it. When I eat, I have to wipe with each spoonful just to make sure I'm not dribling on myself.

I also still have mouth pain at various times in different locations. Sometimes I'll have a surge of pain in a certain part of my mouth like its coming back to life but it usually doesn't last long. And the one persistent feeling is the burning in my lower lip. With my lower jaw moved forward, the braces are rally cutting into my lower lip.

Yesterday my surgeon gave me device to exercise my jaw (the "torture device"). I have to insert the device, widen my mouth/jaw until it hurts, leave it there for a stretch and then relax. He wants me to do this 20 times about 12 times a day! Ouch, after doing it last night I had got a pretty bad headache and went to bed early. But I don't get to pass "go" until I get to a range of 40 mm and right now I'm barely at 10 mm.

Speaking of mm's, I learned yesterday that my advancement was a total of 11 mms; my jaw was moved forward 5 mms and my chin 6. My surgeon is very happy with my profile.

I went back to work mid-week which was two weeks from my surgery date. Interesting reactions from co-workers. Some really saw a difference. Some didn't. The hardest part about returning to work was talking. It really hurts with all the mouth pain, lip burning and rubber bands, to talk. And I do a fair amount of talking at work. My energy level is slowly getting better but still not really up to par. Because of the face swelling, I still have to wait a few more weeks to return to yoga. The only exercise I'm getting is walking a half hour in the mornings. And as of today, I have lost about 5 pounds since the surgery. (Jeff has lost 6!)

I had my third manual lymphatic draining (MLD) treatment yesterday. I highly recommend it. Its relaxing and seems to really be helping with the swelling. Last night I also got an amazing foot reflexology treatment. If you live in the Southern California area, I highly recommend my therapist, Cynthia Bartholmey (listed on Dr. Vodder's website). She definitely has the healing touch. She's located in the Beverly Hills/West Hollywood area, 323.240.9048.

The Gory Details

2006-11-07T10:40:00.000-08:00

Wow, I can't believe two weeks have already passed since my surgery. They seem like lost weeks. My surgery for bilateral sagittal split ramus osteotomies with mandibular advancement and genioplasty was scheduled for 10/25/2006 at 8:30 am. We arrived at Santa Monica UCLA Hospital at 6:30 am. Everything went smoothly and I was in a hospital gown, cap and booties in no time. The blankets were warmed which had a calming effect. The nurses were really nice, the anesthesiologist looked like he just graduated from high school. My surgeon, Dr. K, showed up around 7:30 and so did my dentist who wanted to make sure that my bite was put in the right place. They wheeled me in sometime around 8:00 am or so. I had a conversation with the anethesiologist about using benzodiazepines because of my history with them but in the end, I opted for being calmed down. I don't remember much after they transferred me to the OR table.

My surgery lasted 4 and a half hours. I remember waking up and Dr. K telling me it was all over and I was doing fine. I was a bit woozy but otherwise felt fine, no pain, no weepiness. I came in and out of conciousness in the recovery room and remember thinking, thank god its over! When I first woke from the anesthesia I thought it was really funny and kind of odd that my legs were sort of buzzing and vibrating. It took me a while to realize that they had put some sort of leg-gloves on both my legs that were hooked up to a machine that massaged my legs to keep the blood flowing. Finally around 3:00 pm they wheeled me into a room. I remember being wheeled down the hallway and into an elevator and not caring too much if anyone saw me.

I remember waking up again and Jeff was sitting in a chair. I asked him how long he had been there and he said 5 minutes. My concept of time was warped. Other than my face feeling really big, espcially my lower lip, I don't remember feeling too bad. Until about 7:00 pm just as my surgeon came to see me. I was really thirsty and I had been chewing on ice chips and drinking small amounts of water. Then the nausea hit me and I started vomiting blood. Dr. K said that it was blood that I swallowed during he surgery. He said tried to suck it out but I became concious too soon after the procedure. So I threw up a couple of times and then I felt fine. I received wet oxygen and ice packs on for my cheeks and went back to sleep.

I did not use the pain pump, I didn't need it. Jeff left and I went in and out of sleep during the night. It certainly wasn't easy getting out of bed those first hours. Everytime I had to go to the bathroom, I had to ask for assistance. It was a production to take off the leg equipment and to unplug the IV. And I was completely mortified at how I looked. My face was swollen and my lower lip was huge. I couldn't imagine that I would ever look normal again. Thank goodness Jeff was there to assure me it would be okay. I could not have made it through this without him.

The next morning I turned on the TV. I was really tired since the aids woke me every half hour to take my vitals. The breaking story was the Esperanza fire. It was really terrible news and I watched it continue on throughout the day. Four firefighters (later 5) lost their lives.

During the day developed a fever. Nurse Barbara told me I had to sit up, take deep breaths and cough, that the fever was an indication of infection in my lungs. Another small complication was that my blood pressure, which is normally low, was really low. One aid was particularly concerned and he ended up raising my legs to improve my blood pressure. When Dr. K came to see me that day, he said I would be released the next day. Which meant a second night in the hospital.

That night my lower lip really started to burn. That was pretty much the only pain I had. What I really minded more was the numbness. And that I could barely brush my teeth as I had rubberbands on my eyeteeth. I had a big bandage across my face and so it was hard to wash my face as well. And one thing is for sure -- I really do not like being in a hospital. But the nurses assistants were the best! The food on the other hand was really pretty bad. It didn't dawn on me what my diet would be like until brakfast showed up. Clear broth and apple juice!

When I got home, Jeff started cooking up a storm of soups and I spent a lot of time on the sofa sleeping. By then my mouth started waking up and I started having a lot of pain. I didn't mind it because I knew it was an indication that I was beginning to heal. But I didn't expect to be so tired. Even today at Day 13 I am still feeling tired. Here's another picture of me during my recovery process.

Chef Jeff

2006-11-07T07:18:00.000-08:00

Thought I would share the recipes for the blended soups Jeff has been making for me. My favorite is the cauliflower soup and I definitely recommend adding nutmeg.

Roasted Butternut Squash Soup

2 butternut squash
3-4 cloves of garlic, crushed or minced
Olive oil
Olive oil spray
Salt
Nutmeg

Preheat oven to 425. Take 2 butternut squashes, cut off the two ends, and cut each in half lengthwise. Put on a baking sheet covered with foil. Spray with olive oil spray and sprinkle with a dash of salt and pepper. Roast in the oven for about 45 minutes. Remove and allow to cool until they’re cool enough to handle. Remove the peel from the cooked squash and put the squash meat aside.

Heat a large pot and then add a small amount of olive oil. Saute a few cloves of crushed garlic (3 or 4) a few minutes – making sure not to burn. Add the cooked squash – cut into chunks - and enough water to cover. Heat until the water comes to a slow boil and then simmer on low for about 15 minutes. Use an immersion blender or add the mixture in parts to a regular blender and blend until smooth. Add salt and ground nutmeg (preferably freshly ground) to taste.

Potato Leek Soup

2 large leeks
5-6 russet potatoes
Olive oil
Salt & Pepper

Prep the vegetables first and set aside in separate containers: Cut the base and the leafy green section off of the leeks, rinse, and make sure they’re very well dried. Cut lengthwise and then again to quarter each leek. Cut into small pieces about a quarter inch wide. Peel the potatoes and cube into approximately half inch cubes.

Heat a large pot and then add a small amount of olive oil. Add the leeks and sauté until soft being careful not to burn. Add the potatoes and immediately cover with water. Add some of the salt and pepper, though less than you think you need (it is easy to add more at the end but impossible to remove if you add too much early on). Bring to a slow boil and then reduce heat and simmer for about an hour until the potatoes are falling apart.

Use an immersion blender or add the mixture in parts to a regular blender and blend until smooth. Add salt and pepper to taste.

Optionally add a small amount of cream and blend in to make a richer soup.

Cauliflower Soup

1 small yellow or white onion
2 russet potatoes
2-3 large stalks celery
1 head cauliflower
2-3 cloves garlic, crushed or minced
Olive oil
Salt

Prep the vegetables first and set aside in separate containers: Dice the onion and celery and store together. Peel the potatoes and cube into approximately half inch cubes. Clean the cauliflower, remove all green stems and leaves, and break into roughly one inch pieces.

Heat a large pot and then add a small amount of olive oil. Add the onion and celery and sauté until soft and the onions are starting to get clear. Add the crushed garlic and sauté another couple of minutes, making sure not to burn anything. Add the cauliflower and potatoes and enough water to cover. Add some of the salt, though less than you think you need (it is easy to add more at the end but impossible to remove if you add too much early on). Bring to a slow boil and then reduce heat, simmering for about an hour or until both the potatoes and the cauliflower and almost falling apart.

Use an immersion blender or add the mixture in parts to a regular blender and blend until smooth. Add salt to taste.

Optionally, add some freshly ground nutmeg to taste.

Vegetable Soup

4 large carrots
4 large or 6-7 small yellow star squash
4 green zucchini squash
2-3 russet potatoes
3 large parsnips
1 medium onion
3-4 large stalks celery
4-5 cloves garlic, crushed or minced
¼ - ½ red bell pepper
Olive oil
Salt & Pepper

Prep the vegetables first and set aside in separate containers: dice the onion, celery, carrots, parsnips, potatoes (peeled), and red bell pepper. Trim the ends and peel the green squash. Cut lengthwise and then again into quarters then cut into ½” wide slices. Trim the ends from the yellow squash and cut into pieces about a half inch square.

Heat a large pot and then add a small amount of olive oil. Add the onion, celery, carrots, and red bell pepper and sauté until soft and the onion is starting to get clear. Add the crushed garlic and sauté another minute or two, making sure not to burn anything. Add the squash (both) and sauté another several minutes until the squash starts to warm up and get slightly soft on the outside. Stir often to allow even cooking. Add more olive oil if necessary.

Add the remaining vegetables and add enough water to cover. Add some of the salt and pepper, though less than you think you need (it is easy to add more at the end but impossible to remove if you add too much early on). Bring to a slow boil and then reduce heat. Simmer for roughly an hour until the potatoes are starting to fall apart and all the other vegetables are very soft and will almost fall apart with a fork.

Use an immersion blender or add the mixture in parts to a regular blender and blend until smooth. Add salt and pepper to taste.

Optionally, you may replace the squash with equivalents, including yellow baby squash, yellow crookneck squash, etc. You may also add other vegetables. For a slightly milder soup, you may leave out the red bell pepper or add more for a spicier soup.

Holloween -- Oh What A Face

2006-11-06T09:13:00.000-08:00

So this is what I looked like on Holloween (Day 6). I didn't need a mask to scare anyone. Right around this time I was beginning to accept that it would take much longer to heal than I had expected (since I did no research beforehand). In particular, I realized that I could not wish away the burning feeling of my lower lip, that I would have to get used to it and that it could take weeks or months to go away. I hate the numbness in my chin!

My mouth started to wake up and everything hurt, my teeth, the insides of my cheeks which are pretty chewed up, and my gums where the appliance in my lower mouth is pushing against the gums and under my tongue. I had panick attacks several nights in a row, probably rebound effect from the benzodiazepines they gave me to calm me down before the surgery leaving my system. For the panic attacks I drank calm tea with raw organic honey, very calming. For pain I have been taking tylenol since the 1 darvocet I took made me feel sick. Even in the hospital after the surgery I opted not to use the pain pump as I am very sensitive to those types of medications.

How I Got Here (or The Orthodontist Who Did This To Me)

2006-11-05T07:01:00.000-08:00

(My fiancee Jeff and me x-mas 04.)

I was minding my own business a few years ago when my dentist told me that he would not be able to move forward on costmetic crowns on my top front teeth because I had an overbite and would need braces! At the age of 46 this came as a complete surprise to me. So off I went to see the orthodontist. This guy was just going to slap some braces on me even though my case was "difficult". He did not even have my x-rays on the day of the consult. So a friend sent me to her orthodontist, Dr. A (the man who "did this to me"), who spent quite some time measuring and then sent me off for more x-rays and pictures. Needless to say, I also found a new dentist.

I was stunned on the day I sat in Dr. A's office and he told me that I would need more than braces, that I would need orthognathic surgery, something I had never even heard of. I wanted to cry, I was really upset. But after it began to sink in and I began to look more closely at myself in the mirror, I could see what Dr. A saw -- that my chin was small and that my bite was off. Not by much but enough to have been the source of many of my dental problems over the years such as having lost many lower molars at an early age. But why had nobody ever told me!

I got my braces put on and then spent about a year trying to get my insurance company to approve the procedure. In the end, I was granted an exception and the surgery date was put on the calendar. Yikes! Now that I had fought so hard to have the surgery, I was petrified. Did I really want to go through with it? Well, my dentist told me that I really had no choice, that if I didn't want to lose more teeth and bone it was really my only option.

Now that the surgery is over, I have implants to look forward to. And that will require more surgery for bone grafts and then the implants!

Thank You!

2006-11-04T11:25:00.000-08:00

I would like to express my graditude to those who have shared your orthognathic experience. When I came home from the hospital 2 nights after my surgery (lower jaw advancement on 10/25/06), I was very thankful for the stories, blogs, pictures, etc. I found on this blog and other places. They helped take my mind off of my ordeal.

My surgeon told me my recovery would be 10 days and the only person who I spoke to regarding her experience before my surgery was a woman who went back to work after 6. She basically painted a rosy picture of the ordeal. While I appreciated that she put me at ease and I know she was well-intentioned, I was ill prepared for how awful I would feel and look. And how awful I would feel about the way I look. So when I found pictures of others and saw how swollen they were and how much better they looked only a few days later, I was greatly relieved!

The top picture is me 3 days after the surgery and this one is how I look today. I still have swelling on my chin and jaw; my chin is still completely numb and my lip feels like its on fire all the time. My fiancee has beent taking really good care of me, making sure I am eating and drinking enough so that I haven't even lost a pound although I am only eating soups and protein drinks. My surgeon says that I'm coming along quite nicely. Yesterday I had a manual lymphatic message (something I read somewhere as being recommended). I'm beginning to feel like a human being again.