The "Plum Pit" Is Back

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.

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

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!

Thursday, Not Monday

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

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

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!

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?

Brandy found this on Kelsie's blog.

So Many Blogs, So Little Time

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!

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

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!

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.)

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?

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

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.

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

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

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!

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.