Monday, December 10, 2007
So, this past Friday I had an 8:30 am appointment with the Orthodontist to remove the braces. His office is in the National Naval Medical Center (Hospital) in Bethesda, Maryland which is, on a good travel day, about an hour's drive from where I live. At that time of the morning, however, you tend to hit the beltway traffic and a one hour drive could easily turn into a two and a half hour slow-jam. Not knowing how the traffic was going to be (it was drizzling rain / snow), I left the house at 6:00 am -- wouldn't you know it that traffic was light, there weren't any accidents, and I made the trip in under an hour. The problem was that the Orthodonist ended up running late because he had an appointment with a cardiologist that pushed back all of the Orthodonist appointments about an hour. So, I get there an hour and a half early and don't get seen until an hour after my scheduled appointment.
But I'm getting my braces off so it's all good!
Once in the chair everything went pretty smoothly. He started with the upper braces by clipping the bands around the molars and then prying off the brackets. With only one or two exceptions, they all popped off fairly quickly - I was surprised because I'd had them on for three years. After he finished with the upper braces he removed the lower ones and, if anything, they came off even easier.
Let me ask you guys who have had braces removed recently -- wasn't that a weird feeling the first time your lips touched your teeth after the braces were removed?!?
The next step was the grinding off of the bonding material and, while there wasn't any pain involved, I felt like there *should be* ... the sound of that high-speed grinding instrument made my skin crawl more than any other dental procedure I've been through.
But I had my braces off so it's all good!
Now, I don't know what I was thinking but I knew that I was getting temporary retainers once the braces were removed. I guess I thought they would use previous molds to create the retainers and they would be ready for me almost immediately. Little did I know that I'd be sitting through two more rounds of goop-filled metal trays! I'm not going to say I actually gagged while making the upper trays ... I will say I'm glad I didn't have breakfast that morning!
But I had my braces off so it's all good!
By this time it's about 11:00 am and the Orthodontist tells me that the temporary retainers will be ready by 2:00 pm (maybe sooner). The way the morning started I knew it won't be sooner and I definitely wasn't going to be driving home and coming back. Luckily the Medical Center has a pretty good cafeteria so I went down and had my first brace-free lunch - a basic fish & vegetable meal. Not too taxing on the newly brace-free teeth which, I have to say, were just a wee-bit sore after all the debonding and grinding from earlier in the day.
At 2:00 pm I stopped back by the Orthodontist's office and caught him as he was heading out for yet another appointment with the cardiologist. He went over the daily wearing and cleaning rituals with me and gave me some teeth whitening gel which could be used with the temporary trays - I guess this is pretty standard.
About five minutes later the dental assistant was finished sanding down the temporary retainers and I put them on for the first time. The top retainer fit perfectly and went on very smoothly. The bottom retainer, however, fits a lot snugger (if that's a word) but feels great once it's on. Getting them both off to eat is still a bit of a challenge because I don't have long finger nails and it's sometimes difficult to "break the seal" to remove them. Once I've gotten one side started, though, they come off pretty quickly.
And I have my braces off so it's all good!
Updated photos are coming ... I promise!
Monday, November 12, 2007
So last week marked my seventh month since surgery and, I must say, I was getting a bit frustrated at not hearing those magical words from my Ortho ... "I think it's time we take those braces off you." Well, during my appointment last week he said it and it looks like I'll be getting them off at my next appointment!
As ready as I am, I'm a bit apprehensive as well. I kind of like the security of the bands while I'm sleeping and I know that my teeth won't be moving out of place as long as the arch wires are in place. And I have no idea how the teeth will look (whiteness-wise) once the braces come off. I almost wish it was like when Mrs Shanton (Stephanie) had her braces off - she didn't know until she showed up for her Ortho visit!
Kristen & Mary - if you guys read this: Do you recommend I schedule a cleaning on the same day immediately after the brace removal. I understand the Ortho will clean the teeth to remove the bonding cement and all but I'm not sure that's going to be enough after three years of braces.
Monday, October 8, 2007
Here's my six month photo:
The Orthodontist is "fine-tuning" things at this stage and he has me wearing three elastic bands - one medium elastic band in a triangle pattern on the left and two heavy elastic bands in triangle patterns (two triangles) on the right. If you remember, two weeks before the first surgery the surgeons decided I didn't need to have the upper jaw surgery ... even though I had (have) a two millimeter cant. I keep thinking the Orthodontist wouldn't be having to do so much "fine-tuning" if I'd had both the upper and lower jaw surgeries.
My next appointment is Wednesday, 10 October so we'll see if I'm ready to schedule a debracing date. I tell myself that I'd rather get it as close to perfect as possible regardless of how long it takes but December will be my three year bracing anniversary and I'm anxious to get this over with.
On a separate note - does anyone have any experience with Porcelain Veneers? I've got significant tetracycaline staining on my teeth due to taking antibiotics as a kid and want to whiten them up (nothing Hollywood - just a natural color).
Wednesday, August 29, 2007
Last time I mentioned that the Orthodontist had placed me in a *kind of* weird elastic pattern. Well, after a week the left side had moved significantly faster than the right, so I went back for an unscheduled appointment and he placed me in the more traditional *triangle* pattern. This is where the elastics are connected to the upper incisors as well as the two teeth on the lower jaw immediately below them. This is supposed to align the jaws on the *vertical* plane rather than moving them side-to-side on the *horizontal* plane. If you remember, the surgeons decided two weeks before my first surgery that I didn't need to have the upper jaw surgery even though I have an ~2mm cant ... this *triantle* elastic configuration is designed to better address that issue.
All I can say is -- Wow! these elastics work and they work FAST! I noticed a change within two days ... it's amazing how quickly these changes can happen.
Hopefully I'm still on track for debracing during October 2007. My next Orthodontist appointment is on September 11th so I'll post more photos then.
Wednesday, July 18, 2007
Fast forward to yesterday to my Orthodontist appointment. I told the Orthodontist about my concerns and he said not to worry ... that he was going to be able to correct the bite using heavier elastic bands (heavy - 1/4 in. 6.4mm) and a different configuration. What he did was place the bands on both the left and right bottom incisors and the left and right upper back molar. I don't pretend to understand the intricacies of Orthodontia but the intent is to move the upper jaw forward a bit and the lower jaw back a bit. Well, for the past two days my jaws have felt like they're being squeezed in a vice ... not terribly painful but a constant ache. And, I've already noticed that the edge-on-edge bite is no longer happening! I'm supposed to wear this configuration for the next month and then I'll hopefully transition to night-wear only.
The really big news, though, is the Orthodontist is predicting an October 2007 de-bracing time-frame! It's not an exact date but I'll sure take it :)
Thursday, July 12, 2007
So, I've been wearing elastic bands (which I can remove for eating and brushing) since the surgery in order to line up the lower mid-line with the upper mid-line. What I've noticed is that the left side of my lower jaw has moved into position but the right side has stubbornly refused to move. This has caused a slight edge-on-edge bite pattern on the left side and is very frustrating because it seems as if we're moving backwards on the treatment scale.
My next Ortho appointment is this coming Tuesday so hopefully he'll be able to work some magic and get the right side lower jaw moving.
Wednesday, June 27, 2007
Hope everyone is well.
So, three months post surgery and things are progressing nicely. I had appointments with both the surgeons and orthodontist last week and, by all accounts, I'm where I need to be at this point in time.
The surgeons said my range of motion and my ability to open wide are good (I don't have exact measurements) and that the incision points have all healed as expected. They also reminded me they don't want me running or lifting heavy weights (basically anything that might cause me to clench my jaws) for six months post surgery ... I thought I'd definitely be back in the gym by now. They then said, "See you in four months" and I was out the door.
The orthodontist removed the archwires so I could brush and floss without them and put a couple of bends in the upper archwire to bring a couple of premolars down a bit. I tried to get him to commit to a debanding date ... no luck there. It's still way too early to start talking about that. My next appointment with him is in another three weeks.
Still a little bit of numbness on the left side of the lower lip and chin area and some residual swelling on both sides of the back mouth area. I know the updates have been slow lately, but that's the way the healing's progressing at this point.
Monday, June 11, 2007
A huge waste of time in my opinion.
I did manage to schedule my next post surgery appointment in conjunction with my Orthodontist appointment ... I'll still have the traffic to deal with but at least I won't have to do it twice.
I'll post more next week after my two appointments.
Friday, June 1, 2007
Mary – you know, it is the small things, the getting back to “normal” things, that make me realize how far along in this whole process I’ve come. It seems like only a little while ago that the braces were first put on when, in reality, it’s been two and a half years already.
Kristen – yup, I still have a bit of numbness but it’s pretty much relegated to the left side of my lower lip and chin area. It’s weird too … I’ll be sitting there and then my lip and chin will feel like they’re jumping and jerking due to the nerves coming back. I keep looking in the mirror to make sure I’m not making any weird faces :) . The diet is getting better – lately I’ve been branching out a bit to various restaurants (Famous Dave’s Bar-B-Que and a couple of Italian ones in the area). And it’s funny – I have absolutely no desire to hit the fast food drive-thru. Hopefully I can stick with that!
Aixa – Hey! I’m not sure on the time-line for the elastic bands … it could be that the Orthodontist will have me stop wearing them after my next appointment or I could wear them until I have the braces removed. The good thing is that I can take the elastic bands off when eating and then put them back on after brushing/flossing.
Mrs Shanton - :) It’s funny (now) but I could only find one or two pictures of me smiling pre-surgery. It’s not something I consciously thought about – I just developed a habit of not smiling when cameras were pointed in my direction. It feels good knowing there’s now a natural symmetry to the lower third of my face.
One last thing … If you haven’t done so already, please check out Brandy’s Blog . She underwent both upper and lower jaw surgery just over a week ago and is making a fantastic recovery.
Tuesday, May 29, 2007
Well, here it is ... two months already. Time is definitely flying by.
I managed to sneak in to the Orthodontist's office last week after my appointment with my Optometrist (one of the benefits of military medicine is all of the doctors offices are co-located within the hospital). My eyes were dilated and I didn't feel like driving by braille 40 miles back to work in the middle of the day (and it was a sunny day to boot) so I checked with the Orthodontist's secretary to see if there had been any cancellations / no-shows. Luckily for me there was and I got in to see him right away.
During the visit he removed the archwires (and surgical hooks) and I was able to floss and brush without interference (Yay!) for the first time in months ... it was awesome. He then replaced the archwires and had me start using rubber bands again - he wants try and align the midlines a bit more. My next appointment with the surgeons is on 5 June and my Orthodontist follow-up appointment is three weeks after that.
Things are progressing nicely ... in fact, the changes are so minimal now that there's really not alot to post about. I'll do the best I can with the updates so I hope ya'll check back again.
Wednesday, May 23, 2007
Needless to say I'm a bit frustrated. This is week 7 post-surgery and was supposed to be my first post-surgery ortho appointment. I've rescheduled for Thursday next week so I'll hopefully have more updates then.
Thursday, May 17, 2007
I've noticed that my lower midline has moved about 2 mm off center (back to the left side) over the past six weeks and that my bite is a wee bit off as well. I know that additional movement is often needed after the surgery to finalize tooth placement so I'm hoping that's what is needed now.
I'll ask the Ortho directly when I see him next week but would like to hear personal experiences from fellow jaw surgery people too.
Will update again after next week's Ortho visit.
Wednesday, May 9, 2007
I had another post surgery appointment today and it went very well. My jaw continues to heal nicely so the surgeons said I could go bands-free during the day and only wear them at night. The surgeons also have me wearing a lighter type of band ... 1/8 " light instead of 1/4 " medium. I'm glad for the change because it's another milestone on the road to recovery but I'm a bit hesitant to wear the lighter bands at night (due to stability reasons). I'll give it a couple of nights and switch back to the medium bands if I think I need to.
I was also given the go ahead to resume a chewing diet ... woot! The surgeons don't want me trying to chew anything too tough / hard right off the bat so no steak or pizza just yet. Besides, my jaws still don't open very wide and I'm kind of unsure how my new bite will work. It's going to take a lot of practice to get back in championship eating shape :)
One last thing for now ... my first post surgery appointment with my Orthodontist is in two weeks. I'm hoping he'll remove my archwires (along with the surgical hooks that are attached) and replace them with new ones (minus the surgical hooks). About the only thing I'm not looking forward to is the dreaded post-adjustment tenderness. Of course, I've already stocked up on a giant-sized bottle of Advil and, just like the voting in chicago, I plan on using it early and often.
Sunday, May 6, 2007
Wednesday, May 2, 2007
I took the above photos yesterday ... there's still swelling in both cheeks (can't see it here) and the lower lip & chin area (I can definitely see it in the smiling photo). I think the next set of photos will be at the two month post surgery mark.
Recovery is going really well. This is my second full week back at work, I'm getting a bit more adventurous in my diet (thank you Taco Bell!), and my weight loss seems to have leveled off. Speaking of weight loss, we had a command directed weigh-in this past Monday and I couldn't wait :) . The last time we did this I weighed 180 pounds ... this time I was 164 pounds. No kidding, the last time I weighed 164 pounds was at least 10 years ago -- and I feel good. And before anyone says anything, my Body Mass Index (BMI) is 23.5 (normal is 18.5 - 24.9 for my height). I'm sure some of the weight loss was muscle mass so I know I'll put a few (hopefully)pounds back on once I'm given the go ahead to start running and hitting the gym again.
Sleeping has gotten a bit easier now too. Being that I'm only at four weeks post surgery I'm still hesitant to sleep fully on my side ... I kind of sleep so my jaws aren't pressed completely (if any) into the pillow. Oh yeah, I had a weird (sort of) experience Monday and Tuesday morning -- I woke up CHEWING ... and this is still a big no no. It's been seven weeks since the first surgery and this week is the first time this has happened. I'm not hungry as I'm putting something in my stomach every three hours or so ... maybe my body is trying to tell me something. Like I said, weird.
And that's it. The visible signs of recovery are slowing down and I know I'll need to work on being patient as I work my way through the healing process. My next post surgery appointment is a week from today and my first post surgery Orthodontist appointment is two weeks after that.
Thursday, April 26, 2007
Seriously, it rained a bit last night and I was hoping that it would have washed all the pollen off the trees and cars. Did it? Nope ... I now have a nice pollen "paste" thing going.
Wednesday, April 25, 2007
I'm getting more adventurous concerning my eating habits. I don't mean I'm trying to chew ... that's still a big NO GO. I'm just trying more variety. For example, I went to a restaurant yesterday for the first time since the surgery and had fish, macaroni and cheese, corn, potatoes, and (my favorite) cheesecake. Today, on the way home from the appointment, I stopped by Taco Bell and bought three Burrito Supremes … I ate the filling and tossed the wrap. Awesome!
Oh yeah … almost forgot. One of the women at work mentioned to me that I look 10 years younger. I don't see it ... maybe it's a combination of the surgery, the 15 pounds I've lost, and the little sun burn I managed to get over the weekend. Whatever, I'm very pleased with the outcome so far and can't wait for all of the swelling to go down and the braces to come off so I can see the "final" result.
And now for a couple more updated photos:
12 March 2007 (one day before Surgery #1)
Saturday, April 21, 2007
Overall I'm glad to get back to work as it's a return to the "normal" and a milestone in the healing process. Now I just need to concentrate on letting the jaws heal enough so I can start working on the "widening process" and, before you know it, I'll be back to a normal diet.
Speaking of normal diets ... I finally managed to eat something other than soups, Boost, and smoothies last night. I cooked up some Lipton Creamy Chicken Pasta Sides and boy was it good! Of course, I had to use a baby spoon and sort of suck the pasta into my mouth but it was SOOOO worth it.
Wednesday, April 18, 2007
My sleep cycle is getting back on track as well. I've stopped sleeping in an inclined position because the swelling has decreased significantly - there's still a good bit of internal swelling (both cheeks and especially the lower lip/chin area) but, unless you know me, you probably can't tell. And I've experimented with sleeping on my side instead of my back ... so far so good but I wouldn't do it if I wasn't wearing the elastics.
Tomorrow is "back to work Thursday" for me and, as it turns out, I'm ready. I was thinking about this yesterday ... I've only worked three days in the past five weeks because of the two surgeries. I know the Marine filling in for me is ready for me to come back too!
Finally ... an updated photo from today (Two weeks post surgery):
Friday, April 13, 2007
My next appointment is this coming Monday ... will update more afterwards. In the meantime, here's a photo I took just a few minutes ago:
I still have residual swelling on the inside of both cheeks as well as the chin and lower lip area. From what I've been told, it could take several months for all of the swelling to go away.
Thursday, April 12, 2007
The tight elastics have been removed and replaced with "1/4 inch Medium" guiding elastics. This means that I'm able to remove the elastics on my own when it's time to eat and brush. This is a HUGE benefit.
Another good thing is that my bite has been stable over the past 24 hours ... it hasn't tried to revert to it's old position. I really think this second surgery did what it was supposed to do.
I'll take some new photos a bit later.
Tuesday, April 10, 2007
In the side view photos you'll notice a small brownish/black area ... that's where they went in from the outside put in the screws. They do this because it's a lot easier to ensure proper placement that way.
And I sure do look tired in these photos :)
One Week Post-Surgery #2 (10 April 2007)
I have an appointment with my surgeons tomorrow afternoon. I'll update again when I have more information.
Saturday, April 7, 2007
Then the alarm clock goes off because it's time to take my medicine. My head is still the size of a bowling ball. It's the middle of the night and I haven't had a decent night's sleep in I don't know how long. And to top it off, it's snowing outside (one day before Easter Sunday).
Thursday, April 5, 2007
Wednesday, April 4, 2007
I'm back home and feeling pretty good. The surgeon said that they went in and removed the titanium plates and screws, rotated the lower jaw a couple of more millimeters to the right and slid it forward just a smidgen, and then put new plates and screws in to hold it in place. They also had to shape a couple of the teeth so that the bite would be better. The only thing is that my jaws are tightly banded shut with elastic bands again ... for the first week anyways. The reason I'm tightly banded with elastic bands is because I evidently have very stubborn jaw muscles and they didn't want to take any chances.
I feel good ... and I actually could have been released from the hospital yesterday evening. I elected to stay the night because I didn't feel comfortable leaving that early and I had to have x-rays taken early this morning. I was drinking water almost immediately upon waking up and walking around shortly thereafter. Also, like the first time, I didn't have any adverse reaction to the anethesia.
And I didn't miss American Idol ... woot!
Monday, April 2, 2007
Thursday, March 29, 2007
I'm so glad tomorrow is Friday so I'll have the weekend to recover and prepare for next week's surgery.
Wednesday, March 28, 2007
Speaking of jaw surgery and diets, Delag (a contributor over at the Archwired web-site) found a really good web-site dedicated to those people who have their jaws wired / banded for whatever reason. The web-site is called *8 Weeks Wired* and offers advice on such topics as pre & post surgery care, nutrition, recipes, supplies, et cetera. I haven't had a chance to go through the whole web-site yet ... will do that prior to next week's surgery.
Monday, March 26, 2007
So, I now have another surgery date for Tuesday, 3 April 2007 and get to go through this whole process again. Yay me!!!
The Surgeons will be using the same incisions as before and will remove the current hardware, reposition the lower jaw, and then attach new hardware. The main differences this time is that the bones haven't had time yet to reattach fully so it'll be easier to dislocate the lower jaw and the chin augmentation surgery has already been done so I don't have to worry about that.
Now it's time for me to go grab a couple of Coronas and see if I can't figure out how to make myself a cheesecake milk shake.
Friday, March 23, 2007
This past Wednesday I had my first post-surgery appointment with the Surgeons. During the appointment they removed the elastics and, I kid you not, I literally felt my lower jaw drop open. It was kind of like the slack-jawed response you sometimes see people give when they've witnessed something they just can't believe. I'd say it was no more than 1/4 inch or so, no pain, no problems whatsoever. It just surprised me a tad and made me want to hold my lower jaw closed with a free hand for a bit until I was sure the blasted thing worked properly.
As I said previously, the Surgeon said they were going not going to replace the elastics because they wanted to see if the bite held the correct position without them ... she said that was their normal method although almost all of the other post-surgery accounts I've come across this is not done. They took more digital x-rays, set me up with an appointment for the following Wednesday (I've got a standing appointment every Wednesday for six weeks post-surgery) and I was on my way.
Well, it took less than one day for the lower jaw to move back into the same position it was in the first morning after surgery. Now, both the upper and lower mid-lines are in alignment with each other, the lower jaw appears to be in the correct position relative to the upper jaw ... the only thing is that the only teeth currently touching are one or two molars (hard to say how many due to the residual swelling) on the right side. I called the Surgeon Thursday morning (22 March 2007) and they set me up for an appointment first thing this morning (Friday, 23 March 2007).
So I leave the house at 5:30 this morning, two hours early due to the notoriously bad Northern Virginia / Washington DC traffic, and wouldn't you know it, there wasn't any traffic! I actually arrived at the hospital right around 6:15 am. I'd rather be early than late but my appointment wasn't until 7:30 am. I was in time, however, to speak with one of yesterday's surgery patients who was getting his morning after check-up / x-rays ... well, I did the speaking and he, because he had both upper and lower jaw surgery, just kinda looked at me. I told him to hang in there, that it was all down hill from here, that the swelling and discomfort were all temporary, and that it would all be behind him before he knew it.
I finally get in to see the Surgeon and, after a bit of consultation with the Chief Surgeon, they decided to take more x-rays and leave the elastic bands off for the weekend. I do, however, have another appointment Monday morning (26 March 2007) and this time I expect it'll be a meeting between me, the Surgeons and the Orthodontist (he's co-located in the same area in the hospital) in order to determine exactly what is going on and the best course(s) of action to take.
So here's what I think may be the issue:
1) My jaw muscles need to be "retrained" and I'll go back into elastics on Monday; or,
2) My lower jaw is in the proper position and the orthodontist (once he's been given the go-ahead to continue treatment) will do his magic to realign the possibly wayward molar(s); or,
Wednesday, March 21, 2007
Well, today the Surgeons decided to remove the bands to see how the jaws align without the added structure. The lead Surgeon's usual course of action for lower jaw surgery is to forego the elastics as long as the jaws remain in the desired position. I have another post surgery appointment next Wednesday (28 March) and they will decide then whether or not I need to go back into elastics. Here's hoping I don't but I think I just might have to ... we'll see. And I'm still on the blended/liquids only diet.
Below are comparison photos of a couple of days before the surgery and today. Both photos are showing my "natural" bite at the time of the photo.
Tuesday, March 20, 2007
I was at the beach when all of a sudden the sand started hardening like cement around my head. I was struggling to breathe and could only barely breathe through my mouth ... my nose was completely closed.
I woke up thrashing around and realized that I was attempting to breathe through my mouth which continues to be very tightly banded closed.
My next post-surgery appointment is tomorrow. Here's hoping they replace the current bands with ones that aren't quite as tight.
Monday, March 19, 2007
Sunday, March 18, 2007
My Sister Alice (far right with white shirt and green beads) is staying with me until tomorrow when she'll be flying back to Biloxi, MS. She had made plans to celebrate St Patrick's day with a couple of friends of hers in the area. As you can see, I didn't know that she was going to invite them over for a few minutes so they could consolidate cars. Had I known I might (just might) have put on my green pajamas. Especially because Sharon (2nd from right with green shirt and green beads) gave me a little mutated chicken / bunny critter to help me feel better.
On Sunday I decided to venture out of the house and go to the local Borders Book Store. As you can hopefully see from the below photo, the bruising down my neck has gotten a very nice shade of yellow.
Walking around Borders was quite uneventful. Even the little kids didn't stop and stare too much when they saw me ... I'll have to try harder when I go to the grocery store next week. Just like a couple of days ago, however, I started feeling the swelling pick up almost as soon as I walked out the door. I didn't feel poorly ... just tired out awful quickly. Luckily I'll be off work until Thursday, 29 March so I can work on getting my stamina back up.
Saturday, March 17, 2007
Of the two, I'd have to say the one that had me the most worried was breathing. I had always had an open bite that resulted in my breathing through my mouth when I slept. And I've never had the best of times when breathing through my nose due to various reasons.
After the surgery I was heavily banded which prevented me from opening my mouth at all and, of course, the swelling was having an effect on how well I could breath. This led me Wednesday night to experience a slight panic attack when it felt like I wasn't getting enough air throughout the night. Nothing too much ... I didn't go running around looking for the scissors or anything to cut the bands. But I did spend a rather large percentage of my time just concentrating on getting full deep breaths through my nose for most of the night. And it wasn't an issue where the nasal passages were clogged ... they weren't. I had used Afrin earlier that day and had followed that up with Ocean's Nasal Spray closer to bed time. It just felt like I was laboring way too hard for each breath.
The other breathing issue that just occurred over the last day/night is that I'm creating a whole lot of saliva that requires me to constantly swallow throughout the night. At times this has caused me to startle awake thinking I was drowning. Not a pleasant sensation.
Other than that, though, things have been progressing along nicely. The swelling is starting to subside, I'm putting down more liquids each day (water, Boost, banana shakes) thanks to the Zip-N-Squeeze bags, and my energy levels are starting to slowly increase.
I may have pushed it too far yesterday though. I was getting a little bit stir crazy in the apartment and asked my Sister to drive me to my office so I could show off my swelling to my co-workers (they're Marines ... they like this kind of stuff). It's about a 30 minute drive each way with minimal walking (some stairs) inside the building. I'll tell you I could feel the swelling increase just from walking out and climbing into the car ... much less walking up the stairs at work. After we returned home I was done for the day.
Today (Saturda, 4 days post surgery) the swelling seems to be subsiding a bit. It does, however, increase throughout the day. And I'm turning a nice shade of yellow down my neck, past my collar bones, and onto my chest. I'll see if I can't get a good photo of that for later.
Friday, March 16, 2007
Monday, March 12, 2007
I confirmed the surgery time with the Hospital ... 7:30 am. That means I'll be checking in to the hospital at 5:30 am.
With that check-in time they just might not need to give me any anesthesia.
Saturday, March 10, 2007
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-Wear comfortable clothing suitable to the type of surgery you are having.
-DO NOT bring any valuables or wear any jewelry.
-Please do not wear make-up, contact lenses, or fingernail polish.
-Please remove ALL body piercing.
-Dentures and eyeglasses must be removed before going to the Operating Room.
Females - If you have been given a urine specimen container, obtain a urine sample at home on the morning of your procedure and bring it with you to the Ambulatory Procedures Unit (APU)/Short Stay Unit (SSU). It will be collected when you check in at the APU Nurse's Station.
Children are to wear their pajamas and may bring a favorite toy.
MEDICATIONS - do not take any aspirin-containing or Motrin-like medication (including over-the-counter) for two weeks prior to and two weeks after your surgery unless otherwise directed by your physician. These medications include but are not limited to: Aspirin, Excedrin, bufferin, Anacin, Cama, Alka Seltzer, Motrin (Ibuprofen), Indocin, Tolectin, ClinorU (Sulindac), Naprosyn, Toradol, Advil, Nuprin, Aspergum, Vioxx, Naproxen, Celebrex, Diclofenac, mobic (Meloxicam), Bextra.
Do not take the following herbal products - Gingko biloba, Garlic, Ginger. These can prevent blood clots from forming and have been associated with prolonged bleeding.
Do not take Vitamin E supplements.
TYLENOL IS OK. IF ONE OF THE ABOVE MEDICATIONS OR HERBAL SUPPLEMENTS IS TAKEN, YOUR SURGERY MAY BE DELAYED OR CANCELLED.
DO NOT EAT anything solid after midnight on: 12 March.
DO NOT DRINK anything after midnight on: 12 March.
If ordered by your surgeon, you may drink clear liquids up to the time you check in at the APU. Once you check in nothing else may be taken by mouth except prescribed medications with sips of water. Clear liquids include water and coffee without milk.
Only drink the liquids on this list. Orange juice is NOT permitted.
DO NOT DRINK ANY ALCOHOLIC BEVERAGES WITHIN THE 24 HOURS PRIOR TO YOUR SURGERY!
Other items for consideration on your day of surgery (as applicable):
- Complete surgical scrubs as directed with Betadine/Hibiclens/Ivory/regular soap (the night before and the morning of surgery).
- If you require inhalers please bring them with you.
- If you utilize a CPAP machine please bring it with you.
- Bring a copy of your Advanced Directive, Living Will, Five Wishes, or Power of Attorney.
Meals on the Short Stay Unit (SSU) (Overnight Patients)
One you return to the SSU after your procedure, you will be offered the option to receive meals from the Nutrition Management Department via the National Naval Medical Center billing system.
Cost per meal: Breakfast - $1.70 Lunch - $3.30 Dinner - $3.30
Apple juice, ginger ale, gelatin, popsicles, broth, ice cream, and crackers will be available for in-between meal snacks. Your family may also bring you meals, as there are several fast food alternatives available in the hospital.
Yesterday I went to the Orthodontist to have the surgical hooks installed on my archwires. I had this idea that I'd get a couple of them on each side of the upper and lower jaws ... maybe eight in total.
Boy was I wrong!
I've got 18 of those things (nine on top and nine on the bottom) ... basically, one in the middle of each of the brackets. The good thing is that, at lease so far, they aren't bothering me in the slightest. Not even when I eat - a very nice surprise. In fact, my mouth doesn't feel any different at all with these things installed.
I did manage to get my shirt caught on the upper surgical hooks (don't ask me how). Had to go get a mirror to get it loose.
Yeah, I'm talented like that.
Tuesday, March 6, 2007
I've done a ton of research so I have a pretty good idea on what to expect. I'm not stressing ... actually looking forward to it being over. The only thing still up in the air is whether I'll be having upper and lower jaw surgery along with genioplasty or just the lower jaw surgery and genioplasty. I'll find out for sure this Friday when I get the surgical hooks.
I'm *NOT* looking forward to that.
Tuesday, February 27, 2007
While walking around Ikea the other weekend I spotted a twin-sized “slatted” bed named "Malm" (pictured below) that actually inclines on the head-board end.
Sunday, February 25, 2007
Possibly the best piece of advice I've received in regards to preparing for jaw surgery was to buy Zip-N-Squeeze bags. As you can see from the above picture, these bags are resealable bags with a straw built into them. They were created by Susan Beaudette, a Registered Nurse, who had experienced many of the frustrations oral surgery patients had when it came to getting proper nutrients after oral surgery.
The reinforced straw is the key because oral surgery patients are likely to be on a liquid / blended only diet for a period of time immediately following surgery and they aren't allowed to suck liquids through a straw. The only viable options are to either use a large syringe (somewhat unwieldy in my opinion) or these wonderful Zip-N-Squeeze bags.
I've ordered enough zip-n-squeeze bags to last six weeks although I'm not sure if I'll actually need that many. I've also order a couple of their gel-pack "Cool Jaw" wraps as well as "The HEALING JAW" guidebook.
Saturday, February 24, 2007
I went to my pre-surgical appointment this past Tuesday (20 February) and everything was good-to-go. One of the surgeons took some x-rays of the upper jaw and I completed all of the pre-admission paperwork. At that time I was still a go for both the upper and lower jaw surgeries. I took the paperwork to the Hospital Admissions Unit and had an EKG and some bloodwork and that was it.
And this is where things get a little ... odd. The surgeon called me Wednesday evening and asked me to come in for additional measurements on Thursday (22 February). I get there and the Chief Resident Surgeon asks me why I'm having upper jaw surgery. I told him that the plan from the beginning had been to use the Lefort I 3-piece to widen my upper jaw and correct the cant. He then showed me the last set of molds I had taken (November 2006) and said that the upper archwires had done their job and that they could correct all of my bite problems ... except the cant ... with only the BSSO. He also said that I would definitely need the genioplasty due to the lower jaw being moved backwards.
Now, I have no burning desire to have upper jaw surgery ... or any surgery for that matter ... but I have two concerns with *not* having the upper jaw surgery. 1) Can they guarantee that this 2 mm cant (less than 1/8 inch) won't cause bite problems in the future; and 2) After two plus years in braces and going through surgery, is it too much to ask for a PERFECT outcome?!? I'm not vain enough to think that 2 mm will make much of a difference - it just feels a bit like I'm settling (and I don't like to settle).
The two surgeons I was speaking with both assured me that the 2 mm cant would not cause problems down the road and that, in their personal and professional opinions, they recommended against the upper jaw surgery. In the end I decided that, if the original reason to have the upper jaw surgery was no longer an issue (widening of the upper jaw), I could live with the 2 mm cant. After all, I really liked the outcome I saw using the molds and, who knows, maybe the 2 mm cant will add a bit of character to my face.
The surgeons did say they would take my case back to the review board this next week to determine whether or not I'd need the upper jaw surgery. So, I'm continuing to prepare for the worst while hoping for the best.
My braces journey started in 2004 while I was assigned to Marine Corps Recruit Depot San Diego. I went to the Depot Dental Clinic for an annual check-up and cleaning and happened to ask the Dental Officer what, if anything, could be done to correct my wayward teeth (brushing and flossing were a real pain due to the significant crowding). Braces weren’t even a thought as I was actually interested in the possibility of veneers. The Depot Dental Clinic had a Dental Officer trained in cosmetic dentistry and she gave me a once over … turns out veneers weren’t an option due to my cross-bite. The Dental Officer gave me a consult to the National Naval Medical Center Bethesda Oral & Maxillo-facial Surgical Department and my journey began.
A little about the Department of the Navy Orthodontic Program. There are approximately 14 Naval Officers trained as Orthodontists servicing approximately a million Navy and Marine Corps personnel. These Orthodontists are assigned to major Naval Hospitals throughout the world. In order to be accepted into the Naval Orthodontic program a patient must be evaluated by one of these 14 Orthodontists with many x-rays and facial measurements taken. The Orthodontist then presents the case to a review committee and a decision is made as to whether or not the patient’s dental situation is of sufficient severity for acceptance into the Naval Orthodontic program. The vast majority of cases reviewed are not accepted … they are instead recommended to pursue orthodontic treatment in the private sector.
Once accepted into the Navy Orthodontic program you begin your treatment. A patient is supposed to remain in the geographical area for a minimum of two years (estimated treatment time) to ensure continuity of the doctor/patient relationship. As I’ll get to in a minute, this doesn’t always occur.
I was referred for Orthodontic treatment in January 2004 and my case was prepared for review during that time. Unfortunately, the case review boards were postponed due to a lot of the doctors being deployed in support of the Iraq War (this was the early stages of the war). What is normally a two month process ended up taking almost 10 months and, in October 2004, I received word from the Orthodontist that I had been accepted into the program and they were ready to begin my treatment. I was fitted for spacers a few days before Thanksgiving 2004 (not the ideal time for that) and received my upper brackets and first archwire the first week of December 2004. I had my lower brackets and archwire applied about six weeks later (January 2005).
I mentioned previously that a patient is supposed to remain in the geographical area for two years. In my case I was selected for promotion which necessitated my reassignment. Fortunately I was able to request assignment to the Northern Virginia area and am stationed within 40 miles of the National Naval Medical Center Bethesda. The Dental technicians in San Diego secured the archwires (basically wrapping wire around the brackets and the archwires) and I left San Diego in June 2005. Once in the Northern Virginia area it took about three months to get back into the swing of things due to scheduling conflicts and such but that eventually resolved itself and things have progressed smoothly from there.
A comment or two about the Oral & Maxillo-Facial Surgery Department staff. There is one Orthodontist assigned to this Department so I’m able to see the same person for each of my adjustments. The same can’t be said of the surgical staff. They work as a team and, in the past six months I’ve seen three different surgeons. A good thing is that the Orthodontist and Surgeons are co-located in the hospital so communication amongst the team is very easy … I’d have grave concerns if this wasn’t the case. I have no doubts that all of the surgeons are highly qualified; I’d just feel more at ease if I had one “primary” surgeon that I could go to with questions.
That’s about it for now. I’ll post in a bit about my upcoming surgery that’ll be conducted on Tuesday, 13 March 2007.