Tuesday, February 27, 2007

Sleeping After Surgery

One of my big concerns for the period after surgery is sleeping. Specifically the need to sleep in an inclined position due to swelling and sleeping on my back (I'm a "side-sleeper"). I thought of sleeping in the recliner or propping the head of the mattress up but neither one really appealed to me.

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.

You can’t see it in this picture but, trust me, the head-board end inclines like a lounge chair and is, surprisingly, rather comfortable. Plus, I bought the "Medium Brown" version ... looks much better!

Sunday, February 25, 2007

Zip-N-Squeeze Bags

I think I'm almost ready for the surgery.

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've never been one who enjoys having his picture taken ... I'll see if I can scrounge up some photos and get them uploaded to the Blog.

Latest Surgery Info

I started my braces and surgery journey back in 2004 and I'm scheduled for surgery on Tuesday, 13 March. Until a couple of days ago, I was supposed to have both upper and lower surgery with the possibility of a genioplasty (chin surgery). My lower jaw is rotated to the left approximately 5 mm and my teeth meet "end-on-end" with a cross-bite on the left. My upper jaw also has a slight (approximately 2 mm) cant on the right side. The original plan was a Lefort I 3-piece to widen my upper jaw and correct the cant and a Bilateral Sagittal Split Osteotomy (BSSO) to de-rotate the lower jaw and move it back into a normal bite pattern.

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.

The Beginning

Hey there. I’m 44 years old and have been a U.S. Marine for the past 26 and a half years. I had known for a long time that I needed orthodontic work to correct very crowded lower teeth as well as upper teeth that had a mind of their own. I also have a lower mid-line that is off-center to the left by about 4-5 millimeters and my upper and lower teeth meet “edge-on” instead of meeting in a normal bite.

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.