Sunday, November 18, 2012

1 Year Post Op

6 months before and one year after jaw surgery

One year and two days ago, November 16, 2011, I had double jaw advancement surgery.  Today while cleaning out some photos, I came across the ones on the left of me in braces after the lower jaw widening, but before the advancement surgery.  The ones on the right were taken on the one year anniversary of my surgery, wearing my retainers.  Aside from the changes in hairstyle and glasses, I was struck by the difference in my face then and now, one year after the surgery.  In the first photos, my nose is much more prominent and I can clearly see the lower part of my face set back.  Today my face seems normal in its proportions.  It is still clearly me, just better, I think.

Looking back at how terrified I was the day of my surgery, I can still appreciate the apprehension, but I am so glad I made the journey.  My sleep apnea is gone, I can chew on both sides of my mouth, and I am in less danger of losing my teeth.  I still have some minor adjustments to make in the spacing in the upper teeth which will happen by the addition of a crown on one of the front four teeth and then adjustment of my retainer.  The final bite adjustment will come after that.  Then I can start reducing the time I have to wear the retainer.  Eventually it will go down to night only.  I am looking forward to that.

Right now I am waiting for the crown/veneer to be made for one of the upper teeth and because of that I am relegated to drinking tea, coffee, and red wine through a straw.  The whitening is done and but the first veneer they made was whiter than my other teeth so they had to start over.  I have to maintain the level of whiteness I have now so that they match when it is ready.

The feeling came back almost entirely in my jaws after the surgery.  I still have a little area on one side that has mild pins-and-needles feeling, but it is very slight and I can feel through it.  The only area that is still problematic for me is the weakness in my hip where they did the bone graft.  The timing of my jaw surgery was unfortunate in that it collided with my recovery from knee surgery  to remove torn cartilage.  The knee surgery and the bone graft were both on the left side.  It has taken six months of grueling physical therapy to get me 90% back to where I was before my knee and jaw surgeries because of muscle loss during recovery.  But I am hopeful that by the end of the year I will be finished with PT and can go back to more or less normal physical training in my sport.  For a 60 year old, that's not too bad.

My headaches are fewer now and I am really hoping that after the final bite adjustment, they will be fewer still.  For those of you still considering this surgery, my advice is still to just make sure you have a good orthodontist and a great surgeon.  I had both.

Tuesday, August 7, 2012

Nine Months Post Op...Braces Removed!

Braces off, five days before my 60th birthday
Nine months post jaw surgery and three years and two months after I began my journey to fix my bite — the braces came off.  To say yesterday was a happy day is an understatement.  That is not to say that all the work is done, because there is still some "restorative" work left, as my orthodontist said.  He was unable to fully close the spaces between my upper teeth.  I took my photo carefully, avoiding the spot where they are most visible.  My dentist will now enlarge some of my teeth to fill in the gaps.  He may also make some of the teeth longer, to counter the bad effects of all the grinding and clenching I did in the past.  Then the final bite adjustment will be made and some teeth may need to be shaved  a bit so that it is perfect.   Then the whitening.

But most of it is behind me now and even without the professional whitening, my teeth look pretty good.  It took less time than you would think to remove the braces.  About ten minutes.  But it took more like 40 minutes for them to polish off all the cement left on the teeth.  They use a burr on a tool that looks a lot like a dentist's drill and the noise is disquieting, to say the least.  My teeth and jaws were sore afterward and it did trigger a headache later in the day, but that could have been partly from the manhattan cocktail I drank in celebration!  It was worth it (the manhattan, I mean).  Actually, it was all worth it.  The last several nights have been peaceful with no clenching and the snoring and apnea disappeared months ago.  I like my profile a whole lot better and most of the numbness is gone ( still have a little on one side).

My only regret is that I didn't lose much weight in the process.  This is possibly due to my age and likely due to much feeling sorry for myself during the process.  Six months of wearing a bite splint that stuck out of my mouth and made me drool all the time, then braces, then lower jaw widening, then double jaw advancement and the bone graft for my upper jaw.  I am still recovering from the latter as it left my hip muscles weak.  So, ok, I gave in to some ice cream and pudding and later, when we downsized and moved wine helped a lot to ease the stress.  Time to get back into shape now.  I begin my sixth decade with fewer problems and less pain.  That's something.

Friday, June 29, 2012

Seven Months PostOp

I guess it is a statement in and of itself that I haven't blogged here in so long.  Life returned to normal after the first 90 days.

I am now past six months and my surgeon cleared me.  "You're done", he said.  No need to see me at the one year mark.  My sleep doctor also gave me the boot after my last sleep test showed no evidence of obstructive sleep apnea.  I am cured of that at least.  No more CPAP, no more snoring, no more waking up six times or more in the night.

In three days I see my dentist.  If he gives the ok, my braces come off on 23 July.  I have been holding my breath for the last three weeks.  I am anxious, yet afraid.  What if he says no?  I desperately want the braces off before my 60th birthday in August.  I have dinner reservations, my Mom is flying out, and yesterday I bought a Kate Spade dress for the occasion.  Braces will just ruin it.  Besides that, I am sick to death of picking food out of them.

My headaches got better last month, only to come roaring back after the last orthodontic adjustment.  Sigh.  This is why I am holding my breath about the dentist assessment.  If I am still clenching at night, how can I be done with braces?

On the eating front, I can bite into a hamburger or sandwich.  I can even eat some nuts if I am careful.  Still cannot bite into an apple though.  I managed to gain back the weight I lost (a whole 8 lbs) while moving and going on vacation.  If you are over 50, don't expect great weight loss from this surgery, unless you don't know how to make a high-protein smoothie.

On to Monday and the date with the dentist.  Will stay in touch.  If all goes well, will have after photos in a month.

Friday, February 10, 2012

90 Days Post Op

Day 92...smiling again
I have arrived at the three month post op stage.  Supposedly the jaw bones are healed.  Saw the surgeon and the orthodontist this week and while the orthodontist is still fiddling with my bite, the surgeon said I am done with him.  I still have to go back for a 6-month and then 1-year visit, just to be sure everything is ok, but basically, I am recovered.

This is not to say that the nerves are fully recovered, because they are not.  But they are significantly better than they were a month ago.  I have feeling back in my entire chin, although it still feels weird.  I still get electric-like shock waves when I run my finger over my chin.  The right side is "thawing out" faster than the left, but I have hope it will all come back now.  I can put lipstick on without cringing.  This is huge.

I am eating most everything that I ate prior to the surgery now.  Not eating nuts or hard crackers or popcorn, but I wasn't really eating those anyway since the braces went on.  I can eat orange slices without even thinking about it and I can even eat a Lara bar now.   The other day I bit into a banana the normal way, instead of cutting it into small pieces or mashing it.

Day smile...wearing computer glasses.
Still clenching at night, but until my teeth fit together better there isn't much chance of that changing.  My front teeth are still hitting funny in one spot.  The orthodontist closed up the spaces between the teeth on top but because the teeth are too small it meant that my front teeth were hitting funny on both sides.   So, now he is opening up the spaces again...a little.  He says I am on normal track for getting the braces off after surgery — 6-12 months.  So, since I am at 3 months, I suppose it is possible I could be out of these things by summer.  But I'm not holding my breath.

I am talking almost normally.  I can even talk in Russian again.  My conversation tutor was so shocked when she called me the other day and I could talk to her!  Still some Russian words that I have trouble pronouncing, but hopeful it will come back when the braces are off.

I am starting to exercise again.  My hip (from the bone graft) is totally healed, but now I notice the knee pain more from my cartilage removal surgery last year.  Still can't put on the armor and spar in my Naginata practice (have to wait until I am a year out from surgery), but I can do the non-sparring things until my knee hurts too much.

Most importantly, my smile is back.  It is a little different now, doesn't go up at the corners as much, but hey, it's a smile.  And I'm doing a whole lot more smiling lately.  If you are still in the liquid diet, drinking out a syringe or sippy-cup stage, take heart.  It does eventually end.

Saturday, January 14, 2012

Day 60 Post Op

Day 60 Breakfast
Day 60 post op and I have reached two major eating milestones in my recovery.  Last night I successfully managed to eat chicken teriyaki strips from the take-out place!  It was actually much easier than before my surgery to bite through the chicken.

Second is today's breakfast featured in the photo.  Greek yogurt parfait with banana, blueberries, honey and ...yes, Udi's granola.  Ok., I couldn't eat all the granola, but I was able to eat all but the most hard pieces of nut and raisin.  Normalcy is returning to my life.  Not that I won't still behave myself for the most part.  I still have braces on so still nothing sticky and chewy like caramels or popcorn or pizza crust.  Still, this is great and it has put a big smile on my face.

I talked to my Mom last night on the phone and she wanted to know if my migraines were now history.  She says everyone is asking her.  Ok, for all of you out there, including my friends who thought it nuts to do this "just to get rid of sleep apnea".  Once again, there are at least 5 reasons I chose to do this: 1) get rid of ONE of my migraine triggers; 2) cure my sleep apnea; 3) give me a fighting chance to keep all my teeth; 4) be able to chew on both sides of my mouth; and 5) be able to bite through pizza crust, an apple, and other hard things that most people with a good bite can do.

Yes, I still get migraines, although I think I am getting slightly fewer than before the surgery.  My teeth are still not in their final position.  The orthodontist is now able to start doing moving them since my jaws are mostly healed.  They put large spaces between my upper teeth in two places in preparation for the surgery.  Still not sure why they needed to do it, but they did and it left me with a lisp and a very large overbite after the surgery.  Now that the wires are moving my teeth again the overbite is gone (in two weeks) and the spaces are starting to close up thanks to the big elastics.  Now both sides of my molars hit at the same time, but my front teeth are still hitting funny because of the new positions.  So I am still clenching (although the botox helps keep it minimal) I won't know how much an improvement in my migraines I will have achieved until my teeth get into those "perfect" spots.  But I went into this accepting that a one third improvement in the frequency of my headaches was success.  I know it is complicated and probably why my mother doesn't understand, but i have a lot of migraine triggers.  The surgery may solve one of them.  Not eating gluten got rid of my migraine with aura.  I still have reactive hypoglycemia and low blood sugar can trigger a migraine as can a change in the weather or dehydration.  I cannot change everything.  I will always have some migraines.  I have accepted this.  I wish everyone else would too.

The sleep apnea and the prospect of my degenerating jaw causing  gum recession and possible loss of  teeth was more serious and scary to me.  My narrow airway also caused breathing problems during exercise and the loss of sleep from the apnea was really degrading my health.

You shouldn't discount the importance of being able to chew properly.  It is a huge quality of life issue.  According to my doctors, as we age, everyone's bones shrink and the jaws recess somewhat.  In my case, I had an underdeveloped lower jaw and the orthodontist in my youth made it worse by removing teeth to solve the crowding problem.  By the time I saw my current orthodontist (and the sleep doctor and the surgeon) my jaw was so small that my tongue was too big for it and my airway was extremely narrow in one spot because of how far back my lower jaw was positioned.  The work around I developed to be able to chew a meal put a huge amount of stress on my jaws and on my joints.  This caused facial muscle fatigue and inflammation which then triggered the migraine response and the nausea, light and sound sensitivity.

In my opinion, I had no choice if I wanted to lessen the pain in my life and improve my health.  Orthodontics could only do so much.  If I had not had the surgery, I would have had to wear a bite splint that stuck out of my mouth and made me lisp for the rest of my life.  I would have had to sleep with a CPAP machine which gave me gas and made me gag for the rest of my life.  Bottom line:  it is my life.  I made my decision and I still think I did the right thing.

Tuesday, January 10, 2012

8 Weeks Post Op

Day 55
Tomorrow morning it will be 8 weeks since my surgery.  My doc says 8-12 weeks is the recovery time for bone healing.  So there you go.

Still not a great picture.  Used the camera in my laptop and cannot figure out how to get the flash off so have to mess with the image in Photoshop and its still not great.

Saw the orthodontist last week and he has started moving my upper teeth again to close up the awful spaces between my teeth that give me a lisp and make me look like a hick.  This involves rubber bands...really huge strong ones (made in Korea, though not sure why that sticks in my mind).  The mongo elastics come with a little tool to get them on and off and at first I thought I didn't need it because surgeon doc gave me such a nifty scissor-like tool already.  Well, the thing with the mongo elastics is that they are so thick that they are hard to get on and off and one in particular does not want to come off the back tooth unless I cut it off...unless I use the cute little plastic tool that comes with the elastics.  Go figure.

The other thing I figured out this week is how much easier it is to floss when I use the compact magnifying mirror that I carry with me when I am out and about.  I lay it down on the counter and then I can actually see what I am doing!  It also keeps the food particles off the big bathroom mirror so I don't have to clean it so much.  It is far easier to clean the compact mirror. Yes,  I am so lazy.  Flossing, by the way is MUCH easier now.  I can open my jaws more than one finger wide easily.  Two fingers still is a bit uncomfortable, but less so than a week ago.

Eating is easier.  Surgeon doc says I no longer need to wear his elastics during the day so I am finished with the taking on and off before and after meals.  Thank God.  Don't seem to have to take the mongo orthodontist ones off before eating, just after to brush and floss.  I seem to be able to eat things now that were "challenging" a week or two ago.  Like grapes and orange slices.  And toast.  I even had a revelation about how I could eat baby carrots.  I could steam them first and then let them cool. Why didn't I think about this before?  I can cook them to desired softness and then cool them and keep in the fridge and be able to have a semblance of a low-cal snack.  True, the fiber is probably not as good, but it's better than resorting to pudding. Yes?

Exercise.  I went back to Naginata practice last Saturday and discovered that now that my hip is better (bone graft stuff all healed) my knee that I had cartilage surgery on last March is really hurting when I put all my weight on it.  Seems like the whole left leg is weaker so I started doing the physical therapy exercises to strengthen it again.  Also have to take an anti-inflammatory prior to practice and maybe use the heat pack on the knee.  Otherwise, I would have been ok with the exercise.  I have been trying to do a little more in my daily routine.  Like take the stairs instead of the elevator, etc.  Still not full strength when I do 3 flights of stairs.  But in my regular routine I feel fine.

My stitches are nearly all gone.  Just one little one left on the upper jaw.  This makes cleaning the teeth easier. Grabbing the end of a stitch instead of the dental floss was a real wake-up call. Not good.  Not good at all.

The feeling is coming back in my chin and lower lip.  More noticeable now.  My lip is so good that I can drink from a cup without much fear of dribbling down the front of my shirt.  When I touch my chin I feel little shooting nerve pains in my teeth (like when the dentist hits a nerve) so I guess that means the nerves are regenerating.  Yay.  I can talk better now because of it.

So how come no one ever comments on this blog?  I know people are reading it.  Would be nice to know if it helps anyone.  I have the same issue with my gluten-free blog.  I wonder if it is the Google password stuff they make you do to post a comment.  Any suggestions? Maybe I'm just boring. Whatever.  On to week 9.