Check Up with the Surgeon

I had a check up with the surgeon yesterday.

This appointment was supposed to be the final post-op pictures, but I went to this appointment with some questions/concerns. 

1) The right side of my mouth still hits heavy.  The bite is so much better than before the surgeries, but I do not want say the journey is done until it is even. After all I've been through with this, I don't want to settle for anything other than what it should be.  I mentioned this to Dr. M, and he said he would like me to see Dr. S in the next month for him to even it out. This is called occlusal equilibration. AKA: bite adjustment. This would be him shaving down my teeth a little to even out the bite. 

2) I have had a pain under the right side of my tongue for about a month or so. At first I thought it was a sore on the side of my tongue, but I realized there was nothing sore to the touch.  The pain came...comes when I open my mouth to a certain degree when eating or yawning. Once it reaches that certain part, I feel a shooting pain under the right side of my tongue that goes from the back to the front.  Dr. M made sure there were no numb spots on my tongue and felt around that side of my mouth. 

He said this pain is probably being cause from one of the screws in my jaw.  There is a screw in my lower jaw bone right where the major nerve passes, so when I open my jaw to a certain point, the nerve is hitting the screw causing the shooting pain. He said this will diminish in time as that nerve will toughen. 

3) I noticed I am still grinding my teeth at night.  He said that may just be who I am now. I hope not, but nothing to do about that!

4) He said there is still a tiny bit of puffiness right near my nose. 99% of people wouldn't notice, but he says it will continue to disappear. 

5) The tingling on the right side of my lip and jaw is still improving. 

I'll update after the equilibration! 

Bye Bye Braces!

The title says it all!

For the first time in years, I have zero metal in my mouth. It is niiiice!

Orthodontist
I got my braces off on April 28th.  It is not the most comfortable appointment, but it isn't the worst either. There is some pressure when they get the brackets off and a lot of pressure when getting the bands off.  I do not like that part at all! Once all of the metal is removed, they have to get the remaining glue off with a high-speed hand piece. Basically, they "drill" it off.

With all the glue gone, my teeth got a quick polish, and I got some new molds made of my upper and lower teeth.  These were done in order to make my retainers.  Thankfully, both retainers are removable.  I used to have a permanent metal retainer across the back of my lower teeth.  It was a pain to keep clean all the time, so I requested not to have it.  The biggest concern is that teeth could shift if I didn't wear them, but I wear them religiously, so there is no problem there!

When we were done with that, I head home with a goody bag of teeth care products, treats I wasn't allowed to have with braces, and balloons!

 

                     

I picked up the retainers the next day.  I was expecting an old school retainer, but the kind I got are called Tru-Tain. They are made of clear plastic and fit onto my teeth like a perfect puzzle piece. I love them because you can't even tell I have retainers in!

When I first put them in, I  did feel a little stressed because my bite hit heavily on the right side. Dr. S assured me that my bite should settle.  He explained that my braces have been holding everything tightly in place, and now that the braces are off everything will relax into place.

He was right. No surprise there... He's the expert.  My bite has settled a lot! It feels pretty even across most teeth when I bite now.  There are still some spots that feel imperfect, but I'm not too worried about it. I will a) see if they will relax into a better position, b) get used to it, or c) get the teeth shaved a tiny bit.

I have noticed my midlines have moved a teeny bit again. They were perfectly lined up when I got braces off, but as my bite relaxed into a better position, the midlines shifted slightly.  I'm sure no one would ever notice it, but since I am now aware of it, I do.  I wish it were perfect, just because that was one of the points of having the double jaw surgery, but it is an improvement!  I'm curious to see if my surgeon will ever say anything about it.

Not having the braces has made my puckering exercises a lot easier! I am noticing the tension in the muscles around my mouth getting better.

Surgeon
I had a follow up with my surgeon yesterday.  His first reaction at seeing my braces-free teeth was, "Braces are gone!? That happened so fast!" to which I responded, "You said that was okay!!" Haha, I MADE SURE my doctors were on the same page before anything happened.

Visits with them are very quick now.  I'd say we are in the building less than twenty minutes.  He said my bite looks great, and my smile looks dynamite.  There is also some swelling left around my nose and upper lip giving me a Who-ville look, but he says that should be gone in the next month or two. I'm glad that he is feeling good about the results because I know he wouldn't settle.

My mom wanted to make sure to voice any questions or concerns, but I honestly didn't have too many right now.
- I was not completely happy with my smile a month or so ago. I thought my smile showed a lot more of my gums than it used to, but that is better. Something about my braces being gone remedied that. That being said, there are still times where I don't recognize my smile.
- I know my numbness and tingling is improving.  That is definitely a slow process, but it is getting better! It is crazy to think that there are still parts of my lip and chin area that doesn't have complete feeling back.
- Diet: I asked when I would be okay to eat harder foods.  I'm eating pretty much everything, but I asked about carrots, apples, and corn on the cob type foods. He said I'm allowed to try those foods at the end of June.

I go back to see him in three months for a recall and final post-op pictures.

It's been a little while since I have posted pictures, so here is 4.5 months after surgery.

 

LOOK AT THAT BITE!
(You can barely see the retainers in.)

Quick update!

Things are going well!

Orthodontist

Dr. S says my braces can come off this month as long as Dr. M is okay with it! That's the exciting news. In other news, they clipped a wire that was poking me and put a new power chain on my upper braces. I mentioned how my bite feels off at times.  Sometimes it still hits more on the right ride or heavy on a tooth in the front.  Dr. S shaved down a little of my front tooth in hopes of making my bite a little more comfortable. It was an immediate difference, but then it felt like it hit more on another front tooth. Dr. S said that he wanted to wait before shaving any other teeth down.  The bite should settle and get more comfortable. It's been a few days, and the bite is already feeling more normal.

Surgeon
My follow up with the surgeon lasted about 5 minutes. Dr. M came in and said things are looking good. He says my smile is "going to be dynamite" after all of this. Fingers crossed he is right! Gooood news: I got the green light for getting my braces off!  Wooohoo! I was not expecting it to be this soon after surgery! I was thinking it would've been June at the earliest. 

Both doctors said they could tweak my bite after the braces are gone. I'm not quite sure how, but what do I know? 

Next:

April 28th - braces off

May 1st - teeth cleaning (getting rid of the stains from the mouth rinse!)

May 13th - follow up with the surgeon

"Oh. You're not joking?"

In the last week or so, it really seemed that my bite had settled a lot. Everything just seemed a lot more relaxed, and I was feeling pretty confident with how things felt.

Orthodontist
In my last post, I mentioned getting some small spaces between my upper teeth.  Dr. S got my message and did want to see me.  I went in the next day, and they put a power chain on my upper braces to close up those gaps. Easy fix.

A power chain is just really small rubber bands all connected.
(not my teeth)

I saw Dr. S yesterday. They took out the old power chain before Dr. S took a look. He had me "open and bite" quite a few times before asking, "How'd you like to get these off the next time you're in here?"

I laughed, then stopped when I saw his serious expression. "Oh.  You're not joking?"

He wasn't joking! He said everything looks good to him.  We just needed to check with Dr. M to see what his thoughts were. Chances are it will not happen next time, but I'm totally okay with that. I thought I'd be in braces at least another four months!

After getting a new power chain on, I mentioned just a few tiny concerns (again) to him. 

1) My midlines- still not center. I know that truly isn't a big deal. It's just aesthetics, but I had to have double jaw surgery. I wanted it to be right. No one would ever be able to tell, especially since it is improved from what it was before, and I didn't even notice then!  He changed how I wear my rubberbands in hopes of correcting that.  He said he wasn't sure if he'd be able to get them exactly lined up, but that's fine. I had actually already accepted that conclusion. The bite is the important factor here. 

2) The bite - Like I mentioned before, my bite has settled a lot.  The bite was hitting pretty evenly, but I think maybe just a teeny tiny bit more on the right. He did some tweaking with the wire on the braces that I think will push that molar up a little bit more. 

I'm glad I mentioned it, but now things feel different again. Not bad, I'm sure, and not forever, but it makes me nervous! Now it feels like I hit more on the left side. Eek! I don't like this back and forth.

*sigh* But like I've said, I trust both my doctors, and I know it will all be okay in the end. 

Surgeon

Today was the surgeon's appointment.  When I first got there, one of the nurses asked if there were any problems, pain, or numbness. I am still having some uncomfortable tingling on the right side of my chin and numbness on the roof of my mouth.  I have no problem with the amount of time it will take as long as it improves. Luckily, both are slowwwly improving.

There was a lot of "bite and relax" commands at this appointment. Again, he is really happy with how things are looking.  He commented again about some of the cheek swelling left behind.  After his examining, he stepped back and asked if Dr. S has given me any sort of timeline. He agreed that things are progressing towards getting braces off!  He wants to see me one more time (in five weeks) before setting that appointment though.

I still need to work on reanimating my face by continuing the pucker and smile, but a lot of that movement will be easier when the rubberbands, braces, and brackets are gone. 

Diet: I can eat pretty much whatever I want now.  Nothing super hard, crunchy or taking a lot of bite force.  No carrot sticks, bread sticks, chips/crackers, etc...  He said the texture of cucumbers is about the hardest he'd like me to chew.  I am still working on getting some range of motion back in my jaw too.  I doubt I'd be able to bite a sandwich or burger yet. 

Mom took me to Sweet Tomatoes (a soup, salad, and pasta bar) right after the appointment. It was so nice to eat salad, but it was so strange to chew! It felt really uncomfortable, but that will just take some practice.

Exercise: I can do whatever I want! Chicka chicka yeahhhh! 

A Little Less Metal

Updates from a couple of appointments... Five weeks post op!

Orthodontist
I went to the orthodontist last week. I was a little nervous about how it would be getting work done since I still haven't really been able to open my mouth. It wasn't bad, but it wasn't necessarily fun either. What is exciting is that my metal mouth is a little less metal! All of the surgical wires and hooks were taken out along with the regular wire. This gave me a chance to brush and floss my teeth. It was so nice to really clean them, but my poor gums are really tender.

I mentioned to Dr. S that I was a little concerned about the midlines of my upper and lower jaws not being lined up. He said we'll have to tweak that through the next couple of months of orthodontic work.  He put me in rubber bands on both sides, and said to set an appointment for just a month away.

When I was leaving he mentioned that I might notice some spaces appearing between teeth.  Well, I have. There are really small spaces between some of my front/side teeth. What I can't remember is if he said not to worry about that or give the office a call. Whoops! I called them to clarify that. He was out of the office, but I left a message with an assistant and will hear back from them if I need to come in before my next appointment. One concern I did have was that I noticed my bite had changed from when I entered the office to when I left.   I don't know why! Maybe just from having to hold my mouth open more than I have in six weeks, but I was hitting heavy on the right side again! There's no quick fix to that though, so I hoped the rubberbands would help.

Surgeon
I met with Dr. M on Monday.  Thankfully, he is still happy with how I am healing. He saw that stitches were still hanging on, so he put on a topical anesthetic and finally took out the last stitches. They are dissolvable, but in some cases, like mine, they take forever to disappear.  Swelling is mostly gone, but Dr. M told us that the residual puffiness across my cheeks will be gone in about six months. It will be unnoticeable to most, but he, my mom, and I will be able to tell it is still there. I mentioned to him that the bite was only hitting on the right again, and he said to stop wearing the rubberband on the right side.

Orders from Dr. M are to continue to pucker and smile a lot. (He got a good laugh when my mom said to just imagine kissing someone...) He said that I'm still really stiff around my mouth because they had to cut through all those muscles during surgery.  It is really stiff, but I don't really like doing it for that exact reason.  It isn't comfortable and takes a lot of effort.  I guess the puckering is like a bench press for my lips; gotta build that muscle back!

My diet menu is growing little by little.  I think I technically could have been allowed to eat pasta the last week or so, but never chanced it. Oh, well. So, now I can now eat some pasta and some meats. Finely shredded chicken and small bits of ground beef or turkey are okay, but I still have to be very gentle with chewing. Even though I've mostly been craving vegetables, we went to Waffle House for an easy dinner in celebration of chewing.  I had a little omelette and part of a waffle.  Chewing is such a strange feeling to me right now.  I was making myself use my teeth for the waffle, but it makes me so nervous now. I haven't used my teeth in so long that now it just seems alien to me.

Dr. M mentioned that he thinks I could be out of braces in about six months! Honestly, I would not care how long it took as long as it was correct when this was all done.

Concerns at this point
- My bite not hitting correctly.  I'm getting real tired of it hitting on that low hanging molar on the right.
- The jaws not being lined up perfectly.  I know that's pretty much just aesthetics though.

I got upset with both of these being an issue earlier this week.  It's just frustrating when both of these present issues are the reason that I had double jaw surgery.  Dr. M mentioned that my bite will probably change and hit in all different places all through this recovery.  I try not to stress because it isn't productive, and I have a lot of faith in these doctors. They won't be happy with the outcome unless it's perfect. We all want the same thing.

Things I've noticed
- The facial swelling that is lingering.  It's a lot better, but I still know my face is a little squishy.
- My upper lip is definitely a little fuller. It has just a little bit more pout/pucker than it used to.  I don't mind it, but it's odd getting used to a new feature.
- My mouth stays closed.  I had no idea how much this affected me, but I will be laying in bed, watching tv, or relaxing and realize that my lips are still together.  It's really nice to realize I'm not sitting here looking like a grouper with my mouth falling open.
- Slowwwwwly but surely getting a little (seriously, just a little) feeling back in my palette.

I doubt there is significant change from my last pictures, but here are some 5-week-post-op pics.

        

        

A month? Already?!

I cannot believe it has been almost a month!

I'm feeling pretty good. I haven't taken a pain killer in a few weeks, but I will need to take some Advil in the mornings or at night if swelling is hurting.

The last two weeks have been hard at times. This recovery is definitely emotional as well as physical. Luckily, there has been nothing like coming off the steroids like last time, but there were a few days where I just felt kind of down, like nothing felt normal or routine.  That's bound to happen after two weeks of recovering when all you do is watch tv and movies and work through sudoku and word search books. Don't get me wrong, that's a great day, but it definitely gets old after weeks.  I finally got to a point where I knew I needed make some conscious changes in order to get out of a funk. Going to the mountains with family and some family friends last weekend  helped... except for the fact that eating delicious food is a high priority in the mountains, and I was stuck on liquids!  I also put the living room back together by deconstructing the recovery camp I had set up, moved back to my room, and actually started back to work a little bit. I work in an office right now, so it is a lot of answering phones and interacting with people, so I've only been doing a few hours a day.  It goes well, but it wore me out the first couple of days.

There isn't much pain, but I have had been a little sensitive to coughing and yawning the last few days. I'm not quite sure what it is, but on the upper gums on my right side something hurts, almost like a sting or burning, when I open my mouth.  It stops after the initial "sting", so my guess might be that I'm getting feeling back in that area and a surgical hook might be catching on some tissue.  That's just my guess though. The swelling is still there, and it will be for a while longer and reduce at a slower pace. Oooh! Once thing I've noticed and really like is that my relaxed mouth stays closed now.

 

   

        

Today was my third post-op appointment with Dr. M.  Again, he was very happy with how things are looking! That's incredibly reassuring! My bite has settled a little more, so teeth are touching on both sides. Woo! It is still hitting a little heavy on the right side, and I actually forgot to mention that today, but I know it will get resolved by one doctor or the other. I mentioned to Dr. M about the pain on the right side of my mouth, and he said that it could be some scar tissue that is being stretched when I yawn. He took a look, and didn't say if he saw anything, but he did say that the stitches up there may be restricting that skin that is trying to move, so he clipped and removed a lot of the stitches in my mouth.  Continuing the warm, salt water rinses throughout the day will continue to help them dissolve.

One thing that has been worried me over the last couple of weeks is the fact I noticed my lower jaw was no longer aligned with my upper jaw (like in the image from a few weeks ago).  That exact thing was a major reason I had the double jaw surgery and not just the upper, so, of course, I worried! Not to mention, it was perfectly aligned the day after surgery. I may have noticed it on an off day because I definitely stressed about it for an afternoon before mom finally called Dr. M's office.  She was right to call because I would have worried about it for two weeks. One of the amazing nurses/surgical assistants called us back to answer some questions. She explained that the jaw is still settling, and it will continue to shift for a little bit. The swelling and scarring are affecting it right now, and it is normal for the bite to change at this point. When I was apologetic for being needy, she was more than comforting pointing out that I haven't gone through this before and how was I to know what is and isn't normal in the recovery process.

I expressed my concern with Dr. M this afternoon, and he didn't seemed too worried. He said that Dr. S will be about to shift it back into place.  He also gave me the go ahead to set an appointment with Dr. S to get all of my surgical hooks and wires off.  I am seeing them next week to get part of this grill out!

Old orders from Dr. M: Pucker and smile, pucker and smile, pucker and smile. This will break up some of the "stunned" nerves and get more motion back in my face. I try to do this, but I just don't do it like I should.

New orders from Dr. M: Keeping moist heat (hot water bottle, steamed towels,, hot baths... NOT heating pads) should help with the swelling at this point. He said no more ice packs, which I haven't used in a few weeks.

Leaving the office, Dr. M said that I am "still on a restricted diet with super soft foods". The sword still eally makes me feel like nothing has changed on that front.  I feel like I'd be able to handle some more substantial food, but what do I know! So for two more weeks, I will continue to drink a lot of my meals. I can do mashed potatoes, eggs, and I started grits recently.  Part of me thinks I could move to noodles, but I think that might qualify as a soft food, not a super soft food.  Plus, I think I'll wait for that green light from the surgeon.  I'm alright with it right now. I've gotten pretty used to this diet, and I've lost nearly 15 pounds since surgery.  All that being said, I ventured out with my dinner tonight. We had some friends over for soup and salad, and there were Red Lobster biscuits.  I broke off tiny little pieces and ate them.  No chewing, but I feel sure that was a little overzealous.... Whoops! I'm paying for it now. I think it was a little too rich for my stomach after the diet from the past two weeks.

Since I am on the super soft food diet for two more weeks, if you have any suggestions or recipes, please feel free to share them in the comments! :)

Also!! This blog has been read on SIX continents! Thank you all so, so much for taking the time to follow my silly little experiences. It means so much to me.

Week 2 and Post Op #2

Tomorrow marks two weeks since surgery, but not much has changed.

While most of my days are still very lazy, I've gotten out a bit more this week.

After picking up the correct prescription last week, mom and I stopped by our church and a friend's work to say hello.  It was a lot of attempted smiling and more talking than I had been, which was probably good for exercising those muscles, but it wore me out for that afternoon.

I also ventured out of the house on Saturday. My dad, brother, and I went to see Interstellar. (Incredible movie!) I felt almost guilty being at the movies when I am still not at work, but movies don't exactly require much effort.

The swelling has gone down a little bit more each day.  Pain and jaw spasms (Random occurrences since surgery) is rare now. My smile is improving as the swelling goes down, but there is still a lot of stiffness in the front of my face.

I had my second post-op appointment today. Dr. M is still very pleased with how things are looking. He keeps talking about how nice my profile will be. The rubber band that Dr. M told me to keep on the left side of my braces helped a lot this week.  He told me to go ahead and stop wearing it when I told him it almost feels like my bite was hitting a little heavier on the left side as of the last day or so.
I got in a little bit of trouble when mom  mentioned to Dr. M that  I'd lightly been blowing my nose. Even though I thought it was fine by now, he made it clear with the "Do NOT blow your nose."
This appointment also made me realize how numb I still am. Dr. M mentioned that the two back brackets popped off during surgery, leaving the wire exposed.  He and a nurse showed me that these wires had been digging at my gums and cheeks in the back.  There were two ulcers that had some bleeding, and I had no idea until I saw it in the mirror! Dr. M said to keep some wax on there to prevent to irritation.  I see him again in two weeks and will be on a mostly liquid diet (maybe some thinned mashed potatoes or eggs) until then.

When I got home, I tried to put a ball of wax on the end of the wire until I got frustrated.  I don't have my full range of motion back, so I can't open my mouth too wide.  I even tried using some tweezers to place the wax in the right spot, but I just couldn't reach back there. Part of me just wanted to ignore it since I can't feel it, but that would just mean more discomfort later.

I have an appointment with Dr. S on Thursday for him to take a look at things, but mom called the office while watching my many attempts with the wax to see if they had anything this afternoon or tomorrow. After hearing what the issue was, they said to come on over since it is such a quick fix.
All Dr. S had to do was clip off the excess wire. He asked if it felt better and laughed when I just said, "I don't know!" He was real happy with my bite, and said that he doesn't need to see me again until Dr. M gives me the go ahead.

Keep your fingers crossed everything stays where it is supposed to be the next two weeks!