Post Op & Braces Off!!

Well I am happy to report that my SARPE journey has finally come to an end! It has officially been 30 months since the very start of my journey and I cannot wait to show you the results! But first I need to update you all on what happened with my last jaw surgery back in July 2014.

The morning of my surgery was pretty good, I wasn't as nervous as I thought I was going to be although I can't say I wasn't completely calm. Just a few minutes before surgery my surgeon came to talk to me and said that he forgot to call me the night before and offer to me to have my chin spliced and moved out 2mm as with his measurements he felt that it would just round out my face a little better. He gave me a whopping 5 minutes to make the decision but when we asked if there would be an additional cost he said "yes, another $1200" on top of the $3100 that I already had to pay. We decided that 2mm of movement was not worth the extra pain and money so I declined doing my chin. They wheeled me into the operating room and I was out like a light in no time. Surgery took 6 hours and then I was in recovery for another 2 hours where the first thing I remember waking up to is the person in the bed beside me barfing. Luckily the anesthesia doesn't have that effect on me but just the sound of someone else yacking made me want to yack. However that was not much of an option for me as my jaw was wired shut.

Waiting for surgery

After surgery when my husband got there

 I finally got to my overnight room around 8:30pm and I was there for about 45 minutes just to find out that none of the nurses had called my husband to let him know that my surgery was done and that I was ok. I could not talk to communicate with the nurse so I motioned for a pen to ask her where my husband was. They had a shift change at 7 pm and of course no one thought it would be a good idea to let my loved ones know I was ok. I was in a lot of pain at this point and I could not talk and all I wanted was for my husband to be by my side. So finally they called him and he was able to make it to the hospital by around 9:45pm. At this point I already knew I hated the nurse that was assigned to me. She kicked out my husband at 11;30 claiming that he was not allowed to stay with me through the night and that their policy said he can come back at 7 the next morning however we learned the next day this was not the case. At this point, I was in a ton of pain, tears rolled down my eyes and I could not communicate without writing anything down. She kept scolding me to stop writing and to start talking to communicate. I absolutely could not no matter how hard I tried. My jaw was wired shut for one and secondly the swelling was getting worse every minute. At this point she refused to give me any pain medication. I did not have any pain control from 7 pm right before the nurse shift change to 7am the next morning. I obviously did not sleep at all and I had to keep begging for more meds and more ice packs . At one point in the night the nurse disappeared for over an hour and a half as I was pushing the button every 5 minutes needing help. She finally came back in told me I'm fine and then left again. All I could was sit and wait for the morning to come when shift change happened and my husband could battle for me. 

Shift change finally came and the nurse that took over was very apologetic and gave me some pain relief. Shortly after 8 my husband came in and not long after that my surgeon came by to check on me. I was able to write down what had happened and he was furious. He went out to find the nurse but of course she had already gone home for the day so he raised his concern to the head nurse. I was given a number to call to submit a complaint as soon as I got home. At this point my surgeon informed me that he had moved my top jaw up 5mm so that my gummy smile would not be as prominent and he also cut the two bottom bones on either side of my lower jaw and extended them out to help with better alignment of my teeth. In total, I had 7 plates and 29 screws between both up and lower jaws. I was able to go home later that afternoon to start my recovery.

Morning after in hospital

Going home

Being home was a huge relief however the look on my sons faces were priceless. They were extremely worried about me and I was so swollen it kind of scared my 3 year old. The worst part about recovery was not just having to be on a liquid diet but the worst part was not being able to breath very well. I literally felt like I was breathing through a straw for a few weeks. I am not normally an anxious person but not being able to breathe made me extremely anxious.I was not able to sleep very well as I would wake up and try to gasp for air and it wasn't possible. For the most part my lips were completely swollen shut so in order for me to eat/drink I had to put the syringe tube through my lips and slide along the side of my cheek to the back of my mouth and then slowly squeeze the water into my mouth to swallow. It was extremely difficult to get used to swallowing without being able to move your jaw. Not only was the swelling attractive, I also had no feeling in  my lips so my saliva literally would just fall out of my mouth. I had to keep a towel with me at all times and basically just let it wick up my spit for at least two weeks. I lost 6 pounds in 6 days and in total I was down 18 pounds in the 6 weeks of recovery. I had very frequent nose bleeds for the first 3 weeks and then they eventually stopped. I was told to use gentle nose sprays and keep a humidifier beside me while I slept. That was really the only way I was able to breath properly without feeling like I was going to suffocate.

Swelling Day 3

Swelling Day 4

After one week I had my surgical checkup and it was one that I will never forget. So I had been wired shut for that first week and at the surgical checkup they were trying to remove them so that I could get some looser elastics put in and to allow my jaw to have a little more movement and so that I could try to "brush" my teeth. The assistant that was taking these out had no problems on the left side of my face however when she got the the right side she was struggling and in the event she ended up stabbing my gum/cheek and hitting a nerve which put my chin muscles into spasms and it hurt so bad my reflex was to jump forward all I could do was cry in agony. I was hyperventilating which I've never done before, the doctor ran in and kicked the assistant out and tried to calm me down. Another assistant came in and put some ice on my jaw and eventually the muscles/nerves stopped spazzing and I was able to calm down and get my x-rays. The surgeon was successfully able to get the right side loosened without any extra pain and I was finally able to brush my teeth. He assured me it was normal and that all the pain sensors in my face were very raw and that it would get better over time. The top of my pallet was completely numb and I had a splint up there that actually had wires sticking through  my gums to hold my jaw in place. This was to be removed at my 6 week checkup.

Bruising

Elastics also from fang to back molars on both sides

Front teeth elastics to keep alignment

So after the second torture session I was able to go home to keep up my recovery. The nice thing was that I was allowed to remove these elastics whenever I ate lunch which consisted of mostly Boost and vitamin water for quite a few weeks. By week two I ended up with an infection in the bottom left side incision which was not fun. Swelling at this point had just started to go back down but with the infection the left cheek got huge again so I had to go back to the surgeons office for a checkup. He prescribed me some antibiotics and off I went.

Left side swelling started to come back

I have to say by week 4, the liquid diet only was getting extremely old and I remember standing in front of my pantry just wanting to eat everything that I couldn't. I could not wait to get my hands on a cookie or granola bar and for that matter even fruits and veggies!!  The recovery was very mentally and physically taxing. Not to mention that just 5 weeks before this jaw surgery I also had a laproscopic surgery to help remove some of the tissues that had grown in my lower abdomin which was confirmed to be Endometriosis. However that's a whole other story for another day but at this point I was just ready to be back to normal again.

These coiled wires are the splint wires through my gums (5 total)

Finally the 6 week mark came and I went back to the surgeons office to get my splint removed. Because the splint was wired through my gums, he had to temporarily freeze my mouth with a mouth wash that I had to swish around for a minute. The removal of the splint didn't necessarily hurt per-say, although it did not feel great either. I could feel the sensation of the wires sliding out of my gums but no real pain. Afterwards the gums were pretty swollen but it didn't last very long. I had to immediately go over to my orthodontists office next door to have a palatal retainer put in to replace the splint which was supposed to keep my jaw from moving and allow to heal over the next 6 months. After the retainer was put in I was given a new set of elastics which were a lot of more forgiving then the set I had been given at the 1 weeks post op and I had to wear those for 3 months. After the 4 1/2 month post op I was able to stop wearing the elastics and had to wait an extra 2 more months to get the upper palatal retainer out. January 16th I was able to get the retainer out and then FINALLY Feb.17th, 2015 my braces came off!

No more braces!!!

 The same day the braces came off, they put wires on the inner side behind my top two teeth and bottom 6 teeth to make sure there is no movement back to where things were before. I had to get some molds done of my teeth to get some clear retainers which I had to come back later that day to pick up. I wore the top retainer 24/7 except to eat and the bottom one only at bedtime for the first 8 weeks. As of April 14, 2015 I only need to wear these retainers to bed and go back in 4 months to make sure there hasn't been any changes. I'm officially free!

Stay tuned for my next post to see the final before and after results!

July 2014 - Top and Bottom Surgery - Round Two

Well it's been about 7 months since my last update and there really hasn't been a whole lot going on for my teeth until now. I am officially one week away from my next jaw surgery and I have been outfitted with all the surgical hooks. I was originally under the impression that this surgery would be for my lower jaw but boy was I wrong!

I had my pre-op appointment yesterday with my surgeon and found out that I will be undergoing top and bottom jaw surgery in order to properly align my bite. As I pointed out in my last update, the front two teeth are 2mm out of alignment from the middle of my face. This has to be fixed at the same time as repositiong my bottom jaw. From what he explained to me is that he will have to go in and break the top jaw in 3 places around my incisors and put it into proper placement. In doing this they will have to go through my sinuses which will in turn help me be able to breath better through my nose. The bottom jaw will be broken in 2 to 4 places and squished upwards to close up my bite. In doing this it will elimiate a little bit of my natural double chin look and position my bite into a more stable place to help relieve the tension on my joints. I was warned that by having to do the top jaw again that I might end up having to get veneers to fill in some spacing that may occur between the two smaller teeth beside my front two big ones. The little teeth may be too small to fill the gap that he needs to create for the bite to work. I am so dissapointed as this may mean that I could have to dish out even more money afterwards. He did say that may not be the case but it is a possibility that he wanted me to be aware of. I was not expecting to have to go through so much again..

So now that we know how I am going to be tortured next week, here is the breakdown of what I need to do for recovery afterwards:

- I was given a prescription for liquid morphine to take care of the pain however they no longer make liquid naproxen which would have helped with the inflammation. In order to control the inflammation they recommened that I stock up on children's liquid advil or crush up extra strength advil but it is extremely disgusting. On top of that I HAVE to keep switching out my facial ice packs every 30 minutes for the first 72 hours. That means during the night and everything with no exceptions.
- I need to sleep sitting up at a 45 degree angle for 2 weeks
- I need to drink clear liquids only for the first 2 days with a minimum of 2 - 3L a day for 6 weeks. Apparently 2L of water is 40 full syringes
- I will be given a syringe with about a foot long hose to attach to the end which will be my life line for feeding myself for a long time. The hose will go to the back of my molars where I can shoot the water , juice etc towards my throat. I will be able to have watered down smoothies and protein shakes after the 72 hours as I can stand for the first 6 weeks. I will be aloud to use a straw after 10 days but not a day sooner they kept stressing.
- I will be "wired" shut by strong elastics for the first week and then at my post op one week later they will switch out the stronger elastics for a little weaker ones which will alow me to be able to swallow pills if need be. They recommended some kind of benadryl to help with the anxiety of being wired shut.
- I was given sponges on a stick that are to be used to "brush" my teeth with a solution that was prescribed to me. I remember I had to use these last time as well but at that time I didn't have all the brackets and wires in my mouth. All of the incisions will be inside my mouth with dissolvable stitches again.
- I am not aloud to raise my heartrate for the 6 weeks and limited to light walking and not lifting anything over 10 pounds
- I can expect nose bleeds for the first two weeks
- Swelling and bruising will be bad and I will be numb especially around my lips so I won't be able to drink from a cup for quite a long time. After 3 months I can expect to get some feeling back but after a year whatever hasn't come back won't. I am still numb under my top lip especially along the gum line and now that they will be re-entering that area, I am worried that I will lose even more feeling this time. It is hard enough to smile so I hope I don't lose even more ability to do that.

I am scheduled to be at the hospital at 9:30 am with my surgery time booked for noon. The surgery itself is roughly 4 hours and then into recovery for 1 or 2 before I get to go to my room. I will have to stay over night to monitor bleeding and keep the ice packs going. I am told the actual breaking of the jaw isn't painful aftewards, it is the swelling and the incisions that are the painful part.

I guess the elastics have a habit of breaking during that first week but the surgeon informed me that if they do break my jaw won't fall off. Everything is screwed into place securly and the elastics are there to help hold it in proper placement. The surgeon also mentioned that he can tell I am a mouth breather due to my red puffy upper gums. I remember after my last surgery for a while I could breath amazingly clear through my nose but after a while it all closed up again. He mentioned that it will get even better this time and should be more permaent. The best part is that my lips will be able to properly go together without being forced and then the gums won't be exposed to the air so much and will have a chance to go back to their pink not so puffy color.

The surgery itself is covered under our provincial health plan however the office fees for the molds, measurements, scans etc was $3100 which I had to pay before I left the office yesterday. He gave me all my prescriptions ahead of time so I will need to get those filled and then I will be almost ready for next week. I have attached some pictures of where I am at now and we will see how different I look after this next adventure:

All the surgical hooks are on in between every bracket top and bottom and you can see how off centered my top jaw is

You can see that my two front teeth are off centered and goofy looking



Showing how off my bite is

January 2014 Update...

Well I officially missed updating everyone on my one year surgery anniversary back in December but I guess better late then never, right? Since my last update in August, a little bit of change has happened. My bottom front middle teeth now have a small gap between them which I never imagined could ever happen they from the way they started out. I will post some comparison pictures at the bottom for you to see.

I have finally been put back on the surgery wait list as of September 2013 but the sad part is that my surgeon is now up to a 12-14 month waiting list. My first surgery was only 3 - 6 months and I got in at the 3 month mark. I have phoned a couple of times since to see if the wait list has gone down but it hasn't budged. Until then, I am stuck in the waiting game and my braces will be on that much longer.

 I have been getting really worried lately about my top front teeth being shifted over to the left side of my face (right side in pictures). I know I had mentioned it to the orthodontist quite a few months ago and he assured me that the surgeon knew what he was doing and made the cut where it needed to be. However I have also noticed this last month that the front right tooth looks like it kind of dropped a little bit lower then my left tooth. I will definitely be mentioning this again at my next appointment this month.

The last 3 months I have had a wire tied around the two front teeth to keep them together. I still notice that the gums around the front four teeth are always redder and darker then the rest of my gums which is strange. I clean and floss and waterpik like crazy so I know it's not a hygiene issue. I like to think my body must still be trying to heal the bone?Who knows...

Anyways, that's about all for now. Here is the good stuff, the comparison pictures:

December 2012 - compared to....

December 2013 - You can see the redness in my gums still and the gap in the bottom teeth

Summer 2013 compared to....

December 2013

December 2012 compared to....

December 2013

December 2012 compared to....

December 2013

December 2012 - Before surgery compared to....

December 2013 - 1 year later  where you can see the top teeth are off to side a bit. Big change in my facial shape.

This will blow your mind!

WOW, the first thing I have to say is Thank-You to everyone for your kind words and support this year! It is amazing how even a complete strangers comment can chear a person up. So thanks thank thanks! Now lets get to the good stuff.

It is unbelievable that I haven't posted in 4 months and that time seemed to have flown by. The progress that my teeth have made is amazing and you will be able to see in the pictures below how much they have actually moved. I finally got my expander out on July 9th and I couldn't be happier. I have to say though that I thought it would have been a fairly quick and easy process to get that thing out but I was in the or-tho chair for a little over an hour. The assistant tried to pry it off and it was hurting so bad so eventually she called my orthodontist over and he had to cut the bands off my molars. I guess from all the pressure and expansion the wires did not want to come out. After it came out it was like that bright light "Ahhhhhhhhhh" singing kind of moment. I was instantly free and couldn't have been happier until about an hour after I left and my gums above the inside of my teeth started to swell up where the wires had been basically implanted . They swelled up pretty good for about a week and then finally started to go down after that. It has been about 6 weeks since the removal and I can still sort of feel the lines from where the wires were pushing my pallet outwards but they don't hurt to touch anymore, thank goodness.

I did find out that I will most definitely have to go through with a second surgery. This one will be the lower jaw surgery to realign my bite. Right now there is no way with braces and elastics for my bottom jaw to move into the proper position. I am not sure yet when the surgery will be but I do know it will be another 3200 bucks (not covered by any insurances) and most likely at Christmas time again. I have my next appointment this coming week so I am going to try and find out when I need to go back to the surgeon to find out more details about that. I believe they need to make sure all the teeth are nice and snug back together and straight as can be. So for now, I am just going to try and enjoy the freedom of no expander and save save save for the next surgery. If anyone has a magical money tree seed, please pass one on to me!

Food has constantly been an up and down battle of what I can eat and not eat. I find that for about a week after I get the braces changed, I can only do soft foods and then after that I can up it to burgers and hotdogs which have to be ripped into little pieces because there is now way I can bite into anything (even at this point). I do really miss steak especially being summer BBQ season but what do you do? Luckily my hubby is a pro at bbqing so he can make my burgers taste like steak any day.

I still do not have much feeling in my top gums above the front 6 teeth. I can feel a tiny bit when I touch them with my tongue or push on my front teeth but it's a very strange feeling almost like they are fake if that makes any sense. I have heard from multiple people that the nerves can heal over time and it has now been just over 8 months so I've still got some healing to do yet. Overall though, now that I can see some progress, this whole process has been worth it. My jaw joints still hurt the odd time if I smile excessively (which for those who know me, this happens alot) or if I have over done it with chewing and also after all my ortho/dentist appointments from having my mouth open for a long time. I have to say the pain in my joints is no where near as frequent as before all this came about, which is great! So for now I will keep on the up and up and hopefully pretty soon I'll be able to start saving for a nice REAL vacation rather then a "vacation " of pain.

Check out these pics !!

Before Smile (Dec 2012)

Smile now (Aug 2013) HUGE difference

Day before braces went on and 32 turns (Feb 2013)

Now on July 30 2013

Aug 2013 showing how bite doesn't line up

Gap is closing up... yay!

The last 6 weeks have flown by since I got the bottom braces on and I have had another adjustment yesterday. My orthodontist was very happy with the movement so far and I have to say it is nice to see the gap finally closing up. This time around he decided to zig zag tie my four front teeth together rather then just the two. They used the same clear rubber string as last month which was actually stained a nice bright yellow. I swear it is almost impossible to stay away from food and drinks that stain so bad!

 The pain is hard to describe because it's like a pressure/itchy/achy feeling all at once. It's kind of like how your teeth feel when a new tooth is growing in with lots of extra pressure. Ever since the adjustment, my jaw joints have been really sore and at times the pain killers have no effect. But compared to what I went through in December, I really don't feel right complaining too much about this minor temporary pain. 

I have found that heat has been the most helpful for the pain. Things like soup, tea, hot chocolate, coffee and warming up the magic bag have been the most helpful. Anything cold shocks the nerves and makes it worse so I stay far away from anything of that sort for at least the first few days after adjustment. 

I am also very happy to say that I can now start the count down to the expander removal!!! My ortho decided that July 9th will be the magic day so I have officially started the count down of 70 days from today!

I would also like to thank everyone for your comments and encouragement, this is exactly why I love having the blog! I get to hear from people who have been through this and also people who just want to say great job. Makes me smile!

Anyways, enough talk for now. Check out my updated pics:

April.29 - Four front teeth tied together. Apparently the teeth won't look like they are off to one side by the time I am done.

A little blurry but at least can see the shape of the teeth now

Profile pic from April 29

Owwwww :( Bottom braces on...

If there were a pill I could take that would knock me out for the next 18 months - 2 years I would take it in heartbeat! Bottom braces are on and OUCH! :( The appointment took about an hour in total and was actually quite painful. Not so much putting the bottom braces on but changing the wire on the top was excruciating. The orthodontist decided that it was time to start pulling the teeth together so he got his tech to tie my two front teeth together with some clear rubber string. I could literally feel them moving when she was pulling and tieing the string. They also ended up putting a heavier gauged wire on this month which apparently is 3x the size of the original one. The pain right now though on the top compared to the bottom doesn't come close. The reason it is so painful is because of the overcrowding between the front 3 bottom teeth. Two of the teeth have pushed the third one behind so they have put a spring between the two outside teeth. This will push them apart in order to make room for the one behind to fall in line. I was surprised however that I did not have to wear any spacers in the bottom molars and that they do not use the caps for the bottoms like they did for the top. They do my molars with silver brackets and the smaller front ones with clear brackets. Not by choice he just did it that way for his own reasoning I guess.

The spring in the front is kind of shaped outward like a half moon and once there is more room it will straighten out. But because of this half moon, it is digging into my bottom lip whenever I move it. This makes talking, eating, drinking almost literally anything painful! I put wax on it and that at least stops the pinching but the damage was already done the first hour after it was on.  I go back now in 6 weeks and we'll see how much progress I can make by then.  For now, I'd love to go into hibernation if I could. Not only because of the pain but because I am so done with this winter already!

Here are a couple pictures: Check out the pictures I took yesterday of the space between the front teeth and then this one! They literally were tied closer this afternoon. So crazy!

You can barely see the cross tied front teeth but they are almost touching now. The spring on the bottom and the metal brackets on the molars. Day 1 always sucks!

Day 1 of bottom braces

Week 5 of Top Braces - Bottoms on tomorrow

I have actually made it 5 weeks with top braces and overall that time went pretty darn fast. I am however not looking forward to adding more metal to my mouth tomorrow when the bottom ones go on but I know it's another step in going through this process. There has been a lot of movement for the top teeth the last two weeks. The wire is poking through the right side bracket at the back of my molar pretty far now. Sometimes wax doesn't like to stick so the wire goes into my cheek regardless. I was going to go in last week to get them to cut it off but just couldn't find time. My family and I have also been fighting a nasty cold this last week and when you have all this metal in your mouth, lets just say its not very fun when you need to cough anything out. I am however VERY thankful that I have managed not to get sick with any type of cold since my surgery back on December 12th. I have to say that's pretty darn good!

My daily routine for cleaning these things have been that I need to brush right after I eat anything and then at night before bed I brush, use the small cone headed brush to get between the brackets, then floss, then waterpik the rest that got missed and clean out the expander. Once that's done, Listerine rinse and off to bed. The whole process take at least 15 minutes and now I am going to have to add on another 5 - 10 minutes for the bottoms to get cleaned. Fantastic! As if it's not hard enough to get my kids to bed at a decent time! Anyways, I have to keep reminding myself I will get used to it and it's only for a short couple years.

I have taken some updated pictures and will make sure to update you on how the process goes for the application of the bottoms tomorrow. Not looking forward to it at all but here goes nothing...

5 weeks with top braces

Top view of my pallat 5 weeks after top braces - Amazing difference

Top view of my pallat before surgery and braces - You can see in the little flappy part in the middle of my gums how much was expanded in the picture before. Crazy!

View of bottom teeth the day before bottom braces go on