3 Weeks!

It has been a whole 22 days since surgery! I have to say this past week has gone by a lot faster than the previous two when I was wired shut. I've been out and about much more this week - I'm feeling more like my old self and only having to pop the occasional advil or tylenol here and there.

Last Friday (the 2nd) I had my appointment with my surgeon where he clipped my wires off. It went pretty well, however, I did almost faint. I'm not exactly sure why. I wasn't nervous or scared. I didn't have any pain either. My doctor explained that this can happen and in fact a patient he had seen earlier actually did faint. It's the feeling of the release I think - the wires were my jaw's security blanket and when they were removed, my jaw felt "loose". Luckily that feeling lasted only a few minutes and now I'm completely used to my two little rubber bands which I remove only at meal times.

On the 8th, I had my first post-op appointment with my orthodontist who just gently prodded and took a look at things. There's not much that can be done until my splint comes out (at the 6 week mark). Speaking of this splint, it is quite annoying. Food gets stuck in there every time I eat and it now looks just plain nasty. It's the one thing keeping me away from a completely clean mouth and clear speech. Well, at least I've only got 3 more weeks to go. Anyways, pictures and x-rays were taken and everyone in the office oohed and ahhed at my post-op appearance. My surgeon should be proud.

Even though I can only open wide enough to barely fit a (baby) spoon in, it still feels so much more liberating. No more bland foods! My first foods I devoured after my appointment were mashed potatoes and macaroni and cheese. It was so nice to finally feel satiated again. I'm quite grateful that I can now have foods like hummus, ice cream, applesauce, rice, pudding, polenta, and gnocchi. Today I actually had my first meal out in public: oatmeal pancakes with maple syrup. It was delicious and I didn't even care if I had some extra hanging off the (numb) right side of my lip. I've even been able to cut up fruit into small pieces and eat that with only a little difficulty, but I see myself making progress everyday. I'm still a bit swollen and obviously quite numb, but it has only been 3 weeks so I can't complain.

My next appointment with my surgeon is this coming Wednesday when we will be working on some jaw stretching. Fun! Here are a few pictures...


20 days post-op





22 days post-op

Wires off tomorrow!

I'm so excited for my de-wiring tomorrow. Hopefully I'll be able to get some "real" food down - at least some applesauce and mashed potatoes? I am so tired of ensure and chicken broth and of not being able to speak clearly. So far, my weight loss is at about 10lbs. I'm sure I'll be on my way to weight gain next week. I'll update tomorrow with the results of my appointment.
Here are a few pictures..I'm still pretty swollen and numb- on one side of my face more than the other, but at least my lips are back to normal.


8 days post-op




12 days post-op

One week post-op!

I can't believe it has already been a week since surgery. I have to say it did go by pretty quickly. Things are getting better and better everyday..just one week more and my wires will come off! I'll definitely be looking forward to that.

So I had x-rays taken yesterday - that went well and were really neat to see - before and after comparisons. My doctor's appointment also went really well; he said things look great and he got rid of the "jaw bra" I was wearing throughout the week. I was weighed and of yesterday had lost 8lbs in 6 days so hopefully I won't be losing much more. I have to increase my caloric intake, but it so hard to get much down when you're consuming only liquids and through a syringe on the side of your mouth. Also, below my eyes much of my face is pretty numb, I mean I can still feel when I touch everywhere, it just feels much less sensitive so I hope all of my feeling will return sometime soon. I'm still waking up pretty congested as well, but other than that I'm fortunate that everything has gone well and I'm recovering nicely.

Here are a couple pictures..please excuse the disheveled hair.




One week post-op

Picture update

Definitely not the most flattering pictures.


4 days post-op


Today, 6 days post-op

I've definitely had my fair share of swelling, but surprisingly (knock on wood) I haven't had any bruising at all. Yesterday I went for a walk around my neighborhood with my mom for the first time since surgery. It felt really nice to get out and get some fresh air. I might do it again today, but it does take a lot out of me.
I have x-rays today at 2 and then my first post-op appointment with my surgeon today at 4:15. I'm still wearing the jaw bra except when bathing and eating, which is getting easier, but still a task. I've lost 7lbs so far, hopefully I won't lose much more. I'll update with the results of my appointment. Till then!

First post-op update!

Hi guys! Sorry I didn't get to updating sooner. I've just been so tired and became a bit nauseated when reading/writing. So I had my surgery (upper, lower, genioplasty) on Friday morning starting at about 8:30 am. I finished at about 2:30 pm. It went really well, minimal bleeding, and my doctor even decided to give me a bone graft on my palette (freeze-dry, apparently) to facilitate the healing process. I spent two nights in the hospital and came home Sunday afternoon. I've had hardly any pain, thanks to the morphine while in the hospital. I have two thin splints wired onto my top and bottom teeth as well as my top and bottom teeth wired to each other..so I'm pretty firmly shut. I've been wearing a "jaw bra" around my head that my doctor wants me to wear for a week - it's kept the swelling down for the most part except my lips are HUGE. I wore ice packs around my face for about the first 48 hours, I don't know if they helped much, but it definitely felt heavy so I'm glad to be done with those.

Post-op recovery has not been as bad as I thought, at least so far. The first two days after surgery I had a good amount of blood that dribbled from my nose which was a bit bothersome, but then that dried up in my nose and made it hard for me to breathe even though I used a breathing mask in the hospital and a humidifier at home as well as a few different nasal sprays. Most of the gunk in nose is gone now, though so that's a relief. I also had a very sore throat from the breathing tube they inserted during surgery...still doesn't feel 100%. My other biggest complaint is the oral pain medications I was prescribed - it's disgusting, makes me want to throw up which would not be good at all. I'm to the point now where I can barely tolerate it, but it's definitely made me debate whether I should even take it, but I'm a little scared of the pain I might have. It is quite hard to speak and be understood, but I expected that. Eating was quite difficult at first, but it's getting a little easier. I've been using a syringe that I stick on the side of my mouth and push the "food" in there, but it really has to be liquid thin consistency.

I've lost about six pounds already, my doctor said if I lose more than 15, then it's feeding tube time - which he hasn't had to do ever before. I'm hoping I won't be the first. I'm already getting tired of chicken broth and ensure, but there's really not many choices while I'm wired shut. I see my doctor next on Thursday to check in and then again on Friday, July 2nd - when my wires are removed and I will have rubber bands instead. My biggest concern now is keeping my mouth clean - I use a prescribed mouth wash and a super soft toothbrush on the front of my teeth but it never seems enough. My doctor said he expects my braces to be "sparkling" when he sees me on Thursday, which will be quite the task I think. Any tips?

Overall, even though it's been hard at times, I have no regrets and am really happy that the worst (I hope?) is over. I've been up and walking around my house, can't imagine going out in public quite yet, but we'll see..maybe I'll take a stroll around my neighborhood tomorrow. The only problem is the pain medications makes me quite drowsy. I look forward to recovering and seeing the final results when the swelling diminishes. I'll keep updating as much as I can, probably after my next appointment.

P.S. Please pardon grammatical errors and punctutation.

I've included a few photos:


Before being wheeled into the operating room



Post-op


First post-op meal - vegetable broth

Twas the night before..

Quick update and final 'before' photos..

Orthodontist appointment went well. No heavy duty hardware, just two small hooks you can barely notice (you'll see in the picture). Received a call from one of the RNs. I have to be there by 6:30 am, so not as early as I had thought. Surgery will be around the same time. My last meal was cheese and bread (around 7:30 pm, just a bit past the 6 pm cut off, woops). I took a nice long shower since it'll probably be a few days before I'll be doing that. Now it's off to bed. See you guys on the other side!




P.S. Please pardon the old makeup.

Tomorrow!

Tomorrow at this time I will be in the ICU recovering from surgery...hopefully. I cannot believe how quickly time has passed..seemed like I was months away and now less than a day! I still have an orthodontist appointment later this afternoon to have surgical wires put on..I changed this appointment to the latest possible time so I wasn't walking around with heavy duty hardware in my mouth for several days. The last few days I have been eating everything! I figured I'd get as much in before the upcoming weeks of liquid dieting.

Surprisingly, I am not feeling too nervous..I'm sure I'll have a bit of hard time trying to go to sleep tonight and of course I'm sure I'll be super nervous tomorrow morning. As of yet, I haven't received a call form the anesthesiologist or the exact time I should be there tomorrow, but I've been told I should expect to be there by 5:30 am and the surgery should begin around 8am lasting about 5 -6 hours. I will be at Kaiser Hospital in Santa Clara. My mom will be taking me and staying until I am done and my grandparents (who are still telling me it's not too late to change my mind) and my sisters, brother and brother in law will be visiting that night. My dad should also be coming that night, he'll be driving from Arizona. So I'm sure I'll feel much better to have a lot of family around me.

I'll probably be updating again later this evening after I speak with the anesthesiologist and get back from the orthodontist. I'd also like to post some before shots to compare. I haven't decided whether I'll take my computer with me to the hospital..what do you guys think? I'm actually not quite sure what to bring with me since I've never stayed in the hospital before. I was thinking change of clothes, iPod?

Frustration

So today I was supposed to attend my post-op class - where I would find out how and what to eat and take care of myself. You are supposed to bring whomever will be taking care of you along with you to the class, so I had planned to attend with my mother. I should have known, being the flake my mother is, that she wouldn't make it. I stupidly decided to wait for her and it became too late at that point to go by myself. I called to reschedule this appointment and I find out that the next class is June 24th - 6 days after my surgery! So now none of my questions will be answered, I will not know how to properly take care of myself, what to eat, how to eat, etc. I was looking forward to at least some of my uneasiness being put to rest after attending this class, but now that is not going to happen.

I don't want to sound like a heap of self-pity, but I feel like I cannot count on anyone to be there for me. It looks like I am going to have to take care of myself. Whatever, I have two legs and hands that will work perfectly fine. I can always take a taxi cab to and from the hospital. Looks like I'll be doing this on my own, and maybe that's better anyway.

Getting close...questions?

So tomorrow is my last appointment with my surgeon before surgery and I would like to make sure I have everything answered and all the important questions addressed. But what to ask? I suppose I'd like to know how I am going to look appearance wise post-op - the final outcome. I'd also like to know a little bit more about the genioplasty procedure I am having. My biggest concern is being wired shut for two weeks. What happens if I get sick and have to vomit? Could I choke on it? I know in the hospital I'll have nothing to come up, but what about when I've been home and eating for a few days? What happens when you have the urge to yawn or sneeze? What if I have a panic attack because I feel like I cannot breathe?

Another big concern is nerve damage and numbness - so I've begun taking Vitamin B12. I plan to sleep as elevated as possible for as long as I can and utilize the ice packs as much as possible. The combination of being cooped up in my room and limited breathing gives me claustrophobia. I'm wondering for those of you who have had the surgery, how long was it before you were able to get up, go outside and go for a walk? I think this will be my saving grace, throw on a headscarf and take a walk outside, get some fresh air.

As the big day approaches, I've been getting more and more nervous! I feel like I'm having so much operated on compared to most people with both jaws and genioplasty. Hopefully I'll put some of those nerves to rest after my appointment tomorrow. Till then!

Brainstorming...

So here I am..less than six weeks away and I feel like I should probably start preparing myself with the many necessary items I will need post-op. I'm trying not to wait till the very last minute to go out and try to buy everything in one shopping trip. I've been adding to a list as I think of more and more things I'll need. Here's what I've come up with so far...please feel free to add or suggest anything else you think is necessary or helpful. Thanks!

Here's what I already have
- Zip N Squeeze bags (have 1 package, need more?)
- Juicer
- Blender
- Humidifier

Here's what I need to buy
- Saline nose drops
- Reading pillow (for sleeping/resting at a 90 degree angle)
- Dry erase board
- Ice packs
- Styrofoam cups
- Sippy cups
- Baby toothbrushes

It's a Date!!

It's been a couple months! I am happy to report that I now have a date! June 18th will be THE BIG DAY! Less than 2 months away!! I am beyond excited! YAY!!
My next appointments are as follows:

May 21st - Appointment with my orthodontist for last models.

May 25th - Appointment with my surgeon, Dr. Desai to go over surgery details.

June 8th - Class on post-op care.

June 15th - Appointment with my orthodontist to make last adjustments before surgery.

June 18th - JAW SURGERY!! Upper and lower jaw as well as genioplasty.

I'll try to update as needed!

Brace-face

As promised, here are a couple of pictures: 1 before braces (with my shifted teeth) and 1 current photo, as you can see, a full mouth of metal. I actually don't have many pictures of me with braces since I usually shy away from cameras, even more now that I have braces and realize my facial imperfections. Speaking of which, looking at these pics, I notice I have quite chubby cheeks - scares me to think of what I'll look like after surgery when my face is swollen!

I'm hoping surgery will change all of this for the better...so here's hoping that will happen four months from now! I have to say that my uneasiness about the surgery has somewhat diminished. I've been reading about so many positive results that it's hard to be pessimistic. I'm becoming more excited about the surgery and the new me. I don't have any updates as of yet, but will keep you posted. Till then!

Bit of Background & Current Status

Once upon a time...Ok so it truly feels like a century ago, I had braces put on my teeth for the first time, just like every other 11 year old kid, to straighten my teeth and fix my bite. During my almost 4 year orthodontic treatment, I had the palette expander for about 6 months, if I remember correctly, and the dreaded head gear for almost the entire duration- not that I wore it nearly as much as I should have, but who really does? Nevertheless, having my braces finally removed after 4 long years, at 14 years old and a freshman in high school, I was happy as could be about my perfectly straight teeth.

Well, after tossing my retainer to the side, my teeth sadly began to shift, and by junior year, it was noticeable, but I dealt. After all, insurance would not pay for more orthodontic treatment and neither would my parents. So, after graduating high school and getting my first real job, I decided that I would get braces once again to get my perfect, straight teeth back again.
I got a referral from my dentist, who assured me Dr. Holman was one of the best orthodontists in the country, and made my first appointment. After taking models, x-rays and all the necessary items, Dr. Holman diagnosed me with an overbite and open bite. He explained that the reason my teeth shifted was because my bite needed to be corrected, something only jaw surgery could really fix. No way, I thought. I told him I was not interested, I just wanted straight teeth. I was not going to have major surgery-what for? My jaws never bothered me, so I wouldn't bother them. I will just have to wear a retainer for life so my teeth won't shift again. So in September 2006, I had braces put on my top teeth to straighten out what had shifted. So began the all too familiar necessary evils of braces, but I just kept thinking 10 months of these things and welcome back perfect, straight teeth! It'll be no time at all! If I only knew then...

Getting close to what I believe is the finish line, I wake up one morning with an unpleasant discomfort in my jaw.

In the back of my mind is the jaw surgery talk I had with my ortho many months prior. So, I go online to do some research. I'm intrigued now...now THIS could fix everything. I have problems that I never even knew were problems! YES, I DO have trouble closing my mouth without straining. NO, my teeth do NOT touch down in the front. YES, my jaw DOES hurt when I eat hard foods. NO, I CANNOT successfully eat a sandwich 92.8% of the time! YES, I DO have to sleep with my mouth open at all times! YES my jaw DOES click when I open my mouth! And YES, I DO have a receding chin. I had no idea jaw surgery could correct ALL of these problems! Not to mention a major improvement in appearance - that is a major plus!

I explained what I had recently been feeling to my ortho and told him I wanted to give it a go! I had only wished I'd listened and considered surgery before, since the last 10 months were kind of a waste. We would have to start from square 1- pre-surgical orthodontic treatment which meant WAY more time and WAY more money. So add another 2 years in braces (with surgery expected in between) and $9,000 more. Just put it on the tab.

Dr. Holman refers me to a world-renowned surgeon at Stanford that he has worked closely with for over twenty years: Dr. Powell. I meet with Dr. Powell and am even more excited for this whole process. He's great! I am told that I will need to have upper and lower jaw surgery. He tells me it'll be so easy...that he even had patients my age wanting to wakeboard only a couple of weeks post-op. Wow! He also tells me that the whole wiring shut process is a thing of the past and not necessary. Rubber bands will be used instead. YES! What is most comforting to hear is that over the 25+ years he has been performing this surgery, he is glad to report that he has never had a major complication. He even adds that this surgery will "cute-en me up" Awesome! I'm thinking, "I wish I could have this surgery tomorrow!"

So, I carry on, meanwhile even getting a splint to wear for 6 months (was NOT happy about that- I had SUCH a lisp while wearing it; my job was mainly talking on the phone) looking forward to the day when I'll hear "Ok, you're ready for surgery!" That day finally came at the end of December 2008. YAY! Well...not so fast...

I decide to schedule my surgery for mid-march-Spring Break. I can't afford to miss too much school.
So then it's the waiting game... and then I get a call from my surgeon's office, saying that insurance approval will likely take a while, so in the interest of giving ourselves enough time, it is decided that my surgery be re-scheduled for my next break-end of May when school breaks for summer. OK I'll take that-gives me even more time to recover.
I get a call from my surgeon's office again at then end of February 2009 - Guess what? "Your insurance does NOT cover orthognathic surgery." What??? "Can we fight it, petition it, anything?" I say. "Nope, Great West Healthcare has a specific exclusion for orthognathic surgery. Look into switching to a different insurance company like Blue Cross, Blue Shield" etc. So Great West does not cover orthognathic surgery for anyone, anytime, at all?? And you choose to tell me this now??? Any reason you didn't tell me this a YEAR ago???

The problem is that I am insured through my parents - my dad to be exact- and his company offers 1 PPO- Great West Healthcare and 1 HMO- Kaiser. There's no way I could afford to insure myself. Besides by this time, I'm barely working and going to school full-time at San Francisco State University.
Basically, a lot of back and forth ensues in the following months with absolutely nothing accomplished. So much for in and out in 2 years!
I then start to give thought to the only feasible option-switching to Kaiser. My family is not too happy about this. Besides being an HMO (bad rap) Kaiser has not had the best reputation in my family. Apparently they sent my great-grandfather home after he'd had a stroke- and the next day he died. My uncle and aunt (dad's brother) are both lawyers and they tell me they dealt with a case where a mother and father were suing because their daughter died after having jaw surgery at Kaiser. She was apparently unable to breathe. Horrible.

Fast-forward.
Here I am - a new member of Kaiser- I talked my family into it-telling them there have been major improvements and how bad can it be? I say give it a year and we can always switch back; I really need this surgery, I plead. Because Great West is just SO great, you know. So we have to wait till the end of 09 to make the switch. We are approved and become official members in January 2010. My orthodontist's office tell me that Dr. Holman works with a surgeon at Kaiser in Oakland, Dr. O'Ryan, who is also very good. I'm told she has performed this surgery for 20+ years and with excellent results as seen in many of Dr. Holman's patients. I'm so so sad to leave Dr. Powell- after all, I had the best- I saw him about this surgery for over a year! Will I get the same results with someone else? Well, I gotta do what I gotta do, right?

Mid-January 2010
So, I get a referral from a Kaiser physician to see Dr. O'Ryan in Oakland. I have a good feeling about this. I call to schedule a consultation with Dr. O'Ryan. Booked till April. Shit. This is not good. Problem is, insurance (any of them) won't let me stay on with my parents after age 23. I turn 23 in August. If I wait till April and Kaiser makes me wait 6 months before surgery, there's no way this will be able to happen. This whole thing needs to start happening now so I can barely make the cut off. I disappointedly ask to be called if someone cancels and a slot opens up. Dr. O'Ryan is really in demand. The very next day I get a call from the Kaiser Center in Santa Clara saying that Dr. O'Ryan referred me over to Dr. Desai. Who is Dr. Desai? A maxillofacial surgeon apparently. I make an appointment with Dr. Desai. I guess Dr. O'Ryan knew I didn't have much time or was too booked so she passed me along.

February 2010
I met with Dr. Desai on February 5th. It was over an hour long appointment in which I watched a video on orthognathic surgery and then talked things over with Dr. Desai. My orthodontist's office sent my x-rays to him beforehand and I brought my most current molds with me. Dr. Desai took some measurements of my mouth and pictures, and agreed that I am ready for surgery if I wish to proceed. He asked if I wanted to hear him explain the details of my surgery, adding that it makes some people feel queasy so they opt out. I figured if this is going to happen to me, then I should know, right? How bad can it be anyway? Well, it can be pretty bad. He explained the entire surgery in depth and detail, showing me visually on a skeletal model as well as using my own models. In a nutshell, my surgery would consist of upper jaw surgery-cutting or breaking it into 3 pieces and expanding it-impacting it (moving it up) and moving it outward. When it comes to the lower jaw- it would simply be advanced. Exact measurements I do not know. An additional, optional operation (at the same time) would be the advancement of my chin. I had never heard of the chin advancement before. Dr. Powell (my previous surgeon) never mentioned it to me, however, he never did go into detail about my surgery. Dr. Desai said he would push the chin advancement more if I had major sleep apnea (don't think I do). Nonetheless, having that additional operation would much improve aesthetics. So naturally, I would definitely consent to the additional operation.

Here's the kicker: my jaw will be WIRED shut for 2 WEEKS! What?!? I thought this was a thing of the past??? Guess I'll be living in the past for 2 weeks. Lucky, lucky me. WHY? Dr. Desai said he knows many surgeons in private practice use rubber-bands and shun wires as "old school" BUT in the cases he's seen, better results are often achieved with the practice of wiring the jaw shut. In some cases, use of rubber bands only meant relapse and a re-do. Ok, that makes a little sense. BUT HOW do I BREATHE? What if I panic? Because, let's face it, my nose will be completely congested AND my jaw wired shut, I'm practically panicking now! He told me that I will breathe just fine, most patients find that it's not THAT bad, but if I really start to panic, then I can use a set of wire cutters that Dr. Desai sends home with everyone for emergencies and simply cut the wires, then call him immediately so that he can put rubber-bands on in lieu of wires. Ok, that's a little comforting. Dr. Desai also went over the risks of the surgery. I have to say I didn't know about possible permanent nerve damage (luckily I have age on my side) as well as possible tooth loss (yikes) and embolism (double yikes). I also didn't realize the amount of hardware that will be permanently left in my mouth. Oh well, as long as I don't feel it or have to go through a second surgery to remove them (my orthognathic surgery booklet says less than 2% of patients do, but I feel like I've read a lot more about it happening). So at the end of my appointment, Dr. Desai asked what time I'd be looking at to have the surgery. I told him late May/early June would be best given my school schedule. He said it was definitely doable. There we have it!

But after this appointment, I started to get scared. I guess ignorance was bliss when I didn't really know much about the surgery. So many questions popped into my head after the appointment. I guess what my fears boil down to are after surgery. I'm sure the actual surgery will be fine, and I know that pain can be managed to some extent, so I'm not too nervous about that- it's just the state I'll be in- what if I really can't breathe?? Those couple days after surgery are what I am most concerned and worried about.

I know this has been a super long post- tried to cram the last 12 years of my orthodontic life into something short and sweet- so if you made it this far, you deserve a cookie, or at least a few photos of my brace-face. Till then!

Starting Line

Hello! Ok, here it goes...

After meeting with my surgeon and being explained the entire surgery, for the first time I became quite nervous, anxious actually, even second guessing what I have been anticipating for years now.

This propelled me online to read about others' experiences and motivated me to start my own blog for myself, as well as for people who are going through what I am. We could all use the support and extra encouragement - that everything is going to be OK.

Well, I guess I have more than started my orthognathic journey and that I will leave to tell until tomorrow. It is 2:30 in the morning and I have a long day of classes ahead of me. Till then!