blood work shows some improvement

I had blood work taken yesterday. My anemia is improving. Yeah!

The new hemoglobin level is 11.7...yep, basically a 0.1 movement/week of treatment. It has room to improve, but my general physician is pleased. He consulted a hematologist colleague to discuss the results. She was very pleased, indeed, she was surprised to learn my surgery had been postponed for a hemoglobin level of 11.5. The normal range is (11.1-15.8).

Per her advice, my doctor ordered an additional test (that i cannot remember). Results should be back later today. My doctor will then call the oral surgerons with the update.

What pleased me most was learning how healthy my blood is. Measurements of Iron, Folate, B12, glucose, and TSH were all excellent. I was especially interested in my iron and folate levels after nursing two babies.

In other exciting dental news, I visited my ortho this week. This visit was particularly positive!

• examined latest molds...I think this makes the 8th set taken in 10 months?
• power chain on lowers, working to close gap in front and gap b/w back right molars
• new steel wire on lowers (after the previous one was cut)
• wire crimp to bump up my left canine...turns out the tooth sits a bit low...it's not the jaw plane that's unlevel
• complimented my OD for his well trained eye

Basically, we're making big changes for 1 week, then my mouth has to be stabilized (again!) for the OS to take final molds on 11/10. At one point I yelped at all the movements, the staff asked me if I was okay. I muttered something like, "Well, yes, I've delivered two babies, but, phew!" Poor 13 year old boy in the chair beside me. Sorry.

new surgery date

Well, I am feeling MUCH better. A hearty thank you to those of y'all that left me a note, and to my good buddies that called with well wishes. It does make a difference. ;)
My new date is November 20th. My extended family has been pretty understanding. The iron pills aren't too bad. The funniest aspect of carrying around pills is how often my little one pulls them out of our diaper bag, shakes 'em loudly, and then hurls them on the floor. Nothing like throwing around prescription meds to get everyone's attention!

Other ortho news? I visited my OD this week, too. We're going to make a few minor adjustments on my lower teeth. I am actually eager for a power chain - my lowers feel like they're trying to fall out of my mouth.

So, I am back at the gym, finishing up projects, reading about orthognathic adventures, and enjoying my favorite month here in Carolina. It's finally sweater weather.

On my darkest day of the Katherine-decides-to-have-a-pity-party, I glanced at my Bible on the bedside. I knew it would bring me comfort, yet I resisted opening it. My bookmark opened to a passage I had been reading a few days prior. There was the familiar Proverbs 3:5-6
"Trust in the Lord with all your heart, and do not lean on your own understanding. In all your ways acknowledge Him and he will make straight your paths."

Then I continued to the next few verses...including verse 7:

"It will be healing to your bones and refreshment to your flesh".

how appropriate!

Surgery postponed due to anemia

My surgeon call me just as I was on my way to have my surgical lugs put on. Last week's blood work revealed my iron is at 11.5 g, and it should be at least 12-13 before surgery. I am disappointed more than I can describe. So many details have been planned. I'm sorting out how to rearrange the pieces.

So, the current plan? I'll take iron supplements 3x/ day and have my blood checked monthly. As soon as we see progressive improvements, I can reschedule a surgery date.

Last night, as I lay awake late into the night, I drafted a lovely post about the fabulous evening I spent with dear friends, how they loved on me, prayed with me, prayed for me, how they filled my freezer with meals. My pastoral minister even called me to pray. Oh, I felt the arms of God wrapped around me as real as anyone. I felt safe. I felt ready for Thursday.

There is so much to be thankful for...I hope in a few days time my sadness and anger will depart and I can re-grasp a sense of peace.

Missing my power chains

I never thought I would actually miss those chains. My OD removed them last week at my final pre-surgical adjustment. Since then, my lower teeth have continued shifting, moving outward. It concerns me, though I'm trying to tell myself it's no big deal.

My hubby is on a guys hiking trip this weekend so it's been just us girls at the house. Ah, I wish I was more patient with my children. We had a magical moment this morning reading together, but overall the day has been long. On a good note, they did help me wash the front doorway. We took turns dipping our rags into a bucket of warm soapy water and scrubbing the dirt off our door and lights. Me dressed in gym clothes, the girls dressed in ballet costumes. The girls had already drawn all over themselves with markers after lunch...we were quite a sight. :) Here is my sparkly front door.

Now that the children are in bed, I'm gonna turn on some music, finish my deep cleaning, and hope a little gin & tonic nightcap will help me knock out a sewing project.

Pre-op Recap

My pre-op appointment went really well.

There was a problem with my upper molds warping or something, and so Dr.C called me last evening and asked me if I could go back down to Charleston for another set. Of course, I said yes, he needs those molds to set up the surgical models over the weekend, but golly, it's hard to move that quickly with two small children. I'm sending a shout out to my friend RT in Chas. for keeping my 3 year old during the appointment. I'll take Buttercup with me.

This little twist led to a rush of emotions last night. Lots of rushing around, big change of plans for my day, lack of trust in God that He does have all these details under control, anxiety about the outcome of surgery, etc. I was really feeling swell until about 10:00, then it hit me. I slept poorly and woke up at 4:30 am. Thankfully, this gave me time to blog here :) and pray about my day.

OK, back to the pre-op recap: Both Dr. C, the Chief resident, and Dr.T, the attending surgeon, spent several hours with me. Dr. T did an excellent job explaining the intricate steps of the procedures, the risks of making so many small cuts in the bones of the face, and what happens when "those littler arteries don't read the textbook". It was relaxed, overall, as Dr. T peppered his explanation with comments like, "Well, now I've been doing this surgery for over 30 years, and have never personally seen it, but this (inset really scary outcome) could happen..."

Humor aside, what helped me most was reviewing my ceph x-rays another time, talking about the molds, and hearing the various complications. Such as:

• if a patient experiences too much blood loss during the Lefort, they'll postpone the BSSO until later.


• if i wake up and my mouth is completely wired shut that means my bite was wobbly in the operating room, and they wanted to be certain the new bite sticks (usually due to thin jaw bones making for a more complicated BSSO)


• if at anytime I experience breathing /anesthesia problems, they'll halt the surgery, and I might wake up without having had the procedures, kinda of a better safe than sorry approach.


• what make a nose move and how this surgery will likely affect my nose

We took a bunch of molds during the appointment. Sadly, I came down with a cold on Saturday, and still couldn't breath well nasally, which lead to a whole lotta gagging during the process. It was pretty funny when I started motioning,"I cannot breath!", and the tech, two detnal students, and the surgeons all dashed in to rescue me. Trying to pry gooey, wet alginate off the back of my throat was actually a bit scary.

Here is the technical news: It was wonderful to finally have a plan before me. First, the Lefort I will remove 3 mm of bone from my maxilla, then the bone will be slid back into a proper position, and the lower jaw aligned. Because the mandible swings forward, the current plan is to move my mandible forward about 2-3 mm with a BSSO, for a total of 5mm movement. They not moving my chin. I was kinda hoping they would, but trust their judgement.

To be honest, when I first heard the number 3mm and 2mm, I thought, wow, this is a WHOLE lot of angst for a few mm. Then I remembered that the little 3mm movement will allow me to close my lips without strain...how cool is that gong to feel, I wonder?

Ah, my writing is so choppy today, but I wanted to share the other excellent news. Dr. T thought I only needed to wait 3-4 months post surgery to get pregnant. Yeah!!!! He was not at all worried about the bones shifting, and agreed that I should plan for adequate nutrition. He said soft tissue heals really well.

Oooo, my morning time's up. I'm off to wake up the babies for our morning drive to chuck town.

This is what my babies looked like eactly one year ago...my time flies.

Orthognathic surgery - improved airway, breathing

This post is not a real discussion on sleep apnea issues. I don't have much to contribute there. However, when I saw this picture in Hupp, Ellis and Tucker's book, a big light turned on and I finally understood how a BSSO might improve one's breathing. So, I'm posting it here. May it help someone else on this journey.

Class II - vertical maxillary excess, mandibular deficiency, lip incompetence

Here is an example of a female with a Class II malocclusion, vertical maxillary excess, and a mandibular deficiency. Her treatment plan included a Lefort I, a BSSO and genioplasty. This patient also has a slightly shorter upper lip like me. I will be having these same procedures in less than two weeks.

Before:

After:
doesn't she look wonderful? Like herself, only better. :)

Class II compensation

Does my title seem strange? I've been titling my posts for easy reference when it makes sense in hopes that others researching these same topics will find what they need. It is so frustrating to spend hours online without answering medical questions that seem answerable.

I have high esteem for anyone who has completed the tests, study, training, and Boards that our medical field requires. The authors of Contemporary Oral and Maxillofacial Surgery 5th Edition have invested a great portion of their lives helping people. I highly encourage any fellow info junkies out there (and you know who you are!) to locate a copy of this medical textbook through your public library.

I am going to share a few pages from the book, but there is a plethora of excellent research, photographs and analysis inside its 700 pages. Yup, I've read through the entire book. Twice. :)

This first picture explains why many of us orthognathic patients feel "it gets worse before it gets better". Here is an example of a Class II bite.

2 week countdown - I will sing a new song

I am writing a quick (and randomly organized) post while my babies nap. Much to do today!

Just a year ago I knew very little about orthognathic surgery. I have grown so used to thinking about the BSSO and Lefort I that I forget how gruesome the procedure can sound. What an amazing journey so far. I am immensely thankful this week for a sense of peace. Bono’s lyrics have been floating through my mind all morning.

Words from Psalm 40:1-3 come to mind:

I waited patiently for the Lord;
he inclined to me and heard my cry,
He drew me up from the pit of destruction,
out of the miry bog,
and set my feet upon a rock,
making my steps secure.

Here are my latest molds. Isn’t the difference fabulous? It will be a grand day when I can chew without the “going in a circle round and round” routine. I am really curious what my surgeon will say about the narrow bite on my back right molars. Will he recommend a 1-piece or 2-piece Lefort? My OD thinks he can correct it with braces post surgery. I hope so…it seems like the recovery would be better.

Pre-op on Monday.

Oh, and I borrowed a copy of Tucker's new book (thanks Dr.B!). The new color photos are AMAZING...I'll try to post about these over the weekend. It has been a real encouragement.

Well, babies are awake now. Better run!