Babies and Braces

pearly whites and a big belly

2009-09-27T22:24:00.014-04:00

I love, love, love having my braces off!

I finally purchased a new camera. With our new gadget in hand, our family has been snapping photos everywhere...here are a few of my pearly whites and my sweet daughters.

The first week or so was painful as my teeth settled. Wearing my retainer brought unexpected discomfort around my upper jaw, but only where I have metal screws holding the maxilla in place. I admit to freaking out a bit about this...my right jaw joint is making frequent grinding and clicking noises - NOT what I wanted to hear after undergoing jaw surgery - but until I deliver our baby I am unable to have an x-ray to examine the cause. Thankfully, the pain receded along with a cold...so perhaps it was only sinus pressure? Not really sure.

Right now, I am trying to enjoy the freedom from crazy elastic configurations and not focus on the minor imperfections I see. Honestly, this is difficult after almost two years of orthodontic mania.

These photographs remind me that my daughters won't remember if my teeth have small calcium deposits on them...or if my gums are still puffy pink...they'll remember the love and joy and security of growing up in a our family.

I am immensely thankful to enjoy the benefits of braces....

"To God be the glory, great things he had done!
So loved he the world that he gave us his son,
Who yielded his life an atonement for sin,
And opened the life-gat that we may in. "

psssst....

2009-09-15T21:22:00.004-04:00

As of 12:10 pm EST today, I am de-banded!

Woohoo!

I was totally NOT expecting that to happen today, but of course, am quite pleased. There was a small space in the middle of my lowers that developed after the last adjustment (and change to a wider wire, 72Steels). Well, my dear OD just held these teeth together while he inserted my new permanent retainer along the bottom six teeth. Phew, I won't lie, it was pretty. darn. uncomfortable.

My blog is titled Babies and Braces, two subjects on which I have thought much since being banded in January 2008. Now 37.5 weeks pregnant with my third baby, and memories of giving birth on my mind, I was determined not to let a little pain prevent those arch wires from coming off. :)

It worked!

I am wearing my new Essix retainer on the top 24-7, and will return to the OD for a positioner in 3 weeks to put the finishing touches on my bite. Of course, our baby is due in 3 weeks, too, so this next step will likely be delayed. He he he. It feels marvelous and bizarre and anti climatic and dreamy all at the same time. My face once again looks subtly different. My lips rest differently without the brackets. Hmmm. I am still in a state of mild shock...I mean...can the last big hurdle really be over?

We'll see. I 'll post pics as soon as I can.

Banded together - 8 months post op

2009-07-21T02:44:00.013-04:00

Has it really been almost four months since my last post?

I have not had much orthodontic news to share recently. My OD is trying various rubber band configurations to "settle my bite". Neither of us expected it to take this long, though I admit some compliance issues. :) My current zig zig pattern is so tight I cannot eat/speak well when they're in, which shouldn't be a problem except for the 1st trimester when I was vomiting frequently, and now the 3rd trimester when I am snacking frequently.

The extra metal hooks for bands irritate my gums. My waterpik has been wonderful, helping me keep the pink puffies to a minimum.

When the bands are in, the general tooth achiness reminds they ARE working. I pray these pearly whites settle soon. Wouldn't it be lovely if the braces came off before le bebe arrives in October?

Eight months post op - a little update

I LOVE that jaw surgery no longer occupies every waking thought! That, my friends, is awesome! I LOVE having my lips come together when face is relaxed. I feel more composed, elegant even, knowing my mouth is not hanging open. I love how broad my smile is.

My new smile continues to grow on me. I no longer expect to see the old smile & profile in the mirror. The changes to my nose are more difficult to accept. It's like the nose widened where the screws were inserted, on the side along my bridge, and above both upper canines. Some days I actually long for the old nose. Which surprises me, I didn't think I'd still be wasting energy that way.

My smile continues to relax despite the lingering numbness on my chin and lower lip. My husband and sweet children are benefiting from my improved kissing, too! Honestly, it is not the same as before surgery but it is sooooo much improved, and for that I am thankful.

...I hope to upload some better "Before & After" photographs soon....

rebellion

2009-03-30T23:10:00.005-04:00

For about ten days, I have rebelled against wearing my band configuration (see Susan's blog for close ups). It's not that I have intentionally decided to reject the "ostrich" and "fox" buddies, rather I was too busy eating or talking to bother with them. Staring tomorrow the bands go back in. Each day of bands is a day closer to debracing, right?

I just returned from a weekend trip to Texas to visit family. It was a really good trip. My mother flew with me & the girls, and we reconnected with relatives we haven't seen in years. One of my cousins married a girl a few years back, and she had lower jaw surgery for a Class II back in December. We finally met at a big birthday party for one of my uncles. Though she wasn't nearly as excited as I was to relive the experience, we did connect as the only adults at the party in braces. :)

Here is a snapshot of my two daughters riding a horse for the first time at one relative's ranch.Their hot pink cowgirl princess hats are from the rodeo...yeah baby! Texas rocks.

where's photoshop when I need it?

2009-03-08T21:43:00.019-04:00

I have been thoroughly enjoying the Photography lessons over on Pioneer Woman. That woman does amazing things with her camera. Her bridal portrait post reveals how to make one's skin glow...which my skin does not do in the natural light. It used to glow, but I once I reached age 8 or 9, it started to show signs of aging.

Please pretend I am wearing my Chantecaille foundation, which I would have, but my zany 3 year old decided to "play dress up" with it, and let's just say my toiletry budget does not include Chantecaille purchases, at all, during 2009.

Anyway, I snapped these shots at the Target parking lot yesterday hoping to update my smirky photo. I'm not sure they're any better. Perhaps resting camera on the dashboard is not the best way to take a picture?

I am now resigned that one cheek is fuller than the other, surgery or no surgery. It matches my bigger eye on that side, and now that I think about it, my bigger bosom and my bigger foot. As feeling has returned across my chin and lips, it has moved from right to left (reverse for photos, please). The left side of my smile still sags a bit too. Some days I am more self-conscious of this than others. Sometimes, I manage to concentrate on that little facial muscle and really work it wide open. It's better, but not yet where I hope it to be. Come on optimism...hang in there with me.

Interestingly, profile shots reveal that I still subconsciously lift my chin higher than necessary. Ironic how my lack of confidence can look like arrogance. Hmmm. Years of posturing is a difficult habit to break.

Besides the awesome improvements in breathing, o-surgery did erase a few laugh lines. Ooh, and check out those centered midlines. Sweet!

checking in

2009-03-03T11:00:00.003-05:00

I have my first Ortho appointment in over 5 weeks in about an hour. I'll admit I'm nervous. Will my orth be pleased with my tooth movements? Will he tighten my metal bands again? My teeth are kinda achy this week.

My bands have been out more than in due to constant nausea and little nibbles of food to help with the nausea. I'd really like the extra rubber band hooks out since they make flossing virtually impossible and irritate my gums, but since I've mainly been wearing bands at night, I'm pretty sure they're here for a while. Thank goodness my trusty Waterpik is never far. :)

We'll see what Dr. B. says today....

Is it too soon?

2009-02-23T09:05:00.010-05:00

Following Bella's model of sharing reader's questions, here is a recent question (paraphrased) I received. I included my initial response to the question. I welcome comments - it could become an excellent resource for others looking into the same situation.!

Q: How soon after surgery is too soon to conceive a pregnancy? Do pregnancy hormones cause joint changes and lead to relapse? I read somewhere that one should wait 12 months post surgery to conceive.

A: I'm not really sure. Hormones are powerful, though it is virtually impossible to predict to what extent joints may change. Ideally, the more time one waits the better to provide the body additional healing time, boosting one's nutritional reserves, etc.

Thanks for the comment. I read that post somewhere, too, though I've since forgotten where. I looked up what research was available and found it was mostly applied science. Helpful, but by no means prescriptive. Other readers may be wondering the same thing so I decided to reply with a detailed answer. Hope its length doesn't offend you. I understood your question to be kind and pragmatic. :)

My surgeon and I discussed this very question. He's been practicing since the early 1970s, and he said wait 3 months. I made it just over 2! A second oral surgeon consult also said 3 months - primarily to buffer the estimated 6 weeks it takes bones to heal. My orthodontist had been concerned that my jaw showed signs of condyle sagging at one point. Boy, that bothered me for weeks. But you know, I decided that my jaw was better than it had been, I survived the surgery, and there was NO way I was going to do it again...so it didn't really matter. The nagging worry was debilitating until I released my anxiety. I did check with my ortho about waiting another month or two, and he said in December he didn't know of a medical reason not to get pregnant. I think he knew what I was asking since it's all I ever talk about during my visits. :)

What's interesting to me is that it wasn't until after my second child was born that I noticed my midlines shifting so much. Were the increased levels of relaxin to blame? Or was it the passing of a few more years (I was 29 when she was born, now am 31)? Or the fact that teeth keep on shifting if left unchecked? Not sure. Though my dress size shrank back, my hips never did return to their pre-baby position. Hips are affected differently though than one's jaw.

Below is how I came to my decision. I share it in case it helps someone else...God knows how much time I've spent agonizing over the decision!

My husband and I were both aware of my cycles (I've been charting for about 9 years now). We'd be actively avoiding pregnancy for over a year while we sorted through surgery stuff. We were ready for another baby on just about every level, but perhaps more important, we were open to the idea of life. In particular, this was the real blessing of a quick conception. I trusted my long-held, well-tested beliefs, I submitted to my husband's eagerness for another child (rather than my over-the-top desire to control everything "just so"), and was open. I NEVER expected to get pregnant last month, yet I was overjoyed at the discovery. For us women, there are just a few years during which we can bear children if we're blessed. He is 8.5 years older than I am. Over the last year of waiting, I've been really aware of our ages and the effects of time on biology. Pursing my MBA and this surgery likely means I will not have that extra baby I could have had...

In the end, our openness to life was greater than my fear of a relapse. I hope this doesn't sound naive. Both of us spent much time in prayer.

Now for the science part. I was REALLY scared of being undernourished post surgery. I boosted up prior to surgery, tried to maximize my recovery diet. That fear also led me to take liquid vitamins until I could swallow my prenatals. I continued to supplement with additional iron, since my body likes anemia. :) Some families struggle with birth defects as they welcome more children into their families; I believe some of this can be prevented through proper nutrition. So, I specifically checked my folate levels back in October when I had all my blood work done. Of course, we cannot prevent everything. Therefore, a part of me wanted to wait another 6-9 months to boost my nutritional reserves and order my life "just so". We never did finish our renovation projects or buy that family van I worried so much about...

I know my decision is not the right one for everyone. Even with the "best" circumstances, I understand I may be passing along THE very genes that led me to orthognathic surgery in the first place. Doesn't that catch your breath?

Which leads me back to the beginning....from Psalm 139
v.1 "O Lord, you have searched me and know me,
v.2 "You know when I sit and when I rise, you perceive my thoughts from afar,
v.13 "For you created my inmost being, you knit me together in my mother's womb,
v.14 "I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well.
v.15 "My frame was not hidden from you, when I was made in the secret place. When I was woven together in the depths of the earth,
v.16 "Your eyes saw my unformed body. All the days ordained for me were written in your book before one of them came to be.the end.

October it is

2009-02-19T22:08:00.015-05:00

Two lines. Happy thoughts. Constant fatigue.

That's right, I'm pregnant!

I never thought I would conceive so quickly. Go liquid vitamins! I picked up a bottle of outrageously expensive, whole food, gluten free, yada yada liquid vitamin back when I was recovering. Anyone else having horrible flashbacks of liquid baby tylenol? I stopped drinking that green murky goo over the weekend, and my energy plummeted, my nausea skyrocketed, and I couldn't keep any food down. I was sick every 20 minutes for almost 2 days. Thankfully, I was only a few hours from home, where I slept for a day and resumed my vitmain regime. Tonight, I read on the vitamin bottle it contains something like 1200% of my B6 daily requirement. Lightbulb moment! Pumping up on B6 really does help with all-the-time sickness.

Just another reminder of how jaw surgery supplies can be good for you. ;)

I'm about 7.5 weeks pregnant, and with my nausea under better control, my rubber bands are back on. They make for achy teeth but they're really effective. I can totally chew well on my right side, left side is coming along. More feeling is returning to my lips and chin, with stabbing pains growing less frequent. My mouth feel kinda tight in general, hard to describe. I can almost feel it if I bite the inside of my lips. Let's be honest though, the extra metal hooks for bands are never forgotton. Sometimes I can't see my teeth for all the hardware and rubber in there.

I do love that my jaw doesn't click anymore. I love love love that I haven't had a migraine since surgery. Not a single one. Woohoo! Will the pain when yawning diminsh, too?

My little issue with mouth breathing
I stopped taking my nasal spray because I was concerned of birth defects; without the spray, I catch myself mouth breathing again, especially at night. I know I clinically need to use the nasal spray to shrink my turbinates, and I know pregnancy hormones can make my nose stuffier-than-normal, but catching myself mouth breathing makes me feel like I've failed or something. Most everyone I see says I look the same, or that they cannot remember what I looked like before, but sometimes I miss my old goofy smile. It was so big and so happy! My new smile is fantastically straight but a bit unbalanced. When I'm having a doubting moment, I remember how much better I can now breathe. So if I'm feeling mopey, and think about recent mouth breathing, then I really feel bad. I think some of what I notice is the muscles pushing against all the band movement. Wearing bands does seem to help, so, for now, I'm trying to give myself some slack and not worry to much about it.

I need to end this post with a happy thought. By the time I celebrate my one year surgery anniversary, I'll have a sweet little bundle in my arms! Here is a memory of number 2 in my vintage handsewn top and vintage moses basket. Owhhh. :)

10 weeks post op improvements

2009-01-31T21:12:00.006-05:00

A quick post to document the changes:

Each week is better than the week before. Chewing is better but by no means normal yet, perhaps because my teeth are still shifting in my wires. My arches continue to widen. My elastics are now my friends. The whole insert elastic technique is improving also - I'm down to 3 minutes from 12 or so. The front box pattern has totally moved my front teeth in place. Very cool. My guess is that I have another 6 months of braces.

Feeling is slowly returning to my lower lip and chin. I can feel my finger if I drag it across the chin, but the tingly sensation is kinda painful. Kissing is better, but again, not yet normal. Feeling has returned faster on my right side. When I smile, my left side doesn't quite wake up. I have to concentrate to make my smile, well, smile. Weird. I am hopeful this is not permanent.

My husband has either been working or out of town the last few weeks, and with my attention focused on disciplining my children, blogging has taken a back seat, for sure. Hope to correct that trend! And I hope to take a new picture tomorrow. My current pic looks so smirky.

my new smile

2009-01-23T14:55:00.015-05:00

This week my OD instructed me how to "settle my bite" with elastics. I had been wearing light elastics in a classic Class II position for the last month. Since only my eye teeth have been touching I look forward to feeling an improved bite.

In order to configure the trio of elastics, additional wires were added. Little ones, sure, but really, who wants more metal in their mouth a this point? They don't bother me that much, except when my lower lip is accidentally caught. Ooo-weee! When I wake up, I still feel like someone hit my face with a baseball bat, happily though, this unique feeling is not visible to anyone else! The best part of the new config is the super tight box across the front. I teased my husband that this must have been his idea, to keep me from eating my way back into my old clothes! :)

Now, for the lighter side of dental hygiene. My youngest loves to imitate me wrestling with the pesky little bands. If I open wide, and growl with these babies on, giggles erupt for everyone. Once big sister saw me pull out the camera to capture the cute moment, she, too imitated my antics.

Braces and babies, don't you love 'em? :)

disturbing the peace

2009-01-18T16:31:00.031-05:00

Awake at 5:15, well, make that 6:20...oh, who forgot to set the alarm! Make coffee and feed the children while hubby showers. Is the bag packed? Good. No, you cannot eat a brownie for breakfast, even if they are GrandmaMac's yummy ones. Gulp a carnation breakfast shake, fuss with some makeup, turn down the heat while we're out. Everyone in the car...please...in the car...NOW. Thank you. Golly, it's cold this early. Honey, did you grab the girls' hair bows? No worries, I'll run in. Would you reopen the garage door please? Thanks. And we're off...

My family and I dashed down to Charleston this morning to celebrate the baptism of a special young boy. My youngest's godmother had asked my husband to be a godfather to her much-longer-for son. It was important occasion, and important we arrived for the service on time. The rhythm of the highway and light rain mellowed our young children into delightful traveling companions. One hundred miles later we arrived refreshed.

Quietly, I inhaled the surroundings. Old friends ,who never thought they'd marry, now sitting in pairs here and there. Childless couples, embracing new deliveries. Estranged families, now reconciled and singing together. It was quite a picture! I was happy to sit on the fringe, enjoying the service.

"...and just like the surgeons took a hammer and saw to my jaw a few years ago, and replaced it with a better one (and yes, this is the best they could do --laughter--), Jesus shatters our false suppositions with his sWORD, and replaces it with a true sense of peace..."

Jaw surgery in the sermon? Seriously! How often does that happen?

I perked up instantly. The pastor discussed a passage from Matthew 10:34-40. One point of the sermon was that God refines us through difficult circumstances, crushing our clouded, limited understanding of truth to lead us to Him. This idea totally reminded me of my first weeks after surgery. I was humbled by what my body wouldn't do, surprised by what it did. My comforts were completely disturbed.

I had peace prior to my surgery because "I" had done enough research, "I" had purchased supplies, etc. Post-operatively, I have a richer peace, in part because my peace was disturbed. I realized my dependency on someone other than myself.

Here is a picture of my husband holding his new godson...may baby Joe grow in wisdom and stature with God and man.

Cheers to sermons with surgery references. :)

Babies and braces and babies?

2009-01-10T14:07:00.007-05:00

I am now officially TTC baby number 3! It feels absolutely wonderful to be here, after all the praying, hand wringing, and researching.

I'm am very happy with my decision to postpone #3 until after having surgery. The timing has been good, not just for me but also for my family. I would be dishonest if I didn't share that I've longed for another child for months now. And there have been some big bumps along the way. Certainly, many people face the same longings without the clear hope my husband and I share for more children. I am immensely thankful to be where I am. Truly.

Thank you to anyone who has listened to me ramble through my heart workings over this past year. It has been quite a journey. When I review previous posts, I cringe at the poor grammar, unnecessary anxieties, and nonsense ramblings...and yet, this blog has served me well as both a journal and a fantastic way to connect with other ortho-bloggers.

Oh, and Holly, in case you're wondering who checks your blog like 8x per day, it's me. I know you have great links to everyone. :)

7 weeks post op - edited

2009-01-06T21:52:00.034-05:00

Six weeks has been a grand milestone. I'm feeling more like myself each day. The daily progress remains slow, yet, when I reflect upon where I was a week past, I notice big improvements. Today, I had an adjustment at the OD. It went really well. Elastics have shifted my bite closer, we moved some brackets, and the OD even bonded a front tooth for nicer shaping. Midlines are mostly together. I love how my teeth are lining up in front, how my lips fall across my upper teeth, how wide and happy my smile is. The fullness in my cheeks and the little upturn in my nose are growing on me. By the summer, everything should settle into place.

I'm officially on soft chew foods! I've stopped shedding pounds so I must be eating enough. While I am thoroughly enjoying the new foods, chewing remains frustrating. My ROM is improving - my OD gave me some tongue depressors today to move it even further.

I've resumed my exercise routines. Surprisingly, I'm more into exercising than usual. So much of my recovery feels out of my control, but when I'm doing leg lunges to upbeat gym music, I'm in total control. (I am monitoring this so it doesn't get out of control (ah, puns!)) I'm now sleeping with just 1-2 pillows. My right jaw, the swollen side, is too tender to rest on but otherwise feels fine. Sleeping feels more comfortable in elastics. Feeling continues to come back in my lower lip and chin. Buzzing with occasional stabs of pain on the outside, insides are still numb. Kissing remains strange...think awkward teenage antics!

...some thoughts on the Body Image conversation...
My fuller cheeks remind me of an engagement photo from 2000, when I was 23 and wore a size 10. Marriage slimmed me down, unexpectedly, and over the last 8 years my face thinned as well. The second photo is me in December 2006, age 29, wearing a size 6 (and 5 months pregnant with #2). I think this is why when I see the fuller face, I feel heavier than I am. Just a hunch.

comparing smiles before & after

2008-12-30T15:33:00.021-05:00

I'm still working on a better before & after compare. Here is a quick version for the curious...

1) In braces for 5 months, May 2008

2) In braces for 11 months, 6 weeks post op, Dec 2008

I think you can see how the braces straightened my teeth, widening my smile even before surgery. As my teeth straightened, my overbite (and over jet, too) appeared larger. My teeth should lighten up again after my next scheduled cleaning. The surgery shortened my face, especially noticeable (to me, at least!) across my cheekbones. My cheeks are fuller. My jawline is now more square. I knew one eye was larger, now I can see the very subtle difference in cheek fullnesses prior to braces. Also, now that my lower jaw is in place, my laugh lines have softened. That's good! I still expect to see face #1 in the mirror...when I see face #2 instead it seems strange. Bit by bit this sense improves. My smile is slowly relaxing and broadening as the muscles in my face come back. My lower lip and chin improve daily. The constant buzzing & twitching nerves lead me to believe this feeling will return, too. :)

Yes

2008-12-29T15:20:00.009-05:00

As I approach the six week mark, my attitude is shifting. Finally!

Am I feeling better? Yes.

Can I eat more food? Yes.

Do I like my new smile? Yes.

Is my energy returning? Yes.

Is the mild depression lifting? Yes, mostly.

Isn’t that good news?
Yes!

...here I tried to recreate a shot from last Christmas.

gastronomic bliss

2008-12-21T22:50:00.004-05:00

Our family visited my in-laws today. My sweet MIL pick up some smoothie mixers for me. Also, we dined at a local pizza spot where I experienced a moment of culinary bliss...ravioli in pesto sauce. Hmmm hmm good!

4 weeks pics...it's getting better

2008-12-20T14:15:00.018-05:00

...I actually put on foundation and my favorite top for this...:)

I poured over other's before & afters for hours. It totally helped calm my nerves. Then again, nothing prepares you for looking into your own face in the mirror. Bizarre, really. I've lost 10 pounds now, but since my cheeks are fuller, I actually feel like I've gained weight. Is there such thing as a post-surgery eating disorder?!

Perhaps it is the permanence of the experience that feels so strange.

The fourth week marked the end of my pain, per se, though I still describe my general state as uncomfortable. Something is always achy, twitchy, sore, etc. I am truly a joyful person - don't let the pessimistic sound of my posts fool ya. :) Also, I can now swallow tiny motrin pills, woohooo, so no more liquid motrin cocktails for me! My energy wanes after lunch big time. Most days I try to sneak in a nap...how do you working folk do it?

The best sign of recovery this week is that I cooked an entire meal for my family. We were all thrilled.

So, for any other orthognathic-obessessed folk out there, here is what I think 4 weeks out. I'm uncertain whether one side is more swollen or if my face is that lop-sided. Everything feels swollen, and my husband say I look better in person that in these photos, but I do continue asking myself,"What if this is my final look?" The tip of my nose has come down a bit; it's likely in it's final spot. I love where my upper lip falls against my upper teeth when I smile, though the uneven muscle tone creates a very crooked smile.

At an ornament swap this morning, I totally covered my smile when laughing because a) it hurt to laugh and b) I was aware of how weird I looked. O confident self, where art thou?

Lastly, and I admit to being apprehensive about writing this, but I wish my lower jaw had been moved further or my chin moved out. My new lip compentance is fabulous - truly - doesn't the profile need some balancing? Right now, I'm trying to trust the surgeons who do this sugery all the time, on lots of different bones, and be thankful for the lack of complications I've experienced.

3 weeks pics

2008-12-20T13:46:00.009-05:00

....premiering fresh from the shower, sans maquillage...

It feels so strange to post these. I don't completely like the results yet and feel very self-conscious about my new look. Sometimes, I think there's no difference at all and wonder if it is all worth it...I guess this is where the conviction that one's long-term health is more important than a short-term aesthetic change.

Here is how I felt at 3 weeks post op, written the night I snapped these photos:

Christmas music? Check. Haagan Daas? Check. Feeling better? Hmmm, can I get back to you on that?
When friends ask me how I'm doing I don't know what to say. Yes, I can talk, but it aches. Yes, I'm sleeping better but I wake up swollen like Humpty Dumpty. I am constantly frustrated eating. I miss kissing my husband. Most of all, I miss my optimistic self.

I admit, it has been really difficult to stay positive. I'll be minding my own business, and BOOM, a gigantic zap of pain attacks my chin. Each zap means another nerve is waking up. Thankfully, this stage, too, shall pass. Isn't there some improvement around the 6 week mark? Feeling under my eyes, around the corners of my mouth and around my upper lip has returned. Every couple of days another part of my mouth regains feeling. Swallowing remains strange.

Of course, having any surgery during the holidays is challenging. I miss the aromas of good & good-for-you-food filling the house. I'm at home again tonight instead of celebrating with friends. I miss arriving places with lipstick applied correctly....my lips are still kinda wonky. As the swelling under my nose improves, my upper lips are slowly unfolding. My moods are settling down. The mild depression seems to be lifting more each day.

My father kindly asked me today if I was pleased with my new look. I think so...

Honestly, I’m still growing into this softer face. I liked how Million Dollar Smile phrased it, "getting used to new angles". My fuller cheeks make me look younger – that’s a plus, I guess. They also hide what little cheek bone I do have! I don’t yet like my nose angles. It’s funny how looking at other’s photos I can see the little difference is just that, little, but when I examine my own face in the mirror the difference seems E-normous.

Running holiday errands this week, I ran into several neighbors, each of whom asked me if I had had my surgery yet. This was weird. It‘s good still look like myself, right? Is it good that they don’t see the improvement. Or maybe they see a difference, it registers as "not an improvement" and so they ask? I’m not sure.

OS follow up 23 days post op

2008-12-17T20:51:00.016-05:00

My Monday check up with the surgeons went well. The entire visit was over in 10 minutes. In short, they were both very pleased with my results, smiled at me a lot, and told me to come back when my braces were off, for a final x-ray and photo. OS even said with a warm grin, "Lady, you're healed." ( he said lady in a pleasant tone, not that middle school slang tone)

I was rather surprised.

When I mentioned that my OD thought there was condoyle sag, my attending OS laughed slightly, and asked the chief resident who assisted the surgery to come check out my bite. Right on. Midline? Right on. Next, they reviewed all my x-rays. Again, right on. I was delighted! I reminded myself how far my jaws & teeth have moved thus far, and even if every tooth wasn't perfect, my current smile is a huge improvement.

There's still some tweaking to do for sure.

A funny moment occurred while looking at the x-rays. The attending reminded me how much tooth I used to show when my lips were at rest. He said the normal range is between 2-3 mm or something. I interrupted him to show off I knew my own measurements, that I had shown 7 mm. Well, he laughed and said more like 157 mm! Humor seem much more appropriate now that the surgery is behind me.

At the end of my extraordinarily brief appointment, I wanted to hug both men (and find the other 2 lady surgeons who cared for me in the hospital). Alas, the clinic was busy. I settled for a handshake. All the appointments, and the fretting, and the blood work, and the drug effects, and late night calls to the dr...all of it seemed over too soon.

This is a huge generalization, okay, but since both of my performing surgeons are men, and both are well, surgeons, they weren't too big on the whole touchy feely aspect of me processing the experience. :) Oh, I wanted to tell them all about it, but I could tell they didn't really want to hear. They've likely heard it before.

The attending did tell me I was too critical of myself (I already know that sir!) and reiterated how pleased he was with the surgery. The resident didn't say much - he leaned in close to measure my new upper lip angle, checked out my jawline scarring, told me that would go away in a bout 3 months, and smiled at me really big! With their combined positive energy, I left the hospital on cloud nine.

Of course, once I was in my car driving the 100 miles home, I thought of all the questions I had intended to ask. The only advice given was to be sure not to chew until I was 6 weeks out. I am to call if I have any concerns, but otherwise, the attending surgeon didn't think seeing me biweekly would do much good. Who knew I could feel so relaxed in the hospital again? Just walking down the hallways at previous appointments had shaken my confidence.

I've been pondering how best to say thank you. How does sending a large box of citrus to the office sound?

First OD visit, post-op

2008-12-12T20:14:00.009-05:00

I went to the OD twice this week. I initiated the appointment, and am so glad I did. I wanted to remove the surgical lugs. Yippee!

Bad news? My OD is concerned my condoyles have sagged. Uh huh. NOT what you want hear after surviving two weeks of what I’m coining as “the darkness”. His concerns worried me for several days. Really, though, what can I do except wear my elastics and wait for the swelling to go down? I think this is pretty common. I’ll speak to my surgeons about it on Monday. My assessment is that the OS was very pleased with my bite while the OD preferred my teeth to be set end-to-end to compensate for the settling in process.

My left side looks great. My right side is slightly class II, so that side has stronger elastics. The plan is to correct my bite while the mouth is still settling. Then, around the six week mark, we’ll start tweaking rotations, mid lines and such.So, new flexible wires are in as well as a lower power chain. My little persistent gap finally seems to be closing. Prescription is to wear the Fox elastics on the left & Ram elastics on the right 24-7 for the next three weeks. I feel more pressure than pain from these, though my cheeks are still puffy and catch on the elastics whenever I speak.

Since I cannot chew any food, the additional pain hasn’t slowed me down. Well, perhaps it’s made me grumpier than usual. I am definitely more focused on comforts than I used to be: warm socks, smooth puddings, hot showers, fresh sheets. As long as I don’t have to chat much, excursions help me distract myself from the discomforts.

Last night, my husband and I taught an NFP class. Oooh, I paid for all that talking today. Every muscle in my jaw aches, even under my chin. My face also swelled back up. Grrr.

Oh, I cannot for these babies to come off!

Brrr...

2008-12-09T19:50:00.010-05:00

I've been surprised by just how sensitive my face is, to well, just about everything. So many friends have loved on my family with frozen meals that most nights, I'm pulling supper right out of the oven. It's a real treat, for sure! Strangely, that initial gust of hot air really stings my face. It's the same when I step outside into colder air. It's like someone turned on a giant internal vibration device on...any shift beyond about 10 degrees F feels really uncomfortable.

Sunday, I tried joining my little ones at the park. Weather was a cool, 50 degrees F. I lasted 3, maybe 4 minutes before jumping back into the car, turning up the heat, and placing the warm rice pack I'd brought along, on my cheeks. Husband-of-the-year took over thankfully.

Been reading about similar experiences on Archwired and Yahoo....

The best explanation I've found is this: the metal expands/contracts at a different rate than bone & tissue, therefore, the sudden shock of temperature change "feels" noticeably different. At this point, that difference registers as pain. Hopefully, once the nerves are back in place, the sensation will just be "different".

I guess it's good I'm here in Carolina. :)

how my young children are reacting...

2008-12-07T12:32:00.009-05:00

Hi Katherine, you asked about my children. Overall, they are taking it in stride. It took my youngest (18 mos) about 4 days to come around. She is a sensitive, quiet child. We bonded one afternoon when we spent about 5 hours together, just us two, and said very little. For my old chatty self, this was different and beautiful. I need to remember this when she grows older! My older daughter (3yrs) spells love with time and activity. She doesn't mind my new look but is impatient with my lack of energy, apathy and sometime tears. Since my return from the hospital, she's grown concerned I'll disappear again anytime I have a doctor's appointment. She's not yet aware that this is just a stage. My take is, like potty training, she'll figure it out eventually....my challenge is to remain calm & steady for her.

My physical pain ebbs and flows unpredictably as have my emotions. Sweetpea is the first to say, "Mama, don't cry, it's okay...just go take your medicine." While I am touched by her sympathy, I am concerned she's acting like a parent. I reassure her that I am "not feeling well" and soon I'll be back to my old self. This comforts her. Also, I try to warn her when I am in pain. When I feel good, I make an extra effort to engage her. My other tactic has been to follow our general routines. Mentally, I know they're too young to remember this experience well. I guess my fear was that we'd all find ourselves in a new pattern and then let that become normal. Thankfully, my husband is pretty grounded. He (plus the many dear friends who have "remembered me") are keeping me from straying too far.

Thanks for asking about my little ones. :)

quick pics - a side view at 14 days out

2008-12-04T21:25:00.007-05:00

I don't quite have the energy to post proper before & after pictures. Here is a quick comparison of my profile about 1 month prior to surgery and about 2 weeks after surgery.

In my after shot, you can tell my nose still turns up from the residual swelling. Also, my surgical lugs are on, as well as, lots of dental wax. I am not completely used to my new look, but I do like the placement of my chin foreward.

Upper jaw: impacted 3.5 mm

Lower jaw: moved forward 5mm

coming out of the dark

2008-12-03T13:33:00.012-05:00

Each day continues to feel a bit better!

I'm still experiencing some pain and mild depression - though there are moments where I feel the old me has returned. Since my OS encouraged me to talk at Monday's appointment, I've been trying to talk more, to stretch out my waxy-feeling facial muscles, but of course, it increases swelling and sucks all my energy.

Thank you to my friends for emailing, calling and loving on me. It makes a difference. :)

The Darker Side Effects of Dilaudid

Today, I finally investigated the side effects of the pain reliever I was taking. Since I couldn't swallow very well, and vomited several other pain meds in the hospital, Dilaudid's 2-4 mL doses worked well for me. I am grateful for the pain relief the drug provided, but goodness, it seems I was sensitive to the drug in almost every category! I'm so glad that I am not still taking this powerful drug every 3 hours.

For anyone researching jaw surgery and such, here is a copy/paste of the side effects. I've italicized the ones that effected me. Also, I checked out withdrawal symptoms, and BAM - there were other symptoms I'm experiencing.

I am glad I am not really going crazy!

"The major hazards of DILAUDID-HP include respiratory depression and apnea. To a lesser degree, circulatory depression, respiratory arrest, shock and cardiac arrest have occurred.

Dilaudid is an analgesic narcotic with an addiction liability similar to that of morphine. It is apparent within 15 minutes and remains in effect for more than 5 hours. Dilaudid is approximately 8 times more potent on a milligram basis than morphine. Often called "drug store heroin" on the streets. Dilaudid inhibits ascending pain pathways in Central Nervous System. It also increases the pain threshold and alters pain perception....of course, the pain alteration is why this was so helpful during those early days. :)

The most frequently observed adverse effects are lightheadedness, dizziness, sedation, nausea, vomiting, sweating, flushing, dysphoria, euphoria, dry mouth, and pruritus. These effects seem to be more prominent in ambulatory patients and in those not experiencing severe pain.

Less Frequently Observed Adverse Reactions:
General and CNS:, Weakness, headache, agitation, tremor, uncoordinated muscle movements, alterations of mood (nervousness, apprehension, depression, floating feelings, dreams), muscle rigidity, paresthesia, muscle tremor, blurred vision, nystagmus, diplopia and miosis, transient hallucinations and disorientation, visual disturbances, insomnia, increased intracranial pressure

Cardiovascular: Flushing of the face, chills, tachycardia, bradycardia, palpitation, faintness, syncope, hypotension, hypertension

Respiratory: Bronchospasm and laryngospasm

Gastrointestinal: Constipation, biliary tract spasm, ileus, anorexia, diarrhea, cramps taste alterations

Genitourinary: Urinary retention or hesitancy, antidiuretic effects

Dermatologic: Urticaria, other skin rashes, wheal and flare over the vein with intravenous injection, diaphoresis"
--from web.md

Here are the possible withdrawal symptoms:

Withdrawal symptoms from Dilaudid can occur four to five hours after the last dose. dilaudid withdrawal symptoms usually last 7 to 10 days. Ah ha! Users may respond to the pain of dilaudid withdrawal by taking another dose without realizing they have become addicted. Dilaudid Withdrawal symptoms include but are not limited to:
severe anxiety , insomnia, profuse sweating, muscle spasms, chills, shivering, tremors, restlessness, yawning, gooseflesh, restless sleep, irritability, anxiety, weakness, twitching and spasms of muscles, kicking movements
severe backache, abdominal and leg pains, abdominal and muscle cramps, hot and cold flashes, nausea
anorexia , vomiting, intestinal spasm, diarrhea, repetitive sneezing, increase in body temperature, blood pressure, respiratory rate, and heart rate

some Tidings of comfort

2008-11-30T08:54:00.030-05:00

This morning I am resting at home, wrapped in blankets, cradling a warm cup of coffee, and listening to the morning service at First Pres. Oh, how I appreciate internet access to our warm church family during my recovery. Hearing Dr. Ferguson humorous deliver the children's message comforts me. Hearing the choir sing the wonderful Gabriel's Message, comforts me, too. (this is a great link if you enjoy fine choral music).

I have felt very lonely this week. If anyone is still reading my all-over-the-place blog, you'll know I've had some rough days. I have new compassion for the home bound, the elderly, the truly alone. I'm grateful for that.

After sleeping in a recliner for three nights I am breathing a bit better. I've also practiced breathing through my Airlife spirometer. Last week,I could inhale about 2250, then it dropped to below 500 this week. That's how little oxygen I received! Thankfully, I improved to 750 yesterday.

My children have been very patient with me. My older daughter, full of compassion, rubs my arm, instructs me with big eyes, "Mama, it's okay, you'll feel better soon." Then a few hours later, "Mama, I know you can't really read yet, but can I sit in your lap with my book?"...and then she climbs into my lap with about 8 books, 2 baby dolls, and a snack.

My younger daughter still tugs on my shirt indicating she wants to nurse. I tell her we can't, she sighs, gives me a tiny hug, and scampers along. Later, she brings me a book to "read" with her, her latest crayon creation rumpled in the fingers.

Scenes of everyday family life comfort me. The sage old saying: "Do ye the next thynge" is still apt. When there is nothing to do, do the next thing.

For me, that meant finishing the hem on some dresses I had sewn for my daughters. Here is the dress on my new bed. It's the first time I sewed piping & a ruffle. Sweet sister dresses in French blue corduroy with a pretty contrasting lining.

My second improvement has been managing my pain. I decreased my Dilaudid over the few days, kinda saving it for when it got really bad, and thankfully many of the narcotic side effects have disappeared.

not as edgy, can concentrate
appetite is returning slowly
GI track is normalizing
all over itchiness is gone
no more nightmares...these were really wreaking havoc w/sleep

Still do experience the following side effects of surgery:

constant low grade fever chills
throbbing pain & spiked stabs of pain in my chin
swelling under my nose is worse due to the Lefort I
stitches in upper jaw itch constantly
numbness - nose, cheekbones, half of chin, roof of mouth, all upper teeth

Pain meds now consist of Motrin/Ibuprofen 800mg every 8 hours, plus 400mg Tylenol as needed. I have about 3 doses of Dilaudid left before my OS appt tomorrow. These are for tonight.

My splendid spouse turned our gas fireplace on last night. Ah, I waited 2 years for that moment! It was SO nice to sit somewhere other than my bedroom. He picked up some Pho soup at my request. I blended the meat for extra protien. What a pleasant change from chocolate Muscle Milk sh kes. He put the children to bed, and we chatted just like old times in front of the fireplace before he departed to put in a few hours of work at his office.

In ways both big and small I am encouraged.

my iron lung

2008-11-29T09:21:00.004-05:00

I remain in the "wincing and weeping" stage for another few days I am afraid. My current hurdle is trying to breathe deeply. After listening to my growing list of physical ailments, my husband ordered some blood work to be drawn. The results from last evening's trip to the hospital came back positive, that is, there were no obvious signs of infection. They did not, however, reveal what is causing me such pain.

I suspect it is muscular, from how difficult it is to find a sleeping position. If anyone reading this would share how they handled their post-op sleep, I would be much obliged. If I move my head much out of center, my ear aches terribly, but it feels like my neck is begin pulled somehow.

Goodness, I am a mess!

As best as I can describe it, I am wearing an iron lung that prevents my from breathing anything other than the smallest of breaths. Pleghm drips onto my esosophelgus-whatever, and then I can't cough. Any breathing causes my chest to constrict into muscle spasms.

Should I see a chiropractor? Do I need a muscle relaxer? I know I need help. My next visit wit the OS ins't until Monday at 1 pm.

Thanks y'all.

lounging in bed, again

2008-11-27T09:43:00.006-05:00

Today marks 1 week since surgery. Amazing. On Day 5, I felt awesome. noticed lots of swelling was down, chatted up a storm, smiled with my children, saw visitors. but once again did not sleep. Day 6, I sadly paid for all that talking. still no sleep at night. Today, the situation is somewhat improved, but uncomfortable. I can't quite shake the frequent "white, hot pain" spasms.

So, I have modified my med schedule. This should help with sleep. Without any rest, every response is exaggerated. Y'all, I was taking a different med at every hour for six days. No wonder I feel loony!

I'm called the OS to ask him my questions. He was pleasant, reassured me that all my issues were temporary.

Kinda vacillating between wincing and weeping. Where did my old normal self go? Sorry to sound down. It's just gonna be one of those harder days. Maybe today is my low point?

happy anniversary!

2008-11-25T13:52:00.021-05:00

Eight years ago on a cold, rainy day B and I said our vows in front of many dear family and friends. Thank you to anyone reading this blog in 2008 who supported us back then. We young things needed lots of advice along the way! With each year that passes I am more pleased with my groom. As I see my respectable sins, too, I am reminded how little I deserve such a fine man. All good things really are a gift of grace...

Some highlights of those 8 years:

2001- B is a student, I am laid off in the tech crash...we are in love, in debt, scared and decide to try small town living....who knew we'd find such a grand hometown in Columbia?

2003- B is still a student, found a job I adore, but I'm traveling too much with work.

Next, B is still a student, and he encourages me to follow my dream of studying abroad for an MBA. Now we're both students again, have no money, but are very happy. Remember climbing Mt. Schafberg?

2005 - We celebrated 5 years together, realizing for how much of it we had lived apart.

Blessed with a baby girl, now a SAHM. Still think sometimes about the roads not taken but, mighty happy.
2007 - Blessed with a second baby girl.Look at 'em cooo-ute baby feet.

After hearing me talk about it enough, you encouraged my wish of getting braces. And here I am on our 8th anniversary. Gooby lipped, and despite the temporary grumpiness, still very much in love.

Happy Anniversary B!

the prettier side of recovery

2008-11-24T21:39:00.009-05:00

I am feeling the effects of my last dose of narcotics, so this post is a quick one. Here are my humorous attempts at keeping it real. :)

I am feeling a bit like Ms. Jolie. Other adults are watching my children while I hang out with a good looking husband. Strangers tell me how lovely my children are. Oh, and the more water weight I lose, the better my giant lips look! Definitely puffville at my house this week.

Discovered a cool trick: when the rushing sounds of my pulse race through my ears, I push on all sides of my face and it's instantly quieter.

Check out these sexy lips...they got worse but sadly, or maybe not, these are the pics I snapped of the uber grossness.

macho for morphine

2008-11-24T12:03:00.003-05:00

I felt so confident at 8:45 am that I skipped my 9:00 dose of dilaudid. Silly girl. By 10:00 I was very aware of my error. Ooew, I have never been so delighted to hear my clock strike 12 noon! To help pass the time, I picked off the ooey whatever was growing on my fat lips. Yuck.

Now my face will stop shaking. I'm making myself repeat, "I will not go macho again. I will not go macho again."

Alright, back to staring aimlessly at my wall. Isn't beige the best color of all?

Home

2008-11-23T20:34:00.002-05:00

What a pleasant word to write. It’s now Sunday evening. All reported was that my surgery Thursday morning went smoothly – and my recovery is progressing. Surgery took just over 5.5 hours. The last 36 hours on floor 7W have been very difficult. Hours of intense pain ticked along, the first twelve hours measured in 6 minute increments on my morphine dispenser. As each click brought relief, my eyes grew heavy and an oxygen alarm notified the nursing staff my pulse had fallen. Ooh, and the drug cocktail makes me itch all over.

Those were long hours indeed. Like falling love, reading about it this surgery and experiencing it are entirely different.

I needed to spend an extra night in the hospital to manage my pain. Here is where the good news begins. I am not wired shut, nor am I wearing any rubber bands. This enables me to mumble somewhat coherently. Also, my pain has been higher in part because so much feeling has returned to my face! My chin flutters 4/x hour. My face tingles all over. One of the surgeons thought this was super.

The daytime nurse, Lynne, and evening nurse, Brenda, made it all bearable. Their kindness blessed me immensely! Guess what? Brenda underwent the same surgery about 15 years ago. Her encouragement throughout Saturday night helped me reach “the other side”. At last, I experienced enough relief to see the end was somewhere…

We left the hospital at 12 noon today, raced 120 miles home, in order to pick up prescription pain meds in Columbia in the right liquid/dose/volume. Only one pharmacy carried liquid dilauded in 4mL. These two hours were awful. I felt as if my whole person was being shaken…every new metal screw in my jaws rattled with the road wear.

So far, I have been too concerned with pain management to worry about my new look. My precious three year old wouldn’t look at me at first, then warmed up, piling toy after toy on the bed, saying, “Here Mama, for when you feel better.” I did tear up when my precious 18 month old would not meet my eyes. I tired covering up the swollen parts, and saying her name softly, but she still looks away.

In a few days time, we’ll feel better. For now, I am glad to be home.

the lugs are on

2008-11-19T13:32:00.012-05:00

I wish I had kissed my husband more last night. I didn't realize just how strange these surgical lugs would feel.

Today's appointment with my OD was good. The entire staff was fabulous. Inquisitive, thoughtful, gentle, patient, encouraging. Lots of well wishes were exchanged. Though I was very apprehensive on Monday and Tuesday, I feel more excited today. It must be that fight-flight adrenaline rush I'm feeling....that and being covered in prayer by my dear friends & family.

This adjustment was THE most painful experience I can remember. Getting the lower wire in brought tears to my ears for several minutes. Why isn't torque a 4-letter word? See, we had to cut the wires out b/c of the crimps. The new wire is straight and this has to be hooked to my teeth before new crimps could be added. My mascara trail was more dramatic than I would have liked but what can you do except cry at a moment like that? The staff handled my pain well. Four people and 800 mg Advil later my mouth felt better.

I muttered that if I ever feel like not wearing my retainer in the future, I will remember this moment. Seriously.

Here are my teeth today before any changes were made. Crimps are visible (and coffee stains, too!)

Here is a picture of my naked teeth right before new steel wires & lugs were added.

Here is me grinning in the sunlight, cold air rushing through the lugs. 31 looks chic doesn't it? I have hundreds of thoughts to journal, but most of them don't belong on my blog. :) If I have time, I'll try to post some of them. Right now, my energy needs to go to laundry and household tasks before we leave town tonight.

Two bright spots to share.

First, my father called last night to wish me well. He's traveling for business through Asia, so when we saw his call from Taiwan we grabbed it quickly. Thanks Daddy for praying for me. You can never hear someone loves you too often! Second, I have dinner reservations tonight at the romantic restaurant where my husband and I had out first date. B, do you remember how I kept dropping my napkin so I could accidentally move my chair closer to yours?

Well, my husband will not likely post while I'm at the hospital. I should be back online in a week or so. Surgery tomorrow should take about 5.5 -6 hours. It is so strange to be in this moment.

Dr. Ferguson has recently framed his sermons in this context: what is God doing with you, right here, at this time, and in this place? For now, I can answer that He is keeping me under His banner.

And in that day there shall be a Root of Jesse,

Who shall stand as a banner to the people,

For the Gentiles shall seek Him,

and His resting place shall be glorious. - Isaiah 11:10

a shout out

2008-11-16T23:03:00.003-05:00

I want to give a giant shout out to my friend-of-a-friend Brooke who first sported a -cutest-blog-on-the-block background. You are such the trendsetter. Thank you for sharing this fun blogging tool with us orthognathic bloggers. :) - katherine in Columbia

Game on!

2008-11-16T22:50:00.003-05:00

My doctor decided to postpone the Saturday afternoon test until lunchtime Sunday. Phew, this morning was a bit rough but I'm glad I made it. Drum roll....my hemoglobin soared to 12.3 today according to my blood work.

I chewed on ice chips in the evenings. The small pumpkin spice latte Saturday morning was a very pleasant reprieve.

The headaches and wooziness weren't THAT bad. During Sunday school this morning I joked with a friend that "water is totally overrated". Of course, at any point I could have broken down and chugged a liter. It was never a dangerous situation - my physician monitored me about every 3 hours via interview. The nadir was my constant whining to my husband, "Honey, i'm thirsty...do you think I could grab a little glass of...?" I would not recommend this route to someone else, but I would repeat it if necessary.

Tomorrow I chat with the OS.

a reverse diet

2008-11-14T19:45:00.006-05:00

This week I can eat whatever but drink nothing. Next week, I'll be able to drink and eat nothing. SO Ironic. To prepare for my next round of bloodwork, my doctor has encouraged me to dehydrate my body. Uh-huh. Can you imagine my expression when I was told to avoid drinking anything or eating anything that is comprised of a lot of liquid, " for two days? It isn't that bad, though, now that day 1 has passed I am really thirsty. We had a lovely day of heavy thunderstorms, so unusual for November. All I wanted to do was sip a cuppa of joe (or maybe 5 cups!) and read. Instead, I added an extra gym class today to dehydrate. :)
My aim of course is to raise my iron levels past that 12.0 mark. The current plan is to test tomorrow evening at my local hospital. Monday I have the second pre-op and blood work appointment with my OS in Charleston.

Hope to have more good news to report.

*Ferritin - this was the additional test ordered with my last round of blood work. It measures the iron stored in tissues, I think. It came back positive.

blood work shows some improvement

2008-10-31T13:29:00.000-04:00

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

2008-10-25T14:37:00.000-04:00

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

2008-10-15T12:53:00.000-04:00

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

2008-10-10T20:38:00.000-04:00

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

2008-10-09T05:30:00.000-04:00

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

2008-10-07T14:42:00.000-04:00

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

2008-10-05T22:09:00.000-04:00

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

2008-10-05T21:58:00.000-04:00

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

2008-10-03T15:12:00.000-04:00

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!

1, 2, 3, jump!

2008-09-27T19:23:00.000-04:00

This has been a good week for my teeth. I saw my OD, who adjusted some upper wires, I think, to further pop out my front 2 teeth. He also crimped the lower wires on a back molar to help push it into proper place.

Each night around 3 am I have awoken to dental pain, and though not fierce enough to warrant pain meds, it is a constant ache.

In general, I'm a long term thinker, some might argue to the point of dysfunction. When my doubts plague much of my waking moments, it can be hard to remember that distant picture of health. At my last appintment, when I saw how well my molds fit together I almost cried. It was a tangible reminder that this difficult journey is all worth it. Yeah for molds!

Other good news to share? I chatted with my surgeon on Friday. He arranged to import my digital profile into the Dolphin software. We'll review it together at my pre-op appt on Oct 6th. I doubt I can put into words how amusing this discussion was. Here is my surgeon, giving me instructions for emailing him a photograph. It's just my face. I'm no beauty queen, it's totally legit, and I am an ultra-conservative kind a gal, but let's just say it was awkward.

Thank you Dr. C for accommodting my request.

I am really starting to grow excited about surgery. Finally! I feel some pressure to complete all those projects I assigned myself in August (what was I thinking?!), though no one but me will really notice. Also, the volunteer work I do has kicked into gear, and I'm finding it difficult to relinquish control over projects I've nurtured for a few months. It's been another opportunity to "die to self", that is, to let go of my prideful ambitions. It's easy to write that last sentence but terribly difficult to live it.

To close this post, I want to share an anecdote. My husband is the love of my life...so I asked him if he wants me to freeze some meals in advance. You know to help him while he nurses me and cares for our very active children. He said, "Nah, don't worry, you won't be able to eat much, and the children don't eat that much, I'll be fine, thanks." Now, my spouse is the sweetest, most noble, loving husband a girl could pray for, but I gave him one of "those looks". A look that said, "I don't care if you feed our toddlers pb&j for 2 weeks, but I will need F-O-O-D!"

Next week I am connecting with my inner Julia Child & our extra freezer. A girl has got to eat.

do I really need to stock up on Zip n Squeezes?

2008-09-24T16:02:00.000-04:00

I am getting my supplies in order this weekend, and wondering if I really need to order the ZnS. They sound really helpful, but could I live without them? What do y'all think?

On a related note, does anyone have extra jaw surgery stuff there willing to recycle? I'll be glad to reimburse you through pay pal or something.

Thanks in advance!

a great overview of Orthognathic surgery

2008-09-22T09:44:00.000-04:00

As my surgery quickly approaches, I'm re-reading the available medical articles on orthognathic surgery, specifically anything on "Class II + long face syndrome + Leforte". I am still uncertain how to predict & accept how the upper jaw surgery will change my face. This morning's google search turned up the following website. The pictures are quite clear, and provide an excellent overview of orthognathic surgery types.

http://reynoldsoralfacial.com/oral_surgery_loveland_co/rec_orthognathic_surgery.html

Be sure to scroll all the way down!

more tweaks

2008-09-16T20:27:00.000-04:00

A quick post to journal about my adjustment:

I am SO glad I scheduled an extra appointment with the OD. Today's 10 minute power chain exchange morphed into a 90 minute wire-bending party. Everything took so much longer than any of us had anticipated. I dashed out of the office at one point, retrieved my youngest toddler from a friend's house ( thank you dear Laura), and then sat her down in the chair with me for the last 30 minutes. The office staff absolutely dotted on my sweet Buttercup. Phew, my morning was completely shot, but at least my teeth are once again on the move.

Both steel wires were removed. New bends and such, new power chain, and a special something or other was added to widen my lower arch as much as is possible. It's painful but bearable. My OD also took a set of molds - and I may go in again next week for more tweaking.

I don't really understand why two weeks ago, the office was like, yeah, we'll see you in 5 weeks for your hooks, and now they are moving so much it translates to 1 appt a week. Oh, well.

At this point, I am ready for the whole orthodontic process to be over. That said, I'm not interested in postponing surgery. I'd rather wear braces for a year while pregnant than postpone that 3rd baby another six months....SweetPea needs another playmate to help her eat all that chocolate frosting. :)

It's also time I stop putting so much thought into my teeth. In the end, I'll become dust again no matter how perfect my bite is!

I am proud of my homemade birthday cake. I used a recipe from my grandmother's old Fannie Farmer cook book. It's a classic, with a torn binding and food spots throughout! SweetPea helped with each step, and based on the mess we created, I think she truly enjoyed her birthday.

My feelings are mixed. Today, I am once again apprehensive about surgery. After months of this self-focused jaw study, the good news, it that all I need to feel better is a glance at a bad picture. This one shows how my recessed chin follows me everywhere. Ha ha... I am immensely thankful that there is a re-/solution in the near future.

Dentofacial deformities

2008-09-07T14:06:00.000-04:00

taken from Correction of dentofacial deformities with orthognathic surgery: Outcome of treatment with special reference to costs, benefits and risks by Karin Panula

"2.3.1. Psychosocial profiles of patients and their expectations regarding orthognathic surgery

Orthognathic surgery is a complex process leading to changes in the appearance and functions of the dentofacial structures, including respiration, swallowing, speech and mastication. These alterations take place in a single moment during the operation in contrast to the traditional orthodontics in children, which produces small, gradual changes during growth. Thus, orthognathic surgery may seriously challenge the patient's capacity to adapt. This adaptation may be easier if the psychosocial indications and implications are thoroughly evaluated prior to any treatment and also during the presurgical phase. "

I have been talking up my forthcoming surgery to just about everyone I see. It's been theraputic, kinda, though I think my need to tell everyone is to control how they'll react to my new face. Perhaps the new me will not look that different. And then everyone will really think I am crazy!

Besides the physical aspects of jaw surgery, this quote often comes to mind when I perceive an expression that says, "So, what's the big deal? Why are you talking about that jaw stuff again?"

No one has actually said this to me. :)

Certainly, this journey has given me more compassion for others in a state of waiting. My single friends, who long to be married, must grow weary of the "you dating anyone?"question. My childless friends, who long to care for children, must grow weary of the "are you getting any help?" questions. We all have some needy area in our lives. My hope this week is that when I find myself wallowing in self pity (which, trust me, I can do with the best of 'em!) I will seek true comfort...and be open to provide comfort to others.

scary braces

2008-09-05T14:20:00.001-04:00

I think I scared off all my readers with the palin pic. I sure hope not...'cause while I was really psyched by her speech a week ago (though by no means blind to her weaknesses), this is still a blog about Babies and Braces. :)

Just spoke with my surgeon today. He listened to my concerns (again), and confirmed our dates are set for October. He was fine with the recent movements my ortho made to wires, bite, etc.

After some discussion, he explained why their office doesn't use the Dolphin imaging program to generate my new face. Don't have a server for it. Hmm. We brainstormed that the Ortho dept at MUSC, which does use this software, should be able to help us. We'll see. I know in the end it's the surgeon's hands I'm trusting, but I'd like one more peep at my proposed face. Of all the details of surgery this freaks me out the most.

Maybe it's better not to see the future? Maybe the future would freak me out more? When my hip bones rotated forward post baby girl #1, it was really weird. My pregnancy weight came off quickly, and one day I felt courageous enough to try on my skinny jeans. Surprise they fit, just not cross my hip bones. After another 9 months of body sculpting and nursing, I gave 'em to goodwill. They just didn't look the same as they had before la bambina.

And la bambina now? She turns three next week. Here is a snapshot of her on her way to the first day of preschool. I just had to dress her in my first sewing project...a very fine pair indeed.

Steel wires are back

2008-09-03T08:15:00.000-04:00

I had a good adjustment yesterday. New steel wires were placed on both U/Ls. My OD shaved the wires near my front two teeth to "pop them out". He also put an upper type wire on my lowers, trying to pull the back molars out to a wider arch. When the technician cut the back wires, I swore I heard a molar shatter...thankfully, it only felt like it did. I'm beginning to think "regular ol' plastic surgery" would be way better than what I've agreed to.

Beware anytime you hear the words "torque" and "molar" in the same sentence. Owieee!

I pushed for one more adjustment appointment before my surgical wires are placed, just to make sure everyone is on the same page. Too much has been arranged at this point to risk moving my surgery date again. :)

I snapped some pictures yesterday which show how my two jaws line up Before surgery. The persistent gap was much improved going into my appointment, but within minutes of my teeth being strapped onto the steel wires, it opened back up again. Argh...It's true what everyone says, it gets worse before it gets better.

Orthognathic surgery before & after

2008-09-02T10:48:00.001-04:00

This week I’ve been thinking A LOT about Before and After.

What will After look like? Feel like?

I have been pouring over the usual suspects (other blogs & archwired) to prepare for surgery. I named this blog Babies and Braces because that’s where I am right now. Most of my analogies link these two ideas. I feel just I did when I was 34 weeks pregnant with my first baby. Every physical sensation (i.e. chewing anything) reminds me that the Big Day is coming very soon. Excitement and anxiety collide in my waking thoughts. Just like reading birth stories helped me prepare for my labor, so has seeing others’ After photos. Thank you y'all for bravely posting your shots of swollen cheeks, bloody noses, and bizarre elastic configurations. Will I be as brave?

Here are links to a few of the Before & Afters I admired. (Of course, there are others, but I focused on the easy-to-navigate-pages for this post). If you have one to add to the list, please note it in the comments. I hope this will serve as a quick reference instead of scrolling through the yahoo group photos.

· Karl http://www.thisisjustwrong.com/
· Rachel http://breakrachelsface.blogspot.com/2008/08/one-woman-two-faces.html
· Kelsie http://orthognathicsx.blogspot.com/2007/03/looking-back.html
· Leah http://leahsjawsurgery.blogspot.com/2008/05/last-post-before-surgery.html
· Amie http://amiesjaw.blogspot.com/2008_07_01_archive.html
· Lisa http://s67.photobucket.com/albums/h287/npfieldhockey/jaw%20surgeries/?action=view&current=ca25e93b.pbw
· Tori http://www.archwired.com/phpbb2/viewtopic.php?t=27353&postdays=0&postorder=asc&start=15
· Arvensis http://www.archwired.com/phpbb2/viewtopic.php?t=27529&highlight=pics

small bites

2008-08-19T14:35:00.000-04:00

This week, my teeth are moving in baby steps, but as any braces wearer will confirm, a little change goes a long way. My bite now fits together in two different spots. The only way to describe it is that I'm beginning to "sense" what my final bite will be. If I push my lower jaw forward, the right side matches up. If I push my jaw & correct the asymmetry, then the left side matches.

It's exciting to feel movement and confirm that postponing surgery was a good thing. Overall, I feel general dental achiness shifting from tooth to tooth, plus some jaw pain and headaches through the day. I think the latter two symptoms come from clenching my jaw (especially when I try to pull my lips together).

Saturday I took the children to hear Lunch Money perform at our library. Marvelous outing. Though I couldn't eat any of the free popcorn, watching the children boogie to the music while wearing balloon critters was too cute. Rock on.

committment to loveliness

2008-08-08T13:48:00.001-04:00

I have enjoyed reading Emma's posts, and so am adding some loveliness to our little household. My talents do not lie in the creative realm, but, my, how I have relished an outlet for homemaking crafts. Here is what I've been working on in July:

my first sewing project --reversible sister dresses - the tortoise shell buttons SO make the dress!

adding a fancy trim (discovered at $2/yd!!!!!) to our powder room shower curtain - I love how the trim ties the damask paper and silk fabric together

decorating the wall murals in our playroom with construction paper and elmer's

My next goal is to jazz up our den with some fancy pillows. It has only taken 14 library books, 6 trips to fabric stores, and my collection House Beautiful and Southern Accents mags to get started! Postponing my surgery date has had some benefits. :)

random thoughts

2008-08-07T17:28:00.000-04:00

It's raining and thundering right now, dinner is on the stove, my children are hanging out with my husband while I catch a few minutes rest. It's been a busy day, a good day - I must be nesting in prep for surgery b/c I actually got excited cleaning today - even the baseboards and door frames sparkle.

For some reason, though, I feel insecure today about the whole surgery experience. Could it just be pms? :)

I've been daydreaming about changing surgeons, and returning to the swanky private practice in NC. Dr. T was amazing, and everyone has heard of him, but no one really knows my surgeon in SC. I know I have been through all these thoughts before. Perhaps it's time to call my surgeon for some reassurance. You know, at least share my concerns, etc. He's pretty cool.

I had a 20 minute og/gyn surgery two weeks ago and that alone has sent 11 separate bills for anesthesia charges. Though it's all to be covered by my insurance...cannot imagine how complicated jaw surgery will be.

It's is soooo good to have a place to jot down my concerns. I can tell my friends are already WAY BORED with jaw surgery stuff, and the fun hasn't really begun yet.

A first place finish

2008-08-04T11:58:00.000-04:00

My braces made a sparkly debut at this year's Rockville Regatta. I felt right at home on Saturday night, when we danced, beach music style, amoung the Lowcountry's hippest teens, except these kids were all OUT of braces. Since my lips will no longer really close over the brackets, I decided to spend the whole weekend smiling.

I am so proud of my hubby who earned first place in his boat class! He is in the boat on the right of our dock. Go B. go!

Pho good!

2008-07-31T14:28:00.000-04:00

Our town now hosts its very own Pho restaurant. My family and I ate at Pho Viet the other night, and boy it was yummy. Beef broth full of nutrients, easy on the braces noodles, fresh veggies, clean highchairs, hip techno dance music (well, I liked it!), and mango fruit shake for dessert. They offer bubble and jelly pearl drinks, too.

My husband smiled at me over our bowls of steaming broth. He said this was my kind of spot. So right!

You know, you can take the girl out of the city but you can't take the city out of the girl.

new brackets

2008-07-31T14:14:00.000-04:00

Yesterday I went to the ortho for a checkup. Overall, a good appointment. A lot of little adjustments were made.

Two brackets were moved. One on my front right tooth, and the other on my right back molar, #7.
New power chain on the lower.
New metal ties on the upper.
Upper wire changed from square steel wires to flexible nickel-titanium.

The front tooth was polished, and you can notice the slightly brighter shade of enamel under the new bracket. Yeah, my teeth are still normal under all that metal.

Phew, not eating much since. My latest way to decide if it's been a good visit to the ortho? If I am limited to protein shakes and instant mashed potatoes. I'm becoming quite the connoisseur; today's flavor was "Four Cheeses.

A postponement

2008-07-28T14:44:00.000-04:00

All parties have decided to postpone my surgery until mid October. I have mixed feelings on this. A later date provides the persistent gaps time to be resolved, gives me additional time to arrange childcare & to plan out my liquid diet using the fabulous new blog, Jaw Dropping Blends. The delay also postpones my plans for another baby several more months. I so wanted to be pregnant by November/December. :(

There’s always a silver lining…and mine is that I can extend my time nursing sweet little Buttercup. She’s nursing about once per day, and now that we can nurse for another two months, I’m glad I didn’t rush her to wean in July as I had originally planned. Saturday, I chatted with a friend whose baby is due in October. She talked about her plans for the next 10 weeks, and I realized, jaw surgery was kind of like having a baby. You wait, and read, and wait some more, and dream, and wait, then ka-boom, you find yourself at 3:18 am wondering when life will “feel normal” again. Too bad those handy zip-n-squeeze bags can’t making infant cooing sounds.

The whole postponement situation got me thinking. Think of all the fun projects that can be completed in 10 weeks! I maxed out my library card with books on sewing pillows, slipcovers (why not try something really useful?), no-chew cookbooks, children’s crafts, and decorating ideas. I filled up two notebook pages with “to do” ideas!

$100 molds

2008-07-17T07:28:00.000-04:00

Here is a quick update while I feed the children breakfast. Yesterday's appointment went very well and I feel good about the surgeons. The chief resident and the attending surgeon spent 3 HOURS with me. The two Drs. answered all my questions. Their plan:

impact my upper jaw, reducing my gummy smile by about 4mm.
based on how much this swings my lower forward, move my lower jaw forward with BSSO, for a total movement of 4-6 mm.
no decison yet on chin, waiting for final calculations from mold manipulations

Sadly, there was a mix up with the front desk and the big History & Physical + blood work appointment was postponed for another day.

It cost me about $100 in babysitting, plus gas and food, plus a day of my husband's sick leave to take the molds. Of course, finally feeling comfortable with the surgical team was "priceless"! :)

I smiled big when my husband looked at the chief resident, and said, "Well, Dr.C, I'm putting my wife in your hands."

The bigger surprise is the apparent confusion over who is determining that my teeth are ready. Ortho thinks the surgeon is pushing for late August, surgeon thinks the ortho is pushing for late August. It all started when I asked if we cold move forward in late summer and everyone said yes. Hmm. So hopefully, the two parties will sort this out soon. My teeth feel like they're still moving slightly, and while I was really, really looking forward to getting this all over with, I completely understand a little patience now will result in a much better result.

My little beauties are both running fevers today and are now wholly covered in yogurt and smooshed blueberries :) ...off to take care of them!

an Afrin high and other news

2008-07-15T19:57:00.000-04:00

My, my. I feel very content right now. My 2.5 year old and I met with a great ENT this afternoon. It was very good news all around. The best news is that my precious daughter received a clean bill of health. I am soooo grateful! I was concerned she is becoming a mouth breather, and while he didn't argue with my observations, he confirmed that there is no medical reason for her to do so. Yeah! We're encouraged to monitor her eating/drinking, to see if she can chew with her lips closed, and to keep an eye on any halitosis developing.

He said my mouth breathing is probably due to my inflamed turbinates, large tonsils, and a deviated septum....but that at this time he does rec'd surgery to fix any of these. I am going to try some a steroid nasal spray and see what it does. Boy, the Afrin he sprayed to see up my nose r-e-a-l-l-y opened things up. I am still taking deep nasal breaths several hours later! This is the "breathing high" that my yoga/weights instructor has been talking about. :)

Guess what else I observed in the waiting room? (Since we waited for over an hour, I had plenty of time to people watch while I distracted my toddler.) More than half the people had underdeveloped lower jaws. Is that not crazy?!

The ENT is a close family friend, in fact his daughter is babysitting for me tomorrow while my husband and I drive to Charleston for the big pre -op work up, which meant that I felt completely comfortable today. So, when he offered that he thought jaw surgery would improve my breathing, and that in his medical opinion it was the right thing to do, I was ELATED. He thinks moving my lower jaw forward will help move my tongue forward as well. Hmm. Is my ortho going to like that I wonder?

Oooo, I am almost giddy with thoughts of tomorrow. In my mind, it's a make it or break it appt. If I still feel uncomfortable with the surgeons, then I am sooo finding another doctor! I'll try to make a rational decision, of course, but that's is my 100% emotional conclusion. :)

Sings of slow healing?

2008-07-11T14:57:00.000-04:00

I am growing concerned that my body is a "slow healer". The morning after my molds were taken, so two days ago, these ugly blisters popped up and almost glued my lips shut. For two mornings now I have cautiously worked my lips apart, the blistering skins fall off, and they burn. Disgusting, no? Does anyone else suffer with these? I have NEVER had a fever blister. My theory is that my lips overstretched during the game of tug-o-war unsticking molds. The ortho tech said my lips have an unusually small opening/stretching ability...and I can't help but think this and my OB experiences are related. No stretch = big tear. Hmmm. I healed well after both of my deliveries but s-l-o-w-l-y, and only really got my energy back when I followed my midwife's advice for two weeks of bedrest.

When I saw these little blisters on my lips, I shuddered knowing that I will likely be a slow healer. Ahhh, I don't feel discouraged so much as I feel frustrated that my body won't do as I say. For now, I am checking my vitamins for proper dosages of C, B12, iron, and folate, eating as well as I can, and trying to stay rested.

back home

2008-07-10T07:09:00.000-04:00

I had a grand time with my family. The children adore the water, my husband repaired a lovely old sailboat in time for our local regatta, and my brothers joked around just like the summers of our childhood. Marvelous memories all around. Here is a pic of some local sea island heirloom tomoatoes. Surprisingly, few others liked 'em, so I gobbled as many of them as I could. Another surprise was the evening my dear father listened intently as I explained why I was having jaw surgery. My family doesn't quite "get it", but I love that they're trying so hard. :)

As soon as I returned home, I began catching up on what everyone is doing. Hopefully, this weekend I can post some comments. This week is full of doctor's appointments, and a million calls to find childcare for each of the appts. Phew! Which reminds me of how much I need to begin planning for childcare help for the extended post-surgery recovery. My DH will take off 2 weeks, a real luxury, I know, but I sense I'll need help for a few weeks after that.

Wendesday, I had another excellent ortho appointment. I finally understand how to best work with the office staff. We took molds, which wasn't that bad, except when the lower mold refused to budge. ooooh, for a few minutes I swore my teeth were going to opo out! The tech was super sweet. Her goal was to have the molds come out so well that my oral sureon will not try to take molds next week during my pre-op visit. Next, my lower wires were changed from 62s to 60s, I think, and new power chains placed.

The ortho also crimped my wires in several places to work on those slow moving areas. One front tooth remains pulled in and the lower gaps are persitent. Ouch! It was uncomfortable at first, and within about 2 hours pretty painful. This morning, my mouth still aches intensely. I am actually kinda exicted, though, my teeth are finally moving again. :)

We discussed his concerns about surgery and my switch to a teaching hospital. This time he was positive. Good, I needed some encouragement. His additional advice struck me as Very Important.

Ask for the smallest splint possible, this will protect my bite and reduce an open bite problem after surgery.
When I asked about possible changes to my nose, he said be sure to ask for a VY closure or something, this helps keeps the tip of the nose from tipping up.

Gotta research these and work on my list of questions before next week's appt.

On a personal note, my emotions regarding surgey have been all over the place recently. One day I am fine, the next consumed with worry - about the surgeon, the swelling, you name it. Reading the great ortho blogs since we returned from vacation has really helped. And Archwired's forums are good, too. My dream? To be as carefree about surgery as my daughters were when this photo was taken .

results from my adjustment

2008-06-19T13:58:00.000-04:00

(from Tuesday)
Had a great visit to the ortho this week. We were going to take molds this week, but decided to wait for my gaps to finish closing. It was heavenly to brush and floss without wires! I was making so many noises of joy that the 8-yr brushing next to me gave me a strange look. Who knew getting gunk out from between my back molar bands could bring such happiness?

My next appointment is July 9th, right after a family vacation. The ortho will take molds and we'll set a surgery date.

I kept the same wires but they ortho added a metal twist under my two front teeth to help bring them out. Great news. These teeth did not move much at all over the last month.

Wednesday - my teeth have ached for almost 48 hours now. No more wight loss, though, since I remembered how comforting cookie dough can be! I remind myself that each bolt of pain is progress. The constant discomfort definitly makes me less patient with my small children. Poor dears.

Addendum - This morning, my surgeon called and I have a date. Woo hoo! I am growing more nervous as the day passes, but I am thrilled. I'll go down to Charleston (100 miles away) on July 16th to have surgical molds taken, and then the big show is set for August 26th. So many family decisions are depending on having a date set - a giant hug of appreciation to my husband for his patience in all this. With dates in hand I can begin arranging for child care.

summertime

2008-06-17T13:28:00.000-04:00

My youngest is teething (finally) and woke me up at 4:15 today. Instead of reaching for another cup of joe, I decided looking at some favorite pictures would perk me up until supper time.

Here is a fun snapshot of my oldest playing in the pool with my brother.

celery cheeks

2008-06-16T13:12:00.000-04:00

I am waiting for an adjustment tomorrow after my first month with power chains. The space in my lower teeth seems pretty persistent, though the constant-but-different teeth aches over the last 2 weeks encourage me that something is going on. :)

The lack of a surgery date has not kept me from dreaming about jaw surgery. It's weird how it's taken over my dreams lately. The inside of my mouth has lots of tender spots from I guess, night time "chewing". When I slide my tongue inside my cheeks, it feels like a piece of celery, with all its' tiny ridges.

A good thing about my gray power chains is that they don't stain as badly as the ligs did. For my birthday last week, DH and I ate fabulous Korean curries, drank red wine, and split a decadent dessert & coffee, without any telling dental signs!

My toddlers are in their first swim lesson this week, which means I'm skipping my exercise classes and pretending to be a teenager again. Where did those long summers at the pool go?

jaws are all around you!

2008-06-07T22:06:00.000-04:00

Now that I am on this jaw surgery journey, I notice folks with jaw problems everywhere. I mean it. Kinda like when I was pregnant with my first baby and, kaboom, there were pregnant ladies all around me. :)

Sometimes this amuses me and other times it disturbs me. The other night I ran to the grocery store after the kids were in bed. On almost every aisle another shopper and I stumbled into each other. This woman had kind eyes, a bit tired, and smiled each time we passed. What struck me though was how far her lips hung from her mouth. Her lower jaw was so recessed that her lips appeared to be spilling off her face.

I fought the urge to give her a giant hug and pester her with questions. Had she struggled to breath through her nose, too? Did she have headaches? Had her jaw recessed more over time or was it always like that? She was middle aged, so I also wondered if she'd considered surgery or over time accepted her situation. Of course, there was NO WAY I would ever actually speak those thoughts to her. And situation isn't the right word, but you know what I'm trying to say. As I paid for my groceries, she pulled in line behind me and I snuck another glance. I thought, "Wow, I am really blessed. My lips can meet if I pull 'em with all my might." As I drove out of the parking lot, her car stopped behind mine at the traffic signal. It was really weird.

Reading about Leah's, Holly's and Heather's recent experiences has helped me grow more comfortable with the idea of surgery and all. And yet I still fret about how other people will react to me after the fact. I wonder how others will judge my decision - maybe because I struggle with judgment in my own heart?

The other jaw stuff on my mind has been a renewed interest in mouth breathing. I am slowly solving the riddle about my "long face syndrome". More on this later...

Thanks

2008-06-02T21:31:00.000-04:00

Hi everyone,

I am breaking from my usual journal format to send a hearty THANKS to each of you who have shared an encouraging word or a helpful comment. Your thoughts have really meant a lot to me. They have helped me find perspective on what can be a highly subjective experience.

We are celebrating my youngest daughter's first birthday this week, and I decided to make a photo collage with one photo from each month of the past year. It is amazing to see just how fast time passes. Even though each day brings a slightly new dental discovery, all in all, the last four months have fluttered past as I went about my usual routines. The photographs made me smile, albeit with melancholy for the passing of such a sweet, sweet time. You readers with children know just what I'm talking about. :)

My self esteem is in a better place today, and as I scanned through hundreds of photographs, a couple of thoughts struck me:

I miss not having braces, but am sooooooo glad I'm finally got 'em!

when I smile with sincerity, my jaw problems are way less noticeable!

life is too short for me to take myself as seriously as I have been!

So I just wanted to say merci beaucoup - grazie - gracias - danke to everyone. Let's smile!

Good news to report

2008-05-29T07:32:00.000-04:00

Several positive developments over the last week have really cheered me up.

First, I finally have my powerchains in place. Hopefully, these will close the gaps in my lower teeth. The first 4-5 days were uncomfortable but manageable. Because my lower jaw is asymmetrical, I think the tooth that is in the center of the jaw serves a fulcrum. Most days it feels like the tooth is falling out of my mouth. Strange. Can you see the midlines in this pic? I think they're improving slightly. My two center upper teeth are unfolding also, broadening my smile. All in all positive steps forward!

Second, I spoke with the chief resident down in Charleston. It took 6 calls with messages before a real nurse manager came on the line. When I explained all I wanted was to know the "next steps", she put the resident on the line. I was thrilled to hear Dr. C's voice. He confirmed that his office had wisely copied all my files during that initial visit in April, so the ball is in their court. Dr. C is super nice. When on the verge of tears I told him I'd gladly trade some IQ points for a normal jaw, he chuckled and offered some much needed encouragement. :) I feel better about having him assist Dr.T.

Drum roll please.......the big news is Dr.C gave me a tentative date for mid-to-late August!

This may be pushed back - it seems like my teeth are creeping along - but having a date allowed me to finalize some summer plans. Yes to one family trip; no to the other. Knowing I have at least 12 more weeks to surgery has motivated me to make some other summer arrangements. I found a wonderful woman to care for my children one day a week. In turn, this means I can follow through on some much-anticipated projects! I have enrolled in a smocking class and a beginners' sewing dress construction class. Also, I have set aside time to finish some genealogy research.

Third, we spent the weekend down on the coast, at my favorite place in the world. Many happy childhood memories flooded my thoughts. To share this place with my own children and some good friends was just marvelous! The view from the front porch is amazing.

Fourth, my children have been especially well-behaved. My toddler has taken to imitating her music teacher (she attended a little mother's morning out program this past year). It is adorable! "Sweetpea" lines up her chairs, sets a doll in each one, and then begins reading and singing to them. Little sister "Buttercup" plays along rather nicely. My husband snapped this pic of us one afternoon as I reviewed animal sounds with the baby. Aren't the two little heads adorable?

Fifth, yesterday was a super day all around. It began with a visit to the dentist for a 3 month cleaning. Praise God for another healthy checkup! The dentist power washed my teeth using a baking soda spray. It turns out my dentist Dr. Kevin studied with Dr. T in dental school. Lots of good discussion yesterday on post-surgery hygiene. My teeth felt lovely all afternoon. I followed that appointment by a much needed haircut. After an inspirational trip to the grocery store, my family enjoyed their first three-course meal in sometime. The evening ended with a sweet coffee date with a good friend. Are you reading this MB? :) Her affectionate humor and sensitive questions wrapped me up like a giant hug. :) Thank you MB!

just for fun

2008-05-15T20:55:00.000-04:00

I am sorry my last post sounded melodramatic. Too much time spent obsessing over all things orthodontic, I guess. There are a thousands of things to be thankful for, and many more aspects of living that make me smile...sometimes I forget to share the lighter side of my life.

My 2 1/2 year old firecracker suggested we pull out our crayons this morning. Who knew coloring could cheer me up?

Second surgical consultation

2008-05-11T14:40:00.000-04:00

It’s been a two weeks since my consult with a second surgeon in Charleston (also named Dr. T, go figure). I needed some time after the shock of that appointment to process everything. I felt like tiny sand crystal along a wide beach. Poor directions, an impolite receptionist, a thirty minute wait, several bewildered residents, then a stoic resident, and finally…the attending surgeon. There was some kind of confusion about who had my chart, but once they found it, and all four surgeons were in the examination room, we were in business!

On a positive note, the team spent twice the time with me as the private practice Dr. T.

Here are some of the more memorable quotes:
*** “Look, see this? And this? She’s a classic long face syndrome”
*** “I saw it as soon as I walked in…” (I sat at the end of a long, narrow room that did look like a storage closet)
*** “yeah, yeah, these things usually go together” (during a discussion of my large tonsils, constant state of minor congestion, headaches, underdeveloped lower jaw, and overdeveloped upper jaw).

My primary goals for the appointment were to receive a second opinion, to decide whether to not to have my upper jaw moved, and to select a surgeon. The first two questions have been addressed. I’ve decided to definitely go for the BSSO, to move my mandible forward. Dr. T also recommended a Lefort to address the gumminess in my smile. My initial consult recommended the Lefort, and now that the initial shock has passed, I am more receptive to the idea. If I am going to go for surgery, why not fix it all at once?

Now I need to choose who will perform the surgery.

Both surgeons are located 100 miles from my city. Because Dr. T in Charleston bills through an in-network teaching hospital, my out-of-pocket costs would be low. While I am confident in Dr. M.T’s technical ability, my patient experience at the teaching hospital was mediocre at best. How important is a good bedside manner? Is it worth paying more out of pocket? How did y’all decide which surgeon to go with?

I must not have sounded very confident about surgery because Dr. T. spent a lot of time explaining that I must decide about surgery in order that my orthodontist could develop a course of action. I said I had, rather it was deciding whether or not to move my maxilla that distressed me. At this point my goals are to create a normal, balanced profile, to protect my teeth from the rough wear & tear of misalignment, and to improve my breathing. Aesthetics motivate me, too. Now that I understand the important role of a good bite and good breathing, I am ready to do take action on a long-standing to desire to “fix my profile”.

Thankfully, I brought copies of Dr.T in Charlotte’s assessment, and the Charleston team of surgeons agreed 100% with his diagnosis. Good news, sort of. I think I was still hoping at this point someone might convince me I didn’t really need surgery. Anyway, the team was utterly confused why I was there if I’d already seen Dr.T; It is his textbook that these guys all studied.

So, I explained how my husband and I wanted more children, and how our medical insurance factored into that decision. Every one of those residents thought I was loony to want more children, and seemed totally confused why this would be a factor. Umph. By this point, I was upset. I was not just some “long face syndrome” case study in the chair, but an individual.

The last five minutes of the appointment were pretty interesting. The team decided to take fresh x-rays, and the incoming chief resident showed me how to bite while relaxing my jaw/facial muscles. Wow…this was really hard to do. I had no idea I tense so many muscles in order to bite, smile, talk, etc. Anyway, when the attending surgeon and chief resident examined the films in front of me, I noticed just how far apart my lips are when my face is truly relaxed. Wow again….it was hard to fight back my tears at that point. You know, the awareness that I had worked for so long to make my lips meet – the whole time thinking, “If only I tried harder…!

You may be thinking, ok, what’s the big deal? Well, two thoughts struck me then. First, no matter how hard I had been trying to modify my behavior, my lips were not going to meet on their own. I am kinda sensitive about being a mouth breather. I mean, for years I have believed this to be a huge personal weakness. Look around the room sometime, and yep, almost everyone else can close their mouth naturally. Not me. Second, I am now aware that all those “strange smile” photos over the years were actually snapped with me trying to pull my lips over my teeth! This also makes me want to cry because it means that while I thought the facial expression was an occasional thing, if I am constantly pulling my lips, then it is actually a constant expression. Yikes!

I looked over some photo albums and found a sample shots. Easier than I thought...

Lip incompetence is not a huge hardship, I know. :)

The closing hymn this morning was von Schlegel’s 1752 hit, Be Still My Soul, a beautiful hymn that brought me much comfort. Here is the poetic beginning:

Be still, my soul: the Lord is on thy side.

Bear patiently the cross of grief or pain.

Leave to thy God to order and provide;

In every change, He faithful will remain.

Be still, my soul: thy best, thy heavenly Friend

Through thorny ways leads to a joyful end.

Things are moving - 3 months in braces

2008-04-22T07:06:00.000-04:00

Waiting continues to be challenging. I needed some encouragement this past week, so I reviewed my teeth photos. Golly, it is fantastic to see my smile changing.

Here is my initial smile in late January & now in late April:

Here are my upper arches:

Here are my lower arches:

Lastly, here is a view of my bite:

In some ways, having braces is no big deal. Most of our family activities have continued unchanged. Friends no longer comment on them and most strangers ignore them. At other times, I am constantly aware of my braces. Every sip of coffee and bite of curry - note the yellow staining in my recent pics - is a calculated action.

Braces have revealed (to me at least) my own vanity. I'm thrilled to be fixing my teeth, but in a strange way, changing one attribute has made me acutely aware of other attributes. Attributes I'm not going to change, such as the shape of my nose, or my hair texture, or how different 30 feels from 20. In general, I feel better than I did 10 years ago but sometimes I think I'm way too self-critical.

spring is in the air

2008-04-09T17:52:00.000-04:00

Ah, the glorious days of spring are in full bloom here in SC. April and October are my favorite months, so, I took an hour during "joint nap time" today to jump in the yard and prune my flowering shrubs. The hour today was as good for the yard as for my spirits. :)

The previous owners built our house about 25 years ago. Little treasures pop up now and then. I found this sweet little daisy tucked in beside a cheery tree. The tulip is from a dinner party we threw on Friday. Much sweeter than the plumbing fiasco with lead to this newly renovated master bath.

This month, I have about 4 weeks between adjustments. No big ortho news to share, really. Things are moving around. My pain is minimal - praise! - and I am eating most of my favorite foods. Teeth movement is localized to my back molars and my lower front teeth. There is a small space that continues to open, then all the lower teeth shift out, closing the space, and then my mouth repeats that action. Over and over. It feels strange, but must be progress?

I am in a hold pattern regarding surgery until my appointment with a new surgeon on 4.28.08. In the interim, I'm researching both doctors. And praying consistently, too.

My babies are growing so fast! Our youngest, buttercup, is really not a baby anymore, making our nursing moments that much sweeter. Here is my latest snapshot of her, which I like because it reveals her gentle dispostion.

an update on surgery

2008-03-30T13:57:00.000-04:00

Here is an update on my surgery timeline. Thank y’all for your encouragement regarding a previous post. I’m beginning to embrace the idea of orthognathic surgery. This post is focused on the practical side of things, but I also have some thoughts on how my decision affects my family. I think a lot of us struggle with this. More on this later.

After each uncomfortable adjustment, I yearn more for an established timeline. It seems like so many decisions in my near future hinge on surgery plans.

· Another baby - my husband and I are ready to welcome another child into our family. The longer I postpone surgery, the longer we wait on this. I really like the spacing between my first two children (21 months). My body has finally recovered fully and other family items are in order.
· Family vacations – there are some neat opportunities to meet up with extended family this summer. Until we have a better idea about surgery, we can’t commit to spending savings or vacation days. My husband has offered to stay at home with me & the children post surgery for two weeks.
· A new car - we’re ready to purchase a family car, though I think we can delay this purchase until our next child is on the way. With each month that passes, I have to adjust my formula for investing in our current automobiles, planning trips, etc.
· Remodeling our house – like most folks, we have a long list of “someday…” house projects. :)

The good news is that my teeth should be ready by late July/early August. Remember how excited I was to be classified as medically necessary? Well, because there are not any oral surgeons in my insurance carrier’s network, I discovered I’d have to pay about 85-100% of surgery services out of pocket. Ouch! There is one oral surgeon in the state who bills through a hospital, which means I could cap out my expenses at the hospital max. This fee is more reasonable but would still require a significant sacrifice.

I have an appt with Dr. T in SC in late April. I feel like I’m cheating on Dr T in NC. I am finally comfortable with the idea of him performing surgery. And his office staff is great, too. If necessary, I’ll consider working with an oral surgeon in a nearby state. We’ll see. Open enrollment for insurance plans is mid-November. By then I will have reached a decision. In the meantime, my husband has most graciously listened to me evaluate the possible scenarios ad nauseum, listed here in my preferred ranking:

**have surgery in mid August, try for baby #3 in the November, buy a family car in January
change ins. plans in November,
**have surgery in spring ’09, try for baby #3 in summer ’09
try for baby #3 now, buy family car in fall
**change plans in November, have surgery in summer ’09 (though this might mean weaning baby #3 early…)
**don’t have surgery

It is an excellent opportunity to for me to rely on God. Perhaps I'll be blessed with an open door/closed door moment. Even if I don’t have a clear answer on a decision, I know that I can trust His character. If I keep my heart focused on Him, then I'm confident I will act within His will.

spacers

2008-03-29T22:46:00.000-04:00

My ortho put in spacers about 10 days ago. They were as annoying as I’d feared, but after a week the discomfort disappeared. Then bands were put on my two crowns and one large amalgam. Oooh, they feel strange. My teeth shifted from touching on my right side to the left side. Overall, I’m pleased with the improvements.

This is my lower arch at 3 months in braces. The bend in the midline has smoothed out and spaces are closing up. My lower incisors feel like they need to rotate a bit more.

This is my loweer arch right after my braces were banded.

I never imagined that getting braces would improve my figure. My thoughts had been so focused on changes to my teeth that I forgot that not being able to chew *could* be a good thing. Before anyone reading this grows alarmed, I am not developing a disorder. Rather, I am enjoying the one plus of constant teeth aches – weight loss!

I am learning some new recipes here, but I find that during most meals, I loose interest in struggling to chew and stop eating. Oh, and snacking with my toddler has lost its appeal too. Making fruit shakes in the afternoon does seem to help. And my 2 1/2 year old "sweetpea" still thinks it's a treat when I spike our shakes with good-for-her cod liver oil. :)

What does this really mean to me? I ordered this swimsuit from Lands end. The built in under wire and swim skirt make me immensely happy. For the last three summers, I’ve worn really ill-fitting suits because I couldn’t find a decent suit. Why do maternity suits scream hoochie mama? Anyway, now that “buttercup” is 10 months old, I can finally pack away my frumpy clothes. Besides the wonders of braces, my swimsuit ready person would like to thank my exercise instructor, Anna Benson. Anna teaches a fabulous fusion class at my church. For the first time in many years, I am looking forward to wearing a bathing suit.

**p.s. - at my banding appintment, I was able to brush sans ligs, wires and all. Such a great feeling!

the original diagnosis

2008-03-13T21:17:00.000-04:00

Thank you Google! I discovered my scanner stopped working because I updated IE to v.7 last week. A few downloads later and we're back in business. Here is my original x-ray and diagnosis from Oct 2000. Sorry the scan quality is not better.

Xray pics

2008-03-13T15:08:00.001-04:00

For inquiring minds and to help me record my progress, I decided to post my head scan and panarex shots. If I can fix my broken scanner, I'll post a panarex pic from 2000. It's pretty cool to see these side by side.

"It's medically necessary"

2008-03-13T14:43:00.000-04:00

...the official word from my health insurance. This is wonderful news!

To prepare myself for the idea of surgery, I have been utterly immersed in orthognathic blogs and adult braces websites. Thank you to everyone who's shared their experiences.

The library nerd has struck again! I checked out my surgeon's oral surgery textbook. Much appreciation goes to Diane at our local library who helped me track down a copy. The book contained an immense amount of information. The photographs were shocking, though not at all what I had expected. For instance, a Lefort surgery depicted a man who had his face attacked by a chainsaw. Ouch! My own possible surgery pales in comparison.

I do wish it weren't such a complicated decision. Deciding to buy our first home was so much easier. Though I'll need to re-certify every 90 days, I am thrilled with the good news this week.

More thoughts on orthognathic surgery

2008-02-28T06:45:00.000-05:00

One day I am all for it and the next plagued by doubt. I’m still waiting to her back from my insurance company. Many hours spent on the phone this week. The oral surgeon’s office has been extremely helpful (as you’d expect) and has resubmitted my pre-certification request as an inpatient operation after insurance denied the outpatient procedure. The fees are truly mind boggling.

I am frustrated by the well-intentioned people who tell me I am fine just the way I am. If I felt fine about my teeth, I wouldn’t be spending so much money and volunteering for daily pain. About 99% of them wore braces as children. Their bite is healthy, their teeth are straight, and they don’t get headaches and such. Their lips touch when they close their mouth. I’m struggling to find a good analogy when this topic arises. Orthognathic surgery is different than having my tummy tucked. I asked someone recently to imagine if they were still “wearing” the teeth they were born with. That kind of helped them see my point!

This question woke me up today: if I correct my jaw alignment and our daughters inherit the very same recessed chin and gummy smile, will they grow to think I don’t accept them as they are? They are lovely girls. I hope they won't need to go through all this. As I type, it's 5:30 am and my two year old daughter, who rises early, sings hymns next to me and reads her little children’s Bible. It reminds me what’s really important. I’ll continue to pray about the decision.

First adjustment

2008-02-28T06:40:00.000-05:00

It was very anticlimactic. I had been a little concerned about having spacers put in; this was postponed until next month. Several metal ties were placed to close in gaps created after my initial banding. Ouch, I felt like my teeth were twisting out of my mouth. Let me just say how wonderful braces have been for my flossing routine – now there is enough space to actually clean between my teeth. Oh, and new ligatures rock. Yeah!

My orthodontist, Dr. B, looked at my mouth for about 30 seconds. Then I spoke up and said, “Wait, I have a few questions!” I wanted to discuss the oral surgeon’s notes, to talk about Dr. T’s textbook (which I tracked down through inter library loan), and get a sense of my timeline. Well, everyone was pleasant but I could tell they were ready to go home. My entire appointment lasted about 10 minutes. I hope the rushed treatment was due to the time of day and not to the fact that I was now locked into treatment. Everyone was so accommodating during my previous two appointments. My mouth is sore enough that it woke me up this morning but not nearly as bad as before. Thank goodness.

initial surgical consultation

2008-02-22T14:29:00.000-05:00

The visit to Dr. T’s office was great. I live about 100 miles south of his office, so getting there took some real effort. My dear husband offered to take a half day off to stay at home with our children. This was especially nice for them – the baby really needs her long morning nap and our toddler loved the extra time with her “Papa”.

I was terribly nervous throughout the entire visit. I arrived about 30 minutes early and flipped through the pages of People magazine. This was a terrible idea! My usual magazines are the Economist, National Review, House Beautiful and when I can find it, Southern Accents. I don’t usually read People or US. That day reminded me why. It was difficult to feel confident when it seemed like everyone in the office was examining my teeth. Seeing glamorous stars with perfect everything just made it all worse.

When Dr. T asked me what I wanted to correct, I tried to describe the complex feelings I have about my mouth. His bedside manner was delightful. He asked clarifying questions without prying. Next, he took some photographs of my teeth & jaw profile. We had to take several…it turns out I subconsciously pull my lips over my overbite. My lips don't really meet! I’ ve since read other bloggers who say they do the same things. It’s good to know I am not the only one. A special thanks are in order to all of you who have posted pics of your “before” photos. They have really encouraged me.

After much discussion, Dr. T recommended I have upper and lower surgery. Next, we discussed these two procedures in more detail. He merged my photo with the software – my “new” face stared back at me. When I kinda freaked out about the upper surgery, he said something like, “well, I think we can achieve about 90% of the results with about 60 % of the surgery…doing lower surgery only is okay.” He remarked that as my face ages, my upper lip will cover some of my upper gums. I guess this is good news? So far, my chin is okay. No need to do genio.

The most interesting thing I learned is that my panoramic x-ray revealed my jaw bones had shifted “significantly” in the past few years. It is so good to know what I see in the mirror is not just a figment of my imagination. Maybe my two pregnancies exacerbated the asymmetry? You hear how your pelvis joints relax. I also learned I have arthritis in my jaw. A few other bloggers have mentioned this too. I am eager to learn more about this aspect. Is there something specific that causes this? Does my asymmetric bite create constant friction on my joints or something? Not sure.

I am now waiting to hear back from my insurance company. Thank you to everyone who has shared their experiences so far. I found Stephanie’s blog especially helpful. Dr. T said my mouth should be ready for surgery in 6-9 months.

On pondering surgery...

2008-02-04T13:40:00.001-05:00

My appt with the oral surgeon is this week. I am excited, apprehensive, cautious. This afternoon, while my children are napping simultaneously (which almost never happens!), I looked through some photos. Does everyone get this obsessed with their teeth? I found a few that triggered strong internal cringing. From a certain angle my smile looks great, but from other angles, it looks, well, awful. Here are a few for comparison.

Good news tidbit: I faced two large social events this week in full braces. Just kept telling myself to "exude confidence & radiate beauty". It's corny, but it really did help!

Before photos

2008-02-02T22:25:00.001-05:00

Why blog?

2008-02-02T21:50:00.000-05:00

Seeing photographs of other people's teeth moving during treatment is *so* encouraging. After my initial consultation with an orthodontist, I had many questions. Reading personal experiences has helped me sort through the plethora of info out there. Though my unhappiness with my teeth and profile brought me this far, will I still like my face if I go through with surgery? Is my recessed chin that noticeable? Is my bite responsible for my headaches & ear issues? How much will all this cost? How will my plans for more children tie in with their proposal for orthognathic surgery?

I am still looking for more information about juggling orthodontic treatment with small children. Hopefully, journaling this process will help someone else who finds themself in a similar position. My plans are to post about once a week.

My braces have been on for about 10 days. They are beginning to feel normal, though my bite continues to change every 2 days or so. It feels really weird. I have an appointment with an oral surgeon on Wednesday, Feb 6th. I am curious what he will advise. My younger daughter is 8 months old and still nursing. How will my plan to delay weaning another six months fit into the treatment plan? I was kinda thinking about a third pregnancy in mid-to-late 2008. Does this still make sense? We'll see. I am still undecided about surgery. At this point, it's still 50-50.

2008-01-31T15:05:00.000-05:00

So, I finally got braces. Yeah! I was elated for about thirty minutes. I even snapped this photo on my mobile and sent it to my family. Over the next few hours, the reality that I would be wearing this gear for up to two years began to sink in. Discomfort set in by early evening and all I can say is thank goodness for civic meetings, red wine and Tylenol. I know, I know, you're not supposed to mix these things. I'll have to add this incident of my growing list of "I will NEVER ....!" escapades.