Good news to report

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

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

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

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

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

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

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

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.