Day 0- Mar 28/12

I made it! Everything went as planned mandibular BSSO only, no genioplasty.

My day started out with a nice long relaxing bath (uninterrupted too!), then packed up and watched hubby eat a tasty looking continental breakfast.  Then we were off to the hospital to get admitted.  Saying bye to Paul was the hardest part as he looked so worried and was tearing up, made me cry too :')

Went into the OR around noon, remember them strapping me in and putting on a mask. After that I woke up in recovery rather calm and still sleepy. Finally got moved up to the floor around 3pm and slept on and off for the rest of the day. Had a couple brief visits from hubby, my inlaws and a friend but was really to sleepy still. Around 7pm I attempted to eat some soup, pudding and juice and managed a bit of each then started to feel a bit nauseous so quit while I was ahead. I even managed not to be sick despite the vomit fest going on around me all night long with two of my other roomates.

Pain has been not bad 2-4/10. PCA hydromorph for pain and Maxeran for nausea were my friends. I also got Prednisone for swelling and a few doses of prophylactic IV antibiotics to prevent infection.   
Swelling is defintely there (I think my cheeks look like Quagmire from family guy.... Giggity giggity).

Numbness my lower lip and tongue was completely numb post op but has already started to tingle.

Elastics on both sides from lower molars to upper canines at front, 3 or 4 on each side. 


Preop brave face:

Post op:

And for those who are curious about my "last supper"
...We went to Tony Romas for steak and ribs (yes I had both), loaded baked potato, steamed broccoli and strawberry new york cheesecake for dessert. SO GOOD :D Hunger Games movie was awesome too.

Wow this post got long...day 1 to come later!

See you on the other side!!!

Well, tomorrow is the BIG day and also my one year in braces anniversary!!  

Hubby and I are staying in a hotel tonight while grandma stays at home with our daughter (2 hours away). We're headed out on a date night for dinner and then going to see the Hunger Games after :) Should be a nice distraction from surgery tomorrow.  I still haven't decided what my last real dinner will be...something crunchy/chewy for sure!!!

Hopefully I'll be able to sleep tonight. Off to the hospital for 9:15 in the morning, surgery at 11:00...yikes, this is really happening!  Can't wait to get it over with.  Send good vibes my way!!  

Probably won't be able to update for a couple days. 

See you on the other side...

Chandra  

  

Pre-op profile pictures...4 days to go!!!

Here are my latest profile pictures, I tried to photoshop out some shadows.

The first picture in each is my natural bite,  the second picture in each is posturing my lower jaw forward without smiling and the third for side views is posturing forward with smiling to simulate the surgical advancement. I have pretty much decided not to have the genioplasty (90% sure) unless he feels it is absolutely necessary as I am happy with how my chin looks from the front now and still want to look like me post-op though I realize the genio will improve my profile more I don't want to end up with a "big" chin.

 RIGHT

LEFT

4 days until surgery!!!

Food suggestions???

I haven been stocking up on a few things like soup, juices, puddings, Ensure for the fun post-op diet.  I see the dietician next week who will likely suggest other things to...

I have also started a multivitamin and hi-potency vitamin B supplement also bought some benefibre to mix in with liquids.  I still need to pick up some protein powder too.

What were your favorite "foods" post-op?  Any suggestions are appreciated :D

2 weeks until surgery!!!

Sorry I have been MIA for a bit but have been very busy the last few weeks. Finding time to blog with a toddler is tricky! We had an awesome two week vacation in Mexico which was great distraction from my upcoming surgery. I also indulged in great food the whole time without any guilt about the 5 lbs I gained which I'm trying to keep on for surgery.

I saw my OD on Friday and had my impressions done for the surgeon, new x-ray taken and surgical hooks are now in place! Only 2 on the top and 4 on the bottom. I thought they would be uncomfortable but I really don't notice them unless I'm eating because more food gets stuck and they're a bit harder to clean around, otherwise not bad at all.

The gap is still there but slowly closing, no power chains until after surgery now :(

Here are my latest pics...

The front tooth on the left (your right) is angled in a bit and looks worse on camera

More posts to come in the next few days. 2 weeks until the big day!!!

February adjustment

I also saw my orthodontist this week for another adjustment. I filled him in on my appointment with the surgeon and he feels that I will be ready for surgery even if the gaps aren't completely closed. My next appointment will be mid-March for pre-surgery impressions to make models and for X-rays. I will also get the blue molar pads removed from my lower back teeth then. I will need to see him 2 weeks, 4 weeks and 6 weeks postop for checkups but won't have another adjustment until at least the 6 week postop mark.

Good news!!!!  We've started working on closing my central gap now. Basically they added a figure-8 fine wire to three teeth on the left to move that side as a group and attached the powerchain to the right central incisor to start closing the gap. My new powerchains are white (boo! They stain easier).

For the lower arch they changed to an "M-wire" (I think the "M" stands for medieval torture device!!!) this was by far my most painful adjustment. I'm not sure what was so different about this wire, I'm guessing it might be the shape but it was also inserted differently. Usually they put the wire through the channels in the back teeth then close the bracket doors on the other teeth. The torture wire gets closed into the front brackets first, then somehow (painfully) pushed and bent/closed into the other brackets and then bent and forced into the channels at the back. I was in the chair for almost 40 minutes. My mouth hurts just thinking about it. Had to put heat on my jaw that night which relieved things a bit. Also got new power chains on the bottom to finish closing up the very small gaps.

I tried googling m-wire and this was the closest thing I could find to what I think they might have put on the lower arch.

Here are my latest pictures:

Answers from the surgeon

I saw my surgeon on Monday and got the answers to my many questions. I was really impressed that he took the time to answer each of my questions and then some. I deal with many surgeons in my job and can say that most are not this patient and willing to take the time necessary to make you feel comfortable. I also had to fill out the hospital intake forms which really made things more real!

Here are the answers he gave to my questions:

What do you recommend? BSSO and genioplasty, upper jaw surgery not required.
Do you think my teeth (gaps) will be ready by March 28th? As long as OD feels teeth are in suitable position.
How much overjet do I have now(measurement)?  He does not measure, moves teeth into best position for bite. From what I have measured myself I would say 8-10mm.
Asymmetry? Yes, there is some but will not be changed with this procedure.
How much movement (and what kind) do you expect?  Again no measurement but will move forward lower jaw as much as able and angle slightly if needed to ensure best bite position.
Will BSSO be sufficient to correct bite? Yes, ortho to finish positioning postop.
Does amount of movement increase risk of permanent numbness? Yes  Age? Can't change it so doesn't matter.
Discuss hardware used to stabilize.  Titanium plates and screws.
Any long term risks? Hardware... 5% of patients need hardware to be removed at some point can be done in office with freezing if necessary.
Previously mentioned open bite...front/back? No open bite now so will not be open postop.
Can I expect a perfect bite post-op/post-braces? Will move mandible forward to align jaws, ortho to finish aligning teeth/bite.
Any incisions to face or intraoral only? Oral incisions only.
Bleeding? Always a risk for bleeding but should be minimal.
About how long will the surgery take? 1.5 to 2 hours. Be there at 6:45, surgery at 8:45.
Will it be you or a resident performing the surgery? Surgeon with resident assisting, follow ups will be with resident.
Will I be banded or wired? Not wired, elastics only.
Splint? No.
Surgical hooks? Yes, ortho to apply.
Swellling...Ice good or bad? Ice x 24 hours then heat after that.
Manual lymphatic drainage (massage)? I didn't ask about this but have training in this area and plan to do self-massage to promote drainage, very light massage technique will not cause any harm.
What changes can I expect in my face?  Cannot be predicted accurately, even if twins had the same surgery they would likely look different.
Do you have software that can show me potential profile and front view pictures? No.
How will surgery effect lip competence? Should improve with genioplasty, without genio lip competence will not dramatically improve.
How will surgery effect mouth breathing? Should improve.
Does genioplasty increase chance of permanent numbness with increased traction on the nerve?  Yes, anything that involves the nerve can cause numbness
Opinion re: need for genioplasty? Recommended but not mandatory. I was previously strongly leaning towards no genio as I like the shape of my chin viewed from the front, I just don't want to end up with a 'big' chin. He said surgeons usually prefer bigger chin, maybe I can negotiate a medium sized chin??? This is worrying me the most at the moment. As of right now I won't see him again until the surgery date but I may call about this.
Can I expect to be free of jaw related headaches after?  May not resolve if related to clenching.  I honestly think at the moment my jaw pain is more muscular and related to my worsened bite from the braces/extractions as I don't really recall having this pain in the past.
What are my chances of relapse? Up to 25% experience some relapse. 1-3 mm not usually noticeable, if 4mm or more further surgery may be recommended.
Supply list? I think I will follow my fellow bloggers suggestions on this front.
Diet info? Will see dietician in hospital postop. I plan to stock up on liquids, soups, puddings etc
Vitamins (Calcium, D, B)? Protein powders? I plan to take vitamins and high protein shakes.
Postoperative meds? Pain medication and prophylactic antibiotics.
Chronic nasal inflammation...post-nasal drip, swelling, breathing, prior injury to nose? Not much will change in this regard...if ongoing problems could see ENT.
Preoperative physical? Yes, need forms returned 1 month prior to surgery.
Should I stay in the city overnight? Inpatient? YAY! He will arrange for me to stay in hospital overnight since I live 2 hours away.
Sleep positions postop? Whatever is comfortable. I'm planning to sleep in a recliner downstairs.
When is first follow up office visit? Timing of other visits to plan for travel/work. One week, two weeks, fpur weeks, three months, six months, one year.
Time off work? 1-2 weeks. I'm planning for 3 weeks just in case as my job involves ALOT of talking with patients and other hospital staff. If feeling ok I may go back sooner but don't want to feel rushed.
Cosmetic suggestions re: bonding canines post-braces, who to see?He can give me a list if my ortho doesn't have a local recommendation.
What if I get hit by baby/dogs? Avoid for 6 weeks....hmmmmm. Again this one worries me, seems to happen on a daily basis. Here's hoping I can avoid this :S

Yikes, that's a lot of questions (and answers) but I'm sure he's used to it. Sorry for the gigantic post, it will also help me remember all of the answers too. His last piece of advice was to try to think about the surgery as little as possible from now until then, not sure if that will happen. Though I do think my two week Mexican vacation will help with that (16 more sleeps!)...can't wait!!!

That's all for now. Will post about my adjustment and new pics later :D