Introduction

For most of my first 24 years, I had only been able to eat on one side of my mouth. While this didn’t cause too many problems initially, within the last few years it led to my jaw rather painfully popping and locking up. Over the winter of 2002, I was clinically diagnosed with an asymmetrical jaw. To correct this, I had 8 months of orthodontics to position my teeth for after my surgery, followed by a Sagittal Split Osteotomy to raise the left side of my jaw even with my right side and to bring my lower jaw forward, and a Le Fort I Maxillary Osteotomy to close up my overbite. After the surgery on May 19, 2004 (and a subsequent unplanned surgery on June 2, 2004), I had another 8 months of orthodontics to make sure my teeth were lined up properly.

When I was doing my research, I was astounded at the lack of web resources for my condition, and I decided to create this webpage to help towards filling that apparent void, at least in terms of personal accounts. One of the most interesting sites to me was a page (since taken down) that chronicled someone else’s experience with one of the same surgeries I had. It made me feel better that I was not the only person undergoing this process, and also helped prepare myself better for my own treatment by learning from what he had already gone through. I hope to provide that same camaraderie through this site, as well as use it as a place to organize my thoughts and resources concerning my treatment. Please keep in mind that I am not a doctor, and what I’ve written about here should only be used for informational purposes, and certainly not to diagnose or treat similar symptoms. If you have any comments, questions, or otherwise, please feel free to email me (even if I haven’t posted in months, this email address will still be active for as long as this page is up).

January 21, 2006. Uncategorized. No Comments.


Updates

I had my first real* cleaning in a year today, and it went about as well as expected. Meaning, not so well - I’m still not entirely comfortable flossing, since I can’t feel my gums to tell when I’m doing damage, my fillings do need to be replaced (but not until I decide if I’m going to try to change my bite again), my gums are receding (I’m also attributing that to not being able to feel my gums as well), and in part of my gums that I can feel, it’s too sensitive and painful to brush that tooth properly. But I got a recommendation for an oral surgeon and orthodontist in the area, so hopefully I’ll get going on that shortly. I still need to put a call in to my old oral surgeon to run everything that’s going on past him - although he’s not covered by my insurance anymore, he’s my best starting point since he’ll be able to compare the X-rays I’m presuming he will take against my older X-rays.

I also went to the orthodontist on Friday. My goal was to have one of two outcomes happen: either have my lower right bracket reset (given the position my tooth had gotten itself into, the bracket had to be set on in the front at first, but as the tooth was being pulled back up, it was starting to rotate), or have my brackets taken off outright. I was leaning towards the latter, and that’s what I ended up with… I didn’t even have to cause a fuss :) I was just getting frustrated, since I felt like my entire bite was being sacrificed just to try to get those two pairs of teeth to meet up, and I was not happy to see my front teeth start moving around and my overbite opening up again. So I’m back to wearing my retainer, and while it is quite painful right now (pretty much everything moved - I thought it was just my front teeth, but every tooth all the way back to the molars is shifting again), but I’m overall pretty happy with the discomfort. At least that way I know things are moving back to where they belong.

*”real” since I don’t really count my cleaning six months ago, when all the dentist did was poke at my teeth, tell me to replace my fillings and that I should bleach my teeth. My teeth actually got cleaned this time, scraping, floss, polish and all.

January 20, 2006. Uncategorized. No Comments.


Well, I’ve just been dealt a pretty devastating set-back, if I do say so myself. I’ve been in denial the last couple of months about my jaw - I knew my bite was opening up again, I knew my teeth didn’t look right, and yet I still convinced myself that things were okay. The problems with my teeth meeting up properly that I noted in my last entry actually got worse once I started wearing bands on both sides again. With the bands holding my jaw more stable (and to the right), the fact that my teeth weren’t meeting up properly just became more pronounced, and now it’s blatantly obvious that my bite has opened up again on the left side.

At my orthodontist appointment last Friday, I made sure that when I bit down, my teeth only touched on the right, since while that is my normal bite, my jaw usually swings around so much I don’t always have it in the right place (which is what happened at my last appointment). The pit in my stomach got worse the longer my orthodontist looked at the left side of my teeth. When I asked, “They’ve opened up again, haven’t they?”, he threw his gloves down in frustration, giving me the answer I was afraid of. Sooooooo…. here’s the gist of it: the teeth on my left side have opened up again and my overbite has gotten worse, so braces need to go back on (FOR THE THIRD TIME!!), I may need surgery again depending on whether it’s just my teeth that moved or my jaw too, and then I’d be facing a lot of retainer work, nightguards, and other stuff to try to keep my teeth in place when it’s all over. Again.

I feel like I just wasted the last two years of my life going through all this treatment for my jaw, and to have to go through it again… I’m so upset about this. My orthodontist wanted me to schedule an appointment to put the braces back on, but I said 1) I’m not even sure if I want them back on, and 2) if they do go on, it won’t be before the wedding (May 10). So I have a few months to mull this over, possibly get a second opinion, etc. He’s worried about the lack of stabilization in my mouth, I’m worried about going through all of this again for naught. I pointed out the fact that every single time I’ve gotten braces off, my teeth have always opened up again on the left side. There aren’t any guarantees that my teeth won’t just open up again, and he also couldn’t predict what the consequences would be if I just let my bite do what it’s pretty clear it wants to, although it would probably involve TMJ issues. I then pointed out that I’m already having problems with my jaw anyway (since I still can’t open my mouth as wide as i used to be able to and the muscles feel pretty tight on the left side, which he claims is normal within my post-surgery timeframe), and since I’m (at least, now) very disappointed about my outcome from the last surgery(s), I don’t really want to go through all of that again and have the tightness/numbness most likely get worse.

I asked if I could only get braces on the left side, but he seemed skeptical that that would work, and also said that if we’re going to tackle this again, we need to be more aggressive (thought I had already done the “aggressive” route!?). He then mentioned pulling at least my back molar on the bottom left (I imagine on the right side too then), since “I’m not using it” - which is true, since it has nothing to meet up with, due to my upper bicuspids being pulled out ages ago, but it is still disturbing to hear. (little known fact - the strange mouth issues started fairly early with me, and in middle school I had several mouth surgeries, and one was to cut back my cheek tissue since my back teeth were practically buried under it, and I still have no space between the back of my molars and my cheeks. Fun, fun.)

The one positive to all of this is that I would be getting any further orthodontic treatment for free from my current orthodontist. He said he didn’t feel like they had done right by me, and while I don’t necessarily agree with that (I really think it’s just the way my mouth is, rather than anything he did or didn’t do), that may very well influence my decision. I still have a lot of thinking ahead of me, and I’m going to start looking for an orthodontist by me (I’m still traveling an hour each way every 6 weeks to see my orthodontist I chose when I still lived in Maryland, even though I moved a year and a half ago) to get a second opinion from, and also probably pay a visit to an oral surgeon - probably my old one just to start off, but he’s also still in Maryland and doesn’t accept my new insurance so I imagine I’d have to find a new one if I actually go through this again. Sigh…

January 12, 2006. Uncategorized. No Comments.


It looks like I’m free from the orthodontist for a little while… I had my last scheduled appointment on Friday, and now I’m just supposed to call back when I’ve met with my oral surgeon and am ready to talk about my mouth. So that should buy me some time, since I’ve pushed off the decision-making until after our reception in August now. I literally was in my orthodontist’s office for less than five minutes, just long enough for him to watch me bite down and then proclaim that I need to have braces put back on as soon as I get back from my honeymoon. After listening to him say a couple more times how important it is that I get braces back on, I pointed out that unless it’s my jaw that moved again, I’m not planning on going through braces again. With the way he readily agreed to that, I think the Big Discussion/Showdown About Stacey’s Mouth is just being postponed until after I see my oral surgeon. That should be an interesting talk when we actually sit down in his office to discuss my treatment as more of equals than when I’m in the chair and his hands are in my mouth as he’s asking me questions… I really think he’s underestimating just how little faith I have in braces at this point. I mean, they’ve done a beautiful job straightening my teeth (and now that I’m able to wear my retainer again, my front teeth look much better - very pleased about that), but unless he can absolutely guarantee without a doubt that braces will bring my teeth together (and not in the usual screwed-up way where the bands just pull the outside edges together so my teeth are all tilted) and keep them there this time, I have no interest in potentially messing my teeth up more.  I can use my left side more than before to eat, so that at least is a huge improvement.

January 5, 2006. Uncategorized. No Comments.


My visit to the orthodontist yesterday wasn’t quite as bad as I was anticipating. Instead of putting multiple buttons on my teeth on the left, he instead just put a pair of buttons (well, a bracket and a button, since I haven’t found that two buttons really hold onto bands that well) on my back right molars. He was pleased with how my teeth are coming together on the left, and just wanted to pull up my lower right molar that had basically slid off to the side… the one that he had previously said we’d leave alone as long as it didn’t get in the way. I did actually ask him what the plan was this time, and if there would be any way to hold that tooth in place once the button came off. I pointed out that that tooth has moved to the same place each time I’ve gotten braces off, and I’d really rather not go through wearing bands if it’s just going to move back again. He assured me that he’ll figure out a retainer to rein in that tooth, and so I’m wearing the bands as I was told (albeit a bit begrudgingly, especially since my teeth hurt now).

It wasn’t until this morning that I realized the bigger problem than just the one tooth moving - my bite is pretty messed up again. My teeth on the left are touching relatively well, and the teeth on the right touch well too, but not at the same time. I finally watched myself bite down in the mirror this morning, and noticed that when my teeth touch well on the right, my bite is right on midline but only one tooth on the left is touching, but when they touch on the left, my lower jaw is about a half-tooth width over to the left from midline and I don’t have any good contact on the right. I’m hoping wearing bands on both sides for now will help, but this is definitely something that I will bringing up to my orthodontist at the next visit. I can still use my teeth just fine (although that does explain some weird bite patterns that I’ve noticed), but I’m just concerned about long-term uneven wear on my teeth and jaw if shifting my jaw to eat on each side will be the norm for me from now on.

In a very unexpected piece of good news, it no longer hurts for me to open my mouth. I’m completely dumbfounded by this, but I just noticed that I don’t feel the tightness and discomfort that I used to when I would yawn or otherwise open my mouth wider than I do to talk or chew. It’s completely random, but I am so happy to just be able to open my mouth without all the tightness, especially since while I can’t open my mouth to as wide as I could pre-jaw issues, I can at least open to a perfectly tolerable width now.

November 23, 2005. Uncategorized. No Comments.


I’m pretty sure I will never be done with orthodontics at this point. I went to the orthodontist again this morning for the maybe-third time since I got the buttons on, and they’re still not off. Well, actually, one of the buttons was replaced by a bracket (the buttons aren’t too good at actually holding onto the rubber bands, and it was getting difficult to function without being able to move my mouth again), which seems to be disconcertingly more permanent. I thought I was supposed to be finishing treatment, which normally entails getting rid of the treatment tools, rather than getting them put back on. My orthodontist also mentioned putting two more brackets back on the left side at my next visit, which has obviously made me a bit irritated. I always think of the good questions (like, “What exactly is the game plan here? Do you plan to keep me in treatment indefinitely?”) only after I leave, so I’m going to do as I was told until my next appointment, but then I seriously need to figure out what’s going on here. Yes, my teeth are moving again, but maybe that’s just the way my mouth is going to be. I don’t want to keep having to go through this if my teeth are just going to move the second the bands are off anyway. I’ll wear the retainer, but there’s also a certain amount of letting go that I think may need to happen, since as long as my teeth are still functional (which they are, despite the movement), I’d prefer to not live the rest of my life worrying about if each and every tooth is in perfect position. I’m disappointed that my surgery didn’t have longer-lasting effects alignment-wise, especially since I feel that if I had gotten into speech therapy sooner after my surgery that my teeth might not have moved this much, but they’re still touching much better than before (the outside edges of my left teeth are touching pretty well now, which they didn’t used to, but the left inside edges have been pushed apart by my tongue thrust). Besides not being able to open my mouth as wide as I used to be able to, I have been happy with the results of the surgery jaw-wise, since I no longer have the locking up or clicking. So while I think I’m moving further away from a resounding “Yes” to the ever-popular question, “Do you think it was worth it?” I’m still satisfied enough with the results, just frustrated at not being done yet. And yes, to the other popular question, I would do it again.

October 11, 2005. Uncategorized. No Comments.


I’m still not done with the orthodontics… It’s not as bad as it was sounding like at my last appointment, but I’d really like to just get into the just-wear-retainers-every-night routine instead of being asked to wear them 24/7 and keep coming to appointments every six weeks still. So I went in this morning, and got “buttons” on my left upper 6 and lower 7. At first, I thought I’d be getting the buttons/bands on the very back molar on the right side, which didn’t make any sense to me unless they were somehow going to be able to corral that tooth in with a retainer, since as soon as the buttons come off again, it would just slide right back to wherever it wants to go anyway. So since I’m not really using that tooth anyway (thanks to having my 2nd bicuspids removed on top, not all of my teeth even have a tooth to match up with), my orthodontist agreed that we could just let it go, unless it ever starts getting in the way of my other teeth (doubtful). So I’m wearing a band on the left side again, which is fine, since that’s the side I’m concerned with keeping the teeth touching anyway (5 months post-braces, and the tongue thrust hasn’t pushed my teeth apart yet!! woohoo!).

I also got a wire glued behind my bottom front teeth, which I’m pretty happy about. It was getting a bit frustrating, since every single time I took my retainer out for longer than 20 minutes, my teeth would shift around, and I’ve already had my retainer redone once to try to push my teeth back into place.

My jaw still is not where I feel it should be in terms how wide I’m able to open it. I’ve plateaued out with the tongue depressors, although I’m still trying to work with them (I’m at about 1 3/4″, I think, but I can’t increase them more than once a month or so now). My jaw is still tight and is starting to click if I try to open it too wide repeatedly, but it’s still better overall than before surgery, and I can eat much more easily now than a few months ago.

There is one newish development that I wasn’t really expecting: I’m getting the feeling back in my face! After being told by my oral surgeon that the residual numbness on the left side of my face was likely permanent at this point, I’ve noticed that most of the feeling is back on the part of my lips and chin that I could only feel vague sensation on for the last year. My gums still aren’t all the way back yet, but they also seem improved from even a couple of months ago, so I still have hope :)

July 29, 2005. Uncategorized. No Comments.


One year after my first surgery, I’m feeling much more positive about the whole experience than even six months afterwards. I still have some residual numbness in my upper gums and right side bottom gums, as well as on the right side of my lower lip and part of my chin. I can feel a little bit of pressure sometimes, but even if more sensation doesn’t come back at all, it’s not that bad. My teeth are still touching on the left side very well, and while I ended up losing a lot of range of motion in my jaw due to scar tissue (at the lowest point, I was only able to open my mouth about an inch), I’ve been slowly stretching it back out again, and I’m currently at an inch and a half. My jaw hasn’t popped or locked up since surgery, and the only time it hurts me now is when I’m stretching my jaw out or if I’ve just gone to the dentist (but even the last time I went, I just massaged between the cleaning and my jaw was hardly even hurting by time I was done). My smile is a little bit different from before (I show less gum now and it’s more symmetrical), but my face is still slightly crooked, which won’t be changing anytime soon unless I have the plastic surgery necessary to give me a more prominent chin and even out my face. I’ve had a few recommendations gleaned from my various doctors that I’m abiding by because they seem to have helped immensely in getting my jaw better:

-no sleeping on stomach or otherwise resting directly on jaw
-no chewing gum
-no overly chewy or hard foods
-keeping tongue so the tip is always touching just behind my alveolar ridge at rest
-no taking large bites of food
-chewing evenly on alternate sides

I’m also still dealing with what I’m presuming to be psychological aftereffects. I’m doing a bit better with not panicking when my mouth is being worked on now, but I’m still having all sorts of problems with getting overheated and lightheaded if I exert myself too much or even just get too warm. I’ve only had this problem since my surgeries, and the only thing I’ve come up with so far is that it’s stemming from when my body was just so focused on healing itself after the surgeries that my temperature control was skewed (those were the days of cold showers since if I were too warm, I would get very light-headed and see black spots in front of my eyes).

June 4, 2005. Uncategorized. No Comments.


It turns out that my oral surgeon and I were a little too optimistic about how quickly I’d be able to break through the scar tissue. I was able to fit in three new tongue depressors in three days, but then I had to stop adding them because my jaw was hurting too much. I am stretching it three times a day for five minutes each, and while the pain is gradually lessening, I’m still not ready to add a fourth depressor in. My muscles are just so tight on the left side of my jaw, and with 21 tongue depressors in, even the right side starts hurting too. It turns out I was wrong with my measurements, though. I actually started out a few months back with being able to open my mouth 1″, I managed to stretch it open to 1 1/4″, and now I’m at 1 1/2″. Even though that’s still pretty pathetic, it’s amazing how much easier it is to eat now, even gaining just another 1/4″ back. So I have to keep working on stretching out my jaw for another week and then call my oral surgeon to give him my progress. If I’m still stalled out, he said he might have to prescribe me some Valium to help relax my muscles, but I’m hoping to avoid the whole prescription pills route. In the meantime, he recommended taking an Advil a half hour beforehand and using a hot moist compress while stretching my jaw.

April 26, 2005. Uncategorized. No Comments.


Despite the fact that my orthodontist told me not to worry about not being able to open my jaw, I decided to go to my oral surgeon anyway. I’m switching insurance companies yet again tomorrow (finally going off COBRA!), and so I got in an appointment yesterday. He concurred that scar retraction does sometimes occur in the year after surgery, but he said it’s a bit more unusual that I’m having this problem so far out (11 months since my first surgery as of today). It turns out that I was on the right track with trying to force my jaw open, but I just didn’t hold it long enough (I was only holding it for 3-5 seconds). He gave me a whole stack of tongue depressors rubber-banded together, and for the next week, I have to wedge them between my teeth - adding another depressor each day - and hold them there for a minute or so. I have to go back in next Monday to follow-up (which, unfortunately, I’ll have to pay out of pocket), and I’m curious to see how much more effective this method will be, since I had gained back about 1/4″ of movement over 6 weeks with how I was doing it before. Dr. G. also took an X-ray to make sure that there wasn’t anything too abnormal going on with my jaw, and while he said it looked fine for the most part, he pointed out that my left joint had flattened out somewhat. Not sure what exactly that means for me, so hopefully I’ll remember to ask him about that at the next appointment.

April 19, 2005. Uncategorized. No Comments.


Another orthodontist appointment, another hope dashed of FINALLY being done with my jaw treatment. One of my bottom teeth has shifted, so my bottom retainer was adjusted to move one of the teeth (there’s a dispute concerning which tooth is actually moving - I think it’s the tooth just to the right of midline that’s moving back, and my orthodontist thought it was my tooth to the left of midline that was moving forward. He’s the one with the gloves and pliers, so the retainer was adjusted to move the left tooth back). He also adjusted the top retainer, which probably should have been done as soon as I first tried it on, since it was so loose I was always just a touch surprised that it didn’t dislodge during my sleep and choke me. So because of the adjustments, I’m looking at another full six weeks of wearing my retainers 24/7. Ughhh.

In the past six weeks, I’ve been able to open my mouth another 1/4″. Yes, I can open my mouth a whole 1 1/4″ inches now. I’m slightly concerned about this (I’m encouraged by the fact that I’ve able to gain some range back just by stretching my jaw muscles, but I don’t like not knowing what exactly is going on to make me lose so much range of motion), but my orthodontist said that it was to be expected within the first year after surgery. He didn’t say anything further about seeing my oral surgeon about possible scar tissue, and now I’m not sure if I should just go ahead and see my surgeon anyway - I’m switching insurance companies yet again in a couple weeks, and my surgeon is not in the new insurance’s network. Maybe I’ll try to get one more appointment in with him so I know if I even need to worry about finding a new surgeon…

April 8, 2005. Uncategorized. No Comments.


The braces are off!!! I got them off on 2/22, but I haven’t quite figured out how to work my new computer since then (Windows -> OS X) so I haven’t updated lately. So my teeth feel big and slimy and wonderful again, although it really wasn’t as exciting as it could have been if I had gotten all of the brackets off at once. I have to wear my retainers 24 hours a day for six weeks, which I’ve been trying to keep up with, since one of my bottom teeth has already moved just from having my retainers out to eat. The left side of my mouth is still touching beautifully - granted, it’s only been three weeks without the bands, but I feel like I’ve been really good about keeping my tongue out of the way so maybe I can start being optimistic that things will continue to go well. In fact, my teeth are touching better on the left side than on the right at this point, but strangely enough, I don’t care. I figure the left side will eventually push apart a little bit, and everything can come together then, hopefully. I can still chew just fine on both sides, so no worries yet.

Speaking of worries, one more has been lifted off of me recently - my old insurance company finally paid my hospital bill for the first surgery! My mom had to step in to get things done, but within two weeks, the hospital and insurance company were actually in communication with each other, insurance finally got the forms they needed, and they paid it. Woohoo!

March 15, 2005. Uncategorized. No Comments.


I just had the first of the braces-removal visits to my orthodontist yesterday. I was hoping he would take all of my brackets off (for obvious reasons), but he ended up leaving a few on my back right teeth and then the ones on my front teeth, presumably to hold my teeth in place until I get my retainers, and also so I can wear bands for just one. more. week. I’m excited that most of my braces are off, but it’s kind of tempered by the fact that not all of them are off, and also because the wires are sticking out beyond the brackets and really tearing up my lips. I think I can deal with it for one more week, though :) So I’m scheduled to go back in next Tuesday, when they’ll take the remaining brackets off and give me my retainers. It turns out the ceramic braces don’t come off very neatly - the one on my upper right cuspid (which is normally really sensitive anyway) ending up breaking into pieces and had to be removed with a dremel, basically. Not too pleasant. Luckily, the rest of the removal process didn’t hurt that much - it turns out there are some benefits to my gums still being numb ;)

Just because life is never easy, I’ve had a new problem crop up - I can’t open my mouth more than about an inch and a half. That’s not very much at all, but I’m not even sure how long that’s been going on, if it’s been that way since surgery or if it’s something new. I guess it just got to be a habit to eat in small portions, but then I realized I literally could not open my mouth more than the width of a sandwich. So I told my dentist about that today, as it was fairly obvious something was going on with my range of motion since I could barely even open it wide enough for the little mirror to get in there (oh, even worse was doing the molds at the orthodontist - the top tray actually got stuck in my mouth. Ugh.). So Dr. F. told me to let my orthodontist know next week (strange how the technician didn’t seem that concerned about it…), since with all the changes that I’ve had with my jaw, this is something I need to stay on top of so more serious issues don’t occur. At least my jaw didn’t hurt after my teeth cleaning - it used to lock up and be horribly painful for hours, but despite obviously straining today to open my jaw wider, I was able to massage away any pain really quickly and it actually felt better than normal right after I left.

The insurance problems still haven’t been cleared up. My old insurance company is still requesting the UB-92 from the hospital but still actually just wanting descriptions of the diagnostic codes, and the hospital is still sending over UB-92s and not the descriptions because I don’t believe the insurance company has actually asked the hospital for those. I try to pass along the message of what the insurance company really wants to the hospital, but there seems to be some sort of communication breakdown there. I just signed yet another medical release so my mom can start working on this too, so if all goes well, she’ll be able to make some progress since she works in the industry and knows the ropes much better than I do.

February 16, 2005. Uncategorized. No Comments.


I just had my final check-up (six-month post-jaw unwiring) with my oral surgeon. Dr. G. was very pleased with the way my teeth were - my jaw has healed nicely, and he gave me his blessing to get my braces off next month. I saw my X-ray that they took for this visit, and he was right - my teeth did look perfectly aligned still, which made me feel a lot better about noticing that my jaw still looked crooked. I had misunderstood the extra chin surgery he had wanted to do when I initially had my surgeries - I thought it was just a chin implant, but it turns out that it was also to shift over the whole chin segment so that it would be symmetrical with my face. I didn’t realize that my jaw was physically longer on the left side (I just thought it was angled incorrectly), so the surgeries I did have didn’t correct that part of the asymmetry. So at least I know it’s not because of something going wrong that my face looks a little crooked, although I highly doubt I’ll ever be getting the surgery to correct my chin at this point. It’s not that noticeable anyway (at least, I hope not), besides that I don’t really feel up to going through any surgery again for quite a while.

I also noticed some squiggly things in the X-ray behind my back lower molars, and it turns out those are wires that I didn’t even know I had. Dr. G. told me they were under my gums, but it didn’t occur to me until after I left to ask if he meant that they went through my gums or were entirely underneath them. Either way, they’re going to stay in unless they start causing me problems. He also asked if I had any remaining numbness, and I pointed out the areas on my lip and chin that didn’t have all the feeling back, and also said that I couldn’t feel most of my gums still. He told me that the numbness in those areas is probably permanent at this point, unless the nerve from the left side of my face starts growing over to where it’s damaged on the right side. It’s tolerable enough, though, since it doesn’t feel like I’ve had a shot of novocaine there or anything - I can feel pressure there, but the sensation just isn’t 100%.

January 15, 2005. Uncategorized. No Comments.


The Recovery page is finally done!!! …sort of. It’s up, but the pictures got a bit distorted, and quite frankly, I don’t feel like dealing with them anymore tonight. So while I’ll say that I’ll try to fix them soon, in reality, they’ll probably stay that way for a while.

January 4, 2005. Uncategorized. No Comments.


Yet another orthodontist appointment today. We finally set the dates for my braces to come off, so that’s good news. Unfortunately, those dates are still two months out. So the braces are scheduled to come off in February, my last oral surgeon checkup is coming up in January, and speech therapy should be wrapping up soon too, so at least the end is in sight. Orthondontics-wise, we’re now waiting for my left cuspids to move a bit more. They were hitting prematurely, and so on my last visit my wire was stepped out to move the upper cuspid out while the lower cuspid was stepped in. It did help, but I think they’re still hitting much more than the right side. Speech therapy has been going well. It’s proven to be even more beneficial than I thought it would be. We’re working on changing a lot of my behavior (i.e. starting to chew on the left side now and then alternating evenly between sides, holding my tongue so the tip touches behind my alveolor ridge as my resting position, etc), and actually making a lot of progress. I’m finding myself keeping my tongue from between my teeth without even trying to do so consciously, so that’s making me feel much more comfortable about getting my braces off.

I’m also still trying to get insurance to cover my first surgery. They’ve paid for my second surgery already, but for the last couple of months, I’ve been going back and forth between the hospital and insurance (and apparently they’ve been going back and forth themselves), since insurance is asking for another form before they’ll process my claim, despite the fact that it seems as though they sent me the form they’re asking for in their initial request to me. Unfortunately, the notes on my record at the insurance company don’t seem to match with their request, and so the hospital hasn’t been quick to take my word and just send the descriptions out that insurance needs. In a completely separate issue, I’ve also been trying to get my oral surgeon and the hospital to coordinate with each other to remove what I think is an erroneous diagnosis from my first surgery. On the page with all my diagnoses, tucked in between “mandibular hyperplasia” and “maxillary hypoplasia” is “tobacco use disorder.” ?! Since I’m not sure if this would affect any of my insurance premiums - besides that I don’t want it on my records if it’s wrong - I’m trying to get that taken off. It’s supposed to be a simple process of my oral surgeon signing a form from the hospital asking that it be deleted from my records, but it’s two months and numerous phone calls later and it hasn’t happened yet. I just don’t understand how it is that no one ever mentioned anything about tobacco use the whole time I’ve been in treatment until it showed up on the bill six months later… besides that I don’t even smoke! (well, except for some - perfectly legal - shisha a couple times a year, but that shouldn’t do enough damage to end up on my hospital bill).

December 22, 2004. Uncategorized. No Comments.


I had another orthodontist appointment today, and if all goes well, it will just be another visit or two before I get my braces off. Dr. D. told me we just have to wait until my last two teeth touch on the right side, which should be the next visit with the bands he planned out for me. Due to my tongue thrust, my overbite and left side had opened up again, but the overbite is much, much better again. I was doing better for a while for keeping my tongue from between my teeth, but it’s so difficult since the behavior is so unconscious and ingrained now and my diligence slipped after a while. I have to start wearing a couple bands to pull the left side together again, so hopefully that can hold everything together and keep my tongue out of there until I can go to speech therapy. I’m really hoping therapy will be the cure for this, but I’m also a bit afraid that they won’t be able to help me, because of my age or whatever other reason. I guess I’ll find out soon enough, though - I have a doctor’s appointment on Tuesday, and I’ll be getting my referral for speech therapy then. I have a couple places in mind, and so as soon as I get the referral I’ll be making an appointment and finally getting in to start my treatment.

October 14, 2004. Uncategorized. No Comments.


I had my first dentist appointment since surgery on Tuesday, and it’s so nice to finally have my teeth clean again! They said I did a really good job (I didn’t mention that I had bought a dental pick since I couldn’t deal with the griminess), and I made it through this whole thing without any new cavities. I started panicking a little when they first started cleaning, but I was at least able to calm myself down better than I have been at my oral surgeon’s. Just the thought of anything painful happening in my mouth has proven to be more than I can handle at this point. Since I still can’t feel most of my gums (and half of my lower lip and a bit on my chin), I got out of the ritual bloodbath known as flossing since it still feels too weird to me. My dentist was really, really pleased with my profile and he said my teeth look excellent. However, when he asked if I was happy with the surgery and I said I mostly thought it was worth it and that I was still waiting to see how it would turn out before I can give a definite answer - because as of right now I’m very frustrated by the fact that my tongue is still pushing my teeth apart - he did not seem very impressed with my oral surgeon’s judgement. I told him how Dr. G. had assured me that my tongue thrust would stop after the surgery because my tongue would adjust and no longer rest between my teeth. Clearly that hasn’t been happening, so my dentist suggested the same thing Dr. D. did right from the beginning: speech therapy. Since I refuse to have gone through everything I just did and have it go back to the way it was before without at least trying to fix it, I’m going to give them a call once I get my insurance straightened out. I’m finally switching from COBRA to my current work’s insurance, which hasn’t exactly been a smooth process, and I’m fully expecting to have some problems with the hospital billing me after I’m terminated at CareFirst. It’s been more than the 60 days since my surgeries, and while I still haven’t received my bills from the hospital, I’m not sure if it would open a huge can of worms if I were to call them to see what’s happening.

I also went to the orthodontist a few weeks ago to get my wires adjusted for the first time since surgery. He was also happy with how my teeth looked, except for the fact that they were separating on the left side again. He laced my top teeth together since they had kind of spread out during recovery, and now I’m into the bands section of treatment - one on the right to pull one of my teeth out that had moved too far inwards, and two on the left to try to close the gap. I learned my lesson the first time I had braces, though, and so I’m cooperating and actually wearing the bands this time around. I’m determined to meet the Thanksgiving goal Dr. D. set for getting my braces off.

August 13, 2004. Uncategorized. No Comments.


I’ve now been through two surgeries, and I’m well into my recovery. I managed to get my surgery rescheduled on a cancellation, so I had it done on 5/19. The surgery went well, although the first few days of recovery were much worse than I thought they would be. It was strange - and yet wonderful - to feel and see how much my bite had changed. For once, my teeth were touching on the left side and my overbite was much more closed - top teeth nearly resting on the lower brackets, and my fear about tongue thrust opening up my bite should prove to be unfounded. Now that my upper left teeth have been moved further out, there’s so much more room in my mouth.

Unfortunately, I ended up having some (unusual) complications that landed me back in the hospital after two weeks. I had my wires adjusted while I was still in the hospital the first time, but the top front segment of my jaw had continued to move and it was now too far to one side and at an angle. I ended up having to go under and have basically the whole surgery done over again, just without breaking anything this time. Now there are plates holding the upper front segment in place, and I’ve made it through two follow-up appointments with my teeth still aligned. The recovery was better than the first time around - much more swelling, but I bounced back more quickly. In fact, I was back to work a week later, working a full eight-hour day.

June 11, 2004. Uncategorized. No Comments.


If all had gone as planned, I would currently be in the hospital recovering from my surgery. Instead I am waiting impatiently on this to clear up so I can reschedule my surgery. Two days after I got my final clearance from my doctor, I broke out all over my arms from poison ivy, although it had been two weeks since I could’ve even been exposed to it. I also was apparently having an allergic reaction to the latex in the first-aid tape and band-aids I was using to cover my arms at night, so now I’m allergic to latex as well. I had to go back to my doctor, and she was so concerned by my overly-pale and generally sickly appearance (probably brought on by the fact that I’d hardly slept for three days from the itchiness) that she drew blood yet again to check my blood counts and insisted that I start on Prednisone to get rid of the poison ivy. Unfortunately, I couldn’t have my surgery while on steroids, so my surgery had to be postponed. I’m really hoping the poison ivy will clear up within the two days I have left on the medication so I can get cleared by my doctor again and reschedule my surgery. I’m dreading the thought that it could be another month before I can get hospital time like the first time the surgery was scheduled. I can’t believe I have to go through all the preparation again - both physically and emotionally. If the surgery can be scheduled before 6/8 then I should be able to use the blood I already donated, but the psychological let-down is really the worst part of all. The massive disappointment and realization that I will have to go through the mental preparation again when I was so close to having it done is the hardest to cope with at this point, but there’s pretty much nothing I can do about it now except wait for everything to fall into place again.

May 15, 2004. Uncategorized. No Comments.


I’ve now had blood drawn two times in as many days. Of course, we’ll see if there are more lasting negative effects than just feeling light-headed and out of it this evening. My mom and I went to see Dr. G. yesterday for the last appointment before my surgery. We got a lot of information about the surgery, some of which I’m almost wishing I didn’t know, i.e. how they manage to get enough room in my mouth to maneuver during surgery (answer: they peel my lips over my nose or chin, depending on what jaw they’re working on). I also learned more about the upper jaw portion of the surgery. That procedure is called a Two-piece Le Forte I Maxillary Osteotomy, which I now have a week to research so I can feel more comfortable about it before it happens to me. It turns out that it’s not just a break below my nose, but there will also be two vertical breaks so my front teeth will be a separate segment from the rest of my jaw, at least until they wire it back in place. The wires they’ll be using to hold it stable will be going up past the bottom of my nose and will hopefully be permanently secured there. The bolts holding the rest of the breaks together may have to come out at some point, though, and if that happens, I’ll need to go back into surgery to have them removed. Also, with all the vertical breaks happening to my upper jaw, I run the risk of tooth damage as they go between my teeth to break the jaw, so I may need a root canal in the future, or I may even lose the teeth if they become infected. There’s also a slight chance the sinuses will be affected, since the break will be going into the sinus cavity, and there’s also the risk of permanent numbness - as with the lower jaw - if the nerve running right above the proposed break is damaged.

So after the appointment at Dr. G.’s, we went down to the hospital so I could donate a unit of blood for myself for the surgery - which also served as a good test run for my mom so she would know how to get to the hospital before the big day. The blood-letting went fine, until I went to the doctor today. Even though I had told the hospital that I just donated a unit of blood yesterday when they called me this afternoon, they still requested a CBC. So I just got blood pulled again, and my doctor is concerned that my iron levels may be low enough that they’ll want to postpone my surgery, since they’ll already be at decreased levels from yesterday, besides that my iron is usually pretty low to begin with. And who knows if all my paperwork will get to where it needs to go before my surgery - it seems no one remembered anything of what they told me last week, such as the existence of a form my doctor needed to fill out and what sorts of tests/examinations/etc I’d need before surgery. My doctor seemed to think it wouldn’t be necessary for me to have weight gainer supplements during my recovery, which I may still have to resort to depending on how I do maintaining my weight. I’ve been trying to put on weight for the past couple weeks, and I’ve managed to gain… 3 pounds. And this is starting from a lower weight than normal (as in what I weighed my sophomore year of high school), and I’m sure stress isn’t helping my efforts either. If nothing else, at least this surgery will let me relax for a bit after it’s all over, until my mom starts forcing me to get my own food and go for walks around the block to keep my blood flowing. I was looking forward to chicken soup (…er, broth) being brought to me in bed, but maybe I can still negotiate for that at least for the first couple days after surgery.

May 4, 2004. Uncategorized. No Comments.


I have exactly two weeks to go before my surgery, and I’m starting to get nervous. Besides the first few months after I initially heard the treatment plan, I think I’ve been dealing well with the whole situation - at least in terms of not being too scared about the surgery and outcome. It was more just a struggle to get to that point, having to stay completely organized and on top of things in order to follow up on everything that I apparently needed to. However, after going to my orthodontist appointment on Monday, it’s finally starting to dawn on me that this surgery is soon going to become a reality for me instead of some distantly visible goal. All Dr. D. did was make sure my ties were all pushed down, and then he told me that he would let me know after he met with Dr. G. again if I needed to come in to get the teeth separated where my upper jaw will be split. The whole drive home I was in this strange floaty state, where I was coming to grips with the realization that the whole surgery is practically upon me. The more I think about it, the more I’m doubting that this is absolutely the best plan for me. I realize that it’s necessary if I ever want to be able to chew normally, but I also don’t think it’s going to be the magical cure-all for my TMJ. After all, the part of my jaw by that joint won’t even be affected by the surgery - the relevant breaking points will all be more towards the middle of the jawbone. I also know that these doubts are most likely perfectly normal preceding such a big event, and so for the time being, I’m trying not to get too caught up in my nerves.

April 28, 2004. Uncategorized. No Comments.


I went to see Dr. D. on 2/22 and he told me that the tooth we were waiting on should be fine for surgery, especially since if it still needs to be adjusted, it can be done after surgery (which is what I thought should’ve been done from the start).  He put three surgical hooks on my front teeth, top and bottom, just in case I had my surgery before my next visit with him (which was unlikely, so I’ve been wearing them unnecessarily until the next appointment, although at least they aren’t tearing up my mouth like I thought they would). Dr. D. also redid my records and molds so that he could bring them when he met with Dr. G. again. Apparently that meeting went well, since CiCi called me a few days after my appointment to set up a surgery date. After talking it over with my new boss, I told CiCi to get me in as soon as possible. Over a week later, she called me back with the date of May 12 for my surgery. I’m a little disappointed that it’s still nearly a month out, but I guess it’s progress, and I’m sure the next month will go by quickly as I get ready for the surgery.

I’ve now put in for my time off work and made a multitude of appointments. I’m planning on taking a week and a half off work for the recovery, and I’m just hoping that will be enough so I don’t need to take too much time away from work (seeing as how I’ve only been there for a few weeks now). I now have an appointment with Dr. G. the week before the surgery to go over the procedure one last time, and then that afternoon I’ll be heading to the hospital to donate a unit of blood for myself, just in case I need it during the surgery. I also have an appointment with my regular doctor to get a full physical and history, and then I cancelled my dentist appointment for the week after the surgery, and I’ll just have to let them know as soon as I get my jaw unwired so I can come in to get my teeth cleaned. I’m sure that will be quite a relief to have that done after six weeks of not being able to brush my teeth properly.

April 18, 2004. Uncategorized. No Comments.


Well, Dr. D. seems to think that it will only take one to two months to push that tooth down, so hopefully he’s right. He just reset the bracket on the tooth, but I could hardly even tell the difference - hopefully it will be enough that I’ll only have to wait the one month rather than two. I let Dr. G. know the estimate, and CiCi assured me that I wouldn’t have to come in again when Dr. D. decides my tooth is ready and that I can just set the surgery date over the phone. While this is certainly more convenient, I’m just a little nervous, since I thought it was a tooth on my left that needed to be pushed down, while Dr. D. and the letter from Dr. G. both said it was a tooth on the right side. We’ll see.

February 20, 2004. Uncategorized. No Comments.


It looks like I spoke too soon. I went to see Dr. G. on Friday, fully expecting to be able to finally set a surgery date. Instead, he hit me with the news that I have more problems with my mouth that I need to get straightened out first, which could take several more months. I have a tooth on the bottom left that’s sticking up so far that it will impede the other teeth from touching if I were to get the surgery now, so that needs to be orthodontically pushed back down beforehand. If it’s going to take more than 6 months to do that, however, Dr. G. said that it might be worth it just to file it down instead of waiting that long. Also, it looks like I will have to have my top jaw broken as well. Dr. G. is proposing that he break my jaw horizontally just below the nasal cavity in order to bring my top jaw down to close the gap mentioned in the previous update. Then the other major problem is that my left back teeth won’t touch if my lower jaw would be brought up now since my upper jaw is narrower than the lower jaw on that side. To counteract that gap, my upper jaw will need to be broken between the two back molars so that my jaw can be swung out a bit and secured. Dr. G.’s staff is checking to make sure that the top jaw will also be covered under my current surgery approval through CareFirst. Because of all these proposed breaks, Dr. G. is now recommending jaw wiring for the recovery because of its increased stability. He also cleared up that while I will most likely have to stay overnight in the hospital, I should only need to be out of work for a week, which is much better than the month I had envisioned. And in case I change my mind about having a chin augmentation (I doubt it, though), I was quoted $2,000.

For the first time yet, my bill at the oral surgeon’s is paid in full as well. After several calls on both my and CiCi’s part, we finally got CareFirst to pay up on the claim from 8/1/03, which they kept claiming I didn’t have a valid referral for (I did). The other outstanding claim from July was thankfully cleared up without too many problems last month, just requiring a resubmittal (where do these claims go? I had checked on that one much earlier on and they had it then).

February 16, 2004. Uncategorized. No Comments.


After a few more delays, it looks like we’re finally making some progress on getting my surgery done. I went in for my last orthondontistic appointment before surgery (again) this morning, and had a heavier wire and laces put on my top teeth to help close up the gaps that were starting to form. Dr. D. had brought my molds over for Dr. G. to see sometime in the past month, and from what I gathered, my bite is pretty much ready for surgery. However, as Dr. D. was showing me on my molds how my teeth would look after surgery, he then pointed out that he’d like the bottoms of my top teeth to come down to the top of the brackets on my bottom teeth. He claimed that that would help prevent against a relapse; in which case, that’s definitely something I’m interested in getting fixed. He said the gap there would be something that would be corrected during surgery, and that he was going back to see Dr. G. directly after my appointment. I now have an appointment on Friday with Dr. G., so hopefully we can finally set a surgery date and I can learn more about this other issue and if that will mean that he will have to break my top jaw as well.

February 11, 2004. Uncategorized. No Comments.


My appointment with Dr. G. didn’t go quite as expected. When his first words to me were, “What are you doing with the braces?” I realized that this wasn’t going to go that well. Apparently, Dr. D. hasn’t contacted Dr. G. at all, and Dr. G. is even doubting the necessity of me having braces before the surgery. He thought my bite was fine, and that I definitely didn’t need any extractions (something else Dr. D. was considering). I also asked him about Dr. D.’s recommendation that I go through speech therapy to correct my tongue thrust. Dr. G. assured me that my tongue thrust did not cause the gap between my teeth, and that my tongue will naturally find room in my mouth after the gap is closed, with the jaw wiring being especially helpful in retraining it. So I talked to him for a while about the surgery, and basically, it’s going to hinge on Dr. D. and his decision on if we can go ahead with the surgery or if we need to complete more of the orthodontics first. Dr. G. said that he would definitely call Dr. D. that week to hopefully clear up any confusion that’s been caused by their lack of coordination.

February 10, 2004. Uncategorized. No Comments.


It looks like I’m already heading into the homestretch for the first phase of my orthodontics. I went to the orthodontist today to get tightened up, and I’ve apparently switched from titanium wires to steel (which I was already warned that they were going to hurt quite a bit more than the titanium ones). The molar Dr. D. worried  would move the wrong tooth ended up just moving itself, which is what we wanted, and it’s now lined up nicely with the rest of my lower teeth and is actually touching again. I made my appointment for January to get retied again, and then I have an appointment in the beginning of February to get a new set of molds made so I can bring them to Dr. G. for approval. Since he has already told me that my bite is fine for surgery, I’m not anticipating any hold-ups on his part, so hopefully I’ll be able to schedule surgery sometime in March (assuming Dr. G. is available and can get hospital space then). It’s still two months away, but I still consider this to be very good news.

December 2, 2003. Uncategorized. No Comments.


It turns out that my initial visit on the 13th to get my spacers in and the follow-up visit on the 17th to get one replaced were unnecessary. Because my bottom back teeth are set too far back into my cheek tissue, they weren’t able to get bands around them, and opted instead for brackets on the bottom and top molars (?). So now the brackets are digging little holes into my cheeks and they hurt even worse than when the other ones went on, but I’m being diligent about the wax, so hopefully my cheeks will adapt soon. Dr. D. warned me to watch my back second molar, though, because it has shifted significantly and is so out of position that he’s concerned that it may pull my first molar out of alignment along with it. Right now, my first molars on the top and bottom are overlapping well, so I have to make sure they stay that way. As always, I took pictures for documentation purposes, but more so this time so I’ll be able to tell more easily if the first molar gets the second molar back into position, or if the opposite occurs. If that happens, I’ll have to go back in and get either the wire removed from that back tooth, or I’ll have to start wearing the dreaded rubber bands to pull it into alignment (I already forgot).

October 20, 2003. Uncategorized. No Comments.


I had another appointment with Dr. D. this morning to get four more spacers put in so they can band my back molars next week. Dr. D. did receive the letter from Dr. G. after they faxed it over, and my doctors finally met last Wednesday. I was afraid it wouldn’t go very well, because Dr. G. certainly seemed frustrated with the lack of communication the last time I was in to see him. However, it seemed to go all right, and so the plan is still for Dr. D. to level out my teeth before the surgery, which should take about six months. After that, he’ll do more molds, I’ll take them over to see if Dr. G. approves of my progress, and if so, then we’ll be able to proceed with surgery. It’s just hard to be patient with this whole process, since I just want to speed the whole thing up and get it over with, especially before CareFirst changes their mind. I think Dr. D.’s attitude has also improved toward working with Dr. G., since he was so impressed with Dr. G.’s ability to get CareFirst to approve treatment that he’s already referred another patient to him. I figure that if he’s referring more people to him, it must mean that he’s more willing to work with him than he seemed at first. Besides my current discomfort from my new spacers, the braces haven’t been so bad yet. In fact, I can already see a marked improvement on my right side, since my second bicuspid had collapsed inwards a bit, and it’s already straightened back up again. All the teeth on my right up to the cuspids are now touching, which is the first time that’s happened for at least a year or two.

October 13, 2003. Uncategorized. No Comments.

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