Surgeries and Next Steps

Yesterday, I went to see Dr. Keith (my oral surgeon) to talk about how screwed up my jaw is and what needs to be done to fix it. Don came with me because I would have been a hot mess without him. He really kept me from not bursting into tears and hyperventilate.

Tip: If you are going to any kind of important meeting, bring someone who you 100% trust. They will help to keep a level head and maybe might ask questions that you didn't think of. 

After talking about my jaw and about the results of the work up I did in January, Dr. Keith told me that I will require 2 surgeries. He told me that I have 2 problems.

Problem #1 : My upper jaw is too narrow. This is why my top teeth are so crowded. They don't have anywhere to move to!
Problem #2 : My upper jaw does not meet my lower jaw in the correct place. This puts strain and pressure on my jaw joints. It also makes chewing very difficult.

If left uncorrected, my jaw joints will become inflamed (again) and could potentially lead to bone loss in my jaw joints. This bone loss could cause me to not be able to open and close my mouth anymore. Basically, I wouldn't be able to eat solid food or talk without extreme pain. For that reason alone, I've decided to get both surgeries done.

The first surgery is known as Surgical Assisted Rapid Palatal Expansion (or SARPE). This surgery will widen my jaw to give my teeth the space they need to become straight. This will require day surgery at Mass General Hospital in Boston. Because I'm an adult, my jaw has stopped growing. This makes it really difficult for my orthodontist to move my teeth to make them straight. In order to do this, my oral surgeon will have to cut into my upper palate; one spot in between my top front teeth underneath my nose and near my cheek bones. It will be done from inside my mouth so I will have those lovely dissolving stitches. I've been told to expect to be out of work for 10-15 days. I've also been told that I'll be pretty uncomfortable for the first week. I'll have to sleep sitting up for a little while and won't be able to eat solid food for awhile after.

I'm not going to lie, I was really disappointed when I found out about the 2nd surgery. I've been resigning myself to this huge surgery and then BAM! I'm told that I need an additional surgery. It really sucks. When you are expecting one thing and then are told another, it can really play with your confidence. It made me have second thoughts about this whole process.

Thank goodness I have a really awesome support system. My family and friends have all been great throughout my journey. And I couldn't do this without my rock, my partner and best friend. I'm proud to call you my other half and my husband. Don, I love you more than anything. Thank you for always being there for me and making me laugh. The laughter is what makes me forget all my worries and to keep pushing on. Again, I couldn't go through this without you.

Since I'm going to be going through a lot in the next couple weeks, I'll hopefully be able to post more. My next dental appointment is March 5th where I will be getting my top braces fitted. And I think we will be starting the process of getting my appliance made. More on that to come!

Day 1 - Getting Bottom Braces put on

Well, today was the day that I got braces... sorta. A small hiccup at the dentist's office yesterday is the reason why I have to wait 2 more weeks for the top braces to be put on. I have a couple cavities that the orthodontist wanted filled before the top braces went on. But that's ok, not a big deal. It'll give me time to get used to the bottom braces that I had put on this morning. Neither the brackets or the wire hurt. What hurts the most is the spacers I had placed for the back molars. God, those elastics are such a bitch! I was told to try and do all my chewing on my back teeth. However, the teeth are really sensitive now so I could barely eat any of the dinner I made tonight. Bummer. This will probably happen fairly often from now on. Le sigh.

Also, apparently, getting colored O rings (the little rubber bands that hold the wire to the bracket) is no longer cool anymore. The technician automatically put grey bands on my teeth. I asked for colored O bands and she seemed surprised that I had even asked. She told me that they were thinking about not ordering the colored ones because no one really uses them anymore. Not even kids! Last time I had braces, I had all the colors! But she told me that she'd redo the bands if I wanted colored ones. I figure that I might as well have some fun with it! I got pink for Valentines Day HAHA. I think next time I'll either get purple or teal. Depending on what they have. Hopefully they don't stop ordering the colored ones because I want to have fun with this stupid braces thing.

Here is the first of many photos.

Day 1 - Getting Bottom braces on (pink)

Next Steps...

Hope everyone had some happy holidays! I got The Little Mermaid on blue ray so of course was Christmas was great.

But, back to reality! Right before the holidays, I had my 2nd appointment with the orthodontist. It included getting some more x-rays, pictures, and the dreaded impressions. After Dr. Klein and I spoke, she told me that I would have to schedule an Orthognathic Work-Up with my oral surgeon. I'm still a little unsure of what exactly will happen at that appointment, but I was told that my surgery team will form and they will decide exactly what type of surgery I need. They told me that I can expect anything from blood work to x-rays to an EKG. Unfortunately, it is not covered by my insurance (GRRRR) so this will have to come out of my own pocket. And it's not a cheap appointment. $1500 for a single appointment! Ridiculous! Thankfully, it's a new year and my FSA has just started. I opted to get the max my company offers. With the $1500 work-up and braces, we will definitely use it up no problem.

Speaking of braces, I have my appointment to get them on. Wednesday, February 12th is the big day. Now all I need to do is decide on a sweet color. Hmmm, decisions, decisions! I'll have to search online and see what all the cool kids are doing.

Well, hopefully I'll update again in a few weeks after my work-up!

Happy Birthday to me!

So this is a little unrelated but I celebrated my birthday today! Happy 27th birthday to me! One thing that we do every year for my bday is to go down to Harpoon Brewery in South Boston and grab a birthday beer and pretzel. PS: Harpoon makes the best pretzels. Just as good as if you were in Germany. No seriously, they are fabulous!

With everything going on with my jaw, it was really nice to go out and celebrate and have fun.

After the beer fun, we went and grabbed sushi (my favorite). After that, we hung out with friends and generally had a good time!

I really like beer, so what better way to celebrate than at harpoon?! Too bad next year my birthday is on a Monday. But, I am still going to harpoon, no one can stop me!

I ate real food!!

I ATE A CHEESEBURGER!!!! 

It was wonderful and probably the best burger I've ever had. It was the first burger I've been able to stuff into my face in months!

Recovery - TMJ Procedure

Well, it's been a little over a week since my surgery and I feel great! I got my stitches taken out today and I have to say that it was very strange. I've never had stitches before the feeling of them being taken out was totally bizarre! But it didn't hurt one bit which was good.

For those wondering about after the surgery, here's my advice!

• Before you leave the hospital where you had your surgery, make sure you (or your reliable loved one) have any discharge papers. My nurse in the PACU (or Post-Op area for those not in the medical field) put together a folder for me. Inside it were my discharge papers, my instructions on what to do and what not to do while healing, and my prescriptions. It also contained a card with my follow-up appointment on it and the time. 
• If your doctor tells you to do something (like physical therapy), don't blow them off and not do it. I followed my doctor's instructions for after surgery and I believe it is the reason why I feel so great only a few days into recovery. They know what they are talking about so make a strong effort to do what they tell you to.

Next, here is what I did per my oral surgeon's instructions after surgery. If you are having a similar procedure, you can expect to have to do something like this.

• For the first 48 hours, use the provided ice pack in 30 minute intervals. (Basically, when I wasn't sleeping, I was icing my face. Doing this was a major part of why I think I'm doing so well.)
• On the first day, do not take a shower. After the first day, you can take a shower and wash your hair being careful of the stitches. (You have no idea how difficult this was! I felt so gross after surgery that all I wanted to do was wash my hair and go to bed). 
• After 48 hours, switch to low heat using a heat pack or warm, damp washcloth. Do this in 1 hour intervals for 24 hours and then every 3 hours. 
• Do jaw joint exercises/stretches as directed by Dr.
• Do not chew any hard or chewy foods for first 72 hours (candy/hard crunchy vegetables/gum/steak/etc. You won't be in the mood to want them anyway.)
• Do eat soft foods such as yogurt, mashed potatoes, apple sauce, jello, pudding, icecream, smoothies. (I had my operation right after thanksgiving so we had tons of soft foods like mashed potatoes, squash, and pumpkin pie that I could eat which was wonderful! After the first 3 days, I started eating pasta like mac n cheese which was also good.)

My recovery time was approximately 10 days. However, I work in a hospital and my surgeon was concerned about germs (since it's that wonderful time of year!). He really wanted my stitches to be completely healed up before allowing me to go back to work. Getting an infection inside an open wound with direct access to a joint would not be fun. Most people can probably get away with 5-7 days for recovery. Definitely talk to your doctor and bring up your concerns about going back to work (if you have any). 

And now, here's a lovely picture of me after my surgery. My throat was really sore after because they inserted a breathing tube while I was out under the anesthesia. The PACU nurses were kind enough to give me popsicles! This is me trying to smile. Some of my muscles were still sleepy so it took a little bit for them to wake up. I'm also wearing my face bra, haha. On a funny note, my hubby got yelled at for taking this picture of me. I asked him to take this photo so that i could post it on the blog. Well, a nurse saw him taking a photo and yelled at him. His face was price less because he had to tell her, "She told me to do it." I guess nurses frown upon people taking photos of other people while under the effects of anesthesia. If you plan on talking any photos, make sure you clear it with a nurse first, lol.

And that's about it for this surgery! It really isn't that bad. If your MD or Surgeon suggests you get this surgery, it really is very minor. I'd highly recommend it! If anyone has any questions, please feel free to post a comment down below.

This was day 2 of recovery. You can see my drugs on my nightstand and my puppy keeping me company. I was very happy cause I had just taken a shower! HAHA.

Next time, I'll talk about the next stage of this journey which is braces!!

Bilateral TMJ (Arthroscopic) Procedure

On December 2nd I had a bilateral TMJ Procedure. A lot of people are curious about the procedure, what happened and how it helped me. I'll try to be as simple as possible!

The procedure I had was done on both sides (bilateral) and dealt with the TMJ area, specifically the joints connecting the top and bottom jaws. My oral surgeon made two cuts, one cut on each side of my face in front of my ear. From there, he used a very tiny camera to see the joint. The camera was no bigger than the tip of a regular pen (totally cool how advanced technology is). Then, he injected steroids into the joint to reduce the inflammation I had. After that, he stitched me up, wrapped my head in an ice pack (known in the TMJ Surgery world as a face bra, lol), and sent me off to PACU to wake up. The procedure was about 30 minutes (15 minutes per side). I was probably out for a total of 2 hours though. The PACU nurse taking care of me was very surprised that I woke up so quickly. Most of the time, patients have a hard time shaking off the general anesthesia. I saw Dr. Keith before and after my surgery. He even gave me some pictures of my jaw joint after I woke up. It was great to actually see what he saw. After I was awake and had my IV line removed, I was given my prescriptions and sent on my way.

My experience was pretty easy seeing as how I work in a hospital and most hospital OR/Surgical Suites function in the same ways. Here are some tips for people having surgery that I found helpful to myself:

• If you are having any surgery that involves general anesthesia, make sure you have a reliable person to give you a ride home. If you don't give a contact name with phone number when you register, they'll 100% cancel your surgery. My hospital was liable for my care 24 hours after I left. And if I decided to operate a car and drive myself home and then got in an accident, it would be their fault. I'm married so it was a no brainer to me. My husband just drove me home.
• Since I had stitches on my face, I needed to keep my head straight. I bought one of those travel pillows and put it in the car for my ride home after the procedure. It really helped to keep my head from bouncing around and banging my stitches. I also had a light blanket (I'm always cold so the blanket was for added comfort). 
• Wear comfy clothes to your surgery. You'll have to change into one of those uncomfortable and revealing blue hospital gowns but the clothes are for when you go home. I had pajama pants and a loose t shirt and a sweatshirt. There were some people there wearing tight sweaters and jeans and boots. I just can't imagine how they woke up from the anesthesia and put their clothes back on. I know I was barely able to pull my pants up, nevermind figure out boots. 
• Make sure you have everything before you leave. Refer back to the reliable person for your ride home. They can be your second set of eyes. This includes any prescriptions from your surgeon. I left with a whole folder full information along with my two scripts. But don't worry, the OR staff won't kick you out before you are ready. 
• The night before your surgery, have some soft food left overs on hand so you don't have to cook while you recover. Mashed potatoes, squash, apple sauce, jello, ice cream. My husband even made me a smoothie which was nice. 

I'll talk more about my recovery in the next post!