Wednesday, June 22, 2011

Metal Mouth?! Again?!

So I know I just updated a few hours ago, but I got all mushy and showed my mother the blog. It was good to have her see it and support my choice to share my journey with other people. And when she saw my questions and concerns she didn't shy away or act like "well this is your own choice..." No, she actually answered some of them for me. The most shocking being the answer to my braces question.

In my questions and concerns post I had mentioned a concern regarding braces in the future. Would I still be able to get them? Not only will I be able to, I'll be required to. I don't know whether to be bummed or excited. After all, this would make it my third time having braces, and this time I'm in college. The good news is braces never bothered me in the least. I actually thought they were kinda cool and would look forward to orthodontist appointments when I could change the color of the ties. Plus, having braces again will make my smile truly perfect. My upper teeth have shifted a bit and there are gaps between some of my teeth where they migrated to try to fill space left from an extraction. Add re-aligned teeth to my post-op bite and profile and I'll be smiling, chewing and turning heads with the best of 'em! So this update isn't so much about something that worries me, but more of a "Heh! That's interesting..."

A Little Ray of Hope

News today is much better than yesterday. My mother spoke to Dr A this morning and he said that he's still going to fight insurance, but whether or not they cooperate he is going to figure something out for me. What exactly this means I don't know. What I do know is that Dr A is absolutely wonderful and I'm so thankful to have him as my surgeon. So maybe surgery is still happening this month? I certainly hope so.

Tuesday, June 21, 2011

You've got to be kidding me...

I don't know what to do. I'm almost in tears right now I'm so frustrated. Dr A contacted my family today to let us know that my asshead of and insurance company will only cover the lower jaw. That isn't going to fix the problem!!! If only my lower jaw is moved I'll be left with an underbite, still improperly aligned jaws and more problems than I started with! Dr A said he's going to fight the insurance company for coverage, but to be honest I've lost hope. Insurance companies are merciless. They don't give a rip that a girl is in pain and has been since she was 11 years old. They just want to hold on to their damn money like the greedy thieves that they are. It was the same trying to get them to cover my birth control, which I take for medical reasons, not so I can go sleep with whoever I want and not get pregnant. This is such crap! I'm sorry for the language but I am just beyond frustrated and upset right now. And, even if Dr A does win my case, which I doubt, by that time it'll be too late for me to have it this summer and I'll have to wait another whole year! If insurance doesn't cover this I can't get the surgery. The truth is that my family just doesn't have enough money for it. I really need this surgery and for that I need insurance to cooperate and help me out. I just want to curl up and cry right now.

Sunday, June 12, 2011

Hmm...Questions and Concerns

So nothing has happened since my appointment last week with Dr A (not that anything was supposed to happen), but a lot has been happening in my brain. That "lot" being questions, concerns and overall nervous little worries.
The first question is how on earth is this going to be done sans braces?! I totally forgot to ask Dr A about it when I had my appointment. I can be such a dope sometimes.
The second one is will I be able to get braces after surgery if I want? Or will it totally mess up wall the work done in the OR?
And what about the IV? My poor little veins blew 8 times during the attempts to sedate me for my wisdom teeth and that was for a 20 minute procedure! How are they going to hold up to 7 hours?
What if it doesn't help my pain at all? Yes I'll look better, but the main goal of this is to reduce my pain. I don't know how severe the degeneration of other patients' joints is. Is mine worse or better? Did it help at all for those who have progressed to osteoarthritis with disk displacement?
WHAT IF I DON'T LIKE MY FACE?! I actually have come to love my face. I think of it as cute and pixie-ish. Granted I have a pretty feeble profile, but from the front I just look fine-boned and delicate. I don't want to come out of this with less self esteem than I go in with.
Sorry for the rant and the whining, I'm just starting to get these nagging thoughts now that this is becoming more and more of a reality. 

Friday, June 10, 2011

What's been going on to this point

So in my previous post I explained the whys and wherefores of the situation. So here are the big questions. What has been done up to this point? When's the "big day?"

In terms of what has been done I'll catch everyone up. Almost exactly a year ago is when I finally convinced my family that enough was enough. I was sick of the pain and annoyed with the face that was causing it. I have a prominent nose. Add that to a recessed jaw and a very gummy smile and you'll start to see that there are  some structural issues underlying the pain.

So with the pain and facial woes in mind I set up an appointment with an oral surgeon. We had originally set up the appointment with Dr. A - a surgeon who my mother works with and knows to be a friendly man. Sadly the office was having some problems with their suction system so Dr A was in a different office to do wisdom teeth extractions with functioning equipment, which meant that Dr A was not going to be seeing me that day. The other surgeon came in and I explained everything to him. He took some x-rays. The x-rays show that my bite is quite out of line and I had have open bite. My palate is tilted and the joints showed evidence severe degeneration of the TM joint for a gal my age (or anyone for that matter). Considering this has be a problem since sixth grade the surgeon was pretty surprised. He ordered an MRI and took molds for a night guard that would hopefully relieve some of the pressure on the joint.

My first year of college was just over a month away, and hopes of getting things done quickly diminished. I learned that there was quite a lot of work to be done before the surgery could even begin. In the hopes of getting things moving along I got the MRI done and the "replacement" surgeon and Dr A (at my mother's request) went over the report. The findings were not encouraging. It showed that both disks were out of place, the bone had been worn flat (it should look like a football) and I had some nasty little splinters on the right side. My best option at this point was orthognathic surgery.

I won't go into details but we dropped the "replacement" and got on board with Dr A, who has since been the one taking care of my case. At this point I was off to school, so any work was put on hiatus. Over the nearly 2 month long winter break (actually the very last week of it) we finally got the ball rolling. In the last week of January (with only 7 days before I was to head back to college) I had my wisdom teeth removed.

The procedure itself went well, and Dr A, god bless the man, even put up with my behavior when they were trying to put me under. The first attempt to start an IV ended poorly. I felt some pain and my OS told me that my vein blew (it's not as bad as it sounds, the fluid just backed up under my skin - ow). After a rather extensive blood panel a few years ago I pass out from needles. They don't scare me, blood doesn't bother me, but for some reason my blood sugar goes through the floor and I'm out. So, naturally after this first attempt I started to go out. I was trying to stay conscious and the nausea hit. They stuck me again and that vein blew. They stuck me again. And again. My veins are so pathetic that they couldn't hold up to the fluid and they kept blowing. At this point was was miserable. I was dizzy and nauseous and writhing and moaning begging them to "make it stop. Please, just make it stop." The poor nurse! She tried giving me laughing gas but that just made things worse for me at this point. Dr A was patient with me despite my shameful behavior and just told me "Nora if you need to pass out don't fight it." I didn't and I went down like a tranquilized elephant. They had to try to start the IV four more times after I passed out. In the end they stuck me intramuscularly with the sedatives and managed to get an IV started. Once that happened the procedure took only about 20 minutes. Only three of my wisdom teeth had actually ever developed and even those were rather immature, so naturally my OS had no problems extracting them.

The first day of recovery was hellish. I vomited from the medication several times, causing my face to swell up even more. My face was ginormous! Pain was minimal though, and my mom patiently fed me jello and small spoonfuls of soup. She was also taking care of my sister who had had her wisdom teeth removed the same day as me. Mom is such a great woman. After the first day though things got better. The swelling peaked on day 3 after which it started to go down. By the time I returned to school my stitches were beginning to dissolve and the majority of the swelling had gone down. 

Since my wisdom teeth were removed things basically came to a standstill until this previous Tuesday,  June 7th. I went to see Dr. A and had more molds and x-rays done. They also took some facial measurements. Dr A went over my MRI report again and we (my mother, father and I) sat down with him while he discussed the procedure using a cool skull with metal plates as a model.

Basically the procedure is going to go like this. My upper jaw will be sawed into and a chunk removed to shorten it in order to remove the "gumminess" from my smile. It will then be tilted so that my palate lies flat rather than at an angle, moved forward ever so slightly and held in place with four small plates. In order to make enough room for my lower teeth to meet the uppers properly, he may have to separate my upper jaw into three pieces. My lower jaw will then be moved forward and screwed in place. The final part includes my choice of a sliding genioplasty or a hard silicone chin implant so that my chin is not so recessed. I'm still not sure which option I'm going for. Any ideas or advice from anyone? Then I'll be wired shut and on a liquid diet for 6 to 8 weeks.

So when is this all going to happen? Well, if all goes well with insurance I'll be going in for the operation before this month is out! This will allow me a full two months of recovery time before I need to go back to school. Of course I will not be fully healed by that time, but I will, at least, be able to take care of myself.

I am so excited! I can't wait to have less pain. It seems like after 7 years of pain I've forgotten what it's like to not be in discomfort. I'm definitely looking forward to the benefits of this procedure, but I'm nervous about the liquid diet and the new face. Will I be able to handle the stress of feeling so "helpless?" Will I be happy with how I look? Despite my "flaws" I've come to see myself for the beautiful person I am after years of struggling with my self esteem. How is it going to feel to look in the mirror and see a new face? These are all question I don't have answers to, and I'm hoping that this journey, along with this blog, will help me find the answers and strength that I need.

Sorry this post is so long, but a lot has happened to bring me to this point. Future posts will of course be more current in their content, and hopefully not so wordy! :)

Thursday, June 9, 2011

Here's where it all begins

I guess to start I'll tell you what has brought me to this point - and I apologize in advance for my rather disorganized posts. I'm sure that by the time this is all over I'll be a pro. :)

For about 6 years now I have had TMJ, and in the past 3 or so years it has progressed to the point where I have developed osteoarthritis of both the left and right TM joints.  On both sides the bone has been worn flat and the disks are out of place.  I also have osteoids (little bony splinters) on the right side.

All of these issues are the result of an attempt to correct a rather significant over bite. The first plan of action was a night brace to hold my upper jaw back to allow my lower jaw to grow forward and meet it. The night brace did not help and I believe it is what led to the first "pops and cracks" in my jaw as I had never had a problem before having the appliance. Well I still had an overbite, so in the end my orthodontist "faked it" and pulled two upper teeth then closed the gaps made by the extraction in order to correct my bite. This of course failed to address the root of the pproblem: improper alignment of my jaws.

After dealing with the pain I said enough was enough and asked my mother to set up an appointment with an oral surgeon to see what could be done. I was so relieved! The surgeon confirmed that I did indeed have some issues in my bone structure which have brought me to where I am today. That "place" being pain, popping/clicking/crunching of my TM joint and general discomfort. The solution is orthognathic surgery (both upper and lower jaws).

I have created this blog to chronicle my journey through surgery so that I may seek support from others who have gone through it and to hopefully help someone out there who is going through what I have and will endure.